Reflections on Our Journey to Haiti

Back in our air-conditioned world at the Miami hotel room on Friday night. Neither one of us is able to sleep, just too much to process–-countless faces, smiles, conversations, encounters, and issues - big and small, administrative, operational, and clinical details. We miss our colleagues at MN – they have become a big part of our lives the last few days, especially the women and children that waited so patiently at MN for services.


En route to Kansas City we talked and distilled our collective experiences and observations, as we continue to do back in K.C., slowly easing back into our daily chores, deadlines, and a different timetable. Admittedly, it has not been an easy transition, and we know that it takes time. Meanwhile, this period after a very intense trip is allowing us to reflect on things objectively, which is important.

Our last thoughts and conversations before we boarded the flight to Miami (from PaP) were about the synergy that exists between our two organizations-–the Kansas City Foundation and our Birthing Home in Haiti. As we discussed and reminisced about our colleagues, their passion for serving women and children in their community, and their quiet determination and strength, we realized that the recurring theme throughout our stay and during conversations with our colleagues was about the importance of education and communication, not only between our two entities but also for the people we serve, especially women.

Nobel Laureate Amartya Sen has argued in his book “Development as Freedom,” that the single most important investment a nation can make in its future economic development and the well-being of its citizens is the education of women. Sen demonstrates that “women’s access to education enhances their ability to exercise decision-making power in the home and enhance their control of the quality of their lives and those of their children.”

In the micro-credit sector in India, in impoverished places in Sub-Saharan Africa, and in my nonprofit work stateside, I have learned about the importance of education in empowering women to take charge of their health, finances, and education. Our lives are governed by universal needs that demand equal access to basic human rights, and being able to enjoy good health is one of those rights. And MN, along with countless other NGOs in Haiti, is working tirelessly to organize and provide “conditions” necessary for good health-–through medical, social, cultural, political, and infrastructural means.

MN’s work in Haiti is testament to the power of women’s education and the attendant raising of their awareness. Time and again, we heard from women themselves, and the staff, how education (in the context of health) is changing mindsets and lives. Even men are becoming interested in learning more about vaccinations for their children and the importance of family planning. There is also a growing awareness about the importance of attended deliveries for women, not only within their own families but among other women in their community-–that it saves lives and improves quality of life.

Betsy frequently says that we are not giving Haitians a hand-out but rather a ‘hand up’! This distinction is important, and applies not only to the work we do for mothers and babies but also to our colleagues in Haiti. We provided some tools-–a location, infrastructure, the equipment and supplies, basic methodologies and universally accepted guidelines for healthy mothers and babies, and most importantly, our trust and confidence. They took those tools and with determination applied them to their community! We did not do anything ‘for’ them, but empowered and respectfully allowed them to do for themselves.

It is admirable and gratifying to see our colleagues take these tools and enhance them with education, training, initiative, and desire to learn more–for improving the maternal and child health in their community. They continue to desire to make and are making a profound difference in the quality of life of women and children, which directly impacts maternal and neonatal mortality outcomes.

Our staff not only perform lifesaving health procedures, they educate women during all phases of patient interaction at MN. There are handouts and presentations in Creole that demonstrate techniques, teach good health, offer common and shared experiences, and provide cultural anecdotes and stories - all in order to spread education and awareness about maternal and child health.

As a result, the community is craving more and demanding more. We witnessed this first hand when we visited some mothers at their homes, and when we participated in a community health committee meeting. We face the joyful burden of the community demanding more as awareness spreads about our work in the community, and through “word of mouth” of mothers who experience the quality, compassionate and effective care at MN. We need more space as our patient volumes increase, as women keep coming from not only our zone of service but beyond, from nearby townships, and further away.

We will tackle it all, slowly and with the help and commitment of our staff, for not only do they execute a superb model of care, they continue to make it better! We are proud to work alongside them, even if from quite a distance. And, we have so many people to thank for making this hard and life-changing work possible! I don’t think we have the words to express our gratitude and appreciation to our staff in Haiti, our board of directors in the U.S., our founders Betsy and Stan, and all of YOU – our volunteers, donors, friends and advocates. YOU make this possible. Without YOU, we cannot continue to do this work of giving Health and Hope to the beautiful people of Haiti. Thank You!

Thank you also for your encouragement, love and support. Thank you for accompanying us on this journey!

MN has more than 40 Haitian staff at our Birthing Home and we are open 24/7. With everyone attending to patients, it is hard to gather for a staff photo. The picture below features some of our colleagues who had a moment to spare.

Our Journey to Haiti - Day 7 at MN and Return to Miami

Thursday, August 5th – Our Last Day at MN!
I woke up early to spend few extra minutes enjoying my morning routine – two cups of coffee with milk that’s fast becoming my favorite, and catch up on writing on my MAC.

Morning Coffee and Writing

We arrived at MN around 8 a. m. today. Just like other days, there are lot of mothers and children waiting to be seen. One of our consulting rooms is full of beds on the floor, where moms, who have given birth last night, are resting. Our post-partum beds are full as well. By late afternoon, some mothers were given the OK to leave and the consulting room was used again for its original purposes. Our staff is incredibly flexible and adept at accommodating changing needs and priorities.

Newborn at MN

Because Internet access at our lodgings has been spotty, we took few minutes to check emails to make sure all is well at our KC offices. It was good to find encouraging comments and support from MN friends on our blog – Thank You All. Lack of connectivity coupled with our time spent on tasks we came here to do, means that we can’t always email our supporters back home timely or upload pictures from our travel. However, out of sight is not out of mind – and we are grateful for your love and support and it makes our work here possible!

Patient In-take at MN

We got ready to finish our remaining tasks at MN. I took some time to take few more pictures of colleagues hard at work and of mothers and children. Our first interview of the day was with our Community Health Coordinator, Louis (who is a real charmer!). He happily shared how the community health program works and how he and the promoters plan strategies and tweak their approach to their educational and awareness work per the community needs.

Louis is Popular with Kids During Home Visits

Like his colleagues, Louis is passionate and committed to this community. He is knowledgeable and we had experienced his deep connection to the families MN serves and the mutual affection during our travels within MN’s zone of service yesterday.

Louis with his Trusted Bike

Heather and Anu with Ms. Edeline

Next, we talked with Ms. Edeline, a nurse auxiliaire. She is a quiet woman of profound common sense! She understood and underscored the importance of education, especially when it comes to family planning, as well as about prenatal care. According to Edeline, education is critical in making sure that women understand the importance of skilled birth attendant before delivering a healthy baby.

We went and helped Robin take inventory of medicine and supplies that had arrived a day before, in the depot and inside the big (and VERY VERY HOT) storage container. Another hot and humid day here!

Patient Receiving Treatment at MN

As Heather and Robin wrapped up another meeting over administrative details with Rosemond, MN’s Administrator, I got to watch the patient in-take process, nurses administering treatment to women and children, and made conversations with several MN staff over what a typical weekend looks like for them, away from MN.

I learned that weekends are spent on family and friends, church activities, swimming with kids, going to the market in nearby communities – in other words, very much like our weekends – stateside!

I also got a chance to talk with Rosemond for few minutes. Rosemond and a few other MN staff speak pretty decent English. I learned that Rosemond has a college degree in Public Administration and his love for both God and MN is unparalleled in its intensity! He loves to talk and is quite philosophical in his approach to life and work.

One sentiment that we heard over and over again from all our colleagues (as well as other people we met during our stay) was the responsibility that comes with addressing the lack of access to medical care for their (Haitian) communities. This means that Haitians (MN staff and people in our community) now feel a responsibility to take charge of their own affairs and work alongside each other, to ensure that our model of care is successful and that other communities learn from them.

Heather and I smiled in unison because this gives credence to the fact that our founders’ guiding principle of “indigenous management” is working wonders and it is working beautifully. Thank you Betsy and Stan from the entire MN team for your vision and inspiration! They miss you both and send their love!

L-R: Kenso,Heather, Anu (front), and Rosemond

We would be remiss if we don’t give our sincere thanks to Robin, Rosemond, Odine and Kenso (a bright young man and a recent graduate from BTI with business management degree), for sharing the small office space that they all use for their work everyday. I am sure it was not easy to be constantly interrupted by us – installing software and hardware, hijacking their chairs and workspace with our laptops and bags, and interviewing some of the staff inside the cool confines of this small office. We noticed how politely Kenso (who is a recent hire at MN for database and admin work), excused himself when we got deep into IT and administrative talks! Without complaint, he would simply move to the small space near the pharmacy and continue his work with just as much attention and seriousness. We noticed Kenso! And we thank you for your good nature and great work at MN!

How Adorable Is She?

We walked around and said our goodbyes (very hard to do) to our colleagues. I took in the beautiful nature around MN one more time and said goodbye to Marcelin, our guard and gardener. It was hard not to cry as we bade farewell to the patients waiting inside. We craned our necks to get one last look at our colleagues before the ambulance took us out the MN gate one last time.

On the drive home, Robin tried to lighten the mood with her observations and jokes. We sang songs with the staff (getting a ride back home) including the national anthems of Haiti and the United States. Back at our lodgings, Carmen and Evelyn were hard at work for what is to be our last dinner prepared by them. The kitchen and our room (adjacent to the kitchen) smelled fantastic and we could not wait to eat.

We had invited Robin to dine with us and we all enjoyed some Prestige beer, rice mixed with beans, plantains, spiced potatoes, carrots and onions, salad of tomatoes and cucumbers, and flavorful Haitian meatballs with another one of Carmen’s great tasting sauces. The meal was fit for the royalty and we felt incredibly grateful and humbled by this amazing hospitality. With Robin’s help,
Carmen gave us one of the recipes for a sauce. This is for you Chef Michael!

Delicious Dinner at our Lodgings

We Finally Took a Picture of US at MN!

Quote of the Day: “Education is important! Women who don’t have it give birth at home… and they don’t make it.” Ms. Edeline, MN’s Nurse Auxiliaire.

Friday, August 6th - The return to Miami

We woke up at 4:30 am – strangely, the rooster decided to sleep in today! Another amazing thing… we had no electricity trouble overnight or in the am as we got ready and did last minute packing. We enjoyed our last cup of coffee in the small dining area and I stole few moments to walk in the beautiful morning light and take some pictures of Hope for Haiti facility. The nature around this place keeps it fairly quiet – even though the noisy National Highway is right outside the gate. I looked around for our noisy friend the Rooster so I can capture him on the video, but alas, he decided that goodbyes were just not his scene!

Where We Stayed

 After the short drive to the Les Cayes (locals pronounce it Au Cayes) airport, we boarded a smaller Tortugair plane than on the way in, and took off for Port-au-Prince. It was hard saying goodbye to Robin! The morning flights are beautiful, and the landscape was just as breathtaking as our trip in. Our hearts seemed a little heavier, though, as leaving and saying goodbye is difficult. We took courage in the thought that just like the resilient and beautiful landscape of Haiti, its people are resolute and beautiful.

Mountains and Water - Haiti from the Air

View from the Air is Simply Breathtaking!

         

As we got close to Port-au-Prince, we observed many tent cities…

 Zo called out to us as we walked the tarmac to the domestic airport building – it was reassuring to know we would soon be in his good hands. Just like when we came out of the international airport, we were bombarded by drivers offering their services the minute we came in through the door at the domestic terminal. We simply said “No thank you.” A Tortugair employee offered to help us find our bags. Heather noticed his last name was the same as Zo’s. When she mentioned Zo’s name, Rolex (yes, he explained, just like the watch), he claimed to be his cousin. (Is the world really that small?!) Once in Zo’s car, Zo said he knew that “troublemaker!” who often claimed to be related to Zo. (No relation.)

During the quick drive to international airport, Zo told us demonstrations were happening in downtown PaP to oust President Preval. The lines outside the terminal were frighteningly long, but after a quick hug goodbye, Zo somehow placed us and our luggage in the hands of three guys who escorted us to the front of the line and right up to security. The area was packed and chaotic. We struggled to stay together, and a nice gentleman reassured Heather “he had our backs.” He told Heather we had arrived just in time, he had heard that the expats had closed their offices and operations because of the demonstrations downtown.

Wait was not so bad to get to the ticketing and to check our bags – immigration was painless. Security was fairly simple too – no questions asked, everything through. Of course, we didn’t have any souvenirs! We simply had no time. Once inside, it took us a while to figure out that we were feeling comfortable because – here’s the shocker – there was AIR-CONDITIONING! We had so gotten used to the heat that it took our tired brains a while to figure out that we were no longer sweating. We got comfortable and set up camp for the five hour wait for our flight.

Our New Friend  

Once in the waiting lounge we reconnected (so OK, it IS a small world!) with the Tortugair pilot who flew us into Les Cayes. He was waiting to catch a flight back to Brooklyn. We chatted about American Airlines’ monopoly in the Caribbean, Haitian affairs, politics, and life in general. He has been flying in Haiti for the past year and a half and was stressed. He seemed happy to be going home. While in Cayes and PaP, we got to hear some similar POVs… mostly expressing concern that the progress isn’t moving fast enough. He was curious about our work and asked us many questions. He congratulated us for doing the hard work… the work that builds the community. He wasn’t critical of aid and recovery NGOs but thought there were more NGOs like MN needed.

Later we made friends with two young boys sitting next to us. Sebastian, 9, was crying because he did not want to leave Haiti to go back to Brooklyn. His older brother Alexander was trying to comfort him. After we offered gum, he cheered up and began talking about the earthquake (he was in a house in Leogane with their father, while his brother was in NY with their mother.) Alexander explained that it was an agonizing four days of waiting before they could make contact with their father to confirm everyone was alive. Alexander kept saying “34 seconds. That’s all it took. 34 seconds to kill so many people.”

The overwhelming reality of the earthquake and its consequences are not going to go away anytime soon! We noticed a lot of people (Haitians especially), seemingly lost in thoughts, staring into space, and many seem sad and tired… we wondered about the psychological impact and what, if anything, was done to help them restore strength and faith. For our part, we smiled and talked with as many people as we could, especially women and children at the airport. Again, our goofiness and sense of humor kept us sane and made people around us laugh. We are glad to be of service!!

Back in Miami, Heather and I relaxed with some pizza (yes, our guilty pleasure!) and a glass of wine. Our hygiene habits were hard to break… will be hard to break. We continue to use the alcohol wipes instead of tap water! We had to re-learn about the water pressure in the shower and using hot water!!

While we were dinning, we fell into easy conversation with our bartender Jean Baptiste. Ironically, he is a native of Haiti, and has been living and working in Miami the last 17 years. His love for his country was evident though and he was proud of his fellow Haitians and their resilience in the face of so many natural disasters and calamities. He grew up in Port-au-Prince and regaled us with stories of his youth – how beautiful the city was! I believe he mentioned it used to be called the “Paris of the Caribbean!” He described the incredible music scene in downtown PaP, the food, the inexpensive and free lifestyle, and there was a gleam in his eyes that told us untold tales! He was sad to see the destruction post earthquake but he also knew that Haiti WILL rebuild.

We are tired, exhausted, and feel strange… that feeling is hard to shake, but this trip has given us so much hope, determination, and assurance - that we will be back to see our friends and families back in Haiti. It gives us strength to continue to do our part here, at our home, in the USA.

Quote of the Day: “People of Haiti will not have it any other way… it will be rebuilt.” Jean Baptiste in Miami. Heather and I agree wholeheartedly.

Here are few more pictures from our time at MN:

Heather Pointing Out MN Zone of Service

Heather with a Mom at MN

With MN Community Health Promoter Mr. Enel

Robin doing Inventory at MN Depot

Mom and Babies - This is Why We Do What We Do!

Our Journey to Haiti - Day 5 and 6

Tuesday, August 3^rd  

Title:  Every Day is a Busy Day at MN

The electricity went off a record EIGHT times tonight. I don’t think either one of us remembers walking out of our dark room down the dark hallway to switch the lever so we could at least have few fans working. I think at some point in the morning, we just gave up and tried to sleep in the heat. This makes for an interesting restless night and then a full day ahead of us makes us incredibly exhausted. I don’t want to sound ungrateful, as I am well aware that our accommodations are comparable to a 3-star hotel, but we both miss various little things back home. Still, we wouldn’t trade this experience for any amount of comfort.

When we left Kansas City, we talked about NOT complaining—which is often customary for most Westerners. We vowed to keep our sense of humor, and since both of us have a very solution-based approach in general, this helps with almost any issue that comes up. Most importantly, we already knew that we needed to respect the local customs and culture and those we are here to help, not hinder our colleagues’ hard at work at MN! It is good to be honest and we admitted that we are a bit spoiled. Indeed. But making this vow helped keep us on our best behavior and we have tried very hard to NOT complain…. I have to admit I enjoy being ‘roomies’ with Heather – we joke and laugh a lot and we make others laugh as well. We find pleasures in simple things (a room that has been swept and clean towels) and we try to focus on the funny and positive side of life. Because of this, we have been able to withstand small discomforts like 100+ degree weather without electricity (for our KC friends, we dare you to spend ONE day without air-conditioning and fans!). Heather’s habit of talking with the bugs at our lodgings usually has me rolling on the floor with laughter. Just the other day, I overheard her hollering at a mosquito in the bathroom in desperation: “Why won’t you die?!”

Sense of humor is a MUST, I think, when traveling anywhere! And it helps that most people we have met here so far have a great sense of humor and they are quick to smile and joke with us. Our inability to understand a lot of what is being said (which shows on our faces) usually makes people laugh here and am sure they think we are completely goofy.

  

Our day started early again today and Robin picked us up around 7 a.m. I shared a little about the National Highway before. When we leave our Hope for Haiti lodgings, we usually stay on the highway for few miles before turning onto what would be the equivalent of a gravel country road in US. Both Heather and I truly enjoy the natural world that surrounds this rough country road, even though the sturdy MN ambulance/truck has us jumping up and down on our seats involuntarily! We get to see rural Haiti on this road… more rice fields, corn or millet fields, okra plants taller than us (what isn’t taller than we are?), bananas, breadfruit, coconut trees, wild flowers, goats looking at us with their big eyes, the mooing cows, and the donkeys doing what they usually do--ignoring people around them! We usually come across egrets and other water birds, sitting gracefully still in the rice field or on top of plants. This region does not seem to suffer from lack of water (wish there was some kind of infrastructure in place that moved this water to dry areas in Haiti).  We often see artisanal wells with water flowing from them 24/7 (which makes me cringe when I think of all the time I have spent in Africa where women walk for MILES to get two buckets of drinking water that is often dirty and full of diseases.) The water we see isn’t always clean. We still see a lot of people enjoying the morning baths and kids playing in the water on our way to MN. Everyone waves and smiles. We also love the fact that people here are incredibly enterprising. The roads are dotted with several small stalls and carts selling almost everything imaginable – clothes, shoes, vegetables, fruits, soft drinks, freshly made bread (which we sampled – delicious!), people trying to eek out a living from the land and they are proud!

It was another busy day at MN! When we arrived, there were already lots of moms waiting to be seen. An assortment of motorcycles and rented vehicles dots the front of MN throughout the day. There are four mothers in labor today – a couple of them not yet ready to deliver so they are walking around looking miserable. We wish there was something we could do for them, but we know they are in good hands. Heather and I split our tasks again so we can accomplish all we came to do. While she participated in scheduled meetings on meetings on various clinical and administrative topics with Robin and other lead MN staff, I got ready for more interviews with the clinical staff.

I first talked with Ms. Adelle, a nurse auxiliaire, whose job is to visit post-partum mothers in the community (every Monday and Wednesday), and to do HIV counseling.  She is young and her energy is contagious! Like the other MN staff we have met, she is dedicated to her work and appreciates how much MN helps the women in her community.

I talked with another auxiliaire, Ms. Osseline. We learned that while each nurse auxiliaire (MN has six) is responsible for a specific area, most of them also help with whatever is needed in any clinical setting at MN – prenatal consultations, vaccinations, labor and delivery, patient in-take, postpartum care, etc. For example, Ms. Osseline is in charge of the Family Planning program, but she’s also responsible for training our Community Health Promoters. She takes great pride in her work and informed me that she is also in-charge of drafting reports (not an easy task!) for MSPP--Haiti Ministry of Health. She has an easy smile! I really enjoyed talking with her and learned much about how important family planning education is in this community. No health situation or case is isolated and she took great precision to explain the important ties between educating women (and men) about family planning thus discouraging HIV, other sexually transmitted diseases, and preventing early pregnancies where outcomes might not be positive for both young mothers and their babies.

Ms. Osseline and Anu

After few hours of work, Heather and I put on our IT hats (again) and installed some software and a surge protector on the server. Hats off to Robyn, Philip and Jim! We think the IT situation here, at the moment, is under control!

Our lunch is usually pretty simple, a couple slices of bread with a couple slices of cheese, from the Hope for Haiti fridge. We did bring some crackers and granola bars from home but this heat and work keeps hunger at bay. Water has never tasted so good!!

After a little bit of break, Heather and I got to visit with some of the women waiting inside. With the help of our interpreter Clausel, we first made sure we weren’t intruding on their time and personal space. After their reassurance, we introduced ourselves as MN staff working in the US and asked them the reason for their visit, and to tell us little bit about themselves. Just like most people we have met here, these women are gracious and kind and answered our questions with patience. Most of them are pregnant – anywhere from 4 months to counting the hours till they deliver. No doubt, some of them weren’t very comfortable but they still allowed us to take their pictures. Just as Heather and I were feeling that we should perhaps stop pestering them, one of the young mothers-to-be (Marline) stood up and said “I love you.” (Yes in English!), then she hugged us both. We didn’t care that everyone saw us crying. 

Marline, Heather and Ms. T

It reminded me of my mother who always used to say (when I worked in the NGO sector in Africa) that the only way to relieve frustration is to do what you can and simply go out and help people. There is no nobler course of action, even if it is difficult, and gets little recognition. We saw recognition in Marline’s eyes and that’s what made us cry. We knew that she knew MN is trying to do all it can to give hope to mothers like her and she knew that we know she is strong and will continue to empower other women in her community to take charge of their own health for a positive pregnancy. I think the recognition and respect was mutual.

Our next conversation was with our Lead Midwife, Ms. Odine Charles. She has a lot of experience working throughout Haiti with hospitals and health institutions. She is a very strategic thinker and while working closely with Robin, she is hoping to strengthen MN’s clinical processes and procedures. She gets the big picture and she has great ideas and insight into both the operational and clinical details of our work. We feel incredibly lucky to have someone of her caliber at MN to provide oversight and direction to our clinical staff.

Next, I chatted with Marie Alourdes, who oversees MN’s nurse auxiliaires as well as our pharmacy operations. She has been at MN for several years, and her son (now 3 years old) was delivered by MN volunteers!

I knew that most of our patients can’t read or write and I was curious how MN pharmacy staff dispense medicine and make sure that the mothers understand how much medicine to take per day and the required timeline. She shared that the staff devised a very clever system to address this issue. The times of the day are determined by number of circles (one zero (0) means morning, two zeros mean morning and afternoon and so on…). Since the patients can count from one to ten, the staff usually puts the number of pills to be taken right above the circles. We both thought that was a brilliant solution!

Four babies arrived today, opened their eyes and looked at the world around them for the first time. We feel blessed to see the beginning of so many precious lives during our short stay at MN.

Towards the end of the day, we witnessed another proud dad holding his newborn while standing on the scale to weigh the baby. He was so incredibly focused on the baby that he barely noticed anyone around him. As he hesitated to go inside the delivery room to see the mom, the nurse auxilliaire joked that he was scared to go in.  He took mild offense and said that if he were scared, he wouldn’t be at MN! We all laughed.

Quote of the Day: “Do not get discouraged.” Advice to us from nurse auxiliare in charge Marie Alourdes.

Wednesday, August 4^th

Title: Visit to Port Salut and our Zone of Service

We had originally planned to start our day with a visit to Pere Alphonse (MN’s Chaplain.) But when Robin came to pick us up at 7 a.m., she informed us that our plans had changed overnight because she and Odine needed to visit the Medical Director and one of the surgeons at the Community Hospital of Port Salut (referral hospital), an hour’s drive from MN. Following the strike which began at the General Hospital in Cayes on Monday, we needed to find a fast solution so our patients needing surgical procedures had a place to go to that was, if not ideal (due to distance,) the best option and a great record of service to this community. The patients we refer out usually need more sophisticated procedures for cesarean sections, complications in delivery, hemorrhaging and preeclampsia.

Community Hospital of Port Salut

This was serious scenario because Cayes and nearby townships don’t have many viable options for MN to send patients and the worry and stress showed on Robin’s face as we drove to MN to pick up Odine Charles, our Lead Midwife. We also learned that the private hospital that admitted one of our patients on Monday was overwhelmed and would not be able to accommodate more patients.

We tried to take in the scenery around us.  The drive took us up and down the winding roads with amazing views of the green-blue ocean on one side and mountains and valleys, with houses, trees and animals on the other. The scene is bucolic and hypnotic! The hospital is pretty big and it obviously serves critical health care needs of the Port Salut community and nearby townships, including Cayes. We saw patients everywhere - waiting outside with their families and inside, crowding around the reception window, radiology, operating rooms, all the way down the hall, waiting to be seen or taken in by surgeons on the gurneys.

On Our Way to Port Salut

We stood waiting for some time to meet with the Medical Director. Finally, Dr. Sinal Bertrand (Sergo) came over and took us to his office. It was hot and incredibly humid inside and as soon as we walked in his office, a solo floor fan working furiously went out. No electricity! What rotten luck. Anyway, Robin and Odine soon were engaged in a serious discussion with Dr. Bertrand. Heather and I were observing and as we saw several dejected gestures and collective sighs of resignation, we feared the worst and decided to pray harder. We could see that Dr. Bertrand was an incredibly busy man but he, like most people we have met, was kind, considerate and had a great sense of humor. Because we knew that Robin and Odine were the best people to discuss MN’s work and referral system, we stayed very quiet and observed – we admit it is VERY hard for us to not participate in a dialogue! With a devilish grin, he pointed at us and asked if we were “dumb” (as in mute).  Robin quickly explained that NO, we do talk but felt it was not the best time for us to contribute as we felt confident that Robin and Odine were able to explain our needs and request their assistance.

We thanked him profusely and left. We could not wait to get in the car and ask Robin and Odine about how the meeting went. Well, it turns out that the meeting went very well. He was more than willing to accept MN patients at his hospital. The dejection and resignation we thought we saw turned out to be the collective disappointment with the strike at the General Hospital in Cayes. Suddenly, our day brightened a lot and the heat of the day seemed to dissipate. Indeed, the weather in Port Salut was breezy and cool. The large cloud we had seen during our road trip had bought some rain. With the stress lifted from us all, our drive back to MN was very pleasant and productive with strategic discussions about our referral system and logistics of moving patients to the hospital in Port Salut.

The meeting was successful but it gives you a glimpse into the busy and challenging world of MN where priorities change and emergencies such as strikes in the General Hospital force us to constantly scramble.   Our work, even in the best of circumstances, is difficult. We are lucky to have committed staff at MN who do all they can to make sure that our work is never stopped.

Wednesdays at MN are vaccination day and the Choupounet was full of cute babies of all ages. I took some pictures. They liked seeing their pictures on the screen of our digital camera. (Thank you John and Betsy.) This little handheld camera has been a convenient help in capturing the lives and stories of people here.

Wednesdays are Vaccination Days at MN!

I got to chat with Henri Enel, one of MN’s community health promoters, who has lived close to MN pretty much all his life. As a local resident, he has a deep knowledge of his community and their healthcare needs. Like his colleagues, he is incredibly dedicated to his work for his community and he appreciates being a part of our family.

Next, we hopped in our MN ambulance with Louis, our Community Health Coordinator, as our navigator, to travel around our zone of service.  We met a mom who has delivered at MN plus a couple of community health promoters. We also met a community group/committee working with MN in our zone of service on various interrelated topics- including women and children’s health, for improving this community.

We enjoyed talking with Fredia, one of our community health promoters, at her home and met her mother (who is a Matrone –a non-medically trained birth attendant)! We asked her about her work and how health promoters (like her) are received by families in the community. We learned that most people in the community know about MN and usually they are welcoming to the promoters and they DO listen to their advice regarding family planning, attended deliveries and immunizations for their babies. Fredia lives in Bellabe village and today, she had visited three households in her village for family planning education and counseling.

Freida and Her Mom Who Is A Matrone

Fredia and her sister with MN group

We walked back to our car and headed towards Giyou village, where the committee members were waiting for us. It was enlightening to meet with the group members, including another of our community health promoters, Mr. Jean Yrel. We learned that the group is part of a bigger organization called Asosyasyan tet kote Giyou (ATKG), which is involved in several initiatives besides healthcare. They offer guidance and services to community members about agriculture, animal husbandry, making chocolate and soaps, and encourage families about the importance of sending their children to school! We were impressed! This group has a list of objectives pertaining to each issue they think their community needs to invest in and meets regularly. We thanked them for their time and commitment of their service to their community and they thanked us for employing the concept of community health promoters because they are a big part of the transformation taking shape in our zone of service.

Members of ATKG and MN staff

After a brief stop at MN to drop off Louis, we headed to the rectory at Torbeck to meet with Pere Alphonse.  We chatted with him for more than an hour, talking about MN’s history and thanking him for the spiritual counsel he provides our staff and families.

It had been a long but fruitful day and it was almost 6:30 by the time we got back to our lodgings.  Five babies were born at MN today!

Pere Alphonse with Robin and Heather 

Quote of the Day: “We are all missionaries.  You end up where God sends you.” Pere Alphonse, MN’s Chaplain. 

Our Journey to Haiti - Day 3 and 4

Day 3: Sunday in Cayes and at MN

After a night of thunderstorms (which quieted the insomniac chickens – even if temporarily), our Sunday began with church bells resounding from a nearby church. Traffic on the way to MN did not seem any quieter for a Sunday – even though most merchants are closed - but we observed people dressed in their best for church services.  We passed many churches, full of people singing, on our way to MN.

Our second day at MN was also fairly quiet.  Two babies arrived over night.  Only one expectant mother was at MN, and while she had not yet reached true labor stage, she seemed miserable nonetheless.  We longed to do more for her as she walked the grounds, but found some comfort knowing that when her delivery time came, she would be in the best hands around.

MN Outside In 

We met and visited with midwife Ms. Boulotte and nurse auxiliaire Ms. Larrieux. We learned a great deal about their work and their passion for improving the health outcomes for their community’s women. Ms. Boulotte has worked at MN for four years and Ms. Larrieux (a part-timer) started just a few months ago.

Heather with Ms. Boulotte, Ms. Larrieux in the Background

Later, the three of us donned our IT hats and installed some software and worked on updating inventory of our laptops.  It is amazing how quickly the dust and humidity wear down this equipment.  But even more impressive is how our staff effectively utilize technology in their daily activities and how eager and adept they are in learning new technology.

Visitors came and went throughout the day, bringing miscellaneous items to the postpartum mothers and offering comfort. 

Toward the end of the day, as we were wrapping up, two mothers and their babies were leaving MN.  A proud papa (or one extremely relieved that HE did not have to go through labor and delivery), bounded through the front doors of MN, his rented/borrowed transportation waiting outside.  He was literally beaming – smiling and nodding at us as he strode into the postpartum room, and emerged again with his entourage in tow.  Mom followed (still a bit fatigued) with a young girl (very happy and helpful) carrying a newborn, wrapped in blankets and a hat.  Another mother followed, again with a young girl carrying a newborn in tow.  Everyone crammed into the waiting older model Toyota SUV, except the proud papa - who jumped on the back fender, and secured himself around the spare tire for the trip home.  With a honk and many waves, the group departed through the MN gate.

After hugs and kisses goodbye to Ms. Boulotte and Miss Larrieux, and reassuring Marcelin we would indeed be back tomorrow, we piled into the extremely toasty Land Cruiser and headed to our lodgings. It has been a long but fruitful day and we feel that much was accomplished.

Quote of the Day: “These women love MN” – from Ms. Larrieux, MN’s nurse auxiliaries, about women waiting patiently.

Day 4: A Busy Monday at MN

Our day started EARLY (6:20 am), when we picked up Rosemond, our Administrator and Odine, our Lead Midwife on our way to MN. 

I made (well, tried to) a video of our journey on the national highway – which is probably the only decent road running through much of Haiti, to capture the cultural landscape that is hard to put in words. The motorcycles, the bicycles, the over-stuffed trucks and tempos that people use to get to their destinations within the region, the UN cars, the police cars, women heading to work in the morning, dressed in their best (add high heels!)… all this absolute chaos, taking place alongside the tranquil rice fields, the cows, chickens, turkeys, donkeys and the goats watching everything, the banana and coconut trees heavy with fruit, naked kids frolicking in puddles and streams- big and small at the edge of the road.. all this sheer madness and different worlds, seem to run parallel and without conflict. Nobody gets mad for cutting in front, they “maneuver!” There is a lot of honking, but no road rage, no menacing or impolite gestures – people here for the most part, like to smile and I am sure that alone keeps any unpleasantness and conflict at bay! As I said, I have tried to make a film, which I will edit and hopefully post after our return home but really, you have to be here to understand.

In sharp contrast to the calm of MN on Saturday and Sunday, Mondays at MN are packed!  Women were already waiting in the Choukounet (Creole word for waiting area) outside.  We celebrated mass with the entire staff under the leadership of Pere Alphonse (MN’s chaplain) and Rosemond. Pere Alphonse’s sermon reminded us to remember God in good times and bad times – don’t just go to God when we have problems.  People everywhere should work together and care about one another; he used MN as an example of how working together brings about good for everyone.

Patients Waiting To Be Seen by MN Staff 

A staff meeting followed, where we shared our gratitude to the staff for their service to MN and their community.  Many people wanted to then share their gratitude with us for coming, and for helping make MN possible.

We witnessed a referral leaving MN in the ambulance and Robin (MN's In-Country Director) in action across the road from MN (no cell phone reception on MN property), to find a place for the mother to go. This mom needed an operation. Staff at the General Hospital in Les Cayes just went on strike.  Robin is incredibly calm when managing the case, making call after call…determined to do all she could to make sure mother would have a healthy outcome! After many calls, a decision was made to transfer the mom to a private hospital in Cayes. One of our MN nurses went with the patient, as they usually do, along with the driver.

I interviewed Junie – HIV Nurse at MN and learned that thankfully, the instances of women contracting HIV remain low in our zone of service. She shared that the youngest mother-to-be she has seen at MN and who tested positive for HIV was 14! I gleaned from our talks with other midwives that early pregnancies are quite common here. Hopefully, with MN’s community health programs department taking family planning education and awareness to community, this practice will change.

Ms. Junie, HIV Nurse at MN

Next step was to talk with nurse auxiliare Gerlin, who is sort of a super, multi-tasking machine! She not only dispenses medicine to women from our pharmacy, she also assists with labor and delivery, post-partum care for mothers, as well as serve as an intake nurse, when the number of patients waiting outside increases. Just like today. The medicine dispensed is probably what any of us know in other countries – multivitamins, vitamin C, folic acid, painkillers…. Of course, add malaria drug to this mix! Our interpreter Clausel really earned his keep today as Gerlin talked fast and in long sentences and he had to stop her several times mid-sentence (which annoyed her) so he could translate without forgetting her previous message. She is quick to smile and quick to forgive though, so he is safe.

Patients Waiting Inside & At the Pharmacy Window

Back to our lodging where we worked few more hours with Robin (and some uninvited mosquitoes) on more topics. It is amazing how much one can focus when supplied with snickers and chilled Sprite (in glass bottles). YAY! If Robin didn’t have to go home, we would have kept going till late night. We saw an alert for tropical storm Colin and its potential to hit Haiti today/tomorrow.  Here’s to hoping it doesn’t develop into a hurricane, and stays clear of the island.  Not what Haiti needs now!

Our night ended with a delicious dinner prepared by HfH’s talented and graceful cooks - Carmen and Eveline. We had whole broiled fish, rice, a wonderfully rich stew of potatoes and carrots, and thick slices of plantains, served with fresh avocados, tomatoes, and cucumbers.  

Quote of the Day: “Family Planning is perhaps the most important service MN could provide to Haitian girls and women.” – Ms. Junie, MN’s HIV Nurse.