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!