Wednesday, June 23, 2010

Driving in Haiti--or even being driven--is nothing if not a adventure. The poor condition of the roads and the vehicles--and poor is a nice word to describe them--makes the strap hanging down from the car ceiling by the window, not just for decorative purposes. The holes and rocks in the road, the lack of driving patterns and lanes, the road-clogging number of cars trying to get someplace in a hurry all combine to make driving challenging at the least and dangerous at the worst.

Drivers in Haiti have to have the reflexes and judgment of expert video game players as negotiating the roads of Haiti, particularly Port-au-Prince, is like being in a real-life video game. More trucks than not have cracked wind shields. They belch black smoke, their interiors are stripped of all but the necessities (and seatbelts aren't considered necessities), and often there are empty beer cans rolling around on the floor.

We were fortunate on our most recent trip to have a fine driver, Jean Claude. He drives for the sisters who run the clinic in Cite Soleil. Besides being a good driver, Jean Claude, like most Haitian drivers, has to know how to keep his truck running. I can't even guess how many miles it has on it, and one Haitian mile has to be about the equivalent of 100 U.S. miles. Jean Claude faithfully and cheerfully got us where we needed to go, and we are grateful to him.
Jean Claude is pictured above with his truck, outside our guest house.

Monday, June 21, 2010

Earthquake Stories

It's been remarkable to hear people's stories about where they were when the earthquake hit. Our friend L was driving home from work. As his vehicle bounced over the rutted roads, he thought, "I need to slow down." He braked but his car continued to rock back and forth. He wondered if he had a flat tire until he looked up and saw the telephone wires swaying wildly. Earthquake. When it was finished, in less than a minute, he continued his drive to his home, part way up the mountain, having no idea of the devastation.

L's wife, who teaches at a school, was home and worried about him. Their cell phones and television were out, and they didn't find out about the extent of the damage until much later. Even until today, there is no cable television in Haiti. It apparently ended with the earthquake.

L was lucky in that his factory wasn't damaged much. Donations from his business associates abroad flooded in, and he and his co-owner divided up the money between his 500 plus employees. One of his employees, Nadia, is the sister of Jackson Jean-Baptiste, a Haitian Hearts patient who died in 2006. L often gives her a ride to and from work.

When we went to supper with L and his wife, he told us about how for fun he had an American Idol-type talent competition among the workers in his factory. He was impressed with some of the singing and dancing talent and would like to have them perform at restaurants, like the one we were at.

L's wife, N, worked at the Union School, a private, American-style, college prep, English language school with grades pre-K through 12. Fortunately, the quake occurred after regular school hours and those who were still on the premises managed to get out safely. Before the earthquake, the school had an enrollment of 300 plus; months after the earthquake when the school started up again, there were only 35 students, as many left for the United States or other countries.

L & N opened their home to medical teams from the United States. For them, life has now largely returned to normal.

Wednesday, June 16, 2010

Through A Mirror Dimly

We talk to all kinds of different people when we're in Haiti, and we hear different opinions of what the problems and solutions are. One of the last nights we were in Port-au-Prince, we went out to eat with an American couple who have been in Haiti for more than 30 years and raised two children there. The man, L, owns a manufacturing business, and the woman, N, is a teacher.

We had dinner in a restaurant. Our friends had to fight a lot of Saturday night traffic on Delmas to pick us up, so we didn’t sit down to eat until about 8 pm. We asked the couple what they thought the solution was to the tent cities. We agreed that it is a difficult problem to solve. L has met with one of the camp leaders to offer employment to some of the people living in camps who qualify.

We heard from another man who runs a business and offered to help one of his employees who lives in a tent get back into a house that his employee didn't want to leave the tent because he didn't have to pay rent and he and his family received free food and medical care. Going along with this, L said that a man who sells water reported that his sales are up, despite free water being available. They decided that some people have more money to spend because, again, they aren't having to pay rent. As we think about this, we have to take into account how terribly inferior housing conditions were for the Haitians before the earthquake for them to view living in tents as not that big of a step down.

This reminds me of a statement that John made earlier in the trip. We were walking along the partially destroyed street of Delmas 31 when we heard, "Clank! Clank! Clank!" the sound of metal on metal. It was a man, whom we've dubbed the "clanking man." Prior to the earthquake, he lived in a tent below a bridge and fashioned items out of scrap metal. After the earthquake, same thing. Back then, we went into his tent and it was hot and mosquito-ridden. As we walked by him this time, John said, "You know who was affected least by the earthquake? Clanking man." His life was so awful already ("We are living in misery," he told us before) that it could hardly get worse.

But it has. A good day in Haiti, particularly Port-au-Prince, before the earthquake, was like a natural disaster. It is imperative that we understand how bad things are now that they have had a most devastating one. Hundreds of thousands of people are living in tents, which won't last long and will be inadequate when hard rains come. Poor sanitation and people living on top of each other create conditions that can breed epidemics.

I can't imagine what the environment inside the tent is like at night. We spent our last night in Port-au-Prince in a guest house. The heat and humidity were stifling, suffocating. During the night, I didn't think I was going to be able to take it, I was so uncomfortable. And then I thought about all the people sleeping, or trying to, zipped up in the tents, and I was ashamed of myself.

Sunday, June 13, 2010

A Haitian Bus Ride

The day before yesterday, we travelled by bus from Les Cayes back to Port-au-Prince. We decided to take the bus instead of fly back because it is cheaper and we would be able to see some beautiful coastline scenery.

Departure times in Haiti are a moving target. First, our bus was going to leave at 4 am, then at 3 am and finally at 2:30 am. As John says, if you can't take a joke, don't blame Haiti. A group of hardworking gentlemen from Grand Rapids, Michigan had to get to the PAP airport to catch their flight, and they chartered the bus to take them. These men had been doing construction projects at the hospital near our guest house in Cite Lumiere. There was room for us on the bus, though, and we decided to go with them, rather than try to catch a bus later in the day when the traffic would be worse. We wouldn't be able to see the scenery but we would arrive in PAP early in the day. Plus we heard the driver of the 2:30 bus was good, nothing to be taken lightly in the challenging driving conditions of Haiti.

The bus was able to go fast on the smooth road, lightly trafficked road (at this hour) leading out of Les Cayes. As we left the coast line and crossed the southern peninsula, the sun was rising and we began driving through some towns as we approached PAP. Even at 5:30 am on a Sat. morning, the streets and towns were filled with people and vehicles. Haiti is on the same time as the midwest, giving them early morning light.

As the traffic picked up, our bus began passing other vehicles. We had one scary moment in the passing lane when we were barrelling toward a truck and it didn't seem as if we had time to get over. "Yikes!" I said right before our bus driver pulled back into the right lane ahead of the truck we were passing, avoiding an accident by the hair of his chinney-chin-chin. "I can't believe there aren't bodies all over the road," muttered the man next to me.

We drove through what was left of Leogane, the epicenter of the earthquake. Lots of tent cities. Carrefour, a sprawling suburb of Port-au-Prince was in bad shape. Carrefour is an oceanside town that then goes up the mountains. In between the ocean and the mountain is a flat, fairly narrow piece of land. It seemed as if all of the rubble from the earthquake had been swept into this flat area and was competing for space with all of the people, markets, and structures that didn't collapse. It is a jumbled mess.

We arrived at the airport and got a ride to Gertrude's guest house, where he headed out on another adventure. More in the next post.

Saturday, June 12, 2010

Digging Up Haitian History

Since John's last trip to Les Cayes, he had been wanting me to meet a German man, Johannes, who lives in the area and knows a lot about Haitian history. As you will see, in fact, he and his wife Luise are living on top of it.

We met them at their home just up the hill from our guest house. Johannes and Luise have been living in Haiti since 1975. Since then, Johannes has learned a lot about Haitian history. He explained to us the difference between the two native groups who populated Haiti before Christopher Columbus arrived. The Tainos, the majority group, were originally from Brazil and were peaceful. The more aggressive Arawks, who came from the northern islands of South America, like Guyana, would send attacking parties to fight the Tainos, and, according to Johannes, also practiced cannibalism.

Johannes then brought out some of the pottery and other artifacts that he has found on his property.

The dirt holds layers of history: the lower you go, the more ancient the history. He has also found bottles and other things that the French brought over. Johannes held out a part of a bone and said, "Here's just a little piece of someone's body that tells how they died." It was a vertebrae with part of a iron rod through it.

The Haitian Revolution, which started in the 1790s was a bloody war. "It was based on dishonesty," said Johannes. The French told the slaves that if they helped them defeat the Spanish, who were attacking from the east side of the island and the English, who were attacking from the sea, that the French would give the slaves their freedom. Napoleon reneged on the deal, though, and things got ugly. With its massive production of coffee, sugar, and other products, he thought Haiti, the richest French colony and one of the richest colonies in the world, was too valuable of a colony to lose. When the Haitian slaves defeated Napoleon's troups, the first and only black republic started by freed slaves was born.
The picture at the top of this post is a view from Johannes' backyard. After breakfast, we went outside and Johannes showed us a wall of dirt where he began picking out little pieces of property. It's amazing what history we are living on top of!

Friday, June 11, 2010

Of Amputees and Assumptions

For most of our week at the guest house near Les Cayes, a couple of guys from the United States have also been residents. One of them Peter, a recent high school graduate, was born in Haiti, but grew up in Florida. He was assisting Derek, a doctor and the other resident, with translating in a clinic where they were working. Peter's father is from this area, as his some of his family.

One evening, I was sitting at the desk in our room typing, I heard the front door slam. When I got up to look in the living room I saw it was Peter along with a man who didn't have any arms. "Wow, that guy really suffered in the earthquake," I thought as I ran through a list of everything he wouldn't be able to do: feed himself, get dressed, write, or even give someone a hug

Later in the evening, I asked Peter if the man he was with was one of his patients. Peter looked puzzled, so I continued. "The man who didn't have any arms."

"Oh," said Peter. "That was my dad."

Wow, talk about false assumptions.

We found out that Peter's dad lost his arms in a sugar cane auger when he was 13. One arm got trapped and he instinctively went for it with his other arm and it was trapped. He lost both of his arms right below his shoulders.

This was a reminder to me that Haiti was a dangerous place with numerous people who lost limbs BEFORE the earthquake. Now this awful natural disaster may have created 100,000 or more amputees.
Because the need for prosthetic limbs has always been great in Haiti, the hospital in Cite Lumieure, down the road from where we are staying, has a prosthetic unit that is pictured at the top of the page. It has been extra busy lately as teams from the United States and other countries fly to Haiti to make and fit prosthetics for people who need them.
This week we saw a young woman, whose leg was amputated well above the knee, receive her prosthetic limb. One of the woman on the team explained that it is much more difficult to learn to use an artificial limb when the loss of limb occurred above the knee. We watched this young woman walk gingerly back and forth across the room, getting used to the way the prosthetic bent.

Making prosthetics isn't a quick process; it involves making casts of legs. A kiln, pictured below, is used. The team made eight prosthetics this past week. They will also see the patients for adjustments as they get used to their new legs.
Hopefully, like Peter's dad, who has gone on to earn two degrees and raise a wonderful family, these people who have had such loss, can go on to lead productive lives.

Wednesday, June 09, 2010

Haitian Resilience?

I subscribe to the Bob Corbett list serve about Haiti. Recently on the Corbett site was a link to an interview of Michele Montas, a Haitian journalist and former spokesperson for UN Secretary General Kofi Ban Ki-moon by journalist Alice Speri. Here is an excerpt:

You talked about Haitian resilience. What does that mean really? What are some examples? Can that still happen?

It is happening. It has been happening since the quake. The day after the quake, when you had kids from the slums going into the university and getting students out of the rubble. There was no international assistance there, it was Haitians helping Haitians. It was people with their bare hands getting other people out of danger. The way people have bounced back… The way we have had for instance, life coming back to the streets, street sellers being back selling vegetables, selling rice, different things… The informal sector bounced back in an incredible way. Resilience is the Haitian’s way of accepting conditions. In any country of the world you would have what you had in Chile, you would have people looting, people just reacting violently. Haitians were incredibly disciplined after what happened. And I think it is something which is linked to Haitian experience, within the last two centuries. It’s something which is linked to a long history of resistance first and way after that facing incredible conditions of life.
I think this is true. In our work in Haiti and in spending time with our Haitian Hearts patients, who are so sick and then usually come through major surgery in good fashion, we have seen this resilience. We also see it in our seven-year-old son. John often reminds us that it was Luke's ancestors who more than 200 years ago defeated Napoleon's troops. Haitians are tough and resilient.

Then, also recently, the following anonymous comment was posted on the Corbett list.

I have never posted due to the fact I live and work here as a private individual and have done for many years. I employ people and would not want to jeopardise mine or my friends' livelihoods by offending the wrong people with my subversive thoughts about reality, dignity and decency.

Anyway, my point -

The thing that troubles me is that I keep reading how resilient Haitians are.

Well the truth is that they are just like anybody else - they are upset and badly shaken by events like anybody would be. It is almost as if one has to worry less about Haitians in peril because
they can handle more stress than your average human being. Almost an excuse not to afford them the concern that one would an American, Frenchman, Paraguayan or whatever.

This is wrong.

I also agree with this comment. There is something self-serving, especially now, about focusing on the resilience of Haitians. If we think they are so tough, perhaps it gives us a pass on doing our part to help them. You know, "Oh, they're Haitians. They're tough. They'll be alright. Yes, I know they are missing limbs and family members, but they are used to things like this and it doesn't bother them as much as if it happened to, well, me." In some ways emphasizing Haitian resilience is dehumanizing.

If we want to speak of the Haitians' resilience, let's speak of admiring it, of it inspiring us to act, to show our own toughness in responding to a catastrophe of huge magnitude.

I'm sure the little girl pictured above is resilient. She is one of the children living at Gertrude's orphanage.

You Can Always Pray

Yesterday, John taught a clinical lesson at the Missionaries of Charity compound to the nurse practitioner students. One hundred or so children live here some temporarily and some permanently. One of the sisters was holding a three-year-old who was understandable sad: she came to the sisters after the earthquake and no one knows anything about her family. She must feel so incomplete and empty, as if an important part of her is missing.

I described the Missionaries of Charity to a couple of people in Haiti as the Marines of Catholic nuns: they can only go home once every ten years; they are never seen eating or drinking; and they wear these habits that I hardly see how they keep from passing out in. It is hot and humid in Haiti now; it seems like 30 seconds after you take a shower, you need another one and this is without wearing a couple of layers of head to toe clothing. Despite these hardships (or perhaps because of them?) the sisters are productive and do very difficult work caring for the poorest of the poor.
On our way home, our hostess Beth Newton asked me what I thought of the Sisters' place. I said that I had been to their building in Port-au-Prince, but, still, it was a shock to see so many children without parents. On the wall of the building, sayings from Mother Teresa, the founder of the order, are painted in Haitian Kreyol including, "Every child is precious and a gift from God." I wish the world's priorities reflected this truth. As we go about our busy days, it's never a waste to offer up a prayer for the abandoned children of the world.

Two Haitis

"There are two Haitis: Port-au-Prince and everything else," is a statement we hear a lot. Flying into Les Cayes, one of the passengers on the plane said, "I tell everyone that Port-au-Prince is not the real Haiti." As someone who has spent most of her time in Haiti in the capital, I had to agree that at least from the air, the Les Cayes area looked much different than Port-au-Prince. It was shockingly green, for one. And then on the ground, there aren't as many people around. Many of the roads in Les Cayes are much better than those in PAP.
The above photograph is from the balcony of the home of our friends, Tim and Joan Reinhold. They are Christian missionaries who live 10 months of the year in Haiti. They, with a lot of Haitian help, built their beautiful home by hand, which is how so many things are done in Haiti. Tim and Joan help put roofs on school and churches throughout the southern peninsula of Haiti. Teams from different Apostolic Christian churches in the United States come and aid them in their mission. Their accomplishments are very impressive.
After the earthquake, many of the Port-au-Princians headed to the provinces where they had family or friends they could stay with. But after a few months, it was time to return home, which in many cases was now a tent. The lives of the people in the provinces aren't exactly easy on a regular day and they couldn't continue to support their extended families any longer.
We have heard Gertrude's suggestion several times by our American friends in Les Cayes: that hopefully Haiti will become more decentralized after the earthquake with Port-au-Prince not having such a stranglehold on all the government functions. If there was more infrastructure and commerce in the rest of the country, people could find employment outside Port-au-Prince and the terrible crowding in the city would decrease. And then, maybe, we would speak of one Haiti instead of two.

Tuesday, June 08, 2010

A Teaching Stint in Les Cayes

One of the reasons that we are in Haiti now is because John was asked to teach at a school for nurse practitioners. This is his second stint teaching at the school in Les Cayes. Yesterday, he lectured on pediatric appendicitis and shock. Today, we will go to a clinic run by the Missionaries of Charity, and John will give the students a clinical lesson with the pediatric patients.

The students are very motivated. They work full time and then come to class in the late afternoon. Yesterday, they had taken a pharmacology exam prior to John's class. They paid close attention during John's lecture and took lots of notes. It helps that John can teach in Haitian Creole.

The nursing classes are held at a business/technology school downtown, next to the new Coast Guard building that is being constructed. Here is the view from campus:

Yes, that is a cow grazing by the ocean. A new pier is also being constructed and many of our American friends hope that container ships will be able to dock and unload at Les Cayes. Many people have told us that they hope one of the responses to the earthquake is that governmental control and functions are decentralized from Port-au-Prince, making functioning throughout the rest of the country more effective and efficient. We will see.

Monday, June 07, 2010

Tent City, Haiti

Almost six months out from the earthquake, the most noticeable change to my eye is the tents: they are everywhere, some places in huge camps, sometimes in small groups, and occasionally there will be a lone canvas pitched off by itself. The tents are in industrial areas, on private property, on government property. They are often found where houses were once located. There are even tents in the medians of roads.

This is not to say that other effects of the earthquake aren't obvious. Rubble is strewn everywhere, more than usual. Half completed buildings hang in ruins. Certain parts of the city were damaged more than others: the Delmas section of Port-au-Prince appears to have been particularly hard hit, A portion of the road Delmas 31 was destroyed and we had to hike down through a steep gully and cross a dirty stream to make our way down the street. The inpatient unit at Grace Children's Hospital on Delmas 31, a special place to us, is not functioning and tents serve as the outpatient clinics.
One of our Haitian Hearts patients, Jenny G., pictured below, is standing next to the car she slept in the first two months after the earthquake and the tent that served as her bedroom after this.

So it is the tents that may be the most ubiquitous symbol of the earthquake.

Saturday, June 05, 2010

Providence Guest House

Our friend Gertrude is doing a hero's work in Haiti. She runs a guest house/orphanage in LaPlaine. Gertrude's original guest house in Delmas was destroyed in the earthquake. Gertrude was sleeping at 4:52 pm when the earthquake struck. It woke her up and she was disoriented. She fell three times as she tried to run. "Jesus, help me," she cried. The rumbling stopped and she ran outside as her guest house was crashing down.

Prior to the earthquake, Gertrude had the house in LaPleine where abandoned children were staying. Fortunately, none of them was hurt in the earthquake. Some of the children she cares for were abandoned at the General Hospital. Some of them are disabled. The orphanage currently has 37 children. Her guest house, Providence, helps fund the orphanage. She has 22 staff members to care for these children. As you might imagine, there are many expenses in running an orphanage.
When I asked Gertrude what she would do if she were in charge of Haiti, she gave a three-part answer. First, she would feed the people. Next, she would focus on the long-term progress of the country, creating housing and jobs. Finally, she would build infrastructure throughout Haiti, not just in Port-au-Price. "If people had what they needed in the provinces, they wouldn't come to Port-au-Prince," she said.
"In the hour of our poverty, this is the time for it," she said.

Friday, June 04, 2010

Dr. John in Action

Dr. John helped a lot of children this past week, many of whom had ear infections. John said, "I think I have seen so many ear infections because people are living outside. And now it is starting to rain."

Examining children's ears can be a challenging process. Some of them look upon the otoscope as an instrument of evil. They want nothing to do with it. We had to hold one little girl down on an examining table to get a good look inside her ears. Others who aren't quite as afraid, put their shoulders up as John places the scope in their ear. He jokes, "Kids don't understand that when they put their shoulder up, it makes it hard to see in the ear. I've told them but they insist on doing it over and over."

Many children have temperatures and other symptoms that are caused by these ear infections, and so it is important to diagnose them so an antibiotic can be prescribed. We see one child's middle ear that is half-filled with puss. The babies feel much better when their ear infections are treated. And so do the moms.

She Needs the Knife

Meet the lovely Jenny G. She is 30-years-old, gainfully employed, and lives in a tent, which is better, I guess, than the first two months after the earthquake, when she slept in a car. Making Jenny’s life more difficult is that she has a severely ailing heart. The medical solutions are almost extinguished for her and as John would say, she needs the knife.

Jenny had surgery to repair heart valves in 1999; now she needs surgery to replace them. She looks good, but had to stop a couple of times and rest when she was climbing the stairs. She is in congestive heart failure, with a number of the symptoms that go along with this condition. If anyone reading has contacts with hospitals or medical centers or cardiac surgeons who might be interested in helping Jenny please e-mail me.

It’s hard to sit next to Jenny and know that she has a fixable problem, except for the fact that she was born in the wrong country.

Survivor Experiences of the Earthquake

We’ve heard several people’s stories about where they were and what they were doing during the earthquake. One woman was outside and realized what was happening, as she had felt tremors before. But some other people around her, didn’t know what was happening and thought the loud noises were shooting; they ran into their houses and then the houses collapsed and they were killed.

Another woman was at work, on the fourth story of a building. When the earthquake started, she sat frozen at her desk, while all of her co-workers fled the building. She is in poor health. She said the building first swayed to and fro and then it went up and down. But it didn’t collapse. When the earthquake was over, her colleagues rushed back into the building and helped her out, as her health isn’t good. When she walked home from work, she saw body parts in the street and heard people calling from buildings.

Another woman was in a large house during the earthquake. First she ran upstairs, and then she ran outside along with the other people in the building. No one was hurt, but the house was destroyed. She said that she couldn’t stop laughing. Even as people came by the house seriously injured, all she could do was laugh. Shock is displayed in different ways. How can this have happened? In 45 seconds 140,000 people lost their lives and there was billions of dollars in property damage. How could it seem real?

Bag On the Ground

After more than three years, this blog is now true to its name, Live From Haiti, as I am typing these words from a guest house in the LaPlaine district of Port-au-Prince. Today I accompanied John to the clinic run by the Daughters of Charity. Today and yesterday were feast days (The Feast of God) so there weren’t as many children and moms at the clinic as usual; several of them were patients John had seen before, and thanks to medicine and treatment, were doing much better.

John’s doctor bag in the above photo survived the earthquake. He had stored it at the sisters, and when he came in for his first day of work on this trip, it was sitting on the chair in his exam room as if nothing had happened. Even more amazingly, one of his suitcases, which was stored at a guesthouse which collapsed during the earthquake was pulled out of the rubble.