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.