Old McDonald had a...Goat!

When we got back from our immersions, we began to get more involved in the work that we will be doing for the rest of the year.  For example, Beth is doing tons of stuff at Fon Ibo School.  She is helping in the computer classes, working on raising money to build several playgrounds, and coordinating with the principal to start a school library.  Frankie, who is interested in mental health and social work is helping out at the "Maison du Bon Samaritain" (House of the Good Samaritan).  This is a residence for mostly elderly people as well as those with other medical needs who do not have the necessary support.

And then there's me.  It looks like I'm going to be working in several different fields - which is actually exactly how I wanted to spend my year here - working in as many areas as possible with the hopes that one would stick out and speak to me and help me figure out where I'm going.  I am going to be doing some microfinance work (more on that later) as well as working with the 3rd Grade at Fon Ibo school to develop an art program (more on that later too!).  Because of my interest in the environment as well as my background in Environmental Science, I will likely be doing some things in this area as well.  For example, we are in the early stages of starting an environmental education program in some local schools.  Besides this, I will hopefully get the chance to do some work with Sr. Pat, who is very involved in environmental issues in the area.  Several weeks ago, I had the opportunity to accompany her to a conference that was happening in Greppin, a town on the other side of the river, about a 20 minute drive from here.  The topic of this conference was...goats!  I knew nothing about goats before coming here, other than the fact that they make incredible cheese, but I figured it would be educational, interesting and a great way to practice Creole.  Goats are also very prevalent here, and an important part of the local economy, so I thought the information may prove to be beneficial at a later date.

Goats are an integral part of the local Haitian economy and crucial for families that are living in poverty.  They act as a kind of security system that grows over time.  Goats can be sold to provide instant income.  Breeding provides long-term stability because of the continual replenishing of food or income.  They can be killed to be sold as meat, or eaten to provide nutritious meals.  They are relatively easy to take care of, eat a wide variety of foods and reproduce several times a year.  I believe that the coordinator of the Goat Summit, Rhoda, called goats “the Haitian bank account.”

The first two days were attended by goat farmers/experts and leaders of different community organizations.  I sat in on the second day where the main themes of the Summit were discussed in great detail and presentations on these topics for the following day were organized.  Four main topics were chosen by the group that were thought to be the most important for people who are raising and maintaining goats.  They were food, health, management of habitat and the potential for milk consumption.  Some other minor topics were discussed as well, such as how to choose healthy goats in the market and some breeding issues (I got a brief genetics lesson in Creole during this part).  On the third day, people from all over Haiti joined together to learn this information with the goal that they would bring this back to their own community and reach out to others.

It was an extremely interesting experience.  Although I would not consider myself to be an expert, I would say that I know a whole lot more about goats now than I did before.  I was very surprised at how much I was able to understand.  I would guess that I was able to get maybe 75-80% of what they were saying.  The other 20%, I could kind of figure out based on the pictures that were drawn or the few words that I did understand.  I could give you tons of information (in Creole of course), but I'll just give you some of the fun facts that I learned.

Fun Fact 1:  There are over 50 varieties of grasses, trees, and seasonal plants that goats like to eat.  These include napier grass (napye), sugar cane leaves (fey kann), avocado (zaboka), hibiscus (choublak), peanut (pistach), and corn (mayi).  Their favorite food, however, is called "doliv."  According to the Wikipedia page, the English names for doliv (Moringa oleifera, stenopetala) are moringa, the drumstick tree, the horseradish tree and the benzoil tree.  I had never heard of it before, but I’m pretty sure if doesn’t grow in North American climates.

Fun Fact 2:  When choosing goats in the market, there are many things that you should check.  For example, the back of the goat should not be too slanted (do dwat), they should have pink gums (jansiv woz) and pink under their eyes (anba je li ta dwe woz).  If they have white under their eyes, they are suffering from anemia.  (I knew this from when I was working in the clinic.  I was so excited that I was able to use information from one thing I did and apply it to a totally new situation!)  You should also check the teeth to verify age and size.  You can tell the age of the goat by looking at the size of the lower middle teeth (they change as they grow older), and the size of the goat should correspond with the age.  If they are comparatively small, then they are likely undernourished and a bad investment.

Fun Fact 3:  Goats can get a variety of diseases.  Some of these are preventable with vaccinations, but some have to be treated on a case-by-case basis with antibiotics and other medications.  Common diseases are tetanòs (tetanus), parazit anndan (parasites inside), parazit deyò (parasites outside), atrit (arthritis), chabon (not sure what this is in English), and klamidiya (potentially chlamydia, but I’m not sure).

Fun Fact 4:  Although there are tons of female goats here, who have lots of babies, people do not often collect goat milk, either for drinking or other purposes.  Several organizations are looking into tapping into this market.  I learned that goat milk is very similar to human milk and is thus easier to digest and can be very beneficial and nutritious.  I learned that you can milk a goat twice a day, 12 hours apart, and that dipping the utter in warm water makes the milking process much easier.

There are hopes that this information will be passed onto local goat farmers throughout Haiti for more productive farming.  I believe there are plans to have a similar kind of meeting for farmers here in Gros Morne and, potentially, for some kids to start raising goats.  It is also possible that the women who received micro-loans may move into goat farming after establishing solid loan repayment.  I’m still not certain, but I’ll be sure to keep you all posted!

Some pictures from the Summit!

We went rummaging in the grounds to find some examples of plants goats can eat.  We ended up finding a bunch.

It's a little difficult to see, but the black marks on the map of Haiti are all the places represented at the Summit.

Milking the goat!

The milk we got!

One of the classrooms when we were divided into groups.

Learning about the different habitats goats can be raised in.

The building the Summit was held in.  There was a large classroom at one end and many bedrooms that some of the people attending the meeting stayed in.

Our way back into Gros Morne.

Confirmed.

I was planning on heading back to Gros Morne Saturday morning, like I had the weekend before.  I talked with Johnny to see if he would be able to take me back on his moto and he said he would be able to.  Saturday morning rolled around and I was all packed and ready to go.  While I was eating breakfast, Sr. Victoire was saying how sad she was that I was leaving and that I was not staying.  There was a large confirmation mass on Sunday (which I found out about on Friday, after I had already talked with Johnny) and they were bummed that I wasn't staying for that.  The Bishop of Gonaïves was going to be there and they really wanted me to stay.  Long story short, I ended up staying until Sunday afternoon.

Before I go any further, I am going to give a slight lesson.  Within the Catholic Church, there are seven sacraments (rituals) that one goes through throughout their life.  Among these are baptism, marriage, anointing of the sick, and confirmation.  When one is confirmed, one receives "the spiritual seal, the Spirit of wisdom and understanding, the spirit of right judgment and courage, the spirit of knowledge and reverence, [and] the Spirit of holy fear in God's presence" (Catechism of the Catholic Church).  In some places, young children (around 2nd Grade) are confirmed and also receive the sacrament of the Eucharist at the same time.  In this particular service, however, around 30 teens were going to be confirmed.

In the morning, everyone was running around making last minute preparations.  The mass was supposed to start at 9, but in Haiti time, that actually means more like 9:30 or even 10.  The church was packed and everyone was dressed to the nines.  I was initially sitting on a bench with 8 or 9 other people, but an elderly couple came in and were standing next to us.  I had been told that the mass could last anywhere from two to three hours, so I figured I would offer them my seat.  I didn't mind standing and the back of the church offered me optimal people watching as well as leg room and the chance for fresh air and a breeze.  The mass started around 9:30 and ended around 12:30.  I understood most of what was being said, but by the end of the 2nd hour, my brain was pretty tired.

The best part of the mass was the music.  I had heard the choir practicing the night before, but I think they were joined by another choir as well.  There was so much singing and they had a band (trumpet, drums, bass and electric guitar and the piano) to accompany them.  I'm not sure what it is (because I had a similar feeling when I attended a service in Malawi), but there is something about the kind of music that they were singing or the way in which it is sung.  There seems to be so much joy in it. Because I had heard some of the songs the night before and many of them are pretty repetitive, I was able to hum along and sing some of the words.  What I like most about Haitian hymns is how easy they are to harmonize to.  I was able to sit in the back, make up my own harmony and have a grand time.

After the mass, the sisters told me that we were going to be eating with the Bishop (we called him Monsignor).  After helping Yves move a bunch of chairs and crowding a bunch of people into the pretty small dining room, we had our meal of rice, beans, fried plantains (my favorite), picklies, some kind of fish (there were entire fish bodies on the platter), mac and cheese, and goat.  Pretty soon after the meal, the car was started and the Bishop was preparing to go.  Sr. Victoire caught my arm and told me that I needed to get my things together because the car the Bishop came in was leaving and they were my ride back to Gros Morne.  Luckily I had most of my stuff packed from the previous day, so I ran to my room, threw everything else into my backpack, said my brief goodbyes and hopped in the car with the Bishop of Gonaïves and the several priests who accompanied him.

Our ride was pretty scary.  I had thought that the moto rides were rough but the "road" that we were driving on was not really made for cars.  There were huge boulders that we had to dodge or drive over and some places did not look wide enough for us to pass through.  Trying to get up the river banks was terrifying.  I thought our car was going to tip right over at one point.  But, we made it back safe, and I was so happy to see our gates.  Before I got out of the car, I asked if they wanted to stop and talk to Sr. Pat or Sr. Jackie, but Monsignor said he didn't need to.  So, I got out, found my keys and opened the door.  Sr. Pat yelled to me from our balcony and asked if that was the Bishop.  I said yes.  She asked if he was staying, and I said no.  I asked if she needed to talk to him, she replied in the affirmative and I asked if she wanted me to run after him.  She hesitated for a second and then said yes.  I ripped off my sandals (it was raining a little bit and I was scared of slipping), dropped all my stuff on ground, and sprinted down our driveway.  Our driveway is essentially a long hill and running down it, in the rain, was very exciting to say the least.  I could see the car in front of me, but I was afraid that I wasn't going to make it in time.  The car stopped for a second before they were going to turn onto the main road and I had just enough time to bang on their back window and make it to the passenger side window just as they were turning on to the road.  The Bishop rolled his window down and as I was gasping for breath (I'm a little out of shape), I tried to explain that Sr. Pat and Sr. Jackie wanted to talk to him and would he be able to turn around?  I must say that it was a little comical, my running after the Bishop of Gonaïves and banging on his window.  But, given the week that I had in Riveyè Marcel, it seemed almost normal and a very fitting ending to my immersion.

The two weeks that I spent in Riveyè Marcel were awesome.  I learned so much, was able to see many new sides of Haiti and its people, and met many new and wonderful friends.  I am thankful that everyone was so welcoming, open to having a stranger take part in their daily activities and patient with me when I didn't understand.  My Creole improved dramatically and I felt as though my base in the language became much more solid and much larger.  I was very happy to come back to Gros Morne and see Beth and Frankie and the rest of my family here, nevertheless, I am going to miss Riveyè Marcel and all the people I met.  But, I'm grateful for the experiences I had and I'm looking forward to visiting.

Yves and a buddy playing on a moto.

A Few Thousand More Words...

On Friday, I tried to help Sr. Victoire open some files off of a flashdrive she received at an environmental conference she attended.

My chamber pot.  This was in my room and the nuns actually used them.  I thought about it one night when I woke up having to use the bathroom, but I didn't have the courage...

A special guest.

On Friday, after school got out, I went for a walk with Yves behind the house.  (Yves took this picture.)

(Yves took this one too.)

(He took this one too.)

I spent Saturday afternoon talking with these boys.  It was good Creole practice and I helped one of them practice some English.  It was a very interesting conversation.  They were very interested in my parents and if I actually had a mother.  They wanted to know how many children my mother had and if my father had any other children.  They wanted to know if I had a boyfriend.  They were fascinated with the hair on my arms (and my legs) and kept telling me that white skin is more beautiful than black skin.  We also listened to some music and they told me that they loved Justin Bieber.  I had one of his songs on my phone and we jammed out a little bit.

A Picture is Worth a Thousand Words

I didn't spend my entire week in the dispansè, so I've added a bunch of random photos that I took throughout the week.  Enjoy!!

My new buddy Jackie.  We gave all the kids that came to the dispansè a Dum-Dum lollipop.  Jackie thought it was so funny that his tongue had turned blue after he finished his.

The food that I ate during my two weeks was much more traditional and typical than the meals we have in Gros Morne (we had pizza the other day...), so I took a few pictures.  This is a "kenep."  They grow all over here and there was a large kenep tree in front of the school in Riveyè Marcel.  It's kind of like a grape on the inside, but a little more slimy.  You suck on it and scrape the fruit off and then spit the pit out when you're done.  

We had rice and beans all the time.  On this day, we also had cooked cabbage, goat and boiled plantains.  We also had "zaboka" almost everyday (avocado).

Yves and me!

We had this for breakfast a few times and once for dinner.  It's kind of like oatmeal, but I don't think it was made out of oats.  It had anise in it and you added lots of sugar.  It was actually quite tasty.

We had tea for breakfast and for dinner.  Some of it was anise tea (I think) and it tasted a little like chai tea.  We also had this kind of tea.  I have no clue what kind of leaves they were, but I'm pretty sure they were gathered around our yard and then put in the tea pot.  I ate a lot of things that I wasn't entirely sure what they were.  I asked about some things, but others I decided not to.  For example, one of the last afternoons, we had some kind of soup/stew dish.  It had these hunks of stuff that when I took a closer look, looked like tripe.  When I got back to Gros Morne and asked about it, they said that it was most likely pig skin (you could see tiny black hairs on one side) and it was just a cheaper cut of meat.

Sr. Victoire was working with some teenage girls who weren't in school.  She was helping them learn to sew and make headbands that they could sell in the market.  This was the sewing machine that they were learning to sew on.

On Friday, I had a bunch of free time, so I figured I would see if I could make a headband.  Here's my masterpiece!

Yves and I working on math.  We were doing expanded notation.

I'm not sure why, but I really liked this scene.  It kind of reminded me of something someone would set up to paint a still-life.

This little guy hung out in my bathroom for almost two days.  He refused to leave no matter how many times I poked him with my flashlight.  Let's just say we became very well acquainted during his stay.

Katie W., BA and RN?

Compared to the previous day, Wednesday was much less action-packed.  I translated for Tammy again and lots of the patients had the same complaints from before.  We did have several interesting people come in, however.  One young man came in with white patches on one of his cheeks and wanted some kind of cream to make it go away.  Crystal said it was a skin condition called Vitiligo in which patches of skin lose pigment over time.  Michael Jackson had this.  I did my best to explain to him what it was and that it wasn't bad, but that it was something that he was going to have to live with for the rest of his life and it will get worse.  I can't imagine what this young man was thinking as I was telling him, and I don't blame him for not understanding completely, even when I asked Jean to explain everything better.  I never thought that I would ever have to deliver news like that to someone.

We had another gentleman come in who was having trouble breathing.  He said that he had been in a car accident and had gone to the hospital, but this had happened several months ago and he was still having chest pain.  It turns out that one of his lungs had collapsed.  A tube had been put into his lungs from the side of his chest to reinflate it.  Crystal said that he needed to start working on strengthening his lung muscles again.  She suggested getting a straw and taking very deep breaths 20 or more times a day in order to do this.  This was one of the instances where I noticed that doctors doing this kind of work need to be creative.  Hospitals may have special instruments that you can breathe into to help build muscles, but  we didn't have this kind of specialized equipment, so she had to come up with an alternative solution.

*      *      *

Thursday was the last day that the team was going to be at the clinic.  The day started out with Tammy and Denise finding me on their way up to the dispansè and saying that there was another woman in labor.  I started mentally preparing myself, but it turns out that she wasn't even 1cm dilated and was having what are known as Braxton-Hicks contractions, or false contractions.  She stayed for most of the day and received some IV fluids, before she was placed on a mattress frame and carried to the hospital in Gros Morne.

The previous days had steady streams of people, but it was nothing compared to the last day. There were so many people waiting!  I started off translating for Tammy again, but Johnny showed up and I was sent to help out in the pharmacy, where they were counting and handing out medication.  They didn't really need any help, so I cleaned up trash and sorted through empty pill bottles to make packing everything up in the afternoon a little easier.  As the morning wore on, however, and more and more people were waiting to see the doctors, it became evident that something needed to be done.

We knew from the first few days that many of the people in the waiting room had pain and heart burn and really just needed Tylenol and Tums.  In order to make it easier for Tammy and Crystal to actually see all the people that needed to see the doctor, we needed to figure out who really needed to see the doctor and who just needed Tylenol and Tums.   (To throw in a medical term, this is called triaging.)

 So, I got myself a stack of note cards and a pen and got to work.  I walked into the waiting room with 25 or so people and told everyone that there were too many people and not enough time for the doctors to see everyone.  I told them that I would go through and talk to each person and if they had general pain and heart burn, I would write them a card and they could go directly to the pharmacy to pick up their medicine.  (Mind you, I'm doing all of this in Creole.)  I went person to person, asked for their name and their age and what the problem was.  If they had anything beyond pain and heart burn, I asked the questions that Tammy usually asked and wrote their answers on the card so Tammy and Crystal had as much information as possible.  For example, if people said they had stomach pain, I would ask if they had diarrhea and if their "dèyè" was itchy (signs of worms).  If they complained that they could not see or read, I would explain that we didn't have any glasses left, but that there was an eye doctor who came once or twice a year that they could see.  In the meantime, I advised wearing a hat with a brim and trying not to strain their eyes.  If they had other eye trouble, I would ask if there was any itchiness or fluids leaking out and what color it was.  If people said they had a cold or were coughing, I would ask how often they coughed and when they did, did any gunk come up.  If this was true, I asked what color it was.  If they complained of dizziness when walking, I would tell them that we didn't have medicine for that, but they needed to take breaks when they started to feel their heart pound or feel dizzy and to drink plenty of clean water.  One kid came in and showed me his ear, which had a kind of bubble it in.  I was pretty sure that this was some kind of ear infection, but just to be on the safe side, he waited to see the doctor.  One woman came in and said she was having constipation, so I was able to write what she needed and she never had to see the doctor.  I was able to narrow the line to see the doctors down by at least half, and incredibly, Tammy and Crystal were finished by noon (when they said they needed to be done) and everyone that needed to be seen was seen or had gotten instructions to come back and see Sr. Julienne next week.

As the week went on, I became more aware of how difficult it is to do work like this.  Supplies are limited and once a medication is gone, there is no way of getting more.  Creative solutions to problems are necessary.  Medications that may not typically be used for certain ailments may have to suffice.  There is also no way for people to get all the medicine they actually need.  Yes, we are able to give things for worms, vaginal infections, ear infections and other things like that, but what happens if it comes back?  Then, they are right back where they started.  People only received a month or so of pain medicine, Tums and vitamins, so after that, they either have to find money to buy more or live without it.  I also wondered whether or not people actually did what they were supposed to with the medicine.  I was buddies with one of the little boys who came in with "boutons" and when I asked him the next day if he had put the medicine on, he said no.

I also learned that there are some things that we didn't know.  For example, we had several mothers come in and say that their child's eyes were white.  When we looked in, there was no visible sign of infection or anything wrong.  I asked about this when I returned to Gros Morne and they said that they meant that the lower eyelid was white, which is a sign of anemia.  We also had a handful of people come in and say that they had fevers at night.  Tammy would take their temperature, which would be normal.  It turns out that night-time fevers are a symptom of malaria.

I found out that in order to do what Tammy and Crystal were doing, you can't just be a surgeon or a psych nurse.  You have to be a pediatrician, an OB/GYN, a geriatrician, a cardiologist, an eye doctor, and everything in between.  You have to be knowledgeable about all kinds of sicknesses and how they are treated as well as alternate medications that can be used to treat them.  On the first day I was there, Tammy said something about how she wasn't an eye doctor (or something like that), and Crystal's response was "You're everything today."  I thought that this was very fitting.

Overall, it was a wonderful experience.  I learned so many new things and surprised myself at how much I liked what I was doing.  I never thought that I would work in a medical clinic, especially one where I was so involved.  I am so thankful for Crystal and Tammy and their team for letting me participate and putting so much trust in my Creole and in my "nursing" abilities.  Although I don't think I'm going to sign myself up for med-school when I get back to the States, I definitely know way more about health care in Haiti now than I did two weeks ago.

The gentleman with the abscess getting his bandages changed.

The line to see the doctors.

The waiting room towards the end of the last day.

Tuesday

I had arranged with the others to spend Tuesday in the clinic taking pictures and listening.  But when they opened it around 8:30, they asked me if I could work with Denise and explain to people how they needed to take their medication because Jeanette wasn't there.  It turned out that Johnny wasn't there either, so I ended up having to translate for Tammy.  My Creole was immediately put to the test, and I had no choice but to sit down and listen hard.  I was actually able to understand most of what the patients were saying.  Today, we had more pain and heart burn, but also several UTIs, many cases of worms, eye infections, and a woman who had been attacked by a donkey and had sprained her wrist.

Towards the end of the morning, I had an elderly man and his wife come in.  It was a little difficult to understand, but there was clearly something wrong with the gentleman's mouth.  Tammy looked in and then called Crystal over.  It turns out that the man had a huge abscess in his mouth.  It was likely that he had had a tooth infection or a cut in his mouth that had become horribly infected.  Crystal said that he really needed to go to the hospital, but that she needed to do something now or he would end up septic.  She gave him some oxycodone and some numbing cream, waited 30 minutes for it to sink in and then started work.  Now, normally I would have cleared out and prevented the inevitable vomiting and passing out that usually happens when I'm around stuff like this, but Crystal said that she really needed pictures taken.  So, I did my best and took pictures without looking too closely.  I also felt like the wife needed some support so I held her hand while she watched.  I'm not entirely sure what Crystal did, but I do know that she made a small incision and blood came squirting out.  I accidentally saw that while I was checking to make sure the camera was in a good spot.  Then, I took a tiny peek again and saw the scissors in his cheek.  After that, my head started to swim, my vision turned dark and my mouth started to water and I knew I needed to excuse myself.  When I came back in, his head was bandaged and they were telling him to come back tomorrow.

The afternoon went by without any other real excitement.  I saw a young man get his diabetic ulcer on his leg cleaned (with no passing out this time), but that was really it.  The real excitement started around 4:15pm, just as we were getting ready to close for the day.  A family came in and said that there was a woman in labor and she needed to be seen.  Crystal is not a baby doctor and Tammy isn't either, although she has three kids of her own and loves babies.  They said that unless it was an emergency, the family needed to take her to the hospital here in Gros Morne.  They said it was an emergency.  So, they brought her in and we got ready.

My headlamp had already been used for the abscess surgery, so someone found that and I ran to find my other flashlight.  By the time I got back, the girl was already on the table and Crystal was checking everything out.  I just want you all to keep in mind that all of this was being done by the light of a headlamp, a single bulb overhead and, while we had it, the sunlight coming in through the open door.  I started out holding a leg, but because I could speak Creole they sent me to talk with the large group of people that was crowding the door to tell them that they needed to leave because we couldn't all fit in the tiny room.  When I came back and asked what needed to be done, I was told that I needed to help support the mom because we couldn't figure out how to make the bed raise from a laying position and there wasn't time to try and mess with it.  So, I crawled up on the delivery table, situated myself behind the girl and spent the next two and a half hours supporting her while she was pushing.  She would push and I would use all my strength, (my abs got an incredible workout), to make sure she didn't move.  She would hold on to my legs and neck while she was pushing.  Although it was hard work and my entire body was sore for several days afterwards, I figured if this girl could push out a baby, the least I could do was hold her up and try to make her a little comfortable.

Things started out moving fast.  Crystal was thinking that the baby would come within an hour or two.  But, as time when on, she still wasn't dilated all the way.  After about two and a half hours of pushing with no baby, the mom was exhausted and the breaks in between pushes became longer and longer.  Around 7:00pm, I went with Tammy and Crystal to have a quick dinner and then went back to time contractions.  When I left around 11:00pm her contractions were still around 5 minutes apart.  They should be between 1 and 2 minutes in order for the baby to actually come.  I came back at 3am and the mom was sleeping and had no contractions within the 10ish minutes I was there.

By the morning, the contractions were still not close together.  The mom was placed on a stretcher that was carried by several men and they began (on foot) the two or more hour journey to the hospital in Gros Morne because she needed blood.  Gros Morne didn't have what she needed, so they sent her to Gonaïves, a larger city some distance away.  Gonaïves didn't have any doctors, so they sent her to St. Marc, another city even farther away.  By the time all this had happened, the baby had been in the birth canal for around two days.  Unfortunately, the baby did not make it.  The mom also had a pretty bad infection and there was the potential that the baby wasn't living when she first came to us.  But, the mom is doing okay and the last news I heard was that she was recovering here in Gros Morne.

To say the least, this was an incredible day.  Just to give you some perspective at how crazy it was, I am not one to swear, (like I've never uttered one in my life), but one may have crossed my lips when I first crawled behind the mom and we started pushing.  My roommate at school is a nurse and in the fall last year she had her maternity rotation.  She saw several births and would come back and tell me all about them.  She told me how beautiful they were and how it is something I had to see.  I told her that never in a million years would I ever watch a baby being born.  I guess I was wrong.  Although it was something that I don't need to see again for a long while, I will admit that it was an amazing experience and something I will never forget.  The girl was only 19 years old.  This was her first baby.  While I was sitting behind her, I was thinking about what I was doing at 19 and that there was no way I could do what she was doing.  I was surprised at the almost immediate connection I felt with this girl, although I barely knew her name and she had no clue what my name was.  Her mother wasn't there and I really felt that if I was having a baby I would want my mother there, so I wanted to make sure she knew someone was there for her.  During our time together, I had one of the Haitian women that was in the room ask me if I was the father .  Obviously I said no and was a little confused.  It turns out that the father, (I'm not sure if it is the father of the mom-to-be or the father of the baby), is usually the one that sits behind during labor.  Apparently what I was doing was pretty special in the Haitian culture, and I was touched that this girl would let a complete stranger play such an important role.

Overall, I learned a lot throughout this experience.  I learned a whole new set of Creole vocabulary and because the proximity of my head to the mom's mouth, I was often the one to tell the others that she was ready to push or her legs needed to be held.  I got to see what childbirth, (or at least half of it), is like, learn about everything that needs to happen internally for a baby to actually be delivered, and how to do all this using only the resources you have – using a headlamp for an examination, and putting in an IV without the proper needle.  I also got to learn a little bit about the culture around childbirth in Haiti.  It was an incredibly public affair, with tons of people trying to get in the room and watching outside the door.   The midwife, who was actually a man, came in with the mother and stayed with her the entire time.  There was no pain medication given or asked for.  While the mother was pushing, other women in the room would cover her mouth and tell her to be quite, because women do not typically show any sign of pain or emotion during labor.  Because I was sitting so close to the mom and we were both sweating profusely, I asked for a towel to wipe her brow.  When I went to do this, the women stopped me and said that it was better for her to be hot and sweating because it made everything easier.  Over the next few days, I learned a little bit more about the health care situation in Haiti, and the lengths people have to go in order to receive the medical care they need.  I also learned that it is common for women to lose at least one baby during their child-bearing years.

I will admit that there was some truth in what my roommate said.  Although I'm not sure I would call everything I saw beautiful and while she cried out of joy, and I wanted to cry out of shear terror at what was going on, it was definitely a special and an unforgettable evening.

My mid-labor selfie - fear combined with sweat and rain makes for a great photo.

And the Adventure Begins...Again

Warning:  I just want to let you know that the next few posts are going to be rather lengthy given all the stories that I have to tell.  I would maybe take a quick pause and go get a cup of coffee or tea or at least small snack to enjoy before you start reading!

My story begins on Monday, the 22nd of September at around 9:30am.  I hopped on the back of another moto with another stranger and made my way towards Riveyè Marcel.  The ride itself was a little less zen then the previous two rides (it was more bumpy and the rivers were a little higher), but it felt much quicker.  When I first arrived in town, I was amazed at how comfortable and happy I felt. I recognized some of the people in the market and I was easily able to switch back into Creole mode.  I knew where I needed to go, where to put my stuff and who people were.  I was confident in my abilities and I just felt great - very different than what I was experiencing the previous week.

After putting my stuff back in my little room, I headed to the dispansè to drop off a box of stuff I had brought with me that the doctor group had left in Gros Morne.  I was expecting to just drop it off, but they said I could stick around if I wanted.  So, I plopped myself down in a corner and watched.  I was able to follow, for the most part, what patients were saying.  It was great Creole practice.  What I thought was happening was confirmed when it was translated into the English or French for Tammy and Crystal.  I could hear about how they needed to be treated and then would try to guess how that would be said before it was translated back into the Creole for the patient.

It was extremely interesting to hear about the cases that were coming in.  The first day, many people came in with pain in the back, head and various joints.  This was mostly because of the lifestyle they lived and the fact that the women carry large amounts of weight on their heads.  Many people also have heart burn (anba kè - below the heart) and eye trouble.  Some had the beginnings of cataracts (a blue/gray tinge in the pupil) while others had tiny bumps on their eyes that were caused by extended sun damage.  Other people came in and simply couldn't see.  Tammy and Crystal had brought a whole box of donated reading glasses and some prescription glasses.  It was fun to see as people tried on the different magnifications, how their face would light up when they could actually see.

After lunch, I hung out with the sisters for a little while before I went back to the dispansè.  Before we had left for lunch, Crystal had asked me if I could come back and take pictures of everything.  She said that she wanted to be able to show pictures to the people who had donated glasses as well as use them to continue to get funding for next year.  In the afternoon, we saw more people with pain and heart burn, but we also had a man come in with some kind of rash on his arm, a pregnant lady with a UTI, and a child that had "boutons" (buttons) on his legs and arms.  Tons of kids have these.  They are round scabs that are caused by a fungal infection.

In evening, we had dinner in the Kay Pè where Tammy and Crystal and their team were staying.  It was a little overwhelming to be eating with so many people and to be listening to Creole, French and English being spoken all at the same time.  The rest of the evening was pretty uneventful except for the rat I saw on the way to the bathroom and the several spiders I had to share the shower with.

I was slightly braver this time around and got a few pictures of my ride.

Crystal listening to this woman's heart.  This woman was around 90 years old.

One of my new friends - Jackie!

Doctor Who?

After spending the weekend back at home in Gros Morne, finishing my laundry, remembering how to speak English and thoroughly enjoying real showers, I headed back to Riveyè Marcel on Monday morning.

Before I begin my narrative, you need to know some slight background information.  For the past few years, a group of doctors has come to Riveyè Marcel for around a week to work in the dispansè (clinic).  They provide free medical consultations and medication for the week.  It just so happened that two Canadian doctors were going to be in town at the same time I was.  The sisters in Gros Morne said that I may have a chance to watch or maybe work with the doctors and gave me strict orders to not speak English with them.  I didn't really have any idea whether or not I would be actually working with them before I arrived.  I figured that they would just do their thing and I would maybe watch for an afternoon, but I would spend the rest of my time like I had the week before.

Turns out, I very much underestimated my involvement.  But, I'm going to leave you on that minor cliff-hanger and introduce you to the team.  This way, you'll know who I'm actually talking about.

Here is the team I was working with.

Crystal:  She had been to Riveyè Marcel at least twice before doing the same thing.  She is a surgeon in Michigan, but was born in Canada.

Jean:  Jean is a Haitian man who was originally born in Riveyè Marcel.  He has since moved to the US, but comes back with the doctors to translate for them (and to visit his family that still lives in the area).

Jean and Crystal

Tammy:  This was Tammy's first trip to Riveyè Marcel.  She and Crystal are best friends.  She is a psychiatric nurse somewhere in Canada.

Johnny:  Johnny was actually the one who drove me to Riveyè Marcel the very first time.  He speaks French as well as some English and worked with Tammy who also speaks French.

Tammy and Johnny

Denise:  Denise and her husband come to Haiti for a chunk of time each year.  They do a variety of work in a town nearish Riveyè Marcel.  She used to work in the medical field and this week, she counted all the medicine that was given out and sorted it into bottles to give people.

Jeanette:  Jeanette is Jean's sister and worked with Denise giving out medicine.  She speaks a little English and helped explain to people what each medicine was for and how to take it.

Bob:  Denise's husband.  He came for the last day or so and helped count medicine.

Jeanette, Bob and Denise

Polo:  Polo lived in Riveyè Marcel and acted as a kind of receptionist.  He would write each person's name on a card that they would then give to the doctor.  He helped organize the crowd and would tell people when they could go ahead into the consulting room.

Saddie:  Bob and Denise's little dog.  She just hung out.

Saddie!!

Me:  It turns out that I was a larger part of the team that I ever expected!

I'm still working on my doctor face...