Bonswa Ayiti...

oh my gosh it is my last night in Haiti! i don't even know what to begin to think.

last night i had a scare bc when i was feeding hanna grace, all of the sudden her lips turned blue, and it was probably the single most frightening moment that i've had in my life. the color came back and her breathing resumed, but they are taking both the twins to the doctor tomorrow. when i saw her blue mouth there was sheer panic going through my head. she is so tiny and fragile, i doubt that she can handle much of anything right now. i seriously thought she was going to die right then and there in my arms and there was nothing i could do about it. it all of the sudden hit me just how fragile these early days actually are and how easily something could go wrong. the twins are extremely premature and had they been in the states, they'd be hooked up to all kinds of machines and no one would be able to touch them. here we have to make due with what we have...no fancy machines or lights, but plenty of people willing to do whatever it takes to help these babies defeat the odds. and lots of prayers.

church was extra nice today bc guess who i sat down right next to? gabby! i'd never seen him there before, but somehow this week we were side by side. quite a coincidence. the service was extra energetic today and at one point everyone started dancing down the aisles...the whole place was going wild, like one big party praising the Lord. it was really cool to see. the pastor mentioned the 4th of july and said how much he appreciated all their friends in America. there was a choir singing and they were amazing... their voices filled the entire church.

like every sunday we spent a lot of time with the kids, cute as ever in their church attire. i've acquired a little posse consisting of a couple kids f/ the hope house and two girls who play around the outside of the clinic. they really love the attention. we walked up the hill for lunch and then back down to the orphanage bc mal wanted to get her hair braided again (the medicine is really working, btw)... a couple of the older hope house kids are really good at it, and we can pay them in soda and candy. they did a really good job on mal's hair, kind of looked like a mohawk in the back. some of the younger girls were playing with my hair...i had so many knots that i actually had to cut my hair a bit afterwards. dooney and meeslin are like my little sidekicks whenever i'm around the orphanage... they're both a little mischievious, so i always have to keep my eye on them. dooney always throws my purse over her shoulder and struts around saying "mwen rele bwittney" .... all the kids pronounce my name either bwitt or bwittney, i think they have a hard time with the r's, but it sounds really cute. along with carnesise, i will probably miss these two girls the most out of all the children.

one of the baby turkeys died and one of the boys cut off the head with scissors and chased me around with it.

the other day when i was sorting through medical supplies in the warehouse, we came across some catheters that had been opened and were now un-usable. we were just going to throw them away but there were some boys hanging around and they said that they'd take them. long story short, there are now little boys running around the mission with sling shots made out of rubber catheters. apparently these kids are taught how to be resourceful at a young age!

normally we go out to lunch after church with wiki and cadrak, but today we couldn't bc diana needed to deliver some supplies to some of the victims of when the two school building collapsed in port au prince. wiki has his big national exam tomorrow, so i don't think i'll be able to say goodbye before i go...it definitely stinks, but we will have to stay in touch. cadrak might be able to take us to gwo papa poule tomorrow before i leave for the airport...i can get some haitian food and i wanted to hand out some toys and mushwas (bandanas) to some of the village kids. hopefully that will work out, but you can never tell around here! mal got special permission to get out of work for an hour so she can come with us...they know that the two of us have become really close since we've been here, so they made an exception. mal lives in ottowa but might try to drive her ninja down to NYC so we could meet up for a day or so. she is a crazy crazy girl...lots of hidden talents and very free-spirited. tough as nails but with a good heart.

i don't know if i've mentioned this, but it hasn't rained in a couple weeks...we've had lightning storms every night and it's been incredibly hot, but no rain. tonight we were all sitting around talking when there was a huge crack of thunder and it started pouring. we all were cheering and being as hot as we were, there was no question that we were gonna go out and run around in the rain. the kids were all running around trying to catch the rain in their mouths and buckets... there was a whole lot of squeeling going on! the boys were still shooting at a wasps nest with rocks and their new sling shots. one of them killed a hummingbird, i have no idea how. when the rain stopped there was a massive rainbow over the mountains....i wish i had my camera, it was so beautiful and such a little blessing to end my trip.

we had cheeseburgers and watermelon and chili for dinner...the interns did the dishes and we were all singing and joking around in the kitchen making a mess. mal finished cutting my hair and we all hung out outside for bit. i don't have to watch the babies tonight bc i'm leaving tomorrow. it's hard to think about never being able to hold them again...i've spent so much time and so many nights with them in my arms. then again there are so many relationships that i've made that have to come to an end, especially when it comes to the kids. but there's nothing i can do about it other than just appreciate the time that we were able to spend together... but that's easier said than done.

i'm pretty much doing all my packing in the morning. my flight leaves around 3 so i will probably leave the complex around noon. i have a lump in my throat just thinking about saying goodbye. i've become at home here so quickly, it will be weird to not sit outside while mal sneaks a cigarette on the rock pile or get a drink at midnight and see all the boys still up playing cards or dodge lizards in the shower or speak freole with the cooks or time my mornings just right so i can get a ride on the atv or sweat through all my clothes and sheets every night or check my shoes for tarantulas or argue with the interns about who has it worst or have those two hours between work and dinner every night when there is no relief from the heat and everyone sits outside sweating and talking together and guessing what's for dinner...

it helps to think about how exciting it is to finally go home and see my family which i haven't seen in nearly 7 months. everyone was so worried about me going to a 5th world country alone, but supported me nonetheless. as always, my parents trusted my discretion and, although they were nervous, they knew that it was something i was going to do. time and again i've found that it is the things that are a little risky or make me a little uncomfortable that are the ones which end up being the most valuable. it is my family and friends which have constantly given me the courage to delve into the unknown that has enabled me to have cumulative life experiences that have led me to where i am now. this experience was especially valuable bc it solidifies what i've always felt i was called to do with my life. whether in an inner city or overseas, this experience has made it impossible to ignore the limitations on healthcare when it is a victim of social structure. what is easily remedied in one country may be a death sentence in another. what may be easily affordable to one family may be the entire livelihood of another. what is thoroughly evaluated on one skin color may be perfunctorily examined on another. after witnessing the faces of healthcare disparities i've been able to grasp the concept of farmer's that says that healthcare for the poor is something that should be done apologetically, not proudly. rather than thinking i am a doctor working in hostile conditions, look at the sacrifices i've made to serve you, one might choose to think i am a doctor and this is the least that i can do to rectify the disadvantages that our social structure has forced you into. it is not guilt, but rather a duty to restore balance in the gaping inequalities which have transformed good health into a commodity for those born into the right circumstances. it is so much more than medicine...it is anthropology, religion, politics, racism, superstition, etc.

as i leave haiti, i remember not so much the filth of the slums or the dangers of nighttime, but i recall rather the beautiful landscape, the pride of the country, the friendly smiles and "bonswa"s of the people, the children maintaining laughter even when they are hungry and hurting, the non-haitians who have given up their former lives to serve in the throes of destitution, the sense of hope and aspirations for change by the young people, the appreciation of all the little things by those who barely have anything. it is a beautiful country filled with generally good people. not to say that the danger and violence and backwards practices aren't real, but it is unfair to write-off an entire country bc of the iniquities of a few or because it is unfamiliar to almost everything we have ever known. fortunate are those who are able to know without seeing, but i only know what i have seen. names and faces and children... we are not so different, only lucky.

it's impossible to quantify the things that i've acquired and grappled with in this past month. there is no doubt that i will never look at things the same. i will not be able to ignore what i have seen, and that is the single most important aspect of this experience. haiti is no longer a tragedy on the news; it is the home of friends. if this concept of friend can transcend literal contacts, then i will not be able to push aside the plight of so many.

i am unbelievably grateful for the opportunity to have grown and learned so much this past month. i could not have anticipated the impact that it would have on me, but i can only hope that it is something that will stick with me forever.

peace, bonswa.

winding down...

i started packing some of my things together today. i did some jobs around the school this morning, but then i had to watch the twins in the afternoon while the staff was away for an event at another mission. it was nice to be in a room that had electricity...i just read magazines with the babies on my chest, they're getting easier and easier to take care of, although their cries are getting louder! i'm really going to miss them both, i;ve spent so much time with them over the last week or so, i will have to stay updated on their progress. Hanna Grace and Jeremiah. it is amazing to me that they had been rescued at the brink of death and now they have a wide open future in front of them. it is a miracle at work! cody and i were talking today and we decided that even if the only thing that the mission had ever done was save these two babies, it would be worth it all.




a small pastors group arrived yesterday (3 men, 2 women) so they stayed here last night. this morning they were all complaining about the mosquitos and the heat and not being able to sleep. they even mentioned buying a plane ticket home...they opted to stay at a resort-type thing about 45 minutes away instead of here with us. first i wondered if they knew they were in haiti. then i wondered if they had seen people sleeping in wheelbarrows and filth all around us. then i wondered if they thought they could do the Lord's work without ever getting their hands dirty...
.....


after work i went down to the hope house and the little girls washed my feet in the laundry tubs. dounie kept on pinching the bottom of my foot and when i finally looked i saw that there was a freckle that she was trying to pull off. they took my shoes, purse camera, and water bottle...they all get a kick out of me having to chase them around for my stuff...it's always easy to catch them bc they start laughing so hard that they can't catch their breath.


my last big dinner was really nice...haitian food...brad made an announcement about me leaving on monday. we all sat around joking afterwards...josh shaved all of the boys' heads...i'm really going to miss the staff here....they've accepted and welcomed me from the moment i got here, now we all pal around like we've known each other forever.

i can't believe how much i feel like i just got here. nor can i believe how naturally i slipped into this position. what a window to an entirely different world. so much that i am leaving....mentors in the staff, friends in the interpretors and interns, and many many little children that i've grown to know and love. so much can happen in a month, yet it can fly by so fast. i've been trying not to think so much about leaving, but that of course leaves me with the shock of an abrupt goodbye. how much any of us will keep in contact or how much i'll be remembered, i just don't know. so many people come in and out of missions, i'd like to think i've left a footprint in a mind or a heart, but it's hard to tell. i guess it's inconsequential when compared to the impact that this place has had on me. i've learned so much about myself through this experience...i've gained perspective, questioned my faith, grappled with guilt and inadequacy, and seen things that i wouldn't have believed hadn't i seen them with my own eyes.


it's surprising to me that i leave less with the impression of poverty and depression than i do with awe of haitian pride, resilience, neighborly love, and sincere gratitude to God despite a life of hardships.



my heart sinks to know that i leave in a day, but at the same time i'm leaving with everything (and more) that i could have hoped to gain from this experience. the challenge will be holding on to it all as i become more and more removed with distance and time.

field day at the hope house

last night was rough bc mal got sick again and was throwing up non-stop all night. i have no idea what's wrong with her, but it's pretty bad. she's so skinny and she's barely been keeping anything in this whole week. she is having tons of tests done, so hopefully we'll find out something soon. she's been looking for flights home, i feel so bad for her.

today all of us interns were assigned to the hope house and it was probably the most i've laughed since i've been here. it was kind of like a field day for them, a day full of fun activities, prizes, and games. there were 7 teams of 8, each with different colored bandanas and foam visors...some of the activities included a race to see which team member could eat a whole sleeve of pringles, one where they had to fish out gummy worms with their faces in a bowl full of jello, one where they had to pass lifesavers to one another on a toothpick using only their mouths, one where they had to lick honey nut cheerios and stick them on each others faces, and the best was when the teams raced to see which could finish a whole can of peanut butter and jelly. i could not stop laughing the entire time...the kids were having a blast! here are some pictures from today's activities...

i wish i could write more, but between mal and the twins and a full field day, i can barely stay awake! my time here is winding down, i don't quite know what to think. but i do know that i won't miss the mosquitos.

gabby.

it is fitting that my last day in the clinic would be the day that i was able to change gabby's dressings. in case you don't remember him, he is the 22 year old boy with sickle cell anemia whose massive necrotizing ulcers on his legs refuse to heal. he is the boy in the wheelchair that smiles and chats with everyone. he is also the boy whose shreaks you can hear from the pharmacy as his dressings get changed. he was the first case i had heard of when i came to mission of hope, my first encounter with the limitations of 5th world medicine. also, the first testament to the strength of haitians.

he is a daily face within the clinic...everyone knows his name and his story, the pain he has endured for the last 7 years. i had been working in triage all morning taking vitals when he came into the clinic to get his bandages changed. the nurse asked me if i wanted to change the dressings, and i agreed if it was okay with him. i watched as he peeled yesterday's bandages off his legs, the fine threading sticking to every bit of exposed pustulating tissue. the entire area was raw and just oozing with slimy orange gunk...the ulcers covered and entire half of his inner right calf and partway around his left ankle. i was so nervous to first touch his wounds...the area was just absolutely raw...as i cleaned out the gashes with something similar to hydrogen peroxide, the whole area sizzled as he recoiled in pain. i could feel my hands burning through the gauze and my gloves, i could not believe how incredibly hot the area became as i applied cleaner...it was like placing your hand on a stovetop. i don't know why this happens, maybe bc the infection was so bad, but it took me entirely by surprise that his body could produce so much heat...if i felt like my hands were burning, i can't even begin to imagine what he was feeling.

it was a strange feeling to be sitting there with my hands on his wounds and inflicting such severe pain. knowingly hurting him so badly that his entire body was contorting in agony. it was just like i had seen with the man with gas gangrene, only this time i was the torturer rather than the onlooker. by the time i finished and rewrapped both his legs, we were both sweating.

and then once again he was smiling. he made sure to let me know that he was okay...i think he may have felt just as bad for me as i had for him...actually, i think he was most worried that i felt bad for hurting him. he quickly resumed the carefree attitude that was so characteristic of him, but we both knew that that tiny window of agony was real and that the pain lingered. having those two moments immediately juxtaposed was dramatic to say the least. we've all experienced things gone wrong that have ruined our whole day, yet gabby had grown so accustomed to pain that it in no way was reflected in even the moments immediately following his treatments. there is no mistaking the sincerity of his smile. this boy possesses a level of strength that is rare to see in a lifetime.

the remainder of the day involved other odd jobs, nothing too exciting. we ate dinner at brad and vanessa's house, the owners of the mission. they are amazing people. they have a beautiful house on the side of a mountain with a breathtaking view. brad and vanessa, along w/ dr. cheryl and lawrence, are such an inspiration.

tomorrow the hope house kids have a field day, so i am in charge of a team and i think it will be really fun to run around and participate in some crazy events. i will try to take pictures! i have a twin shift again tonight at 2, so i should be getting to bed soon. i can't believe that i am leaving here in 3 days.

peace, bonswa.

babies babies babies

how many times can i mention how incredibly amazing this whole experience has been? the last group just left, so the 25 of us interns and staff just shared a huge Haitian feast behind dr. cheryl's house. the food was amazing and we were all in stitches the entire time. half of us are from the states and the other half are from canada, so we were busting on each other on account of the fact that it is Canada Day. we've all become so close, it really is unbelievable how quickly we've all become so comfortable with each other. we passed the itty bitty twins around as we were all eating, it is so beautiful how the entire mission has come together to raise these two babies who would otherwise have been left for dead. i can't get over this fact. everyone has a role...whether nursing the babies, staying up all night with them, knitting clothes and blankets, donating food, staying with them during the day, taking them to the clinic, it is a community effort. everyone has made some sacrifice or another for the sake of these children, but it is obvious to everyone that it is something that we must all come together to do. again, it is so beautiful.

today was my day off so i spent it in the clinic working with dr. jenifer. it was incredibly busy! the first two patients were newborns...one had been born last night, and the other had just been born this morning. most births occur at home in the huts, so naturally this can lead to infections and complications. they often cut the umbilical with dirty knives cleaned with contaminated water. both babies this morning had to have their umbilicals tied off and re-cut and cleaned. it was crazy to see how even the baby born a few hours earlier was about twice the size of the twins. the majority of the patients today were babies, children, and pregnant women. dr. jenifer said that God must have set it up that way bc he knows that i am leaving soon.

one of the toddlers who came in was covered from head to toe in scabies (insects burrowing under the skin)...it was the first time i had seen this here, but somehow i saw 3 cases of it in one day. some of the kids f/ good samaritan orphanage have it and it is extremely contagious....with all the clinging and climbing they do, i have no idea how i haven't caught it! at least now i know what it looks like. on a side note, i was looking at dr. jenifer's dermatology handbook and i noticed that every single example of a rash, lesion, etc was pictured on white skin. in actuality, many skin problems look wildly different on a dark-skinned person than on a white person. how presumptuous to assume a white clientele. no where did it explain that a tell-tale sign of worms are blanching patches of black skin. to not have even a single skin infection on dark skin shown in an entire dermatology resource is surprising and disturbing. something i may not have noticed hadn't i been working with haitians every day.


one lady brought her twin infants in and one had severe hydrocephaly. what that is is when the baby has excess cerebrospinal fluid in some or all the ventricles and usually the child comes out with a huge head. it is dangerous bc it puts a lot of pressure on the brain which can cause damage or death. when i say severe hydrocephalus, i mean SEVERE. the poor boys head was so big that it was larger than his entire torso. it was so large that he couldn't even lift it up....when the mother was holding him i noticed that it was about the size of her head, if not larger. it was such a bizarre and sad sight to see. the surgery for this birth defect is complicated and dangerous and involves the incorporation of a shunt that will redirect the excess CSF. not surprisingly this is not something covered in haitian medicine. dr. jenifer said that she might know someone who could do the surgery, but the outlook is shaky anywhere, nevermind in a 5th world country. the poor mother was so concerned and desparate for help, it broke my heart to think of what was in store for her and her child. despite the fact that he could barely move his head, he maintained a full smile for the entire time he was with us. this was a little blessing amongst so much uncertainty.


dr. jenifer is adamant about me performing a lot of the exams and being really hands-on when i'm with her. it takes twice as long but she says she likes having me around bc helping me will help even more patients. i've learned how to distinguish between different types of lung infections by listening for subtle differences that originally all sounded the same to me. she started making me examine the patients first and come up with my own diagnosis. it's a lot of pressure, but it's a great way to learn. she's even had me examine the pregnant women...i don't think it will ever cease to amaze me the beauty of a woman with moving living child within her.


one man came in which asthma so bad that he had to sleep sitting up in a chair every night. he was so loud it sounded as if his entire chest was hollow and that air was just bouncing between his ribcages. the wheezing was not like what you normally hear with asthmatics, it was more like a loud whistle from the depths of his chests. it was alarming how much like a machine this man sounded like. i think if i closed my eyes it would sound like i was in a factory. the relief from the nebulizer was drastic, but it seems to be a temporary fix to a permanent problem.


mal was feeling so much better today that she actually worked construction. she did welding this morning and dug trenches in the afternoon. she will be tested again to make sure that she's gotten rid of all the parasites.

i was able to talk at length today with dr. jenifer about practicing this type of medicine, why she does what she does, and how she deals with what she sees. i don't know if i've mentioned this before, but she is haitian and lives right in port au prince. she is an inspiration to me in so many ways. she practices medicine with grace, knowledge, patience, and assertiveness. she says that the most important thing to do is listen to the patient bc when it comes to 5th world medicine, sometimes it is all that you have. she sees patient after patient after patient and treats the last with as much attentiveness as the first. with all the frustrations that come with resource limitations, voodoo remedies, and lack of education, i don't know how she does it. yet she continuously contends that the Lord has blessed her with this position. haiti is lucky to have her, and am so incredibly grateful to have had the opportunity to have worked so closely with her.




it amazes me how many heartbreaking things i've seen while i've been here, but even more so how many truly beautiful things i've witnessed. haitians have a way of coming together to make things work. everyone is your neighbor and burdens are beared by communities rather than individuals. they have so little, but what they have is shared. one lady spent the last of her money to bring a young boy to the clinic last week. when asked if it was her son, she said that she didn't know him, but she saw him on the side of the road on the way home from work, so she brought him to us. though she could barely afford one way, she didn't think twice about doing what she felt was the right thing to do. little things like that remind me that while haitians endure material poverty, they are wealthy when it comes to spirit and benevolence. perhaps the worse poverty is that known to the rude american doctor who does not know that his patients are his own brothers and sisters.


tonight i have twin duty again from 1-8am. tomorrow i am in the clinic again. my friday construction got changed to working in the school, so it looks like i've an easy schedule from here on out. i'm trying not to think about leaving, but it is a constant weight on my shoulders. i have to remind myself that it wouldn't be so hard to leave if it wasn't so great to be here. but of course i have much to look forward to when i go home.

peace and bonswa.

last tuesday on the mission

good news, mal is feeling a bit better this evening...looks like the meds are working already. last night was a long night with the twins...between the 2 of them i was up about once every hour. it is exciting though bc it means they are healthy enough to drink. i'm so happy that the mission was able to adopt them...they are very lucky. i'm also grateful to even have a tiny role in the first few weeks of their lives. tonight i am on second shift which means i go to bed early and then i am on twin patrol from 1am-8am. they're so incredibly adorable, i don't mind sacrificing some sleep!

i spent some time talking to rachel (director of hope house) last night and she was explaining to me that it was rough at the hope house this year. there was an orphan named marenda that had been rescued as a child bc she had been left in a trash dumpster that had been lit on fire. her body was half covered in burns and she had a severe bone deformity or disease in her legs that made it difficult to walk (perhaps the reason why she was left to die). no one really knew what was wrong with her bc haiti does not have the testing that she needed, but she had been improving really well. in november she started to get sick with a cold that she couldn't shake and it seemed like she was beginning to get depressed. there were a series of tests that she needed to get done, but they were so hard to get that she could only get one at a time. meanwhile she was constantly getting worse, to the point which no one could touch her and it was even painful to turn over on the bed. in january, while they were still waiting on two more tests, she passed away at age 16. she had known pain and suffering her entire short life. they never found out what was wrong with her bc haiti doesn't do autopsies, but it could have been something entirely treatable had they known what it was. naturally it was a huge loss for the mission and just another of the many frustrations due to lack of resources. what is merely a prescription in the states may be a death sentence in haiti.

a side note on burns...many many patients who come into the clinic have burn scars from their childhood. brad explained to me that these are very common in haiti for multiple reasons...first, there are burn pits everywhere. bc there is no waste disposal system, most haitians just burn all their trash. coupled with the fact that i've seen children barely old enough to walk alone on the sides of the streets, it is not surprising that so many adults have burn scars. also, burning is used as punishment, as well as in voodoo rituals. in fact, a haitian woman in NYC was just arrested for burning her baby after she laid him in a circle of kerosene which she lit as part of a voodoo ritual.

...

today i was assigned to a group and we went to the beach. it was a beautiful day and the sun was strong. they are telling me that i am starting to look like a haitian. cody, roger, and i went out on a canoe and went snorkeling at the coral reefs. the water is bright torquoise and the corals were beautiful purples and oranges and blues...i can't believe that nature can make such radiant colors and they are hidden away on the ocean floor. we saw some crazy-looking fish and one of the haitians dove to bottom and picked me some really cool looking coral....soft when it was underwater and then almost instantly solid once it was exposed to air. we swam around for nearly an hour...i must have rubbed against one of the poisonous ones bc my arm started stinging and a patch of my skin started bubbling at the surface...it felt like someone was putting a lit match to my forearm. the bubble blisters stung in the salt water, but were barely noticeable once i was out. we canoed alongside the mountains and it was one of the most beautiful sites i have ever seen.

afterwards we went to the site of the new property, and as we walked through the rows and rows of tall banana trees, nearly 50 children appeared from all directions. they just come out of no where, half dressed with no shoes with their hands raised up for you to pick them up while the others grab your hands and legs. from what i've seen, it seems like the people worst of are those in the countryside. it is most often where i see children with protruding rib cages, swollen bellies, orange hair, massive skin infections. the little girl that i was holding had only a skirt on and she was sweating from head to toe. i could feel her raspy, clogged breathing with her naked back against my arms. it was a lung infection that you didn't need a stethoscope to hear. some of the other kids had really croupy coughs...but they all just went on like they had not a care in the world, just happy to have strangers "love on them" as they call it, albeit for a tiny amount of time.

i'm off to bed to steal some sleep before my baby shift. tomorrow i have a day off but i will probably spend it in the clinic with dr. jenifer. i can't believe that i leave so soon. i'm excited to see my family...it has almost been 7 months, but it will be so hard to leave. i've taken in so much in such a short amount of time, i don't know if i've digested it all quite enough. somehow i feel that many of the images that i've witnessed will be forever engrained on my brain and in my heart. i only hope that the associated emotion will remain salient far beyond my immediate memory.

the generator died today. perhaps we will have to heat up the babies' formula by candlelight? i will plan on sweating through my clothes again! peace and bonswa...:)