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.