I was picked up after a delay due to some issues with the driver coming late which meant a late start in the clinic; this can be tough without lights when it gets dark. We returned to the school in Carrefour to distribute medications per the plan for those patients who had received prescriptions from the previous mobile clinic we held. A translator and one of the doctors came to help. We had discussions with the school director Jones with the help of a woman I’d met at the guesthouse about the need to have electricity provided since there would be medications to pass out and we’d need ample light to do so. I wanted to plan ahead so that we would have enough lighting to safely and correctly manage the patient’s. After deliberation, Jones agreed to have the lights on without us paying extra. We did not arrive at the site until late afternoon which meant it would be getting dark soon. Patients arrived, questions came up about wanted to be seen, but due to time constraints we only planned on filling scripts that had already been written. James the translator helped me with translation and one of the Haitian providers helped process medication orders. We left later on and headed back to Port au Prince.

The Great Lord made a way for me to get to my favorite church thus far out here, Port au Prince Fellowship for free when I was going to pay for a taptap. Pastor John who manages Heartline Ministries over the guesthouse I’m staying at called and said it is okay for Pierre to take me to church. We got to church late, but it was a good service. There are two Pastor John’s, one I knew from previous missions and I got to meet the other one from Australia. This is a church I’d like to partner with for mobile clinics in the future and I had the chance to discuss this with him, he advised that I speak with Pastor John of Heartline Ministries which I plan do as he is the program director. After getting back to the hospital we made arrangements to go to the beach for the afternoon, we agreed on $1500 gourdes for gas. I wanted to go to a beach in the North as these are nice with sand and I’d gone before and snorkeled. We ended up going to a few different beaches in the South part of the island before we settled on one as these were closer in to the city. These weren’t as elaborate as the ones we saw didn’t have sand and have areas on the gravel areas where people play games, sports or other activities. The beach we went in cost $75 gourdes per person to enter. There is loud music playing, I recognized American R&B or hip hop music playing. A number of the Haitian doctors went with us and it was fun to take a time out and enjoy hanging out in the ocean. After we left the beach we headed to a Haitian restaurant on the roadside on the way back to the city. $1000 gourdes was enough for everyone to have a plate of rice and beans, chicken and salad with a coleslaw consistency. We headed back to town and while driving through saw music performances through the downtown area by the National Palace. We eventually made it back to the hospital and I got dropped off at the guesthouse.

This was a solemn day of remembrance sadly of a multitude of people who suffered traumas and didn’t survive the earthquake of 2010. Many of the people I’ve interacted with here in Haiti have shared their awful stories of loss in the quake. Somehow in an amazing, clearly God ordained way they have found the strength to carry on. Some of the stories they have shared seem impossible to fathom enduring. The strength, courage and resilience is truly admirable. I was so happy to be able to spend the day with two of the Haitian doctors who’d traveled great lengths catching the bus to come volunteer with this clinics, one came four hours from Okai and another came two hours from St. Marc for the mobile clinics. A pharmacy technician from the trauma hospital Bernard Mevs volunteered to spend his day off helping out at the clinic. We also had a Haitian translator and a medical student accompany us with an American EMT. Such drive speaks volumes about the passion they have to serve which ignites a spark in my desire to make the growth of these mobile clinics thrive in my absence. The driver picked us up from the hospital. As we headed up the road we saw the largest police presence that I think I’ve ever witnessed with cars, motorcycles and armed UN trucks with officers holding big guns in such high volumes. I was not sure what happened or where they were going. Part of what I sought to do on this trip is find a pharmacy we can work with regularly to get bulk medications at the best prices. Enroute to the mobile clinic, we headed downtown to a pharmacy in the Iron Market called Valliere. The area is very busy and crowded with many vendors selling numerous products so it’s a lot to navigate through. But the prices for medications were good and they have a wide selection so I will plan to do future business with them. We stopped for juice on the way to the school in Carrefour. Once we arrived, there were at first not too many patients. Maybe word spread about us being there because the volume began to grow. We had a total of four Haitian doctors who I’ve worked with before. After they each got set up in the various rooms with equipment they began seeing patients. We set the pharmacy up in the room upstairs as before and patients began to flow through. By the end of the day, it was dark in the school without electricity which I would have needed to pay for if we wanted it. We made arrangements for patient’s to come back on Monday who’d been given prescriptions from the various doctors so that medications could be dispensed. After the clinic, Jones wife Natasha made our group dinner at there house which was nice. It was good to have a medical student accompany us via the clinic. Over the days I have spent here I’ve met number medical students, majority from the trauma hospital. They have wanted to help with clinics and most have been 6th year students which is advanced. They seem to be enthusiastic about helping so I’m happy to have them involved, although they have to be supervised if prescribing medications. The potential of having a new cadre of providers who can engage in and run mobile clinics in the future is great. Even better is as they progress in their programs to internships…there are a variety of places in Haiti they may end up working which creates possibilities for mobile clinics to be held in different places throughout the country. After dinner, we headed back to Port au Prince in the truck. We made plans to spend Sunday afternoon at the beach. They dropped me off at the hospital and everyone went their own way. The night driver Gideon from the hospital took be back to the guesthouse. I spent some time talking with one of the guys Pierre who helping run the guesthouse through Heartline Ministries and he enlightened me with information and Haiti and practices.

The day started with Jones, his brother and his friend picking me up from the guesthouse in Tabarre. We headed to Bernard Mevs hospital and gathered up more people to come help with the mobile clinics. I had been storing medications at a room in the hospital. We picked up translators and 3 Haitian doctors came to help and an EMT who ended up helping in the pharmacy. I picked up 3 bottles of children’s multivitamins from the pharmacy. We headed out for a mobile clinic in Carrefour in a pickup truck. We had a bumpy, but fun and insightful ride getting to see interesting sites through downtown. We drove past many people on congested streets, most seemed to be selling some sort of product from fruits and vegetables to clothes and other misc items. It seems one can find most any retail product needed on the streets. We stopped off to pick up water and food for a couple of the docs. Once we got to the school we set up the clinic in the different classrooms. It was spacious which was nice allowing us to set up 3 rooms for the pharmacy and patient care. Some classrooms were filled with patients waiting on benches. Many people were there waiting patiently to be seen. I later learned that Jones stood on the roof and announced on an amplifier that we were coming to provide medical care, in a community without access to regular care, it was clear why there was such a massive turnout for the clinic in high demand. The volume o patient’s was so much greater than the church based mobile clinic and the flow was a challenge with so many patient’s. I had to make sure everything was in order and ensure the doctors had all the supplies that they needed plus get the medications set up in an orderly way in pharmacy and then staff the pharmacy with the help of the EMT, it felt like such a huge task. At times it seemed overwhelming with 3 different providers writing scripts and volumes of patient’s lining up in the hall. The pharmacy was set up in a classroom on the top floor. There was a gorgeous view of the ocean from the upstairs windows, but there was not much time to enjoy it. Filling orders for medications was a very involved task. Each person had to be educated on the proper use of the medications which had to be done through translators with instructions (i.e. dosing, etc.) written in Creole by the translators which was time consuming. I tried to designate some others to help with logistical efforts such as signing in patients. The doctors flowed through the patient’s seemingly quickly, much more so than we could fill the orders which created long lines and a loud environment with people waiting in the all. We had to set up boundaries greatly limiting the number of patients with a goal of no more than 2 at a time in the make shift pharmacy so that we could focus on getting the medications dispensed and patient’s informed on proper use of them and how to refill those given for chronic conditions. The hardest thing was interpreting orders and the handwriting from different providers. Some of the instructions were written in Creole, calculating pediatric doses and putting the appropriate amount of medication together then teaching the parent or guardian how have children take medications was also difficult. Sometimes I had to get creative with suggesting things that they could use to give the children meds because they may not have measuring instruments at home. I’d try and at least demonstrate a visual amount on what to give using a syringe, and we had extra syringes so we also gave those out to administer medications. If there were medications we did not have, we’d write the instructions out and send patient’s to the pharmacy to buy medications. We worked until it was dark. Jones wife cooked for us in their house walking distance from the school which was nice as I was hungry.

Woke up to french toast, fruit and coffee. I hung out with my Dad briefly at the guest house. I went to the hospital and bought some medication (metronidazole) (to treat a variety of common infectious diseases seen). It was challenging to set up everyone, the medications and supplies to get everything to the church where we were holding the mobile clinic. We had to use two different cars to transport everything. We headed to the church and set up everything. Patient’s started arriving and it began to get busy. I saw patient’s leave and I was questioned about the price of the clinic from someone. I found out that offerings of money were being collected from patient’s for the clinic. I was very disappointed to learn this and I spoke with Pastor Luke who I had worked with to arrange the clinic. Pastor Luke suggested that they were taking this money up as an optional offering for those receiving care from the clinic. I had the translator help me to relay the message that it is not okay to charge patient’s (as that it not something we discussed). I had translators stationed at the front door for the rest of the clinic day to ensure that patient’s did not pay any additional fees. I had to trust that this was being done, but the experience was quite an eye opener as the things I need to be aware of that can potentially happen with mobile clinics. I had been told previously that the patient’s in Haiti feel like the services had no value if they were offered for free. It made me think throughout the trip that perhaps we should start charging minimal fees per visit in the future like 75 gourdes per visit and a less amount for return visits. That would be less than $2.00 US dollars per visit, but in some places this would be cost prohibitive like in a tented camp. So perhaps in the future, we’ll it suggested donations per visit and not required payments. These are things to be discussed with the Haitian clinicians in planning strategies. I received a text message from Jones the school director in Carrefour about the clinic planned for the next day saying that 400 patients were expected the next day for the school based mobile clinic. It felt like, in spite of challenges, particularly unanticipated one’s that came up, the clinic turned out to be a success by the day’s end. Getting that text message at the end of the day was an eye opener. Plans will need to be put into place about crowd control and limiting volumes of patient’s seen per mobile clinic visits. Measures will have to be applied to avoid burnout on the Haitian clinicians who have been generously donating their time for clinics around their other obligations. A number of us went out to dinner after the clinic; we caught a taptap to Mucheez, one of my favorite pizza places. Afterwords the Haitian doctors and I spoke about more mobile clinics.

I woke up to breakfast, fresh fruits mango and pineapple with coffee, always nice to awaken to food. After getting dropped off at the hospital to meet volunteers for a mobile clinic, through divine intervention more doctors stepped up to serve. There were many challenges, a test of faith. I started the day with what I thought were not enough doctors. We left the hospital with 2 Canadian doctors and a Haitian doctor. The local staff had their own jobs which have to be worked around. We packed up medications and all of us into a small jeep, it was tight fitting. I had to lay across people to fit in, but this is often the reality for Haitians, many people on public transportation compressing into tight, crowded spaces and riding on many bumpy, unpaved roads. I was so happy to be getting started with the mobile clinics, thanks to God, somehow all the logistical matters weren’t relevant. James, the translator followed us on his moto and we got separated with routine police stops and heavy traffic. We all connected at the church at Delmas 31 where we were holding the clinic for the next two days. There was much construction going on in the church. The church workers helped us create provider, pharmacy and patient waiting areas with tables and chairs. They signed in patients as they came through the doors and sent them upstairs where we were stationed. An announcement was made at the church the weekend prior I understood by Pastor Luke about the clinic so that’s how people were aware of the free health care being offered. We set up medications, supplies, equipment and a plan. Patients began to flow in, the church family helped with keeping order and flow which was awesome. By the end of the day I had 6 doctors who voluntarily showed up to serve. Haitian doctors came as they could. We even had a Dean of a Medical in Canada help out for the day. It was like watching my dreams for mobile clinic success unfold, a testimony of God’s faithfulness when we carry out visions He gives us. Patients were triaged and sent to the different providers. Trying moments came up with not having some of the medications available that I had requested initially. Lesson learned about the importance of double checking medication orders before cashing out. One pastor helped me get a ride to the pharmacy at the hospital. We hired a driver from the street. There was miscommunication about which pharmacy to go to first (I had a backup plan to go to a local pharmacy 4C if the hospital pharmacy couldn’t meet our needs). We finally got to the hospital after we stopped by a store to pick up refreshments of mango juice and cookies for the group. The driver wanted to charge extra for going to the other pharmacy first, but I was not in agreement with this plan so he agreed to take us back for the price we settled on. I got the meds needed from the hospital pharmacy and we returned to the clinic where they had continued to see patients through the afternoon and the order flowed well. We went out to eat as a group downtown at a local restaurant which was good; I ordered spaghetti, a popular dish in Haiti and had good peach juice. I heard traffic had issues with something about Aristede being in town, we didn’t have issues. It was after dark after we returned to Bernard Mevs and then to the guesthouse with my Dad.

I had breakfast with French toast, fruit, coffee. I spent half of the day at Bernard Mevs helping out in triage. Disturbing and memorable cases included: a 13 year old girl being carried by presumed family members who’d been shot randomly in the buttocks on her way to the store in Cite Soleil (a place we’ll do mobile clinics within); and an elderly woman brought in on the floor of the back of a taptap (mini-truck) seizing uncontrollably in my arms, possible poorly controlled blood glucose levels- she lost consciousness and was sent to the ICU. It’s all preparation for the kinds of possible cases to be encountered in mobile clinics. I was Blessed by the Lord’s awesome Grace to get transportation (which can be hard to come by) and made arrangements to pick up the medications ordered from Sophia Pharmacy in Petionville. He added extra meds free and I bought extra medications and inhalers at the hospital. My Dad came with me to stay the night at the guesthouse after we hung out at the hospital that evening. An ICU nurse Sarah, an EMT Nathan and Haitian medical students expressed interest in mobile clinics. Earlier that day I talked to staff /others about doing a book on recovery from trauma. The idea is inspired by all of the many Haitians I have interacted with who have shared some of their devastating losses from the earthquake of parents, siblings, friends, homes, businesses… The strength and resilience they have had is remarkable. It would give those interviewed for the project the chance to share their stories and inform others on how to recover from traumas, share coping mechanisms and survive major losses in life. I would like to end the book with the success stories of mobile clinics and how those who have endured such a magnitude of losses found the strength to give back and help others through mobile clinic work in Haiti. Sadly, it seems like a normalized issue to have suffered major losses in the 2010 quake, so probably not something that many Haitians take time to discuss with one another which can be cathartic and therapeutic. This would be a long-term project to be developed through interviews with a focus on healing as the mobile clinics become more established.

Breakfast started with fresh fruit, juice, chocolate chip pancakes and coffee- very nice. We were picked up by Ricardo, he drives for Bernard Mevs and he took us to the hospital. My Dad was greeted by Toni, the chief medical officer who was concerned about needing his help with fixing possible broken respirator. This is why he is in Haiti to help repair broken medical equipment and teach the locals how to do so through his organization BETA. With already limited equipment, it is critical to have someone available to repair things, otherwise when the machines malfunction patients can die. My Dad made progress meeting with folks. I helped out in Triage clinic which at that hospital includes diagnosing and treating. Myself, a translator & Pierre an EMT made plans for mobile clinics. We enjoyed a flavorful Haitian lunch provided by the hospital; I chose the plate with vegetable mix, rice, and black bean sauce. I made some arrangements with a friend’s brother who runs a pharmacy in Haiti to collaborate on possibly cheaper medications for mobile clinics. The goal is to find a local pharmacy where we can purchase medications regularly for mobile clinics in Haiti. This may require getting meds from different pharmacies as not all of them offer low prices on all the meds or even have all the medications in stock. He came and met with me at the hospital and I provided him with a list of medications, again to try and get the cheapest deals so he will get back to me with prices. I was impressed that he spent two hours getting there to meet me on a taptap (local mini-truck) and he was so willing to come back. That, to me, is the kind of service that makes one want to engage in long-term business interactions. There are more doctors and a pharmacy tech possibly interested in mobile clinics. I went to dinner at the UN restaurant with my Dad and volunteers from Bernard Mevs. Gideon dropped me off at guesthouse after.

I tried to arrange a ride to Port au Prince Fellowship church with John who I knew from Walls guesthouse. His car broke down so he was unable to take my Dad and me to church. I spent most of the day at the guesthouse on the rooftop in the sun trying to arrange transportation as I really wanted to take my Dad to the mountainside to see a nice part of Haiti. My friend Claudel came and met me, we caught a motorcycle to the hospital. Jones came with his friend and picked up my Dad and I. We went to Hotel Montana, a beautiful venue perched up top of a hill overlooking the city with a great view. I, the driver and Jones ate from the buffet where they had an array of tasty Haitian food with salad and desserts. We headed back to the guesthouse after an interesting ride through town filled with the sights and sounds of the city at night. My Dad really liked the guesthouse. They had dinner for us waiting; he had a plate of chicken and rice with black bean sauce. The Haitian ladies make sure the food here is delicious! We talked on the roof and then headed to bed. We both had our own rooms due to low volume at the time which was real nice.

I woke up to tasty fresh fruit, toast, cereal, juice and coffee. My friend Jones came to get me with his cousin. Jones is a school director in Carrefour, about an hour or less from Port au Prince at a school where we have done a mobile clinic and will do more community based clinics. The area I was told only has one maternity hospital so limited access to medical care and needs for care are extensive. We went to Bernard Mevs trauma hospital, our meeting place, to pick others up who’ll help with mobile clinics. We headed to Sophia pharmacy, in Petionville, run by the family of the pharmacist Martin at Bernard Mevs. We discussed mobile clinics, plans, I gave him a list of medications and they will provide a quote for prices for mobile clinics. He agreed to help out with clinics and work on quote for medications. I’ve learned networking across the regions with individuals at all different levels in developing countries is part of the key to success. We headed to Epidor, a popular bakery with good food, to pick up lunch for carry out which consisted of pizza, pastries and bottled water. We headed back to Bernard Mevs to talk and make plans for mobile clinics. While meeting, I heard the loud screaming wales of a grieving companion over the passing of a young appearing man who I heard died of TB and HIV just days after being admitted. Interesting and disheartening to see such expressions of pain. When I asked an employee standing by why no one was attempting to comfort her as she just laid in corner near the middle of the hospital in distress, I was told this is a part of the process when someone dies. My friend Windy who died at age 26 from lymphoma had been in that room, where people who are terminal are reportedly sent about a month or two prior, not long before my arrival. It’s sad to reflect on such loss, especially knowing the heartache of those left behind to mourn. On the other hand, these are the elements that motivate me to do mobile clinics in places where people otherwise may not get care to alleviate some of their suffering, and ideally get them connected with further resources for treatment when needed. We continued planning, specifically to have the mobile clinics begin this week in a large inner city church and a school, next week a tented camp. The other goal is to do an additional mobile clinic at an orphanage we previously served in. These venues enable us to work with community leaders to provide relatively secure environments and promote safety. Mobile clinics operated through Global Mustard Seed Missions will be limited to these four types of venues in the future. That night, I went to dinner with a group from Bernard Mevs including my Dad. We went to the UN restaurant which is an open air place with big TVs where people go to socialize and eat. My Dad had a chicken gyro style sandwich and I had a mozzarella & tomato panini with plantains and RedBull. We headed back to the hospital after and then a driver took me back to the guesthouse.