Monday, December 25, 2006

Joyeux Noel!

"Oh the weather outside is delightful. . ." Everything's upside down in Haiti, including the words to this song, though they are true today: sunny skies and temps in the 80's for Christmas in Haiti.

It hasn't been the best Christmas weekend in Haiti, as UN troops stormed Cite Soleil, killing at least nine people. Elsewhere the usual grind of poverty went on, punctuated by loud fireworks at night and music coursing through the streets.

Being the middle class Americans that we are, we escape the misery, even as it surrounds us. Our only real hardship is being away from our families for the holidays, though the addition of our new family member here in Haiti makes it all worthwhile.

Wherever you are and however you are celebrating Christmas, we send you the following greetings:

Happy Holidays to you from Haiti, where we have spent the last five months waiting to complete the adoption of our son, Luke Innocent. We are grateful to be able to spend this time with Luke, a joyful little boy, who is changing his parents for the better.

Haiti is a humbling place to be. People suffer terribly from poverty and disease. We believe that where people are suffering, God is especially present. We see this presence in the faith of our Haitian brothers and sisters, who are so grateful to God for the little they have. We ask your prayers for them and for all of us that we might work to bring justice to the world and bear witness to the Child born two thousand years ago in Bethlehem.

We wish you and your families a very Merry Christmas and a happy, healthy 2007!

John, Maria, & Luke

In the photo above, President Rene Preval gives a Christmas address to children gathered on the lawn of the National Palace.

Sunday, December 17, 2006

One of the Differences Between the Haiti and the Dominican Republic

Please make sure you read to the end of this post to discover what the photograph to the right is of.

I haven't written much about Haiti's disastrous environmental situation. Most of Haiti's once lushly forested mountains are now barren. There are many reasons for this, including the sugar plantations that the colonizing French cleared the land for. Currently, Haitians cut down the trees and turn the wood into charcoal for cooking. Although it is mainly poor people who do this, the rich in Haiti help provide a market for the charcoal as some like the way their food tests better when it's cooked over charcoal than when it's prepared by other means.

Besides being an eyesore, the unprotected, deforested land is vulnerable to the tropical storms that regularly lash Haiti during the rainy season. As the water rolls down the mountains, it takes the topsoil with it. This hurts the fertility of the land and also causes horrendous flooding which kills and displaces thousands of people each year.

The picture accompanying this post is a famous one from National Geographic. It was taken over the border of Haiti and the Dominican Republic. More clearly and starkly than any line on a map, the difference between the mountains of Haiti--the name means high country--and the mountains of the DR indicate the border.

Saturday, December 16, 2006

Kidnapping II

Here are a few more points about the kidnappings.

The kidnappings terrorize the rich and the poor. No class of people has been immune from being snatched. The kidnapping of children to this degree is a new phenomenon.

One of our Haitian Hearts patients called his host family in the United States and asked them to encouraged us to go home, as he was worried about our safety. Our little commitment asleep on the mattress prevents us from doing this. We stay in a safe place, so that's good.

The kidnappings get a lot more media coverage than the kids dying quietly in the slums. Unless the hospital morgue workers put out their bodies in a courtyard to protest their low wages, which happened this week at the General Hospital in Port-au-Prince.

The kidnappings hurt Haiti beyond the immediate victims. People don't want to come here or invest here when they learn about the crime. The kidnappings really hurt the economy.

There are all kinds of theories about why there are kidnappings. One is that the powerful people who control the drugs that move easily through Haiti want to keep the country unstable and the law enforcement corrupt and disorganized so they are allowed to conduct business as usual.

One of Wyclef Jean's workers was snatched. At the concert that Jean put on in Jacmel a few weeks ago, he pled for the release of his employee. The man was released, and this is what one of his captors had to say about kidnapping. "We freed the journalist after considering how much effort Wyclef is doing to help our sisters and brothers in the forgotten ghettos," said a captor who called himself the "Commander." "I don’t like what I’m doing, but I don’t think I have an alternative for the time being," said the Commander, who has three children himself. "Sometimes I really want to stop...I wish I could have a normal life. We also have feelings." Many of the gang members have had terrble lives and now resort to doing terrible things themselves.


I was going to write a post about the kidnapping that's been going on in Haiti lately. Then I read the post my husband wrote at his fantastic blog, and I decided, with his permission, to plagerize it. Why reinvent the wheel? Thanks honey!

On Tuesday my wife and I looked up when we heard the low rumbling chop-chop sound and saw a white UN helicopter circling over one of the major slums in Port-au-Prince. The pilot continued this maneuver for an hour. Obviously he was looking for activity on the ground.

We now know what he was searching for.There has been a string of new child abductions in Port-au-Prince. Gunmen abducted at least 10 children in and around Port-au-Prince this week. Approximately 100 adults and children have been kidnapped in November, and another 60 already in December.What has everyone’s attention in Haiti is that children are now being targeted. Many of the kids are released unharmed, but a six year old boy was recently abducted in the capital and taken to a large northern city and shot.

“Snatch teams” work in the city. They abduct adults by boxing in their vehicle in traffic and heavily armed thugs grab them. The victims are then transported to one of the local slums where gangs move the abducted around and make ransom phone calls from the ubiquitous cell phones which many people carry. Sometimes the abducted person is moved to another gang. Unless you live in the slum or are a gang member, no one can enter the slum safely, including the 9,000 UN soldiers in Haiti.

This week, at several schools in the capital, men would show up after school was let out saying they were the child’s guardian and that they were there to walk the child home. They have shown false ID’s and stolen the child. In an incident that made international news, a vehicle with seven children on board was hijacked by armed thugs just north of Port-au-Prince, and the kids taken. (All the children were released unharmed several days later after a ransom was paid.)

Several days ago a spokesman for the United Nations police force in Haiti said, “Now the kidnappers target children because they know the children are our hearts. They want to hit us in the heart so they can get the money more rapidly.”The residents of the capital are even helping police in door-to-door searches for the missing children.

Fear of kidnapping has led many schools in the capital to close until after the Christmas holidays. The number of children in their school uniforms, laughing and talking with each other while they walk down the sidewalk to or from school, has decreased. Haiti’s infant mortality rate is one of the highest in the world, most Haitian kids do not get enough to eat, suffer parasites, lack primary medical care, and carry heavy loads of water on their heads. When you think that Haiti’s children could not suffer any more injustice, you find out that you were wrong. They start kidnapping them.

Wednesday, December 13, 2006


The vivid blue bowel of a sky was undiluted by clouds except where they ringed the horizon, strewn over the brown mountain peaks. With the sun shining and the temperature in the 80’s, it would almost be possible to think you were in an island paradise.

But then we heard the violent, chop chop chop of the white UN helicopter flying overhead. As we watched its pattern in the sky, I said to John, “It looks like it’s circling.” He nodded. “The slums are right down there,” he pointed to a location about two miles away. Irony isn’t dead in Haiti as the worst slums are on the ocean. “Wharf Jeremie is right there, LaSaline is there and Soleil is there.” The helicopter continued circling for about 15 minutes. “I wonder what’s happening down there,” I murmured.

Whatever it is, it probably isn’t good. “People are trapped down there,” said John and he doesn’t mean this figuratively. The slums are a trap within a trap.

“People can’t get out of the way of the bullets. They can’t go anywhere. They can’t hide.” All too often, the bullets find them.

“The gang members aren’t good guys and the UN soldiers aren’t good guys.” If you’re killed by one of their bullets, it doesn’t much matter whose gun it came from.

“If the poor people sniffle, they get shot.”

“Working in Cité Soleil is voyeuristic,” continues John. “The acuity of the illnesses is severe. I wanted to do so much, but I could do so little.”

Sunday, December 10, 2006

The Face of AIDS in Haiti

You may read reports of the numbers of children in the developing world who are afflictedwith HIV-AIDS. Here is one young man in Haiti who has the disease called SIDA here.
"But then there are the children, and what am I to do about them? That's a question I can't answer. . . Listen! If all must suffer to pay for the eternal harmony, what have the children to do with it, tell me, please? It's beyond all comprehension why they should suffer, and why they should pay for the harmony."
Ivan in The Brothers Karamazov

Friday, December 08, 2006

Merry Christmas Maxime!

We had a major victory this week! Maxime, a 21-year-old young man, pictured to the right was accepted at a major medical century for heart surgery. He needs a new heart valve as the one God gave him was ravaged by rheumatic fever.

Maxime has been to the States once before, a few years ago to have his valve surgically repaired. He now needs an artificial valve put in--they are appropriately called-St. Jude's valves--one that will last him the rest of his life.

Maxime lives near LesCayes, a bumpy, six hour ride away. His brother brought him to Port-au-Prince several weeks ago and John examined him. Maxime ended up staying with us for a night and it was quite memorable. During the rainy season, the water pours from the sky, and in the case of this night, it poured in our room too--right onto my pillow. A leaky roof was nothing new to Maxime, though. His leaky heart is much more concerning.

Hopefully, it will not be leaking for much longer. We are in the process of gathering all of the paperwork and plan to have Maxime on a plane for the States before Christmas.

Wednesday, December 06, 2006

"Team of Rivals: The Political Genuis of Abraham Lincoln"

I've loved everything I've read by Doris Kearns Goodwin from the Kennedys and the Fitzgeralds to No Ordinary Life about Franklin and Eleanor Roosevelt during WWII. Team of Rivals is no exception. Kearns latest tells the story of Lincoln's life through the prism of politics. Her depiction of Lincoln's rise as a politician willing to forgive his friends and enemies to a president who includes his talented rivals in his cabinet is a portrait of the temperament ideal and necessary to lead the country through the devastating Civil War.

Most fascinating to me was Lincoln's progression from a poor young man to an influential Illinois pol. He had to overcome disadvantage that his more privileged rivals--William Seward, Edwin Stanton, Edward Bates, and Salmon Chase--never dreamed of. Lincoln had the magnamity to appoint Stanton as the Secretary of War, even though six years earlier, Stanton had cruelly snubbed Lincoln, even referring to him as a gorilla. Stanton worked like a dog as the Secretary, though, and came to love Lincoln.

As in Haiti, children of the 19th century die frequently and early. The Lincolns didn't escape this scourge. Abraham and Mary Lincoln lost three of their four boys: Edward, 2, to tuberculosis in Springfield, Willie, the favorite child,11, to typhoid fever during some of the darkest days of the war, and Tad at 18, from "compression of the heart," likely caused from TB. Thousands in Haiti die of these diseases today; both are curable with antibiotics.

The book also describes Lincoln's connection with Peoria and other parts of central Illinois. In his great Peoria speech, in which the future president spoke opposite Stephen Douglas in support of keeping slavery out of Nebraska, "Lincoln implored his audience to re-adopt the Declaration of Independence (which stated famously that all men are created equal) and 'return slavery to the position our fathers gave it; and there let it rest in peace.'"

I wrote an op-ed about turning 40 that appeared in the Peoria Journal Star. In it, I quoted a stanza from one of Lincoln's favorite poems, "Mortality," by William Knox. Kearns includes the same stanza in Rivals. With death all around him, Lincoln became preoccupied with the subject as the content of the poem indicates:

Oh! Why should the spirit of mortal be proud?
Like a swift-fleeting meteor, a fast-flying cloud,
A flash of lightning, a break of the wave,
He passeth from life to his rest in the grave.

The older one gets, the truer those words become.

Kearns peppers her account with many of the amusing and illuminating stories that Lincoln told to emphasize his points. When Lincoln was making his historic journey to Richmond, the capital of the Confederacy that was now in Union hands, the president was forced to transfer from a ship to a barge to a row boat, due to torpedoes and other debris in the water. The military men were nervous and chagrined, but not the president. "The situation reminded him, he cheerfully noted, of a man who had approached him seeking a high position as a consulate minister: 'Finding he could not get that, he came down to some more modest position. Finally he asked to be made a tide-waiter. When he saw he could not get that, he asked me for an old pair of trousers. But it is well to be humble.'"

Finally, a piece of timeless wisdom from the timeless sage: While the disastrous battle of Bull Run was going on, Lincoln took the time to write a cadet who was miserable at West Point and was contemplating quitting. "'Allow me to assure you it is a perfect certainty that you will, very soon, feel better--quite happy--if you only stick to the resolution you have taken to procure a military education. I am older than you, have felt badly myself, and know, what I tell you is true. Adhere to your purpose and you will soon feel as well as you ever did. On the contrary if you falter, and give up, you will lose the power of keeping any resolution, and will regret it all your life.'"

This little blog review can't do Lincoln or Ms. Kearns' book justice. My advice to you is to read the book.

Monday, December 04, 2006

What's Up? Who Knows.

It’s a riddle wrapped in mystery inside an enigma. Winston Churchill described Russia this way, but he just as easily could have been talking about Haiti. It is difficult for Haitians, much less visitors, to figure out what is going on. UN troops roll their tanks through Cité Soleil and fire their machine guns hoping to kill gang members but the bullets more often find innocent people. The young man above is on crutches because his leg was shot off. His look-a-like brother is also on crutches having nearly lost his leg to a bullet.

Some of the gangs run kidnapping rings. We’ve heard that they share a cut of the proceeds of the ransoms with UN soldiers who look the other way as the victims are brought into a holding house in the slum. Perhaps this would explain why UN soldiers in their tanks watched as an American was kidnapped in front of them last year. Or maybe the alleged anti-Americanism of some of the troops, who hail from places like Jordan and Sri Lanka, is the reason. But then occasionally, UN soldiers are killed by gunfire from Soleil. Some Haitians refer to the UN troops as tourists, whose main interest is in making connections with local girls.

Common wisdom is that hostages are released after a ransom is paid, as was the case with our Haitian friend Paul a few of weeks ago. But then a couple days later, the same gang killed a 21-year-old girl after a $4,000 was paid for her release.

And the gangs, what’s their deal? Some people say they are just common criminals with a criminal’s motive of profit. Others say that they are loyalists of Aristide who want to destabilize the government and are calling for his return. Then others say they are secretly supplied with guns and money by right wing enemies of Aristide. Some left wing publications refer to the gangs as community organizers. The UN troops are the real villains they say. The only reason John can go into Cité Soleil safely—if you don’t count the random UN bullets—is because he is accompanied by someone who has a good relationship with the gangs. Plus he is providing much needed medical care. Then there’s the view that the young men who make up the gangs have no other alternatives in Haiti. They are hungry and angry because they know the way the rest of the world lives.

It’s hard to figure and hard to predict too. Who would think that a well-regarded film festival held in Jacmel, this past weekend, a concert fronted by Wyclef Jean, would make a tour of Cité Soleil and some of the other slums? But that’s exactly what’s going to happen later this month. A truck carrying a 15-foot-tall screen will make its way to Port-au-Prince and beginning December 11, will show films dealing with issues that face the audiences—AIDS, crime, domestic violence, and child slavery—while entertaining people too. In the midst of hunger, disease, and violence, people will get to go to the movies. For lives that are unremittingly hard and painful, this may seem like frivolity. “Life is so fragile here,” said one young man. “You go to sleep not knowing if you will wake to see another day.” But as Haitian-American writer Edwidge Danticat said, “Sometimes it’s that one moment that flips things. It can be pretty incredible and could flip the way you look at the world.”

Friday, December 01, 2006

Children of the Slums

These are pictures John took this week during his work in Cite Soleil and LaSaline, two Port-au-Prince slums where the poverty is vicious. But the children are luminous.

Thursday, November 30, 2006

Books Gone Wild

I’m way behind in my book reviews. On this overlong trip (four months and counting), I have read Left to Tell by Immaculee Ilibagiza, Pride and Prejudice, To Kill a Mockingbird, parts of “The War Against the Cliché” by Martin Amis, “Team of Rivals: The Political Genius of Abraham Lincoln” by Doris Kearns Goodwin, “Mediated: How the Media Shapes Your World and the Way You Live In It” by Thomas De Zengotita, “Inspiration” by Wayne Dyer, “Finding George Orwell in Burma” by Emma Larkin and probably a few more that I’ve forgotten. I’m currently reading “The Brothers Karamazov,” and at my 21 pages a day schedule, should finish it by the end of the year.

So which book was my favorite? “Team of Rivals,” largely because of its subject matter but also because of Goodwin’s writing talent. I will write mini-reviews of each of these books. In some way, these books have something to say about Haiti and as I know your interest in Haiti is why you’re reading this blog I will make sure to point this out.

I discovered the book blogs on this trip: Conversational Reading, Slush Pile, Syntax of Things, Book Fox, etc. Yikes! They are great and educational, but big time suckers too. The internet is infinitely interesting and a lot of other things too.

Tuesday, November 28, 2006

A Pictorial of Haitian Slums

I’ve posted pictures of some of the worst slums in the world: Cité Soleil, LaSaline, Warf Jeremie. They are all in Port-au-Prince and aren’t fit for rats and goats much less human beings. Yet, hundreds of thousands make their homes here.

John has been working in these slums over the past couple of weeks at a mobile clinic. He has been accompanying a priest who has decent relationships with gang members, which allows them to move through the slums somewhat safely. Besides the awful filth and poverty these people live in, they also have violence to contend with. The gangs control the slums. Occasionally, the UN makes shooting forays through the slums and the bullets fly indiscriminately, as one .

The people have sad and lovely faces. They shouldn't have to live like this.

Saturday, November 25, 2006

Filling the Water Jug

The details tell a story. Take the water jug in our little refrigerator, for example. The water that comes out of the faucets in Port-au-Prince is not safe to drink. So most mornings, the housekeeper fills the jug with purified water. Now, here’s the interesting detail: she fills the bottle as close to the top as she can possibly can. This makes it practically impossible to pour the first glass of water without spilling it, especially for a klutz like me. It’s not only the nice housekeeper who does this. So do the bartenders and waiters when I’ve taken the bottle to them.

So what does this tell us about life in Haiti? Here’s my theory: too many Haitians, including those who work at the hotel, clean water is a precious, precious commodity. Many of them have to walk miles each day for it, carrying bottles on their heads. It only makes sense, then, that one would fill the bottle as full as one possibly could. Each drop is valuable.

At the hotel, though, this scarcity doesn’t exist. In this situation, it would make more sense to leave a little space at the top of the bottle. The Haitians transfer the sensible rules from one situation where they apply to another situation where another approach would be better. This is a trivial example of a tendency we find often here, that of concrete, in-the-box thinking. We hear this from American educators all the time: their students only want to learn by rote and memorization. The idea of applying knowledge to different circumstances is foreign to them. On Thanksgiving, we dined with an American woman who is spending a year teaching 5, 6 and 7-year-olds. “I try to get them to use their brains, to think for themselves, to problem solve. They don’t know how to do this.” Prioritizing and thinking ahead to the next step seem to be difficult.

John mentions a medical example of the above. A medicine cabinet in a clinic is to be kept locked with the head nurse having the key. A one-year-old boy was having seizures and medicine that he needed was in that cabinet. The nurse left the room with the seizing baby and the medicine cabinet to do charting, and as per the rule, she locked the cabinet, while two doctors were
attending the child. The doctors did not have access to the medicine without spending time finding the nurse and getting her to open the cabinet. But she was following the rule.

The Haitians are resourceful in other ways. They can cook over open fires and get clothes impossibly clean by hand. And I guarantee you, they don’t spill water when they pour it from containers, no matter how full.

Thursday, November 23, 2006

Happy Thanksgiving from Haiti

Did you know that the national U.S. holiday of Thanksgiving began during the depths of the Civil War? Thanksgiving was celebrated at various times by the states prior to this. According to Doris Kearns Goodwin's "Team of Rivals," in 1863, Abraham Lincoln's Secretary of State, William "Seward presented Lincoln with a proclamation that invited citizens 'in every part of the United States,' at sea or abroad, 'to set apart and observe the last Thursday of November' to give thanks to 'our beneficent Father.' The proclamation also commended to God's care 'all those who have become widows, orphans, mourners or sufferers,' and called on Him 'to heal the wounds of the nation' and restore it to 'peace, harmony, tranquility and Union.'"

What do the poor in Haiti have to be thankful for? At times, it can seem like not much. But they would tell you they are thankful to God. The weather in Haiti is good. They currently have a democratically elected president. They are grateful for those who come from other places to help. They love their children. When they have the resources, they are excellent cooks. They love to sing and dance and praise God. They also have hope, mainly in God, for themselves and their children.

In part it seems as if the above proclamation was written with Haitians in mind for this country is indeed a land full of orphans, widows, mourners, and sufferers, much like 19th century America, but worse. Later today, we will be having our Thanksgiving meal with children at an orphanage. These are the lucky orphans though; they are not on the streets or serving as child slaves, restaveks, in the homes of the rich. The proclamation commends these people to God's care.

If you believe, as we do, that God is most present among the poor, the sick, and the suffering, then He is very present in Haiti. He needs us to be His eyes, hands, feet, and ears to help alleviate the misery so many live in.

We want to wish everyone reading this a Happy Thanksgiving. We have much to be grateful for. We are all basically healthy. Our families are doing well. We are making slow progress toward the completion of our adoption. We are in a place where John can use his medical talents on behalf of those who need them the most. We thank the poor Haitians whom we know for showing us what is truly important and for their kindness to us. We thank God for creating the world, including a little boy named Luke Innocent.

Friday, November 17, 2006


One of the most rewarding parts of being in Haiti is seeing Haitian Hearts patients. To the right is 5-year-old Jenny. This dynamic little girl had her heart repaired at Cleveland Clinic this past spring. Jenny had a congenital defect called a patent ductus arteriosus. This is a hole that we all have when we are in utero, which allows blood to bypass the lungs, since our mother is breathing for us. After birth, it normally closes within 24 hours and when it doesn’t, intervention is needed.

The good news is that this defect can be repaired in a cath lab without open heart surgery. A interventional cardiologist threads a coil through the child’s femoral vein and it closes the opening. Jenny came through her procedure with flying colors, spending only one night in the hospital. Now she is back in Haiti with her mom. Her pastor, who originally brought Jenny to John because he knew she had a heart problem, recently brought her to the clinic where John works. Joltin' Jenny looks great!

Saturday, November 11, 2006

Hungry & Sick

A couple of weeks ago, we had lunch at the Hotel Montana, a fancy-schmancy place that overlooks Port-au-Prince. We met Dr. Gretchen Berggren, a U.S., Harvard-affiliated physician who Paul Farmer called the Mother Superior of public health in Haiti. She and her husband have worked decades in Haiti, trying to eliminate maternal tetanus and a host of other childhood diseases. They began their work in Haiti at Hopital Albert Schweitzer in Deschapelles, a hospital where John spent four months working in the nineties.

As part of their work, they collected demographic and health information on people in the areas they studied. They would then try to implement commonsense health procedures, like pregnant women having a birth plan. When women have a plan, they are less likely to deliver at home

After meeting her and hearing a little about their work, I asked Dr. Berggren what the number one public health problem in Haiti is. “Malnutrition in children under five,” she responded without hesitation. She went onto explain that a lot of deaths from diarrhea and pneumonia were actually caused by malnutrition as children were too weak to fight the illnesses.

It was a little bizarre talking about starving children in a gran manje place like the Hotel Montana. Gran manje literally translates as “big eater.” It is a derogatory term for the elite in Haiti, particularly the elite who don’t care much about the poor people who surround them. They are big eaters in a land where food is scarce but bizarre experiences aren't.

John saw the children pictured above at the clinic. They both suffer from malnutrition and also possibly tuberculosis. I have fantasies of taking children like this to the Country Buffet.

Thursday, November 09, 2006

Who Gets a Chest X-ray?

Above is a picture of a chest x-ray from one of John's patients. Many people come to the clinic with bad sounding lungs and getting an x-ray is crucial to diagnosing the ailment, particularly when it could be tuberculosis, which is lethal, though curable with the right meds. The good news about x-rays at this particular clinic is that they only cost the equivalent of $6.50 U.S. The bad news is that many of the patients don't even have this much money, and neither do their friends and relatives.

In many cases, Haitian Hearts pays for x-rays, medicine, and food for patients. We can't do this for everyone, though, which is an agonizing, Sophie's-choice type situation to be in daily. Who to help? We are limited people in a land of unlimited need. This reality doesn't stop us from wanting to help, but does leave us feeling badly for those we don't assist.

How do we decide? We look at the way people are dressed and their over all condition. The signs of malnutrition are obvious. How ill the child is also plays a role in the decision. If the parents are carrying cell phones, we don't give them money. But most of the people who come to the clinic are poor, hailing from places like Cite Soleil or other slums throughout Port-au-Prince. The little bits of money--to us--that we give out at the clinic can go a long way to saving lives.

Friday, October 27, 2006

The Comeback Kid Part II: Willy Fortune Malavolti

Prayers, the will to live, and good medical care can go a long way in keeping a person alive as they did with our friend Willy Fortune. Here is a belated update on Willy. He was hospitalized at OSF St. Francis Medical center on June 21 with shortness of breath and lots of fluid on his abdomen. (You can read more about these events at the entry from July 26, The Story of Willy Malavolti).

After more than a month in the hospital, on July 28, Willy had surgery to replace two heart valves on. He was in critical condition for weeks afterwards. He remained on the ventilator until August 16, had fluid on his lungs, blood clots, emergency surgery for a punctured colon, and chronic kidney failure. Willy coded at least once during this time. One of the doctors on the floor gave him a zero percent chance at survival, but added that because it was Willy, that might be enough.

And sure enough despite some setbacks, day by day, Willy grew stronger. His kidneys were supported by dialysis and when they continued not to improve, peritoneal dialysis was installed on September 23. The day before this procedure, Willy was able to talk with his Haitian mother who told him he was being prayed for all over Haiti, including at the cathedral in Port-au-Prince. She told Willy to have faith. “God begins things, and God ends things, she told him.”

On October 5, the miracle we were all praying for, the miracle we hoped the Haitian statue of Mary overlooking Willy portended, occurred. Willy went home from the hospital! He is now with his large and loving family, continuing his recovery. Please keep Willy and his family in your prayers!

In the picture above, Willy's Haitian mom holds a picture of him at his home in the United States. She had just spoken on the phone to Willy, who was in his hospital bed at OSF St. Francis Medical Center.

Thursday, October 19, 2006

The Innocents

My husband John, besides being an amazing doctor, also takes some amazing pictures, this being one of them. On the way to clinic, the driver was following this U.N. tank, when the soldier leveled his gun as they passed a cemetary on a dangerous corner. What a world we've created for our children.

Tuesday, September 19, 2006

The UN's Commitment Problem

Last week an orphanage in Croix-des-Boquets, a village not far from Port-au-Prince, was attacked. The orphanage director, a Catholic sister, had fired a teacher for a problem, and he retaliated by returning with about 120 people, who were armed with machetes, sticks, and clubs. They wanted to execute the three sisters in charge and burn the building to the ground. The Haitian police couldn’t handle the situation, so the UN was called in. They surrounded the building and escorted the sisters from the premises.

Rather than disperse the violent crowd, though, which given their significant firepower—tanks, machine guns, etc—one would think they could do, they guarded the building until arrangements could be made to transport the children to other orphanages. After about two days, they loaded up the children on a school bus and took them to their new homes, namely other orphanages that had agreed to take them in. The bus got stuck in a ravine, and the UN soldiers had to call the orphanage director to come and get the 11 boys they would be caring for, all of whom had been riding around in the hot bus all day with no food or water.

In the meantime, back at the orphanage, the crowd was allowed to loot and demolish the orphanage contents and buildings—home, school, church. It is doubtful that any of those children will ever return to this location. And who knows if the Sisters can safely continue to work in Haiti.

The minimal response from the UN soldiers—peacekeepers—is why most people in Haiti vastly preferred the presence of the U.S. Marines to the UN. The Marines wouldn’t tolerate this kind of behavior by a lawless crowd. All over the world, the UN peacekeeping forces have been criticized for their lack of action. They stand around while crimes are committed in front of them. The forces here in Haiti are drawn from countries all over the world—Sri Lanka, Pakistan, Chile, Brazil, China. It’s a stretch to call some of these guys professional soldiers. In fact, the Haitians call them tourists, as the main goal of some of the soldiers seems to be hooking up with local girls.

Occupation by a foreign power is never ideal and centuries of complicated history involving the exploitation of Haitians has led to this state of affairs. But if you are going to have occupiers who carry big guns, they should use their power to defend and protect the innocent and not allow the bad guys to carry out crimes resulting in the displacement of 50 children and the theft and destruction of property.

Hard Life, Big Smile

Smiles seem more dazzling in Port-au-Prince, where they stand out against the harshness of life and the bleakness of the cityscape. This man is one of the lucky poor. He has a job. He cleans our floors and bathroom, and he cleans them very well. He removes his shoes when he comes into the room so that he does not track while he mops; he puts one of those white paper bands over the toilet bowel when he has finished cleaning it; he scrubbed part of the floor extra hard to get up a sticky substance. He has pride in his work. This is not true of all of his counterparts. Some of them beg from us, an offense that would get them fired if the owners of the hotel knew about it.

But many of the staff here are very competent. As I was writing this, a waiter we particularly admire handed me a piece of paper with the word “saucers” written on it and asked me how to pronounce it. He got it correct on the first try. This waiter, with his quiet dignity, is always trying to improve himself. This morning another waiter saw our almost-empty water jug sitting on the table and filled it for us. This may seem rather basic, but in Haiti we learn not to expect the basics. John has said of a few of the workers, I would hire him.”

The employees here have a nice place to work. They make a wage that helps them support their families. They all look like they have enough to eat. This is why I call them lucky. Many Haitians, including some who work here, have a dream, and that dream is to get to the United States. For a poor Haitian, this is not a very realistic dream, equivalent to an American’s dream of winning the lottery. And even those of us who are largely satisfied with our lives and have endless options, seem to want more: more money, more happiness, more love, more things. More. More. More. I watch the way the man in the picture cleans our room, with almost a Zen-like involvement in the process and attention to detail and I think: For those of us with enough to eat, this man teaches us a lesson, to live our days well, wherever we find ourselves, and to give our best to others.

Friday, September 15, 2006

A Living Saint

Can't you see how good this woman's soul is by looking at her eyes? Her name is Madame Therese (pronounced Thereze). She is a devout Catholic, who prays the Rosary at least four times a day. Actually, Madame Therese prays all day long--starting with kneeling by the side of her bed in the morning, giving thanks and praise to God for another day. She ends the day this way also. You can tell by her peaceful, warm presence that she spends a lot of time with God. You don't have to ask Madame Therese what the most important thing in her life is to know it's her faith. She walks to Sacre Coeur, her church in downtown Port-au-Prince. When Madame Therese received a gift of a rosary and a picture of Our Lady of Perpetual Help, Haiti's patron saint, she reacted as if she had been given silver and gold.

Madame Therese represents the rubric "poverty with dignity." By American, material standards, she is poor. But she has enough to eat, clothes to wear, a small home, and some education behind her. She speaks French as well as Creole. You can see this dignity in the neatness of her dress and her deliberate, graceful movements. People aren’t more valuable because they have more money.

Madame Therese says that the biggest problem in Haiti is that, "Haitians don't love each other." Certainly we have found that to be the case; many rich Haitians have nothing to do with the poor, and the poor are too busy fighting for survival to care for each other.

Madame Therese spent some time caring for the little boy she is holding in the picture. She would sit on the edge of the bed, watching him as he napped on his mattress on the floor. She laid sideways on the bed when she slept so that she could easily see him. She cared for him with kindness and gentleness, as if he was a temple for the Holy Spirit.

Madame Therese is 54. She looks older than this because life is hard in Haiti, even for those who aren't sick and starving. But her soul is fresh, lively, gleaming, eternal.

Madame Therese is what is good about Haiti.

Blog Over Kill?

No, the above isn’t some kind of evil creature from a planet far, far away. It’s a pair of sickened, blackened, diseased lungs, which got that way by too many years of inhaling smoke, against their will. Pictures of this ilk are sometimes used to try to scare people into stopping unhealthy behavior. But I have it on good authority that these tactics don’t work. Maybe the pictures are too overwhelming or the gruesome consequences are too far in the future to worry about.

So what does all of this have to do with Haiti? One of the main reasons I started this blog was to tell the stories of poor people in Haiti. The details of their lives are largely missing from media and therefore our consciousness. I’ve been on a run of very tragic posts. This being Haiti, the-poorest-country-in-the-western-hemisphere, sad stories beat down the door, especially those involving children. But I don’t want to kill hope along with ignorance. We want things to improve, and for that to happen, we need a lot of people to get involved. I don’t make calls for action in this blog, but my wish is that in reading about how poorly some people are forced to live, you’ll be motivated to do something about it.

So, in view of the possibility that negativity overkill depresses the likelihood of people feeling they can make a difference, in the next few offerings, I’m going to highlight what we like about Haiti—mainly some of these poor people I’ve been writing about. They are survivors—some of the toughest, most resilient people on earth. They have lessons to teach us.

P.S. Oh yeah, I’d stay away from the cigarettes.

Hidden Deaths

The above picture is of the body of a four-year-old boy, wrapped in a sheet. Over the weekend, he had a fever and a seizure. By the time his mother brought him to the clinic on Monday, he was in a coma. He received an IV of electrolyte solution. Four hours later, his respirations turned agonal, the slow, irregular rate heralding death. And then he was gone.

As of 2004, 117 children out of every 1,000 born in Haiti don’t live to see their fifth birthday. These children die of diseases like malaria, tuberculosis, typhoid, pneumonia, diarrhea. Their lives and deaths aren’t reported in western media, other than as an aggregate statistic. At the beginning of this month, a child in Massachusetts died of a mosquito-borne illness. I know this because it was reported in an article by the Associated Press, along with a beautiful picture and a description of the child.

I would like the above photograph to literally flesh out the sad statistic of child death in Haiti. Let’s not protect ourselves from the truth.

Thursday, September 14, 2006

How Haitian Mothers Find Out Their Children Have Died

What happens, is that you show up at the hospital in the morning, like you have every morning for the past two months, this being where your baby is a patient. You’re not from Port-au-Prince, so you’ve been spending your nights in a slum nearby. Back in May, when you first came to the capital, trying to figure out what was wrong with your daughter, you had to scrounge the money from some Sisters to pay for the echocardiogram. The echo confirmed the diagnosis of the nice blan doctor; your baby has a hole in her heart and this is why she won’t grow and is sick a lot

You walk up the stairs to the in patient unit, a little preoccupied. Your baby, Ferna, has been having a hard time breathing lately, although no one else seems too concerned. You walk to your baby’s bed: it is empty. You turn slowly, looking for a nurse. “Li mouri,” she says, with a wave of her hand. She died.

The first picture is of Ferna's mom. She returned to Port-au-Prince several weeks after her daughter died. She and her husband did not have the money to bury Ferna. They do not know what happened to her body.

The second picture is of Ferna, a week or so before she died.

Monday, September 04, 2006

Labor Day

Today is Labor Day in the United States. Haiti has more than its share of holidays—Ancestors Day anyone?—but people who are lucky enough to have a job, don’t get off the first Monday in September day. Haiti’s unemployment rate is high, by some estimates 80 percent. This is only accurate if we consider paid employment. For in fact, the average Haitian without a job has to labor very hard just to survive. Getting water can require people to walk several miles a day carrying heavy containers. I think that’s one of the secrets of being poor: it is hard work.

I am re-reading “Down and Out in Paris and London" by George Orwell. Here is his description of tumbling temporarily into the suburbs of the poor.

“You thought it would be quite simple; it is extraordinary complicated. You thought it would be terrible; it is merely squalid and boring. It is the peculiar lowness of poverty that you discover first; the shifts that it puts you to, the complicated meanness, the crust-wiping. . . Your linen gets filthy, and you run out of soap and razor-blades. . . .You discover what it is like to be hungry. . . you go out and look into the shop windows. Everywhere there is food insulting you in huge wasteful piles; whole dead pigs, baskets of hot loaves, great yellow blocks of butter, strings of sausages, mountains of potatoes, vast Gruyère cheese like grindstones. . . [Poverty] annihilates the future. . . When you have only three francs, you are quite indifferent; for three francs will feed you till to-morrow, and you cannot think further than that. . . You think vaguely, ‘I shall be starving in a day or two—shocking isn’t it?’”

The people in Haiti know a different magnitude of poverty than the one Orwell is describing, but there are similarities. Haiti is largely deforested, a natural disaster complicating a humanitarian one. There are many reasons for this. Of late, Haitians cut down trees, turn the wood into charcoal, and sell it. The rich fuel this practice as much as the poor, often preferring to have their food cooked over this charcoal. A couple of years ago, John and I passed by a shanty. Out in front sat several coffee tins full of this blackened wood charcoal for sale. As we looked at it, the man there said, “We know it is not good for the land to cut down the trees. But we need to feed our families.”

Hidden Lives

I’ve read two books within the last few months that have talked about hidden lives. “My Life with the Saints” by James Martin, has a chapter discussing the largely unknown life of St. Joseph, one of the most revered saints. “Finding George Orwell in Burma” by Emma Larkin describes the repression and censorship in Burma that allow constant injustice to occur in secret.

I find the lives of the poor in Haiti to be hidden from modern view. Oh, the media occasionally punctuates its free flowing, hip, upper class, western narrative with pictures of famine and war victims, refugees and AIDS orphans. But they appear as an exception, rather than the rule, when in life the opposite is true. And the coverage is thin; we only get a snapshot. What are these people’s lives really like? What are their dreams? What are their gifts? What do they contribute to their families and communities? What will they tell you they need for life to be better? What are their personalities like? What makes them laugh?

When a mother and child sit in front of John at the clinic, I wonder what their home is like; what they will do the rest of the day after they leave; what does the mother think about her status as one of the poorest people in the western hemisphere? Does she wonder why people don’t do more to help or just accept that this is the way it is? Who knows about her and her suffering?

We are very familiar with a three-year-old Haitian boy, whose first year of his life is a secret to us, as it soon will be to him, buried in the deep chambers of his memory. We will wonder about this hidden year all of our lives.

To paraphrase Henri Nouwen, poor people may be hidden from the world but they are visible to God. Important things are often hidden. We know very little about the life of St. Joseph or even the first 30 years of Jesus’s life. While the developed world lacks the will to “find” the hidden people of the developing world, most of us want others to know of our good deeds. Jesus said to do good and pray in secret. We have it backwards.

There are those people who are determined to record the secrets that everyone should know, sometimes at great risk to themselves. Emma Larkin writes of such people in Burma. “One friend of mine spent hours each day in front of a run-down computer recording the day’s events as he heard them through the grapevine. ‘I have to do this,’ he said. ‘Nothing is reported in the official news here, so, if I do not write these things down, tomorrow they will be forgotten.’ I also met a historian who is busy compiling a modern history of Shan State in eastern Burma. It is a history of the military occupation of the Shan lands by this government, he explained. ‘I know it will not be published, but I must write it. I must make a record. Then at least it is there, and maybe one day . . .”

I hope this blog reveals some of these hidden people to you, not completely, but at least you will know they exist and a little of what their lives are like.

Monday, August 14, 2006

Ceftriaxone and the Purpose of Life:

“It’s not good when you see nine and ten-month-old babies with dirt under their fingernails,” says John of some of his patients. It means they are spending too much time on the ground in the filth. This isn’t a safe place for anyone, much less babies.

Some of these babies also have high fevers, brought on by various infections. Bacterial infections are treated with antibiotics. We brought 30 grams of ceftriaxone with us, a heavy duty, injectible antibiotic. This drug went generic last summer. Under the brand name, Rocephin, it cost $40 a gram. Now, it’s only $10 a gram in the United States and $33 U.S. a gram in Haiti, which is still much too expensive for the average poor Haitian.

John can usually get about two doses from each gram, depending on the size of the child. Many times he will have a nurse give one injection and have the mom and baby return the next day for another. Often after the first dose, the child will be much improved the next day. Three weeks into this trip, John has already administered about 30 injections.

Of course, the source of many of these infections is dirty water and other unsanitary conditions. Given that we aren’t eliminating the source of the infection, does our work seem pointless? No, and I’m going to let Dr. Francis Collins, who directed the Human Genome Project, one of the most scientifically significant projects ever, tell you why:

“I went to West Africa to work in a small mission hospital for a month. I went there in the midst of all sorts of other scientific endeavors. It was a bad time to leave, but I really wanted to do this. I went there with this image that I was going to make a profound difference in that situation. After a couple of weeks, I was really depressed. Here was a circumstance where all the patients I was trying to take care of had diseases that didn't have to be. They were the consequence of poor public health, of contaminated water, of inadequate nutrition. I knew I could pull some of these people back from death, but I knew they'd go right back out to that situation. My dreams of myself as the healer for this large population were lying in pieces on the floor.

“One morning I walked in to see a young farmer who we had treated the day before for tuberculosis, and he looked at me and he said, 'You know, I get the feeling that you're wondering why you're here.' He said, 'You came here for one reason. You came here for me, and that ought to be enough.' And that sticks in my mind -- more than any moment I think I have experienced in my life -- as truth. We should have our grand dreams, we should pursue them, that's what being human is all about, that's part of the nobility of our enterprise. But we should never forget that what really matters is what you do one-on-one with a single human being. Where you reach out and you try to help them make their life a little better. And if that's all you do, your whole life is to do that occasionally, then you have succeeded.”

John treated the child pictured above at the pediatric clinic at Grace Children's Hospital in Port-au-Prince.

Wednesday, August 09, 2006

Willy and the Will to Live

It has been 12 days since Willy had surgery. He remains in critical condition, though he is now responsive. He has had a number of challenges since the surgery: blood clots in his lungs, renal failure, a tear in his abdomen, and the always present risk of infection. Making it is a long shot. Like many sick Haitian children we have seen, though, Willy has a strong will to live, despite all the suffering he has endured. We see this time and time again in the children whose parents bring them to the clinic where John works. Even in the best of circumstances, these people’s lives are filled with misery. They live in mosquito-infested shacks with dirt floors and leaky tin roofs. They feel fortunate if they get one inadequate meal a day. They have to walk miles for water that may or may not be clean. There isn’t much to look forward to in terms of life improving for them or their children. And yet they want to live. Life is good. “Choose life,” says God in Deuteronomy, and the Haitians uniformly do.

This outlook accounts for the low suicide rate in Haiti. We have never heard of this happening. A 1989 study by the Dade County (Miami) Coroner’s office found that Hispanics, Native Americans, and Haitians have suicide rates of 13.9, 11, and 3.1 per 100,000 population per year respectively.

A posting on the Corbett list-serve, which carries notices and e-mails about all things Haitian, contends that Haiti is a breeding ground for terrorists with sympathies or links to Al-Qaeda. The author’s evidence isn’t very good, but I do think that terrorists can recruit people in places like Haiti, where poverty is so extreme. However, I think that even the most hardened, ideological Haitian would find the notion of suicide bombing crazy. They appreciate the old Cold War acronym MAD: Mutually Assured Destruction . Violence that results in one’s own death? How can that make any kind of sense?

And so they live each difficult miserable day, thanking God for the privilege and for the little gifts He sends them. Voluntarily checking out early is not an option. And if they get any chance to extend their lives though medical treatment, they are going to flight like fury to make it happen. That’s what Willy is doing now. Life is good even when it’s hard.

The picture accompanying this post is of Desir Dukens. Desir is a 16-year-old who lives in Port-au-Prince. He is in the advanced stages of rheumatic heart disease. Like Willy, Desir wants to live, as his blast of a smile demonstrates. But in a land of no heart surgery, the prognosis for Desir is not good.

Accommodations in Paradise:

Americans who come to work in Haiti generally stay in guest houses, hotels, or private residences. For a variety of reasons, we stay at a hotel in Port-au-Prince. John negotiates a monthly rate—about $42 a night—that is cheaper than the guest houses. These establishments charge between $25 and $30 a night, per person, though this usually includes two meals a day. The downside of guesthouses is that guests share a room with other travelers, so there is no control of bedtime or noise. There is no air conditioning. Only a couple bathrooms serve the guests. In some of the guesthouses, mosquitoes are ubiquitous. It would be difficult for us to stay in these accommodations for an extended period of time and impossible for John to ensure the security of his medical equipment.

Our hotel room has a little refrigerator, air conditioning, and constant power, thanks to a generator. We have wireless in our room and our own bathroom. The bed sheets are changed every other day and the floors and bathroom are cleaned. The door locks, so our stuff is safe. It’s no four star place, more like one or two—but it’s cool, comfortable, and safe. The hotel overall is more secure than guesthouses, with a gate and a guard. U.N. forces and other armed people also dine here frequently. A couple of the owners run around with beefy-looking handguns tucked in their back pockets. People have been kidnapped outside of guesthouses and a guard was killed inside one of them. I don’t pretend to think that hotels are immune from violence, but they do seem safer and are definitely more comfortable. Our hotel has a pool—of questionable cleanliness—and an open air restaurant, where we often have breakfast and supper. With the refrig in the room, we are able to keep soda, beer, cheese—all the essentials— on hand and make at least one of our daily meals.

Despite the advantages of the hotel and its relative economy, John feels guilty about bunking here. The whole notion of staying in a hotel seems too plush to him. Until about two years ago, he lodged in guest houses. But for all the above mentioned reasons, he started patronizing hotels, first at a place on Delmas 19. Unfortunately, that part of town was becoming increasingly dangerous—we heard nearby gunfire daily—plus the hotel wasn’t well run. After the maids picked up our dirty towels, we couldn’t get new ones until the towels they picked up were washed and had dried in the sun Why the owners didn’t invest in a dryer, I don’t know, but it was emblematic of the way they treated their help. It was also difficult to understand as occupancy at the hotel was very low. Were towels really so scarce?

So about a year in half ago, we started staying in our current accommodations. This hotel is nicer than the first one we stayed in and also cheaper. Plus, it’s within walking distance of the clinic where John works and not far from the airport. We are some of their best customers, especially now, since people are staying away from Haiti due to the kidnappings. But from time to time, John will go over the math again, as if to reassure himself that staying here really is a better deal. I tell him he can just blame it on me. “I’m married now, and my high maintenance wife insists we stay in hotels.” I wouldn’t care.

In a country where obscene poverty surrounds us, it may seem petty to focus on these details. Last week, a 14-month-old baby girl John had been following, died. He escorted the hysterical mother home. She is from out of town but is staying in a slum called Cité Jeremie. From where we are staying, we could throw rocks and hit the tin roofs of this shantytown. Her accomodations were partially constructed of garbage (see above). People sleep in dirt that turns to mud when the rain comes through their leaky roofs. There is no air movements and mosquitoes swarm through the fetid shadows.

Given that these are the living arrangements of millions of Haitians, we should feel guilty about where we stay. An attorney friend of ours who is very active in social justice work at home and in Haiti occasionally stays at the same place here in Port-au-Prince. The last time we saw him here after he had eaten a good meal and gotten a good night’s sleep he commented on his need for nice accommodations, “I’m a candy ass.” We all are, compared to the poor of the world.

Wednesday, August 02, 2006

A Pizza Party:

On Sunday we went to a pizza party. Our friend Mary, who works at the Missionaries of Charity—Mother Teresa’s sisters—home for the dying in Bel Air, invited some children from the Sisters’ home for children who are sick to the guest house where she stays for pizza and ice cream after Mass. She invited us as well.

About 11:30, Mary and her visiting friend Dee, drove to the children’s home and picked up about 15 kids whom the Sisters had selected to attend the party. These youngsters ranged in age from about four to ten. Some of the children are sick and some are living at the home because their parents cannot afford to take care of them. I asked Mary about one little boy about six who had a bloated abdomen and almost no waist. “He has AIDS,” she told me. A four-year-old boy was blind, though this did not keep him from scarfing down his share of Dominoes Pizza. Yes, there is a Dominoes in Port-au-Prince, two actually. It is the only American fast food chain I have ever heard of in Haiti. An 8-year-old girl was deaf and mute.

All of the kids were still dressed in their church clothes: frilly pink dresses for the girls, yellow shirts and dark pants for the boys. They nibbled on appetizers of cheese curls. Pretty soon the doorbell rang, just like at home, and Mary walked in with eight boxes of pepperoni pizza. The kids got as much pizza as they could eat along with Coke and Couronne cola, a sickly sweet yellow-orange fruit soda.

A 3-year-old boy we have a special interest in sat next to a 9-year-old girl, who shared her soda pop with him. This boy is used to swiping food off other children’s plates, so the sharing is a revelation. Not to have to compete with other children for food and attention: Mon Dieu! What a world! John sat next to the blind boy. “He was very interested in the pizza,” John said. “He had no problem locating it and eating it.”

Mary told us a story about a handsome 8-year-old boy at the party. He came to live with the Sisters because he was sick, but after he was better, his parents did not return for him, which is frequently the case. The Sisters had found an adoptive family for the boy, but he didn’t want to be adopted; he wanted to live with his mom and dad. A staff member and the boy went to the boy’s town to search for his family. They searched and they searched, but couldn’t locate them. The staff member said, “We can’t find them. We have to go back to the Sisters’” The boy said, “Let’s look for a little while longer.” Heartbreaking.

The kids burned off their lunch by running laps around the house in a giggling herd with the 3-year-old leading the way. The older girls would haul him up the five stairs on either side of the house. It was like watching the running of the bulls in Spain: an exuberant stampede of childhood joy. No one was smiling more broadly then the 3-year-old. What fun to play with the children!

We have come to know up close how much potential these children have. The smarts and athleticism and creativity and spunk and personality they possess stand out in bold relief against the depravity of their environment. These children are descended from some of the toughest people on earth: those who defeated Napoleon and established the first republic via a slave rebellion. We can see in all these children gifts that their environment doesn’t always nurture or allow them to exercise. It’s a loss for the kids but also a loss for the world because we need them.

After the running around, Mary served vanilla, strawberry, and chocolate ice cream, as much as everyone wanted. It was the end of a very good party.

The young man in the picture wasn't at the pizza party, but he too, has a lot of potential.

Wednesday, July 26, 2006

The Story of Willy Malavolti (AKA Willy Fortune)

The Story of Willy Malavolti (AKA Willy Fortune):

The children above and to the right are Willy's fellow citzens, who are sick right now in Haiti.

John met Willy Fortune about eight years ago in Haiti. His mother lugged the playful boy with the blue lips up the mountain to the hospital above Les Cayes, where John worked. John could tell by Willy’s look and the sound of his heart, which for starters, was located on the wrong side of his chest, that he had congenital heart disease. An echocardiogram in Port-au-Prince revealed Willy to have multiple serious heart problems, including transposition of the great vessels. Children with only this defect never live to the age of 10, but some of Willy’s other defects were offsetting the transposition enough that he was still alive, though blue.

Physicians at OSF St. Francis Medical Center reviewed the echo and medical history of Willy and decided they could help him. In 1999, Willy flew to the United States and had the first of his two heart surgeries to repair some of his defects. There were major complications, and he spent five months in intensive care. During the second surgery, Willy had to have a pacemaker put in to regulate his heart beat because his conduction system, the electrical portion of the heart that controls the beat, was damaged. After he recovered, Willy was discharged a much healthier boy. He flew to Boston to be with his father. Some time later, his father flew Willy back to Haiti, where he lived with his mom and sisters in two room cinder block house on the side of a mountain.

John was fired from OSF in December 2001. About a year later, OSF ended its involvement with Haitian Hearts. During John’s frequent trips to Haiti after Willy returned, he examined Willy and took him medicines. In January 2004, on a trip to Haiti, when John examined Willy, his heart would only beat 60 times a minute no matter what his activity level. Willy’s pacemaker had a five year battery in it and it was getting close to the end of its life, so it was conserving energy. John e-mailed OSF and asked if they would replace Willy’s pacemaker battery, a relatively minor but crucial heart procedure. He offered to pay for the procedure. OSF refused and their attorney sent a letter saying that they wouldn’t accept any of John’s Haitian patients because of his attempts to embarrass the hospital through his picketing.

John returned to Haiti in March. Willy’s mom told John that Willy had almost died and was very weak. A physician friend of John’s was able to get Willy accepted by a hospital in Tennessee. In May 2004, Willy ultimately had a new pacemaker put in his heart at Vanderbilt Children’s Hospital in Nashville. His Peoria host family then flew him to Peoria for John’s and my wedding. After we returned from our honeymoon, Willy came to live with us for a few weeks. We knew that his chances at continuing good health were not good in Haiti, so we decided to search for an adoptive home for Willy.

Rose and Al Malavolti answered an ad John’s mom placed in a national Catholic newspaper. An experienced adoptive couple, they came to our condo with some of their many, well-behaved children. Like most people, they fell in love with Willy. A couple weeks later, he went to live with them. In the past two years, Willy, who due to his severe heart condition, spent no time in school in Haiti, learned to read. He also became Catholic. He is now surrounded by 14 brothers and sisters, six of them Haitian also, who along with his parents have given him a wonderful family.

As we gathered the necessary legal papers for the adoption, a finalization date was scheduled for July 5, 2006. In the spring of 2005, Willy began to retain fluid in his abdomen. In June, his parents took him to a pediatric cardiologist in Rockford, where they live. The doctor examined Willy and said because of his complex history and anatomy, he would be best served by going to Chicago or to OSF in Peoria where the doctors were familiar with his case. John spoke with pediatric cardiologist Dr. Doug Schneider who said he would see Willy.

The Malavolti’s drove Willy to Peoria on June 21, 2006. He was admitted to the hospital through the emergency department. An echocardiogram revealed that he has two leaky valves, causing his poor heart function. A cardiac catherization indicated that his heart is likely strong enough to withstand the assault of surgery. What is known for certain is that without surgery, Willy will soon die. He will hopefully have surgery later this month. The oxygen, IV medications and nutrients, and constant monitoring are currently keeping him alive.

It has been a tough road for Willy, but we believe that God is giving us signs that things are proceeding as they should. A big one is that he is at OSF St. Francis Medical Center. After refusing him two years ago, the hospital accepted Willy as a patient. He has insurance through his parents and he came in through the emergency department. Plus, he is probably not considered a Haitian Hearts patient anymore. Whatever the reasons, it’s good that he is there as the doctors in the pediatric cardiac practice are the most familiar with Willy’s complicated heart.
Due to his fragile health, Willy has had his ups and downs during his hospitalization. As the adoption date of July 5 approached, it became apparent that Willy would not be able to leave the hospital for the courtroom hearing. The family’s attorney, Willy’s court appointed attorney, his parents, and I all met in the courtroom at the appointed time. Because of Willy’s condition, the judge said he would go to OSF later that evening and do the adoption.

At 5:30 pm, the same players along with a court reporter, all assembled in room G218 of the Pediatric Intermediate Care Unit (PICU). Willy’s sister Ann and brother Pascal were also present. After a brief hearing and amid many smiles, the judge signed the adoption order. There were hugs all around. The most crazily optimistic or imaginative person in the world could not have predicted two years ago that Willy would not only be hospitalized at OSF, but he would be adopted there. Only God could have thought up this one.

John and I have been to visit Willy several times while he has been hospitalized. During one of our first visits, John commented that the wooden carved statue of Blessed Mother Mary from Haiti that he had given OSF back in the good old days as a thanks for caring for Haitian children was not in its usual place. In fact, John did not see it anywhere. We both felt sad about this.

A little over a week ago, we went to see Willy on a Sunday evening. It would be our last visit before we left for out Haiti trip. A couple of days before, Willy had been once again moved to ICU as he had had problems breathing. On this evening, he was stable and the swelling in his legs decreased. We joked and talked with him for a few minutes and then said good bye. Across from Willy’s room was a small, no longer used nurse’s station. “There’s the statue,” said John and I looked up to see a light brown wooden statue of Mary, surrounded by several children, on a table against the wall of the station. She was facing diagonally, looking directly into Willy’s room.

We do not know what the outcome will be for Willy at OSF St. Francis Medical Center, but we are grateful to the forces that allow him to be there. Willy wants to live and has emphatically said that he wants surgery. He knows it will be high risk. Please keep him in your prayers

Wednesday, July 19, 2006

A New Girl

Fastina was successfully operated on in Joliet, Illinois. After staying with us for a week in Haiti, Fastina, John, and I flew to St. Louis on Thursday, May 18. We spent the night there and then drove to Joliet the next day, where Fastina had some pre-op testing. Fastina was scheduled for surgery on Tuesday, and we decided she would spend the weekend with us at home.

On the drive back to Peoria from Joliet, we noticed a familiar-looking grey car. We called a number and discovered we were following my cousin, Dr. Dennis Killian, who coordinated Fastina’s pre-op testing and was her cardiologist. We grabbed a bite to eat with Dennis and some of his friends that evening. We returned to Joliet on Monday and Fastina had surgery on Tuesday. John was in the OR and he said her left atrium was huge, courtesy of her diseased mitral valve, which Dr. Bryan Foy skillfully replaced.

Fastina recovered quickly and was discharged to the loving care of the Sisters who founded the hospital. She was hosted by them at their lovely, modern convent in Frankfort, Illinois; for Fastina, it was like having 40 grandmas. She talked to her mom regularly on the phone and had many visitors at the convent. She is currently continuing her recovery with a family in Peoria. Fastina has put on weight and grown since her heart surgery. Her host mom did some diagnostic testing and 13-year-old Fastina scored in the 6th grade level in math and the 4th grade level in reading English! With her health restored, she now has the ability to fulfill her potential.

Monday, May 15, 2006


Fastina is with us. When we went to the orphanage on Saturday, she tap tapped and walked down the mountain with her mother. Very slowly, as she was in atrial fib and needed to lean on her mother for support. Her heart rate was 150 and her right lung sounded socked in with fluid. So we decided the best course of action was to have her come with us and stay until our flight on Thursday. John can monitor, give her meds, and she will get good food to eat.

“Fastina is like a female Willy,” said John. This is big praise as Willy another Haitian Hearts patient, is one of the most gentle, likeable souls around. There is something angelic about him. I am convinced that he’s been to heaven. Several years ago he was so sick and in intensive care for five months. Who knows? Like Willy, Fastina has a shy, beautiful smile. She is quiet and low maintenance, content to watch television in the cool, dark cocoon that is our room. Today her mom dropped off more clothes for her, and she washed the outfit she had been wearing in the sink.

We fed Fastina watermelon, pineapple, banana, and papaya—John wanted her to have the last two potassium-rich fruits to replace all that she is losing with the diuretics—pizza and French fries. While we were eating, I conducted a little social history interview with Fastina. She is 13 and has two brothers, 18 and 11. When I asked her if she had any sisters, she said her sister was dead. We didn’t know about this. Seven years ago, Fastina’s 9-year-old sister, Melissa, became ill in the stomach—John’s guessing typhoid fever or appendicitis—and after three days of sickness, she died. Scratch the surface of almost any Haitian family and you find a dead child.

When Fastina’s mother came this morning, she brought three relatives with her. When they left, Fastina cried. She doesn’t know how long it will be before she sees them again. In some ways Fastina is lucky. Most kids in the developing world who have hearts damaged by rheumatic fever die. But she is facing a big trip to live among strangers in a different culture, where she will have her chest split open in a dangerous operation. Sound like fun, doesn’t it?

The end result will be worth it, though. Fastina is worth it.
The Beginning of Hope:

Today Rene Preval is being inaugurated as prezidan of Haiti and, oh, the pomp and circumstance. Our little inn is overrun with South American journalists, girlfriends of Venezuelan dignitaries, and French-Canadian police officers. Outside the entrance, three National Haitian police officers dressed in their crisp blue and ocher uniforms sit slumped in chairs under the shade of a few trees. A huge UN vehicle somewhere between the size of a tank and jeep is parked to the side. U.N soldiers from Nepal sit inside the gate, armed for action, but with expressions that say they know this assignment will be about as dangerous as guarding a Sunday morning parade.

This week the parking lot has been jammed with all kinds of vehicles, including a bus from the government of South Korea. All the money that is being spent on people attending and covering this inauguration—any excuse to go to a party in another country. President Bush is sending his brother Jeb, the governor of Florida, to lead the U.S. delegation. On television, we catch a glimpse of him seated next to a woman in a broad brimmed hat—probably the new U.S. Ambassador to Haiti.

Cripes. I mean I know we need our rituals, but the more elaborate they are, the more obscene they seem in a country as poor as Haiti. I suppose in some ways it’s good that the inauguration of the Haitian president is receiving this kind of attention. After Aristide’s ouster and two years of an incompetent, corrupt government, the international community is tired of babysitting Haiti. This inauguration is evidence of a democratic success, so let’s celebrate! And even though Haiti is the lowliest of nations, it too deserves to have ceremonies like the rich countries. Riding back from the orphanage yesterday, we couldn’t believe how clean the streets were. The garbage that normally overflows from the gutters: gone. Even a lot of the rocks and rubble had been swept away, making the ride as smooth as I’ve ever experienced. So PAP can be cleaned up with the right motivation.

The ceremony is being televised and the wait staff and a few guests gather around the bar watching the ponderous events. The Haitians break out in smiles when Preval appears, presidential and dignified in his neat dark suit. Jeers greet the picture of outgoing interim president Alexandre Boniface, who looks clownish wearing a wide red and blue sash across his chest that will be transfered to Preval. As the camera scans the well-dressed crowd attending the swearing in, I can’t help but think that this is Haiti’s parasitic class. They live off the flesh and bones and lives of the poor masses, who become suddenly human when viewed one at a time. Like the dehydrated baby at the clinic on Friday. I’m sure his family is all caught up in the festivities. As these fine people wind their way into the Palace and then the Cathedral, I think, “Today you are at the head of the line, but in the line that really matters, you will be behind your brothers and sisters from Cité Soleil.” I’ll be back there with you.

I guess I shouldn’t make little of these moments of optimism and success, however temporary or even illusionary. How else can change begin? It’s just that Haiti has had so many new beginnings that actually threw the country in reverse.

Maybe this time will be different. This morning at breakfast, John said to one of the hotel owners, a man who we would guess isn’t a fan of Preval, “Today’s a big day.”

“Yes,” he replied. “It’s the beginning of hope.”

Saturday, May 13, 2006

How Many Dying Babies in the World Are There?

John plunged back into his work the day after we arrived in Port-au-Prince at the Grace Children’s Hospital clinic. It’s the Friday before the Sunday inauguration of president-elect Rene Preval, and we weren’t even sure if the clinic would be open. But it was. John was kept busy for four hours with patients, fortunately none of them too sick today.

After we finished our Cokes and had given the nurses an English book they had asked for, we were getting ready to leave, when we noticed a patient who hadn’t yet left. An older woman, her head wrapped in a scarf, sat on one of the wooden benches, holding a listless, pale brown baby. This baby had been a patient of one of the other doctors. His foot was wrapped in tape where an IV had been inserted. John could tell by looking at the baby that he was dehydrated.

“Combyen mwa?” I asked the lady holding him. She held up 10 fingers—10 months old. The baby has no neck strength and his head lags back; he can’t lift it at all, though his brown eyes are surprisingly bright. I don’t think she’s the mom I say to John, and he confirms that she wasn’t. Where is the mother? Mama mouri about eight months ago.

John talked with the lady about how important getting fluid into the baby is. She took a cup and a glass jar with a lid out of her bag. She unscrewed the top of the jar and poured some water into the cup. She gave the baby the water as he lay in her arms, but she gave it faster then the baby could swallow and some of the water ran down the sides of his face. John took the cup to demonstrate how to give the baby water. He poured a swallow into the baby’s mouth, removed the cup and let him swallow. After the baby swallowed, John repeated the process several times. “Jesus,” whispers the woman, under her breath. She doesn’t have time for this. She probably has more children at home and this clinic visit is taking the greater portion of a day, all for a baby who isn’t hers. It would make her life simpler if this motherless baby would die.

John stares down at the tableau. “The baby wants to drink,” he says, though the caretaker has put the water away again. One of the nurses walks by and hands the woman two packs of U.N. oral rehydration mix. This baby’s most serious problem, the cause of his dehydration, is diarrhea, the leading killer of children in poor countries. The rehydration mix contains sugar and salt, which the baby needs.

But really the baby should be in the hospital, receiving an IV and being monitored by a nurse says John. None of the clinic staff knows if a bed is open in the hospital. “There are babies like this all over Port-au-Prince,” says John, which partially accounts for the lack of urgency among the staff. John gives the old lady 500 gourdes about $12 U.S. “For the baby,” he tells her, and she nods.

John tortures himself over these cases. “If that baby came into an American hospital, I know the 15 things I would do for him. It would be so easy to save this baby’s life,” he says. Even in Haiti in a well-organized clinic stocked with some basic medicines and staff who have the training and time, this baby could be easily cured. Most times, though, in Haiti, the system doesn’t work and the doctors and nurses are overwhelmed and many of them calloused.

“I have to ask myself is this really a human baby?” John continues. Why are babies in Haiti who are totally curable just allowed to die?”

Transitioning from One World to Another:

For me, the worst part of our trips to Haiti is that at some point in traveling we have to get up in what seems to be the middle of the night and with bleary eyes rush off to some airport. It feels so horribly wrong, like being plunked down in frozen tundra wearing only our undies: something is missing, in our case sleep and the sun. On the morning of this trip, I woke up two minutes before our alarm was set to go off, mysteriously jerked awake from a vivid dream. I had been batting a beach ball to small groups of people, single-handedly keeping the ball in the air, while trying to engage the other people in playing. When I relayed the dream to John, he told me Marie was the beach ball.

Marie is the 4-year-old we are escorting back to Haiti. She had successful heart surgery at St. Louis Children’s Hospital and, after a three month stay in the States, is going home. We left from St. Louis for Haiti via Miami. Marie could not have made the trip easier, though the same can not be said of the airlines.

At first Marie didn’t want to leave her host parents to come with us, but as we were walking to the gate, I said, “Marie, ou ap veni avek Dr. John e mwen.”—Marie, you are coming with Dr. John and me—and she nodded. “This is good,” I thought. But Marie didn’t realize that Jim and Jane, her host parents, wouldn’t be coming along, too. So when Jane handed her to me, Marie started to cry. But it only lasted about 10 seconds as we wound our way through the security line. We had beaucoup carry-ons: a large backpack, a suitcase on wheels, two computer bags with laptops, and Marie’s little backpack. The security agents helped us put our stuff on the conveyer belt, and we got to our gate, C10, with 20 minutes to spare.

Marie sat in our laps, played, ate her snacks and asked, “What?” a lot. It’s amazing how much English she has learned, calling to John, “Wait a minute!” if he got ahead of us walking through the terminal. Our two and a half hour flight to Miami was fine, but once in Miami, we faced a two hour delay and a gate change. As we waited, we ate delicious Cuban sandwiches stuffed with ham, pork, and Swiss cheese.

A sign at the Miami airport reads: “Behind this wall, we are building the future Miami International Airport.” I certainly hope so. Besides its frivolous deficiencies, like not enough restaurants, the Miami airport forces travelers to walk cross country distances to get through customs and to the various gates. Our flight was switched from Concourse A to Concourse C. We walked for 20 minutes to get to our new gate. After we had been walking for 10 minutes, we saw signs that said Concourse E is 16 minutes away. You can walk a mile in 16 minutes!

The flight to Port-au-Prince was fine. Marie fell asleep, leaning against the side of a fellow passenger, who didn’t seem to mind. We were the only plane being unloaded on the windy tarmac of the Touissaint L’Overture International Airport, so we got through customs and claimed our luggage quickly.

Marie is returning to an orphanage where she has lived for the past year and a half. Prior to this, she lived with her grandmother. When her heart problem—Tetralogy of Fallot—was diagnosed, the grandmother placed her in the orphanage so that she could get better nutrition as she waited to be accepted by a U.S. hospital for surgery. My mind is a little eased that we are returning Marie to this place, with its three meals a day, clean water, and schooling, rather than a poor Haitian home. A worker from the orphanage and a teenaged Haitian Hearts patient who also lives at the orphanage are waiting for us. We get into the battered, blue SUV and drive off. They drop us off first. Little Marie climbs in the front seat—no car seats or often seatbelts in Haiti—for the last leg of her journey.