Monthly Archives: March 2012

Haiti March 10, 2012

This was my last morning in Haiti and I was pleasantly surprised that a few of the clinicians and Haitian staff came to visit and give me a sweet send off. I was sad to leave, but knew in my heart I’d return. We made plans for them to carry on mobile medical clinics in my absence and I would help support their efforts with fundraising and getting the NGO, Global Mustard Seed missions up and running. They would continue to arrange mobile medical clinics in the urban and rural areas and as I can work out connections help provide them with medications, materials and volunteers to assist when feasible. I left them with medical books they could use for future clinics which they were so grateful to receive. We walked to a pharmacy that morning to try and get them some meds to carry on. After seeing the prices I reached out o Leslie from the Hope Alive clinic and had some unexpected Blessings that morning as she agreed to provide some medication. The clinicians planned to do the first clinic after I left on March 14, 2012. I was in touch with Pastor Luc who has the 43 churches in the provinces so it was so exciting to be able to make this connection. There is no way this was anything other than the hand of God putting me in all of these places, making all of these connections and keeping me safe through it all. It was such a wonderful gift to have them continue on as I envisioned hope for sustainable efforts but never imagined it would come to fruition so soon. Dreams do come true with hard work and perseverance and of course faith and above all else keeping Christ central as He is still in control. There are many lessons learned on this trip in Haiti, but I think that summarizes the most important ones. The Americares rep, Brian who I’d been working with agreed to follow-up on getting the meds out of customs and he’d already sent someone there to handle it. They would then connect with the clinicians there to provide them the meds so they could continue to render care. I think of the importance of having faith when we cannot see the outcome and it seems hard to envision anything good coming out of trials. But now I see, all along, God had His plans for those medications to be delivered on His time and where He wanted them to be. I am only a vessel here to help as are we all and have to learn to give things to Him and trust in His sovereignty. These plans for the clinics to carry on were so meaningful and such a fabulous way to end my trip in Haiti. Until I can return, I will continue to work hard to fundraise and do what I can to make, what my dad says, my splash a big drop in the ocean. I had been Blessed with so many people to help with the process like the rep from Unitransfer who agreed to continue food deliveries from the warehouse in Haiti. I’m so thankful that things worked out as they did and the dreams I have of mobile clinics are becoming a reality. I ended the trip with picking up some souvenirs the guys helped me negotiate on around the streets of the Walls guesthouse. Bertrand came and picked me up and we headed to the airport. This trip I left with a sense of accomplishment, knowing there is much more work to be done. Check in at the Port au Prince airport went smoothly. Feeling like we all served as Christ’s hands and feet made the load a little lighter and the weight less heavy for the patient’s we touched and who touched our hearts. And that in itself is a reward beyond measure. The strength gleaned from working with such resilient people makes me feel even stronger.

Haiti March 9, 2012

I slept in til around 7ish and woke up to one of my fav meals with pancakes and fresh fruit. I caught up with one of the Texans before they headed out to the north about 7 hours away. Haiti is such a big place in ways and there are so many placed to serve. I then called United airlines and explained that I was supposed to leave that afternoon, but wanted to change til the next day. I was so thankful and pleasantly surprised when they changed my ticket for no fee. What a Blessing that was and I was looking forward to a stress free last day in Haiti. My friend Renulus came to meet me and we headed to the store for some drinks and then set out on a moto (motorcycle) to check out the Mother Theresa Home for Sick and Dying children at Delmas 31. I guess there is another large orphanage in same neighborhood so we were brought there first unknowingly and ended up touring the place as there was not a name on it. The woman who worked there showed us around and it was a nice well kept, but crowded orphanage and I found it that it was actually an adoption center. It was so sad to see so many children needing homes, one as young as 14 days old whose mom died when he was 3 days old. I got the women’s card for the place as I planned to keep in touch with them. I believe divine providence led me to the place. We eventually arrived at the Mother Theresa home and the Sisters there taught us about the place and how they try and refer to children with other co-morbid conditions to hospitals when there is availabilty. They took in very malnourished children off of the streets regularly and even had a community feeding program. We toured the place and saw the heartbreaking cases of the worst hunger and malnourishment and all the physical components that manifest like edema, altered skin texture, big bellies, changes in skin texture and hair color and of course an emaciated thin appearance. I learned to recognize subtle signs of malnourishment during this trip as I never had before from just textbooks as I saw more of it this time around than I ever had. Some children were so bad they had to be started on just fluids and carefully titrated up to foods or they could die. They had different levels with the sickest children at the bottom who could not tolerate food and we did not get to see them. It was heart wrenching to walk through this place and see so many ill and hungry babies. It was encouraging to see their feeding program and volunteers feeding the babies, some who were on IV fluids, even with IVs in their necks. I had wanted to use some of the funds from the T shirt campaign to do a food delivery and was considering this place and the orphanage/ adoption center as recipients. The staff gave me contacts for places to order bulk food from in Haiti. They invited me to a dispensary called St. Josephs the next day where patients would be seen for healthcare services and medications. This is somewhere I’d like to volunteer at on.

After our visits we decided to go out to dinner and went to this nice authentic Haitian restaurant which was crowded and popular. I liked the dim red and green lights and enjoyed the food, my usual beans 7 rice with plantains for dinner and fruity smoothies with papaya we ordered. The Haitian music was a plus and there was even an attached dance room. We headed back to the guesthouse on a moto and spent the evening hanging out there and on the rooftop.

Haiti March 8, 2012

I started the day early in customs at the airport in another attempt to get meds up in the directors office. The morning grew long after spending hours going back and forth between people and offices which was so frustrating. I even had all of the paperwork I needed from the ministry of health and everything, I still couldn’t get through with nothing but delays to get meds out of customs. There was a line of patient’s waiting at the church for a mobile clinic, this time with the other clinicians there prepared to see them, but I was hoping to get the meds to bring to use in the clinic. Instead I spent hours, with several people, including even a police officer who was a cousin of my friend Bertrand, all trying to help me persuade people to release the meds. They let me obtain the bags to go through them and it was even more disappointing to see that a bag had been damaged and opened with items missing. We had to verify the list of meds with what was in the bags, but they still would not release them. We stayed all day until about 3pm when they insisted on wanting money or that I would have to come back the next day. I decided at that point I was done with the process and would not return and instead let Americares reps, the company that donated the meds deal with the rest of the process to retrieve the medications. It was a lesson learned and in the future I’d focus on getting medications in country rather than trying to bring them in to go through customs. Fortunately the clinicians waiting at the church went ahead and saw all of the patients which was such a relief and reminded me that God works things out on His time. Around 3 pm we were warned that there was a lot of commotion going on and we needed to get to a safe place as loud sirens could be heard and traffic came to gridlocked standstills. Businesses, including airport staff and schools were shutting down now and everyone was rushing to get home. It was all political issues and reminded me of the time I was working in a clinic in 2011 and when BabyDoc arrived in town we had to shut down the clinic and rush back to the guesthouse to avoid trouble. I convinced some of the others to go out to eat since it was the end of my trip and we went to a nice lounge called Eclipse at Delmas 31. There was a broadcast of the political state and it had to do with the President Martinelli not relinquishing his passport to prove his Haitian citizenship reportedly. They were accusing him of being American and wanting him out of the country, at least that was the rumor. After we were watching the news he eventually surrendered his passport to prove he is Haitian . Then it was all good and people were celebrating. He was also a popstar and had songs and they began playing his songs in the lounge we were in and many folks were celebrating. We enjoyed food and drinks and spent some hours chatting. The ambience was really relaxing with the dim lights. I had my usual tasty dish, beans, rice, plantains and picklies but somehow it tasted different and good everytime. The plan was to spend the afternoon at the beach, but we had to change that since the upheaval occurred. I was supposed to be leaving the next day to return to the states, but didn’t want to go so was going to call the airlines. That night I met some missionaries from Texas at the guesthouse hosted by Haitians who had an NGO and we had a nice long chat reflecting on purposes of mission trips and the need to respond with actions to what is witnessed. We exchanged contact info to keep in touch.

Haiti March 7, 2012

I got up early and Bernard took me to the airport in another attempt to pick up the medications out of customs. We arrived around 730 and after going through the process of talking to multiple people still had no success. Patience is very necessary and something that doesn’t come easy. I had several clinicians waiting on me at the clinic and people waiting for medical care at Pastor Lucs church as we had planned on doing a mobile clinic there that day. After stopping at a clinic, We finally made it to the guest house and picked up the clinicians then headed to the church. We made do with meds I stopped by a pharmacy to get after going to an ATM in a bank. I saw a huge line of people when stopping by the bank and learned it was people seeking work. Humbling and a reminder of my good fortune. Haitians are hard working people and it’d be a hard country to live in unemployed I imagine. At the church, the members were so attentive to helping us set up the clinic. The people were waiting patiently, a lesson I needed to adopt and practice more. With 3 clinicians and myself we worked through the patients. I learned lessons about organization to have triage, vital signs taken and ideally someone to manage the pharmacy to keep everything in order and flowing, will take it all into future preparations in developing solid mobile clinics. I can look back on this trip and see how the variety if experiences have been instrumental in preparing me for the mobile clinics that I’m managing with God’s guidance. Having these things arranged at other clinics in advance made things work out more efficiently so lessons learned for the future. This basis enables providers to focus on spending time with and moving through the high patient volumes. Though it started off rough, with teamwork, we all pulled together and all the patietn’s were seen. We walked back to the guesthouse and the others enjoyed soda and Prestige Haitian beer while waiting for me to change. Bertrand came with his tap tap and we all headed out to go to dinner. We ended up at a really nice restaurant called LaMaison, it was delicious. Everyone ordered tasty Haitian food, I enjoyed my usual beans, rice with a sauce, salad, plantains and picklies. They shared stories with me about life in Haiti, some really sad and it was good to get more acquainted. One of the clinicians lost his mom and siblings in the quake and you never would have known it with the quiet strength he carried on with and he was always willing to help out. The painful stories people endure are palpable and hard to fathom. It helps put things in perspective about what matters in life. It amazes me how those who have been through some of the worst trials have the most calming and comforting spirits. The determination and resilience Haitians carry, maybe is in part what gives so many people a desire to come serve here as Haiti is a very special place. Somehow exposure to the culture strengthens and Blesses us beyond measure. I cant contemplate how I would carry on in the face of a magnitude of similar obstacles. In the end of it all as my trip nears its final days, it only deepens my desire to come back and serve more. It makes me want to dedicate part of my life from now until I can no longer serve in Haiti to help make a difference. Perhaps, in part I’ve found my calling, medical mission trips abroad, it’s what makes me thrive. I especially love the idea of mobile clinics and meeting people where they are at. I was touched more in this day, which was no doubt one of the hardest, but most emotionally moving and somehow uplifting days I’d had in Haiti. I had a renewed energy to carry on even after the challenges of not getting the meds out of customs and other issues. After dinner we stopped by a couple of different pharmacies to get more meds on the way back to the guesthouse to no avail. Things were really expensive to buy in bulk at the place that was open, and Delmas 2000 the main market I wanted to go to was closed. Most shops close early in PAP, especially on the weekends in the early afternoon by ~2pm most stores are closed.

Latter that night after I was back at the guest house hanging out I was reading through and singing from a worship song book and gave an extra copy I had to one of the stoic guards. Not long after I saw him walking around and singing out of book as well, many songs were in Creole and English. He later came to join me and even though we spoke different languages he sang in Creole and I sang in English, both praising the same God. It was these serendipitous, spiritual moments that left a lasting impression in my heart for Haiti and the people and what an awesome God we serve. He helped me with the Creole verses and I helped him with the English and we sang songs until late in the night. The spiritual unity of believers is a powerful thing and transcends races, languages and all other divisions. Its what reminds me of Christ’s omniscience and a gentle affirmation that he’s always there. That night was a reminder that I’m where He wants me at this point in time. Those moments spent singing had me thinking we never know how we can impact someone’s life.

Haiti March 6, 2012

We got off to an early start I actually made it to the dining room dressed in scrubs at 6:30AM, motivated to start the day. People normally start days really early in Haiti, I have a hard time adjusting to the hours. We had breakfast with fresh fruit, toast and coffee. A morning devotion was the perfect way we started the day with a prayer focusing on letting Jesus serve us through others. We then loaded up in 3 tap taps and headed out to clinic in Croix Des Bouquet about an hour away from Port au Prince driving through dusty and bumpy roads. There’s never a dull moment on the streets of PAP. Lots of stimulation with the sites, sounds, people, activity, animals and whatever random things pop up whether it’s the UN big armed trucks, misc accidents from lack of traffic regulation, buses turned over on the side of the road and vendors running up to cars hustling everything from fresh fruit to shampoo and medications, it’s always a thrill. After awhile , we arrived to a hidden gem, a pleasant surprise next to the grounds of a seminary, a clinic run by Haiti Medical Missions of Memphis. I had previously read about this organization and was interested in working with them before so was very excited to make this connection. It was a very large Catholic based clinic with many services and speciality care called the Clinque Saint E’Sprit (Holy Spirit Clinic). There were even prosthetics, occupational & physical therapy, a large kitchen, guest house a gym and very nice clean facilities with private patient rooms. Volunteers were welcome. I noticed Sisters were present as well. I somehow ended up in the pediatrician/ midwife section so by default was mostly seeing children with ailments through the day, occasionally I’d treat women with genitourinary problems and children has mostly GI and derm issues. It was sad to see such advanced manifestations of simple ear infections that went untreated. We were served a tasty meal for lunch, chicken for those who like it, a bean sauce w rice & beans and fruit. It was comical that we were told to wash our own plates after eating considering there was a tiny kitchen with a sink and like 3 tables of us. This was a custom we’d never heard of, fortunately some folks did it for us so we could keep seeing patients. I bought some souvenirs before leaving (flags, paintings and a necklace) from a man on the translator team and bargained for a good deal. We took group pictures before leaving for the day. We were stuck with a flat tire and after it was changed, stopped by a store called DeliMart in PAP to stock up on goodies like Rebo coffee and other treats.

We spent the evening at the guest house hanging out. I fell asleep early after being tired from a long day and was awakened around 9pm with my bed shaking from an earthquake. I quickly sat up and was on the verge of going right back to sleep til I though about being in Haiti- I ran out of the tent so quick I was the first one out of the guesthouse. Recalling that people had perished in the same guesthouse just two yeats prior from the quake and knowing that I was sleeping under slabs of concrete was unsettling. I was shocked to see people straggling out 10 minutes latter carrying personal belongings. I could see how priorities misplaced could lead to such tragedies in catastrophic events. Poor Haitians I could see standing on the roofs of their houses, who could blame them considering the history. It was a restless night, I went back in but came running out when I’d hear loud sounds fearing aftershocks. I later learned it was around a 4.6 earthquake , but thinking on the damage done from the large one of around 7.0 in 2010 with ~200,000 people perished that was not comforting. I heard there wasn’t damage from this nights quake though.

Haiti March 5, 2012

I spent the morning in the usual routine getting up to breakfast and coffee at the guesthouse. I headed out with the large group I met from Duke University about 7:45 am to a large church Lharmonie (Cite Soleil) to do a mobile clinic. I was really looking forward to serving in this capacity knowing it was a chance to reach patients who likely did not get regular access to care. We set up at tables in the front of the inside of the very large church with one or two providers at each of the tables. There was a separate pharmacy set up that was managed by some of the Haitian staff and a pharmacist named Jonas from Duke. A room next to the pharmacy was available for patients who needed treatment or confidential exams. There was also a separate eye station where they did eye screening with charts and distributed eye glasses. I heard glasses were greatly appreciated and sought after as they were often needed and maybe even considered a status symbol or sign of wealth. A spinal surgeon available focused on seeing musculoskeletal cases. The interpreter who helped me was James. We saw patients of all ages, the youngest who was about 14 days old and had an impressive case of tinea capitis to the oldest who was 91 and impressively healthy not even using an assistive device to walk, her biggest problem was untreated blood pressure and somebody pain. When asked what her secret was to living her in her life her response was “God’s Grace.” She advises younger people that God helps. It was encouraging to hear that and continue to see His presence in the people of Haiti. The spectrum of conditions, some diseases very pronounced compared to mild un-worrisome cases was interesting, especially considering we were working in one of the notorious slums, Cite Soleil, that many won’t enter for safety concerns. Many of the conditions were exacerbated by anxiety, a recurrent theme. When asking around about the opportunities for counseling and resources in the area, I was happy to learn Pastor Luke (Pastor of this Lharmonie church) offers a weekly stress management workshop in the church so I encouraged patients to attend and asked him to make an announcement to remind people to come. I was thinking I would like to talk to more Pastors about implementing a similar initiative so people have some tools to deal with their stress. It was a start to learn about his program and it could be modeled after as there were not any community programs I knew of to refer people to for stress which was a major problem as mental health needs are important to manage. This is a major concern in Haiti considering all of the trauma people have endured. Word of mouth seems to be a very effective way to spread news in Haiti in a timely matter in it’d be great to be able to have programs to tell people they could go to for help. Word of mouth could increase activity in such programs.
Midway between patients and right on time cause I worked up an appetite, we were served a tasty hot meal with beans & rice, a meat n veggie mix that I shared and mmm it was good, stuff like this with harm hospitality makes me love working in Haiti. After the clinic was over, the lead translator, Eddy helped me get transportation to the ministry of health where one of the clinicians was helping me get approval for the meds brought from America to get them through customs. After a long and kinda intimidating motorcycle ride through Cite Soleil, Belair and other historically unsafe parts of town we made it through downtown to the Ministry of Health. I was wearing scrubs so felt like a stood out, but I imagine most people assumed I lived there as the average visitor wouldn’t be on a bike ridin through hoods. On the way back we went to one of my favorite eateries Epidor and got a light dinner and they have an inside ATM which I prefer so I could get cash. We arrived back to the guesthouse walls and I spent the evening socializing with others. I met a woman there selling creatively designed handbags made from recycled products such as plastics from Haiti. It was really nice to network with people from other organizations at the guesthouse.
The highlight and favorite part of evening was singing worship songs together as a big group. The leader, April Perry, NP, led an activity and we went around and said encouraging things to uplift each of the Haitian staff which I thought was cool. It was a Blessing to work with them as they were each helpful.

Haiti March 4, 2012

It was nice to have an air conditioned room to sleep in. I rested pretty well and got up early for church. A couple of my Haitian male friends, Jean and John came and meet me early to take me to Quisqueya for church in PAP. It was a pleasant start to a pretty sunny day to have fresh strong Rebo coffee with sugar, cream and clean water. We headed out for a short walk, got a ride to the bus stop from Bernard, one of the guys who works at the guest house. We then got on a large public bus which was my first experience on a bus in Haiti, it was spacious and much more comfortable then the congested taptaps. After about a 20 minute ride we arrived at the church. The place was all familiar as I attended services there on my last trip in Haiti and it was good to be back. The sermon was timely for me, Pastor John spoke on world missions with data showing increases in believers of the Christian faith worldwide with reference to places that had been visited by missionaries . He then said how missions are not enough as actions are needed. The Biblical themes of “seeing” and then responding were mentioned, such as when Jesus saw Lazarus and “Jesus wept.” The disciples saw the multitude when they were hungry and wanted to send them away to get food. Jesus saw them and instead acted by multiplying fish and bread from just a small number to 1000’s in order to feed the multitude. The message was about seeing as Jesus did and responding by taking actions. I reflected on my trip, the many ill patients I’ve seen and how I can respond in the future by maybe mobilizing others to help. The needs feel overwhelming at times, but I try to keep in mind that for the patients I see and am able to help it makes a difference in their lives. The service was concluded with the song that has the chorus shining in the light of your glory, Open the Eyes of My Heart Lord. It was such an uplifting service and just what I needed to boost my energy for a start to the week doing mobile clinics. I left feeling totally rejuvenated! I met with Pastor John after the service, it felt good that he recognized me from my previous trip and inquired on my whereabouts. We talked about my interest in mobile clinics and he gave me his card to contact him. I learned about the importance of making these connections in Haiti. After church we walked to my favorite bakery called Epidore which has delicious food and is one of the best eateries in Haiti. They even expanded since my prior visit and had such a large array of selections, they are known for their crepes which are so good. I ended up ordering rice and beans with picklies and veggies and a side of mac n cheese that I gave to my friend Jean after I saw the meat inside.

After, we left and got back on the bus for another adventure on the public transportation system and we made it back to the guest house. I decided to walk to the Creole church to visit with Pastor Luc to detail plans some other mobile clinics. He welcomed me and we talked to plan arrangements for the mobile clinics at his urban and centrally located large church in PAP and if time permits on this trip possibly one of his remote locations. He is the Pastor over 43 churches in the mountainous rural areas as has done mobile clinics before. Medical care and access to services is lacking or unavailable in many of these places. It sounds like a great opportunity to connect and plan for future mobile clinics, beyond this trip. I look forward to building on these friendships and possibly developing outreach initiatives.

The rest of the afternoon was spent relaxing in the sun, much of it on the rooftop of guesthouse. One of my favorite meals was served for dinner, this time a different flavored beans, rice, plantains and picklies with salad and other sides. I spend the night sleeping in the private tent which I really enjoyed and this time there was an even larger twin bed in the tent which was very comfortable.

Haiti March 3, 2012

I went to the kitchen early to try and make coffee I developed a new appreciation for the hard work the Haitian staff endure cooking with no coffee maker. I learned to make it from scratch with a makeshift filter and boiling water. It seemed like such a huge task when trying to do it for a large group of people. After a short day in the clinic seeing patient’s we saw fewer than before and ended early. I had planned on returning to PAP on Friday to arrange mobile clinics with Haitian staff. Since I had another delay in getting meds out of customs and want to use them for mobile clinics I decided to wait until Monday. Pastor Luc who I had met before came to the guest house to meet with me in PAP on Friday, as we were supposed to connect to plan for the mobile clinics. I did not realize he would just come early and I was sorry I missed him so we had to plan for another time. I learned how important it is to build relationships over time in Haiti. He wanted to sit down to meet to get acquinted before carrying on the business of mobile clinic planning. It was a lesson for me on putting people first over time even if it meant, as it often did, taking more time to get things accomplished. I learned to value this approach of building relationships first as it feels like it is something we lack in American culture.

I wanted to use the time after the clinic to go explore the neighborhood and a group of translators were going to head out with us. The clinic owners didn’t want us to go out so we stayed in instead. I was hungry and the Haitian cooks made me a snack with fried potatoes which were so good.

I called for my ride, a taptap from a driver named Bertrand and he came to get me. We drove through Carrefour and other cities on the was on the way back to Port au Prince where the Walls guest house was that I wanted to stay at that night. I wanted to get back to PAP for church in the morning at an English speaking service at a church called Quisqueya or Port au Prince Fellowship that I enjoyed before. I also wanted to make plans for the mobile clinic.

En’route to the guest house he took me to a market where I bought foods and some gifts for an old friend of mine. I was able to connect w him and drop off the gifts in PAP.

After arriving at the Walls Guest house I quickly met a large new group. Many of the translators/ staff recognized with the group recognized me and came to greet me with smiles. It was a nice welcome and pleasant surprise. I learned they were working with a large group from North Carolina – Duke University lead by a nurse practitioner to do mobile clinics which was really exciting. I enjoyed listening to the group sing Christian songs with a devotional led by Frantz, one of the translators. He spoke from topics taken from Matthew 25:14-18, and he gave a sermon and said prayers. I felt God’s presence in the midst of all of it and it was so moving and reassuring. It seemed this is exactly where He wanted me to be and I had no idea why I was wanting to come back to the Walls Guest house, just felt compelled to come back. I met with the group leader, learned about their plight for the mobile clinics which was consistent with what I was seeking to start so I was happy to make this serendipitous connection. They invited me to work with them and go to church the next day. The Lord knows how hard this trip has been and it was such a Blessing to cross paths and have this encounter, all by His design in my view. I even was given my own room by the hotel manager Veniel which was nice with AC. They’d move me into my own private tent the next night which was perfect. After chatting with several of the people and taking time out for prayer and reflections I returned to the dining area. The group was singing worship songs out of a book with a guitar, one of my favorites caught my attention, “You’re all I want.” Felt like confirmation for me that this is where I was supposed to be at this moment.

Haiti March 2, 2012

We got up early to breakfast and Rebo coffee and started the clinic as usual. The patient flow was a little lighter. We finished up earlier so we could head out to the beach, myself some of the volunteers and Haitian staff loaded up in two trucks and headed to the beach. These were the south beaches we went to, I heard the beaches in the north that I had visited on a previous trip were nicer. This beach we stopped at had music (much American R&B and hip hop). There was a really nice hotel which had food available for purchase, although from the menu it was all seafood and meat. The view of the ocean and the variable blue colors was pretty, but there was no sand, just small rocks. I walked around a bit and dipped my toes in the warm ocean. I didn’t get in like before at Kaliko beach in the north where I went snorkeling. Most of the team played soccer. I sat by the ocean and chatted with local Haitians while enjoying the captivating scenery with the ocean surrounded by gorgeous trees and mountains in the background. A scene that was so inviting and calming, I could have stayed for many hours just relaxing. I especially loved the hot sunshine, one of my favorite parts of the island. When all was quiet there was a school of yellow/black fish that swam that swam up by the shore by which was a pleasant surprise. There were a lot of small crabs that crawled up on the stairs I was sitting on. I was wishing I had a swimsuit but didn’t bring that gear. After we drove around by some of the road vendors to see if I could find a swimsuit I wanted, but none really appealed. We headed back to the guest house for dinner which was scrumptious again with a veggie combo for me – everyone else had meat- and served with rice. I wanted to spend more time after the clinic hours to check out different parts of town. Later that night it was sad to see hungry and frail cows grazing in the open yard next door, I tried to feed them a little without success. The very large house on the other side of that was damaged in the earthquake and I was told two children perished in it, felt odd to see people just in the bottom of it at night with the top seemingly abandoned. As I was going to bed later that night I came across huge spider in the dark in looked like a tarantula which sent me running and screaming through the guest house only to see big roaches scattering on the ground in the room I was sleeping in. That was unsettling and the staff helped me out. Felt like I needed to stay alert all night long and when the electricity was working for at least part of the night I slept with the light on. Funny the night prior I was awakened with the new kitten running across my bed with a big roach on the divider/ screen not far away. Seemed I was in for another restless night as there were some things I just couldn’t get used to, though I imagine if I encountered enough I’d learn to cope, well with all except the big spiders. I eventually fell asleep that night and woke up the the next day to a new start.

Haiti March 1, 2012

After a good night sleep, I got up around 7, slept much better having quiet quarters. After breakfast and devotions we headed upstairs to see patients. The room I slept in was converted to an exam room. We saw ill patients, but seemingly conditions were much less advanced then other cases I’d seen. There were many gastrointestinal, genitourinary and various dermatologic issues mixed in with a lot of chronic problems like HTN. Diseases seemed to not be as progressed as they were in say the tented camp or Cite Soleil or other mobile sites. Not having labs, as usual in these environments, treatment is empirical based on presentation. Patients’ often wont follow-up if sent away and asked to return. I’ve found it’s best to just treat what you an while they are available. Mid-day we had lunch made by the Haitian staff who were incredibly good cooks. They worked so hard preparing tasty Haitian meals. Lunch was one of my favorites with Haitian plantains with picklies, I seasoned with hotsauce. After eating we returned to patient care. The most memorable patient I had that day was a malnourished, underweight 4 month old whose mom couldn’t breast feed. It was a welcome change to be able to connect them with community resources like Hope Alive’s mom tot program compared to other cases where I have scarce options. It was nice to send her away with formula and having the baby’s energy increase after feeding him formula even if he did pee on my scrubs. Basic items can go such a long way in patient care in Haiti. Trying to include a little public health education about these not to feed for formula, food and many other topics is always helpful. Training patients to be community health workers and teach their relatives or friends lessons learned helps spread the knowledge and ideally change patterns that cause negative health outcomes. Common issues are cheap ways to treat water, consuming natural products in environment to promote health preventing common issues like anemia, avoiding mud pies that are often eaten and cause worms, managing reflux, high blood pressure and a number of infectious diseases. I’d like to bring more Creole handouts to share in the future with pictures for those who don’t read to help illustrate concepts. The day was filled with a lot of teaching around these topics. We concluded the dinner with a delicious mix of vegetarian food (for me, others had a meat dish) combo of flavorful vegetables and rice and hot sauce. After dinner a group of us walked down the street and hung out with some of the locals for awhile as they played soccer, one of the docs gave them a new soccer ball that they loved. It was impressive to see many of them playing without shoes but sad to think of how basic things like shoes are even hard to come by. We spent the evening hanging out on the guest house roof, joined by a stray cute little kitten that found its new home.