For my Ashes, You give me Beauty

As I sit collecting my thoughts over the events of the past few days, I remain amazed that I have been given this experience. For the ashes of my life, for the weakness, pride and stains of humanity I could offer, I have been given beauty. Jesus is everywhere, in His most distressing disguise, in the mother who continues to demand medications for herself after we have finished addressing the needs of her child; in the angry mob of impatient men who approach the gates of a food distribution center; in the countless miscommunications and misunderstandings which flood my daily life; in the tears of a child who has experienced trauma beyond imagining; in the uncooperative patient who complains of illness but refuses to take medication and changes her story; in the winces of the hydrocephalic baby who is slowly dying; in the daily burden of a funeral mass, at which tiny bodies lie alongside those of adults.

I was honored to encounter Jesus in a new way on Saturday morning, when I accompanied Sr. Judy to Cite Soleil, one of the worst slums in the Western Hemisphere, if not the world. The Missionaries of Charity hold a clinic at a church that was destroyed in the earthquake, for the residents of Cite Soleil, adults and children alike. They have no medical training, but they have extraordinary instinct and intuition to know the needs of the people. We traveled through the main roads of Port-au-Prince, then once on the outskirts of Cite Soleil, we turned off a main road onto an active marketplace, with baskets of food, questionable medication collections, clothes, shoes, anything imaginable for sale. The patient driver honked his horn as people gathered their wares and moved out of the path of the truck, some much more reluctantly than others. After several hundred feet of wading through the crowds, we reached a gate, again completely blocked by vendors. After a few minutes, the path was (barely) clear – an orange seller was our most difficult obstacle – and God help us if we damage ANY of the items in our way - and we entered through the open gate. Sr. Judy's immediate remark was, “Welcome to Calcutta!” - and that was exactly what I would use to describe the scene before us. Children and mothers and older citizens begging for care were stacked on either side of the truck, eight to ten people thick, for at least 100 feet. I was afraid we would run over little toes, they were so close to the wheels! We left the car and walked through a pasageway, to a hall of sorts, with children and mothers snaked around the room. I was very impressed with the amount of medications available, and was told I would be one of the “pharmacy techs” for the day, as my Creole and experience here are still fairly limited.

The morning started with a prayer, a brief scripture lesson, and then it was a crash course in tropical medicine, with Sr. Judy as my professor. She sees patients as a provider here, due to her many years of experience and fabulous sense. I started rather timidly, asking question after question as I located medications and listened to her as she related to the mothers and children. The MC's have a superb system down for preparation and distribution of meds, down to these perfect little sachets they make out of magazine and newspaper pages! We searched the crowd, looking for the most critically-ill appearing patients. There were countless children with skin disorders, due to the squalor of tent-living and the contamination of their dwellings with sewage. These are the places you see in the television commercials – the canals of filthy water running through the narrow paths between houses fabricated from tarps, plastic bags, cardboard, rotten wood. The children play in the same water that is used as a toilet, for laundry, for food preparation. These are truly the poorest of the poor.

We treated extremely painful lesions. We saw a little boy with tremendously compromised breathing. We sat with his mother and directed her to go that afternoon to St. Damien (our hospital) – she was reluctant, and we re-iterated and reinforced our deep concern about her son. We may never know if she came. The sense of urgency is almost never present here. I notice it in my every day work, in communication, in attempts to teach or state needs. There is no rush. All is at a different pace. We saw another girl with a mysterious and very high fever, and yet another girl with typhoid. Sitting and talking, dressed up in her finest, with a temperature of 40 celsius! A tiny little baby with a fractured leg from a falling television, was splinted. A woman, seven months pregnant, but barely looking four months along, was given folic acid, vitamins, and food. She was beautiful, and looked heavily burdened with worry. It was so wonderful to be able to speak with her, encourage her and love her for a few minutes. The morning swept by in a whirlwind. It was fascinating to observe the sisters as they worked, firm but gentle in their approach, embracing the challenge of the crowds of relentless patients. I absolutely loved being there, and I pray that I can go again. One of the best parts of the morning was to listen to a surgeon who came with us. He has been to Haiti many times before, and he related that this was the complete highlight of his experience. He worked in the wound clinic, and saw many cancers among the crowd. Such wounds will never heal. But to see his face light up as he talked – it is a great gift to be present when others come alive to this work.

I was emotionally spent after the morning, but had the chance to join a tour of the city in the afternoon. It was something I had been wanting badly, so I jumped into the bus. I was disappointed not to be able to see terrifically well, but it was still very interesting to listen to the discussions of the several first-time travelers to Haiti, and others who had not seen anything outside the hospital walls. We saw the national cathedral, completely destroyed, which collapsed and killed the Archbishop of Haiti as well as several seminarians on retreat. We saw the National Palace, which is slowly being razed. In an interesting juxtaposition, one of the most dangerous tent cities is now just feet from the former landmark, and is notorious for crime, especially against women. We saw the endless stream of tent cities, literally cropped up in any vacant area. The wheels were turning in heads – questions were asked about how to sustain a future in this country, how the citizens of Haiti view NGO's, where to start with improvements, all questions I LOVE to hear! We visited the site of the former hospital and volunteer center in Petionville, where two American volunteers lost their lives. The sign for the hospital hangs precariously, just outside the fence housing the vacant land. The rubble was cleared very quickly after the earthquake – employees, patients and volunteers could not bear to see a pile of rubble. There are still many places that have not yet been cleared, but new buildings are being constructed among the ruins. The country has not died and will not die.

Sunday was a breakfast out! A real buffet breakfast, with pancakes, sausage, toast, eggs, coffee, juice....so delicious. I had recently woken up craving a real American breakfast – this was a good effort! But it was wonderful to sit and start the morning in peace. The rest of the day was a work day for me. I went to the baby house, and tried to work amongst the 35 little ones pulling at my legs and arms. We played for several minutes, then I snuck away to finish organizing charts and take an inventory of the medicine cabinet. Then it was more holding and playing and comforting. I sat with Erline for a while, holding her, tickling her, getting a laugh out of her, observing her as she moved quietly through the house. Dani and Kevin came with me, and were attacked by loving kids for two hours. We came back to the hospital grounds for the afternoon, and I worked away at Excel – not my favorite program, but we are getting along decently for now. Evening mass was at 7 pm, a perfect way to end the weekend, with peace and singing and Jesus.

Yesterday and today were the continuation of my 11-day stretch, and we spent the morning at the baby house. It wasn't going to be the whole morning, but as the joys of miscommunication and/or complete lack of communication follow closely behind all of us, it turned out the be the entire morning. But I am happy to say that all but two children have been weighed and measured. (The two children were at physical therapy). The entire task of doing so took us a half an hour, then we waited an additional two hours for our ride to arrive. I paced for a while, but then tried (unsuccessfully) to take in in stride. There is simply no such thing in existence here as a “quick errand,” “a few minutes,” “be right back,” or a guarantee that a driver will be back with a car at the agreed upon time, or that anyone will be reachable by phone in the intervening several hours while we wait to return to the clinic that we closed in order to complete our “quick errand.” Oh, the joys. But we got the data we needed, and now we can commence with additional nutrition for the children that need it. Yesterday afternoon was “new sandal day,” during which every child received a new pair of flip-flops or sandals. This happens every three months – sadly, not nearly often enough, because the kids are so hard on their shoes, but was still a fun event. This is their last free week before school starts, so they are taking advantage of every minute. Kevin brought them a new soccer ball, and they were thrilled – they kept asking if they could really keep it! So precious. Little do they know, there are a few more to come, to be held safely in the possession of Dani and yours truly. Then the chalk came out – and was a huge hit. It was also yet another opportunity to teach the kids patience and sharing. Two concepts they are not very keen on, but we managed to keep things relatively peaceful. 

Old sandals...

The new and the old

 Today I addressed the challenge of weaning the nurses from numerous handwritten lists to the concept of everything being accessible on the computer. Each child has numerous lab and other tests which are to be completed on admission to the program. Due to the time it has taken to work through this process with the hospital, the large number of children in the program, the children who have continued to arrive since its inception, the numerous unscheduled issues which arise, and the general disorganization of a new program, we are very much behind in completing all of the exams. (Another reason I am here! Job security surrounds me.) So we tediously looked through all the charts (these nurses are so helpful, constantly asking me what they can do!) and listed all of the exams which kids needed. Then, I created a spreadsheet for it (!!!) which can be printed out, and we can check off as we complete everything. So pretty! It will still take several weeks, if not months, but I have expectant faith that this will be done in the forseeable future. I was able to throw away one list today! Many, many, many, many more await me in the mysterious book which I am afraid to open. But we will address each list in time. 

The sun has fallen asleep and the pounding rain has commenced - so I must monitor the progress of the rain as it sneaks under the door and through the windows. I am having trouble posting pictures this evening, so more will come soon. Thanks so much for reading!

Numbers

Fifteen: the pairs of terrified little eyes watching me intently this past Monday, as the owners of those eyes arrived to the FWAL program. They had been on the waiting list for a number of months, and there was now space for them at St. Anne, the baby house. I introduced myself to them, asked their names, complimented their beautiful dresses and dress shirts, and attempted conversation. They spoke back in tiny voices, whispered, “ba pi mal,” and stared at the blan in front of them. Some of the little ones smiled once they realized that one of the dolls had the same color hair as me, and started to loosen the tight grip they had on extended family which had been caring for them since the earthquake. Mothers and/or fathers had perished that terrible day, and other relatives had been bearing the sudden burden of extra little ones for many months.

Ten: the number of attempts made yesterday at drawing blood from “ti Erline,” a precious baby at Ste. Anne. I have mentioned her before – she is very tiny for her age, (we are guessing that she is two, and she is the size of a 9-month old baby), came to the house four months ago and has only gained 1.4 kilograms since her admission. She has a number of worrisome physical symptoms, and we were very concerned that she may have significant underlying disease. She is always sad, withdrawn, and fatigued. I was thrilled to find her playing and smiling on a recent workday there, but she changes from laughing to mournful sobs in an instant. It was heartbreaking to attempt blood draws on her last week, and to watch as attempt after attempt was made yesterday – and I understand the necessity of the blood tests. I left the room at one point. She was brought to the hospital today to be seen by the clinic doctors and finally had blood drawn successfully (only two pokes today)! The initial results I feared the most were normal, but we are waiting on much more. She is desperate, literally starving, for affection, love and security. I was able to hold and walk with her for the remainder of the morning after her appointments, and I prayed to know how to reach her. I fought back tears as she fell asleep on my shoulder. She is a little one who pulls at my deepest heart.

450: The number of calories in a package of high energy biscuits from the World Food Programme. These packages are given a few days per week to the children at St. Louis as their mid-morning snack. They are left from the massive donations made to Haiti after the earthquake. They taste decent and are an excellent source of vitamins, protein and energy. I have been researching the menus at both St. Louis and Ste. Anne in hopes of increasing the caloric intake of the kids. I am excited about high-protein foods, as a number of options for meals include pasta, a cheap carbohydrate, and rice. The cooks here do a great job of using chicken and fish bases for their sauces and soups, which I was happy to learn. I am also researching options for multivitamins – a hot commodity that is in scarce supply here. 

40: The number of Haitian gourdes to the American dollar. Five: The number of Haitian gourdes to the non-existent “Haitian dollar.” I was finally brought out of my complete confusion when asking the price of something and told,”cinc dollar,” which actually meant 25 Haitian gourdes! The “five gourdes = one dollar” dates back to 1912, when the Haitian gourde was pegged against the American dollar to be a value of five to $1. The “Haitian dollar” is still used in everyday language.

149: The number of children living at St. Louis, as of this morning.

35: The number of little ones living at Ste. Anne.

Four: The time each morning that I am now awakened by the Call to Prayer which echoes over from the Jordanian UN camp. My nights are becoming less restful, as the number of laboring women seems to increase at night, and as the various generators supplying power to the property turn on and off. The sun continues to rise consistently between 5:30 and 6 am, and motions me to life as the birds and automobiles signal the day's beginning.

Fourteen: The number of Starbucks Iced Caramel Via packets that came to Haiti with me. (I had to sample one beforehand, of course). I have been slowly using them, loving the treat that comes in the middle of a hot day. (It helps that I only 2 weeks ago realized that we have access to ice cubes!) The Haitian coffee that is made each morning is prepared in espresso pots, so imagine the strength of it! (As my mom would say, it puts hair on your chest! Well, most of us women are not ok with that attribute). So I have a “shot” of espresso in the morning, then occasionally gift myself with my Iced deliciousness at lunch time. So glad to hear that more is on its way to me!!

100: The average temperature, in farenheit, of the day. The sun bakes us as we walk to and from work, and dries our laundry in a few hours. (Bonus!) Never a great consumer of water, I am drastically increasing my intake and still probably don't get enough. The children at St. Louis sleep in metal containers, with decent ventilation and windows. But one still cannot escape the intensity of the heat. Remember also that Haiti is hugely deforested, and there is very little shade offered anywhere. The days this week have been extremely hot, more than what I have gotten used to. When the torrential rain comes, it drenches everyone and everything that is not protected. Think of the nearly 1 million people who still sleep in tents and shacks made out of cardboard or canvas.

19: The cost, in US dollars, of a cheeseburger and french fries, a drink and a chocolate ice cream at Cane Sucre, the restaurant close to the property which is a great little escape. Dani's boyfriend is here visiting, and we went to have a birthday dinner there. Totally worth every cent!

Isaiah 55

“For My thoughts are not your thoughts, nor are your ways My ways, says the Lord.” Isaiah 55:8

I am trying to believe that I have been here for a month already. It seems impossible! I still feel new in so many ways, yet there is somewhat of a routine being established. A “normal” day for me consists of waking up between 6 and 7 am, having a few minutes to myself to collect my thoughts, check e-mail, pray and eat breakfast. When Fr. Rick is here, daily mass is held at 7 am. It has been a funeral mass for at least three people every day. Otherwise, it's on the road by 7:45 or 8 am, arriving at St. Louis by 8:15, and having the morning to do blood draws, continue working through charts, continuing to talk with the nurses, addressing the bumps and bruises, making plans and setting up kids to see the doctor when she is here, (the doctor comes to St. Louis two afternoons a week, then goes to Ste. Anne on Saturday mornings), taking notes and, of course, sitting outside with the kids and talking with them. I return to the house at midday, to email, research medications and health concerns, eat lunch between 1 and 2 pm, then return to the clinic until 4 or 5 pm. Evenings are a shower, exercise, play with the abandoned kids, a light dinner and more catching up on emails. Bedtime is usually around 9 pm, as late as 1030 depending on how quickly my thoughts calm and who is available by phone/Skype.

One little guy, as soon as he sees me in the morning, says, “Take a picture!” Getting out a camera is a very dangerous and risky move in a place with 140 very eager children who LOVE to see themselves in action. The kids have now taken to attacking me with hugs as I walk through the gates to greet them. The smiles I receive as they see that I have returned are so powerful! A dear friend of mine, with whom I was privileged to work with in Haiti my first time around, talked about “The power of the return.” Endless visitors, foreign NGO's, genuinely as well as ulteriorly-motivated people, have made promises to Haiti, shared grandiose ideas, stated plans to provide for long or short-term needs, have left, and have not returned. It is one thing to visit once, fulfill an immediate need, then leave. It is quite another to return and through that return, demonstrate that there is a relationship here, that these people are significant and matter, that one is sincere in intentions and has come again to learn, listen and care. When I remember names, smiles grow even larger. When the kids see themselves in pictures on my computer, they are fascinated. When I share dance songs with them, they get excited. When I discipline them, they are taken aback, but respond very positively. When they understand my Creole, we all laugh and they seem relieved. She can talk in our language!

It is emotionally wrenching to see kids whose physical problems have not been addressed. It is the nature of the beast here in the developing world that resources are simply not available to provide early diagnoses or treatment. There is a young girl at St. Louis with severe cataracts and other eye disease which have rendered her nearly blind. There is another little guy, Stevenson, (I have mentioned him before) who is also severely impaired visually. The kid is very intelligent – he just can't see! There are girls with gynecological issues. There are three kids with heart murmurs – they may be benign, and do not appear to have affected growth and development to date – but as a cardiac nurse, the wheels start turning in my head. Cardiac-wise, there is very little to do here. Children are sent to the States through a program working in conjunction with St. Damien, but the conditions must be straightforward, be addressed through one surgery, and require no future repairs. It is quite expensive to send any child to a specialist here. Teams come through from other countries occasionally. I have learned that a cardiologist will be visiting in October – I hope to perhaps get these kids seen by him. But, again, nothing is simple.

The workers at NPH and the hospital and the adjunct programs work tirelessly for those they serve. It is truly astounding to see people literally pouring themselves out for the little ones. My schedule is now eleven days on, three days off. It is exhausting and a sacrifice of self, emotion, spirit, body, hunger, sweat and tears. But it is also the only appropriate approach. There is much to be done, and it requires commitment, patience, stepping back, holding my tongue, listening, humility, flexibility, constant adaptation and changing of priorities. I have appreciated Joanne's wisdom as I learn the cultural nuances, talked through ideas and knee-jerk reactions. I made a list of current priorities for the FWAL clinics – only 18 talking points right now!! Enough to keep me occupied for at least 12 months, I think. The list continues to grow with each day's events. We are looking at nutrition, as the initial list of 12 children who are underweight and under stature grew to be nearly half the current population at St. Louis, as we plotted heights and weights on the growth charts. This is not a surprise, simply based on the backgrounds of the kids and the extremely limited access to food they may have had previous to their admission to the FWAL program. Use of available resources, the cost of food, the current lack of available vitamin supplements, adequate caloric intake, interest in and understanding of the importance of drinking water, lack of education... those are just a few of the aspects of the problem.

I relished my three-day weekend, doing basically nothing on Friday but resting and spurts of cleaning. We went to Mama Raphael's for dinner and drinks after an all-important trip to the Belmart, where I found Vienna Fingers! Vienna Fingers are a favorite of my dad's, a tradition from family vacations. (There was always much more success in the junk food department when we went shopping with dad on vacation!) Yesterday I rearranged my little corner of the house, doing a deep cleaning, unpacking and re-packing my suitcase, putting fresh sheets on the bed (one of my favorite things – clean sheets!)

I went on a short visit yesterday to an orphanage established by Partners In Health for 50-ish children, many of whom are disabled. We were delivering newly minted animal sculptures, made by a local artist. {Partners in Health is a fascinating organization, well-established here and present for over 20 years. It was founded by Paul Farmer, an American physician known for his work with multi-drug resistant TB. He has written several books and is the subject of Mountains Beyond Mountains, a biography. He has very strong opinions of the States and has harsh criticism for the era of NGO's – it is tough to read his thoughts at times, but also very convicting. I had just downloaded his most recent book, Haiti After the Earthquake, and I believe that the kids I was visiting yesterday are the same little group mentioned in the book! If you are looking for a good history of Haiti and a poignant narrative of the country from pre- to post-earthquake, I recommend his books.} The orphanage was beautiful, clean, very well-furnished, with modern equipment and happy, clearly well-fed children. A great encouragement to me! On the way back home, we stopped at the home of one of the employees, and I was invited to the back yard, where a goat, or “cabrit” in Creole, had recently met his demise and was being prepared for dinner. I prefer not to know my food before I eat it – but it was interesting to observe the preparations! After a relaxing afternoon, I went to mass with Sr. Kathleen and Sr. Judy at a local parish, then had mushroom lasagna for dinner (SOOOO yummy!)

As I think of the traditions from home, college football, apples and cider, tramping through the leaves as they fall, leaping under the covers as the chill enters the air, apple pies, warm drinks, turning the heater in the car on full blast – I realize I will be missing it. It is easy to be lonely as the evening falls and I wish for good deep conversations with friends or anxiously check my email for updates from the homefront. Skype is an awesome invention which I am sure I will appreciate more and more as the months go by. But as much as I like a routine of sorts, I pray that it doesn't become too much of one, or that I become an afterthought. So selfish of me – but I will readily admit that I need the reminders of support. This is absolutely impossible to do on my own.

As Time Goes By

So another week passes, so slowly yet so quickly. The pace is increasing – at least the pace in my head is increasing! The nurses at the clinic taught me how to do blood draws, at which I am proud to say I was very successful. (Well, proud and disappointed, because now I will have to poke the kids!) Having been spoiled by a phlebotomy and IV team at Mott, I had very little experience with the “pickys,” as the kids call them here. But as grace continues to show up, the whole process has been very peaceful. And the kids try to be so brave! I hope to convey to the nurses that quick and simple is best. From my observations, this will be a long process. They observed me giving an antibiotic injection and I could tell they were critiquing my technique. They have a slower approach, very methodical and different. But four years in pediatrics has prepared me well for the yucky stuff, so I am sure there will be more discussion on this one. I have been observing, asking questions, trying to gain an understanding of their logic and choices. Much of the approach here is to treat the symptoms, not necessarily ask for more background and find a cause. But that's the way the culture here is too – how will I survive today; what do I need to do to get to tomorrow? It's a moment-to-moment life, which can be interrupted at any time by a new crisis.

Cultural dynamics and mode of operation in the health care setting are continuing to flood my head with challenges. There is a tremendous amount of waiting here – very few things happen promptly. Issues which would be wrapped up in minutes to hours in our American hospital or clinical settings will take months to years here. I am essentially starting from scratch at the present clinic, in a new program (just over 16 months) that is still unfamiliar to the hospital. So there are meetings and establishment of expectations and changing of ideas and involvement of many people in what could seem like a simple decision. But not much is simple when dealing with a system which is very advanced for the present circumstances, yet is still working to create order out of chaos. This was a tough week from that standpoint. Patience is a virtue I thought I had been given a good helping of in my lifetime, but I will need to intercede for more – just as much to be patient with myself as with others! Each day is humbling in its moments of misunderstanding, spontaneous change, lack of translation and myriad of questions.

I have been blessed to continue working every day with this group of nurses – they are so patient with me, teaching me Creole and French as I teach them English. They continue to be proactive, wanting to assist me with each task and taking initiative on their own. They have endured hours in drenching sweat with me as the clinic fan has broken, always with an ear to the radio and their “Shalom Shalom” programs, singing worship songs, some of which I recognize and of course which they want me to sing in English. We have inventoried the clinic and the extra storage container, which was a wonderful surprise and filled with numerous medications (!) which eased my heart. We have weighed and taken height measurements on all of the kids at St. Louis, and the nurses identified 12 kids whose nutritional status needs to be more closely evaluated. “Not good,” they would say in English as they observed the extremely low weight of a few of our residents. Two of the nurses are completely unfamiliar with the computer, and when they saw the Excel spreadsheet come together and as they plotted height and weight on the worksheets, they were excited! (Eureka!) I sat with Mis Laurent (mis is the Creole word for nurse) and introduced her to the keyboard – our first computer lesson. Her face was determined and she typed away at her first challenge – a paragraph from the policy manual in French. So much fun to see her gain confidence!

An absolute highlight of my week came Friday afternoon, when I brought my computer to the clinic (itunes) and taught a group of kids the Cupid Shuffle. I thought it might be too easy for these children with such a gift for dance, but they were challenged and watched me like little hawks. They asked for the song again and again, wanting to follow me as I danced! Most precious was Stevenson, a little boy of about eight years who is extremely visually challenged. He can see some colors, but only from very close distance. He cannot read well (obviously) and has limited ability to participate in any activities because of his poor sight. He is tactile and has to hold onto whatever anyone else has, touching hair, skin, bags, my watch and ring. So I thought maybe he could learn the dance, since it is a series of simple steps (for those of you unfamiliar with it – it's a 4-beat song, similar to the Hustle. Four steps to the right, four to the left, four kicks, then a change of direction. It repeats itself for the remainder of the song). We danced together, with me calling out directions, and he got it! He was so adorable as he asked for it again and again, then started to teach another little boy. I was gratified to see that he could participate in something group related, and he did well! He insisted that I bring my computer again on Saturday and we danced again. I just love connecting with the kids, and I should have known that it would just take some dance music to bring more little ones into my heart! Then the requests began in earnest – Bring us Shakira! Bring Chris Brown! Rihanna! Akon! Michael Jackson! Celine Dion! (yes, this was the train of thought). So I have begun the search for clean dance tunes appropriate for children as young as six years of age. Difficult task, might I say, in this day. Oh, and we cannot forget Justin Beiber, a favorite of the girls.

I have hesitated to take many pictures outside of the NPH projects. My reasons for doing so are that the Haitian people do not like to have their pictures taken – because they are used so much and feel like a spectacle for foreigners. They know their country is broken. They know there is trash everywhere. They know their homes and common gathering places are in ruins. They do not want people coming, pointing, taking pictures and then leaving. I will post more pictures outside the NPH walls when I can as I see more of the city and countryside, but I must be respectful of the dignity my neighbors deserve.

Dani and I have spent several evenings with the abandoned kids this week. Such a mixture of emotions in that room. We must refrain from judging the mothers who have left their children there – we have no idea the reasoning behind their decision. But it is HARD to see such happy, healthy little toddler boys jumping up and down when they see us come in, in little cribs next to children dying from hydrocephaly and tiny little newborns screaming to be held and cradled. I have spent time with a 15-ish month old boy with huge eyes and an inquisitive face, who moves like lightning back and forth in his crib as he watches where I go next. He relishes being outside the room, as they all do, and we have practiced walking down the hallways in a big square. Then my heart breaks as I put him back in his crib for a few agonizing minutes before he gets to eat, as the two tiny babies on the other side of the room cry louder and louder. One of the little babies has a terribly narrow head, because he is never held and literally moves his head from side to side to side as he is attempting to hold it up and move like a child of his age should! He has no muscle tone because he is rarely stimulated. So I have tried to work with him as our fabulous PT experts have at U of M, not doing nearly as good a job of course but wishing I could transport them just for a few minutes! There is a basket of toys in the corner of the room that is never touched – I have a list in my head of the chairs and toys and bottles and ready volunteers (shout out to George at Mott!) I would have here in a different world. But the little guy settles once in my arms, and is content. But then his neighbor, a beautiful little girl of just a month or so, lets me know that it's her turn, and I move to console her. She has fallen asleep against my chest each time I have held her there, sighing and burping after her meal of milk from a cup. It's either a cup or a syringe here – no bottles are used out of concern that the babies will not be able to breast feed well. So imagine the air bubbles. Oh, the stirring in my heart as I pray that the short moments we have with these children help to heal their broken longing for safety and security of supportive arms, physical affection and loving voices!

A week packed with moments

It's hard to know where to start tonight. This past week has been full, as I imagine they all will be in their own way. I am back in my guest house, returning from a glorious weekend away at the beach with other volunteers, generously covered by the NPFS programs. There is a torrential downpour outside, with lightning flashes and thunder claps closer than I have experienced before! When the rain pounds down onto my roof, I cannot hear anything else at all.

This was my first week on my own at the clinic, and I was blessed to work with cooperative nurses. Despite a still very evident language barrier, we were able to organize all of the charts at St. Louis into alphabetical order and place new forms into them. It was hard to tell who was more determined – me or them! They are willing to give input and share their opinions, which is encouraging to me. This is their country, their clinic, and I am a new foreigner who comes in and is there to assist in improvements. So I appreciate their comfort and am hoping that a trusting relationship continues to develop. I have been observing their practice and can see some significant differences – not terrifically bad or good – just differences. Gauging when to treat a fever, their approach and materials used in wound care, medications dispensed for different conditions, prevalence of certain conditions – it is a different culture here, and the approach seems very classic. As we sorted through all of the “dossiers,” we discovered some significant issues for which there had been no follow-up in several months. It was a great reassurance to bring these to the doctor's attention and have them addressed immediately. She is delightful and now asks me with a smile each time she comes to the clinic, “Should I speak in French today, or still in Spanish?” My request has been for Spanish, but I hope to soon change that! There were moments each day that were overwhelming – the sheer number of children needing the completion of examinations to bring their charts current, the amount of education that is needed for the staffs of the clinic and the homes, the constant heat, which blankets us in humidity and stillness, the desperate need for love present in the many little faces which peek in on me every day, the choice to be patient with the system, which takes days to return blood work and requires a CD from us for each x-ray, viewing results which need attention and knowing that a part-time physician will not see those results for several more days, the inability to quickly move from St. Louis to Ste. Anne, which is located many minutes' drive away, and the daunting language challenge.

the clinic container

the other side, with beds for the sick kiddos

The medications - a lockable cupboard is being built!!

One of many murals that are painted on the containers

watering the flowers and the grass!

I find humor in the midst of the days, though. It turns out that both of the nurses in the clinic absolutely love to listen to the Haitian radio evangelist shows which are hours on end of preaching, intensity of phone calls and altar calls, testimonials and intermittent praise songs. A note on the phone calls – apparently no one calling in knows to turn down/off the radio when they are calling in to a radio station, so all we would hear for hours was loud feedback. Unfortunately though, intense, spirit-filled preaching is not a great way for me to learn the Creole because it is shouted and spoken so rapidly! There are a few hours of relief in the mornings when pop music is played. Popular artists include Michael Jackson, Celine Dion, numerous 80's bands whose songs are covered in Creole... The kids now love to come to the clinic door and shout my name just to see what my reaction will be. They play hand games for hours on end and can be entertained by the simplest things! But they have now begun requesting things from me, such as English books, cars and other toys. Some of the kids still can't say my name, and call me “Veeseete.” Almost, but not quite!

I make a trek of about ½ mile from my house to St. Louis twice a day. I leave in the morning around 8 am, and return from St. Louis back to the hospital around 12:30 in order to have lunch at the common volunteer tent. I then return to St. Louis by 2 pm and work until 4 pm. The walk is both refreshing and a bit challenging. The SUN is out from before 6 am until 6 or 6:30 pm, so it is already blazing hot by the time I head out the hospital gate. The cat-calls start almost immediately – there is simply no way I will blend in here. Just not gonna happen. So the whistles, comments in broken English and attempts to get my attention with whatever phrase can be thought up are trying, but I just make eye contact and say, “Bonju,” (good morning), or “Bonswa” (good afternoon), or ignore them altogether on the external front. Adults and children approach me and beg for food or other items; such is the culture of dependency which is present here, thanks to numerous organizations and people who give handouts, and naïve travelers who flaunt their money.

Internally it is very challenging for me to walk the short path to work, because the blatant poverty surrounds me: the trash is everywhere, on the road and in the fields, the now-torn and nearly ruined tents still house thousands of citizens, collapsed structures remain untouched in countless neighborhoods, the childrens' cries constantly echo from the hospital windows; death is always close by - the vast majority of the people survive day-to-day by the grace of God, and He has not given up hope. My mind churns as I walk and observe and treat and teach and sort and eat and absorb and process. How can a country so long entombed in poverty, corruption, abuse, foreign rule, and disaster after disaster ever hope for recovery? It would be easy to just give up, despair and say there is nothing even the greatest effort could affect. And yet we are driven to continue our feeble work. I feel impelled to be here – by a Spirit much stronger than my own. There have been numerous moments in just the first two weeks of a year-long commitment when I could have chosen to run back to the airport, get back on a plane and try to recover my once familiar life in the States. But that all seems very far away now. THIS is my life. The sweat, mosquito bites, loneliness, fear, simplicity, the daily sacrifice of my comfort for the chance that when one life is changed, that the whole world is changed. And it is worth every bit of that fleeting materialism when I hear the sweet attempts at my name, when I am overtaken by hugs, when the nurses laugh, when the music plays, when the mass is sung, when the dead of the hospital are annointed, when I see the joy present in little faces whose owners are being given security, stability, safety, education, love, nutrition, health, and the chance to contribute a positive future to a country that so needs them.

soo precious!

Loubens, center, and Stanley, right, with another friend.

 

Stanley, my sunshine. Always smiling!

the three of us nurses

My three-day weekend began in the most sober of ways. I attended my first daily mass at 7 am. Mass is held every morning while Fr. Rick is here. It has become the custom to memorialize the dead from the previous day at mass. So it is never known how many bodies will be present. Friday morning there were five. Two adults, from St. Luke/Ste. Philomen (the adult hospital and cholera treatment center), and three children. One of the kids was a heart-breaker for me – a cardiology patient, who had been sent to the States last year for surgery. He had significant complications, became severely ill, and before a good investigation could be done, he passed away. A three-year old boy and a brand new baby were also among the dead. Mass was reverent, the dead were annointed and prayed over, then after mass there was a procession with the bodies, back to the corner of the hospital property where there is a morgue and a crematorium. We were asked to assist in carrying the bodies, as there were many and they are heavy. So we slowly processed around the hospital, singing and carrying the dead. How routinely this is done, how death is not fought, how almost expected it is, how stoic the families are, how foreign this is to American culture. There seems to be often an underlying resignation here. So different. The expression of emotion is rather frowned upon as a cultural norm. Not that it is not done, but that stoicism, even among children, is encouraged.

Shortly after the mass/funeral, we departed for our weekend at the beach. In order to get there, we drove through one of the most devastated slums in the world, Cite Soleil, famous for its danger and extreme poverty. NPH Haiti is building a hospital there, right on the beach. The sisters of Charity operate a clinic there, which I have been invited to attend soon by one of the nuns here. She calls it “Calcutta in Haiti.” We cleared the city, driving through flooded streets and battling with tap-taps through crowded intersections, and drove past “Canaan,” the extreme suburbs where residents of Port-au-Prince were paid to move by some NGO's, then left with no access to anything. Tiny shacks made of wood populate sun-scorched fields, at completely random locations. There is no water, local market, health care or anything around. The forethought and long-term commitment was either absent or financially removed by the planners. Many residents have abandoned the land they were given and have moved back to PAP – where, I don't know.

After two hours, we finally arrived at a beautiful resort, air-conditioning, hot showers, amazing buffet, gorgeous pool and beach. It was both welcomed and strange for me – to be spending a weekend relaxing, enjoying the beauty of Haiti, all the while knowing the terror and insecurity being lived by millions around me. It's a challenge I will likely experience again. But WOW. The island is stunning – mountains, beaches, the color of the water, good food, good company. Just what was needed after an intense two weeks. The return to reality came too soon, but it was still good to arrive back at “my house” and re-enter the routine which is still in development. Uncertainty is everywhere, the people are restless and patience is waning. But the children still sing and dance, and the women still smile when they are greeted on the street. We march toward a future we do not understand yet, but we know it is coming and we actively pursue it. There is no other option.