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.