Wednesday, August 31, 2011

Views from Delmas 5

While we were in Port-au-Prince, we stayed at the home of Vanessa Carpenter (AKA Mama V), who lives on Delmas 5. Vanessa runs the organization Angel Missions Haiti, which, much like Haitian Hearts, provides medical care to children in Haiti and also brings children to the States for surgery. They are also getting ready to open a school.

Vanessa was instrumental in helping coordinate the Navy's efforts in Haiti. She found most of the translators and also recruited others to help. We are grateful to her for asking us to be a part of the mission and for her hospitality to us.

At the beginning and end of each day, I would usually go up on Vanessa's roof, which had an amazing view of Port-au-Prince. All of the glories and agonies of Haiti were spread out before us: the mountains in the distance, the beautiful skies and ocean, tent cities and other little collections of shanties, kids playing soccer and kids singing, Hayti Tractor, the Caterpillar dealer, bustling tap taps. I would walk the roof and contemplate the day, suspended above the city.

Mildrede, one of the Haitian translators, and me on the roof.

Tuesday, August 30, 2011

The Price of Peace

The amount of logistics it took to set up the Navy clinic was mindboggling.

The Navy had to find a site--actually two sites, one for the surgical-screening clinic and one for the medical clinic. This second site needed to be leveled, and then they laid down a bunch of rocks so the area wouldn't be so prone to muddiness. They set up dozens of tents, and some of them, like the dental tent, needed a power source. Then there was all the equipment, food, medicine, and supplies that needed to be brought in on smaller boats from the USNS Comfort. Communication between the First World environment of the ship and the Third World environment of Haiti was also tricky. And then, of course, the possibility that Hurricane Irene would strike Haiti threw a huge wrench into the proceedings. Everything had to be taken down, and the ship left for a couple days. When it returned, everything had to be set up again. To accomplish all of this, the Navy used its own people and also contracted with others.

Observing some of this arduous preparation, I commented to a soldier (the Army and the Air Force were involved too), "Now, I have some idea of what it's like to go to war."

The soldier shook his head and said, "This is harder than going to war."

I was amazed when I heard this but upon reflection, it made sense. The military's typical mission is fighting wars. It's what they are used to. In this case, the Navy was having to work with all of these NGO's and to a lesser extent, the Haitian government to implement this mission. They didn't have the control of their environment that they are used to. But all of this collaboration was the point: the mission was classified as a training mission, in which the Navy would learn to successfully work with a number of different organizations, as frustrating and difficult as that can be.

My first reaction to his statement, however, was a swirl of thoughts and quotes: the constructive process is a lot harder and takes longer than the destructive process; what we need is a moral equivalent of war; it's easier to run an authoritarian organization than a democratic one; if you want peace, work for justice.

And yes, justice is hard and expensive, but really only in the short run. When people are treated fairly, when they have enough food to eat, clean water, adequate shelter, medical care, education, safety--all the things we need for life--war isn't as great a possibility. To achieve this state of justice takes a lot of messy, time-consuming work.

But it's worth it, don't you think?

Monday, August 29, 2011

Haitians Not in Haiti

At least half of the translators who worked with the Navy during the past couple of weeks were junior high and high school students from two schools in Port-au-Prince. where the students are taught in English. Most of these kids are essentially bilingual, being fluent in English and Creole.

I had the opportunity to talk with one young woman, an eighth grader, whom I'll call Jocelyn.

Jocelyn spent her 6th and 7th grade years in Brooklyn with her grandmother, attending school. She returned to Haiti for her 8th grade year and lives with her parents, who both work in Haiti. Jocelyn is an American citizen; her English is actually better than her Creole. Jocelyn said to me,

"The media is always showing only the bad parts of Haiti. They never show the nice places in Haiti, like where I live. People think there are only poor areas in Haiti."

I have heard this criticism of Haiti news coverage before, though usually from people older than Jocelyn. I can't completely disagree with it; most of the coverage of Haiti focuses on the poor. On the other hand, poor people do make up the huge majority of the population.

On this trip, our 22-year-old nephew Tommy accompanied us. This was his first trip to Haiti. After we worked in Cite Soleil and toured other slums, for balance, I wanted Tommy to see a more prosperous part of Haiti. On one evening, we went to Petionville, a Port-au-Prince suburb, and had dinner with some upper-middle class friends of ours. On the way to their lovely home, we stopped at the Haitian bakery, Epi D'Or. Inside the modern building, Haitians ordered sandwiches, ice cream, or had a meal at the cafeteria. "These are all middle-class Haitians," our friend told us.

Back to Jocelyn: I asked her if she was going to attend high school in Haiti. Her answer was instructive: "Oh no. I want to attend high school in the United States."

So despite the good parts of Haiti that are overlooked by the media, Jocelyn wants to go to high school in the United States. I can't say I blame her. But I do see that she is already exhibiting a behavior pattern that is disturbing: she will defend and praise Haiti from afar.

The thing is, Haiti doesn't need her praise or the praise of other people from the diaspora. It needs their brains, their ambitions, their talents.

Haiti needs their presence.

Sunday, August 28, 2011

Discharge Planning?

Today is the last day of the USNS Comfort's presence in Haiti. The ship will now sail home after five months conducting its training mission in nine countries. Besides helping people who needed medical care, the Navy's other goal was to improve its ability to work with governments and NGO's to coordinate health care. I am sure everyone learned a lot.

My last day working at the Navy's clinic was on Thursday. After the translators had checked in and were working, I was assigned to Discharge Planning. This unit referred patients who needed follow up care to providers in Port-au-Prince. The NGO's in Haiti had helped compile a small list of places patients could go to get help. Or, I should say, attempt to get help.

As an American nurse who was helping translate and refer put it, "This is depressing."

For one, many of the patients we saw clearly needed surgery. They had hernias, huge facial tumors, bone fractures that hadn't healed properly, terrible burn scarring, breast cancer that had broken through the skin wall, gynecological problems, eye tumors. These are people who would have been eligible for a surgical slot on the ship but with only 120 places, they filled up quickly.

Secondly, almost all of the patients we saw didn't have money to pay for follow up medical care, surgical or otherwise; that's why they came to the Navy clinic to begin with. I doubt many--any?--of them received any follow up care.

On the plus side, most of these patients left with some medications. I was also surprised at how many of the patients were able to write their phone numbers. We were collecting these in case a a NGO was able find the patient a place for surgery.

I am very happy for the patients who were able to be operated on or receive medical care on the ship. They are the big beneficiaries of the Navy's good work.

Saturday, August 27, 2011

Soleil Clowns

Believe it or not, an organization called Clowns Without Borders exists. Two professional clowns live a couple houses down from us, and they told us about the group.

I'm not sure how I feel about this. On the one hand, children need to laugh and play. On the other hand, I've seen children in Haiti who were too sick or weak to do either. I think I'm too wedded to Maslow's Hierarchy of Needs as an explanatory philosophy to believe that the poor children of Haiti can benefit from clowns. It reminds me of my working-in-child-welfare-days when we used to mount these drives for Christmas presents for foster children. Yes, Christmas presents are nice, but they were not what these children really needed.

When John was working in Cite Soleil a few days ago, he stopped by Catherine Laboure Hospital to see how the patients he referred were doing. He said a few clowns were there and that it was kind of pathetic and bizarre. I know I find the idea absurd. But then Haiti is an absurd place.

Thursday, August 25, 2011

One Life

There is a saying—“One death is a tragedy, but a million deaths is a statistic,”—that is depressingly true from a PR point of view. Once when I was teaching English 110 at a community college, I talked some about Haiti, including the depressing maternal and infant mortality rates, the low life expectancy, etc. I got empty stares from my class.

But then a couple of days later, I talked about a sick child whom John was working with in Haiti. The class was spellbound as I described Mariella’s struggle for life against the ravages of malnutrition and diarrhea. “What can we do?” they asked.

Some of my recent blog posts seem a little vague to me, so I thought I’d focus on a particular child, Fernandez, pictured above. I had the opportunity to spend some time with Fernandez at the Sisters' malnutrition program in Cite Soleil. The Sisters are concerned about Fernandez because he is three years old and only weighs 18 pounds. Sometimes he is interested in eating, and sometimes he isn't. Although Fernandez has recently had a clear chest x-ray, many members of his family have tuberculosis, including his twin younger siblings and his grandmother.

For the most part, Fernandez's affect is flat. But he allowed me to pick him up and we walked around for a little while. He's kind of like carrying a small sack of potatoes; he's dead weight with no muscle tone, due to lack of protein. When I picked him up, there was no catch under his arms, of the muscle tensing, as he isn't strong enough.

But the good news, is that when I pulled a cheese and cracker out of my backpack, he ate it. And then another one. And then another one! I put him down and we walked around for awhile, until he spotted his mother and wanted to be with her.

The next day, I saw Fernandez scooting around on a small tricycle. He smiled and waved at me. A little while later, he came over and I picked him up. We walked around some more, and then I noticed Fernandez's head starting to bob, and conk, he was out. I sat down in the courtyard, and he napped on my lap until his mom came to retrieve him.

So though Fernandez is poor, with its frequent health problems, and lives in Cite Soleil, he has a couple of things going for him: he is enrolled in the Sisters' malnutrition program, and he has a mom who really loves him.

Wednesday, August 24, 2011

Return of the USNS Comfort and the Attack of the Killer Mosquitoes

I’m happy to report that with the threat of Hurricane Irene gone from these parts, the USNS Comfort is back in the bay of Port-au-Prince. We saw it at 5:30 this morning from the roof of our house on Delmas 5. The plan is that today they will resume surgeries on the ship, and tomorrow the onshore clinic will begin again. They didn’t need doctors at the clinic today, so John headed back to Cite Soleil, to work at the Sisters’ clinic.

So this morning, my nephew Tommy, some other volunteers, and I rode a tap tap (not quite as crowded as the one pictured above), the battered pick up trucks that serve as Haiti’s public transportation, up Delmas to retrieve another member of our crew. We would then head to the clinic site to see if they needed any help setting up.

Delmas is a one of the main thoroughfares through Port-au-Prince, leading up to Petionville, a more prosperous suburb. I pointed out different landmarks to Tommy. There is what’s left of One Stop, where we used to buy groceries (some of the Delmas area was hit hard by the earthquake); there’s Alta Grace, where we occasionally went to church. There’s the road that leads to Luke’s orphanage.

When we reached Delmas 91, we turned down a very steep hill, rutted with large holes and rocks. We bounced down it carefully, if, indeed one can bounce carefully; it’s all fun and games until the breaks go out.

After we picked up Jenny, we headed back down Delmas, bound for Terminal Varreux.
The ocean was in the distance, blending with the sky, making it impossible to tell where one stopped and the other began. As we got closer, we saw the USNS Comfort; the all-white ship with the red crosses appeared to be suspended in the sky, sent down from heaven.

At Terminal Varreux, a small group of patients were waiting. We made our way through the newly created mud from last night’s rain, heading toward the dock, where the translators and patients would board a small boat to take them to the ship.

I rubbed my hand, and then noticed I had some black mud on it. How did that get there? Then I saw what I thought was a fly on my arm. I attempted to brush it away, but it didn’t go. I looked more closely at my hand, and saw that it was no mud; it was a squashed mosquito. I looked around at others and saw the huge bugs alighting on any patch of bare skin. I mean these suckers were ginormous! They were getting tangled in Tommy’s leg hair, so I sprayed him down quick with my mosquito repellent. For the next several minutes, we were consumed with repelling the hoardes through spray and slapping. This sounds exaggerated, but it was bad.

In my experience, Haiti mosquitoes are small, silent, and stealthily, less obvious even than the type we have in the States. These mosquitoes were not going to be put off by a mere brush away. They had to be smacked. These were like the Special Forces mosquitoes; they weren’t going to be leaving your skin until they had some of your blood. As our friend Kristin said, “This is like inviting malaria.”

Fortunately after only a few minutes of this onslaught, we were able to take refuge in one of the military’s SUV’s. Since our presence wasn’t required at Terminal Varreux—as much set up had been done as possible—we rode back to Delmas 5. We will see what tomorrow brings.

Different World, Different Risks

A recent New York Times op-ed listed some of the health risks and threats to children today. They include obesity, due in part to the marketing of junk food, exposure to violent and sexually explicit electronic media content, thanks to little regulation, the increasing number of children who are medicated with psychotropic drugs, again facilitated by little regulation. These are all real risks, and the writer ties them to the rise of the corporation, a legally defined person, whose goals (profit) are at times in conflict with the best interest of other legal persons, like children.

Now, you probably know where this post is going. The risks that the writer details only apply to a certain small (relatively speaking) group of children: those from the developed world.

For our friend, above, from Wharf Jermie, a slum in Haiti, and billions like him, these risks don't threaten him, but a host of others do, some of which you can see in the picture. Dirty water carries all kinds of deadly diseases--typhoid fever, cholera, diarrhea. Malnutrition leads to stunted growth and development and sometimes death. Lack of health care, schooling, safe housing, a safe environment all pose huge risks to children, as do the lack of competent child welfare or criminal justice systems. There is a lot of child abuse in the developing world.

The children of Haiti don't have to worry about obesity, violent video games, or psychotropic drugs.

On the plus side, they are forced to exercise their creativity. This boy and his friends were having a lot of fun with their car, made from a plastic bottle and lids.

Tuesday, August 23, 2011

Hurricane Irene Misses Haiti

Despite the original predictions, Hurricane Irene fortunately largely bypassed Hispaniola, the island containing Haiti and the Dominican Republic. Well, at least, I say "fortunately" as I think it's a good thing that one of the poorest countries in the world which lately has experienced a string of horrible luck (earthquake, cholera, other hurricanes) was able to dodge Irene.

But I guess the view that it's fortunate depends on your viewpoint. Here's a quote from an article in the Los Angeles Times:

"Earlier, meterologists had hoped that Irene might slow down; it was headed straight for Hispaniola and the mountain range saddling the island shared by Haiti and the Dominican Republic. 'It would have disrupted and likely weakened the storm,' Feltgen said.

That didn't happen."

Thank God, I and all the Haitian meteorologists say.

Pictured above are the clouds above the bay of Port-au-Prince at sunset, remnants of Hurricane Irene, the storm that missed Haiti.

Some Happy Haiti Pictures

Baby Central

Can't you see the whole universe in those eyes?

The Pied Piper of Wharf Jeremie

Two Life Changing Events on January 12, 2010

As for most people in Haiti, January 12, 2010 was a life-changing day for the woman pictured above. She gave birth to her son, whom she is holding, a little while before the earthquake. When the ground started to shake, the doctor yelled at her to get out of the building. But she didn't get out in time, and her arm was crushed. Fortunately, she and her son lived. She brought him into the Cite Soleil clinic, and John examined him. He was very dehydrated.

Back to Normal

Please don't miss the irony in the title of this post. As a friend who visited Haiti right before we did told us, Port-au-Prince looked as close to its pre-earthquake condition as she has seen it. And she's right. A lot of rubble has been cleared away, people are moving about more easily, much of the shock seems to have dissipated. But what passes as normal in Haiti is unbelievably harsh. Take the fellow above, hauling a car on his back; he was likely doing this before the earthquake too.

Ot take Cite Soleil, which sustained little damage during the earthquake. John told us about a saying that went around Haiti after January 12: Earthquakes don't kill people; buildings kill people. Cite Soleil has few big buildings capable of killing people when they collapse. Lucky them.

But as we saw today in the clinic and when we toured St. Catherine Laboure, a Doctors Without Borders hospital and the only hospital in Cite Soleil, a community of 250,000 plus, people are suffering from poverty and sickness that should be inexcusable in the 21st century. Septic babies near death, a two-year-old with congenital cataracts, dozens of children in the Sisters' malnutrition program, a baby with a terrible, open, fast-growing staph infection on his groin.

Yes, things are back to normal in Haiti and normal isn't good.

Some Haitian Culture

On Sunday, we had the opportunity to visit the Musee du Pantheon National Haitian, located across from the National Palace. The museum is built into the ground and--I don't know if this is the reason--sustained little damage in the earthquake.

The museum has two small wings, one devoted to the seven epochs of Haitian history and the other to artwork. A guide led us through both air-conditioned wings.

The historical wing was fascinating. As best I can remember, the seven eras of Haitian history are: the native period, the Spanish colonial period, the slavery period, the revolution period, two empire periods, and the presidential period.

The most famous artifact in the museum is the anchor from the Santa Maria, one of the three ships that Christopher Columbus sailed on his initial voyage. We snapped a few pictures before the guide told us no photography allowed, so we didn't get a photo of the anchor. However, we estimate it was about 10 feet tall and had the typical shape of an anchor.

The museum also contains the remains of the four men considered to be Haiti's founders: the great Touissant L'Overture, leader of the revolution, Jean Jacques Dessalines, founder of Haiti, Henri Christophe, the builder king, and Alexandre Petion, founder of the republic.

Pictured below are irons that would be put on slaves who escaped (maroons) and were recaptured. They would have to carry the 50-pound weight on their head. To this day, when Haitians refer to something very heavy, they say, "Cinquante livres," or 50 pounds.

Pictured above is a painting from the art wing of the museum. It shows the metaphorical birth of Haiti, with many of the country's influences.


Monday, August 22, 2011

Life in the Slums

Since the Navy operation has been shut down until Wed. thanks to Hurricane Irene, we've had to find other things to do, which hasn't been difficult. Both yesterday and today, we spent time in two of Haiti's poorest slums: Wharf Jeremie and Cite Soleil.

We'd been staring last week across the water at Wharf Jeremie from the Naval clinic at Terminal Varreux. A friend of ours, Jean Claude, who is helping to build houses there, took us to look around. It's difficult to describe these places in words or pictures, but they hardly look fit to support human life. And really, they don't, or at least not very well. Rocks, dirt, sewage, rusty tin, gray-brown water form to combine a hellish scene. Yet children, with their unnatural pot bellies, often naked from the waist down, laugh and play there, just like they do everywhere.

Before visiting Wharf Jeremie, we had stopped by the ruins of the Port-au-Prince cathedral. The semi-professional beggers descended on us, while not once in Wharf Jeremie did anyone ask for anything, other than to see the picture we had taken of them. Below are some children in Wharf Jeremie, carrying a picture of Haiti's most appropriate patron saint, Our Lady of Perpetual Help

Today in Cite Soleil, John worked at the clinic run by the Daughters of Charity. The Sisters have an oasis in the middle of another harsh environment, where children receive medical treatment, food, and schooling. Their mothers learn to sew and embroider. Once again, John Claude was our driver. He knows Soleil well, having grown up there.

We saw this champ in Cite Soleil, enjoying his bath.

My thanks to John and Tommy Carroll for the generous use of their pictures.

Sunday, August 21, 2011

Say It Isn't So, Irene

We received some disappointing news this morning. The onshore clinic was cancelled for today and the next two days, as Hurricane Irene is headed for the Dominican Republic and Haiti. The most recent prediction that we have heard has the storm over Haiti in the early morning hours of Tuesday, August 23.

Unfortunately, the hurricane isn't only affecting the clinic; the surgeries for these three days have also been cancelled. This afternoon, the USNS Comfort evacuated the patients, some non-military medical staff, and the translators. The ship will likely be moving as to stay out of the path of the storm. At this point, the Navy's plan is to resume clinic and the surgeries on Wednesday, August 24, if possible.

We are hoping and praying that both for Haiti's sake and for the success of the USNS Comfort's mission that Hurricaine Irene does not prove to be too destructive. As you can see below, the first day of clinic was very popular.

Working with the Translators

My job on this trip has been helping to coordinate the translators.

First, a little background: the USNS Comfort has been on its humanitarian tour since March. They have brought medical care to Costa Rica, El Salvador, Peru, Ecuador, Jamaica, and Columbia, among others. Haiti is their last stop before returning to Norfolk, Virginia.

At each of the countries the Navy has visited, they have needed translators to work with the doctors and patients. Because the other countries the ship visited are Spanish speaking, they haven't needed as many translators, as many people on the Comfort speak Spanish. In Haiti, they were asking for 100 translators for each day. And by the way, this is a volunteer position; the only pay is a meal and water each day and then at the end, a much-coveted certificate stating that the person did translation work for the U.S. Military. Many of the translators travel up to two hours each way on their own gourdes.

Nonetheless, this did not stop about 150 translators from showing up to work. These translators were referred by various organizations: schools, the US Embassy, churches, and NGOs. My job has been to take down the names of the translators (for the all important certificates, so the translators are very eager to check in with me), ascertain that they are capable of translating, get them their ID badges, help assign them to an area, and troubleshoot for them during the day.

I quizzed them on where they learned English. Quite a few are self taught. Some of the best English-speakers are kids ages 13-18 from a school in Port-au-Prince. They are basically bilingual in English and Creole.

It was a little chaotic the first couple of days, but having too many translators is a much better problem then too few. The translators are assigned to a doctor or a tent. There are tents dedicated to registration, pediatrics, general medical, dental, opthomology, women's health, pharmacy, and discharge planning. Other translators help escort the patients from tent to tent. The system runs a little more smoothly each day.

The clinic is in a hot, shadeless area, so water is very important. The Navy is passing out Meals Ready to Eat, which I'll write more about later.

Pictured above are some translators arriving on the first day of clinic.

Saturday, August 20, 2011

Haitian Hearts with the USNS Comfort in Haiti

Now that the USNS Comfort has been docked off Haiti for three days, what’s been going on? The Navy, with the help of other branches of the services, the Haitian government, and a whole lot of NGO’s, including Haitian Hearts, set up a clinic specifically to screen patients for surgery on the boat. John was immensely important in this process as the Navy had him initially screen the patients. With his knowledge of tropical medicine, which is a nice name for trying to help people in poor countries with their health problems, and fluency in Creole, John was able to direct people to the appropriate station. It took only a day and a half for the ship’s 120 surgical slots to fill up. We were happy to see that one of our Haitian friends was able to get a surgical slot on the boat. We saw her off this afternoon in a smaller boat that was ferrying her to the ship.

Also for two days, and continuing on to the end of August, the Navy is running a shore side clinic at Port Verrieux, a private port the Navy is leasing, for people with non-surgical medical problems. Today was the second day of this clinic; 777 patients were seen today and 737 yesterday. John started working at this clinic today. It is not far from Cite Soleil, and many of the people who come to the clinic are from there. In many ways, this clinic is similar to others that John has worked at in Haiti.

So what the heck am I doing in Haiti besides writing this post and trying not to get sunburned? Check back next time!

Thursday, August 18, 2011

We're Back in Haiti

We've come to help the good folks on the USNS Comfort, a great-looking ship, as you can see below, docked in the Bay of Port-au-Prince. . . .

Help very important people, like this little boy and his mom. Stay tuned for more stories.