(triage at mobile clinic)

This past week a team from Illinois was in Haiti. We had a team of guys wiring some of the camp dorm room for electricity, a veterinarian, a dental team and nurse. The 2 Haitian doctors that I usually work with, Dr Gregory and Dr Rony, worked with us also. I never made it out of the mobile clinics in 4 days to see the vet working or the construction team. The clinic was so busy! I worked in the pharmacy, gave out numbers to people coming to be seen and ran around trying to find needed supplies. I think we all worked really well together, especially considering the amount of work we did. We saw some burns, from people always cooking over open fire. We saw a lot of older people with high blood pressure. And there were plenty of skin infections to go around. The biggest problem was scabies. We gave out treatment and taught the families how to rid their household of scabies. I have been trying to stress the importance of good hygiene to the people in the village of Peredo. But hygiene isn’t as easy in their life as it is in mine. I can take a shower, launder clothes in a washing machine and do all this with clean water. Out in the villages, the women in the families have to carry water back to the house. Some people take a public bath in the river, the same river that animals are standing in and people are washing their clothes in and taking back to the house. So telling a family to wash their clothes, bedding and all the fabric in the house in boiling water is not an easy task. Also the treatment available involves “painting” the skin with an anti-scabies medication twice a day for 3 days and then repeat in 7 days. They have large number of people living in one household so this makes the task very time consuming. The time that the parent spends on this clean up is time that they are not working. They have to work to survive. So for example, the time mom is spending on scabies treatment is time she is not in the market making money or not walking to get water or not cooking for the family. Compliance is a difficult issue. When the clinic is built in Peredo these types of issues can be addressed more thoroughly. The clinic workers can do follow-up and make sure the prescribed treatment is being followed. We can also have health education classes on these common healthcare issues.

(Fluoride treatment of our school kids)

One thing I learned recently about the Creole language is the way they do not take blame for actions. For example, say I had a glass of water and I dropped it. In English we say, “I dropped the glass.” In Creole we say, “The glass fell.” One real life example of this is last Friday the team that was here in Haiti, Pastor Gerard and I were going to a famous waterfall in southern Haiti called Basin Blu (Blue Basin). (see http://www.haitiantips.com/haiti-video.php/1103 for a video of this natural waterfall). We were driving down a steep road/alleyway and a big dump truck full of rocks was coming up the hill. It was a close call whether the trucks were going to hit each other as they passed b/c they were so close. The Trucks did not hit but the side view mirror on the big truck nearly knocked the American Veterinarian, Dr Mike, out of the truck. As those of us sitting in the back of the truck scrambled to grab onto his legs and feet (which were the only body parts still in the truck) the dump truck started sliding backwards and when the rocks in the back shifted, the truck fell over. Pastor Gerard was driving and saw what was happening from his rear-view mirror and got out truck out of the way just in time. God was truly with us that day, I know he is with us every day but He showed it last Friday. It was such a close call. The Haitian driver of the dump truck was uninjured too. After this happened there was a crowd of people all around saying, “The truck fell.” I had to laugh. At that point there was no blame being placed. (From my view from the back of the truck, I don’t think it was anyone’s fault this time. Just an accident) Would have been a different story in the US. It got a little chaotic as Haitians were crowding around our truck. I didn’t speak to any of them in Creole as I didn’t want to say the wrong thing. I only begin speaking in Creole to the police when they showed up. We went to the police station in Jacmel, what an adventure for the team of Americans!

The vast majority of Haitians do not have a vehicle. One form public transportation in Haiti is “taxis”, which are motorcycles. They usually put 2-3 people on a regular size motorcycle. I have seen up to 5 on one! The other form is what they call a “tap-tap.” A tap-tap is a small truck with benches built into the bed of the truck and some kind of covering over the bed of the truck. Sometimes the covering is a tarp, sometimes a sheet of metal or plastic and sometimes a truck topper jacked up high enough to be able to sit under. They pack people into these vehicles and put goods and belongings on top of the truck. Sometimes people even have their chickens and goats on the tap-tap too. There are thousands of these trucks in the city of Port-au-Prince. They get the name tap-tap because when someone is ready to get off they tap the side of the truck and the driver stops.

(Tap-tap)

In the afternoons I have been "following" a different kid from school home. The kids are starting to come up to me after school and ask if I will come to their house! Most of the kids in Peredo live fairly close to the school. At HCO's (Haitian Christian Outreach) school in Seguin, some of the kids walk 4 miles to school. While we are walking I talk to the child and usually our number increases in size as we walk through the village as other kids want to walk with us. When we get to the house I meet the mother or mother figure if she is home. Sometimes she is out doing laundry, sometimes at the market working, and sometimes she is at home cooking, cleaning or talking with her friends. I practice my Creole with the family and am always given a seat. The Haitian people are very hospitable. They get a chair (even if they only have one) and insist that I sit. They usually offer something to eat or drink but being as I don't want to get sick I usually tell them that I just got done eating. It amazes me that these people who have very little-offer a guest everything. I lose track of time sitting and talking with these families. I am trying to collect information for myself on how the kids in our school live. We have done some health teaching with them already and I hope this continues in the future. I want to see the resources they have at home so we can see what types of health promotion teaching would improve their health. For example, one of the teams that came down last month gave every child in the school a toothbrush and toothpaste and we did teaching on how to brush your teeth and how often. So when I visit their house, I ask the child to go get me their toothbrush and toothpaste. I can see where they keep it, if they still have it at all, and if it looks like it's being used. One house was using the toothbrush as a dish scrubber! So if I would have asked the child in school if they were using their toothbrush, that student could have said yes (technically it was being used to wash dishes!). One of the things I am learning about the Haitian culture is that I have to very specific when asking questions!

I also ask to see where the family how far they walk to get their water, how do they store it, where they go to the bathroom, where they store their rice/food among other things. This is giving me a better picture of where the school kids are coming from and what health teaching is important for this specific community in Peredo. I am also getting to know the families in this community. I am praying this helps establish a bond of trust.

Of course when I am walking back I have to stop at my friend Kait-la's house. I talked about her in one of the other blogs. She's the spit fire 5 yr old that I absolutely love! The other day I took her a couple of shirts and a few toys and gave her grandmother some soap and lotion. Kait-la was so excited about the clothes that she stripped down in the front yard and tried them on. Her grandmother told me that Kait-la looks for me everyday. What I didn't say was that I look for her everyday too!

note-I haven't taken pictures when I go out to meet these families. I am trying to be sensitive and think of how I would feel if someone came to my house in the US (who couldn't speak English that well) and asked to take pictures. More pics to come soon!

Cleft lip update

The father of the boy we helped get seen for his Cleft lip called yesterday and reported they they are back home and the surgery went fine! He said the surgery site is healing well and the little boy is running around and eating more than ever!

The Lord is good!

Everyday Stuff

People are finally telling me that my Creole (the language spoken here) is good. I have been studying hard to be able to communicate here. People in the church are being very patient with me and the some kids learned yesterday that I am picking up the art of breaking up fights in Creole. There were 4-5 kids playing here yesterday outside and I was cleaning inside the walls so I couldn’t see them but could hear them. One started screaming and crying and I think the mother hen in me came out and I went out to get the story. In my limited Creole I asked the kid who hit if he wanted me to hit him and he laughed and said no. I then asked if he wanted me to go tell his mom. He said that I didn’t know where he lived! (Sounds like a response from a kid in the US!)Then I gave a lecture on how we don’t hit each other. I walked away not proud for breaking up a fight but proud that I could yell in Creole. Finally!

The weather has been nice during the day here with some hard rains at night. Last Friday evening there was a hard rain and storm in Port-au-Prince and we drove to Jacmel the next day. There is a place called Ka Fou that we drive through coming out of the capital. Because of the rain the night before it was a sludge of mud and trash. Plastic pop bottles and other trash were in the street, on the sidewalks, basically everywhere . The road was littered with trash and mud that had washed down the hill. I saw guys carrying people (mostly women) on their backs crossing the street. I was told that people were paying those men to carry them across the dirty street on their backs. It truly was a mess. People walking through that dirty, disease infested mud. In a city with so many people crowded into one place trash is a huge problem. There are few dumpsters around and those are usually full anyway. So there are big trash piles on the side of the road and once they get really big they are burnt. Kids play around these and dogs, pigs and goats walk around in the piles and eat. Here is a picture of one on the way to the church in Port-au-Prince. No matter how many times I wash my hands while I’m in Port I still don’t feel clean. You can see what kind of a challenge the medical personnel in Haiti are working against.

trash along side the road in Port-au-prince

But the beaches in Jacmel (southern Haiti) are amazing. Light beige sand and blue/turquoise water. Haiti shares the island with the Dominican Republic. The DR is known for it’s vacation spots and resorts. Haiti has the same beautiful areas but they are undeveloped. I guess people are still afraid to travel to this country and because of that there is not much invested in tourism. I admit there have been a few times here that I felt nervous. I can honestly say I was more scared of being in Mexico when I was there than I have ever been here. There are some hotels here and I went to one to eat for my Birthday. The food is good and most of the views are oceanfront. I ordered a chicken sandwich which would be on a sub bun with chicken and cheese and sauce. The waitress came out and told me they didn’t have any chicken sandwiches today (which is not uncommon for restaurants here not to have multiple things on the menu on a given day). So I ordered a ham and cheese sub. They brought us out our food including my sub and another guy at the table ordered grilled chicken breast. So they had chicken and they had bread and cheese but they didn’t have chicken sandwiches! So is life in Haiti!

(Cap Lamandu-hotel/restaurant for my B-day dinner)

(view from restaurant/hotel)