Friday, March 31, 2006

Sister Sophie’s Clinic:

John has been coming to this clinic for many years. Mondays, Wednesdays, and Fridays are pediatric days, and the moms begin lining up with their children at 3 a.m. The clinic averages 50,000 patient visits a year, comparable to a good-sized U.S. emergency room. When John isn’t there, the clinic is staffed by two doctors, a few nurses, and some pharmacy techs. One of the nice features of this clinic is that one small fee covers the appointment and any necessary medicines.

Given the violence, we haven’t been here since September and it is good to see Sister Sophie again. We catch up on all the news in the neighborhood. Despite the reduction in violence, a neighborhood vagabond was shot 17 times and killed (redundant) by a rival gang the prior evening not far from the clinic.

The first child John sees has swollen, hardened lymph nodes under his arms so John orders a chest x-ray. The next few kids have mild fevers, coughs, and running noses—the Haitian crud, John calls it. He attempts to look in the children’s ears with his otiscope as they sit on their mothers’ laps. The otiscope with its pointy probe must look like an instrument of evil to the kids, as they want nothing to do with it. But ear infections are rampant in Haiti, so it’s important for him to check. As we lay the third screaming child on the cot to hold her down so that John can get a good look in her ear, he jokes, “ It must be bad child day today.” In reality, John likes to take care of kids because they have no interest in being seen by a doctor, which to him is a sensible attitude. “I didn’t ask to come here today and have that thing stuck in my ear,” he imagines the child saying to his mother. Many adults, on the other hand, are only too happy to go on and on about what ails them and will take all the attention a doctor can give them.

Being Friday, it’s a fairly light day at the clinic. We will see what next week holds.
On The Way to Sister Sophie’s Clinic:

In December, conditions were so dangerous in Port-au-Prince that we didn’t go to one of our regular workplaces, a clinic run by an order of Catholic sisters on the outskirts of the city. It was not safe for Sister Sophie to send a driver for us and the circuitous route the driver would take made the trip to the clinic last one hour.

At least temporarily, things have improved greatly. Kidnappings and all crimes are down. Pierre picked us up at 7:45 a.m. and the trip only took 20 minutes, even with a couple of UN soldiers from Brazil pulling us over to check the car’s papers. Pierre said the city has been quiet since the elections. “Before the elections, there was violence. Afterwards, it is calm,” he said. This doesn’t seem like a coincidence and is evidence that the violence was more political in nature than criminal. People were frustrated by Aristide’s ouster and the interim government, which didn’t seem to have the interests of the poor in mind.

The ride to the clinic is an exploding, visual cornucopia, a moving collage come to life. A cow ambles down the sidewalk next to a child walking to school. A little boy in raggy clothes perches on the railing of a bridge over a riverbed that is mainly dry despite the frequent evening rains. I wave and he smiles and waves back. The crowds that surround one driving through PAP can seem impersonal and overwhelming and then all of a sudden with eye contact, a brief, intimate connection is made. A grammar school aged child stands naked next to a water pump, examining his dusty jeans. A woman walked out of a hut clutching the hand of a toddler dressed in clothes that are impossibly pristine white, given the dirt that is everywhere in Haiti. Four little boys in matching tan shorts and checkered mauve and blue shirts, their school’s uniforms, try to hail our SUV as if it’s a tap tap. One of the rare Haitian senior citizens sits in a straight-backed chair on his little porch, his head bowed, asleep.

Everyone is telling us that Haitians are placing great hope in the new president Rene Preval. While the poor are already happy with him, he seems to be striking the right tone with the wealthy in his meetings in Washington D.C. with the World Bank, IMF, and U.N. He wants the U.N to remain and he wants foreign investment. Sister Sophie, always a realist, thinks that governing will be difficult for Preval. “There are three groups in Haiti: the poor who voted for Preval, the intellectuals who favored Manigat, and the rich who wanted Baker.” She said the people who don’t want Preval are waiting to make their move. “The Haitian people are very patient,” she said.

Yesterday some friends of ours who run an orphanage told us what happened in Haiti when the people stormed the Hotel Montana in February. The Montana is the ritziest place in Haiti, on par with a luxury hotel in the U.S. It is up on a mountain overlooking PAP. The election commissioners were there trying to decide whether a runoff election should be held, something that many thought would be fraudulent, given Preval’s enormous vote tally in the first round. Kofi Annan and Bishop Desmond Tutu were also there. Somehow, the people busted through the gates of the hotel and were frolicking in the pool and hotel environs. Our friend told us unmarked white helicopters, probably from the U.S. special forces flew in and were hovering over the Montana. When they started flying circles in unison, which according to our friend, is firing position, he had all the children go inside. Shooting wasn’t necessary; there was no damage to the hotel and the people left peacefully. It’s telling that the U.S. would fly in to protect this hotel and its clients, though.

Yvon, Sister’s other driver, took us back to our place after clinic was over. As a testament to how things have changed, he drove one of the most direct routes back, through Cité Soleil. The barricades preventing traffic had been removed and U.N tanks were posted throughout. The street leading to Soleil was re-christened Dred Wilme Blvd. in honor of one of the gang leaders who was felled by a U.N. or Haitian police bullet a few months ago. We see evidence of all the bullets in the holes in the walls and buildings that we pass going through the seaside slum.
Jackson’s Room:

We’re staying in room 17, the same room we were in when Jackson was with us during the month of December. Without his chaise lounge chair from the pool, the room is more spacious. There are new bedspreads on the beds, but otherwise the room looks the same. We brought a suitcase for Jackson, or rather his family. It contains all of the clothes and other things—a Bible, some pictures—he brought with him and also pictures from his funeral, a CD player Jackson was given in the hospital, a stone with his name carved on it and some other items. It’s a heavy suitcase. We will also be giving his mother some money from the memorials that were given in his memory.

It may seem morbid to have pictures of Jackson after he died and of his visitation, funeral, and burial, but our thoughts that they will be important to his family were confirmed today with a phone call. I was speaking with Sister Rose, who helped us get a U.S. visa for a child. She had talked on the phone a couple of times with Jackson’s sister, Nadia. Nadia asked Sister, “Did Jackson really die?”

This isn’t as strange a question as it might seem. I remember when my Uncle Joe died suddenly of a heart attack in NYC. We had his body cremated and never saw him after he died. His death had such an unreal feeling about it—don’t they all?—made more acute by never seeing his body. I kept wondering/hoping if possibly a mistake had been made. I can imagine a Haitian family going through the same process with even more disbelief: Jackson died in another country, a place he had come twice before and gotten better. Plus his relatives weren’t able to participate in the funeral or burial. We are hopeful that the pictures and other items will help the family in their grieving.

A couple of employees at the place where we are staying have asked about Jackson. One of them shrugged his shoulders when we told him that Jackson died. “That’s the way it goes,” he said. “You did everything you could for him.” With a sky high child mortality rate and an average life span that doesn’t reach 50, Haitians are used to dealing with death. Jackson’s family is no exception: his mother has lost her husband and two other sons.

Thursday, March 30, 2006

We’re Baaack! (3-29-06)

Finally, I’m being true to the name of my blog again, as we arrived at the Touissaint L’Overture International Airport at about 11 am today. The cell phone system in Haiti was down but the one-armed man at the airport who is always happy to see John found us a ride to our place, less than 10 minutes away. For a fee of course. We were happy to pay as we had five heavy suitcases that also happily arrived in Port-au-Prince at the proper time. We didn’t want to have to worry about these bags in Miami, so we took the chance of checking them all the way through from Peoria to Port-au-Prince and they didn’t wind up being one of the 200,000 bags lost permanently each year. Our friend rode with us from the airport, saying, “God bless my county. The bad is finished!” After unloading the bags, he and the driver pulled away as he was joyously celebrating the tip that he had earned.

The weather here is wonderful, warm with good breezes. Jenny’s pastor, Michel Charbaneau picked her up at the hotel at about 2 pm. Pastor Michel first brought Jenny to us several months ago. She partakes in his feeding program and his church sponsors her in school. We found out that Jenny lives with her mother, and an aunt and some cousins on Delmas 65 in a ravine. The pastor is going to take pictures of Jenny with her mother at her home. “We will be shocked by where she lives,” predicts John. John listened to Jenny’s heart and looked at her ear. Since her PDA has been repaired, she has no heart murmur. “You should have heard it before,” he said. And her ear looks a lot better too; the antibiotic drops we have been giving her seem to be helping.
Taking Jenny Home

Boy, these kids can knock you for a loop. There is something so tragic about Jenny’s eagerness to get back to Port-au-Prince, where only deprivation and hardship await, her family notwithstanding. But when you’re five, all you know is you want your mom. And I am not uneager to transfer responsibility for her. I feel some guilt about this. Small children consume so much attention and energy, especially when you’re not used to caring for them. It’s a tradeoff: we can have the frustration of doing the difficult thing or the guilt of avoiding it.

Jenny has been much better behaved at this end of the trip then at the beginning. She wanted to hold my hand or be held constantly and she was a little whimpery sometimes. Her attention span is good and she doesn’t need constant diversions like most American kids. In Peoria, we sat on the runway in our tiny jet on the runway for an hour and a half before taking off, courtesy of weather delays in Chicago. She was content to look at the planes that did get to depart and play peek-a-boo with the man behind her.

Thankfully, our flight from Chicago to Miami was delayed too. As we finally boarded and walked through the first class cabin, the passengers regarded Jenny with disinterest except for one young woman who said, “Nice backpack!” of Jenny’s new, pink container. I was too tired to explain to the woman that Jenny doesn’t speak English. The attendants on the plane have the weathered attractiveness gotten by spending too many hours in their climateless tubes. “Good Night and Good Luck” is the movie showing. From row 31, I can see seven screens with Edward R. Murrow's talking head, the fourth screen of the black and white movie oddly purple from my angle. “We cannot defend freedom abroad by deserting it at home,” pronounced Murrow, words that are apparently timeless.

These flights are the first legs of an exhausting journey; you can’t get from Peoria to Haiti in one day. We fly to Miami and spend a short, mainly sleepless night in a dingy hotel arriving back at the airport before 6 am for our early morning flight.

We did notice that as we got closely to Port-au-Prince, Jenny's behavior started to deteriorate into punching and spitting. But with the proper investment of time, attention, and love, Jenny would be a wonderful, flourishing little girl.

Like her country itself, Jenny has so much potential.
Jenny: From Cleveland to Indy to P-Town (3-27-06)

We’re on our way back from Indianapolis, having picked up five-year-old Jenny. Her Cleveland-area host family met us there. Jenny may be breaking a Haitian Hearts record for shortest length of stay in the United States. She arrived here on March 8, had her PDA fixed in the cath lab on March 10 and will be arriving back in Haiti on March 29. John and I are escorting her back.

Jenny had a rocky time when she first arrived in Cleveland. She wouldn’t wear a seatbelt, cried and screamed a lot, and was generally a wild child. “I’ve never had a child that I’ve brought from Haiti act like that,” said John after witnessing her run around the cafeteria at the Ronald McDonald House, out-of-control. Someone said, without elaboration, “She can be vicious.”

It doesn’t help that she has a terrible ear infection, which causes pus to drain from her left ear. John said the infection is so bad that it could be beyond the scope of antibiotics and may need the intervention of an ear, nose, and throat doctor. Jenny has only a thin layer of hair covering her scalp. It has been cut close to her head because of ringworm. She has gold studs in her ears and is wearing a navy blue jumper with embroidered flowers at the hem and black mary janes with white socks. Her top front teeth look like her permanent ones and one of them is chipped giving her a kind of tough look.

Jenny has definitely benefited from the civilizing touch of her host family. Their four daughters took Jenny in one hour shifts and all the attention seems to have done her good. When the host parents and Jenny pulled up at the Taco Bell where we were waiting for them, she gave me a big, happy smile through the van window. This was before she knew she was going with us, though. Then some unhappiness ensued. She cried when Dorothy put her in the car. But it only lasted for about 15 minutes. She quieted as I read her “The Cat in the Hat.”

During her short stay with us, she vacillated between clingy, tearful, quietly satisfied, mildly oppositional—she liked any attention she could get and she responded to John’s threats much more quickly than mine—and a little goofy. What probably helped is that we were able to convince her we were in the process of taking her to her home to "Mama Nadege." In fact, when she was crying in Creole, “I want to find my mom,” John asked her if she meant her white mother, thinking she wanted Dorothy, her host mom or her black mother. She said her Mama Nadege.

Friday, March 17, 2006

Live From Cleveland . . . It’s Haitian Hearts!

Since the beginning of the year, Haitian Hearts has spent a lot of time—more than a month—in Cleveland. We’ve been back and forth between there and our home in Peoria several times. There have been three reasons for our presence in this city on Lake Erie, and their names are Jackson, Emmanual, and Jenny. All were cared for by Cleveland Clinic, and two had successful surgery.

However, the name of this blog is Live From Haiti, and we haven’t been to Haiti in 2006. The reasons for that are listed above, along with their compatriots, Marie in St. Louis and Raphaella, of Boston and Miami. Since we haven’t been able to get to Haiti, we’ve brought Haiti to the United States, which is one of the aims of Haitian Hearts. This can be a difficult task as the two worlds—the First World, i.e. the U.S. and the Third World, i.e. Haiti sometimes mix about as well as toothpaste and orange juice. It can be tough to bring kids from a country where running water is a luxury to a place where a main concern is, “Where are we going to go for lunch?” To most Haitians, it seems like we in America have hit the lottery. They would like a piece of this, too. And when they see how arbitrary the whole thing is. . . well, I’m not sure exactly what they think.

The good news for us, since we like spending time in Haiti and of course we want to live up to the name of the blog, is that we should be returning soon to this island non-paradise. We have another patient, Faustina, who has been accepted by a hospital in Joliet. We want to get her up here soon. We also will likely be escorting Jenny back to Haiti. And there are many patients for John to see.

So thank you for your patience (the Haitians have a lot to teach us about that), and rest assured, we will be reporting from Haiti soon.

P.S. Oh yeah, a couple of plugs for Cleveland: it is so lame that the Rock 'n Roll Hall of Fame is located in this great city but the members are inducted into the Hall in New York City. What kind of reverse provincialism is this? You rockers need to get out more. Also, James LeBron absolutely rocks. He may make us relegate Michael Jordan to number two.

Thursday, March 16, 2006

More Good News!

Five-year-old Jenny had her PDA closed today in the cath lab at Cleveland Clinic. This involves threading a spring through her femoral vessel up to the opening between her pulmonary artery and the aorta. Then, the interventional cardiologist pops it into the opening (AKA the ductus arteriosus), effectively closing it. The doctor called John very pleased by how things had gone. Jenny will be able to go home with her host family on the same day, and will likely be cleared to return to Haiti by the end of the month. Jenny’s PDA had not yet begun to cause her serious problems. But it would in the future. It’s great for the doctors to be able to correct a potentially life-ending problem when the child is still healthy. This is a luxury we don’t often have with the children from Haiti (e.g. Emmanual and others), but with Jenny we did.

It’s been our experience that most doctors love, love, love to operate/do procedures on/take care of kids from the developing world. Most of them make a lot of money and this is a way for them to give back. Cleveland Clinic has a lot of residents, fellows and attending doctors from all over the world. Jenny’s interventional cardiologist is from Pakistan. Some of these doctors from places other than the United States have an especially acute awareness of how poor medical care is in the developing world. Jenny’s doctor thanked John for the opportunity to help Jenny.

With two children getting their hearts mended in the span of two days, it’s been a banner week for Haitian Hearts!

Tuesday, March 14, 2006

A Big Week For Haitian Hearts!

Little 4-year-old Marie spent the night in Peoria with us this weekend on her way to St. Louis. She was an angel, who followed us around and played nicely during the time she was here, swinging her feet in time to the Saturday Night Live theme (I know, I know. . . we had her up much too late). Marie lives in an orphanage in Port-au-Prince, and the good training she receives there was apparent in her behavior. She knows how to wash her hands well, flush the toilet, dress and feed herself. While we would expect these behaviors from an American 4-year-old, most kids in Haiti live in shacks with no running water. Such is the case with Jenny, the little girl who came to the U.S. with Marie. Her patient and saintly host family is putting her through a behavior modification program and also praying a lot.

This morning Marie had successful surgery at St. Louis Children’s Hospital to repair a congenital heart problem called Tetralogy of Fallot.! (Okay, this is called burying the lead). She cruised through the surgery and was extubated—a good thing—very soon after surgery finished. She is a hearty little girl and we anticipate that her recovery will be quick.

Marie is what’s known as a pink tet. Her heart defect hadn’t begun to cause her problems, including cyanosis, which would turn her lips and mouth blue. But eventually it would. A couple of trips ago, we met an 18-year-old with the same heart defect as Marie. He was blue, his fingers were clubbed and he was very thin and weak. We are thankful that Marie was able to have her surgery while she was still healthy.

Jenny is scheduled to have her Patent Ductus Arteriosus (PDA) closed on Thursday. The good news is that it looks like the doctors at Cleveland Clinic will be able to do this in the cath lab, and Jenny will avoid the trauma and risks of full blown surgery. The Ductus Arteriosus remains open before a child is born and normally closes after birth. When it doesn’t, then surgery is required.

Like I said, it’s a big week for Haitian Hearts!

Wednesday, March 08, 2006

Girl One and Girl Two

Two little girls, Marie and Jenny, arrived in New York City today with their wonderful escort, Chris. Flights in and out of Port-au-Prince have been so crazy lately that Chris couldn’t get one to the States until today, and she had to fly to Cleveland via New York with an overnight in the Big Apple. Hmm . . . that gives me an idea for a nickname for PAP: the Big Apple Core. Chris called John and said both girls traveled well. What’s a little international travel when you’re a kid fromHaiti?

Jenny will be having surgery in Cleveland and Marie gets to cross the mighty Mississippi to St. Louis for hers. These girls both have congenital heart problems, so we don’t have to worry about them taking blood thinners like we do with people who have bad valves replaced. And we also don’t have to worry about future surgeries, like we do with patients who have valve repairs, because the fixes Jenny and Marie will get will be permanent and nothing they will outgrow.

We cannot thank our wonderful host families enough for their enthusiasm and willingness to participate in this adventure!

Thursday, March 02, 2006

Cleveland Update

Emmanual’s out of the hospital, so we currently have no patient in Cleveland Clinic, although that could change as early as next week. Three-year-old Jenny Auguste has a surgery date of March 7. It’s the usual race with the U.S. consulate and the Haitian social services department in Port-au-Prince to get them the papers in time to get the visa and plane ticket. Our good friend Chris is running the race for us and them, bouncing around PAP like a pinball. If anyone can get it done, though, it’s Chris. She has an appointment at the consulate on Monday for the visas.

We found out about Jenny a couple of trips ago when a Canadian missionary brought her to us. She has a patent ductus arteriosus (PDA), an abnormal connection between the aorta and the pulmonary artery resulting in too much blood going to the lungs. As far as heart surgery goes, it’s a fairly easy fix; the child doesn’t have to go on bypass. I guess she will be the first easy patient we’ve brought to Cleveland Clinic.

There will be a Haitian Hearts’ presence at Cleveland Clinic next week. Stay posted for further details.