I got up early and met with Larry Roberts at the guest house, a man I previously knew from working at the Bernard Mevs trauma hospital when he was seeking medical treatment for one of the children he was caring for in his group home. He runs an organization called Servant’s Gift which takes care of Haitian children. I planned on helping out at a mobile clinic at a remote school in a town about an hour away from the capital of Port au Prince called Carrefour. He has worked with the school for awhile. A man who is an FNP from Portland, Doug Brown joined us as he specializes in alternative medicine and would be offering these services to the group. We packed all of our meds and headed out in a rental Larry had which was similar to our jeep. He had to negotiate very narrow and sometimes scary roads up steep and rocky hills. Along the way I saw women selling mud pies in big bowls, which were reportedly made of sugar and mud and really did resemble sugar cookies. These were the same pies many of the patients I treated obtained their worms from, and they seemed to be a common snack, perhaps because of limited access to foods. One of the many public health educational opportunities I saw to teach about the seemingly unknown problems associated with consumption of such items. Once we arrived and got briefly acquainted we set up mobile clinics in a couple of the classrooms. Patients were given the option of having more conventional medicine with what I had available or alternative medicines with Doug Brown. Larry helped me see patients and we did our own vital signs, and gave out meds. Between both of the supplies we had there was a substantial amount which was great. The most interesting case I saw was a young woman who we were told had “AIDS’ but we were not supposed to tell her which was disturbing as she’d been labeled as having this disease. She appeared to have a bad case of pneumonia and possibly tuberculosis with hemoptysis and other symptoms, plus she was tachycardic and had a high fever. I did what I could to treat her with meds available and advised her to get to a hospital when or if she could for HIV and TB testing, at least that way she could be informed of her health status. There apparently was no hospital in the area and we were somewhat isolated on a remote hill so unknown if she’ll get any follow-up care. With mobile clinics you aim to maintain an array of meds but for bigger problems like HIV and TB it requires a whole different arsenal of long-term treatment options. Maybe in the future I can add some of these options. The one med I had an ample supply of for TB, Rifampin, was stuck in customs at the airport and due to expire so it wouldn’t have done a lot of good as it has to be taken for many months. More items I need to add for mobile clinics which are much more easily accessible in stationary clinics are nebulizers for airway issues and IV fluids. Again I had a station set up for worm treatment and Gentian violet. Being closer in the country areas there seemed to be more of a prevalene of voodoo. I had one infant who was wearing a tooth around his neck and a small shell on a necklace. When I inquired about the meaning and asked if it were voodoo related I was told by one of the translators it was a Haitian thing I wouldn’t understand. Someone said it was for antibiotic purposes when the teeth are pulled. There are unique cultural practices that are hard to understand in Haiti. At the end of the clinic day the mom of the school administrator had cooked us a tasty homemade scrumptious meal. The view from the top of the school where we ate in a classroom was gorgeous as it overlooked the fabulous large ocean and green lush trees off in the distance. This picturesque Caribbean seen with the warm sun and comfortable climate was so inviting. It was also such a sharp contrast to the immediate neighborhoods in the area we were working within. It is admirable to see the resilience and endurance of the Haitian people. The work ethic and willingness to extend love to visitors is much appreciated. After leaving the clinic I had planned to return to the Hope Alive Clinic in a neighboring town called Mariani. Larry the driver did not want to drive the opposite direction of the capitol though. I was so happy to find out when I called the woman Leslie who manages the Hope Alive Clinic that they were already in the area so I was able to meet up with them as fate would have it, felt like it was God’s plan for me to connect with them. It was reassuring to have a sign that there was somewhere else I was supposed to be since the plans I was hoping for with the Cite Soleil clinic didn’t work out. It reminded me how we have our plans which often are not consistent with God’s ultimate plans. This trip is Haiti is giving me a lot of time to be introspective and let Him move. Larry reminded me on one of our talks that when we step away from trying to do things on such a rigid time structured path it allows God to operate. That’s a lesson I’ll carry with me. Once I connected with the new team in Mariani we got to know each other over dinner with spaghetti at the Hope Alive clinic/ guesthouse where I spent the first night in Haiti. I spent time visitng with the local staff later. I tried to sleep in the room with the other guests later, but many people in one room with lots of snoring made it hard to sleep. Instead I headed up to the rooftop and dragged some mats out to sleep where some of the other local staff were sleeping Libertan and Wilio. I tried not to worry about the possible tarantulas that lived around the guest house crawling up on the mats, but it made for a restless night. We laid up in the late night hours chatting and they taught me about Haitian culture. We laid out under the stars enjoying the breathtaking views of the sky. We could hear what sounded like voodoo ceremonies off in the distance which was a little unsettling with the music off in the mountainous areas. They tried to scare me with stories of bad things that happen at night. We chatted until falling asleep. Funny we were awakened by rain drops pouring down a couple of hours later and I eventually ended up on the porch trying to stay dry, it was a restless night, but I managed to get enough sleep to still wake up and start a clinical day.