In Thanksgiving

I am sitting here in the comfort of my little sister's living room, listening to the Christmas music that is ever-present whenever either of my younger siblings is in the vicinity (starting in August, usually) and smelling the turkey as it cooks. It is hard to imagine that just a few days ago I was in the midst of a hysterical crowd of grieving relatives as they followed their loved ones to the hospital morgue, then dashed home down the dusty road against the vehicles speeding by, politely declining the motorcycle taxi drivers, and hastily packed a bag to return to the US for a week's stay. After an absolutely gorgeous series of flights piloted by a generous volunteer doctor who makes monthly visits to the St. Luc hospital, I met my sister and am getting acquainted with Athens, GA, her current place of residence. And the simple luxuries of American life have embraced me - a comfortable bed, delightful hot showers, raking the crunching leaves, weather suitable for layers and space heaters, amply-supplied grocery stores, quick phone calls and texts to stateside friends, the hilarious dynamics of five adult family members sharing a small living space, a pleasant and low-key canine companion, a fabulous haircut, new old clothes, wireless internet, Pandora playing via computer.  A few hours airborne takes me from one world to quite another.

Rather than go all verbose this time around, I will show you just a few of the moments and people for which I am grateful.

My friend Genessa, who I met during my first trip to Haiti. Here we are with one of our patients, who was transferred to the US soon after arrival at our field hospital. Genessa has inspired me to be courageous and step out in faith.

My sisters, Christine and Margaret. (I'm the tan one!) As one uncle put it, we would make a great sitcom - probably true!

Stanley, aka Mr. Sunshine. This kid is happiness personified.

My beautiful friend Amy, who encouraged me to embrace faith instead of fear and continues to do so. Here we are with just a few of my entourage!

The determination of the Haitian people: Haiti will not die. Haiti cannot die.

The babes! 33 of them in all - there is nothing like hearing your name chanted by these little voices.

A typical greeting upon my arrival at St. Louis

Beautiful Erline, my girl. Her transformation has been amazing.

Maxuel, who has become more and more brave.

My awesome roommate Dani, who above all things reminded me not to take things too seriously! And introduced me to Harry Potter.

Amazing countryside

Christo, and the many other little heroes who are fighting cancer with everything they've got. Their smiles melt the heart and belie their serious illness. These are the bravest of the brave.

A new clinic, with two of my three colleagues! They have accepted me with humor and grace, and are great learners.

The Caribbean Sea. 

This is just a sampling - there are countless other moments and people that have impacted me over the past eighteen months. Thank you, followers of my story and encouragers of this journey, who have supported me in a myriad of ways and have allowed me to serve. Your support is beyond measure. Happy Thanksgiving - may we never forget to be grateful!

Thoughts on a Sunday

That saying, “Years go by like days,” is hitting me quite hard lately. Although, I would wish to add, “Days go by like years.” My head has been heavy and inundated with the enormity of moments I have experienced in these past weeks. I have had this particular blog post in mind for quite a while, and each day I have put off writing it another paragraph’s worth of thoughts is added!  So sorry, dear reader.  

It is hard to believe that only a week ago, we were venturing out from under the floods of Hurricane Sandy. To see the pictures of her devastation in the States causes my heart to hurt even more. We here at NPH were spared her worst at our immediate facilities, but numerous staff and family of staff were greatly affected by the massive rains and winds. When asked if this was worse than Isaac, which hit in August, the reply is, “Isaac was nothing compared to this!” Those most greatly affected were living near rivers or in the tents. We have already begun to see drastic rises in the numbers of cholera cases, as patients arrive at the hospitals here in Tabarre and in Cite Soleil. Thanks to my fabulous former roommate Dani, several containers of IV fluids were donated to us earlier this year and will greatly assist in the massive rehydration which is critical to save a patient’s life. 

One of my friends asked me, “How was your adjustment period?” when she only recently learned that I have been living here for the past 15 months. I thought about that question, and I will definitely hold to the position that every day continues to be an adjustment. And that is as it should be. If I were to dare state that I understand the culture and people of Haiti completely, after only this short time here, I would be committing serious error. Numerous learning opportunities and moments of adjustment are presented to me on a daily basis. Just as I cannot fault my friends in the States for their inability to relate to my experience here and understand as I would wish them to, I cannot fault the Haitians for cultural nuances which are counter-intuitive to me, or for instincts I may possess that are not natural to them.  Here in Haiti, crying is seen as a weakness or an infantile behavior, whereas in my experience it is seen as a healthy release of emotion. Little children crying in response to physical or emotional pain, or mothers weeping when they learn their child is in a terminal state of illness, are quickly hushed and told to be strong. This is not out of purposeful rudeness, but most often based in years’ worth of forced fortitude and mind-over-matter thinking in the face of nearly constant hardship. When I was able to check myself and remember this as the little kindergarten boy wandered and sobbed on the patio of his classroom, and when I scooped him up and sat with him and was able to identify the source of his fear, I was relieved. Ten minutes of snugging and quietly calming down, along with a few assurances that since his mommy remembered to come get him after school yesterday, she would most definitely come today as well, were what he needed in order to return to class. And perhaps, as they watched us, the teachers were able to see how that few minutes of attention and validation was helpful. They must not be criticized for something they do not know to do – lack of knowledge is NOT the same as ignorance. 

Just the usual hanging out and posing during recess ...

 I am both blessed and overwhelmed to be working with the only pediatric oncology program in the country. Time is marching quickly by as I continue to learn the subtle and not-so-subtle differences in the culture of patient care. What will never cease to amaze me is the resourcefulness of the Haitians. I remember this distinctly, as it struck me during my many trips to Nicaragua, and perhaps most evidently, in my first journey here in the days after the earthquake. The ability of the medical staff to think creatively in terms of using what is available to them to the absolute furthest extent possible (we Americans might call this an "off-market" purpose) would trump any number of Stateside colleagues. The real limitation I see here is the concrete thought process that has been present for so many years. The nurses are tremendous, but have not had exposure to or experience with critical thinking. They work with protocols and point-to-point orders. An easy frustration for a foreigner is the matter-of-fact answer one will likely hear when trying to examine a point more deeply: “This is how we do it, because that is how we do it.” A huge challenge for us as visitors to this country, who wish to empower her citizens, is to create and maintain a trusting environment and to develop a relationship which fosters understanding. By openly and quickly criticizing things we do not understand, we paint ourselves as fools. The nurses often laugh when I share from my experience, because such concepts as I may mention are so foreign to them. But when we are able to talk more openly and they begin to share from their perspective, we often find that we are much more similar than they initially thought. They crave learning and have begun demanding that I teach them more! That is my task for this coming week – the commencement of educational seminars.  I would not have wanted to start this any earlier. I have talked before about how important relationship is in this work. I must wait, be consistent, demonstrate professionalism, validate the nurses’ experience and education, and receive their freely-given permission, before I attempt to share or suggest alternative methods of patient care. 

The moments of intensity have been somewhat balanced by much lighter ones. One of my newest buddies in Oncology, Christo, calls me “Bibbitte,” because he cannot say “Brigitte!” My fabulous nurses at the FWAL clinic call me just to say hello and check in with me. One of them, who has a famously large appetite at any time of day or night, shared a great laugh with me in the midst of the hurricane, when she told me her only complaint about being trapped in her house by the walls of water was that she was hungry! The FWAL kids were completely wowed by a Skype conversation with one of my closest friends, and literally wanted to hand her gifts through the computer. Needless to say, carrying on a Skype conversation while surrounded by about two dozen little people is essentially impossible, but they loved it. The women in the kitchen at FWAL make me delicious coffee in the morning and make sure that whenever they are cooking corn meal with bean sauce, that I have a very large plate of it. The kids in Oncology are enamored with the walks I take with little ones crying from the pain of the chemo meds as they enter the bloodstream. I spent a wonderful hour with Angie, slowly roaming the halls as she tucked her head against my shoulder and kept motioning, “again,” as we approached her room. And I was once again reminded that coloring is pretty much the perfect therapy for a case of the “Mondays.” Emerson, age eight, now finds me every day I am at FWAL and asks me to please take him home with me! The kindergartners call my name when they see me walking, and they wave enthusiastically when I meet their gaze. I invite you to visit anytime you are feeling the least bit down, and to try to remain standing as the hordes of little pre-schoolers lovingly attack you with shrieks, smiles and laughter. 

Camera! Quick everyone - attack!

This past Thursday and Friday were the Days of the Dead here in Haiti. They are the feast of All Saints and All Souls in the Catholic Church. On the 2^nd of November, the Haitians often travel to the cemeteries and hold ceremonies for the dead, praying to the Loa of the Afterlife that their loved ones be given permission to enter. As has been the tradition in the recent past, a large group from NPH/St. Luc traveled to Titanyen, the site of the mass graves holding the hundreds of thousands buried so haphazardly out of necessity. Titanyen is also the site where Fr. Rick and a group of volunteers have faithfully honored the impoverished dead with a dignified burial, nearly every week for the past eight years. Our group was joined by the Missionaries of Charity and several children from their home here. This year, a change was the large contingent of Haitians from the local community who walked toward us, perhaps out of curiosity, perhaps urged by something more. A strange development in the last year has been the construction of many homes on the Titanyen land, as the desperate from the tent cities and still displaced from the earthquake or other events are finding a free place to live. It was a bit disconcerting to see houses on the land which contains so many bodies. But as the mass commenced, their reverence was palpable. Fr. Rick spoke of the violence of death which so many have suffered in the traumas of the earthquake, cholera and disease, the humiliation of poverty, and how so many of our brothers and sisters have been further humiliated even after death with such violent and random burials.  We were reminded to pray that a swift and peaceful journey into Eternity be granted to each lost soul. And an amazing event occurred as the service ended. Every person in attendance was given a candle to represent the Light which calls us Home. As the sea of little lights grew, the Haitians standing with us turned and walked toward the graves of the most newly-buried, praying and singing while tenderly guarding their flames. They then placed candles on each gravesite, constructing small fortresses for them out of nearby rocks and continuing to chant for their beloved dead. Grief and solidarity transcend language, and I stood speechless at such a beautiful act of service. The world grew just a bit smaller at that moment. As we said our goodbyes, the tears brimmed in my eyes as I was once again humbled by such extraordinary company. I am a truly blessed girl to witness such moments as this.

May peace, dignity and wholeness, which they were denied in life, be theirs in death.

Hurricane Sandy

Just a quick update for you all: Hurricane Sandy has pummeled Haiti, arriving Wednesday, and has stayed around for two days now. We in Tabarre are safe and as comfortable as we can be under the circumstances! I am grateful for a dry, sturdy home to sleep in and we are being catered to by our Haitian counterparts, who are working hard to keep our elecricity and water going and to provide us with clean drinking water, which will become very important in the following days. We have had HUGE amounts of rain and massively high winds. We are lucky here, however. Much of the country, especially the mountains above us, (our home in Kenscoff) and in the provinces, especially to our west, has taken a much worse hit. Rivers are overflowing, homes are falling and people are essentially stuck where they are because of flooding. The tent cities are saturated, as you might imagine. I try to see myself riding out this storm in a home made of trash bags with a dirt floor, and I cannot fathom it.

I was able to speak with my nurses from the clinic at FWAL, and they are well so far. The floods uphill and in neighboring towns have kept one of them from being able to travel to work. Numerous adjunct employees of NPH have not come to work these last two days. The hospitals are anticipating a rise in the number of cholera patients, as cholera is carried in the water. School has been closed since yesterday, on order of the President. We are hoping that each blast of rain will be the last - please keep the prayers and good thoughts coming our way as we dry out, survey the damage and provide assistance where we can. Fr. Rick and his team were already out in the tent cities yesterday, providing supplies to those in most desperate need.

More updates to come as I have them.

Hands

I was thinking the other day that I miss being able to give good massages. As part of my curriculum back in the days of my first college major, Athletic Training, we were trained in massage. I absolutely loved being able to use my hands to alleviate pain and provide tangible therapy to the athletes under my care. But even more, I think now and realize, I treasured being able to touch them and offer that as a service as well. As I work here, and as I have thought before, there is a poverty of love in our world, and one of the ways we suffer is by lack of loving physical touch. A few friends of mine definitely possess the gift of touch. When I am touched by them, I can sense their love. But I also notice that because I am not in a place to receive regular physical affection from my friends, I may jump or startle when first touched. The kids I am with on a daily basis thrive on the warmth of physical touch. Their hands and arms and legs are intertwined with mine before I can react, and their hugs are given with all their strength. Just this morning I got to sit with one of my favorite little girls at mass, and she ran her fingers across my skirt, studying my arms and hands and then burying her face against me as we stood. It is only natural to hold her close, my hand on her back as she giggled against my waist. I finally had some baby time with our little Francheese, who is usually being passed from teen girl to teen girl. She clapped her hands against mine then cried to be turned and tuck her head into my shoulder as she then stroked my arm with her tiny fingers. 

Wasson, our new little baby boy! (We had no little boy baby clothes yet).

The time since my return to Haiti has been a constant sea of change, with volunteers leaving, a new schedule to keep, a return to hospital nursing, a crash course in pediatric oncology, a different culture of nursing to learn, new nurses to befriend, and most recently, a move into new volunteer housing. Our new places are very cozy, but a tad warmer than our previous ones – the challenges of being spoiled by air-conditioning, then having to leave it! My face is beginning to resemble that of my adolescent self; therefore the photos including me will be kept to a minimum for a bit! By no means are we suffering – just adjusting. And we are appreciating cold water, ice and cold drinks at an entirely new level. (Yet one more thing that we do not think twice about in the US, but that billions of people live without, so much that my nurses were taught that if medications are taken with cold water they will not work - it is such a rare luxury here).  I am now only a few minutes’ walk from FWAL, but a longer commute from the hospital. But I do enjoy making a house a home, and have enjoyed a bit of housekeeping. The walls are a nice warm yellow, which my friends will know I appreciate. The staff is working tirelessly to accommodate the nearly constant demands which we ex-pats are so good at making, and I now have a fabulous front and back porch to enjoy! 

The new digs, Villa Francesca

My new front porch!

I am now spending half my time familiarizing myself with the Oncology ward at St. Damien. This is the only pediatric oncology program in the entire country. Two passionate and assertive doctors run the program, assisted by a dynamic and straightforward nurse supervisor.  My mornings are spent rounding on each of the patients, reading up on their histories and working through their care plans, meeting with parents of new patients and observing the nurses as they work. I am learning massive amounts each day about the culture of nursing here, the demands placed on families, the sheer challenge and obstacles of a fatal disease in the developing world, the acceptance, submission and the simplicity of faith which are extraordinary.  Numerous cancers are treated here, including leukemias, lymphomas, retinoblastomas, (cancer of the eye), Wilm’s Tumors, neuroblastomas, and osteosarcomas (cancer of the bone). Sadly, however, many children are not brought to the St. Damien program until their cancer is in a very advanced stage, after parents search country-wide for answers to the mysterious symptoms present in their child. Therefore, I was asked to join the staff and help to form a Palliative Care program, so that the children who are determined to be in a terminal state can be treated and supported well.

Palliative care is essentially the support of the whole person and the numerous aspects of a patient and family’s life in the presence of chronic or acute illness. In the States, many resources are available and there is often a multi-disciplinary team consulted to begin planning and implementation of Palliative Care. The patient does not need to be in an advanced state of illness to benefit from Palliative Care – ideally, it will begin at the time of diagnosis, in order to provide for and accommodate the many issues which develop with the onset of illness. These include spiritual care, pain and symptom control, physical and occupational therapy, emotional support, continued schooling, art therapy, decision-making and social support, and the continuous process of educating the family.

There is, of course, a large disparity of resources and care available to the children and families here. But the directors of the Oncology program feel very strongly that this does not mean that the children entering the final stages of life, and even at the start of their treatment, should be forgotten or abandoned in such a state of weakness and pain. I am honored to be able to work with them and to begin training the nurses in this approach to care. This is a slow process, because before anything else, the development of a relationship must take place. I am getting to know the nurses, learning how they operate, observing the relationship between the nurses and doctors, asking oodles of questions as I learn an entirely new area of medicine, and my ultimate favorite thing, sitting with the kids. They are among the strongest, bravest people I have ever met, smiling and nervously approaching the pale-skinned lady as they laugh. They proudly show me their “picky” scars and are glad to oblige when I tell them to slap my hand and give me a picky too. 

Susanna, one of my newest friends

My buddy Christo

The hospitalized child is often very fearful, and carefully watches any approaching person wearing scrub pants or a lab coat. But there is gentleness and power in an outstretched hand. Too often we forget in the rush of tasks to pause for this, and we quickly begin examining a patient instead of approaching them gently. All of my relationships here in Mango, as the Oncology ward is labeled, (each room is labeled with an item, due to the very low rate of literacy, as to accommodate the large number of citizens here who can recognize a picture but not a number or letter), have begun with the simple gesture of that hand outstretched. The kids tentatively and slowly bring their hands to mine, explore my fingers, find my rings, smile and glance back for the security of mom’s presence, and then slowly start talking. The absolute highlight of my week was the sight of a new little friend, Christo, as he recognized me at the top of the stairs, and despite the huge tumor in his abdomen, leapt up the remaining steps to wrap his arms around my neck and hug me with all his might! We exchanged squeezes as we traveled down the hall toward the room where he knew he would have to receive chemotherapy and blood draws, but his smile and instant demand for candy, as he saw it last week in my bag, made me laugh. When we first met, he was terribly scared, but we played through the rungs of his crib and I offered him stickers, which he promptly placed all over his t-shirt. He then showed me his juice and his food. He screamed as he was examined, and then when his blood transfusion was started, and he reached for my hand to hold. What a thrill to gain his trust and then converse with him for the rest of the morning through the door of the office which adjoined his room – that was just the beginning! Now he comes to find me as soon as he arrives, demanding that I feed him his morning spaghetti and sit with him while he watches TV. We snuggle together as he sits on my lap while I work. I was able to sit with his mom and assess how much she understands about his disease, which helps me to understand what the parents’ impressions are of what they are told by the doctors, what they hear and what they interpret from the big words and scary prognosis. This is nursing – what is done in the minutes and hours between doses of medication and vital signs, the constant assessment of the patient and family, the sitting and talking and ministering to them, validating their experience and fears, meeting them just as they are, and providing the answers which we do have in our possession.  It is comforting and encouraging when the easy answers are not there, sharing from our experience, giving insight and counsel while respecting the uniqueness of their situation and remembering that we can never understand exactly how they feel.

I was always a little bit proud of my hands – I thought they were attractive and strong, and my nails have always grown nicely. Then when I entered the hospital setting in the US, nail polish was strongly discouraged and I had to give it up.  On a stupid impulse one afternoon, I grabbed a razor in our inventory room, and as I was opening it, it sliced my finger just so perfectly that a ridiculous series of events ensued. For two hours, a blood pressure cuff was fully inflated and cut off the circulation to my lower arm while attempts were made to stop the bleeding and my blood vessels were cauterized.  A nerve block was given, and the wound was then wrapped too tightly for the next 24 hours. This produced a massive wound resembling a burn injury, put me within days of receiving a skin graft, and deemed me unfit to work for an additional six weeks.  I was terrified that I would not regain sense or motor ability in that finger and that my hands would be forever stained by my incompetence to handle a tiny sharp object. More than that, though, I feared that I would not be able to use my hands to support patients through the most basic tasks, holding them, assisting them in movement, offering massage to friends, even typing on a computer keyboard or carrying equipment. Again, we do not think twice about using our non-dominant index finger, but it is a pretty necessary component of daily life! But now, two years later, I offer it easily to the tiny hands that timidly grasp it. It is held for security during a scary procedure.  I hold the bottle to feed our babies, I balance the numerous supplies and carry them from storage to the clinic, and my little Erline leaps into my arms. I hold Valson and he steadies himself before jetting away, I caress little faces and am led to a seat in the large waiting area and handed a spoon to feed Christo, and I adjust my camera to take photos of the endless poses the children eagerly enter.

Rosenie (r) with Stephanie, one of our newest little ones

Baby Francheese with Sonya, employee of NPH Germany

Some days I sit just craving a hug from a friend or the strength of their hand as it lovingly squeezes my arm and rests on my back. The volunteers hold hands at mass on Sunday evenings, reciting the Lord’s Prayer over the bodies of our recently deceased brothers and sisters. Any of 200 residents of the FWAL program will grasp my fingers as soon as they encounter me. Little Antoine tells me he has a “malade” (problem) with his finger, which is easily remedied with a kiss and a little bit of water. Fabienne and Mama lovingly make me bracelets. The cancer patients give me “five” as hard as they possibly can. I deal out the cards in our game of Uno. I examine the knee of a visitor who has fallen. I wash and dress the newly-burned chest of a school student. I cherish the delicious Haitian 7Up as I drink it.  We cannot possibly count the number of times we use our hands throughout the day, but perhaps we can be a bit more conscious of how we use them and to whom we offer them, outstretched in friendship or offered in prayer, holding pen to paper in the quickly disappearing act of a handwritten letter, dignifying others through acts that confirm the genuineness of our words.

Love Out Loud

“I love you.” Three words which, when said in sincerity cannot be heard too often; but only when actually demonstrated to be sincere and genuine. In too many relationships and situations, we forget to seek the best for the other, becoming too absorbed with ourselves. Then, how can those words be received with trust and believed?

It’s been a whirlwind of a two months, a bit surreal and yet all too present. I spent the month of August at home in Michigan, attempting to be present to my family and friends – and for the first two weeks I felt like I was in a dream state, searching for energy to function in such an ordered and organized society. Let me explain to you that this experience and life feels so removed from my life in the States that it takes days for me to realize that Haiti and the United States are actually on the same planet, let alone only a few hundred miles from each other. My body and mind were screaming for a chance to process this past year, and to discern whether and for how long I should continue to work here. The heaviness and sheer intensity of the last twelve months, coupled with my disbelief that a year actually passed so slowly and so quickly at the same time, caused me to pause and simply attempt to breathe once I got home. The modern conveniences of life in the States were a welcome gift, and yet the ever-present amazement at the overwhelming surplus of ridiculous “stuff” we Americans apparently “need” did cause slight nausea with occasional moments of dizziness as I re-entered the mall and supermarkets near my house. More than 300 types of cheese in one store? Fruit and vegetable spray – captioned “the soap you can eat,” even the menu at Starbucks (don’t get me wrong – I indulged in several fabulous Coconut Soy Mochas, thank you very much!), were causes for a step back and a deep breath. I did very much enjoy my delicious burger with goat cheese on my first day at home, and pretty much every meal I ate – the variety of foods and drinks is just plain stunning. And the shoes! I did not know that I loved shoes so much as when I had been away from the world of fashion for a year. I found myself looking longingly through my mother’s design magazines, wishing for walls to paint fabulous colors and for walks through the vintage stores to furnish a new place. These distractions served a two-fold purpose, I can look back now and realize.  I do cherish the freedom and stability of a life in the US, and when I am called to return there, I will have a wonderful time setting up house again and creating a cozy place to live and to welcome friends. But yet, I also know now what freedom is present in a world with very few possessions, where the emphasis is placed on not things and materials and the latest fancy phone or car, but on the moments spent with children and friends in relationship, moments which cannot possibly be bought or held in time by the amount of books or the most comfortable couch. 

Mangos! So messy and so delicious!

My awesome pupil Stevenson, who remembered all of his letters and numbers!

 It was wonderful to re-connect with friends and to hear their vocal support of my life and service. It is all too easy to forget that I am remembered and loved from thousands of miles away when I sit sweating in stifling heat and wonder if the internet is functional anywhere today, when my new roommate finds other work and the circle of volunteers grows smaller, when the same children are living in a hospital room labeled “Abandoned” for months at a time, when temporary tents are removed to make way for parking lots, when daily mass is most definitely a funeral for tiny bodies and the stench of death has permeated the entire chapel, when new security measures are present at the hospital due to escalating crime, when cholera spikes after Tropical Storm Isaac, when cancer patients cannot receive their medications due to delays in deliveries, when the groups of boys lie prostrate in front of the UN gates awaiting the soldiers’ leftover food, when hit with the total chaos of the Port-au-Prince airport upon arrival. To sit holding new babies only seen previously in photos, to be touched and listened to by hands and hearts that know me from outside this tiny island, was a massive blessing that I just wanted to somehow package up and bring back to Haiti with me. It is one thing to hear or read those three little words, but yet an entirely different experience to sit with those who say them and be tangibly loved, understood and pursued.

The two weeks since my return have been equally as surreal as my visit home. After only a few minutes in-country, it is hard to remember that I spent a month Stateside. The visits with friends, the weddings, the fundraising parties, seem years away already. Part of my dread in returning was that re-entry is like a blow to the chest – it hits hard from the outset, with the harsh sun and the blatant poverty, with the emotions and fatigue of my fellow volunteers, with the desperation which we work to empower our brothers and sisters to overcome. However, the endless stream of massive hugs and kisses and questions heaped onto me by the children who are overjoyed that I kept my promise to come back, serve to ease the sting a bit. Erline’s huge smile as she envelops my legs in her arms. Little Stanley’s constant presence every moment I am at St. Louis. The well-meaning staff which tells me I have come back fatter. The delicious corn meal with bean sauce that is served for lunch. The hospital staff as they stop me and tell me it is so good to see me again, that I am remembered by them, and as they ask after my family and if I had a good vacation. The concerned and gentle reprimands of more seasoned volunteers who tell me change is inevitable and to not be afraid: these are all serve as remedies as well. And as I sit in my house after a massive deep-cleaning of my roommate’s now empty room and unpack the groceries from a Sunday supermarket trip, where goat cheese (mmm!!) and filters for my new coffee maker were successfully found, as were bananas and yogurt and sweets for the kids, and I listen to the fantastic mix of current American music hits so lovingly put together for me, I am amazed that only a few days have gone by since my arrival.

Within the next few weeks, we will be moving to new volunteer houses, about ½ mile away from the hospital, and which are yet to receive electricity and running water. The tents that stood for nearly three years to house short-term volunteers have been taken down. My current house will soon be turned into additional hospital space for the overflow of chronic patients. I am now splitting my time equally between the Angels of Light Program and the Oncology unit at St. Damien, working with an awesome team of doctors and nurses, and dangerously at risk of falling in love with a whole new group of little heroes. I absolutely love being back in the hospital and am being inundated with new observations and thoughts as we begin coordinating a Palliative Care program and I sort through the differing cultures of the American setting and the Haitian patient and family. One of the things I have always loved about the developing world is that it is nuts and bolts – the basics at work, with limited resources but unlimited chances for relationship and critical thinking. This culture tests even the best assessment skills and challenges the provider to seek thorough answers with minimal information. There is no quick computerized result here, no available x-ray posted within minutes of its completion. If narcotic pain medications have been donated, there is a chance to control severe pain; otherwise it is the basics and the comfort of a mother’s or caregiver’s touch which must suffice. The staff here is stalwart, strong and amazingly resourceful, creative and enthusiastic but firm and determined. The kids have strength that puts mine to shame, smiling through unimaginable pain and enduring the daily blood draws and chemotherapy effects with minimal tears. They come from all over the country, having been referred from place to place before finally learning that there is a cancer treatment facility in Haiti. 

Do not mess with a boy and his beach ball.

Jessica and Sabine

 The FWAL nurses and I will soon moving into a much larger clinic space at St. Louis, with more autonomy and space to use. Oh – a quick aside – the three of them did a superb job of running the place in my absence, which was not a surprise to me but was still very gratifying to see on my return. They are anxious to learn more from me, and I am channeling my inner educator as I plan seminars for the nurses, staff and kids. My amazing pupil Stevenson remembered ALL of his letters and numbers and wrote them out beautifully for me at my first request, bringing me to tears. The kids ask me over and over again how I left and came back, unable to conceive that I took two planes to go home and that the US is such a large country that I did not see any of the American volunteers that have visited before. They sit with me and stroke my arms and legs, loving me out loud. Stanley has started singing, “All the children love Brigitte, and Brigitte loves all the children.” I pray that both he and I will know this to be true every day.

In this age of sweeping stereotypes and hatred-induced, prejudiced statements, with combative politics, violent attacks, and quickly drawn conclusions based on hearsay, I wonder sometimes if we have forgotten how to love. In the selection of scripture readings at one of the weddings I attended, Love was defined, and though I had heard the verses countless times before, they struck me more deeply as I heard them. Witnessing the poverty of the unloved stirs the spirit. I am afraid that in the Western, stimulation-overloaded world, love is becoming an afterthought. As I sat with my friends and family and laughed at shared experiences, as I attended the wake of a cherished daughter who chose to end her life because she believed she was unreachable, as I held friends in hugs not wanting to let go, as I watched new love grow and spoke with understanding souls, as I attempted to relate stories of Haiti in just a few minutes, as I let go just a bit and dared to puncture the calm façade that I somehow feel I must maintain, I had to choose to believe those words. But this is one of the most wonderful aspects of working with my Haitian children. They always hope, always persevere, always believe, and they bear the hardship of life while standing in determination and expectation that tomorrow will be better. They love out loud, actively chasing after life and vocally expressing their feelings. That is how I experience love here – in the woman who insisted on carrying my heavy box as we walked together, in the doctors who stand determined to care for their end-stage cancer patients as compassionately as possible, in the nurses who tell me they are noticing the good trends in our diabetic patient’s blood sugars, who rejoice when another one of our kids completes TB treatment, who excitedly ask me when I will start to teach them more and are equally as excited to share their time and workspace with me. It is in the little blind boy, previously terribly malnourished and timid, who now refuses to let go of my hands when I visit him and laughs when I tell him he is handsome and healthy. He strokes his new stuffed dalmation puppy and asks if I will come back tomorrow. It is in the little girl who bravely circles the hospital floor twice, with her arms grasping my waist, and tells me it doesn’t hurt. And it is my new challenge to myself – to love out loud, to drown out the noise of anger, misjudgment and impatience, to check myself when a negative comment is about to escape my lips. Perhaps if we consciously choose to actively and genuinely love, patiently, kindly, gently, wishing for good, compassionately and hopefully, we will live and demonstrate to this world that love can be louder than hate, even defeating the darkness altogether.