Trip summary Haiti May-June 2013 (departed 5-23-13 returned 6-3-13) 2013 Photos

Rather than a detailed account of a recent adventure in Haiti, this is just a brief recollection.  The trip helped bring the Haitian team together, run mobile clinics, and stimulate discussion on future mobile clinic plans.  It was helpful to learn about visions from the Haitian team members.  Upon my arrival, there was a flood in the area of the house I’d be staying in Tabarre in Port au Prince (PAP).  It created some challenges with electricity being out and required some creative approaches: different size boards laid out to walk over the muddy water to get in the house and candles used to light the house at night. The house was big and warm, and I really liked the lime, coconut, and avocado trees  in the back yard.  A friend made sure I got settled.  I awakened in the tropical climate with the sun shining, a good start to the day.  With getting in later than planned the day before and luggage getting delayed it put a change in the plans which were to go to Jacmel with the group the day I got in town. Instead, we headed to the airport Saturday to hire a driver with a truck or van in lieu of renting, which seemed like a safer option. We made plans to meet up with the Haitian doctors along the way picking them up in different parts of town as we were heading to the countryside town of Jacmel, about 3 – 4 hour driving from PAP for a retreat at the beach.  Our driver was a nice pastor, and we had a really clean large van with plenty of room for all of us and our bags.   I decided to treat everyone with us to a weekend getaway out of my own personal expenses.  It was a token of appreciation for the work being done through mobile clinics, plus a way to have fun and take time for rest. Recognizing the importance of team building, rewarding service, and motivating the team to plan for more clinics, this weekend was also chance to reach for these goals.  The doctors shared hopes they had and even wanted to take me to meet someone in the political arena, I think a senator in Jacmel which sounded like a good way to build connections and get us established.   I hope we can these collaborations in the future on the next trip, as we were only in Jacmel for the weekend so time was limited.   The town seemed peaceful, had much more of a laid back, less crowded and chill feeling than the busy city did.  We enjoyed relaxing at the beac,h and they played soccer, a favorite sport in Haiti.  We stayed in a charming hotel, the Hotel Florita, not far from the beach, with many rooms, so everyone had plenty of space.  I liked the Haitian food from a restaurant or food stand in town we had when we arrived.  The hotel staff prepared a spread with meat and rice for dinner for the group.   Everyone eats together, the sense of family and sharing we lose touch with back home. I was surprised to find the group patiently waiting for me to arrive downstairs before we all ate.  A couple of the doctors found some club to go out to;  good they got to take time out to play as they work hard.

We headed back to PAP Sunday night.  We had time that week for planning mobile clinics.  We went to Valiere Pharmacy to stock up on medications for mobile clinics.  It is a really challenging task to obtain an array of medications and get enough stock a mobile clinic.  It’s hard not knowing the amount of patients who’ll present with various common ailments, even with lists of medications available from different resources and having experience buying medications for the mobile clinics it’s tough.  I brought a variety of over the counter medicines with me in the country put together back in Oregon in medication packing parties and also sorted and packaged by high school girls through the school I attended St. Mary’s Academy.  Still, anticipating the appropriate medications to potentially cover an assortment of chronic and acute diseases, have an adequate amount of medications of each kind of drug, other supplies like syringes, first aid, diabetic supplies and wound care materials presents quite a huge at times tough task.  This coupled with the art of negotiating with the local pharmacies in Haiti to get the best deals requires a lot of patience and persistence.  I was able to bring some supplies for the doctors such as thermometers,  gadgets to check oxygen levels and heart rates examine eyes & ears but this to can be challenging to manage in terms of trying to get the best deals and pack objects appropriately for international travel. My goal is to get each doctor their own portable diagnostic kit kind of a motivator kit for doing clinics.  My Dad has given me guidance with ideas for items to include since he has an organization pending nonprofit status that focuses on training locals on the repair of biomedical equipment in developing countries.  Long-term goals would include at least one or more portable EKG machine to be shared in the kits.  I plan to put together kits with basic diagnostic equipment, like oximeters, thermometers, blood pressure cuffs, low cost otoscopes / ophthalmoscope devices and some supplies for some common simple diagnostic tests in the clinics like urinalysis strips and pregnancy tests.  The vision is for each of them to have their own tool kit in a bag for use ideally solely for the clinics so they don’t have to use their own equipment.   Possibly someday we will expand and get a stationary clinic, my dream is one on wheel like a big mobile clinic van.   I’ve explored stationary clinics pricing them a bit as it could serve as a base for mobile clinics.  Having this base with a small lab for diagnostic techniques would be good, but keeping tests practical and cost effective is the objective with mobile clinics.

Back in town, I had a chance to walk around and explore the neighborhood I was staying in Tabarre which is walking distance from the United States embassy in PAP.  I felt nostalgic in this area as it was not far from the first site, Bojeux parc, a field hospital with outpatient clinic care that I served at in Haiti in 2010.  It was an amusement Park turned into a clinic in response to the traumas of the earthquake in 2010.  I did clinics at this placed in Haiti when I volunteered with another organization at that time.  I learned that the clinic shut down which was, I can imagine, was difficult for the patient’s who benefited from the healthcare services rendered and maybe even depended on the care.  I used to walk to the market Belmart that was a well stocked convenient store by the clinic so I had a chance to do that again.  I met the translators that helped to inspire me to run the mobile clinics while I was serving at that site.  Most all of them went on to complete Haiti’s first paramedic training program and are working as medics, a much needed skill in high demand in Haiti.  One of the translators, Windy, particularly inspired me with his ambition.  He helped me go to an orphanage that we later held a mobile clinic at and provided care for deserving children. Windy, in spite of any obstacle he faced, trained in the medic program, helped get a school / clinic started in Cite Soleil notoriously known as endangered slums.   Sadly for those that knew him, Windy succumbed to an illness, lacked sufficient access to medical care and left this life at age 26, January 6, 2012.  I think of Windy and how just maybe these mobile clinics can make a difference in preventing such suffering in another patient like Windy, with such a promising future, but by circumstance a lack of access to medical care.  Just maybe, these clinics can be a platform to make someone’s burdens a little lighter, health outcomes a bit stronger, and life ahead a lot better.  So onward we continued after mobile clinic planning to carry on mobile clinics through the week with a goal of having them grow to spread in different places in Haiti and be sustained by the local Haitian team.

Opportunities for improvement

We spend a fair amount of time going to a local large pharmacy, Valiere Pharmacy by the Iron Market the downtown PAP.   Each time I go here I meet individually with one of the presumed owners, a woman in their office in the pharmacy.  It is easiest to use this method in order to compare prices and negotiate so we can get the best bulk deals on large purchases for an assortment of medications to stock the clinics.  I have also obtained medications at a variety of pharmacies in Haiti and a seeking one to partner with where we can arrange for mobile medical clinics kits to be purchased electronically online from the states for pick up by the Haitian team members to use for clinics in Haiti.  I tried to work out a deal with this pharmacy, but it requires per report, selecting medications individually basically each time.  Additionally, it was suggested that to open an account with a bank in Haiti for the transactions.  These are not the ideal processes so we will continue to seek out options with perhaps Valiere and / or other local pharmacies in Haiti where we can establish a partnership for future medication exchanges.  I made purchases at the local pharmacies to obtain medications.  It is hard to determine the correct number of patient’s and amounts to buy of different medications.  Bringing a pharmacist on the next trip to help us collaborate with a local pharmacist will help improve this process.

Hiring a regular driver can be expensive in Haiti and while striving to negotiate the lowest prices with different drivers met from networking usually with someone I knew there or a friend of a friend.   It seems kind of common for drivers to rent taptap (the local truck mode of transport there, called a taptap presumably because you tap to get it to stop).  The costs of renting if for a day can be spendy, maybe up to $100 I think was the max I ever paid. Negotiations for prices can be a bit of an obstacle.  Gas prices and cars are relatively expensive in Haiti.   Finding a driver to take a group of us for a mobile clinic at a price that I’m willing to pay was a challenge, though we managed to do it each time.  Balancing the costs of food for the doctors and myself, housing, travel (i.e. flight) and other ancillary costs out of my own expenses and medications, supplies and equipment out of the Global Mustard Seeds Missions (GMSM) organization budget is delicate and takes careful attention.

Mobile clinics

To prepare for clinics we picked up bulk pens and notepads to be used for record keeping.  A short-term goal is to put together a standard one page form for the clinicians to use for the histories & physicals on each patient.  I also want to get a pharmacy form put together for use with the mobile clinic pharmacy with GMSM letterhead on it.  It will include patient’s vital signs and basic information.  This will help with record keeping and also give a chance to double check order for medications against the vital signs. I’d like to get a carbon copy with these records for the patient’s to have a takeaway form that they can return with or take to an outside pharmacy when indicated.  I worked at a different clinic with another organization in Cite Soleil and the patient’s returned with their prior health history forms which was nice to have as a reference.  I’d like to have our records scanned into a database after the clinicians get done seeing patients.  This way they can be uploaded into the computer and used to track patient data or even referred to for return visits of the patient’s seen.

It was good to be able to return to Cappva, the tented camp in Cite Soleil where there are still many people living in financially impoverished circumstances.  The community leaders seem to welcome us with open arms.  I feel secure and protected even those these areas have bad reputations in terms of safety and a history of being riddled with crime and problems.  I see it as a chance to serve where the help is really needed and make a difference in delivering health care where it may otherwise be lacking.  Plus when walking out God’s calling on your life I believe there is a hedge of protection that comes with it, so He covers each of us in the midst of it all! I enjoy returning to a place where we have hosted clinics before and having a comfort level in the camp leaders stepping up to provide organization and a sense of security.

Learning from previous experiences of high patient volumes, the Haitian doctors actually helped us take the initiative of distributing numbers of cards to patients which helps with crowd control and maintain order so we don’t get overwhelmed from high volumes of patients seen. We had on average about 3 or 4 Haitian doctors with each of the mobile clinics we did.  I appreciate being to work with the locals as they are likely used to working with high numbers of people with a lot of complex patient histories and they are familiar with the management of endemic tropical diseases.   I worked with all Haitian teams this trip and did not have a volunteer just for the pharmacy so the doctors each set up tables to see their own patients and I worked in the pharmacy to dispense the medications.  I needed a translator to help do the teaching so I had some folks come along at our different clinics who helped me with patient teaching.  Our clinic was held in a wooden shelter that had benches and tables of different sizes with some chairs. I had a separate small room about the size of a small closet that I set up different medications on to try and keep organized

We also ran surprise mobile clinics at a place called Village de Dieu which means Village of God which was great to be able to set up makeshift clinics in an area we’d not worked in and provide needed services.  It was enroute to the beaches in the North which are nice so there was a warm, welcoming view of the ocean from the outskirts of the Village.  We set up the clinic in a wooden shelter area but it was smaller and there was not as much space, but one learns to improvise so we made do.  The doctors shared tables.  We had an extra doctor work with us that we’d met at a pharmacy when negotiating medications to purchase.  It’s always a Blessing to have additional help to see patients.  We received warm thanks from the clinic site for the unexpected visit.  We decided to return to have another clinic there that week, realized sometimes the best outreach is that which is unanticipated without plans. We stopped by a roadside food spot for some spontaneous Haitian food which is always good to me.

Midweek we ate a Haitian restaurant for dinner- the food is always tasty and I really like the ambience of dim lights and authentic feel for the culture at the places I’ve been in for dinner.   A group of us topped off the end of the trip at a trip to the beach Kaliko much closer to the city.  We spent some time that night before talking about their hopes for clinics; their dreams of coming to U.S. institutions to get training; their desire to have American doctors come work alongside them (in the mobile clinics).  All of these seem like achievable dreams.   Hearing their desires motivated me to take the discussion back to my hospital with administrative persons in a position to help create potential connections.  My friend knew the manager on duty which was nice so we got to tour the beach at the resort for free where there’s usually a charge.  My plan was to get back in time for church at Port au Prince Fellowship, a place I love going to for worship, but with stops along the way at a town we made it there after service was over. My friend shared the powerpoint from the sermon with me so at least I got to read on the message.  It’ll definitely be one of the stops planned for my next trip to Haiti.  I left medications with the Haitian doctors with the doctors to carry on mobile clinics in my absence.  

Reflections and updates : 

Prior to the last trip in May 2013, we submitted our first grant application to the Bill Gates Foundation.  It was done until tight deadlines, and could have been better prepared with more detail and research, but there was a lot learned in the preparation of the application that will definitely give us an advantage for future grant proposals.  We have not yet received the decision on the grant. 

I have been pleased that the Haitian doctors have done mobile clinics and made plans for more requesting medications.  Seeing the beginning of the dreams I have for GMSM come to fruition through these leaders who I believe make a difference in giving hope to each individual they serve is encouraging.  Trying to find a systematic process where we can together come up with a solution for a long-term sustainable mission with Haitians helping Haitians is challenging.  Maybe this could be done in part with enough funding from outside resources as we continue to grow.  Ultimately though, the objective needs to be based on more than just funding.   In the past we talked about charging patient’s minimally a flat rate for services rendered.  Those who cannot afford to pay would of course not be denied care.  I’d been advised that there is a value associated with services received with a charge.  I would expect to have the Haitian doctors charge no more than $1-2 US dollars per visit maximum and less for follow-up visits.  This fee would include the consultation and medicine received.  We have not discussed yet where testing prices for labs would come into the fees.  Considering that the average income of those receiving care is little to none, we would not want to create a financial burden for people.  It was recommended that we do not charge those persons living in tented camps. The four venues that we have focused on with mobile clinics are churches, tented camps, schools and orphanages.   Reflecting on what activities thus far is educational and provides a platform for growth.

As we plan for future clinics, I want to get a system established to track the patient’s seen with records scanned electronically so that we are documenting cases on more than written records.  This will be a goal for the next trip planned for December 2013.

In Portland OR, a fundraising committee has come together to meet and plans are under development  for the next benefit for Haiti, Taste the Tropics II to be held at Mercy Corps to support GMSM mobile clinic initiatives in Haiti.  The details of the event are being organized with prayers and plans for it to be very successful will be revealed as it unfolds.  There is a plan to have the Haitian community locally involved.  Two of the Haitian volunteers from within Haiti, the local President of GMSM in-country operations Dr. David Renelus and Logistics Coordinator, Adonique Denis both have visa appointments through the embassy to seek approval to attend the event.  The hope is that they will be able to participate and present their perspectives on life in Haiti and serving in the mobile clinics.  It would be great to showcase the work these leaders have done in Haiti, notably voluntarily.  Haiti is a country filled with determined people who overcome in spite of suffering an often inequitable share of setbacks and hardships.  These leaders step up and lead by example, extending their talents, energy and skills to make life a little better for those less fortunate.   We are reminded that whatever our call or path in life, we should strive to do it with love and passion. Our theme for the event is promoting service and hope in keeping with the GMSM motto to “Make your drop a big splash (D. Schuster).” 

I am keeping in touch with the local clinicians and making plans to get them additional medications. A friend from Seattle who is running a school and clinic in Cite Soleil agrees to take meds for me in April on theirnext trip. I’m planning for my next trip in May 2013 where we will take a weekend to go have fun in Jacmel at the beach… and do more mobile clinic planning

The first mobile clinic was done after my departure. The Haitians hosted a clinic at the church we were not able to make it to before. I was able to do some planning with the help of one of my friends whose a medical student in Haiti and fluent in English and one of the local Haitian clinicians, Renulus David, who I made the in country President of Global Mustard Seed Missions. My goal is to give those involved each a different title to instill a sense of ownership. This will be planned in the months to come.

This was my last morning in Haiti until I returned. Adonique and Emmanuel helped me out at the hospital where I had been storing the meds to get them together and stored at Adoniques place as he would keep them for the next mobile clinic. They helped me pack at the guesthouse. I had a chance to speak with Dr. Romel that morning who agreed to do mobile clinics with the Haitians so that was a great connection I’m looking forward to having. We had a last meeting that morning at hospital that morning and a young lady who is a social worker joined who agrees to help with the mobile clinics. i made notes and agreed to type them up to email out for mobile clinic plans. It is exciting to have collective involvement from different people growing in the mobile clinic efforts. One disappointing thing was leaving my cell phone behind and not having enough time to get it, but I thought it was lost so I am thankful it had been found and I’d have to work on getting it shipped. Adonique and Emmanuel both came with to the airport as someone from the guesthouse gave us a ride. They helped me walk my stuff inside, we took pictures and said our goodbyes until the next visit. I had a sense of peace about this trip and a feeling of accomplishment. With dreams coming true so far, I do realize that there is so much more work to be done- it will continue, hopefully and moreover prayerfully for the years to come. These small mustard seeds that have been planted will grow and blossom with mobile medical clinics, run by local clinicians going on throughout Haiti.

It was a challenge to get a ride to church; I eventually was able to get dropped off by Pierre from Heartline Ministries part way into town. He helped me arrange for a moto from there, wearing a dress and all it felt awkward riding a motorcycle to church but it was the quickest way so I did it. I made it safely to Port au Prince Fellowship and was happy to be back. I got there just in time for an amazing sermon on taking natural risks which felt so timely for me. Pastor John talked about taking risks and having faith such as risks of starting a business. He illustrated the lesson with Biblical characters like: the story of Jairus whose daughter died and he sought Jesus who brought her back to life; the woman with the issue of blood who touched Jesus cloak with faith and was healed. The sermon was so moving to me as it spoke to taking the risk of starting this nonprofit Global Mustard Seed Missions which focuses on having clinicians and staff from developing countries affected by catastrophes like Haiti runs their own mobile clinics to serve their own people. My vision is to help them do this by getting them medications and equipment, perhaps making it sustainable by charging patients small fees for service who can afford to pay something, but not restricting care from anyone who cannot. I want to limit the need to have outside care as I believe in the skills and talent of the local providers to meet the healthcare needs of their communities, especially since they are familiar with managing the common diseases which present. The sermon gave me motivation and inner confidence in this big goal reminding me to hold onto faith, which has been the theme of this meaningful trip. After church that day, I met up with Adonique who helps run the PowerPoint during the services. We got some juice and caught taptaps back towards the hospital to get to Bernard Mevs. I was hanging out on the roof and a group of us had planned to go to the beach that afternoon. Dr. Renulus and Adonique hung out on the roof top with me as we waited for the driver Daniel. The afternoon was passing and Daniel was taking too long so we decided to set out on public transportation and just plan to go somewhere local. I really wanted to go to the Port au Prince Jazz Festival taking place that evening at a hotel in Petionville with an afterparty in another venue. Dr.Renulus had to get back to St. Marc and Adonique didn’t want to go to the festival so we kept it local. We went to a local Haitian restaurant called Kokoye which looked nice especially from the cars in the lot. Daniel and a couple of others finally met up with us there, but as it was dark by now, Adonique and I went and ate there ourselves. The food was good, I have a good friend local dish called Akra with some spaghetti Alfredo and he has Shrimp cocktail with a Shrimp salad. We talked for a long time there and headed out, it was late around 10 or so, we ended up catching a moto.

Last day for a mobile clinic for me on this trip before I would pass the baton to the Haitian clinicians/ staff and others helping until I can return. The clinic in Cite Soleil went very well, although it felt like the patient flow was never ending. By mid-day or so, I had a total of 6 docs helping, Haitian staff outside entertaining the children with soccer I think and there was a visiting artist who’d flown in from NY, she was doing paintings with the children which was fabulous, a leader from the community took time to pass out the goodie bags to children that I’d brought. The pharmacy, I volunteered in went well, it was super busy throughout the afternoon. By the days end, we had to have the doctors come and start filling the prescriptions they had written themselves. We had to have a couple of trucks bring us as there were so many people, Nick who works at the guesthouse had a chance to visit the clinic and see us in action after he dropped us off. Fortunately, I’d had a chance to stop by the store earlier and stock up on water bottles and Haitian pastries so we had snacks to get us through the afternoon. We had to unfortunately, cancel the other clinic due to time constraints. It was the perfect way for the Haitian clinicians to have a start to clinics to carry on after I leave. By about 5 pm a couple of the doctors needed to get back to the trauma hospital so I had to have the driver take a separate trip to get them and others back. The driver did not want to take two trips and for a few hours or less he did not return. It felt like a test of faith cause we were in Cite Soleil after dark and he initially was not willing to come back. After several phone calls to others we were unable to secure another ride. One of the guys who was with us was a friend of his and he talked to him so he came back to get us all. We brought a little girl back with us and her mom to the hospital who one of the doctors felt like needed additional medical care. The girl was seen in triage at the hospital. Her and her mom were given cash to get back to the camp the next day. The driver, Gideon from the hospital dropped me off at the guesthouse.

I spoke with Ramata on the phone that morning, who’d flown out from Portland, she goes to the same church as me, Immaculate Heart. She wants to do work with the mobile clinics in the future, but will be flying back to Portland th next day, she was only out briefly for another group. She does trauma care and is originally from the Congo where there have been many traumas so it is a great future source of support as many people in Haiti have endured significant traumas. If possible, she’d join for the mobile clinics this Saturday before flying back to Portland. I had planned to spend this Friday working with Dr. Ramel who is the medical director in a clinic in a town called Croix-des-Bouquet I’d volunteered at before which provides a variety of community services from maternal care to primary and speciality services. He had a group come out from Puerto Rico who were holding a remote mobile clinic. Due to my transportation issues and having a cold, I was unable to make it in time. I decided to use the afternoon to prepare for our mobile clinic on Saturday, the last before my departure, although the plan is for the Haitian clinicians to continue them in my absence. It required more planning to make them successful then I realized. Our hope for Saturday was to have a sort of grand finale and have two clinics, one at the camp in Cite Soleil which really is intense with the high volume of patient’s needing care and another after in one of the clinicians churches near downtown which I’d previously volunteered in with him and his friend running a mobile clinic in 2012. I really liked doing clinics in churches as it was a nice way to meet the health needs in the local community and also in tented camps as it was a chance to really meet complex health care and ideally in the future social needs.

We had to go downtown to the Valiere Pharmacy by the Iron Market to pick up the medications. I was able to get the order that I had previously placed. A couple of the Haitian clinicians met us down there. I was trying to buy a few more meds but decided not to with the wait taking too long and them wanting me to pay first. We headed out and I was able to get a pack of blank notebooks off the street for 150 gourdes. I use these to keep track of the patients seen, the medications needed and for the doctors to write on their patient’s seen plus write prescriptions. I had help from another doctor and two other women from a Canadian medical team who could help with logistics, we were also joined by 3 other of my Haitian friends who helped with translating and entertaining the children with playing soccer I believe at the clinic that day. A project manager who knew a friend of mine and had flown in from NY that day doing some sort of documenting for an artist coming also joined us. The artist would be in the next day and planned to paint with the children and may do some murals in the camp.
We prepared to host a tented camp at a place called Cappva in Cite Soleil, an extremely impoverished area which has been adversely affected with crime, riddled with poverty and a lack of access to resources, this coupled with numerous people living in tight quarters with poor housing facilities has rendered this a dangerous area where the only the brave travel within. I recall in the past wanting to volunteer here in another other clinic in Cite Soleil a not being able to find transportation, presumable Capp due to the inherent risks. The people in the tented camp Cappva had been displaced from the earthquake; I understood from a previous visit that the tented camp residents had not had access to food, clean latrines or water for extended periods. Such harsh conditions, a complex culmination to survive amidst, make it difficult to contain diseases that occur din poverty. Running a mobile clinic as the head person leading the initiative here was no small task, certainly different from the challenges that arise with focusing on seeing a multitude of sick patient’s in a day with having to improvise in treatment plans. Now I had to make it possible for: multiple providers to be able to give care effectively with time constraints to a whole lot of people; ensure that a make shift pharmacy is adequately stocked and organized to handle the flow; have the community leaders step up to manage the long lines and prevent havoc from developing and taking over as impatience grows from long waits in hot climates; have transportation was available; and the many other small and large tasks that come about with surprises like possible equipment failure; lacking enough tests like pregnancy tests or running out of certain medications. Yes, without faith in God and the strength He gives I don’t think there is any way I could have made it through. And knowing were serving and helping people, no matter how tiring it may get or maybe even overwhelming at times, still somehow I love it all. We set up an area for the pharmacy. As it was later in the day by the time we arrived, and we were one clinician short, as we weren’t able to connect with him downtown in time, we had to come up with a plan to minimize the volume and return for more complete clinic another day. I had those assisting pull out the 50 sickest patients (i.e. with fevers…) to be seen. It felt like the line continued to grow as there were many patient’s trickling through from babies on up in the covered wooden contained, but open building we were stationed within. We made plans to return Saturday as there were many more patient’s with medical needs that day. After the clinic, a group of us went out to eat at Muncheez, a pizza place in Petionville. I had a cold with allergies so we stopped by a street vendor in the area to get some medicine, it was nice to just by a few pills and negotiate a low price with some change instead of having to pay for a big box of meds. A couple of us had got out of the car to walk to the vendor and got separated from the group, but we reconnected. Once together we all together we enjoyed pizza, they had Prestige, a popular Haitian beer and I had coke. The intention was to take the doctors out to eat as thanks for their hard work, but due to it being late they were not able to come. I decided in the future I’ll just pay them some for the clinics and not try and arrange for group meals. Later that night, I met with Dr. Daly, a neurosurgeon interested in helping out a lot with the mobile clinics. He has some unique visions that are exciting including partnering with local hospitals to be able to share resources like use of an ambulance for mobile clinics so that we can be better equipped with oxygen and other supplies as needed. He wants to talk to the Ministry of Health in Haiti to make progress with this initiative and he can work with the Haitian doctors to embark on this promising connection. He moved recently to Haiti from Eastern Europe, I found it admirable that he sold his car to help with the move. I helped him find a place with a friend of mine closer to the hospital which was walking distance. We met there for a long time for planning and he came to work at the mobile clinic in Cite Soleil that Saturday.

I was happy the next morning to have slept in a big cozy bed at the hotel and take a shower with hot water. All the showers I’d usually taken were cold, at best with some luke warm water that’s filtered in. I missed breakfast that was served in the restaurant, from not getting downstairs early enough at 8am, but I enjoyed some delicious coffee in the bar made by a young lady there. While I was waiting for my ride, the bartender Jeff let me listen to the music on his phone which included a lot of US West coast hip hop. Daniel came to pick me up.

This was a planning day for mobile clinics. I was picked up from Bernard Mevs buddy a friend Daniel and his neighbor Pedro and later my friend James met up with us. James helps with translation and is resourceful. We headed downtown, passing areas which revealed the beautiful sea off in the distance beyond the streets. We went to the Iron Market where Valiere pharmacy downtown is located by, so that I could stock up on medications. Valiere pharmacy seemed to have less expensive medications. After we arrived at the pharmacy, I was able to meet with a lady who was helping to run it, she told me it was a family owned the business. I had a list of the medications that I wanted to buy refills for so she gave me discounts after negotiating on the ones that I bought in bulk. I talked about plans with her to purchase medications from them for the local doctors to continue mobile clinics in my absence. I want to make arrangements with a local pharmacy so that this can be done with payments made remotely. I received some contact info from her for a local bank as the transactions would need to occur via that means with the bank transferring funds to the pharmacy. The pharmacy closed at 2 that day so I placed the orders, but would have to return another day to pick up medications. We headed out and went out to eat at the Eclipse Restaurant; it was I, James, Pedro and Daniel. I had rice, beans, plantains and sauce with Jumex juice and they each enjoyed food (total came to ~$2000 gourdes. I gave the driver like $1500 gourdes for gas. I had them take me back to the hospital as I was volunteering in triage that night. I had a sick little baby girl come in with respiratory distress that night tachypnea. I worked with the ER doc to get her treated with a nebulizer of Salmeterol and gave oral prednisone. It was a good night, I kind of liked helping out at the hospital. At the end of the shift, Adonique, a friend I’d met from Port au Prince Fellowship came to meet me, we planned to go out to eat, but most restaurants were closed. We caught a moto to Hotel Revelation, centrally located on Delmas, where they had a bar still open which was nice as I was hungry. He had a plate of food with chicken, plantains and a sauce which I had some of and I had ice cream and a Mango shake plus some of his plantains. Since it was so late by the time we were done talking, he went home and I ended up getting a room (after negotiating a discounted rate of about $65US) there which turned out to be very comfortable and clean. There was a nice flat screen TV with cable.