Raindrops on Roses and Whiskers on Kittens

Does this thing still exist?! I’m not entirely sure where to go with this update because so much has happened since the last time I wrote…six months ago… So a brief synopsis: During April, May, and half of June, we ran mobile clinics. I basically went and checked out a bunch of tent cities and some orphanages, and then later we went back and did clinics there. At our very first clinic, we saw 140 patients. With four nurses. On the porch of an orphanage. During those clinics, we saw just about everything you can imagine. And most of the time, we had no doctor, so all the volunteers were turning to me for the final say on diagnoses or prescription. Interesting experiences.

            During May, we also got five dirt bikes which we will use in our EMS response. We can put a medic with a bag on the back of one and they can get through traffic a lot faster than a car in order to stabilize a patient until the ambulance gets there. There is a group of Haitians students who had received a bit of medical training and hope to work as EMTs (once EMTs exist in Haiti). We worked with them in February during Carnival in Les Cayes. Mid-May we began training them to be the medics for our motorcycles. For about a week straight, every day when I got home from clinic, someone was coming up to me with some injury they got while training on the bikes. Even the teacher got an injury. Not his fault, though, one of the girls injured them both somehow. By that point, I was just bandaging whatever wound came in front of my eyes next. But they all lived to attend the classes we began in the beginning of July.

            So finally, what we’ve been working towards for over two years is here! We signed an agreement with the Haitian Ministry of Health and are in charge of their EMS system. Whatever training curriculum we come up with they will accredit and make the national standard. We also sort of became responsible for a lot of other things, like procuring the supplies for their ambulances (a recent donation from Brazil…35 of them). In the deal, we got two ambulances of our own. They have State plates on them, which Adam says basically means you can run over a cop and no one can stop you. That also means I’m allowed to drive. We have a limited number of people here who can drive a stick shift, and I’m one of them. So State plates and stick shift was the key to me getting the keys. Not only that, but the ambulance that I drive is the one for official use if needed. So if the President goes down, he goes in my ambulance.

            But just so we don’t get carried away with things going well and falling into place, let’s just have a little reminder that this is Haiti. Our very first day of class, for some reason (which I can no longer remember), we had no breakfast. Not a problem for us necessarily, but we had agreed to feed our students breakfast and lunch. What most likely happened was that our cook ran out of supplies and neglected to tell us until we were asking where breakfast was that morning. She’s the sweetest woman, but for some reason just can’t understand why we ask her to let us know 48 hours ahead of when she thinks she’s going to run out of something. So Becky and Alex (an EMT who was here for the summer) ran down the road to a street food lady and asked if she would make us 30 peanut butter sandwiches. She agreed and they told her they would be back in 15 minutes for them.

We were rushing to get out of the house because we had to make a stop at the airport, as Becky was heading home for good and one of the volunteers also had to go back to the States. He had arrived the day before, promptly seized in the airport and then again in the grocery store later that day. We all had to pile into the pickup truck because our other vehicle needed a new registration. Which we couldn’t get because it had been backed into a Mercedes in the parking lot of a grocery store and the driver of the Mercedes wanted $1000 US. Because of that, there was a court date. Which our driver didn’t show up to. Therefore, there was a warrant out for our Defender. At the end of our road, we stopped by the street food lady to pick up our breakfast order. She hadn’t started making the sandwiches. Not only that, but we came to discover that she didn’t have peanut butter. So we thought if she just gave us the bread, we would buy peanut butter and the students could make the sandwiches themselves. She only had two rolls. So she had agreed to make us 30 peanut butter sandwiches without having any peanut butter or enough bread to put it on. Happy Monday, everyone.

            But we continued on, and, because it was rainy season, soon found ourselves stuck in a pit of mud. At this point, Becky, Alex, and I hopped out of the truck, and I started yelling for our volunteer to do the same. He was less than amused. He also didn’t seem to understand the urgency of getting to the airport on time and the way the car traffic was going to keep him from doing so. So Becky and Alex took off running down the road to flag down two motos so that by the time the slow volunteer and I got to them, we wouldn’t have to wait. We left the rest of the volunteers behind to dig out the truck. By the time he and I made it out to where Becky and Alex had the motos waiting, the truck had been freed and was driving up behind us. The volunteer wanted to just get back into the truck and drive to the airport. Again, for some reason he wasn’t connecting the bumper-to-bumper traffic and the fact that it wasn’t moving an inch to his inability to make his flight. So we forced him onto the moto, and Becky hopped on hers as well, and that is how I said goodbye to the closest friend I had here.

            The next details of the day are a bit fuzzy, but we must’ve dropped everyone off at the training compound and then Thony and I returned to the house to take Venese to the market. Alex stayed at the house to begin cooking what she could of lunch without Venese so that we could make it back to the training site in time. So the three of us get to the market, park the truck, and walk inside. We spent about an hour gathering all of our various items. When we went to return to the truck, it was gone. At first I thought it had been stolen (our back window was broken out…we got it replaced one time and that very night a doctor somehow broke it again). Anyways, after some investigating, we come to find (I believe from the sugarcane sellers we parked in front of) that our truck had been towed. Where to? No idea. Which police group? No idea. Well that’s great, so I guess we’ll just walk around the city until we find it?

            I sent Venese to go catch a moto so she could get back to the house and cook while we figured out what to do. Finally, I told Thony that we were going to rent a taptap. He looked at me for a bit, clearly not excited about the idea. There was one a few yards from us, and I asked him to go talk to the guy. Eventually we worked out a price and we headed for home.

            A very long time later, the food was finally ready. Alex and I got in our rented taptap and took off for the warehouse. When we arrived, we come to find that we are so late that all the students have already gone home. I hope everyone is incredibly hunger for rice and beans.

            Obviously, the days since have gotten better. Similar days occur every now and then, but that was probably the most ridiculous. (We managed to find our truck that day and get it back the next – it was taken to the police commissariat right next to our training facility.) We trained our own moto medics to the US equivalent of a first responder, and they are now working towards EMT-Basic. We are training the government employees (who are already working on the ambulances…I did a few calls with them to oversee and it’s a scary, scary thing) to the level of EMR for now and they will receive EMT training later. There are 80 MSPP (Ministry of Health/government) students. No one likes testing with me because they think I’m too difficult. I would rather call myself a perfectionist.

            It’s really exciting to see this finally coming together. We’ve all worked a long time for this, and we’ve done some strange and mildly disturbing jobs/patient transports to keep things moving. Obviously, it means a ton more work and me trying to put together EMS curriculum oddly enough, but so far it’s a good ride.

            Hurricane season makes things more interesting as well. They must’ve painted Isaac as a heart-wrenching story on the news in the States. I’ve heard from reporters that any time the media can connect a story to Haiti, they’ll do it. So despite what was said, at least for Port-au-Prince (where all the tent cities are that I’m sure they talked about), there was hardly any damage to think of. There was some wind and a continuous (but not heavy) rain for a day, but that’s all. It did manage to knock out one of the city’s main transformers, though, so we were without city power for a week. Apparently Joyce is heading our way next, so I look forward to whatever excitement that might bring.

            And in the midst of all these happenings these summer, I got a kitten. He is a spaz. I’ve never met a kitten who gets so wound up about things. Anything. Toilet paper, contact cases, coins, fans. He loves being with people and being held, but not like a normal cat. He likes to sit on my shoulder and nuzzle my ear. Or bite my earrings, depending on his mood. I have a shelving unit in my bathroom, which he has gotten quite good at climbing up. But getting down is something he still needs to master. Because of that, he’s taken to leaping from the top shelf (about 5 feet tall) onto my back while I’m brushing my teeth or doing something else unsuspecting. I do not find it amusing.

            We’ve had some trouble thinking of a name for the kitten…nothing seems quite right. So it was kind of like he was a Jewish kitten, not being named until the 8^th day or something, and therefore I thought he should have a Jewish name. My dad suggested Abram, but I felt like Mo (short for Moses) was the better option. But my name choice was vetoed, so (for now) he remains just Kitty. I thought Mo would’ve worked nicely, because it sounds just like “NO!”, which I say to him all the time.

Rocks and Rolling

This morning I was standing outside our gate with one of the women who works at the house watching Thony and Jean, our two drivers, try to start a pickup truck in the field across the way. At one point, some children came up the road and stood by us, the littlest girl taking inventory of everything she could see. “Cow, cow, cow, white person, cow cow…”

After that I returned to the house and perched on my stool for my day of computer work. It seems relaxing after the last two months we’ve had here. The other group we used to live with (but no longer do) came last weekend to reclaim their internet, so I’m still trying to figure out this irritating little white thing we got. A few days ago I was reading my devotion book and saw the words “We lose interest…” and read it as “We lose internet…” and I thought to myself, “Oh my word! Oswald Chambers was prophetic! And he knows just how I feel!”

            Anyways, a few highlights from the last few weeks. When I returned after Christmas, my cousin came with me. I thought it might be weird to have my two worlds mixing, but it wasn’t. We had kind of a low-key week, aside from trying to break into my old house. I think it all would’ve worked out if I had been wearing chacos instead of flip-flops. Next time. The more she saw, the more I realized I wanted her to see…how do you show somebody your life in one week?

            On her last night here, we were planning to just hang out and stay up talking. But while I was in the shower, Becky came into my bedroom and started yelling to me about how there was cholera somewhere. Apparently Jon had seen something on the internet but hadn’t actually been in touch with anyone about it. So we spent the next 14 or so hours trying to find someone who was actually in Pestel and could give us a read on the situation.

            There was a fair amount of debate between the two of us about whether or not we should go. Pestel is 8-10 hours away, and the number of cholera cases reported seemed incredibly insignificant for that amount of travel (obviously I mean numbers-wise…I’m sure the puking people feel that it’s significant). But our caravan headed out of the city around 6pm that evening, right as the sun was setting.

            As I’d only slept for two hours the night before, I found it really difficult to stay awake on the ride out. Thony and I were in our pickup, stuffed to the gills with supplies which meant I couldn’t put my seat back. But I also felt bad that he would be awake by himself. Not bad enough, though, because I still tried sleeping. I assumed every uncomfortable position I could think of and didn’t manage to sleep much, though I was still in some sort of fog. For the last three hours or so the roads were incredibly bumpy and I felt like we were just driving around lost, heading for the edge of the world. Katrina, our long-term volunteer who was awake, was commenting on the roads and said she took comfort in the fact that she knew I was praying. But we finally arrived around 3am…I have no idea how…and I was curled up on a cot under my towel in the freezing cold supply depot (it also doubles as a church) by 4:15.

            The issues in Pestel stemmed from the fact that they are up in the hills and the nearest cholera treatment center (CTC) is a several hour walk. So the group we stayed with out there was setting up their own primitive CTCs to try and fill the gap. (We ended up in meetings with WHO/PAHO about this when we arrived back in Port-au-Prince.) The man we were working with, George, is absolutely wonderful but not medical, and he was trying to learn as much as he could. We visited the different sites each day, some by truck, one by foot, taking care of the patients and trying to do some teaching.

            On Saturday afternoon, the team (with the exception of Jon and I) headed back to Port-au-Prince. Some had to get to the airport, and some had to meet incoming volunteers. We worked late that night at a clinic where the staff seemed to be encouraging the patients to die. Luckily there were only three patients so it wasn’t a fiasco to get under control. To avoid the cold, I took to sleeping inside the truck.

            We continued visiting clinic sites and rounding on the patients the next day, giving instructions to the nurses. We were on our way to the last site when we saw a crowd gathered along the side of the road. There were 15-20 people carrying a woman on a bedframe. They said she was 3 months pregnant and had been bleeding for 23 hours, so they were carrying her to the hospital. It would have been another two hour walk to the hospital they were going to. As we’d been there the day before, we knew they didn’t have any of the equipment they would need to assess and treat this woman.

            I examined the patient to the best of my ability and started a line on her. Jon had gotten a hold of a doctor we knew, and I explained what I was finding over the phone. I had told Jon earlier that I wasn’t sure this woman was actually pregnant – it seemed like her uterus was too big for 3 months and not in quite the right place. He asked what I thought it was, and I responded by saying that my guess would be a fibroid tumor, though that wasn’t necessarily the most educated of guesses. I relayed all this to the doctor, and she assured me that a baby at 12 weeks would be about that size. She then suggested that we do a pelvic exam and told us how to do it over the phone. I volunteered Jon for that task, as the instructions “A healthy cervix should feel like the tip of your nose” just weren’t convincing me that I would do it correctly or find what I was supposed to be looking for. Regardless, she needed an ultrasound, and the closest hospital that could do that was 4 hours away in Les Cayes.

            Jon and I decided that we would take her back to the camp with us and monitor her overnight, then head home early in the morning, dropping the patient off at the hospital on the way. We were still waiting on a contact to confirm that they would take her. We went to sleep around 1am, with the intent of getting up at 3, having everything ready to go by 5.

            So around 7am, we were finally ready to go. The woman and her bedframe and mattress were strapped into our pickup (a shortbed, so we let the tailgate down and tie backboards, etc. in with rope). Her husband and I were sitting on the side of the truck bed with her, and I was holding her IV. It was a painful ride. It was also really cold – I’m not sure I’ve ever prayed for the sun to hurry up and warm me in Haiti, but I did that morning.

The roads were actually really scary, and I was glad that it had been dark on the way there. About an hour into this journey (which we were anticipating would take about 6 hours, as we had to drive slower with our patient who was in a lot of pain), we were following a big truck up this ridiculously steep hill of big rocks and dirt. The truck was kind of like a dump truck, stuffed full of people, animals, vegetables, and other random things. I suddenly had this thought that maybe we shouldn’t be following it so closely in case something happened or it started sliding back down the hill. About the time I thought that, Jon stopped driving. Within several seconds of that, the back fell off the truck, and a woman fell out on top of it, along with some bags. A goat, which was tied inside the truck, also fell out. For some reason, I didn’t care about the woman; all I could focus on was this goat, bouncing and twitching off the end of this truck while it was being hung. Meanwhile, the truck kept going up the hill a little further. (The woman did get up and start walking then. She was fine, I assume she was just very sore the next few days.) When we drove past the truck, the goat was inside and was shaking itself off. I guess it’s hard to hang an animal with a neck that strong.

            The rest of that portion of the trip was much less eventful, and we actually made it to the hospital in 3 hours. I’m not sure if I could’ve sat in that position holding an IV bag for any longer. We met our contact who got us in and got our patient taken care of, and she then took us back to her house so we could recharge all of our electronics. We stayed there for several hours, then as we were leaving discovered that the keys were locked in the truck. Thankfully, the replacement window in the back of the truck doesn’t always go up straight. So we managed to stick a piece of rebar in from the back right window and hit the unlock button on the driver’s side. We made it home about five hours later.

            We were greeted by the rest of our team, which again included the boss, as Adam was back from Afghanistan. After a bit, Jon and Adam went out to catch up. I showered for the first time in five days, talked to Becky for a bit, then got ready for bed. It was nearly 11pm, I was exhausted from the lack of sleep and the conditions we’d been in for the previous six days, and I was just about to crawl into bed when Becky came into my room saying we had a call. One of the security guys we know had called to let us know there was a bad accident on Delmas. Most of our equipment was still packed into the Nissan, which was out with Jon and Adam. Who weren’t answering their phones. The Defender was out of commission, and Thony had taken the other vehicle home. So there was nothing for us to do but wake Thony up and ask him to come get us. So much for a quick response time. But it did give us a few moments to gather up other supplies.

            We raced down the empty roads in the back of the car, hoping we didn’t have a lot of people to put into it. Our backboards would have to lay sideways to fit, and they were tilted upwards since they were laying on the folded down backseat. On our way, we called another paramedic we knew to see if he might meet us there and bring some equipment. We had no idea what the situation was. He said he’d think about it. Great, thanks. I’m a nurse and Becky’s a newly licensed EMT, so we were trying to figure out exactly how to operate when we got there, depending what we found. Someone with a bit more prehospital experience would have been fantastic, but nevermind, we’ll do it ourselves.

            As we neared the end of Delmas 33, a crowd suddenly appeared. Thony parked the car a bit away, and we took off running. I was definitely not expecting what we found. Becky and I had come up with our plan (mostly), so as we neared what I thought was the main scene, I started giving instructions and making observations out loud. “Okay, moto vs. truck, that one’s dead, dead, move on and…whoa, Becky…what just happened here?” We stood there together, for the briefest of moments, confused. Hundreds and hundreds of Haitians were standing around watching, and there was big Caterpillar equipment in the street. We began running again and found some other responders, journalists, and UN police to explain what happened. A dump truck full of rubble was coming from the opposite side of the intersection and lost its brakes when it went to make the left turn. It took out a whole bunch of motos stationed at the corner, as well as street food vendors before it rolled onto its side and crushed three cars. Two of the cars were still underneath the truck, feet from where we stood. There were bodies everywhere. I’ve never seen anything like it.

            Becky and Thony and I stood together trying to figure out what to do next. The report was 56 injured, 27 dead. The survivors had been loaded up and taken to various hospitals, the last vehicle was just leaving as we arrived. (Many have since died.) So we needed to figure out if any of the trapped people we could see were still alive. One woman had had a pulse, but it was irregular, and then she lost it. My back was to the accident as we were talking. I can’t remember at this point what I said, but Thony responded to me by saying, “Adam is here!” “What?” “Adam, he is here, he is on the truck!” Of course he is. I turned around and there he stood on top of the wrecked dump truck. Which was also on the edge of a three foot wall. Becky and I ran over and found Jon. That was the best part of the evening – our team was separated and unable to communicate and we still ended up together at the accident scene.

            We remained there for about five hours. Adam was heading up the extrication and moving of the vehicles, as well as directing the equipment. They lifted the dump truck up a bit so we could pull out the black car, which no longer resembled a car at all. I’ve now told this story enough times that I can manage to censor it a bit. When we stepped in to pull out the car, the smell of blood was unbelievable. We removed four people from underneath the truck and in the vehicles. Bystanders and cops and UN were crowding around taking pictures. Becky and I were yelling at people, she more effectively since she speaks four languages, and she told a cop, “These people’s family members probably don’t want pictures taken of their dead bodies.” He shrugged and said, “They’re not my family.”

            This all took place outside a TV studio, where Haiti’s President happened to end up observing. Afterwards, he met Adam and Jon and said he was impressed with DIRT’s work. During that time, Becky and I were off on the other side of the road treating a man who had cut his leg somehow and then just laid down in the middle of the road. He was quite drunk.

            The next afternoon we were sitting down to lunch together to try and catch up and have a meeting. I got an email from our Les Cayes hospital contact: “Your pt. had her sonogram yesterday; she has ovarian cysts and a large fibroid tumor. She is discharged with Iron, vit, antibiotics and will return in 30 days for surgery. Our visiting surgeon will do the surgery
Thanks guys.” I had little time to celebrate the fact that my diagnosis was correct (in a surprised, “I can’t believe I was right” kind of fashion), because shortly after that, we received a call. The same guy who had called us the night before was letting us know about a bus accident that happened on the road to Jacmel – about three hours away. Reports said dozens dead. We discussed a bit whether it was practical for us to drive out there, if things would be cleaned up by the time we arrived, what contacts we had to get more information. Finally we decided we should just go.

            When we neared the place where the accident would be, we saw an ambulance coming around the corner, so we flagged them down. Inside were three patients. Jon and I ended up assessing them and riding along, as the “ambulances” here don’t actually have trained medical staff on them. They basically serve as taxis. One man had a broken arm, another was just banged up and sore, and another had a possible head injury and broken ribs. As I was checking him again on the way to the hospital, I told Jon that he might possibly have a pneumothorax, but I wasn’t positive. When we got to the hospital, we found that both patients in the back with us had pneumos. The three patients were construction workers, driving a dump truck that flipped. So we hadn’t even found the bus accident.

            It was around this time that we began meeting with the Secretary of State for Public Security. I honestly don’t know exactly how this came about, but he seemed to like us a lot, and we got food every time we had a meeting with him. We were also donated a “mobile command unit” – a gigantic bus that has an exam room, all kinds of cabinets and refrigerators for meds, and sinks for hand washing. The combination of these two happenings meant that we became involved in the medical response for Haiti’s Carnival (Mardi Gras). It was being held in Les Cayes this year, the first time Carnival would not be held in Port-au-Prince.

            I’ll spare the details and give an overview – Becky and Katrina (who wasn’t even technically our volunteer) and I ended up trying to pull this all together by ourselves because everyone else ended up having to be in the States for various reasons. Even now as I write this, all I feel about Carnival is irritated and slightly bitter, so you all are in luck and you’re getting the shortened condensed version! We took 40 people with us. Adam, Jon, and Thony were working at the dispatch center (we basically ended up taking over the event, because literally no other group there who was supposed to be organizing it had a plan), and Becky and I were manning the bus and organizing our volunteer teams. The bus was parked close to the parade route with all of our equipment, so we couldn’t leave it unattended. That meant that she and I got to babysit constantly. We were working 3pm-3am each day, so until we wrapped things up and got to bed (we both slept on the ob/gyn exam table) it was 4:30 or 5, and we would start getting calls from the team or needing to organize things by 7 or 8 the next morning. How we did not all lose our minds still amazes me. The people who got to leave the bus got to shower (we found some missionaries – they knew the people I knew in Saint-Marc). Becky and I walked around in our uniforms (thick long pants, socks, boots, 20lb tactical vests) every day for five days and did not shower.

            However, out of all these shenanigans came good things for DIRT. We worked with the ministry of health after being handed responsibility for all communications, we treated patients, and we ended up being the security vehicle for the President’s float during the last night of the parade. The next night when we were broken down along the side of the road, some people pulled up and offered to tow us. But only because they’d seen us at Carnival and on TV and knew who we were. Otherwise we were just another broken down vehicle of white people. So we’ll see where this takes us! I’m the only one currently in the country, and we just got down a surprise team of 7 EMTs. I can’t even begin to comment on the situation.

            Sidenote: Maeve is in the country right now, she came back and brought with her a team from Ireland to work for three weeks. It has been wonderful to catch up with her, and I’ve slept over at their air conditioned accommodations a few times. It was a little cold for my taste, but nice to be together again. Last Sunday we had Ralphie with us. The little bugger is walking now, still squeals periodically throughout the night, and picks up people’s cell phones to say hello. He’s got some sort of hair-do that makes him look like a little caterpillar. And at one point Maeve and I put someone’s headlamp on him and laughed a lot.

            That evening as we were winding down, talking with some of Maeve’s girls and getting ready for bed, someone came to get the two of us. There had been an accident up the road for the hotel. The report was that a truck hit a moto, the moto went airborne, and then the truck kept driving. Maeve and I arrived in our dresses (mine was still blue, so I think it should count as uniform), two white women in the middle of the street at 8pm. Both patients were still conscious but seriously injured. Someone was supposed to be bringing us gloves, but they were taking too long. So I dashed back across the street, stopping traffic as I went, to meet the security guards at the gate of the hotel. “Julie?!” I asked them. They told me in Creole that she was at the accident. So back across the street I went. But she only had gloves for Maeve. Someone else from the hotel joined us to try and assist and he had gloves. I kept requesting them but he was busy trying to be creative with a splint for the girl’s leg…wrong kind of splint, but details, details. So I started helping Maeve wrap this guy’s arm with no gloves. Surprisingly enough, I managed to walk away with his blood only on my hands and not my dress. Two points. Some of the worst breaks I’ve ever seen – this guy, who also had a head injury, had multiple compound fractures in his left arm, from his hand all the way up to his elbow. His hand was open. Maeve said she could feel his arm crunching while we wrapped it. The girl had multiple compound fractures in her left femur. After they were put in a vehicle and the crowd had cleared away, we walked back over to the hotel. The management was thanking us profusely but also looked us up and down and said, “Um…please don’t go into the restaurant.”

            This is where I give myself a pep talk! Unicef loves me, we’re going to give shots together, I love giving shots (my whole HOUSE IS GREAT, I can do anything good, yeah, yeah…) and my parents are coming next weekend!

Gedeon

I have every intention of one day writing about this past month, but until I get a chance to do that, I’ll simply write the rest of Gedeon’s story. Fortunately (perhaps only for me), he was never stable enough to leave the hospital. That meant that I could visit whenever I wanted to, even if it was 3am. He may or may not have appreciated the crazy white lady who kept talking while he was trying to sleep.

Around the beginning of December, he started posturing, which is something that happens shortly before death. But he remained alert up until the last time I saw him. I figured that he would be gone when I got back to Haiti after Christmas, so I told him what I wanted to tell him, I held his little hands, and I kissed his gigantic head.

On December 26, I received the following email:

Hi,

its Cindy, the social worker at Bernard Mevs Hospital. We've met twice I think, about Gedeon.

Unfortunately, I have some bad news. Like we all expected, Gedeon past away last week. When it comes to death, its always sad, but we all are kind of happy for him because now he is no longer in pain. We believe that he is in a better place right now.

On behalf of the Hospital, I wanted to thank you for caring so much for him. Not a lot of people do, not a lot understand how it must have been for him.

Again, Thank you so much. We all will continue to pray for him.

Sincerely

Cindy

I’m so glad to have been part of his little life. I hope he’s one of the people I recognize soon after getting to heaven. And I hope his head’s still a little bit big. 

Marathon

Every now and then, Jon says that if we actually wrote down what happens each day and showed that list to someone, he or she would either think we were crazy or not believe it. But when you’re actually in the midst of such a life, it’s not a big deal. This is my lame attempt at excusing my lack of new blog posts.

            A few weeks ago, we got in a team of six nurses. They were fantastic and probably my favorite group of volunteers to date. First of all, these women were all very easy-going and flexible. That’s about all it takes to impress me now. Our house is quite nice. And I’ve noticed that volunteers are much more apt to complain than they were when we lived in the old house. Where we drew water out of a cistern to flush our toilets and bathe. Perhaps because our house is so nice they expect things to be less like Haiti? I won’t rant on. But more than once I’ve been tempted to say, “Yes, we know it’s hot. We were also born with sweat glands.” Maybe all these people were taken hostage and forced to buy plane tickets to the Caribbean in the middle of summer.

Anyways, back to the Minnesota women. I had scheduled them to cover the day and night shifts in the pediatric unit at Medishare. Those who weren’t working at the hospital went into Cite Soleil and did mobile clinics. But if I scheduled someone for the nightshift, I gave them the following day off to recover. This group did not want recovery time. At some point during the week, nearly all of these nurses worked 36 hours straight. They were so hardworking and eager to be involved. It was fantastic. One of the nurses spent the day doing mobile clinics (walking through the streets for hours in 90 degree weather), then went with us to an orphanage where she played soccer with a passel of energetic children, then she worked at the hospital all night, and then she went with us to put on a clinic for a women’s group.

            The clinic we did at the end of the week was for KOFAVIV, a group of women who run a safehouse for victims of rape. In addition to setting up a hotline and making sure that these women and girls get to medical care, they also provide counseling. DIRT is in the final stages of formalizing our partnership with this group to provide transport and treatment for any emergency calls they receive on the hotline. We are hoping that as our capabilities grow (with more funding, equipment, and volunteers), we will be able to expand this hotline to more of a 911 and take emergency calls of all kinds. The group that was able to work with the phone companies here to get a free number is called Digital Democracy (in case anyone likes to spend time researching organizations).

            During our initial meetings with KOFAVIV, we were asked if we also do clinics. As we are an emergency medical service, we don’t tend to stock routine drugs. But we had this volunteer group coming down, and the woman who was heading the team kept asking me what they could bring. I sent her a list of medications, and when they arrived, it was just like Christmas in our house. Not only did they bring medications, they also got us two pulse oximeters donated.

            This was the very first clinic like this that DIRT set up and ran. There were some typical Haiti hiccups in the plan, but overall it went very well and we were able to treat about 60 patients. Halfway through the day, an 18-year-old girl came into the consultation room. She was happy and smiling. Our female translator had been called away, so I sent Thony, our driver, into that room for a bit. When he entered the room, she turned away and became very quiet. This young woman had been gang raped two months prior, was still quite damaged, and our nurses had to inform her that she was pregnant. They sat and cried with her, and then brought her over to the pharmacy where she hugged us all fiercely. And then everyone who hadn’t been crying before started crying. We spoke with the KOFAVIV director, and she was more than willing to work with this young woman if she decided she wanted to be part of the program. It was definitely a tough but rewarding day for everyone.

            When I took nurses to the hospital for shift change, I would stick around for a bit to hear reports and make sure the volunteers felt comfortable before I left. For some reason, whenever I have a nurse on nightshift, I feel like I’m abandoning a child. It makes me a little nervous when I go to sleep at night and one of my volunteers isn’t in the house. (Dear Mom and Dad, I apologize for all those nights I stayed out way too late…) Anyways, while rounding on these little critters every twelve hours, I became drawn to one little guy in particular. His name is Gedeon, and he’s probably around a year old. He is an orphan and has quite a case of hydrocephalus. This hospital does a program for hydrocephalus babies – periodically surgeons will come for three or four days and put shunts in. Inevitably, after the surgeons leave, all the shunts become infected. Such was the case for Gedeon. His shunt was removed, but he still had a gaping hole in his head. The infection basically ate away at his skull and you could see to his brain when the bandage was removed.

            The hydrocephalus leaves Gedeon with very little brain function. He basically lays in his bed and periodically cries. His is malnourished which makes his extremities very puffy. He has pressure ulcers on his head from continually laying on it without moving, a feeding tube in his nose, a bad case of diaper rash, IVs in his scalp and arm, and he is so unused to physical contact that he sometimes cries when people come near him. And for some reason, I think he is the most beautiful baby. As the week wore on, rather than rounding with my nurse, I basically went to Gedeon’s crib and talked to him while rubbing his arms or legs.

            I worked in the ER one night while the team was there and would run over to peds periodically throughout the night. In the morning while I was waiting for the nurses to change shifts, I was telling Gedeon how I’d just like to take him home with me. And then I started to wonder if I could. Now, I am known for my “crazy plans” (and in my defense, I’d been awake for over 24 hours at that point), but I still don’t think this plan was that crazy. Essentially, Gedeon was made a DNR (all the fluid in his head is going to kill him in a relatively short amount of time), and they were waiting for him to stabilize before sending him back to the orphanage. I really wanted someone to be holding him when he died, so on the drive home that morning, I sent an email to Jon (who was in the States) asking what he thought. There’s a priest who runs the hospital down the road from us, and each week he does a service for the unclaimed bodies at various morgues and then takes the bodies out into the countryside to bury them. I asked Jon if he thought this priest would be willing to bury Gedeon as well, and he said yes.

            At some point during the week, I was trying to fish for more specific information regarding Gedeon’s prognosis from one of the nurses on the team. I don’t know anything about sick little people, only big people. The nurse I was asking eyed me a bit suspiciously, and I eventually told her what I was pondering. A few days later, she mentioned that the only thing that concerned her was that if the baby was with me, he would do much better than if he was in an orphanage and he may live for up to a month. Obviously, I can’t take care of a baby like him for a month. So the day the team left, I went to Medishare after dropping them at the airport, and I met with the social worker. She said it would not be a problem to have me visit him at the orphanage, especially if I went as a nurse to provide care for him. (I realize that I just said I don’t know about sick little people, but I had to ensure that they’d let me into the orphanage, and a stethoscope is a key that opens every door.)

            As of a week ago, Gedeon was still in the hospital. He had had surgery to close the hole in his head and they put a reservoir on the other side of his head so it can be tapped to pull fluid off. He was still kind of loopy from the surgery when I saw him. He’d also begun vomiting up all his feeds, but I’m hoping that had something to do with the anesthesia.

            In the meantime, DIRT continues teaching our trauma management classes to the security teams and drivers for NGOs in Port-au-Prince. I’m scheduled to teach CPR to this class in about three weeks and I am not looking forward to it at all. I’m not designed to be in front of groups of people so it should go well. Or it will at least be sufficiently awkward to provide everyone with good stories. 

"What Happens If You Love It?"

So it has taken me a month to post this, but I suppose the 13-month mark is significant as well…

Maybe it’s the OCD, but it really seemed necessary for me to have some sort of blog related to the fact that I’ve now been here a year. But nothing terribly unusual happened that day. I had plans to get a ride to the first street food place I ate in PAP. Naturally that didn’t work out, since it was planned, but I did get to ride home with the police after our truck left us sit at an orphanage. Other than that, nothing to write home about. Today, however, in the midst of a perhaps not-so-wise choice, I figured it might be appropriate to dedicate a post to a few of the multiple ways I’ve been protected this year.

            My very first terrifying experience occurred about 16 hours after I arrived in Saint-Marc. Apparently I have a food allergy. Granted, I overreacted to the way the death oranges made my lips and tongue go numb, but at the time, it was quite concerning. I didn’t like Haiti, really hated that I was here, and I was convinced something bad was going to happen to me. It only seemed logical to assume the worst.

            Obviously, I lived to get into more trouble. Sometime during my first week at the clinic, I think it may have even been my second day there, I still didn’t have my consistent hired moto driver. The nurses were waiting with me to make sure that I got home. At some point, a car stopped further up the road, and Anedzia and one of the other nurses went to talk to the driver. Next thing I know, I’m being instructed to get in the car with everyone because this man is going to take us home.  We drive off down the road, Yvena and I sitting on top of each other in the front seat, dropping people off as we go. At some point, the driver shook my hand and introduced himself to me. He then did the same with each of the nurses and I became mildly uncomfortable as I realized that not a single one of us knew who this man was.

            We drove past the road back to my house and up into some hills where we dropped another nurse off. A few moments later, the driver stopped in front of a gate and everyone looked at me. “Your house?” they asked me. Not even close. We sat there a few minutes trying to figure out where I lived. Eventually, I managed to describe the park (that we’d passed awhile before) and felt mildly confident that if we could get back to the park, I could get myself home from there. As we drove back down towards the center of town, we came upon a rukus in the street. Some sort of fight had broken out, stopping a Coke truck from moving any further. More and more people gathered until they were engulfing our car like an amoeba. Vehicle violence is fairly common here…not that I knew that at the time, I was just concerned because I’d only been in the country for a week. But just as quickly as they appeared, the crowd moved on and we continued down the road to the correct gate.

            And then I moved to Port-au-Prince, where I’ve encountered a whole host of vehicle-related incidents.

Our truck is a piece of junk. A clinking, clanking, clattering collection of caliginous junk. Since we bought the truck in February, we’ve replaced the tires (who else knew that tires have little copper thread things in them?! They make funny noises when they rub against the road), caliper seals (twice), calipers, ball joints, something to do with a crankshaft, the shocks and the radiator. Apparently the engine isn’t attached right or something so every time we stop quickly, it bangs into the radiator. Still to repair: brake lights and rear window, which got broken while I was in church. I’m going to pretend the fresh oil spots in the driveway are from someone else’s car.  Mark would always say: “The squeaking means its working.” Hopefully the other noises mean the same.

            One evening, Jon and I were traveling with a volunteer up into the hills in our rear-wheel drive truck. I’d been to the house we were going to once before (in March), so I felt confident that I had a vague idea of where it was. We turned onto the correct road, which is basically a switchback, but then missed the switchback into the gate. We drove up the gravel road a bit further until I was sure we’d gone too far. At this point the road split – to the left it went up and to the right it went down, these two roads parallel to each other. We went up to the left and started backing down to turn around. I was looking out the passenger window and began thinking to myself, “Hey, we’re going to fall off the side of this road here,” but didn’t manage to get those words out of my mouth before we started leaning, as my side of the truck was now on the road down and the other was on the road up. We tried backing up a little more, but didn’t succeed in moving in reverse, only in tipping more to the side.

            We sat there for a bit at a 45 degree angle, just hanging out and discussing things. At some point, Jon said, “Okay, we’re going to roll, so Sarah cover your head on the right side.” I actually felt okay with that at that particular time, because it seemed like it was all happening pretty slowly. I figured we’d just tip onto our side and then someone would pull me out the drivers’ side window.

            But at some point during these minutes where we were sitting there and the Haitians are trickling out of the bushes to spectate and offer advice (very common occurrence, but usually there are enough of them to help – this was too big of a pickle), I realized that we weren’t just going to roll onto our side. There was going to be far too much momentum and we were going to continue flipping right off the other side of the road. If you’ll recall, I mentioned that we were driving into the hills, so we had a good 40-foot fall onto the paved road below and no trees to stop us, thanks to the 98% deforestation. That’s when I began to be concerned. I was sitting half cross-legged with my foot against the door and in between thinking, “This is stupid, I really am going to die in Haiti,” I wondered if my whole foot was going to break or just my toes.

            Eventually, Jon said that I should get out of the truck. Hillari and I were concerned about opening my door because we didn’t want the weight of it to send us over the edge. Jon just kept saying, “It’ll be fine, just do it very slowly – you’re going to have to hang onto it because it’s going to fly open.” I wasn’t sure how I was going to open the door slowly and keep from falling right out onto the ground. I also remember thinking about whether or not I should take my shoes – my favorite flip flops (bought on the boardwalk in 2002). I couldn’t find them with my feet for a bit, the darkness combined with my shaking and the fact that somehow two pairs of Hillari’s shoes had ended up at my feet as well. Luckily, I was eventually successful in locating my shoes and then managed to wedge myself into the truck while opening the door.

            I emerged and rounded the truck. “So what’s going on?” Jon yelled out his window. What went on in my head was, “…I don’t really know what to say to that…our left rear tire is three feet off the ground and we’re beside a cliff?” None of that actually came out of my mouth, except maybe the part about the tire, I just kept looking at the truck and shrugging.

            More Haitians had appeared by that time, and Jon decided he would get out of the truck to assess the situation. Hillari remained inside. I stood there beside the truck holding Jon’s door open (or, rather, up in the air) because I didn’t know what his lack of weight in the truck and the shutting of the door would do. At this point, we called Sam, the person we were going to visit, to see if he could bring some people and help us. The Haitians had brought with them one ratchet strap and were attaching it to some part of our lift kit. They then decided to get Hillari out. Jon and two Haitians were standing on top of the running board and the suspended tire to keep weight on it while they pulled her out.

            At some point during all of this, while I stood there next to Hillari, our “atheist Jew,” I started praying out loud. I don’t remember what I said other than, “Dear Jesus…thanks, amen.”

            Jon handed me his camera eventually and said, “Grosh, get way down there and record all this.” So I trekked down the road a ways, watching for Sam to come driving up and hopefully rescue us. But it was another random car that drove up. It was a Haitian man in a suit, the car still decorated from a wedding. They pulled some of the bows off his car and attached our truck to it with the ratchet strap. The thoughts running through my mind at that point were, “I hope I can find my wallet with my drivers license, nursing license, credit card, and $300 of DIRT money in all the wreckage when we get to the bottom of the hill…or is it all going to burst into flames? What happens when the EMS people don’t have their vehicle?” But finally, with like 8 Haitians standing on the side of our truck, Jon turned it back on and backed it up…or the wedding car guy pulled…maybe some of both – I was intent on my filming after the “GROSH ARE YOU GETTING THIS?” and missed the details. Nevertheless, they got our truck upright again, it still runs, and nobody was hurt. Held up pretty well for a piece of junk.

            These are the things I pondered today on my walk. I had three female volunteers with me, as we had been doing education for a women’s group run by a non-medical organization. Afterwards, we had gone back to their house to wait for our ride. What was to be a one hour wait eventually turned into four. At that point, Jon texted me and said they would be there for us in another hour and a half. He suggested that we might want to borrow some money and take taptaps home. I don’t really like riding taptaps and didn’t feel like I knew well enough which ones to take. I also didn’t really want to risk getting really lost as a group of girls. I suggested to the volunteers that we could catch some motos. They were less than thrilled. So we were down to two options: wait for Jon or my new idea of walking home. I obtained permission from Jon to walk, he thought I was crazy, but agreed to it. After convincing the girls that I thought we could make it home in an hour, or at least before our vehicle did, they reluctantly agreed to it as well. And we set off on our three mile walk through Port-au-Prince.

            I thoroughly enjoyed myself. I can’t say the same for the other three. At one point, a street kid started yelling and chasing us. I initially ignored him because I naturally assumed he was going to greet me with “Hey you, sista, give me one dolla,” but then I realized that I knew him. It was a weird and kind of cool experience – personally knowing street kids is not something I’ve processed since.

            When we reached the busiest sections of town, I began wondering how dumb this actually was on a scale of 1-10. Then, coming from across the intersection, was one of the Haitian boys who lives at our house. He walked us the rest of the way home, and I went back to enjoying myself and the rainbow I happened to notice in the sky.

Third Time - Just As Charming

I am still a ninja. A body fluid ninja. I thought that I might’ve lost my skills after so much inactivity, but cholera outbreak #3 (occurring exactly 9 months after the original outbreak, for those of you that also find dates interesting) confirmed that I’ve still got it.

A week and a half ago, I was looking forward to sleeping in after a few days of mobile clinics. Jon and I were sitting at the table after everyone had left for the day when my phone rang. On the other end was a semi-frantic sounding Fabienne (medical director for MTI), talking a mile a minute. “Oh good. Does the new guy have Mark’s phone? I think he’s ignoring my calls. I’ve been trying to get you since 2am. Cholera has exploded in Port-de-Paix. Wednesday night they had 50 patients, by last night it was up to 100, and as of this morning they have 250 patients. They’ve overflowed the hospital rooms into the hallway and they’re spilling out into the yard and the walkways…” She continued to fill me in, said she was going up that afternoon with some logistics people from GRU, then said, “Can you come with me?”

            After some discussion with Jon about how the week would work (including how we were getting a 16-year-old paraplegic girl to Minnesota for surgery), he assured me he would be fine and said I should go. I called Fabienne back and was told to meet at MTI to leave at 2pm.

            It turned into a Haitian operation. I got to MTI at 2 and waited around for a while. At 3pm, I thought, “Oh, we’ll probably be in the air in an hour,” so I took my dramamine. For some reason, I was under the impression that we were flying up and working the nightshift, since Evangel (MTI’s long term head nurse) and Nick (their volunteer) were there alone. At 4pm, we left MTI and drove to GRU. Where we continued to wait around. When we left there at 5pm, got gas, and then had a brief prayer session, I realized that we were, in fact, driving the whole way to Port-de-Paix. A six hour drive. On second thought, yes, I will eat that bag of Fritos, thanks.

            The highlight of the trip was definitely reaching Saint Marc before sunset and being able to see my old house from the street. That wasn’t too long before I got really drowsy and we turned onto a dirt/gravel road. I kept thinking, “Okay, we’ll soon be off this road, then I can put my head against the window while I fall into a coma.” But the road never ended. Shortly before we reached MTI’s apartment around 11pm, I regained consciousness long enough to see the lights from the island of Tortuga.

            Luckily, I had assumed incorrectly once again, and we weren’t actually going to work the nightshift. So Saturday morning, bright and early, we headed down the street to Centre Medical Beraca. I stepped through the gate and was actually overwhelmed for around 6 seconds. I think I actually said “holy cow” out loud. By that morning, the number of patients had risen to 330, and they were laying absolutely everywhere. It all hit me at once, the sheer number of people (because every patient had family members with them), the smell, and that feeling that I can’t explain. What was different was the noise. It seemed so loud. Maybe it’s because I’ve always worked cholera at night. Whatever it was, after those first few seconds, I snapped out of it and went to work.

            We worked into the early afternoon, then it was decided that Evangel and I would go back to the apartment, sleep for a few hours, and return to work the nightshift. I was happy with that – I had actually volunteered myself and kept pushing to have some of us on nights because that’s when things were bound to get crazy. It felt weird doing cholera without any marines, and I was hoping the familiarity of the darkness would make it seem more normal.

            The only things I clearly remember from that first night are the absolute frustration Evangel and I felt with the Haitian staff, the stress of all the patients and family members (we peaked at 400) calling us and tapping us every three minutes all night long, and thinking I was going to be sick. At one point, I thought I was going to pass out and asked Evangel to take my blood pressure – 85/50. She’s like, “Why don’t you just sit here and drink your water?” For those of you who have lots of experience with passing out, you know that it makes you feel a little nauseous. Not something you want to feel while working cholera. All I could think of was how embarrassing it would be to get cholera, especially since I’ve said so many times that you have to try really hard to get it. As the week progressed, we discovered that I really only had strep throat…which then moved into my chest. The cough I still have is a souvenir from the week.

            I decided I should try to write some things down during the week if I had a chance. From Sunday morning, after our first nightshift:

“One of the 3000 times I was frustrated with a patient and/or family member last night, I said, ‘Why can’t you just trust me?! I’m not going to let you die!’ When I’m not stepping over bodies or watching someone puke rice water on my boots, I feel a little bit of weight from that. Especially since I watched the woman I thought was dying while I held used tape over someone else’s pulled IV site…Should sleep. It’s a trade off – there aren’t dead bodies in the break room here, but I’ve gotta sleep on IV tubing instead of water bags.”

Tuesday

“Scratch that. Evangel and I found the best sleeping spot ever. Absolutely gigantic water bladders full of potable water. Didn’t I just say a month ago that I wanted a water bed? Right outside the gate by the new tents but close enough that we can still hear who’s puking (and a Haitian nurse come change the bag, conveniently enough).

Last night was by far the best (of this outbreak). The staff has gotten into a routine and they evaluate people a little better now instead of just jabbing every person that sits in front of them, so its relatively calm until like 4am. I’m not sure if everyone wakes up to discover they’ve got cholera, or if the nurses get sick of individualized treatment, or just feel like they haven’t gotten to practice their skills enough during the night, but we run a lot more lines in the morning/around change of shift. But Ev and I took over triage this morning. The Haitian nurse moved into the walkway to put a line in a kid Evangel asked for help with because we were both starting IVs in active pukers. So then people that didn’t like that I said they just needed to drink went to her and she stuck them! We’re like, ‘Mm, no no.’ We’re getting good at being mean. Or, Evangel and Nick are; I was already jaded. But she told people that if someone really sick comes in we won’t have fluid to give them and they’ll die because someone who didn’t need LR got it.

Moved mystery worm kid to Urgence. Really humbling when I was first evaluating him this morning – he’s still sunken and floppy but hasn’t been puking for a day and he drinks. Still has weird yellow diarrhea. I was leaving the room to see if there was a place in the tent, still talking to mom. Some woman laying on the table was saying, ‘Nis!’ repeatedly. Irritated by being interrupted yet again by someone who probably wanted me to know their IV was finished when they’d been told that now they could just drink, I sighed and was like, ‘Okay, tale [wait]!’ After I was done talking, the conversation went like this: ‘Okay, ki sa [what]?’ Blah blah, couldn’t hear her. ‘Sa ou bezwen [what do you need]?’ Then mom says, ‘Li renmen ou [She loves you]!’

Patient count yesterday afternoon was 328, so going down. 122 discharges, 104 admits. The second night was when I discovered I still hadn’t been in the actual hospital. Ha.

Officially have red bumps on my big tonsils and the back of my throat but I don’t feel like crap anymore. The perks of having a fever in Haiti are that you get cold enough to have goosebumps…”

My last night working was quite eventful. Evangel had gone into town to get supplies earlier in the day, so she planned to sleep for awhile and go in late. I wasn’t wild about walking to the hospital by myself in the dark in an area I wasn’t familiar with. But eventually I figured I had no choice. I went over thinking to myself, “Okay, situational awareness, situational awareness.” So knowing what was beside me caused me to miss what was in front of me. I tripped over some concrete, nearly falling into dogs that were circling a street fire.

            When I got there, I found the entrance and back hallways had been cleared out. The census was down to 240. I actually thought it was creepier with all the people gone.

            Ten minutes after I got there, I was rounding on the patients in the Urgent Tent and a nurse came running over for me because a kid in triage was seizing. There was not a thermometer in the whole place. He seized again 80 minutes later, for 45 seconds. I got the ambu bag for that one. Not sure what I intended to do with it. Evangel got there soon after with valium. The seizures weren’t cholera related, so my initial assessment had been correct, which was encouraging. He did fine throughout the rest of the night, and we had the doctor see him in the morning.

            Around 3am, we heard an ambulance pulling up. Confused, we went to investigate. There was a woman, she looked around my age, very pregnant and in labor. We took her into the actual hospital and stayed with her for about an hour and a half. She’d had two C-sections before and they decided to do another one for this baby. I was trying really hard not to laugh. I’d only been able to sleep for two hours that afternoon because people woke me up to ask questions and Jon had been calling me from Port-au-Prince. And then it was just too stinking hot. Anyways, the exhaustion made lots of inappropriate things funny. But the pregnant woman was also really cute. She’d go from screaming and singing during contractions to just having a very rapid conversation. In the middle she’d of a sentence (or, that’s what it seemed like, I couldn’t actually understand her), she’d pause and go, “Nis…” and look at Evangel like, “Please rub my back again.” Around 5am, we heard the generator go on for the surgery.

            Around change of shift, Evangel and I found a guy laying by himself on a bed out in the grass between the Urgent tent and the building. He was unresponsive. He had a line, but it was little and wasn’t running that well. I looked at his hands and said, “Heyyy, a molasses man.” Evangel gave me a really confused look, and I tried to explain while we were both sticking 18gauge needles in his arms. “This is how most people looked in Saint Marc. Because nobody knew what was going on, they were all super sick.” This particular guy was so dehydrated, his veins so fragile, Evangel and I both blew our lines. So we ended up putting a bp cuff around his current bag and inflating it as far as we could to run it in really fast.

After two bags he started perking up, getting a little confused. At one point we had to go catch him so he didn’t fall out of bed. Evangel was talking to two guys who wanted jobs as a translator and I was being the one-on-one for the climber, when a Haitian nurse comes up to me saying, “Problem!” I was like, “Uhh…okay. You stay with this guy, don’t let him fall. Where’s the problem?” In the Urgent tent. I had been there half an hour before, and everyone seemed to be doing well. We were actually taking out some lines and sending some people home. One old lady (the woman I thought I watched die the first night), had been sitting up eating when I was in there before, so she was about ready to go home.

            But when I walked into the tent, there she lay on the ground. The huge flies that had been attacking us every morning when the sun came up were buzzing all around her. I checked for heart sounds as a formality, then closed her eyes. Evangel came into the tent then and we both stood looking at her for a few moments. Just a few hours before, the two of us had been talking and she asked if there was something wrong with her because she didn’t necessarily have a lot of emotions regarding all the patients. I told her that there might be something wrong, but I felt the same way, so we were at least in the same place. But we both felt something while we stood with the patient’s husband.

            Before we went back to the apartment that morning, we checked in on our new mom. The baby was a girl. Mom was happy to see us. She was really smiling, but she was also shaking. We told the doctor that we thought she might have an infection and he went to examine her. We went to sleep. A few hours later, I was awakened by a phone call from Jon that started out, “Sarah…don’t freak out…” He’d been in a moto accident and ended up missing his flight to the States. He was also having a mild panic attack about getting the medevac patient onto the tarmac. I tried to be very calm. After I got off the phone, I sent my own panicky email to Mark. While I lay there unable to sleep, the doctor and some of the MTI staff came back to lunch. I overheard them talking about the C-section patient. She had died.

            Just a few hours earlier, I had been talking Nick through the death of the older lady. He kept talking about what he should’ve done differently – how he should’ve checked on her more or been more diligent with taking blood pressures. I tried to reassure him that he did all he could. This was, in fact, exactly what had happened to my first patient that died – the lady in the blue dress. She had recovered from the actual disease, the cholera wasn’t in her body anymore. But the stress on her heart from the electrolyte imbalance was just too much. That all makes sense enough that I could let it go. But my pregnant lady…that one actually woke me up the next night and I sent one of my friends a “what the heck?!” email.

            By Thursday, the census was down below 100, and I needed to get back home for an incoming volunteer. After we’d driven for about three hours, I decided I’d be audacious enough to ask if we could make a five minute stop in Saint Marc. The country director of MTI said he’d do me one better and we’d stop and have lunch there. We stopped at the Deli Mart, the last place I’d eaten out there (interestingly enough, it had been on Thursday October 28, nine months to the day – thanks overactive memory). I was too excited to sit still or eat anything.

            When I finally directed Ted down our street (a few minutes prior he’d said to me, “When you’re done being lost, let me know”), it looked like a ghost town. There were no kids on the basketball court. The market was gone. In its place was a fenced in concrete…area. There were still those few moto drivers by the fence harassing me, though, as I walked up to my gate. At the same time, Merites rode up on his bicycle. I called his name and ran up to hug him. “Ou sonje mwen [Do you remember me]?!” I asked. “Wi, Miss Sarah!” he hugged me again. I went through some formalities, then asked after the small child. “Is he here?” “No.” My face fell. But then he started talking again, and I caught enough of the words to realize he was asking if I wanted someone to find him. I said yes, and then he asked if I wanted to come in.

            I sat in the courtyard on a kid’s school chair that Merites cleaned off for me. There was a new painting on the wall and two more basketball hoops. (Interestingly enough they were positioned on different walls than before – does this have something to do with me popping the one soccer ball when I threw it over the hoop and into the barbed wire? We’ll call that part of my legacy…) After about ten minutes, I was starting to get anxious. I didn’t know when they were going to find Licson, and I felt bad for the people in the car who were gracious enough to make this “five minute” stop. Then his dad came running through the gate, followed by the small child with a huge smile on his face. I ran up to him and gave him a huge hug. I feel like he’s grown up since I left – he’s definitely taller. We talked for a few brief minutes. Then I said that I needed to go but that I would come back again – I don’t know when, but I will come back. I hugged everyone again and walked back to the truck. Even though I’d said goodbye to all of them in November, I feel like I got a little bit of closure from that visit. Definitely better than screaming goodbye to people across the street while I’m taken away in the back of a truck.

            And now here I sit in Port-au-Prince, on Wednesday the 3^rd, (the day of said kidnapping), awaiting a tropical storm. Like I know I’m weird about the date thing…but this is a little weird. Tomas on Thursday/Friday November 4/5. Now I just have furniture and I’m sweating more. I’ve been here too long…I’m really not terribly concerned about this storm. (Besides, the hurricane center says she’s “become disorganized”…how much damage can a disorganized storm do?) I’m considering strapping myself to one of the columns of the carpark. I’ll let you all know how it goes.

It Takes A Village

This is why people have nine months to prepare for children. Maeve and I were acting as foster parents this past week, and I contemplated going to bed at 8pm tonight. Baby Ralph (who’s real name is Markensson) is a 6-10 month old Maeve has been dealing with since I went home in May. He was brought into the clinic with a chest infection and was treated in the hospital. He ended up staying there for about a week because of social issues. He is not being raised by his parents, and there are many different stories circulating about where his parents are/if they are still alive. The hospital wanted to put him in an orphanage. Maeve was trying to avoid that, but eventually did find one the hospital worked with that she felt was acceptable.

Baby Ralph was finally discharged into the care of his “aunt” (who always works during the day, so it’s really an 11-year-old girl that takes care of him) on the condition that they bring him back to the clinic each day so Maeve could give him his antibiotics. Last Tuesday I got a phone call from her asking if we could take him in for a few days. Somehow he got an infection in his arm, and he had two draining wounds. We think they were in a sinus or something, because they were also draining into the area outside his lungs and giving him a horrible cough. But the hospital wouldn’t take him back because of the social issues. So I was sitting at the kitchen table when she walked in holding the little bugger, shrugged her shoulders, and gave me a look that said, “I didn’t know what to do.”

Night One: We put the baby to bed around 8:30 (in our bed…did I mention that Ralph also had scabies?), and Maeve went to bed shortly after. I, of course, stayed up for awhile longer. I think I finally went to bed a little before 11. I’d been asleep for about half an hour when he started crying. The whole night is running together in my memory now, but I know that he was up again at 12:30, 1:45, and at 2:30, Maeve and I just stayed up talking until about 4. We’re pretty sure he got spoiled at the hospital being held all the time, and they had said that he slept all day and stayed up all night (thanks for that, daytime nurses), and he was teething on top of that. We wanted to just let him cry, but unfortunately, the landlord’s wife is in during the month of July, and she had actually wanted to kick us out. But for some reason, she graciously allowed us to stay in the bottom floor while she’s here. So we didn’t want our crying baby to wake her up.

Ralph woke us up yet again at 5, and Maeve asked if I would take him for a little bit since she had to get up soon to go to the clinic. Now, Ralph isn’t content to just have you awake. He doesn’t want you to get in a comfortable position. So even though I was holding him, it wasn’t enough for me to sit up in my bed. I had to be standing. So we went outside and walked around the house for an hour and a half. I tried sitting down in some of our broken bag chairs from the old house, but again, comfort does not equal happiness for the Ralphster.

He started doing this little thing where he’d yawn and then sigh. Like he was just exhausted from working really hard or something. It was irritating because it was so stinking cute. Keep me up all night and then sigh about it.

A little before 7 we went back in to wake up Maeve, and then we were going to feed him. Maybe it’s because he usually just has flour and water, but for some reason he was just not into beef and vegetable baby food. I was holding him, and Maeve had spooned over half a jar of food into him. Then he decided that was enough. Hot orange puke. All over both of us and the bed. Mornings are not my favorite. Maeve almost fell over from laughing so hard, but then she did also clean the puke off my arm and legs because I just continued to sit there.

We got Ralph a pacifier that day, and that helped a bit. Looking back, he really did sleep a little better, but we also got exponentially more tired throughout the week, so every time we woke up it was just 12 times worse (I know, all you actual parents are laughing at us). At one point, maybe during night four, I woke up to hear Maeve telling Ralph that she was going to put him outside the window. (I think that was also the night he peed on her.) We also considered putting him in the tent with Uncle Mark, but thought that might turn out worse for us in the end. (That may have also been the morning when we tried to murder the chickens with a lacrosse stick, but the loudest one got up into a tree. When the baby is actually sleeping, I don’t want to be awake due to some bothered rooster.)

At the end of the week, we had to return Ralph to the “aunt” (but really the 11-year-old), so that Maeve wasn’t accused of kidnapping him. He is not able to go to the orphanage now because we don’t know that at least one of his parents is dead. Different stories continue to circulate regarding their existence/whereabouts. But the little girl brings him back to the clinic each day, and we may end up getting him back again.

I think it’s amazing how quickly you can feel parental. The third night he was here, Ralph was in our room with the door shut. I was sitting at the kitchen table talking with people from another group who were taking their meals here. The Haitian staff had the TV blaring at a ridiculous volume (as usual), plus the radios on, plus the generator was running. And then I jumped up and went to my room because I knew he was crying.

And now the section where I brag about my foster baby. While he was here, Ralph learned to hold his own bottle. He still doesn’t hold it up in the air, but he can hang onto it. The way he sits is absolutely hilarious. I’m not sure what’s not quite right about it, but he looks a little bit like a little frog (he also reminds me a little bit of my cousins Eric and Lindsay’s dog). And he’ll sit there and then just suddenly do a face plant. But it’s kind of like he intends to do that, because then he’ll just stay here and cuddle up to whoever he just fell on. Something he loves that actually makes him sleepy is when someone rubs his nose. So basically, he’s just like Bud. (Because Baby Ralph is also beautiful.) And he has the cutest little smile. Which he whips out at inappropriate times, because usually you’re trying to be mad at him. And I can’t wait to have his little ‘fro cuddled up under my chin and kiss his little face again.