Off to an early start after the routine breakfast, this morning oatmeal, fresh fruit and toast with hot coffee, and a mug to go before boarding a taptap, this time with my makeshift coffeemug halfway secured with a Ziploc bag. Confrontation with the street elements is a sobering reminder of the massive needs in Haiti.  The streets are bumpy and mostly unpaved, an analogy to life for many here.  In the congestion, people are busy hustling misc items in a quest to get paid, items for sale range from foods to electronics or whatever’s clever to make a living.  Shacks made of items found from tin to pieces of wood, tarp and metal make up the homes and vendor stands.  After about a 15 minutes ride through the urban neighborhoods we get to the clinic.  After braving the streets of Port au Prince in the taptap I had maybe a quarter cup of coffee left, enough to get me through the morning.  We set up in the Cite Soleil clinic, now routine as one quickly adjusts when being confronted with many complicated patients after a day of care rendered.  Most of the things used to set up the rooms are old and outdated, improvisation is the key to thriving and humbly making do with what’s available.  The morning was uneventful until about my 3^rd patient that is, a lil infant who was crying incessantly as I was holding him I felt my leg turn warm, I looked down and realized he peed all over my leg. Didn’t think on the fact that diapers are expensive and many of the infants don’t wear them as a result.  One of the nurses Danielle was nice enough to arrange for me to get a pair of scrubs so I could change.  The day pressed on with many acutely ill patients who couldn’t afford to get to a hospital so it kind of felt like an urgent care center.  The one who stood out the most was a little boy sick with bad pneumonia and untreated asthma who required advanced care.   Reflecting on basic meds and access to care we take for granite in the US that prevent escalation of often simple diseases like asthma, but when unmanaged can result in death.  Many of the patients have basic care needs and a host of other health problems.  Running back and forth from the pharmacy all day to figure out meds available was tiring, but I was glad to have access to the variety of options.  We wrapped up the day by about 4 pm. Arrangements were made to take me and 3 of the guys to pick up some luggage with medications that a friend brought for me from Portland the week prior.  It was a relief to be able to finally connect with meds after a long drive and having to stop several times for directions, especially relieving after not being able to get other meds through customs.  On the way back we stopped at a Haitian restaurant and had spaghetti Haitian style which is served with veggies mayo and ketchup and crepes mine w cheese, all good served w fruity juice drinks. We headed back to the guest house and were able to enjoy bits of the Caribbean carnival with large groups of people parading the congested streets with music and dancing.  A police presence was noticed among the crowds.  Observing the different parts of town there seemed to be fewer people living in the tented camps than visible on previous visits, though this was only at a brief glance. Even though the poverty still appeared rampant, it was nice to see people happy and celebrating.  I heard from at least one Haitian that Christians do not usually take part in Carnival as it involves unwelcome activities like drinking and fighting. It was interesting to observe some of the festivities on the way back to the guest house.