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.