Barking Dogs, Mosquitoes and Roosters Oh My! May 14th

We are leaving Haiti Today!!!!!!
I had a great trip...met wonderful people, saw incredible things.
However I will not miss
The Heat
Sweating all the Time
Dogs that bark all night
Mosquitoes that are never full
Roosters that begin crowing at 3:30 am
A world that wakes up completely by 5:30 am
No water at times
I will miss:
Brother Mike and Brother Harry
The student Midwives
Barb and Tracy and Tricia
Prestige beer
Cold showers when there is water
Noe, Pierre Louis and all the children
And Especially "The people of Haiti"
who through everything smile and laugh, are thankful for anything, who help each other, who love their children and families so deeply....who continue on thru unbelievable conditions
God bless and keep you
Au Revoir M'ale

Mobile Clinic May 13th

Today Barb and I went to the Mobile Clinic. 2-3 x a week the sage Femme with students and CNM's go to one of the villages to do a prenatal clinic. The day started hot...very hot, very sunny...whats new in Haiti?
We got to the clinic which began under the shade of a mango tree. About 30 woman sat talking to each other in varying stages of pregnancy. the students began by talking about danger signs of labor, than about hygiene. Then the patient went 2x2 into the little room used for the clinic...tis very small room had 2 Sage Femme, 2 students, Barb and I and 2 patients plus our interpreter......in no time I was in a major sweat. The Students weighed and took blood pressure, the sage Femme took the medical hx and information, then with the students we measured tummies listened to heart tones and did Leopolds for position...then the patients got a months worth of PN vitamins, Folic Acid and Fe. along with malaria meds....all in all very efficient. Barb got overheated and went outside. It took about 4 hours to see 29 pts. Barb sat with the waiting women who all were "Grangou" (hungry) and fed them all the food we had left.
After the clinic Barb got very hot and dizzy and did not feel well. We took her home and gave her lots to drink as well as cool cloths....she had heat exhaustion...by my calculation it must have been about 110 degrees in that little room
I do not like heat...

To help.....what does it mean may 13th

There is a little girl who has been at the hospital for a week. she is not a patient. She is 17 and has a 1 year old boy. She is small and lovely with the biggest smile. She does not speak English or French but engages Barb from day 1. She learns she is here with her sister who is waiting to have twins...
She asks for food, she and the baby are hungry, we listen to her story we give her money. we come back with clothes and more food the next day. Every day she waits for us. She has stolen Barbs heart.....mine too. Barb wants to help her she talks at length to anyone and everyone. The girl has only finished 2nd grade, her mom and dad are dead. She lives with her sister whose husband is "Foolish"(mentally ill) and does not want her there. Barb talks to the brothers and to John Louis who is the director of the orphanage...what can she do? Can she help this girl go to school can she somehow fund her education? (Only $300 a year) John Louis says he will go to the hospital and talk with her and help her...Barb is ecstatic.....
The sister delivers twins...the babies are healthy and beautiful...we bring more clothes....the sister says they have no way to go home....about an hour away....We will give her money to get them home as the husband is not competent.
The next day we come to the hospital we see the ambulance with the patient and her sister and babies...they motion us over John Louis did not come.....What can we do, we watch the ambulance leave...Barb is heartbroken
That night John Louis comes to the house we are at...he was not able to get to the hospital...however he assures us he will find the girl..he has her name and her village
John Louis is a good man..but there are so many people with so many needs....what about this one little girl with the beautiful smile...

Brothers of Francis of St. Zavier may 12th

I have to describe the "Guest house" we are living in. It is run by Brother Mike and Brother Harry. I am in love with them, especially 82 year old Brother harry. He has been here for 18 years. He speaks creole and makes the best oatmeal ever. he is as kind a man as you will ever meet ...and openly critical of the politics of Haiti and the abuses of this poor country. every day he goes to the Azile...which is the orphanage{The order of Mother Theresa} and cares for the older men that live there. he also loves the children. The first day I went to the Azile, he was sitting there covered in children. They were crawling on him, hanging on him...touching him. he had such calm and peace just sitting with the children...now that is religion at its best...
They have an English program that they have set up to teach English to any one who comes. Especially they have worked with young men like Pierre Louis. He is 31 and in his 3rd year at the University in PAP. He was there during the earthquake, and his building came down around him. he was not hurt nor any of his fellow classmates but his University was destroyed. Brother Harry and Brother Mike arranged with a school in the University to accept them for a year all tuition paid. The 3 young men who will go have an opportunity few in Haiti Will ever experience Mike took the 3 to PAP today to get Visas. As Barb and I were walking home from The Azile Brother Mike spotted us from one of the stores and called us over to have a beer. It seems that all three boys had the same qualifications, but only 2 were given visas. Pierrre Louis did not get one. As we sat and shared a beer with them I was so angry at how arbitrarily someone can make a decision that affects a life so dramatically. Do they know that Pierre Louis is the oldest of 6 children, that he wanted an education so desperately that in order to go to High School he had to walk 6 miles each way each day? Do they have any idea that his degree in BA is to return to his small village and set up a High School so no one has to struggle so hard to get an education? Do they not see this good and honest man ? I pray for Pierre Louis that he will get his Visa...Haiti needs him...

Cange ...May 12th

Today is Nurses day in Haiti. There is no school for the students so we decided to take a trip to Cange which is the site of Zamni Lasante {Partners in Health} Which is the hospital Paul Farmer helped build. We rode about 1 1/2 hours in our pick up truck, I am getting used to the "Open air experience" and really experienced the beauty of the mountains and plateaus of central Haiti. It really is a beautiful land, greener than I expected with lots of mangoe trees. my biggest disappointment is most of them are still green.The children hit the trees with sticks trying to get the mangoes to drop. we saw people all over on burros, walking, the women carry all sorts of items on their heads including one with a bucket full of live chickens. The children are priceless, all in their uniforms. The girls always have bright ribbons matching their uniforms in their hair.. many people cooking on the side of the road. the houses are small stone or wood structures. The cooking is always done outside with charcoal...which is where the deforestation comes from.
Water is always an issue. There will be a center in town with a tap. people come from all over and fill their buckets and then carry them home on their heads. As we approached cange the streets were lined on both sides with vendors selling food. mostly beans and rice and these folded over things that looked like pasties. The vegetables they sell are small and sparse due to lack of water. The fruit primarily bananas and mangoes. We did not eat any of the vendor foods as we had been warned. Their is an air of market and people always trying to get you to buy something. the gates of the hospital are like the division from one world to another. Zamni lasante is like a Oasis in the middle of a desert. we asked if we could have someone tour us around. The administrator was immediately available and seemed delighted to see us. he introduced us to a Dr. McKinley, a Haitian who specialized in Infectious diseases. He took us first to pediatrics. We were amazed to see a fully functioning peds unit with a NICU. The hospital has running water, oxygen and can care for preterm infants. They had 4 babies in the NICU on O2 that were less than 30 weeks when born. They do not have ventilators but seem to be doing a great job. We went to the Medical ward where We met another wonderful Haitian Dr. who was fluent in English. He said most of the problems they cared for were infections, malaria, Typhoid, TB and HIV. The men and women are together in one ward but seem very well cared for. they also have a lot of patients that were evacuated there for care after the earthquake. They had so many that they had to use the church as additional hospital space.
I really want to give you the image of this area as it was so remarkable. Not only the hospital and staff but the grounds. The paths were all terrraced and planted with lush, verdant greenery and floweres. The space was cool and calming and therapeutic. The terraces wind up higher on the mountain to the Maternity section. We met the two midwives who run OB. They are responsible day and night for all the patients in Ob. including the prenatal clinic. They work 2 weeks straight and then get 3 days off. I feel like I have it pretty easy!!! They were University trained Nurse Midwifes very knowledgable and did a great job. We met The OB too and he was great...they do a lot of C/S with spinal anesthesia. About 20%. But they get all the referrals from patients in the village who have problems. We then went up higher on the mountain along these beautiful paths to where they have a full school K thru 12. Then we went to the Wilson Building. Where we met Jacki Wilson a South Carolinean lady, who moved to Haiti in 1984 with her husband. He was responsible for the water system which ahs made this area into a functioning hospital and beautiful area. She stayed and has has set up as chool for the arts. She is encouraging haitians to produce artwork and markets it for them. As there is no tourism art has been struggling. She has developed a program where bracelets will be sold in the US, to remember haiti and will support 1000 jobs for haitian artists. Michelle Obama has signed on to promote this. We also visited the church where the 82 year old Father LaFontaint still is active. He was responsible for giving Paul Farmer his foothold here. They have worked together and developed Partners in Health. The book "Mountains Beyond Mountains" describes Cange and is a delight to read. As you know Bill Clinton appointed Paul Farmer and Partners in health to lead the efforts for health care in Haiti. I was overwhelmed and excited...this is a vision for Haiti!

falling off the stool

Well I once again managed to cause some laughter. We were in L&D at night and we had one patient in active labor. She was cute as a button, it was her first baby. She had been in labor for 2 days but was finally complete. We were trying to encourage her to push but all she would do was "squeek" when she had a contraction....she was very funny and we all were trying to get her to hold her breath and push. I sat down on a stool and did not realize the top was not attached to the bottom. i went flying off the chair and walloped my head on a bar behind me. The graduate midwife "Sage femme" couldnt stop laughing. I made quite a hit with her and tho I could not speak any french she chuckled whenever she saw me. The students were more sympathetic and rubbed my head.....The patient delivered beautifully...and all was well

Teaching

Last night at the hospital...not one patient...it was very slow and hot. The staff brings out mats, and we sleep on the floor. It is funny to see all the lights out and not a soul in sight. We had had a very busy day rearranging the storage closet. We found mega boxes of supplies. Must have had 40 ambu bags and no oxygen. There were also a lot of sorely needed sheets and baby clothes. It took a long time but we have a better idea of what is not needed.

Today we also taught a class. We have 12 midwifery students, and we talked about large for dates and small for dates babies. Then had a great discussion about the Luna beads and sexuality...there seems to be a universal want to talk about sex. There were lots of giggles and questions from the students.

We went to Azile again and fed babies. I continue to be amazed at the number of babies there are. Row after row all in little cribs reaching out. I saw many of the children had neurological insults. I also saw a little girl with horrible burns on her thighs and bottom...must have sat in the fire. She had flies all over her but did not cry...just held my hand. The children are often from families that cannot keep due to lack of food so they are here temporarily. They plan to return to get them when they can. The children all have umbilical hernias. It appears to be very common here. One little boy about 5 pick pocketed me while I was feeding a baby...then he pulled my barrette out of my hair...he was all over me climbing on me. I never seem to get enough time to hold these children. The nuns that run this place are wonderful. The facility is also a shelter for HIV infected individuals.. This is the same order as mother Teresa.

Tomorrow we go to Cange, where Paul Farmers hospital is. I am dying to see it after reading the book. As we were leaving the orphanage, the nuns cornered us. They want us to return tomorrow to label medicine bottles...how can you say no to a nun?

We did mange to get out and walk and stop for a beer. Also the dogs here bark all night....

Mothers Day

Sunday began with a marvelous outside service under the mango tree! There is a visiting priest with us with 25 Penn State students. The service was in creole and english. The students sang through most of the service. The student Pierre Louis who is leaving for PAP today to get his visa gave the sermon. It was incredibly moving. We are so well received and cared for here.

There is a waterfall not far from here that everyone insisted we visit. So we rented Motor taxis. Motorcycles with 3 people on them(no helmets) and rode there. The waterfall was quite beautiful. When we got there, there were people trying to insist we tour with them and were quite insistent. Our guide and friend was quite good in dealing with them. In this poor land there is very little ways to make any money. We hiked up to the top of the waterfall where the bat caves are...i slipped a lot...I had sandals on and kept getting stuck in the mud. The little boys took my hand (for some Goudas later) and helped me ...I was stung by a wasp in the cave...good thing i'm not allergic. Then we swam (with our clothes on) in the waterfall....it was so nice to finally be cool.

The ride back was gorgeous as big dark clouds rolled in and the mountains and stark landscape became very defined. As we got close to Hinche it started to pour....huge buckets of water. When we got back to the orphanage the children were playing and laughing and dancing in the mud and rain. We then put on rain slickers and went into town to meet Reina the local midwife for a few beers. A new midwife had shown up without notice and we needed to introduce her...she had been in cite soleil...the worst slum in PAP and had incredible stories.

Azile

We went to the Azile today, an orphanage run by nuns. The facility also caters to homeless men and women. We brought bags of donations and formula. This is primarily a nursery for babies failing to thrive. Their moms cannot or are unable to feed them. The older children swarmed us as we came in. They hang all over you clamoring to be picked up and to be touched. The nuns are wonderful, kind and gently but overwhelmed as the needs increase. There were 3 rooms with cribs of babies, all right next to each other. It was the most heartbreaking scene. Many of the children were quiet, others were crying, many holding on to each other through the cribs. They had towels tied around them as diapers. They were on plastic mats. We are coming back later to help feed them...such beautiful children...so little resources. Not a toy in sight. I think of my own children and all that they have received. How unfair it seems that these children have so little I wish for them, love, food ,water and an education.....we must help

The Director of Nursing

Today we met the director of nursing, who is a University trained Nurse midwife. She is smart, poised, and committed to improving health care. The limits of what they have available makes it difficult to consistently give safe care. There are intermittent supplies of medications. I had a patient whose IV ran out and she needed pitocin. The family would have to go buy another bottle at a local pharmacy in the morning.

If you haven’t read "Half The Sky", consider it....the situations are very real here. The director gave us an extensive wish list of things that would be greatly appreciated including things like an oxygen concentrator, Oxygen masks and tubing, as well as suction. I had a birth where the baby was covered in thick meconium, and there was no suction or O2...I am definitely not a neonatolist or pediatrician. We did our best to clean up the baby and left her attached ....with stimulation she responded....we watched that baby carefully.

The children

Happy Birthday Haney!!!!

After being up all night we came home to sleep but the sounds of the compound and heat make it impossible. The children are so adorable it is almost too much to be able to take. They have nothing that belongs to them except a few clothes. No individual toys or books. They are so well behaved and courteous to us. Focus on learning English is intense. They live in communal homes of one "big boy" and 7-12 smaller boys. They all eat at the same place, usually rice and beans. Barb brought books that are in creole and English, and they were so excited. They helped us with the creole words. It is so dear to see 16 year old boys reading children’s books and being so proud. We walked through the village and the area is so poor. Nobody has anything. A store may have a few containers of flour, some rice, beans and oil. However we did manage to score some "prestige" beer, which was quite good.

Haiti continued

The days are full, very hot, i am bound to lose a lot of pounds in sweat. The orphanage is run by the Xavierian brothers. They support the preferential option for the poor (like Paul Farmer and Father Romero. what resources available should go first to the people who need them the most. Brother Harry is 82 and an incredible man. He has lived in Haiti for 20 years. He is now "retired" and is our host. Brother Mike is younger about 55 and very enthusiastic. They are sponsoring local students to be able to go to college in the states. One of the young men, Pierre Louis, has been staying with us; he has a remarkable story. Pierre Louis was in the earthquake and his building/college collapsed. He and the other students were able to get out but it was the end of schooling in port au prince.

Today we did nights at the local hospital with 3 students. To say it was different is an understatement. As I described there is no water or bathrooms. Family are responsible for bringing all linens and food in. The area is full of family members; they sleep with the patients on the floors in the hallways. The first night we ran into trouble with the staff who shooed us off to sleep and sent the patient on pitocin off to the antepartum unit with her pitocin running free flow. I couldn’t sleep and when I got up the entire staff, nurses, Sage Femmes, students and housekeeper had pulled mats out and gone to sleep. barb and I went out to the floor concerned about the patients we thought should still be in labor and delivery. The patient with free flow pitocin was having contractions every 1-2 minutes and her bottle had run in about 1 hour. The other patient was very active so we brought them both back to labor and delivery....woke everyone up and the patient on pitocin, we settled down and stopped her pit.(No fetal monitoring other than auscultation every 1-4 hours. The other girl was very agitated and BP elevated she ended up getting MgSo4 after a lengthy discussion with the senior midwives. Its a different world...patients labor on plastic sheets and it is very hot. The only water is what their family brings them.

My arrival in Haiti

Well....I have a lot to report. The flight from Miami to PAP went well...but the scene at the PAP airport was wild. So many people swarming all over us wanting to carry bags everyone asking for money...the driver Moliere rescued us and put us in his car with our huge assortment of bags including all of our 300lbs of medical supplies. The devastation from the earthquake is apparent everywhere, the tents are any where there is space. It is about 90 degrees and humid. we drove 5 hours from PAP to Hinche. The roads were sometimes good but mostly horrible. Incredible people, animals, mules, and motorcycles everywhere never saw a stoplight or a stop sign. The town of Hinche is moderate sized very poor, very little economy...but the people all trying to sell things everyone is out on the streets. Everywhere women are carrying big plastic containers on there heads full of water and things to sell. We are staying at an orphanage, about 200 children plus 60 refugees from PAP. The guest house we are at has electricity and running water some of the time. The water is cold but that is great as I am as hot as I have ever been. We have mosquito nets for our beds that work well...I kind of feel like a princess in it.... Our first night I got very little sleep, the dogs bark all night and the roosters start crowing at 3am. . At 5:30 in the morning the children were up reciting their lessons. I have never seen cuter children...they swarm all over us and sing to us wanting us to take their pictures so they can see themselves. We got picked up at 8am in a "TapTap" truck. we went to the hospital. i truly am in cultural shock. The hospital has no running water, no bathrooms. People get a bucket in labor and their family is responsible for any dirty clothes and for their wastes. Everyone sleeps on the floors and there are few sheets...already we are a hit with the medical supplies, drugs, suture equipment and sheets and towels. I saw 3 births today...the midwifery students are smart and wonderful...I am so saddened I do not speak any french or creole. Barb and Tricia were able to communicate but i am not. We do have a translator that helps but it is burdensome. The Induction of labor today had free flow Pitocin and no monitoring at all. The next 17 y/o had pre eclampsia and was given cytotec and no monitoring. Every patient has lost at least one baby. One woman has been here for 4 weeks and had a cesarean. she has a wound infection that is oozing constantly and her lungs sound like crap. Only one Obstetrician...no communication, and no system. we walked home and the streets are full of people, no one has anything but everyone is as friendly as can be. Tomorrow we teach a class on birth positions and home birth. Then Barb and I will do a stint in the hospital overnight. Wish us well. This place is of the greatest need, that I have ever seen.

my arrival in Haiti

Caribbean night/birthday send off

Leaving for Haiti today! last night my kids had a birthday/ farewell party.....Theme was caribbean food..included black bean dip , mango guacomole,fried plantains with crab dip, jerk chicken, curried shrimp skewers, fruit salad, red beans and rice and great coconut cake. Of course lots of wine and you guessed it "Mohitos"
I must say I am a little nervous, but mostly about how to get all the bags I am bringing where they need to go. A huge thank you to all of my friends and family who have supplied me so abundantly....I only hope that I can help...that in some little way what we are doing can make a difference to someone. Great parable in "Half the sky"
A little boy on a beach saw thousands of stranded starfish, he slowly, carefully threw them back into the sea. His grandfather said....how can you possibly make a difference...you can never save all of these starfish...to which the little boy picked up a starfish and said But It will make a difference for this one.....Wish us well

Preparing for Haiti

Hello, my name is Pat, and I am a midwife. I have the incredible opportunity to go to Haiti to teach. I will be working with Haitian women to teach them how to deliver babies safely as part of Midwives for Haiti. Haiti has the highest infant and maternal mortality in the western hemisphere. Because of the generous contributions from friends and family, I am able to bring desperately needed supplies and medications. I will be leaving Sunday May 2nd and will be there for two weeks. I have been so fortunate in my life and welcome this opportunity to provide help at such a critical time for Haiti. Because electricity is limited to one hour a day there, I will try to post entries as frequently as possible. So stay tuned because my countdown for Haiti has officially begun.