Wednesday, July 26, 2017

Busy days!

July 26, 2017

We have been so busy. Then, at the end of the day, when I can finally sit at a computer, sometimes the internet is down. Like tonite. I’m writing this offline and hopefully can post it tomorrow.

Yesterday I went to the ti-clinic. That is the little clinic, meaning 15-20 women will show up as opposed to 60-80. It is 45 minutes on a motorcycle (three to a bike of course!), down the dusty, development road out of Hinche. The midwives come every week to this countryside outpost – a small shack with a dirt floor, a cot, a table and 2 chairs. Outside are wooden, school-room type benches that I assume makes this a small church or schoolhouse. We saw only 10 women, 1 newborn. The midwives talked to them about eating good food. Many of the women seen had had prior C-sections, with wide, vertical scars to their belly buttons. Hinche is just finding the resources to do C-sections now. VBAC is nowhere on their radar.
Upon arrival at the hospital today, all appeared quiet – one woman awaiting a repeat C – section. By 10am, 2 babies had been born – one by C-section, the other to a 3rd timer with high blood pressure. Four midwifery students in bright pink scrubs are working together and attending to the women. Tout bagay anfòm. All is in order. All is good.

There is a new set up in the hospital for the maternity ward. Four exam tables are lined up in a rectangular room, separated by shower curtains blowing in the breeze of the multiple floor fans. White tile and 3 big windows make the place feel clean. Minimal inspection is necessary to notice the blood on the floor, dripping from the end of the exam table where the woman is resting after having given birth. The eye catches the detritus on the moving shower curtains, an unidentified bodily fluid. All of this is an improvement from the last maternity ward, despite the fact that the midwives say that the whole place is too small. When four are delivering at once, I am sure this is the truth.
Despite making 95 baby packs with sanitary pads and “sexy coulottes” (white mesh panties), none of the women I have seen so far in labor and delivery have these supplies. Cloth rags are folded into rectangular wads and placed in a clean pair of underwear. The family brings in a clean pair of clothes for mom and baby less than an hour after birth so that they can both be moved to the postpartum ward. I feel desperate for the supplies, yet I know that there are just so many women coming in. So much to do. We will pass out some of the packs tomorrow at the large mobile clinic so that the women can bring them in when they are in labor.

Other happenings:

Viola and Eva have been going to the orphanages every day. They love the girls, the girls love them.

Dr. Laura has been training 4 midwives how to use a small, portable ultrasound. This is extremely valuable since the Haitian doctors here charge exorbitant amounts to do the exam. There are moments when the midwives need to diagnose a fetal demise, twins, or difficult fetal positions. This is a valuable addition to their skills and services. Until the ultrasound machine breaks down, of course.

Dina has been playing her ukelele, helping with our resident, 6-week old baby. The baby’s name is Mitsushi, but everyone calls her Sushi for short. Her mom is a student with Midwives for Haiti. She’s a single mom and brings the baby to the Midwife House every day before she heads to the hospital for a morning of training in prenatal care. We adore her.

Miss Genette’s brother, Angelo, opened up a fabulous hotel with 14 air-conditioned rooms. Whaaaat?? She invited us all for dinner at the hotel where we met some Canadian teachers. This is where y’all will stay when you come to Haiti with me next year! 

We gave blood today.

Sunday, July 23, 2017

Haiti - We are here!

It took us two days to get here, but no time at all to fall in love with Haiti all over again. It is hot and sweaty and dusty and we love it! Having skipped last years trip due to the Zika virus, we haven't seen our friends in two years. The girls at Maison Fortune have grown older and 20 new girls have been embraced into the fold. That leaves the count at 84 girls at the orphanage. We have clothes and shoes and lollipops and band-aids. Soap and hair bands and underwear. Ti-flashes for our traditional party with them on the day before we leave (a ti-flash is a small flashlight). Viola and Eva took their Kreyol class today and sorted mounds of donated items. We made baby packs, and got a tour of downtown Hinche after Mass. We saw Miss Genette and Miss Philomene. Tomorrow I work in the hospital and a new postpartum home visit program.
We are here!

Monday, August 10, 2015

What day is it?

After a hugely successful week, we arrived in New York City. Not without our final medical adventure though.

After our 3-hour car ride from Hinche to Port Au Prince, checking our much reduced baggage, and settling in to await our flight, Viola fainted and threw up all over the floor. Although she has had episodes like this before, it was still quite dramatic and worrisome for all of us. We laid her down on the floor and I rubbed ice on her neck and back until she felt better to sit up. She borrowed an extra skirt from Norrell and felt good enough to walk onto the plane. The plane ride was uncomfortable and harrowing for her though, vomitting again twice. By the last leg of our trip, Miami to JFK, she had stopped throwing up but was now experiencing body aches all over. Could this be chikungunya? Ugh. She was able to lay across 2 seats with her head on my lap, and that got us landed in New York.

By Sunday, Viola was feeling intermittently better, but still not 100 per cent. Dina was the next to start feeling some intestinal distress. Because Viola is almost back to normal, I am convinced that it is not a mosquito-born illness like chikungunya or Dengue fever. She never had a fever. But most likely, the combo of illness from the toddlers at the Azil, water-born microbes and motion-sickness. Dina seems to have a typical Haiti dysentery. It is a hazard of the trip. We all managed to stave off the mosquito bites, maybe half a dozen each. But it is so hard to make sure that you do not drink the water. We took daily bucket showers and water can get in your mouth. We ate produce that hopefully and probably was treated correctly for us, but so easy for something to slip through. Even the way dishes are washed can lead to an unfriendly microbe ruining your day.

So, we are here in NY. Viola and Dina are sleeping way passed 10:30am. I think this will be the last post unless I put up some more photos here and there. Thanks for tuning in, thanks for all your donations, whether you donated money, time, clothes, stuff. We made it all happen together and supported a small town in Haiti, called Hinche.

Thursday, August 6, 2015

Kijan ou rele?

How are you called?

Aug 6 Blog:
Guest Bloggers: Viola & Eva
            Today, in order to remember the names of our sixty five friends at the orphanage, we decided to take photos of each of the girls with their name tag. With the much needed assistance of Barbara, we managed to pull it off with minimal chaos.

Wednesday, August 5, 2015

Three for One!

We are quickly falling into a regular rhythm in Haiti. Volleyball at 6am (Maria and Norrell “off to work”), then a big nap for us, off to the boys’ campus for lunch and Kompa-guitar playing, moto-taxi ride to the Azil (the orphanage run by Mother Theresa’s order), moto-taxi to the Midwives for Haiti house for dinner and intermittent WiFi, then back to the girls’ for partying and cold-bucket showers.
Last night was especially hot, but that didn’t stop us and the girls from Maison Fortune from hanging all over each other for hours.  Sophia has an amazing voice and we prompt her to sing her favorite songs for us (Justin Bieber). At one point she wanted me to translate Bieber lyrics into Kreyol. She would sing the line in what she thought was English, Viola would translate it to me in English and then I would attempt to translate in Kreyol. It was exhausting and hilarious.
Our Kreyol is getting better and better (pi bon!). Last night I was so proud of myself when I figured out that Islande is actually NOT speaking Kreyol but nonsense words. That was until Viola told me, “Oh yeah, she always does that”.
Today was long, exhausting , and fun. I did C/S number one at 11am.  Dr. Celestine gauged my interest in doing the surgery.  I said, “Sure, I’ll do it,” so there I was in the OR, without him.  Luckily the scrub tech and the anesthesiologist were both Cubanos, so we had a good time.  Sponges and sutures seem to be rationed; sponge, suture, and instrument counts were nonexistent.  EVERYTHING is broken in the OR, but rigged just so.  My second C/S was a 28yo HIV+ lady whose first baby died.  She had an ugly vertical keloid scar.  I did her C/S +tubal and an extensive scar revision. C/S number three for the day had “CPD”, basically completely dilated with extensive caput after just one hour of pushing- a soft call, but not my place to lecture them today.  By this case, people were coming into the OR to watch and some were taking pictures of me. 
There was one patient who took a large dose of malaria medicine in an attempt at self-abortion.  She got the D&C, just like she did at her last undesired pregnancy.  This is a mainly Catholic country, where pharmacists don’t usually sell Misoprostol to women, and where many women are denied tubal ligation due to their age (i.e. under 35yo with 3 kids and 3 late miscarriages did not qualify this week, but the HIV+ lady got her desired tubal).

Chajman lou a. The heavy load. I am here because I think I am helping. If I wasn’t able to do even some small part, I think I wouldn’t come. But the load is heavy and many hands make light work. Veronique, the house parent at the girls’ orphanage where we are staying, is in charge of 65 girls from ages 3 to 20. She knows exactly who is who and what their particular needs are. She knows the 3 girls with learning disabilities and she tells me that she gives them extra special time with her. She is dedicated and committed.  Together we brought our little 3-year-old with the burns to the state-of-the-art hospital an hour away.  She was happy to have me along, as she had never been there before.
Thus a question: how would you know how to access a health care system if your whole country has never had one? As Haiti’s healthcare infrastructure grows, so does the need for the people to know how to use it. I was happy to feel useful, certainly knowing how to work the system even if it wasn’t my own. We waited for 4 hours to see an emergency room doctor. On the crowded benches that looked like pews, a man said that he had been waiting for 24 hours.
No way, I’m an advocate if nothing else. I had taken a tour of this hospital when it finished 2 years ago, so I knew there were other areas where we could go. By talking to a doctor at the nurses station on Pediatrics, I was able to gain entrance into the actual emergency room through a back door. I just wanted to talk with someone and try to get our little girl triaged appropriately (and much quicker than 24 hours).
 I found a blond American doctor. (We certainly do stick out here.) She was from New Orleans, and I understood later that she is one of the teaching doctors here for the Haitian medical residents. People deferred to her. She was willing to come out and look at Jenica and let me know if we should stay or not. Movement in the right direction. She looked at the burns and actually thought they were 2nd degree, no admission to the hospital needed, but in order to get meds and bandages, we needed to wait our turn in the waiting room. Pray some more for help soon.
It certainly begged the question: how long do we wait? 3 hours? 10 hours? 24 hours?  It seemed like we were close to being seen, but it was still so hard to tell. The girls (we had brought along a 4 year old with a rash, too) sat quietly, drinking a kool-aid drink and eating a Haitian street sandwich. Darlene takes care of Jenica like an older sister. Mind you, she’s four. More people fill the Emergency Room church of Paul Farmer. Most have home-doctored injuries like our Jenica. Will they all wait 24 hours for care?
One thing that’s different for sure about the Haitian system and ours: we paid $1 for Jenica to be seen.
Three hours into our waiting, a young Haitian doctor appeared by the reception desk. I jumped at the chance to talk to him and simply ask where we were in the queue. A 3-year-old with burns? He didn’t even know about her! But he was friendly and kind, and went looking for her chart.
By an hour and a half later, Jenica had been seen by the doctor, received sedation to do the debridement of her burns, and was all bandaged up, ready to go home. I was truly grateful for the care for our piti (little one). The female Haitian doctor that we saw was competent and compassionate and obviously knew what she was doing.
Am I helping? For one, I know that I am just as committed to our home base-orphanage as I am to the midwifery program. We are here and we help where we can. If it is helping Veronique and a 3-year-old, so be it. If it is resuscitating a newborn in respiratory distress, so be it. If it is helping the midwives to stay committed to their work, so be it.

The load is heavy. I am willing to do some lifting.

Tuesday, August 4, 2015

A Haiti Day

Prestige is the local beer here and we sit and drink. It has been a long Haiti day for all of us. Lots of stories to tell, but for now, I will just send photos, and rest. A longer post tomorrow about our adventures.