Kara's Travel Blog

July 2007: Highlights

2007-07-25T23:20:00.000-05:00

I has been a while since I've last updated this blog. Things are going well here. The hospital program along with a visiting clinic group and trips to the villages have kept me pretty busy this month. I'm looking forward to vacation this coming Saturday!

Here are some highlights from July:

**Celebrating the 4th of July with Americans and Cubans in Haiti

2007-07-25T23:14:00.000-05:00

We lugged the grill from my house over to the Notre Dame Filariasis Program Residence to have a rooftop party with the Notre Dame, Duke, and Harvard students that are here in Leogane doing summer projects. Frank and Maria Elena also came to celebrate with us!

(Picture: hamburgers in Haiti)

(picture: Kara and Ming with Leogane market in distant background)

(Picture: Proof that I’m trying to learn salsa!)

**CNP mobile clinic

2007-07-25T23:05:00.001-05:00

The founder of the CNP, Dr. Mitch Mutter, came down with 14 people for a week of mobile clinics. The clinics went well, despite a couple of rainy days. On the second day we went to a village pretty high up in the mountains. The trucks were still able to get down the bumpy dirt road to get us there. Around 1pm in the afternoon it started to rain and we were told we had to pack up right then or walk back because the trucks had to leave. They would never make it back down in the mud. We decided to stay and finish seeing all the patients and hike back down the mountain. The only problem was we had a ton of stuff. The solution? Donkeys! We loaded all the stuff up onto donkeys and successfully make the muddy trek back to the main road.

On the third day we also had rain which caused the river that we had to cross to get to the village to swell. Luckily the cars were able to take the round about route to get us out and we only had to cross the river at one point. Water still came in the car though. After a week of this I was completely exhausted. 14 people are just too many to organize. It was great having them here, I learned a ton, but I was so happy to see everyone go.

(Picture: the large group)

(Picture: A consultation)

(Picture: Triage)

(Picture: people waiting to enter the clinic)

(Picture: donkeys!)

**Hike to Kampan

2007-07-25T22:43:00.003-05:00

I took my first overnight trip to the village of Kampan from July 17-18^th! We left the hospital at 6:30am and drove for about an hour to the Grande Riviere. The truck dropped Yva and me off by the river where the truck (or any other vehicle for that matter) could no longer go any further. We then waded up to our thighs through the river to the other side before starting the trek up the mountain. The hike took us 4 hours but was absolutely beautiful. Everyone we passed along the way took the time to say hello and a few people even stopped to chat.

(Picture: view of the river we crossed)

(Picture: Yva enjoying a flat part of the hike)

Kampan is literally at the top of a mountain. The last little bit up to the top was intense, but when we got there we were right in the middle of the vibrant kampan market. The nutrition program was being held right by the market so we were able to go check out the goods being sold. I bought couple of straw hats which ultimately came in handy for the hike down!

(Picture: kids eating the hearth meal)

When the nutrition program was over we were lead to a little house behind the church on the other side of the mountain where we would spend the night. While they were preparing the 2pm meal I fell fast asleep, most likely from utter exhaustion (I don’t remember the last time I hiked 4 hours up a mountain). Dinner consisted of rice and beans, vegetables, boiled plantains, boiled breadfruit, and lemonade. After dinner we just hung out, chatted, and read a bit. The house was really cute. It was a wooden house with mud floors and a tin roof. There were 4 rooms; the dining room, the kitchen, the bedroom (with 2 beds), and another bedroom/storage room. The main cooking area was in a little hut in the back of the house and the outhouse was up higher on the hill. Surrounding the house and down the mountainside were fields of corn. The family also had a few chickens and raised pigeons that made the most horrible scratching sounds with their claws on the tin roof.

(Picture: Kampan house that we stayed in)

(Picture: dining room)

(Picture: outdoor kitchen)

(Picture: Kampan)

There is no electricity in any of the mountain villages and so we went to bed when it got dark around 6:30pm. Yva and I squished into a little bed that was about 12 inches too short for me. Because we were high up it was actually quite cold and I had to sleep under a warm blanket. The coldness also helped keep away the mosquitoes which was nice because we had no mosquito net.

I didn’t sleep well at all and although I would love to blame it on the fact that I was sleeping on a non-existent mattress, I unfortunately think it was because my muscles were just too sore. We were up with the sun and had a breakfast of spaghetti with a slight tint of red sauce and some strong, super sweet black coffee. After saying by to the lovely family that had hosted us, we were on our way back down the mountain by 7:30am.

After about an hour of hiking down we arrived at the village of La Tournelle. The was also a nutrition program being held here so we took a little detour to go visit them. We played with the kids and observed the cooking for a while. The monitrice also taught the moms how to make “serum la kay” (oral rehydration solution) for when the kids get diarrhea. We were served some amazing hot chocolate. They didn’t know I was vegan and so I felt bad not drinking it since they went through the trouble of making it for us. It was so good. It would have been better if made with soy milk though. =)

The hike back down was a killer – almost harder than going up. We made it down in a total of 3 hours because it’s practically straight downhill. I fell about 4 times - twice in muddy spots (it rained the night before) and twice in really dry spots with slippery dirt and rocks. It was quite the scene because I was hiking in a mini skirt (pretty common thing to do here actually), but luckily there was nobody around.

We got back to the hospital at 2pm and I immediately took a shower and went straight to bed.

**Band Camp

2007-07-25T22:41:00.000-05:00

For the entire month of July there has been a band camp at the school next door to the hospital (and thus next door to my house). It is being run by a bunch of American musicians who are living in the hospital guest house (on the other side of my house) for the duration of the camp. The bands, orchestra, and choir are progressively getting better. Every morning at 8:30am the tone-deaf tenors practice “listening exercises” right below my window. They are not so bad anymore, but I’m looking forward to mornings without hearing “So Ni So Ni La” over and over and over.

**Day trips

2007-07-25T22:26:00.001-05:00

I finally made it to the beach. It wasn’t so nice and there was no sand, but it was still the ocean. Haitians swim with their shoes (sandals or nice sneakers). There was lot so of compa playing and the rum was flowing. We decided it was time to leave when a group of rowdy drunk guys started having a soggy bread fight. We went to anicer beach in Jakmel last weekend that reminded me of Thailand. Much better than the first Haiti beach experience.

Ti Moun Yo!

2007-07-02T17:19:00.000-05:00

Here are some pictures of the children and their families that I’ve been working with in the hospital.

(Pictures by Susan Speraw)

(Family from Kret Loran)

(Madeleine and her mom)

(Evanson Wilmar, from Chaterly orphanage near Leogane)

(Kara and Evanson)

(Evans, also from Chaterly orphanage)

(Samantha and her mom)

(Jackson - has a congenital heart problem)

(Eating rice and beans!!)

(Child with Kwashiorkors – notice edema in her legs...she is much better now)

Animals

2007-07-01T13:15:00.000-05:00

I found a baby lizard in the sink. I wish my mother had been here because she would have been just as excited as I was.

Mimi (formerly known as Pasha) loves crackers.

There is a woodpecker who pecks at the telephone pole across from my balcony!

June 23, 2007: Mobile Clinic

2007-07-01T13:08:00.000-05:00

A mobile clinic group just left this morning. They were here for the past week to do 4 days of clinic out in the villages. I’m sad to see them go because they were a great group and a lot of fun to hang out with. This group was led by the wife of a CNP board member and included 2 doctors, 2 nurses, plus 4 others to help with triage and pharmacy. I went to the clinic site with them on Monday and was able to take spend some time with them 2 other days as well in between other tasks.

On Monday we were in the village of L’Acul, about 20 mins from Leogane town. They set up the clinic in the Episcopal church – waiting area in the middle pews, triage at the altar, docs in a room outside the main church, eyeglasses set up on a table outside of the doctors’ room, and the pharmacy was at a window at the far end of the church. I mainly helped with odds and ends and when there was down time I sat with the doctors. The two docs, a pediatric neurologist and a surgeon, definitely were working outside of their specialties! They did great though. Most patients complained of GI problems and practically everyone was treated for worms. Fever (although not current), cough, and backache were also common. There was one little girl with kwashiorkors who ended up being admitted to the hospital the next day.

Overall the clinic days went well. There was a bit of a problem with a corrupt priest in Ste. Etienne, but other than that, things went smoothly.

(Pic – clinic group)

(Pic – Dr. Miller and patient)

(Pic – people waiting to see the docs)

(Pic – kids)

June 16, 2007: Market

2007-06-17T21:08:00.000-05:00

This is what I learned today:

3.5 hours in the Saturday market = migraine + nice tan + dehydration + very dirty feet

A mobile clinic group arrives this afternoon and so I went to help Janine buy food at the market this morning. It was market day which means the market is nuts and on top of that I didn’t realize we were going to buy food for the entire week. We ended up with more stuff than either of us could carry; too much even to take motorcycles back. We left all our stuff (including my bag of vegetables) with a lady who sells fruit and I came back to the hospital to try to find a car to go back and pick up the stuff while Janine went to the meat market (located in another part of town). Unfortunately all the cars had gone to Port-au-Prince to pick up the group at the airport and the one car that should have been around had to go pick up the ambulance that broke down on the side of the road. I had absolutely no food at home and was really looking forward to cooking lunch. I didn’t have the energy to walk all the way back to the market in the sun to get my bag. So, instead I just rehydrated and fell asleep on the couch while waiting for a driver to come back.

It all worked out in the end. The driver returned and went with me back to the market. I had a slight moment of panic when we got there because I thought I forgot where we left everything. You know me and directions! But I was able to find the fruit lady on the first try. Phew. Ender, a notoriously bad driver, insisted on driving the truck through the market (extremely crowded and tightly packed with people selling their goods on the ground) and straight up to the fruit lady’s little stall. Along the way he nicked the stall of someone selling electronics and broke a piece of wood off the side of the booth. Fortunately we made it to the fruit lady without any human casualties.

I’m now well stocked with fruits and vegetables! Here is what I bought:

June 13, 2007: Tiny underwear and a new phone

2007-06-13T19:46:00.000-05:00

ALL my underwear are now too small for me, although thankfully not due to the massive amounts of rice and beans I’ve been consuming. This morning I put a load of clothes in the washing machine, which among other things included all my underwear. I don’t dry my clothes for fear that they will shrink and so I specifically told the women working there not put them in the dryer. She forgot and when I went back down everything was hot and fluffy, straight out of the dryer. Luckily I can still wear everything. I guess it could be worse; I could have turned all my clothes an ugly grayish black color again. =0

The main objective of today was to buy a new mobile phone for our driver, Jean-Claude. His phone has not been working and I’m sure one of these days I’m going to lose him. He wanted a Digicel phone (apparently the best service in Haiti).

Surprisingly, there are 4 Digicel shops in this little town all located practically around the corner from each other. The first store was the largest and even had a nice little phone charging station on the front porch that consisted of about 12 outlets. (There is generally no electricity around here unless you have a generator.) The phone charging station was a big hit and the outlets were overflowing with chargers! The store had a nice display of phones, but unfortunately they only had 1 in stock. So we did some shopping around, but the same went for all the other shops as well. Jean-Claude was not happy with this and so we drove almost all the way to Port-au-Prince to find a shop that had a wider range of phone options. We ended up at a store in Carrfour. We were searched before entering, but the store was air-conditioned so that made it worth it. The Cubans came along because they wanted to go to an electronics store (known to give good deals to Cubans) to get some estimates on refrigerators to send back to their families in Cuba.

Despite doing relatively nothing today, I was exhausted. The last thing I wanted to do was data entry, but every afternoon until 5:30 that is what we do. Evelyne, one of the hospital program organizers, comes to help me and then we go together to check on all the kids at the hospital and give out the milk.

I can’t wait to switch to Plumpy’nut. The milk that we make is really starting to make me nauseated every time I get a whiff of it. I’m not sure how these kids stomach it.

June 12, 2007: Greve

2007-06-13T19:45:00.000-05:00

There is a nation-wide transportation strike today and tomorrow protesting high gas prices. Transportation prices have nearly quadrupled so people are obviously not happy about this. Many places were closed because nobody could get to work.

Luckily we have our own driver so he was able to drive us out to the village to go supervise the nutrition program. When we finally arrived, nobody was there! All the mothers were there in the morning for the vaccine post (held once a month) and they didn’t want to stay until the afternoon for the nutrition program. So everyone just went home, including us.

On the ride back Felicia, who is 4 months pregnant, was complaining how the baby makes her hungry all the time. So we stopped to get some "friage" - fried plantains, breadfruit, and a plethora of fried meats that you can get at little stalls everywhere along the streets. It always comes with "piklis" (a spicy coleslaw) which I really like. I got a bag full of that since all the other stuff is fried with meat. The piklis goes great with any dish. I had it for dinner with couscous and sting beans. Yummy.

June 11, 2007: Haut Gerard

2007-06-13T19:30:00.000-05:00

Here are some pics of our visit to the village of Haut Gerard:

(Picture: Volunteer mother cooling in the kitchen.)

(Picture: Eating!)

In the above picture, the little baby being fed (on the left) is 9 months old and has signs of kwashiorkors. She had a great appetite and no other signs of illness though. I’ll see how she’s doing when we go back to Haut Gerard next week, but unfortunately I think she will need to come into the hospital to be rehabilitated with the therapeutic milk.

(Picture: waiting patiently)

June 7,8,9, 2007: Plumpy'nut

2007-06-13T19:05:00.000-05:00

My boss was in town the past few days for a meeting we had in Port-au-Prince. We stayed at a really nice hotel with a pool and great drinks...all on the CNP! The food left a lot to be desired from a vegan’s standpoint, but since there was a pool it didn’t really matter.

We had an all day meeting on Friday with Save the Children, Concern, UNICEF, and the Haiti Ministry of Health to get the Plumpy’nut project underway. Plumpy’nut is a peanut butter based ready-to-use therapeutic food used to rehabilitate malnourished children that has been shown to work better than the therapeutic milk (F100) which we currently use in the hospital. Plumpy’nut is already being used by some organizations in Haiti but with very different treatment protocol so we're hoping to standardize it's use for the treatment of severe acute malnutrition and use the data collected over the 6-month trial to inform policy chance in the national protocols (currently undergoing revision) for treatment of malnutrition in Haiti. I'm pretty excited to be a part of the project. I was so hungry during the meeting due to the lack of vegetables at lunch that all the talk about Plumpy’nut was making me salivate!!

Mimi

2007-06-03T22:06:00.000-05:00

I forgot to mention – Cathy told me that the cat is actually named Mimi and has been around for about 10 years!! Apparently Pasha was a very similar looking cat that died. The women in the guesthouse who call her Pasha haven’t realized this I guess. I like the name Pasha better and I think I may stick with it. It’s hard to change names after a month.

June 3, 2007: RAM and the Leogane Disco

2007-06-03T21:53:00.000-05:00

This past Thursday night (May 31st) I went with Cathy (woman who had my job for 6 years) and her friend (former Haiti Peace Corps volunteer), Leah, to see a voodoo inspired band called RAM at the Oloffson hotel in Port-au-Prince. RAM plays at the Oloffson every Thrusday night and has a rather interesting and dedicated following. There was a good mix of foreigners and locals and I’m told this is one of the only places around where same sex couples can hang out. The hotel was pretty nice and we had dinner in the restaurant out on the veranda. It was nice to have a pretty good salad and a very strong fruit punch with rum (or possible clarin, Haitian moonshine). Whatever it was, it was either extremely strong or I have absolutely no tolerance anymore. By the third sip I was ready to dance.

The band didn’t start until around 11:30pm and since we were all pretty tired (partly due to the killer fruit punch) we didn’t stay to hear them play for very long. They were interesting though and had a very different sound from the usual Compa music that you hear here.

(Picture: RAM)

We spent the night in the very unfurnished apartment that Cathy and her fellow law school classmates are renting for the summer. There were no pillows, sheets, fans, dishes…nothing. We didn’t even think to buy clean water to drink!

The CNP driver picked us up on Friday morning and Cathy came back to Leogane with me to visit her old friends. It was fun to have her here. She showed me all around and introduced me to everyone. In the evening we went with a group of guys who work for the filariasis project down to the beach. It was great to be by the ocean, but the beach was covered in garbage. I won’t be swimming there.

Last night we went to the disco with some of Cathy’s really good guy friends. The disco is a large room with tables and chairs surrounding the dance floor which is marked by a large rectangle of colored flashing tile lights. Before 10pm they have salsa dancing and after the lights are dimmed and it turns into a proper disco that plays a mix of American top 40 and Haitian Compa. It was fun. All the girls sit around and wait for guys to ask them to dance. Dancing to Compa is fun and a lot more formal than what I’m used to. During the salsa part there were some amazing dancers! I can’t salsa to save my life. One of Cathy’s friends is a salsa teacher, so I’m going to start salsa lessons next Saturday!

May 31, 2007: Lab

2007-06-03T21:46:00.000-05:00

This week so far has been spent dealing with one very bitter little man, Monsieur D, who writes the bills that a patient needs for all diagnostic exams in the hospital. He has been refusing to do so unless patients pay upfront (i.e. bribe him). This has been causing problems for the nutrition program. The hospital director was supposed to have talked with Monsieur D at the beginning of the week, but today it was still the same old story. I can sympathize with him a little. The hospital is having financial difficulties which has resulted in many people, including Monsieur D, not being paid for several months. But if he’s still going to show up to work, he needs to do his job. He told me that the hospital director never talked to him. We argued and I told him I was going right then to talk with the hospital director, again. This scared him enough to write a bill “for today ONLY” for the little boy’s blood work. He gave me the bill for the labs, but today only is just not going to cut it. I went back to the director and little Monsieur D got in big trouble. I’m sure he’s not too happy with me, but he better be writing bills for us from now on. The former manager of the program told me that she had the same problem with this guy when she first got here. Guess he's trying to see what he can get away with.

The good thing that came out of this, other than the fact that I hope to not have any more problems with Monsieur D, is that I now know the process of getting laboratory tests done. This was my first time up to the 3^rd floor. Located up there is the laboratory, dental clinic, the filariasis project lab, and the hospital radio station (that I didn’t even know existed and is apparently one of the most popular stations in Leogane!). I was rather impressed with the lab. There are 2 refrigerators, an incubator (that may or may not be working), 2 microscopes, and a centrifuge. (There was also a pile of old dusty broken microscopes and a centrifuge in the corder). There were a million people in the room, most of whom were students observing. Parked almost right in the middle of the room was one chair for the patient to sit in. I found the lack of privacy for the patient rather awkward, but I don’t think privacy is all that much of an issue here.

I’m essentially taking off the rest of the afternoon and all day tomorrow (Friday) to go hang out in Port-au-Prince with the woman who used to have my job and is now in Haiti for a 2 month law school internship. I’m looking forward to a little break!

May 27, 2007: Fete des Meres!

2007-05-28T07:07:00.001-05:00

Today is Mother’s Day in Haiti. Janine, one of the women who cooks for the guesthouse, invited us to her house for lunch. She lives in a village not too far from the hospital. We arrived around 9:30am just as everyone was starting to prepare all the food for lunch and decorate the house with balloons.

(Picture: Janine’s house)

Janine’s house is cute. It consists of a bunch of concrete/wooden rooms (each with a bed or two) and a small living room. The backyard housed 2 pigs – each with their own mud piles, a bunch of chickens, the outhouse, and a section with old rusted weight lifting equipment. The outhouse did not have a squatting toilet like I had hoped. Instead it had a normal toilet seat over the hole. The seat was almost too high to squat over (and not physically sit on), but I managed. Until now I haven’t had the opportunity to use an outhouse in the village. We’ve been peeing in the bushes!!

I hung out with the women while they cooked for a while. There was a separate little building that functions as the kitchen. It had a little table and three coal stoves. (Most people use coal to cook and I’ve occasionally seen open fires.)

(Picture: Jolina, the other woman who works in the guesthouse, in the kitchen preparing a spicy tomato sauce for the meat dish)

(Picture: The rest of the women preparing food outside)

(Picture: The food waiting to go out to the table)

While we waited for the feast we all enjoyed some Haitian beer and an appetizer of “croquette lam”. Lam (short for lamveritab) is a breadfruitl. This was actually my first time ever eating it. The croquettes are made of pureed breadfruit, spices, and usually meat and cheese (but these were left out for me), shaped into little balls, and deep-fried. They were really good despite the lack of meat and cheese (although I do think they would have been great with the cheese).

(Picture: Frank and Sylvestre, Janine’s son, hanging out before lunch)

Lunch was incredible and there was so much food - rice with beans, two kinds of fried plantains, more lam croquettes, avocado, salad, pasta salad, a vegetable platter with broccoli, carrots, beets, string beans, and potatoes, goat meat, fried fish, mango, papaya, oranges, bananas, pineapple…and champagne to wash it all down!

After lunch we hung out for a bit. I worked on my Spanish comprehension while the Cubans chatted a mile a minute. Little bits and pieces from the year of Spanish I took in college are coming back!

After taking a bunch of photos we hopped in the truck to head back to the hospital.

(Picture: Janine and her mother – Happy Mother’s Day!)

(Picture: right to left – Maria Elena, Kara, Janine’s mother, Frank, Dania, Sylvestre, Janine)

The rest of the day has been relaxing. I napped for 2 hours, there were no major problems at the hospital, and it’s now raining and cooling everything off. The frogs that sound like ducks are out, but I think I’ll sleep right through their quacking tonight.

May 26, 2007: Saturday

2007-05-28T07:06:00.000-05:00

It’s the weekend. I slept in until 8am which was refreshing (but yet not refreshing enough). I didn’t do anything but work at the hospital and go to the market with the Cubans. It was market day and very busy. I bought enough brown rice to last the next 6 months. I didn’t realize I had asked for so much!

I’ve been preparing the milk and checking on the kids on week nights and the weekends. The women who normally run the program aren’t here at these times and I’m just beginning to really realize how big a problem this is. I think it will be great when I can finally set up a schedule with the nursing students to help out. The other thing though is that the CNP covers all hospital costs for the children in the nutrition program. Unfortunately it’s not as easy as just paying the bill at the end of the patient’s hospital stay. There is definitely a bill at the end, but there are also many little expenses on a day to day basis because families have to purchase all medicines, IVs, etc. themselves.

I ran into a problem with this today. One of the mother’s of a little boy who was admitted on Thursday has absolutely no money. (We actually met them at the Ti Foye visit in the mountains that we did on the 23^rd and told them they needed to come to the hospital.) When I went to go see how they were today, the baby’s IV had run out and he had a prescription for an antibiotic and a thermometer (patients even need to buy their own thermometers!) that needed to be filled. The mom hadn’t gone to the pharmacie to buy more saline soln or get the meds because she couldn’t afford it. She was also supposed to be taking antibiotics herself (which I know she had because I gave them to her), but hadn’t taken them because she didn’t have any clean water or food to take it with. I was able to get everything for the baby because I have access to the CNP pharmacy and I have a stash of money to buy what we don’t have from the hospital pharmacy. Otherwise she would have had to wait until Monday! I guess I’m just going to have to ask the pediatrician on try to predict what the children may need over the weekend and get it for them on Friday because I won’t be here every weekend (and it’ll be nice not to have to work everyday).

May 24, 2007: Babies!!

2007-05-27T19:31:00.000-05:00

I almost had to deliver a baby last night. There was a woman screaming her lungs out and about to give birth in the middle of the dark corridor leading to the pediatric ward. The family was trying to get her to the labor and delivery room, but she wasn’t having it. There were no doctors or nurses to be seen anywhere. I went to go find someone and the two docs that were on the roof in the doctors’ residence (one of whom was the doctor on call!!!) wouldn’t come help because they were “not obstetricians”. They would rather let this woman’s family, or worse yet, me, deliver the baby. I was shocked and later really upset with them. I ran home to get gloves to prepare for the worse case scenario (my helping out) and by the time I returned one of the lazy nurses finally decided to come out of her hiding place and investigate what was going on. She still wasn’t doing anything, but I decided she was good enough and I carried on with what I had come to do – feed Vincent (a little boy in the hospital whose mother was also recently admitted for TB and severe malnutrition).

I am not a fan of the nurses here. The nursing students are great, but the actual nurses are horrible. They are not friendly and hardly ever work. Tonight one of the kid’s IVs came undone and was dripping everywhere. There was one nurse around and so I went to ask if she could help fix the IV and her response was, “I’m not a pediatric nurse”. Well, she was the only nurse there and it didn’t take any special pediatric skills to fix the IV. I ended up doing it. Luckily, on my way out I ran into a (very flirty) doctor who covers the ED on Thursday nights and I had him come check the baby’s IV. He ended up scolding the nurse that wouldn’t help me and made her go check on the child. Haha. Serves her right. I think she hates me now though!

Apart from frustrating evenings at the hospital, I had an enjoyable dinner on Wednesday night with the Cubans. We had spaghetti with tomato sauce, fried plantains, and bananas. Apparently it’s a very Cuban thing to eat a banana with spaghetti! It was bizarrely good. The salty tomato sauce and ripe banana actually compliment each other quite well. I suggest everyone try it.

May 23, 2007: Into the mountains

2007-05-23T14:02:00.000-05:00

Today’s Ti Foye visit included another “little walk”. I knew better than to wear my slippery Jcrew flip flops, but I wasn’t prepared for this! We hiked down there:

Luckily it was a nice day and not too sunny, but I’m definitely out of shape.

(Picture: Yva and Kara taking a photo break)

The kids has a snack of peanut butter on bread while the monitrices reviewed the material they had covered. This particular Ti Foye was nearing the end of its 10-day course. The mothers eagerly shared all the information that they had learned such as how to prepare a balanced and high calorie meal for their kids, what causes diarrhea and how to prevent it, how to make oral rehydration solution at home, and the signs, symptoms, and prevention of malaria.

(Picture: Mere voluntaire’s little boy standing outside the kitchen - He doesn't look too happy in this picture, but in fact he happily played and tormented a rather healthy looking stray dog the entire time we were there.)

Just as the kids were about to eat the lunch of rice, black bean sauce, and vegetables, a big black rain cloud appeared and it started to thunder. Yva and I decided we did not want to hike in the rain so we booked it back up the mountain and made it to the truck just as the first drops began to fall! Phew!

May 19, 2007: Let enriche

2007-05-21T16:02:00.000-05:00

I was forced to come inside around dusk today because I had about 20 mosquitoes buzzing around my head out on the veranda. I now have a mosquito coil conveniently placed in the doorway to stop them from coming into the house. There are enough in here already! The sliding glass door on the veranda is broken and only closes halfway. The door is just a gate and so the cat and mosquitoes can enter at will. As far as I know no other critters apart from a few big beetles and moths have been coming in.

Yesterday was Flag Day. The school next door had a big celebration for the students and several bands marched up and down the street (some definitely better than others). I slept in a bit (until 7:30am). I spent all morning waiting for the electricity to come on so I could go over to the hospital to make the therapeutic milk for the kids (it needs to be blended in a blender). By 10:30 there was still no power. I went to find the guys in charge and was told it would be on soon. Still didn’t happen. Turns out the blockage for the hole in a damaged water pipe in the pediatric ward came out and when the power goes on, water spurts everywhere. We had to wait for Albert to come and re-block the hole. Why they just haven’t replaced the pipe is beyond me. By noon I couldn’t wait any longer to get the food to the kids so I attempted to blend the mixture by hand. It’s pretty difficult to blend oil into a water, powered milk, sugar solution. The oil kept rising to the top and the milk was all clumpy. If I were the kids I wouldn’t go near the stuff. I apologized to the moms and told them to mix it well before giving it to the kids. When the power finally came back on around 2pm I remade the milk with the blender and brought the nice homogenous milk shake-like drink to the kids. Much better.

A new 4 month old baby was admitted yesterday. I didn’t see the mom at all yesterday, but today she was there and I was able to talk to her. She had not fed he baby all day because she does not have any baby formula (the therapeutic milk that we make is not fit for infants under 6 months). A container of powdered baby formula is ridiculously expensive ($11) and so it’s no wonder why the moms can't afford it! This was the same problem we had on Thursday with the two other mothers with little babies. We ended up buying formula for them (with CNP money) but today I didn’t have access to the cash drawer. In addition, I’m running extremely low on cash myself. I’ve been paying for things out of pocket because Yva, the woman with the key to the cash drawer, has been out sick. I’m down to 300 goudes – 100 short to buy the formula! Luckily the other moms are great. I asked if they would share the baby formula with the new mom until Monday and they agreed.

May 17, 2007

2007-05-17T19:21:00.000-05:00

Today I went to Port-au-Prince in search of the lawyer who has been helping us get NGO status in Haiti. We’re a certified NGO in the USA, but not yet in Haiti, and it has been a long long process. There is one more paper to fill out and I’ve been emailing and calling this woman since I’ve been here, but to no avail. Today I thought I would go try to track her down in person.

We drove into Port-au-Prince by a different route today - via the market road of Kafou (Carrefour). Busy busy. Jean Claude told me we usually don’t go this way because it is generally “blokis” (traffic jam). The market was along a main road and stretched for miles. There was anything you could ever need – vegetables, clothing, bread, live chickens, sausages, fried foods, fruits, shoes, candy, buckets, toiletries, water, big blocks of ice…you name it, it was there.

Port-au-Prince is all decorated for Flag Day tomorrow. There were flags everywhere and stages set up for the celebration. We saw some school kids having an assembly in the school yard, too, in honor of the holiday tomorrow. Tonight is also the celebration of the mobile phone company Digicel’s one year anniversary in Haiti. There will be a big open concert with many well known singers, including Shaggy!

It turns out the lawyer was not there and I was told to come back Monday. I had a feeling that would happen and so I wasn’t frustrated. I look at it as just another opportunity to practice my French. I was able to communicate and understand everything. It’s coming back...

Back at the hospital I visited the kids and tried to get some admin stuff done. The CNP is in the process of an audit right now and needs all of the bank statements for 2006. I asked for them on Wednesday and I was told they would be ready yesterday. They still weren’t done today. So I had to get the head admin lady, Mme. Aphonse (not the nicest women) to go tell the accounting guy exactly where he needs to look for all the bank statements (in the cabinet by his desk). He’s a nice guy and has only been there 2 months, so I’ll give him the benefit of the doubt. I know how confusing things can be around here. I was told they will be ready on Monday…we’ll see.

This afternoon I went down the street to buy mangoes. I was immediately joined by a young man who called himself “Romeo” (most likely not his real name). I knew he was going to be annoying the moment he said, “hey there, what’s up”. He followed me down the street and when his conversation passed the acceptable line (a line that was fixed in Bangladesh and won’t budge), I told him that he was rude and crossed the street. Everyone else I encountered was nice and I happily returned with 7 gigantic mangoes for $1.40!! Yummy.

Manba

2007-05-16T19:41:00.000-05:00

I put aside all fears I have of aflatoxin today and thoroughly enjoyed Haitian peanut butter. Mmm…all natural peanuty goodness! I eat a lot of peanut butter and have been in major withdrawal these past few weeks! There were a couple containers of relatively aflatoxin-free American “Skippy” at the grocery store in Port-au-Prince, but the added sugar and hydrogenated vegetable oil gross me out. The Haitian “manba” is just peanuts and salt (and aflatoxins apparently).

So, here’s what I’ve learned about aflatoxins. Peanuts contain high quantities of the mold Aspergillus Vlavus, which produces aflatoxin, a carcinogen that has been associated with liver cancer. Practically all peanuts and peanut butters have the mold, but the amount of mold depends on a number of variables. In short the longer peanuts sit around before being made into peanut butter or after unrefrigerated and/or not in air-tight containers, the more mold and thus aflatoxins build up. High temperatures and high moisture environments make the situation even worse, making Haitian peanut butter a haven for Aspergillus Vlavus. In the USA the highest levels of aflatoxin have been found in all-natural, organic peanut butters. So, Skippy isn’t looking all too bad anymore.

I guess it all comes down to whether the benefits outweigh the risks. In Haiti, peanut butter is readily available and affordable. And kids like it. If a child is malnourished and the parents’ can’t afford other foods that are high in calories, fat, and protein (e.g meat, eggs, dairy products), then peanut butter doesn’t seem like such a bad option, aflatoxins and all, considering more than 1 out of 4 Haitian children under 5-years-old are malnourished.

But where does that leave me?? Hmm…I’m vegan and so could benefit from the nutrients in peanut butter especially since I don’t have access to soy products here. But, I can afford the Skippy. I could also have organic peanut butter shipped to me from the USA. But from what I’m reading, there’s really no way to tell if that is any better than Haitian peanut butter anyway! So, I might break down and buy the expensive Skippy…after finishing the Manba Rebo Natural that is.

May 16, 2007: Soup Nwa

2007-05-16T19:23:00.000-05:00

I had an amazing night’s sleep last night. I didn’t wake up once and the power was on the entire night until 5am.

Today our agenda said we would leave at 8am. I knew that wouldn’t happen and so didn’t even go to look for the driver until 8:15…pretty good for me who is chronically early. (Looking for the driver literally means looking over the veranda onto the parking area below.) As I suspected he wasn’t there yet. The power was on and the internet connection was actually quite fast so I was able to catch up on work emails. We eventually left the hospital around 9:30am.

It was a short drive to the village of Bossan. Today was their monthly vaccination post. Every village in the district should have monthly vaccination posts held by a Health Agent (Agent de Sante). The Health Agent gives vaccinations (polio, DTP, BCG, and rubella) and vitamin A, while the monitrices monitor nutrition status (based on a standardized weight for age chart). Currently only a few of the 100 something Health Agents are being paid and so most vaccination posts have nobody there to give vaccinations. Bossan’s Health Agent is a cheerful man and was very excited that we came to visit him. He explained all the procedures to me and I got to weigh some kids! All in all I was pretty impressed, but it scared me that he was recapping needles.

(Picture: Agent de Sante filling out a child’s health card. This child was referred to the hospital for aneamia.)

(Picture: Felicia weighing a child)

The rest of the day wasn’t so productive. There was a hospital meeting (which apparently did not go so well and resulted in doctors fighting with the hospital director and people walking out) and nobody was around. Eva was out sick again which incapacitates me because she’s the only one of the 4 CNP girls who knows how to do any of the things I’m supposed to be doing. We were supposed to do the salary checks today (due on the 20^thwhich is a Sunday, so essentially due tomorrow because Friday is a holiday!), but I couldn’t find the checks and I’m not too clear on the procedure for submitting them. Plus, I’m not going to be here tomorrow because I have to go to Port-au-Prince. Oof.

So to occupy myself I did some reading, visited the hospital kids, learned how to make some amazing fried plantains from Marialene (the Cuban nurse), practiced Kreyol with the guest house cook, studied some French and Kreyol, and made soup.

The soup looks disgusting, but it actually tastes pretty good once you get over the fact that it’s black (despite the fact it has no black beans in it). I was excited to find mushroom bouillon that ended up looking like charcoal. I used it anyway even though it seemed pretty nasty and voila! Black soup. It turned all the vegetables a brownish-grey color too. Yummy.

May 15, 2007: Oof

2007-05-16T15:36:00.000-05:00

I’m sleep deprived! For the past 2 nights the power has gone off at 1:30am. Yesterday it didn’t come back on until 9:30am. Today, it’s now 7am and still no sign of any electricity. It has been too hot and loud to sleep. Two nights ago there were about 30 dogs barking non-stop outside from 1:30am - 5:00am. They were also barking last night, but not for a constant 3 hours. Without a fan it’s too hot to be comfortable and the windows are not designed to let air in. I’m not sure what is going on with the electricity! I will try to investigate today. I’ll be sleeping on the veranda tonight if this happens again!

I did not have electricity at all yesterday until the evening and no water until 8pm when the pump generator got turned on. At 8pm I immediately washed all my dishes and jumped in the shower to wash off the sticky mixture of bug spray and sunscreen. I expected another cold, unpleasant shower. To my surprise the water was kind of warm, and then it was HOT!!!! It must be warm enough during the day now for the water in the tank to heat up. I can’t even tell you how happy I was. It was almost too hot! This was my first hot shower since I’ve been here. I felt so clean!!! There’s really nothing like hot water. It made my day.

Anyway, today started off bright and early. Beverlie, a monitrice who was actually working at the Ti Foye from yesterday (see pics from yesterday), came by my house at 7am. I knew she was coming so it wasn’t a surprise. I’m quite the morning person lately anyway, much against my will. Beverlie is 7 months pregnant with her first child. When my boss was here two weeks ago Beverlie had asked if there was anything that the CNP could do to help her financially with the baby. She estimates she will need about $600 (US) to cover the final pre-natal tests, having the baby in a hospital, and buying the essentials for the baby. This seems like a pretty accurate estimate to me based on what I know patients pay at this hospital. Ashley sent an email out to the CNP Board of Directors to see if anyone would be willing to support Beverlie. She’s a great monitrice and one of the sweetest people I’ve met here so far, so I’m happy that Ashley is trying to help her out. We’re still waiting to hear back from the board members. In the meantime Beverlie told me that the most urgent matter is that she needs an ultrasound which will cost 1250 gourdes or about $35 (US). (She even showed me the order for the ultrasound from her doctor. I would have believed her anyway though.) I wanted to give her the money, but I know that if I start doing that it’ll turn into a messy situation for me. So, I talked with Ashley and she agreed to give her the $35 for the ultrasound. (I’m to say it is from a board member). We’re also going to give her a breast pump so that she can breast feed exclusively and still work. Beverlie was so happy. We had some mango and chatted for a bit. I learned from her that some people think cats and dogs can be possessed with zombies and ghosts and so generally don’t let them in their houses. I think Pasha is free from zombies. The women who run the guest house let her in, so she must be safe. =)

I spent the rest of the day at the hospital and it has been hectic. I’m completely exhausted. In the morning there was a bad motorcycle accident. The patient arrived in a pick-up truck along with about 40 other people. He ended up being too critical to take care of here that he was sent in one of the hospital trucks to Port-au-Prince. We also had a little boy die last night. He was severely burned and malnourished on top of that. He seemed to be doing better so I’m not exactly sure what happened. It’s so sad.

The other kids are doing ok and I hope it stays that way. I learned how to make the enriched milk yesterday, where all the ingredients are stored, and how to distribute it. The two women who do this during the week are not there on weekends and the nurses can’t be bothered to lift a finger. So, I will start making the milk on the weekends until I arrange a schedule for the nursing students to come in and help out. I’m going to meet with them next week to give an overview of nutrition and what we do at the hospital (both of which I’m still learning!).

May 14, 2007: L’ap vini, piti piti

2007-05-16T14:27:00.000-05:00

It’s the start of another week. Overall, everything today seemed a little clearer. I think things are starting to fall into place. My spoken French is slowly coming back and the Kreyole is getting better. I’m still adding in Bangla vocabulary and trying to use Bangla sentence structure, but I think that will fade with time. The best phrase I’ve learned so far is “L’ap vini, piti piti” (it’s come, little by little).

I was told we would leave for the Ti Foye in Kwadepe (Kreyol for “Croix des Peres”) at 8am. I was up and ready to go by 8, backpack packed and everything. I’m still falling for this trick!! We’ve yet to leave on time for anything and so I need to start adding 30 mins to an hour (sometimes more) to any estimated time that something is supposed to happen. So at 8 I did the rounds of the hospital grounds and said “Bonjou” to everyone who was around. We were finally on our way around 9:30am. C’est la vie. It all worked out in the end because the Ti Foye didn’t start on time either.

Kwadepe is a great little village! It is adorable as far as villages go. Tiny brightly colored houses surrounded by banana, mango, and palm trees. The Ti Foye was held at the house of the Volunteer Mother (mere voluntaire). Each Ti Foye is supposed to have a volunteer mother in charge and the monitrices just facilitate and support the mother. There were 9 kids today, all of whom are underweight for age and 3 whom are classified as very underweight for age. We all sat under the banana trees while Beverlie, the monitrice, went over the “3 kalite mange”. I had practiced the song so I could sing along today. =) In the meantime the volunteer mother and the other monitrice, Guerdy, prepared lunch: bean sauce with carrots (with added butter), vegetables with little crabs, rice with chicken bouillon, butter, and oil, and orange juice.

(Picture: Guerdy preparing Ti Foye meal)

(Picture: Beverlie talking with the mothers)

Right now I’m sitting outside on my veranda because it’s too hot inside. There is a nice breeze out here. It would be quite enjoyable if I wasn’t breathing in burning garbage fumes. The garbage pile for the entire hospital is located right next to my apartment. Yup, disgusting. Luckily it doesn’t generally smell. The pile has been building up since I got here and even started to overflow out of the cement walls that are supposed to contain it. They are burning the pile now. Smoke and the occasional large chunk of hospital garbage ash are floating up onto my veranda. I guess it’s good that they are finally doing something about it. I just wish they didn’t choose right now to do it!

May 13, 2007: Cat food

2007-05-13T13:41:00.000-05:00

This morning, bright and early at 7am, Jean-Caude (driver) and I went to Port-au-Prince. I needed to buy cat food, something that’s not available in Leogane. I ran out of the stuff I brought from the States. Yesterday I had to feed her some nasty leftover tuna that someone left in the fridge before I arrived. I even fried it in olive oil and added some bean sauce for extra protein. I can’t remember the last time I cooked meat for anyone! She’s one lucky kitty.

(Picture: Pasha asking for food)

The ride into the capital was great this morning because it still wasn’t too hot and there was a nice breeze coming through the windows. I’m slowly learning the names of places. Jean Claude is great at pointing things out and constantly repeating the names of the towns we pass through. Today he showed me were I can go to the beach, Sunny Plage. The turquoise water looks absolutely beautiful from the road, but I’m not sure how nice the beach is.

The truck’s air conditioner broke, again, on the way back to Leogane. This truck has so many problems. It's actually amazing that it runs at all. Jean-Claude told me the other day that he’s going to teach me to drive it. Today we had our first lesson: starting the engine. You have to put the key in the ignition and turn it half way for several seconds until the engine is “hot” and starts to make a ticking sound. Then you can turn it on all the way. Hmmm…

Right now one of the little stores on the street is blasting Compa. I can hear people singing at a nearby church too. I like it. I think I’ll go sit out on the porch, relax, and take in the sounds.

(She helps me study too)

May 12, 2007: Messe d’Action de Grace a l’Occasion de la Prise de Coiffe

2007-05-13T13:37:00.000-05:00

Today was the “Prise de Coiffe” for the first year nursing students of the Faculté des Science Infirmières De Léogane (FSIL). And what better day to celebrate than on National Nurses’ Day! The ceremony was held at the Ste Croix Episcopal Church (right next door to the hospital) at 10am. It started a little bit late because there was no electricity. Monsieur Edgar, the weekend and nighttime maintenance guy who controls the electricity for all of the hospital compound which includes the church, had gone to the market to buy oil and was not yet back. So we just waited. In the meantime my legs were devoured by a swarm of mosquitoes (big black spotted ones that hurt when they bite).

The church is a very simple concrete building with beautifully crafted metal windows. Unfortunately there are no ceiling fans so it was still incredibly hot even when the electricity came on. Regardless, the ceremony was very nice. The FSIL choir sang upbeat church music and in the middle of the mass all 27 of the first year students went up to the front to receive their little nursing hats. (There are actually 4 guys in the class who don’t get to wear little hats.)

(Picture: nursing students getting their hats)

At the end there was one last song where we all held hands and swayed back and forth to “Gloire à Dieu”. Then we all filed out of the church and onto busses to go back to the nursing school for the reception. There was food (meat filled croissant and some sort of chicken? burger), drinks, music, and lots of speeches. I figured out what to call myself finally. I was introduced as “La Directrice du Programme Nutrition de L’hôpital Ste Croix”. Quite a mouthful.

By 2:00pm I was in major need of some food so I bid farewell to everyone and made my way home. There was a party in the evening, but I decided to stay home and go to bed early.

May 10, 2007: Electricity and trip to Bronyotte

2007-05-10T20:25:00.000-05:00

I woke up to a very loud gurgling sound at about 3:00am this morning. I think I actually jumped out of bed while I was still asleep because the only thing I remember is standing up outside my mosquito net, my heart pounding. It turned out to be the toilet. I have no idea what was going on with it, but it stopped eventually.

I was up for good at 5:30am when the power went off. It's just way too loud outside to fall back asleep. I'm still trying to fully understand how the electricity works at the hospital. There are set times that it is on and off and today I met one of the guys who controls it! (I think I’ll be good to know him!) He also controls the water, which he turns on only after 8:00pm (but occasionally it has been on during the day, too, if we’re lucky). It appears that they shut the electricity off between 5:30am and 7:00am. It’s off for good at 7am if it hasn’t already been shut off. It comes back on sometime after 9am (but usually closer to 10 or 11am). Then it’s off again in the late afternoon and comes back on for the night usually just as it’s getting dark. From what I understand there are 2 different generators and then there is the Haiti electricity. Right now (it’s 8pm) I think we are on the Haiti electricity because I don’t hear any generators going. This isn’t too reliable though and during the day when we have electricity it’s usually from the generators. The different generators are responsible for different circuits, too, so sometimes only certain lights work.

Anway, today was not such a bad day. I spent the morning in the hospital with the paediatrician getting the low down on the kids. We’re going to put all 4 of the kids in the nutrition program. This means the CNP will cover all their medical expenses and provide therapeutic milk (powered milk, oil, sugar, water, and there should be vitamins added but we don’t have access to the proper vitamin mixtures) to rehabilitate them. I think we just need to go over the inclusion criteria because there has been some confusion over which kids can be in the program. There are other things that need to be worked out but that is beyond what I can even think about trying to do right now.

I made Yva go to the Leogane market with me this afternoon. It wasn’t market day, but there were still some vendors there. We ended up taking the truck because Yva hurt her knee the other day and didn't want to walk. It’s nice to have vegetables again!

After the market, Yva and I went to visit a Ti Foye in the nearby village of Bronyotte. It only took 20 mins to get there and didn’t involve any mountains. Yva did a good job at explaining things to me. The women cooked a soup of yams, plantains, carrots, leafy vegetables, butter, and chicken bouillon.

(Picture: Lucnie, one of the two monitrices in Bronyotte, preparing juice at the Ti Foye)

We also went over the “3 kalite manje” or 3 qualities of foods; those that protect, those that nourish, and those that make you strong.

(Picture: Going over the “3 Kalite Mange”)

This evening I went with Frank and Marialena to meet Hilda, the director for the nursing school in Leogane. She’s great! She’s Haitian-American and has started this wonderful nursing school here. I’m going to celebrate national nurses’ day (or something like that) with them on Saturday. I think I may have agreed to teach some public health classes to the students, too.

May 9, 2007: Pediatric ward

2007-05-09T22:54:00.000-05:00

As of this morning there are no lab results for the monitrice. She looked a little better today than she did last night though. I decided to give them another day to come up with a diagnosis before I convince a doctor to presumptively treat her for malaria (or just do it myself).

Today has been interesting. The two monitrice supervisors, Yva and Felicia, who work closely with me did not show up to work. Yva is sick, but she told me yesterday (we stopped at her house on the way home from the village) that she would be here today and I have no idea where Felicia was. This was not good because most of the things I needed to do today involved things they need to help me with. So I hung out with the hospital program organizers for a bit and visited the kids in the pediatric ward. Mme. Gerard told me that none of the kids are under the nutrition program even though all of them were severely malnourished. I did not understand Mme Gerard’s explanation as to why they are not in the program and I couldn’t find the paediatrician, Dr. Matthieu, to help me out. So, I just hung out with the kids for a bit. There was a 2-month-old little girl named Madeleine, a set of premature twins (the littlest things I’ve ever seen) and a 1-year-old boy with kwashiorkors. He is very sick, but I was actually able to get him to smile! So cute. By 1 pm everyone who works for the nutrition program, as well as the doctors, were gone. So that was the end of that for the day. Tomorrow I’ll attempt to figure out what’s going on over there.

After being completely grossed out by the chicken-laced food from yesterday, I told Jolina, the woman who has been cooking for me, that I will cook for myself from now on. I think she is relieved. Today is market day in Leogane (every Wednesday and Saturday actually) and so my intention was to go buy some vegetables, beans, and rice, but that didn’t happen. I asked Jolina if I could go to the market with the woman who goes every day and she told me she would have her come get me when she goes. But she never came. I think it is because her mom is in the hospital (everyone is sick around here). I need someone to accompany me to the market because 1) I don’t know how to get there and 2) I don’t know prices of things. I could have the driver take me there, but driving into the market in a truck will call way too much attention to myself. Being the “blan” (white person) is already a spectacle. And my Creole is still pretty bad and I know I’ll just get completely overcharged for everything. Since I’m going to be here for a while that’s probably not a good way to start. So, for lunch a cooked a pretty disgusting meal of dried soy beans, pasta, and soy sauce. And I ate the leftovers along with some dark chocolate for dinner. I need to do something about this tomorrow too before I get sick!

May 8, 2007: Grande Savane

2007-05-09T22:45:00.000-05:00

We were supposed to leave the hospital at 8am to get to the village, Grande Savane, by 9:30am. Felicia, the woman who was going to go with me, did not get the message that we were leaving so early. In general people get to work around 9 - 10am and leave anytime between 1 and 3pm. I had Jean-Claude go get Felicia at her house at 9am and then we were finally off. I was told there would be a "ti mache" or little walk involved in getting to Grande Savane. My definition of a little walk is not the Haitian definition of a little walk. I ended up hiking up a small mountain in flip-flops today.

The hike would have been great if I had enough water, some food, and my sneakers. It was beautiful up there and it was fun to get out of the hospital complex for a bit. We reached the vaccination poste around 12pm where the “Ti Foye” (the Creole name for the nutrition apprenticeship program) was being held. The kids were just starting to eat the meal of rice, beans, green leafy vegetables, and dried fish that the moms had prepared that morning. There were 6 kids, the majority of whom were between 2-6 months and a couple who were almost a year old. Most of the moms were breastfeeding but also giving the kids complimentary foods. There is strong evidence to support that exclusive breastfeeding for the first 6 months is best for babies everywhere and in developing countries it’s particularly useful in preventing diarrhea (a major cause of infant mortality). From what I hear this is unfortunately not practiced all that much in Haiti for many different reasons. The kids in the Ti Foye were all underweight and had visible signs of malnutrition (e.g. very thin arms, big tummies, and one child had some reddish hair), but seemed to be enjoying the food! While the kids were being fed, the monitrice talked with the moms about the importance of breastfeeding. I had a ton of questions and I can’t wait until my Creole is better so I can ask them!

(View along the way up to Grande Savane)

I was starving by the time we got back to the hospital. Today’s food tasted like chicken soup to me again (or what I remember/imagine chicken soup to taste like). I couldn’t eat it and instead fed it to the cat who found it quite delicious. The rice and beans tasted less meaty to me so I was able to inhale that and then run to my first Creole lesson.

Today has the potential to be a pretty good day actually. BUT in the morning before leaving for the village I was called over to the hospital because one of the monitrices had been admitted last night. I actually talked with her yesterday and she seemed fine! Over the night she developed a very high fever, nausea, and vomiting. She looked horrible. I was told that laboratory tests had been ordered (but yet to be done). I went to see her again in the evening. Still no lab results, although they started her on an antibiotic. By this time there were no doctors to be found anywhere so I went and got Frank (the Cuban doctor - I know where he lives!!). I just needed someone to reassure me that she wasn’t dieing! The family had even called in a priest to pray for her which just freaked me out. I think she has malaria and I have a stash of chloroquine I could give her, but the Haitian doctors insist they wait for lab results (even though it’s extremely likely it is malaria given the high incidence in the area, blah blah blah). The other major problem is that the lab in the hospital is not functioning!!! When I got home I had the biggest headache ever.

May 7, 2007: First day on the job

2007-05-09T18:15:00.000-05:00

So, it’s official. I’m very confused about how things work around here. This is going to be an intense month. My main accomplishment for the day was getting internet access in my apartment. It involved hunting down the computer guy, getting the cable from the downstairs apt, threading it up through the outside veranda roof and into my bedroom window. Not too bad. I also have some idea of the field visits that we'll do this month, set up my first Creole lesson for tomorrow, and made friends with the gate keeper, Jacques. Phew. That's more than enough for one day. I’m feeling quite overwhelmed. I still have no idea if anyone will show up tomorrow at 8am to go out to one of the villages and the language barrier is tough. Knowing French is definitely coming in handy and has enabled me to have a general understanding of what is going on, but it’s just not good enough. I've been avoiding going to see the kids in the in-patient nutrition ward because I just can't deal with that yet. I think I'll go on Wednesday. I need another day to just get used to happier things around here.

Luckily there is a kitty named Pasha who keeps me company at night so I don’t get lonely.

May 6, 2007: Getting settled

2007-05-09T17:55:00.001-05:00

I woke up very early again today at about 5:30am when the power went off. The cat was also meowing in the other room so I got up to feed her. This morning was quieter than yesterday so I was able to fall back asleep again for a bit, but not for long. I was up by 7am. I really wish I were a morning person!

I had soup for breakfast today. I still have someone cooking for me until I get completely settled. I told her I just want fruit for breakfast, but I think she thinks I'm going to die if I only have fruit. So I had mango and vegetable soup today. The food she has been making is good – lots of bean sauce, rice with beans, vegetables, fried plantains, fresh tomatoes, vegetable soups, fresh juice, good coffee. Cooking vegetarian food is stressing her out though. I also recently found out that she has been using butter and chicken bouillon in everything. Yuck yuck yuck yuck. I asked her not to use it but I think that was really pushing it.

I spent all day yesterday and today cleaning my apartment. There is a maid, Zette, who comes to clean every Monday and Thursday, but it appears that she only washes the floors. Everything was extremely dusty and there were a million things left behind from previous people who lived here. It’s nice to have a completely furnished apartment, but there was a lot of organizing to do! Here is the final product!

(I have air conditioning that actually works when there is power!)

May 5, 2007: Saturday

2007-05-09T17:43:00.000-05:00

Last night was my first night sleeping in the apartment. I was exhausted and went to bed around 9pm. The pouring rain created a nice cool breeze coming in through the window. Still, with just the fan on it was 87 F in my bedroom. Not too hot yet (for me anyway), but bordering uncomfortable. My new green mosquito net did a great job at keeping out the mosquito that had been flying around in the bedroom all day. The fan is really quiet and the AC wasn’t working. There was nothing to drown out the very loud quacking/croaking sound outside. At first I thought there was some sort of night market out on the street. That’s just too strange though. The sound wasn’t constant either. It was annoying me like anything so I had to listen to my Ipod to fall asleep. A few hours later when I woke up the croaking sound was still there and so I decided it had to be frogs. It went on all night. Luckily I was eventually tired enough to just fall asleep.

I woke up at 7am to someone yelling angrily about something out by the hospital (which is right across from my apartment). Right after that we lost power again and this time no generator started up. Leogane is loud at 7am on Saturday morning. Many cars, trucks, and motorcycles buzzing by and honking outside the window (the same honking courtesy rules that apply in Bangladesh also apply here), a rooster cockadoodledooing in the distance, people talking (very loudly), someone repairing something at the hospital – loud scraping / shovelling of gravel sound, oh and the occasional blast of Compa music from a passing car. It’s 7am. I don’t get up at this early on Saturday.

May 4, 2007: Moved into my apartment!

2007-05-09T17:32:00.000-05:00

We got up bright and early to leave for Port-au-Prince. By 9am we had dropped Ashley off at the airport and Jean-Claude and I were on our way to Scotia Bank in Petionville (where all the rich people live) so I could get some money. I’ve yet to find anyone who knows where an ATM is located, so I had to get a cash advance on my credit card since I didn’t bring enough cash with me. It took forever to do. From now on I’ll bring plenty of dollars with me.

The Caribbean Supermarket was great. I can get almost anything I will ever want there, although I did not see any soy milk or tofu. That was disappointing.

I also moved into my apartment today! Amazingly the things that needed to get done all got fixed today! All in one day and in a matter of a few hours! I bet that never happens again. My plan is to spend the weekend cleaning and organizing.

And I will have a neighbor! I’m so excited!!! I was a little worried that I was going to get pretty lonely here (I’m still a little worried about that actually). Turns out there are two Cubans, a doctor and a nurse, working at the hospital. They have been at the Hopital St Croix for 2 weeks now and are living in the horrible doctor’s quarters on the roof of the hospital. They jumped right on the offer from Ashley to move into the other CNP apartment next to mine. It will actually just be Frank, the doctor, who will live there. The nurse (whose name I should know, but can’t remember) will stay in the doctor’s quarters because there is another female lab technician who will be arriving next week. Frank speaks perfect English and Creole which is just great for me (I will definitely have him help me out around the hospital!). The nurse only speaks Spanish. It turns out that they are working in Haiti because they make more money here than they do in Cuba. Frank said that as a doctor in Cuba he was making about $25 a month!!! I was just blown away. They are making much more than that here and hoping to save a lot of money. They told me they will most likely be here for about 2 years. Frank is 28, but the nurse is 47, married, and has 2 young children back in Cuba. Frank was telling me that he has no idea why she is here and that she is very unhappy. Frank on the other hand seems to like it and is having a great time.

(My apartment building. I live on the second floor.)

May 3, 2007: Monitrice Meeting

2007-05-09T17:23:00.000-05:00

Today was a LONG day. We got up early to prepare for the monthly monitrice (village health worker) meeting where everyone gets to touch base on what has been happening in terms of the village program over the past month and the monotrices get their monthly salaries. The meeting is held at a training center in the village of Darbonne about a ½ hour drive from Leogane. It took a while to get there today. We had to stop along the way to get the snacks for the meeting – crackers and Tampico (pure sugar drink). Everyone piled into the CNP truck; Ashley and me in the front seat, 4 people in the back seat, and the rest in the back of the truck. I was in the middle and every time Jean-Claude wanted to get into reverse or 4^th gear I had to almost sit on Ashley’s lap.

We were pretty late by the time we finally go to Darbonne, but as I’m told, this is Haiti so we’re on Haitian time. Everyone who knows me knows that I hate being late…but I’ll have to get used to this again. When we got to Darbone all 36 monitrices were there so we were able to start right away. I talked first and then Ashley said a few things. I actually conducted the meeting, with the help of our interpreter Evans. Everyone understands French, but my French is definitely not at any level where I can actually conduct a meeting!

(Picture: entrance to Darbonne training center)

When we got back to the hospital and after eating lunch we did the rounds and attempted to get all the little things done that Ashley needed to do before leaving for the states tomorrow! We also went to check out the broken scales in the hospital. The nutrition kids should be weighed every day, but the girls told us that both scales were broken. Luckily, they weren’t actually broken. The problem was that they just weren’t using them properly. They didn’t know how to read the weight from the manual one and they weren’t putting the electronic scale on a solid surface. I guess the next step is to get them to weigh the kids now.

In the late afternoon Ashley wanted to introduce me to the doctors at the hospital, but everyone had left for the day. (All the docs, with the exception of 2, live in Port-au-Prince and leave the hospital around 1pm.) We did run into one of the surgeons. He gave us a tour of the radiology department (a broken x-ray machine) and the emergency department (a room with 4 beds in it). There was a women who had just popped out a little baby in there. She came into the hospital basically just as the baby came out. The baby was so cute!!! They had the mom just sitting on the bed in the same dress that she came in with. The doctor was telling us how they are in major need of supplies. Currently patients have to buy all their own supplies, including gloves for the doctors to use!

I can’t believe that Ashley leaves in the morning already!! I’m feeling pretty overwhelmed with all the stuff I’m responsible for here. I think it is going to be absolutely amazing and frustrating at the same time. I’m hoping the adjustment phase goes smoothly!

May 2, 2007

2007-05-09T17:10:00.000-05:00

This morning was very reminiscent of my first few months living in Bangladesh. I thought for sure that yesterday the CNP driver, Jean-Claude, understood that I was going to go with him to the airport in the morning at 6am to pick up Ashley, my boss, who would be arriving from the USA. The plan was for me to go into Port-au-Prince and then on the way back to Leogane stop at the bank and the Caribbean grocery store. On the drive back Jean-Claude and I even discussed this and then before he left the hospital last night I told him, in what I thought was very clear Creole, that I was going with him in the morning. He smiled and said he understood. Well, this morning I was up at 5am so I could be ready to leave for the capital at 6am. I waited outside for a while and then Pere Deravil, the director of the hospital, came by to say hi. He asked why I was up so early and I told him the story. He said, “ohhhhhhh”. Then he told me that Jean-Claude had taken the car with him last night so that he didn’t have to come all the way back to the hospital this early to get it. Ah, miscommunication. Luckily I’ve had plenty of experience waiting for long periods of time and at least this time I was just able to go back to bed!

Jolina, the guesthouse coordinator, woke me up around 10am. I muttered some words in the first foreign language that came to mind, Bangla, and she just smiled and walked away. I got up and sat outside and studied some Creole. I expected Ashley to arrive at the hospital around 12pm, but lunchtime came and went and still no Ashley. Yesterday there was some confusion as to what time Ashley was actually arriving. Everyone here thought she was getting in at 3:30pm, but the message I received from her the day before I left for Haiti said she would be getting in at 9am. This is why Jean Claude left at 6am. I was really worreid that I got the time wrong and that he was going to be waiting at the airport all day! Hmm…

I went over to the hospital around 11am to see the girls who work for the nutrition program, Yva, Evelyn, Felicia, and Mme. Gerard. I said hi and that was about it. On the way out I met the Ob/Gyn doc, Dr. Mersier, who the ex-pats think could be a soap opera star, and ran into Albert, the hospital maintenance guy with a NYC accent.

Ashley and Jean-Claude eventually arrived at the hospital around 1pm. Turns out her flight did arrive at 9am (phew) but they ended up spending hours at the bank in Petionville.

Ashley will only be here until Friday morning. So much for my week of orientation in Haiti! So we got right to work discussing exactly what it is I’ll actually be doing here.

In the evening Pere Devavil came by with a big basket of mangoes. Mmmm….

May 1, 2007: May Day in Haiti

2007-05-09T17:08:00.000-05:00

I'm here...finally! And I figured out how to connect to the internet! Yay!

I'm exhausted. I left New Bedford this morning at 4am and didn't reach Leogane until 8pm. The flight was delayed in Miami for over an hour for mechanical reasons. I tried not to think about what that could mean. I was so tired anyway that the next thing I knew we were taking off. I got to Port-au-Prince at 5pm and it took us 3 hours to drive to Leogane because it's May Day. The streets were overflowing with people dancing. It was fun, but driving around here in the dark is just scary. It appears that most places have no electricity and so we couldn't see a thing. There were still a million people walking around and on bikes, too, and we almost ran over a gigantic black pig that was sitting in the middle of the road!!! We made it safely to the Hôpital St. Croix, my new home, and I went directly to bed. I’ll be staying in the guesthouse (located next door to my apartment) for a while until the repairs are completed in my apartment.