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.