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Sunday, February 28, 2010

Leaving Jacquesyl

Our last day in Jacquesyl always makes me feel sad.

I would so much like to stay a little longer. We work hard and sometimes as I walk through the village for the last time, I get get a little time just to chat with friends I've made there. It is always hard to say goodbye.

However, this year before that last walk we were BUSY!!! VOSH saw 325 people, Kris saw many people and extracted 27 teeth, and between Jennifer, Jim and myself saw over 100 kids, some sick, others not really but they were happy to receive vitamins and de-worming medicine.

Sherman met with the teachers and set up a tutoring program to help the kids who fall behind due to the large classes in the lower grades. (Many quit school after the 4th grade if they don't pass the standardized exam.) To have any hope of secondary school children must pass a very difficult 6th grade exam. We are beginning to have some success with the 6th grade and are aiming to work to help more children pass. Our school in Port au Prince has a very high success rate. Our school in Jacquesyl was the first in the area to open after the earthquake when schools throughout the country closed.

We said our good-byes to VOSH and Jennifer's team as well as the translators who worked so hard. New friendships were formed and plans for our next trip to Haiti were already in the planning stages.

As always, I receive more from Haiti than I give. This time was no exception. I received hospitality everywhere I went by people whose lives have been devastated in one way or another. I received a visit in PaP from one of the people my daughter used to work with, Jean Baptiste. He'd lost his home, but he came to make sure I was all right. The workers at the ruined guest house made us so comfortable and prepared us food in the midst of the rubble. A nurse from La Plaine came to assist us at the clinic we did there, and I learned she had been doing the best she could to treat people who weren't hurt badly enough to be accepted at a hospital although in the US they would certainly be hospitalized. At EVERY home we visited, someone found us a chair to sit in even if they had to run to a neighbor's house to get one.

I again witnessed the resiliancy of the people of Haiti. Everyone was doing something. Life was still going on. Some cleared rubble, some cared for orphaned children as well as their own. Those who still had jobs went to work even if they weren't getting paid, because the banks were closed. People still prayed and sang fervently. In the tent cities, people were banging together shelters, waiting in food lines, washing their children and the kids still played and smiled. It was amazing. Just for the record, I NEVER felt like I was in danger and I saw NO violence anywhere, and I was in plenty of RED zone areas.(places not considered safe for NGOs)

Hospitality, Strength, and Faith are the gifts I receive from Haiti.

Thursday, February 25, 2010

Working with VOSH and running medical clinic in Jacquesyl

By Mary Lou Larkin

Thursday Feb.17th

Everyone rose early to go to Jacquesyl. It was pouring rain and it took us a long time to check out of the hotel. But we finally were on our way with the VOSH (Volunteer Optometrics in Service to Humanity)team, Jennifer's team of nurses and 5 translators. It was still raining when we got to Jacquesyl and I was afraid people wouldn't come out, but the church was at least half full with people waiting to be seen by the opticians. We quickly rearranged the benches for people to wait their turn and teachers carried over tables from the school to set up the stations for VOSH. The teachers also brought over some of the children we had identified that needed eye care.

VOSH was a class act. All of them had been to Haiti before and seemed quite relaxed amongst the activity of assuring everyone that they would be seen, figuring out where they could work, who would translate for whom and who from the Jacquesyl community would work at registration. The noise level got pretty high at times and I for one got a little frustrated, but they were cool. Our Jacquesyl teachers were great and helped to keep order. ( I think we exhausted them) VOSH set up stations for acuity exams, glaucoma exams and various other stations which made me realize how little I know about eye exams. At the end there was every possible prescription for glasses was available and those who needed them received a pair. Everyone also received sunglasses. ( The kids thought they were very cool) One person needed a prescription they didn't have and it will be made in the US and sent to Dr.Maklin.

Meanwhile Kris along with Louise one of the nurses and a translator held a dental clinic in the back of the church. Most of what Kris did was extract teeth in the elderly and a few not so elderly and treat gingivitis with Tylenol and amoxicillan. People loved her because she so quickly put an end to their pain and misery. One man came by the center later that night to tell her how much better he felt. Louise was amazed at the procedures and the strength it takes to pull some people's teeth. It's pretty gross, but it sure makes people feel better and I saw a lot of immediate gratification.

Over in the clinic, Jim Morgan, a pediatrician from Hew Haven, CT, and Jennifer Schmidt NP, two nurses, and myself saw pediatric cases. One of the biggest things I learned on this trip was the importance of Haitian translators. Not only did they understand everything mothers and patients said, but they understood problems and nuances and cultural things that it would take an American a long time to figure out. Also because they were not from the town, people seemed more comfortable talking about some things, knowing that they wouldn't be repeated or judged. I was extremely grateful to these translators. These were well educated people who spoke at least two languages well and couldn't find work in this country of too few jobs. When we paid one of them his eyes filled with tears. He told Jennifer that he just volunteered to help because it was so much better than sitting at home doing nothing and never expected to be paid. I am happy that we were able to give him four days of work and hope that he will join us in the future.

It finally stopped raining (I know we were all praying that it wasn't raining in PaP) as we finished for the day. We were all tired and took a little break to rest before getting together for dinner. At dinner we talked about the day. The VOSH team (Dave, Linda, Paul, Anita, Mike and Jack) saw about 125 people. There was a family of 5, all with trachoma, a disease that is spread easily within a family and can cause blindness. It is spread by hand to eye contact between children with the disease or by the feet of flies who feed on the exudate from the eyes. Megan and I had seen a young woman earlier in the week who was blind. She was seen by VOSH who told me her blindness was due to lack of Vitamin A in her diet as a young child. In Jacquesyl all children are treated with Vitamin A supplements, but this young woman had only recently come to Jacquesyl. As so often happens people are sick because they are poor. Poor diets, poor living conditions, lack of soap and water, screens on windows, Kleenex... all things we take for granted.

Mary Lou Larkin

Wednesday, February 24, 2010

Last days treating patients in Haiti

Traveling to Nativity Village through the mud and giant puddles.



Haitian Border with the Dominican Republic



Saying goodbye to Jakzi (Dr. Morgan and children of Jakzi)



Patient with severe Vitamin A deficiency



by Dr. Jim Morgan

February 17 (Wednesday)

I’m blogging the next 4 days “post facto” since Megan left today with her iPhone and we had no way to communicate. We went to Cap-Haitien this AM and took Megan to the airport. Sadly we lost a major player on our team but still had a lot to accomplish. We met Jennifer (Pediatric PNP from Northern VA), her team, and VOSH (a long established optometry/ophthalmic group) at Mont Joli Hotel (Haitian 5 Star hotel which is equivalent of our 2 Star hotels). I didn’t realize places existed like this in Haiti. I had a room with a beautiful view of ocean (from a distance that is), electricity all day (as compared to just 4 hrs. in Jakzi), a TV with 4 fuzzy channels, and a hot water spigot (sadly no hot water came out).

Jenn had arranged for us to do a clinic in Nativity Village which is one of the most poverty stricken areas in Cap-Haitien. Basically a swamp with too many people. When we arrived, we had to somehow portage the large puddles of contaminated water with our supplies. The motorcycle taxis arrived and saved the day! They not only carried our supplies, but all of us across deep, dirty water. They were amazing how they drove their bikes and didn’t dump our stuff (OR US!!!) into the mud. The clinic itself was a huge success both medically and for the patients seeing VOSH. The problems were the same – malnutrition, worms, scabies, diarrhea, fungal infections. Dr. Maklin helped us and we saw dozens of patients. The absolutely worst conditions I have seen so far in Haiti!!! I don’t know why the flies wanted to stay near me.

We went back to Mont Joli that night for a dinner conference with Haitian Health Network at Hotel Roi Christopher. Got to meet the leaders of many of the voluntary health organizations like Haiti MaryCare to see what they were doing in Haiti. Ted Kaplan, who we had all worked with @ Pillette, organized everything with his wife Elizabeth. Best meal of the entire trip and gave us a broad overview of all trying to be accomplished in Haiti. So many organizations trying so hard and I felt proud to be a part of one of the best, Haiti MaryCare.

February 18 (Thursday)
Left early that AM to return to Jakzi. with our team, Jenn, and VOSH. Starting to realize that everything in Haiti is relative. Jakzi is so fortunate to have a clinic that functions daily as compared to other areas that rarely see a medical person. Again, we saw many patients as did VOSH who were doing eye exams and providing glasses if necessary (and if not they got sunglasses which they loved). It was quite cool that day (Haitian perspective that is). About 65 degrees. Rain had stopped, but clouds persisted. Made for great working conditions. We wore shorts, but many of the villagers were in ski coats! Saw a blind mother raising small children who had severe corneal clouding from earlier Vitamin A deficiency. I also saw the worst failure to thrive baby I can ever remember. Six months old and only 6 pounds. I’m learning in Haiti that I have to approach problems totally differently – no lab down the street, tests cost money the patients can’t afford, and you really have to rely on clinical judgment (its sad this is being lost in the USA or that fear of litigation inhibits its use). A trial of a medication for a parasitic infection is all I can do and hope it works. I wanted to test for HIV but not available. We returned to the Center for Formation that evening for a nice dinner with VOSH. Even enjoyed a few cold Prestige before lights went out.


February 19 (Friday)
Last work day in Jakzi. Started to get sad about leaving, but ready to go home to see family and friends. Took a walk from the center to the village to cherish the sites, sounds, and people along the way I’ve met this week. Once there, not much time to reflect. Everyone knew it was our last day and came out to see us. We saw ~100 children in a 4 hour time span, but gladly had to turn no one away. Said our goodbyes at the church and slowly walked home just reflecting on the past two weeks. Before leaving village, went to see Yudinx one last time. He was thrilled to get my cap that read Doctors Have Patience. He wants to be a doctor and I have faith he will accomplish his goal. Quiet evening of packing to get up at 3:30 AM to start our trip home.

February 20 (Saturday)
Awoke at 3:30 AM & got to see beautiful stars of Haiti one last time before going home. Fenalin took us to northern border dodging all of the cows and goats sleeping both in and alongside the highway. It still amazes me I never saw a car hit an animal, person, or another vehicle this entire trip! Two hour wait before the border opened. Small glitch with passports, but easily walked across the bridge into the Dominican Republic. We missed our direct bus to Santo Domingo, but with the help of a new-found Haitian friend Gary, we took another bus to Santiago and transferred to Santo Domingo. There we saw Papito one last time before we went to the airport. How good it was to see his smile before we left! We easily got to the airport on time (a little nerve racking since we had to travel in Haiti, cross the border, and then go 6 hours by bus in the DR). Flight home quiet and even getting through customs a breeze.

Epilogue
This was my first trip to Haiti and suffice to say it was the most life changing journey I’ve ever traveled. Even for the regular team members of Haiti MaryCare, this trip required so much coordination for it all to happen it defies imagination. Especially in Haiti where NOTHING is predictable. This was all do to the efforts of Mary Lou, Sherman, Papito, and the unsung hero Tom behind the scenes at home. Considering we flew to the DR, traveled by bus to PaP, then again by bus back to the DR, back to Cap-Haitien by bus, clinics in Jakzi, Pillete, and Cap-Haitien, and then back to DR by bus and flight out to NYC. Exhausting to even put all of this in one sentence. One always comes away from Haiti appreciating EVERYTHING we have here in the USA. I was so glad to have a roof over my head, a clean toilet and shower, healthy food and water, and 4 hours of electricity at night. It’s so easy to take all of these things for granted. I realized how much time I waste at home sitting in front of a TV, computer, or on my cell phone. How nice it was to even read some books. The old saying “early to bed, early to rise” really applies in Haiti, especially when the roosters start crowing at 5 AM. You really learn a lot about yourself.

I was immersed in a culture that has so little, but is so kind and appreciative of everything people do for them. They work tirelessly without complaining just living from day to day. Many only get one meal per day, yet have a resilience that is extraordinary. I’m convinced this is why so many survived the earthquake is horrendous conditions. I am grateful for my new Haitian friends – Papito, Father Dorcin, Dr. Maklin, Dr. Vaval, and the entire village of Jakzi. I look forward to returning to the village that so embraced me. Hopefully my Creole will be a little better next trip. All prayers and God’s blessings are now needed for those who suffered loss in the earthquake as well as the millions of other Haitians who strive everyday just to survive and hopefully have a better life.

Bus ticket dilemma

by Mary Lou Larkin

Dilemma
When I first went to Jacquesyl everyone asked us for shoes. Then people began to ask for money for their children to go to school. Today everyone had shoes or at least flip flops. Today the majority of the kids go to school and we need to expand the school.

But this trip many, many people asked for bus tickets. Yes bus tickets.....to bring their loved ones from Port au Prince where there is absolutely nothing for them, to Jacquesyl. I wondered would our donors consider this as disaster relief? After what I saw in PaP I would certainly consider it disaster relief.

When the rainy season begins there will be malaria,typhoid, and dengue. Women and girls live in fear of being raped in the massive tent cities. There is little available clean water and no privacy. Away from PaP people will at least have a chance at rebuilding their lives, yet without seeing the devastation and repercussions will people understand this? It is something we need to talk about. Several of us just decided to give our personal money to families we knew to help them bring their families to Jacquesyl.

Tuesday, February 23, 2010

More Miracles in Haiti - Volunteer Optometrics in Service to Humanity

by Mary Lou Larkin

February 23, 2010

On Wednesday 2/17, we said our sad good byes to Megan at the airport and went on to the Mont Joli Hotel in Cap Haitien to meet Jennifer Schmidt's team of one doctor and three nurses and a volunteer as well as Dave McPhillips and his VOSH (Volunteer Optometrics In Service to Humanity) team of 6 people.

Then began another adventurous day of work. We traveled to Nativity Village in Cap Haitien. This is the poorest part of Cap Haiten (CAP) I have ever seen. The homes themselves were built by Food for the Poor (FFP) and while sturdy appearing, are practically built in a swampland somewhere near the sea. The road became rockier and muddier and the huge puddles gradually became the size of ponds. Eventually the FFP bus could go no further and we had to get out with all our medicine, supplies and Vosh's equipment and walk. But...eventually WE could go no further because the ponds were getting larger and larger. People appeared with cement blocks and rocks placing them in these monster puddles so we could gingerly cross, with packs on our backs praying we wouldn't fall. Then they became so deep we couldn't go any further.

Suddenly out of nowhere about 6 motor bikes roared up to us, and yes we climbed on and were each ferried across the water to a path that eventually led to St. Anthony clinic, where the VOSH team quickly set up their eye examination equipment, meds, and hundreds of eyeglasses in a community center, and the medical team set up rooms and meds to see the long lines of people hoping to see a doctor or nurse. It was organized chaos as people crowded the doorway determined to be seen. Our wonderful Haitian translators also did crowd control and we all went to work. This clinic has a doctor one day a week and few medicines.

I worked with Jennifer who is also an Nurse Practitioner, with whom I hope to open a second clinic in Pilette in the near future. We saw pediatric patients some who were vaccinated, many who were not. I saw many children with the tell-tale signs of malnutrition, red hair tips and swollen bellies. Many mothers came because they said they no longer had enough milk to nurse their babies and the babies were weak and dehydrated. The mothers were skin and bones themselves and never had enough to eat. We gave every child vitamins and treated them with albendazole for worms. We saw so many children itching with infected pustular scabies. We poured scabacide into plastic baggies for them to take home.

A father brought his 20 month-old son because he had a cough for a month, but now it was worse and he had a fever. The boy had croup. We had a nebulizer and saline, but the generator didn't work, thus no power to turn it on. There was no prednisone available even in the adult room. The only medication that was remotely helpful was liquid albuterol. The boy was very dehydrated and we mixed our own clean water in an empty coke bottle and added oral rehydration salts, helping the father to frequently give him small amounts. After a few hours he was not much better, breathing faster, more stridorous, a little less dehydrated. It was a horrible feeling not to be able to do anything for him, when the treatment is always pretty routine back home. We finally gave the father money to use at the hospital, but there was no way that I could see for him to get there through the mud and water.

Thankfully, Dr.Maklin, a truly great person and doctor who visits different clinics everyday and is part of the Cap Haitien Health Network, suggested he contact Carwyn Hill whose organization has the only ambulance in northern Haiti. Two of our nurses went through the swampy waters with the father and son as far as they could and the ambulance was able to meet them at the edge of the swamp. Another small miracle.

Meanwhile doctors Maklin, Morgan and Green saw adult and pediatric patients in a sweltering little room next to us. The Haitians tried so hard to get the generator and fan going, but with no luck. You could feel the desperation in people so hopeful that maybe something we brought would make them or their child well again, so afraid we would leave without them even being seen and people just kept coming and coming.

In Haiti the sun sets early and no one wants to be on the road in the dark without streetlights. Cows and goats lay in the roads, people hurry home along the roads and it seems like there are so many accidents waiting to happen. We began packing up around four o'clock. As I walked back along the path to where the motorbikes would once again meet us, so many children accompanied us, each wanting to hold my hand. If they couldn't hold a hand they held my arm, nearly up to the elbow, all the time smiling and laughing and chatting away in Creole. They laughed at my Creole, but seemed thrilled to hear me speak it. It made me wish that we could stay awhile and play with them. They were so beautiful, so excited to have visitors.

We climbed back onto the motorbikes and headed back to our waiting bus. We are tired, sweaty, and very muddy. Everyone has stories to tell. Can you call it a satisfying day? We did the best we could, but there is so much more to be done. For me one day clinics seem like band aids, yet we made a difference for those we saw for that day.

Besides, eye glasses and medicines we were the biggest show in town and brought smiles and laughter. And maybe we helped save the life of the baby with croup.

After a quick shower at the Hotel Joli which is a beautiful old hotel we head to the Hotel Roi Cristof for the Cap Haitien Health Network meeting. This is the organization of many different non-profit groups committed to working in northern Haiti. There are health workers, hospital administrators, people working in sanitation projects, latrine projects, soap and albendazole distribution, and many more. We share information and contacts and work together so no one has to recreate the wheel. It was only formed three years ago, but is making a tremendous difference in connecting organizations spread all over the north.

The VOSH eye team is there for the first time and many people are anxious to talk to them. When we return to the Hotel we finally relax for awhile, talking about the day and getting to know the people from VOSH. If I didn't know better it would seem like we were in a beautiful Caribbean paradise, but tomorrow we hit the muddy roads early and head back to Jacquesyl.

Mary Lou Larkin

Monday, February 22, 2010

Clean Water

by Mary Lou Larkin

Feb 22, 2010

We returned from Haiti on Saturday, February 20th. A day that began at 3:30 AM in order to get a ride to the Haiti/Dominican border, take a bus to Santiago, another bus to Santo Domingo and finally a flight from Santo Domingo to NY. I arrived in Danbury at about 1 AM on Sunday.

Although I hope that myself and others will fill in the many of the stories that happened after our "blogger extraordinaire" Megan Cavanaugh, returned to the US three days prior to us, for work and school, there are a few thoughts about returning home that I would like to share before they are forgotten.

As many times as I have returned from Haiti, the one thing that never fails to hit me is our ready, easy, instant access to clean water in the US. Here water can be had anywhere we go from the many faucets in our homes, from an outside hose, from the closest convenience store, coolers at work. We get hot water or cold water whenever we need it. We can get ice water or ice to cool our water. We can let a faucet run to warm up water or to make it colder.

The first thing I wanted when I got home was a hot shower. I can't tell you how appreciative I felt and how "water conscious" I always feel my first few days home from Haiti, because in Haiti none of these conveniences exist. Worse yet is that much water just doesn't exist. Haitian people spend hours everyday looking for water, carrying water from wells, buying water if they have money. In Port au Prince, in tent cities, mothers washed their children with water from puddles after a rain.

While our team was in Haiti we always had to plan our water use, making sure that we filled our water bottles every morning from the bottled water the nuns provided for us. When we showered, (the water trickled from a shower head), we got wet, turned the water off, soaped up, then turned the water on to rinse.

The one request our wonderful eye care team VOSH asked for was that we would provide plenty of water. We couldn't quite meet the request, but had to give them soda (yes, you can buy soda easily if you have the money) when the water we brought in the morning ran out. At the end of the day, when we went to eat the first thing I wanted was a glass of water. The water we as visitors had access to was clean. We would never get sick from it, never get parasites.

During the past year something quite extraordinary has happened in Jacquesyl. A teacher named Ultide and a heath educator named Jodel took the initiative to apply for a water filtration program. Through funds provided by an outside organization they organized the building of a water house, with a filtering system inside. A large cistern is on top of the house and water is carried by pipes from a giant cistern about a mile away to this cistern and flows into the filtering system, providing clean water which will be sold very inexpensively to maintain the system. The building of this system was completed last September. However the town was required to purchase the actual filters which cost $600.00.

No one in Jacquesyl makes that much money in a year, so Haiti Marycare planned to provide it, but we had so many urgent needs we had not yet been able to do so. Thanks to the generosity of so many people we were able to provide the money during this past trip and clean water is now flowing.

Twelve years ago when I first went to Jacquesyl this would never have been possible. There were no health educators, people didn't know that the water they drank was making them sick, there was no organazational structure to apply for and follow through on a sustainable project. Today, people appreciate not only getting water, but the importance to their health and their children's health.

There is a Haitian proverb, "Little by little the bird builds it's nest". Little by little people are becoming healthier in mind and body.

Mary Lou Larkin

Thursday, February 18, 2010

Health Care, Dental Care, Education in Jacquesyl

Kris Beckman timing flouride treatments for the students of Notre Dame de la Merci.



School children performing a dental hygiene skit.


by Megan Cavanaugh

Tuesday, February 16

Early morning spent sitting on back porch of our little house, warm morning sun, field of tall yellow grass inside the compound walls. I'm watching two baby goats leaping and playing. The roosters are starting their morning chorus. It's my last full day in Haiti, last day in Jacquesyl.

When will I be able to return? People here always ask- will you return and when? I could never walk away from this, once you come I don't think anyone could. You can't ever go back to pre-life Haiti, pretending it's not here. Going home is always tricky- trying to reconcile myself, the land of abundance versus all this poverty and suffering. I try not to get bitter or to belittle life and problems at home, but I am grateful for the perspective this place gives me. I don't ever worry about eating or clean water or just surviving.

Sometimes I wonder if people here know what they are "missing"? All that is out there in the world that they are being denied? How would they react- would they be angry? I ponder and ponder and feel heavy hearted about going home when there is so much left that needs to be done and so much I still want to accomplish here. It feels like throwing a Dixie cup on a bonfire sometimes. But many Dixie cups right? :)

Papito was gone to Cap Haitien to catch a bus back to the DR first thing this morning. We all agree that the morning went less smooth without him. We troop into town, back packs and baseball hats, we weave through the mud puddles, slipping sliding and leaping muttering "ampil boule... ampil." " lots of mud- lots." and our Haitian partners murmur in agreement. You've got to plan your path way ahead of time or you end up balancing on one foot on a 3 inch patch of dry land surrounded by a small pond looking like an off balance flamingo.

Again, we contemplate the weather in Port au Prince. It makes me want to plead with the clouds- ok ok rain lots but rain here!

I walk and talk with Bensua, who works with Father Anescar. My Kreyole is infantile but he is patient with me and eventually I learn that he has seven children and is a grandfather. I congratulate him. He invites me to come see his house and meet his family. It's just the way people are here. Welcoming, kind, family-centered and proud of it. I frown thinking about how this conversation never would have occurred in America. I've got to be more friendly at home I tell myself.

Morning first thing we stop by the preschool- 30 or 40 kids are here in two tiny classrooms- run by Nancy and Ultide. The kids welcome us with a song. Beautiful singing. The teachers show us some of the they tell educational corners they have set up. They tell us how great it's been for the kids and how helpful it is to have the learning materials. They were able to attend a two day seminar for educators of young children that showed them the value of these teaching strategies. This was courtesy of donations made last year by Saint John's Parish.

The rest of the morning is fluoride treatments, coordinated by Kris. She has had the supplies donated from work. Usually we do all three schools in the town- Notre Dame de la Merci, the Baptist school and the three day Adventist school. Not enough time today so we can only do Notre Dame. It's a production but so important.

Sherman organizes a skit with the kids based on a simple story I came up with on the bus ride in from the DR. There is a good strong clean tooth that takes care of itself, battles a cavity and survives. A weak tooth that never flosses or brushes battles cavity and dies. The kids are again theatrical and throw themselves into it. There is laughter and applause.

Kris does some education on oral health. The kids put half the fluoride in their mouths, swishing for a minute with painful puckered faces before spitting in the buckets we bring around. Repeat. A few more classes and we are done about 2pm. It has gone well.

While we are at the school I take some pics of the kids with their new sets of text books also courtesy of Saint John's Parish. Smiling faces.

Jim spends the morning working in the clinic alongside Dr. Valval, the Haitian doctor that works in the clinic full-time. Dr. Valval has worked with Haiti Marycare for the last four years and he works unbelievably hard. He is a great doctor, shy with his English as I am with my Kreyole. We have been able to keep him as a doctor at the clinic, continuity is so important here, but his salary as far as doctors go, even in Haiti, is pretty bad. Every time I see him I think about how hard he works all week out here in the country all alone... And how it's on our list to raise his salary. I admire him greatly.

Late afternoon we walk home and have lunch. Delicious goat stew, fried plantains, coca cola. Father Dorcin joins us, making jokes he holds up a plantain as if it were a host. I'm stunned- I laugh- is he allowed to joke like that?!

Back into town Mary Lou, Sherman and I go to do some home visits. Jodelle as always leads us to the homes of the sick. For the most part Dr. Valval is really on top of everything, he and the clinic nurse, Elirose, are a thorough and formidable team here.

We see an 82 year old man with benign prostatic hypertrophy. A common ailment in the states, but we don't have a lot of good medications to treat it here. What was available in the clinic didn't work. Dr. Valval had to catheterize the man. He is lying on this crummy mattress in a house of mud and sticks with a dirt floor and I'm amazed at the fact that he doesn't already have a raging UTI. He has made it to 82 in Haiti his immune system must be top notch, resilient. He has a kind smile and nods when we tell him he needs surgery and we understand but we don't have the money to send him to have the surgery. It's something we need to discuss with Dr. Valval and Elirose.

A surgery budget. I've gotta look into this when I get home. I add it to my list. This man has no quality of life, and if he doesn't get surgery soon...

We see a 32 year old woman with congenital cataracts, she has just arrived in town 6 weeks ago with her baby. At home she would have has surgery when she was born and had the problem fixed. It's easy in the States. Now she is blind for life.

We see a 41 year old woman who has gestational hypertension and had a stroke 4 months ago while giving birth to her 9th child. Nine children. I examine her. She has some residual, right side weakness and muscular atrophy but her face is symmetrical, her motor strength and sensations good. We give her some physical therapy exercises to do that involve rocks for lifting and some simple ballet moves to gain strength in her legs. The family watches while I demonstrate. We laugh at the silliness of the movements. But she gets it and promises to do them daily.

We see her daughter who is about 9 and has infected wounds on her legs. We clean bandage and treat. We see her father and mother too. Hey why not, we are here. In this section of town we see severely malnourished children. I wish I could make a GNC appear here. Visits continue for a few more houses. We walk to the rectory through town with our usual entourage of children. I've got a different child holding onto each one of my fingers, holding my arms when there is no more hand space. I could get used to all this love.

We see some mothers and babies who are refugees from the earthquake. The babies are healthy, gaining weight and gorgeous. But there is a 4 year old I've seen toddling about. Whe tells us she remembers her house falling down and my breath catches. She whispers the words in Kreyole. We have a meeting with nurse Elirose. She has lost family in the quake and it has changed her world. We tell her how sorry we are and her eyes well up. She talks about her brother-in-law who died, how her sister was buried but now survives and is very fragile. Her brother came across town to dig them out of the rubble. I hug her tight and we tell her to take time away from the clinic if she needs it. Even though we would be lost without her, she needs to take care of herself and her family. She now has even more people counting on her, more mouths. We talk about a list of things- albendazole and de-worming the kids, HIV tests, clinic needs, our hypertension program which is growing in popularity so that people from neighboring towns come to our clinic for treatment. I'm proud of our growing reputation.

We get a ride home in the truck. It's about 8pm, pitch black with a starry sky. We eat dinner. We discuss finances. Throughout the week people give you notes asking for money for various things. Not because they are greedy- because they are poor. Some things are more important than others. Like one of the teachers who asks for money for bus fare to bring three family members (2 kids) from Port au Prince to Jakzi. They have been sleeping outside in a field since the quake.

Anyone we can help get out of Port au Prince. This is personal money we use for these small things to help individuals- not donations. I give some money to a few people who I think have really worthy needs. It's impossible not to. I read about the aftershocks that continue to terrorize people here. The latest earthquake occurred in Cap Haitien, 20 miles or so from where we are. A school building collapsed and three children died. There was also a mudslide. It's confusing which came first.

People talk about the quake like it's a living thing hunting them- chasing them down. It's understandable. Imagine leaving PAP for the north thinking you are probably finally safe and then you start having aftershocks in the north. It makes me uneasy. I start looking at ceilings again- every time I enter a building or shower or brush my teeth. I read emails and news stories on my phone that declare the high probability of a quake in northern Haiti in the next 6 months- a real one- not just an aftershock. I start to loathe unseen fault lines.

Electricity shuts off early so I can't charge my phone or blog or finish packing. Shower by lamplight. Headlamp on I brush my teeth with my bottled water per usual. I'm too freaked out to sleep with my earplugs in. I try to tell myself I'm being irrational. We have been safe all week. But the fear is real and we all feel it. We sleep with our doors unlocked in case a quick escape is necessary. I sleep with my flashlight, glasses and bottled water. Or really, I don't sleep. No one does. The fear is real.

I think about the people here who have lived through the quake here and will be living in fear of the earth collapsing around them for a long time. Rational or not the fear has caught up with me, with us. I debate sleeping outside on the porch and know this is a bad idea with the rain and mosquitoes and I'm being ridiculous and I just lie awake and listen to the rain. Baby goats from this morning are outside crying somewhere nearby. Crickets. I stare at the concrete above me. How do people ever sleep inside after this quake here? I guess they don't.

Even President Preval says he is afraid...

Megan

Wednesday, February 17, 2010

Even Poorer than the Poorest of the Poor

By Mary Lou Larkin

Tuesday 2/16

Even though I've always considered Jacquesyl as the poorest of the poor, even here there are neighborhoods that are even poorer. We visited these houses today, houses made of only mud and sticks, red-headed children with pot bellies, signs of malnutrition and worms. The pot bellies mean that they're also probably not in school- or they would have been treated for worms.

Wednesday 2/17

The aftershocks continue. We learn of a building in Cap Haitien that has collapsed. I find myself looking at the ceilings if I'm inside - always preferring to be outside. Megan tells me this morning she didn't want to even sleep with her earplugs in- just in case... It may sound strange to you, but it is very real here.

I can't stop thinking about how Haitians are going to live with fear for a long, long time. We've had very heavy rains and the mud sucks your shoes right into it. Our clothes and legs are covered in mud but we don't care a bit. We all just keeping praying it's not raining like this in Port au Prince. We think of the thousands and thousands of people living in tents- if they've been lucky enough to get even that. I think of the rain running right through the tent cities, the mud, the lack of latrines, clean water...

I feel an impending sense of doom waiting for the disease to come...

Mary Lou

Health Care in Pilette

Kris Beckman, extracting teeth.



Dr. Jim Morgan, examining a patient for abdominal worms.


Jennifer Schmidt, Nurse Practitioner, examining a patient in Pilette.


February 16

By Megan Cavanaugh

Sorry no time to blog tonight. We are packing in the meetings until the last minute. But today was a great day, flouride for the school children in the am, Jim worked with Dr. Valval at the clinic all day, and Mary Lou and I did home visits in the afternoon. Tomorrow the team is off to a slum outside Cap Haitien for a day clinic and we expect a lot of refugees from the quake. There was a aftershock in Cape Haitien Sunday night that killed three students and so people are feeling very fearful there.

We felt nothing here. I hope there are no more.

Bon nuit

Monday, February 15, 2010

Health Clinic in Pilette

by Megan Cavanaugh

What a day! Such an amazing thing to be a part of. Three different non-profit groups joined together with Haiti Marycare today to do a clinic in the town of Pilette, where there has never been a doctor before for the town. There was a clinic building built but unfinished there- and we used that building.

The journey to Pilette from Father Dorcin's house in Roche Platte was an adventure, as all traveling in Haiti is. The rain had made the road a huge slick of mud. We bounced down a little path through the jungle in Father Dorcin's jeep. And I'm talking Disney jungle, the lush green that goes on forever, thick and strong. The car barely fit on the "road" at all and where there was a steep bank and a pretty swiftly flowing river I thought for sure we were stuck.

But no, this jeep should have been in a commercial the way it went right down the steep embankment and through the river, charging up the other side. Gripping my seat and planting my feet. We reach a road that's all mud and puddles and fishtail our way through it, sliding side to side but still progressing forward. Honestly, it was fun.

However, some of the people who came from a different group today to meet us were not in such an impressive vehicle, and they got stuck in the mud about three miles away and had to get out and walk. Which wouldn't have been too bad except for the mud - and the three rivers you have to cross. So our team gets there and sets up. We use benches from the church and put them in patient rooms. We walk around the empty clinic and imagine it full and running and serving the people in this town. We worry because no one else has shown up and a huge mass of people are starting to gather. We fidget with cellphone and satellite phones and it's just no use, we are in the mountains.

But finally we hear that they are coming, but have been delayed due to said lazy truck. So we start off without them. Jim and Mary Lou see pediatric patients and I see the adults. My first patient is 57 years old and went suddenly blind 13 months ago. His eyes look full of cataracts and the right one is clearly infected, most likely a secondary infection to his condition. He insists that he was working in his garden and a bit of cactus juice (it takes awhile to figure out the right translation) fell into his eyes and he went suddenly blind. Papito confirms that there is such a cactus in the area. I'm at a dead end. I don't know how to treat cactus eye poisoning, we don't exactly see a lot of that in Boston. But I still debate cataracts and then open angle glaucoma, from the way he describes the incident as very painful with a headache.

Luckily we have a team of eye doctors coming to Jakzil at the end of the week. I ask him and his daughter if they can get there and they say they can. So I flush his eyes and teach his daughter and treat his infection and pain. It's all I can do for now, and I wish I could do more for him. He seems weary and tired, but gentle and very grateful. They leave but promise to come to Jakzil on Friday.

The other teams arrive. Wow, we have a lot of medical personnel! It is awesome. The clinic becomes pretty crowded with us all. Everyone is buzzing with excitement to get to work and to be here. We set up more medications and rooms and after a little tweaking, triaging and the normal amount of chaos we have a system down and we are a machine.

We see at least three hundred patients. Pregnant women, babies, elderly, the acutely ill. I work with Dr. Maklin, one of the Haitian doctors who bounces between a lot of the clinics in the north, including ours in Jakzil. We see a patient who complains of diarrhea for 9 months and an episode of extreme illness a few months ago. He looks dehydrated, emaciated and he has a fever. Dr Maklin suspects HIV and we have a rapid test done (courtesy of Ted Kaplans team) and the man is positive. The weight of the diagnosis is huge. My heart hurts for him. It's not exactly easy to get HIV medication in Haiti. But it's not impossible either.

Dr. Maklin tells me about the cultural issues and politics around the diagnosis of HIV in Haiti and we talk with the patient about it, telling him he needs to go to Tru de Nord to have more tests done but that we are very concerned. You can't technically diagnose someone with a rapid test. We give him a letter to bring to the doctor he will see in Tru de Nord. There are HIV treatment programs in certain cities, Tru de Nord being the closest to where we are, but traveling back and forth to get medications, and dealing with the horrible side effects when you are already malnourished and frail... I am so grateful when his wife's test comes back negative.

She is a nurse mid-wife and understands the gravity of the test. Father Dorcin meets with us all and we make a plan to help the man get to Tru de Nord for his testing. We treat his fever, give him oral rehydration packets and treat him for pneumonia, give him vitamins. It's the best we can do for now. We are a whirlwind.

Everywhere I look patients are being seen, being cared for, being given the medication they need and instructed on how to take it in their own language. The translators are amazing, patient and compassionate. Kris Beckman is able to set up and perform tooth extractions for those people who have rotten aching teeth. Anyone who has ever had a real toothache knows how important this is. Dr. Maklin and I treat a few patients for malaria, pneumonia, infectious diarrhea, worms, UTIs and otitis media.

We see some unusual cases, including a boy who has never gotten any vaccines and has a face so round and swollen it should be in my Bates text book next to "mumps." I've never seen mumps, neither has Jennifer, the NP from one of the groups who has joined us. We dont see it in the States, but that is undoubtedably what it is. It goes on for hours, the continue stream of patients being examined and treated but there is always a huge crowd waiting to be seen, never ending. At 4 pm we have to stop, we make sure we have seen all the truly ill people, but we need to pack up and help the team get back to their broken down truck and everyone needs to get back to their home bases by dark. We have all comr from at least an hour away today.

We all agree that if it weren't for the pitch black night that comes so quick, we would like to continue seeing patients. It is a successful day by anyones standards. I am impressed by, and grateful to, the other medical staff and interpreters that joined us. Everyone worked together so fluidly, all wanting to help as many as we could, the best we could in the short time we had. We repack and take turns getting driven out of the jungle to a road, through the rivers and fields of cattle and horses.

We are dropped off at the end of thr jungle path and start walking down the dirt road while Father Dorcin goes back for more of us. It's a cold day by Haitian standards, never more than 80, and it has been cloudy but now the sun is breaking through the clouds above the moutains. I'm telling you, the view is pure Disney, magical. I think I am in The Jungle Book.

We walk up the road slowly taking pictures and as always, we gain an entourage of beautiful, half-naked, brightly smiling and giggling children. I take their pictures in the road and then show them their photo on my digital camera and they squeal in delight pointing at themselves. They touch my hands and skin and hair curiously, shyly. I take pictures of the cute stick and mud houses with the brightly painted doors, children peering out the front door at me, goats sticking their heads through the cactus. They are all curious about the strangers strolling up this remote dirt road through the jungle. The pictures do not do the beauty of this place or the children justice.

I'm so content, I don't know a more satisfying feeling than this. To know I was able to be part of something so good todsy, to help some people who really needed it, to have been given that ability - it is a huge honor and blessing. I know there are people at home who want so badly to be able to do more to help people here, and I try never to take the fact that I am here and able to do that for granted. It's been a really good day. I hope everyone who reads this and donated knows that you made today happen, and it was was real miracle to see.

Thank you, thank you, thank you.

Megan

Off to the Clinic in Pillette

by Megan Cavanaugh

February 15

We are up about 6am to shower and get ready for the day. I am not a morning person, but I'm too excited about working today to be even remotely grumpy about the early wake up call.

We listen on the porch to the call of strange birds and the declaration of morning by all the town roosters. It rained all night and while it was like a gentle lullaby- no need for a sound machine here- we are thinking about Port au Prince and the people in fields without sanitation and praying there has been no significant rain there. The fields will become puddles. But we all know the rain will come sometime. I hope they are moving faster at handing out good tents to people and digging latrines.

Today we will go in groups in Father Dorcin's jeep up and around the mountain to reach the spot where we plan to do our clinic today. We will use an empty clinic building there- it was built and then never put to use. We are hoping to change that. Mary Lou is dreaming big of a chain of primary care clinics here in the very rural and impoverished sections of northern Haiti. And the people really need them. Especially now that their population is overgrown to accommodate so many displaced family members and refugees.

We will go in two trips to the site because all the rain last night will make the roads very muddy, the rivers swollen. It's better to not have the car loaded down too much. We are all excited to begin the day. Eat breakfast of FRESH bananas and papayas and spicy peanut butter on toast.

7:29am
Megan

Sunday, February 14, 2010

Days in Jakzil

Mary Lou Larkin and Angeline's baby girl




The First Aid Play


Meeting with the teachers of the school Notre Dame de la Merci in Jakzil


by Megan Cavanaugh

February 14, 2010

Yesterday was a busy and productive first day in Jakzil. The clinic is closed on the weekend here and the government has declared Friday, Saturday and Sunday days of mourning in Haiti. It's the quietest I've ever heard it the night we arrive, even the dogs seem to know not to bark.

In the morning we walk to town down the dirt road as a group. We have already picked up some of our usual entourage. Today will be a day of planning and meetings. The mission of Haiti Marycare includes education and supporting the development of the town. This morning we are meeting with the three teachers who run the town preschool. We want to talk with them about involving the kids in an activity where we will create first aid kits for the town. We've collected all the materials- this was all done and planned even before the earthquake occurred. So now we want to tie this into a discussion with the kids about the earthquake, what an earthquake is, what happened in PAP and what they should do if an earthquake occurs. We want them to understand, because the fear of not knowing for sure, of their imaginations and things they may have overheard from their displaced relatives now arriving in town to live with them- must be scary for a kid.

We greet the teachers, people I'm starting to know pretty well- Ultide, Jose and Dosselin (Papito's cousin- he has a lot of those!). I love the two cheek kiss thing they do here, and that everyone says "Bon jour" when they pass each other. I see more of my friends throughout the day and am SO happy to see them but also SO happy they are OK and since I don't have the linguistic ability to tell them all this in good Kreyole I make sure they know it in my bear hug.

I see my friend Angeline, the laboratory technician at the clinic. Last year when I was here she was pregnant. Now she hands me this beautiful chubby baby girl in a little pink outfit that just makes me go to mush. She smiles at me, not afraid at all, such happy kid. I tell Angeline how gorgeous her daughter is and she beams. We have a lot of great people we work with here in Jakzil and each one of them comes to say hello.

Some of the kids remember my name, which makes my day, and they ask me for bubbles and dolls and balls- all things I brought last year- and I feel bad to tell them I couldn't bring them this year, we needed all the space for medications and such. Try explaining that to s kid who looks forward to bubbles for 11 months though.

Youdinx, who is a young kid from Jacquesyl, contracted polio at the age of 6. He is now 15 and was attending a school for handicapped children in PAP when the earthquake occurred. We want him to speak to the kids about his experience, but first we want to hear his story ourselves, since we saw his school and dormitory completely demolished in PAP, and all understand it to be a true miracle that he is unharmed. So we gather with the teachers and Youdinx under the shade of a tree behind the rectory and plan.

It takes longer than you would imagine when everything has to be translated into Kreyole and English. We have a plan for a play where the children will act out the importance and reason for having a first aid kit. Then Youdinx will speak and then they will go through an assembly line and each be able to create a first aid kit. So the floor is open to Youdinx. This kid, who I've heard speak before, is old before his time. Smart- he wants to be a doctor he told us last year, and I bet he will be.

So he tells us how he was lying in bed when the first three seconds of the earthquake occurred. Everyone starts running out of building and his instincts tell him he should too. So he gets himself into his wheelchair and as he gets out into the street he looks behind him to realize that the entire building, except for the one section of a room he had just been sleeping in, is completely collapsed. Six boys in the school lose their lives. He is unsure about the girls in their dormitory but knows they are mostly OK. I feel so twisted up inside watching him calmly relay this story when I can picture the rubble of the dormitory he was in.

The children are waiting, all 150 of them, in the courtyard when the first aftershock comes. Youdinx says the whole city began crying out, dogs barking, more buildings falling, it was the loudest noise he has ever heard. People in the street fell to their knees and began praying. When the first aftershock passed,the children realize the main exit of the courtyard has been completely blocked off by a building that has now collapsed. So they decide they better go out the small entry through an alley way before it's too late. They go out into the street and wait for an adult to come find them.

While they wait people began singing hymns and praying loudly. More aftershocks occur, the whole world rocking and crying and falling. They director of the school finds them and is amazed they are alive. The aftershocks continue throughout the night, they sleep outside. Some parents make their way to collect their children the next day. But Youdinx and some of the kids live far away. Eventually he gets through on a cellphone to his brother In Jakzil and tells them he is alive.

His brothers make their way to Port au Prince to collect him and eventually they are able to get their way back to Jakzil. When he is done with his story we are all pretty much crying. It is horrifying to hear such a personal account from such a brave young kid. We thank him for sharing such a frightening personal experience with such grace and wisdom. I will never forget this moment and I know it.

We break for lunch, setting up the first aid stuff and practicing the play. We have a meeting with the teachers of Norte Dame de la Merci who talk about how great it is that each child now has a book for each subject to study from. This was a big project for Haiti Marycare last year, one I was very proud to be involved in. It took a lot of hardworking good people to get these books into the kids hands!

When Youdinx shares his story with the kids in town later, after the play, he makes it more appropriate for the kids, and he has their complete attention. He tells them about what an earthquake is and what to do. He tells them that they can help. And he tells them that even though he is physically handicapped he is grateful for his intact mind and soul, because he knows many survivors will not be so. It's a pretty heavy moment.

The kids put on their first aid play to much laughter and applause. It's getting dark so we have to use our headlamps in the school classroom and guide the kids through the assembly line to create their first aid kits. It's a successful activity.

Long day, we walk back to the Caritas compound where we are staying with an entourage of children. It's dusk. The kids point at things and tell me the word in Kreyole and ask the name in English- "Roche" "rock", "ciel" "sky", "twal" "star". It goes on and on until we get to the gate of the compound and say goodnight.

At dinner Papito tells us there will be an old fashioned Haitian band playing in town tonight and he is going to go and play his saxophone. We all agree that as tired as we are it is something we can't miss out on. We shower and, with lamps and flashlights, walk the road back into town. There is already a big crowd gathered outside the house where the band has started playing. Someone has filled a huge white paint bucket with some type of charcoal and hooked it around the limb of a tree as a source of light. Creative and it works well.

Papito joins right in. There are drums, an acoustic guitar, a guy plays a tin can with a spoon, someone else plays percussion and another is singing. The music is AWESOME. We are swaying. Then we are dancing. I dance a few songs with someone's Aunt, twirling and just moving your hips and feet Caribbean style. I dance for a song with my friend Lilene. Honestly- It feels good to laugh, it's been a pretty serious few days and a longer and sadder period for all the people here. And its so awesome the way laughter is universal, it requires no explanation, we are just laughing together.

We stay for an hour dancing with everyone, listening to the music under the beautiful night sky. Then we make our way home again.

Today is Valentine's day. The morning is church. It's raining. We all pray it's not raining in Port au Prince. It has rained all day. We have a meeting with Father Anescar about the grade school that Haiti Marycare supports. We packed our things and climbed into an old Land Rover and crossed a few rivers and came up into the mountains.

We are staying at Father Dorcin's rectory in Roche Platte tonight. He is quite the amazing host. Earlier today we weren't sure how it was going to end up- but as of 7 pm tonight it was official- tomorrow we have a team of 18 medical providers coming together to do a day clinic in a town that has never had a doctor. There are 45 new families here displaced from the earthquake and almost every single one of them has a member that needs medical attention. So we are excited to get to work tomorrow and to be able to help all the people who need it.

Earlier today the mist came down the mountains and brought the rain, if you hadn't seen them before you wouldn't know they were there anymore. I hope it doesn't rain too much more since the old truck crossed a few overflowing rivers to get here today. Rain running down the mountain... Could make getting home a bit of an adventure. Mostly, I pray it's not raining like this in Port au Prince. I'm missing a good concert with Papito and Father Dorcin. They just sang a ballad about our adventures here this week, so I need to go. But tomorrow will be a good and busy day.

Bon nuit.

Saturday, February 13, 2010

Day 2 of Traveling North

by Megan Cavanaugh

February 12, 2010

Yesterday was another day full of bus traveling, but at least a bit less chaotic than the day before. We think positive! In my opinion there are only a few things worth mentioning about yesterday.

First, we stopped at a bus stop in the Dominican border and had some of the best coffee I've had in my entire life. We also ran into Rinkah Hill, she and her husband are fellow members of the Cap Haitien Health Network and live in Haiti running a new hospital in the north. When the earthquake hit, they kind of had to open on the fly in order to accomodate overflow from other hospitals in the north. We are happy to see a familiar face. I hear a horror story about how some people had no idea what an earthquake was so when it hit they ran INSIDE buildings and homes for shelter and were killed. This is so sad but makes sense- there hasn't been a earthquake in Haiti in almost 200 years, why would people know what to do?

When we arrived in Cap Haitien, the main city in the north, it was getting dark. Father Dorcin was a welcome sight, there to greet us with a pick up truck. Always reliable, always cheerful. We load all the stuff in the bed of the pickup truck and climb in. We completely fill the bed. I happily volunteer to ride in the back on top of all the luggage. If I had it my way this would be the only way I'd ever travel- the bed of a truck with the warm air rushing at you. We roll through the city of Cap Haitien which is still bustling from the day. It has the smell of a Haitian city- salt air, charcoal and diesel.

We see some wounded people walking around, crutches, bandages etc. No doubt this city had an influx of earthquake refugees. I am so grateful this city was not destroyed by the earthquake with its houses stacked upon each other built into the side of the mountain. It's a pretty amazing sight.

We bump along in the truck out of the city. The air is warm and feels great. I've read a small amount of Haitian history and I've got way more to learn, and who better to ask than someone who lived it so I ask Papito to tell me about Aristide. He is a wealth of information, and I learn a bit about the good, the bad, and the fear.

We pull farther out of the city on the stretch of highway, the lights of the city become a glow over the horizon. I remember the first time I came to Jakzil and riding on this road was not even remotely the same. It was dirt, huge rolls and potholes you couldn't go faster than 30 mph for fear of losing a wheel. Now it is smooooooth. In the country it is dark and we only see one other car for the next thirty minutes, though I do see a few people on horses trotting down the other side of the road. No street lights and empty flat road we dodge the cows and goats that are napping in the middle of the warm cement. This makes me remember a time in the past we drove down this road at night with only one headlight and everyone had to be a cow spotter.

Holy stars, I've never been anyplace where you could see so many. And I see at least half a dozen shooting stars before we get to the dirt road turn off that leads to the town of Jakzil. It's smells like jasmine the whole way down the road. Calming and welcoming, I am so happy to have arrived in Jakzil.

Friday, February 12, 2010

Traveling through Haiti and The Dominican Republic

Our outdoor living room at Walls. They kept pulling more furniture from the rubble.

Our blog station



by Megan Cavanaugh

February 12, 2010

Yesterday = BUS. We are up with the sun rolling up our tents and giving them to Abner to pass out to people he knows who have little children and are sleeping in open fields with no shelter. We say goodbye to Veniel and the staff at Walls and thank them for giving us such a good stay - I am amazed at Veniel's resourcefulness and how almost normal our stay- within the guest house compound- seemed, if it weren't for the sight of the collapsed guest home that was constantly reminding me of the terror that recently struck here.

In the tap tap off to the bus stop for another long ride but the UN has blocked off a road so we need to take a long dirt back road that wheels us directly between two tent cities. As we discussed yesterday people are living so close together there is clearly no place for going to the bathroom, they have been using the road between the tent cities for the bathroom. The smell is horrible but the sight of the fields of people who are all living together now in a desperate situation is heart wrenching. I tuck my nose into my t-shirt and breath through my mask and think again about how people will continue to LIVE in this. Not just today or for a few days. When I am safe home back in the us sleeping in my comfy bed there will still be young mothers with their children sleeping in fields worrying about the rain.

The truck pitches to a nerve wracking angle while we try to maneuver our way down a mud hill. I've been gripping this rusty metal bar above my head so hard the last few days I have callouses. We spread our feet apart and hold tighter. I can see the headlines of a newspaper declaring out tap tap accident in my head. We get to the airport. But we are taking a bus. We explain this to the driver and realize we will miss our bus. Go with the flow there will be another.

On our drive we see a food distribution site, the first I've seen. There is a line along the edge of a huge field, it takes a 90 degree turn and continues for as far as I can see. Women will stand in this line all day in the sun with thirsty, hungry children in tow. When they have spent three hours waiting for rice they will spend another two waiting for clean water. And if they are lucky today another two waiting in line for a tent. And then in a few days they will have to repeat the first few steps over again.

20 minutes later: bus station (aka parking lot). Tickets, crowds, heat, luggage, soldiers, chaos as we finally board our bus at 10 am. We leave at 11 finally, the bus is hot from sitting in the sun. We were spoiled on our bus ride to port au prince with the air conditioning and the easy border stop. No such luck on this day. The bus is unbelievably hot.

There is an hour of traffic at the border and they make everyone who is traveling with children get off the bus and clear through a special customs to ensure all the children belong to the adult they are traveling with. Off the bus we are told. So we spend two hours in no-mans land between DR and Haiti dragging our bags off the bus into the heat of the day across the rocky parking lot and into the cement building where they are going through baggage. Total chaos. Back on the bus all Americans we are told. No one has even gone through our baggage, this was an exercise in futility.

Repack all the bags into the cargo hold, jostle through the crowd and back on the bus. I feel like we just got Punked. We can only laugh, and we do. We sit on the bus waiting. HOT. Sweating through your clothes, not just sticking to them, kind of hot.

When we leave customs finally there is a woman shouting angrily in kreyole something about a Canadian passport. The argument continues for the next hour. They pass back out all our passports, mine is the last and I've managed to not get too worked up over it before it's in my hands again. At home I would have already created three scenarios in my head for how I was going to get another passport or get home but here there is too much constant unknown for worrying about the possible problems that might occur. I can only deal with the problems that become a reality. Because when you travel in Haiti there are lots of mini adventures along the way, you've got no control over them.

I count white goats to pass some time. The sun sets and we are still on the bus, the DR looks so different than Haiti. There are trees. And real roofs. And sidewalks. It's cooler with the sun gone. We have been watching the same movie flit across the cracked TV screen for the last eight hours. There is no sound so all I've gotten out of it is that Russell Crowe has an unusually large forehead- I think his forehead is 80% of the movie- and the other 20% is Ben Affleck holding the same confused and slightly pained expression. At 8 pm, ten hours of bus time later, we arrive back in Santo Domingo. And I never want to see Russell Crowe again.

It's dark and raining. Baggage, crowds, chaos. I've got "think positive" on repeat in my head. I climb into the very back of the cargo hold of the bus to start fishing out our bags, something I'd normally never do because I'm a bit claustrophobic but I'm too tired to care about my unreasonable anxieties.

For the third time that day someone asks what day of the week it is. No one gets it right. And no one knows what time it is because we have crossed and recrossed the border so much in the last three days. As if to illustrate the differences- and problems- between the two countries the DR and Haiti refuse to share the same time zone, let alone the same language.

Papito manages to get us a taxi, though there is anger and arguing between the drivers. We check into our hotel. We try to shower but the water doesn't work. Oh well, I'm grateful just to not be bumping around. It's been a long day and we still have a lot to do. These are hard days, the traveling ones, where it would be easy to lose sight of why we are here and to feel overwhelmed because unfortunately, in order to help people and see patients there are days where you just travel. The days that you actually tangibly help people are so gratifying you do forget days like this.

So now we need to collect supplies at Papito's house and bags to repack and we haven't eaten since 8am. We go to a Dominican Chinese restaurant for dinner and I order a burrito. Cultural mish-mash. It's 10pm.

Finally back at our hotel we get into bed at almost 1 am. We have to be up at 7am to get on another bus for another 7 or 8 hours- depending on the border situation in the north- and travel to Cap Haitien. I remind myself that I have friends to see in Jacquesyl and how happy I will be to hug them and get back to work. I think positive. I try not to think about bed bugs. At least I am in a bed. Megan

Thursday, February 11, 2010

My Respect for the People of Haiti

by Mary Lou Larkin

February 11, 2010

I couldn't sleep at all last night after seeing the destruction of downtown Port-au-Prince and thousands of tents everywhere I looked. Where do the people use the bathroom? Where will they wash up? The tents All touch each other. There is barely anywhere to walk. There is dust from concrete that people are breaking up with any thing they can find which fills the air. The only things not destroyed are the statues of Toussant, Dessalines, and the Maron, the heroes of Haiti. It is heartbreaking for me. The tents actually abut the pedestals of the statues. When you look up the mountain behind the sagging and tilted palace, the homes that were once there are all fallen on top of one another.

The university nursing school completely collapsed and many died there. This country depends on good nurses who do so much organizing of public health campaigns. Another incalculable loss.

As we walk through the dust and destruction I see three boys with kites made from discarded pieces of plastic and they are smiling, running and laughing. I see a woman scrubbing a child with a tiny bowl of water. Life will go on and my respect for the people of Haiti can never be expressed in mere words. I have had visits at the guest house of Haitian friends who come simply to say hello and to talk and to see how we are doing. They tell what happened to them, their homes and their families.

We laugh and smile and connect, but in Haiti there is little small talk. Life is too intense.

Mary Lou

Wednesday, February 10, 2010

Last Day at Our Port-au-Prince Clinic

by Jean Eric Massena

02-10-2010

Hello everyone, this is Jean Massena. I am writing from Port au Prince, Haiti. Today was our last clinic at La Plaine. I had a great experience working with Megan as an interpreter and assistant. We saw many different cases and we believe that many of them are caused by the fact that many people are homeless and are sleeping in the streets. We believe that malaria is going to be a big epidemic in the months to come.

In the afternoon we went downtown to "see with our eyes" unimaginable destruction caused by the earthquake. The tent cities are getting bigger. The beautiful "Champ de Mars", one of the biggest parks in the region has seen its proud and elegant National Palace reduced to nothing.

The streets are so covered with a white dust that you have the feeling that it is snowing in the carribean. How can twelve men with nothing in their hands clean up what is left of a 3 floors building? But what a determination they have to continue working with all their strength and their hearts, and for nothing in return.

Our experience today gives us more passion for the work we are doing. We are getting ready to go to Santo Domingo tomorrow and then to Cap Haitian and Jakzil. We fill that we should provide the best health care service to the Haitian people and we wish them a better tomorrow.

Papito

Kembe fem, Stay Strong

by Tom Larkin

February 10, 2010

In my favorite movie, It's a Wonderful Life" George Bailey stays in Bedford Falls, while his brother goes to college, then to war, living the adventurous life that George had aspired to. Reading of your travels, through our new blog, I feel like George Bailey left behind to conduct the battles of Bedford Falls, depositing checks, sending money to Haiti, answering emails, talking to new people about our work.

When George told Mr. Potter off in the office of the Bailey Savings & Loan, he portrayed such passion because he believed what they were doing was important, in that it allowed people to work and live with pride and dignity. Somehow I feel a little like George. Everywhere I go I talk about the wonderful work our team is doing. And my new labor as spokesperson has become a passion I find hard to stifle, and yet my heart is also with all of you as you share your love and compassion with our Haitian brothers and sisters.

I know sometimes the work and accomplishments seem small, when you observe the magnitude of the obstacles before you, but in the eyes of the mother or child who looks to you for comfort you mean everything. You also represent the love and compassion of the many here who have loved and sacrificed by sending their donations to aid our Haitian friends through your hands.

We are all one team, doing what each of us can. I am so proud of all of you and all who have become part of this great effort to help our Haitian friends. It is sometimes in these moments of contact, one person to another, that we sometimes see the face of God. You are that point of contact in Haiti, but we are all sharing those moments with you, and I am also witness to similar encounters here as outpourings of compassion continue. I have the privilege of being the middle man who understands what is happening on the ground, but also feels the tremendous love our friends in America are showing them. Tell them. Tell our Haitian friends that we are not forgetting them, we are standing side by side working hard to provide what help we can. Tell them also that we are grateful for the inspiration they show us by how they live.

Kembe fem, Stay strong.

Lespwa fe viv, Hope makes us live.

Treating Patients in Port au Prince

by Megan Cavanaugh

February 10th

Woke up to the Baptist preacher at 5 am again- fire and evil and sin he yells. Off on our bumpy trip to back to the school we see about 45 patients from 9-1pm. One of my first patients is a thin young man, he comes in drenched in sweat, holding his head, he moans quielty in pain when he takes the seat. I barely have to ask him what is wrong. He is the face of malaria here. He tells me he has had a fever on and off for the last three days and now his head hurts terribly, he feels weak, can barely stand and he even vomited his water he walked so far to get this morning. His temperature is temperature is 107, his heart rate 120, his respiration 24, his blood pressure low. His lungs are clear, his heart strong, but FAST. I give him 1,000 mgs of Tylenol and 600 mg of Chlorquine. I explain with Papito that this should help with his fever and headache quickly but that the malaria takes longer to recover from. I tell him he is SO dehydrated and I am worried for him. He rests in the shade while I see more patients - a broken foot from a woman who was inside her house when the quake struck, a painful perforated ear drum with discharge- she says her ear "popped" during the noise of the quake.

We treat with all the right mediations and supplies because of our friends and family and people who donate make that a possibility. I check on the man with malaria. His temperature is down to 100.6 in just 45 minutes. He tells me his head still hurts. We give him oral rehydration packets and explain he can take more Tylenol tonight but that he needs to DRINK clean water. We explain how to take the rest of the malaria medication and he has friends help him home. I pray he will be all right, and I worry about him the rest of the day.

I'm not trying to be dramatic, I really think we saved his life simply by being here with the right medications. I'm here and I get the gratification of witnessing that but it takes about a hundred peaople back at home to make that happen. People who donate, help with fundraisers, collect and pack medication bags, coordinate flights and finances, drive us around the tricky streets of PAP, pick us up from the airport and make sure we are safe and fed while we are here. We have such an amazing network of support. We work till 1 pm and the only people left are those with problems we don't have the correct medications for. Discouraging, but I promise to return and have a women's health day.

I think we did good today I say to Papito and he smiles and tells me: You and I are going to kill malaria! And we laugh both understanding that we made a small dent today but we are taking on an endemic disease.

We go by our tap tap down town to Port au Prince. Many have tried to explain the destruction and devestation and failed. I will fail too, so I won't even try. I got close trying to take pictures and a strange Haitian man on a bicycle comes to me "no, no, no!" he yells at me. I step back, unsure if I have offended him and Abner wisks me away explaining the man is concerned for my safety- I have been standing underneath a huge sheet of concrete that is hanging precariously by a few wires. During the next tremor it will surely fall.

Devestation, destruction, the living conditions in the newly erected tent city around the collapsed national palace are unimaginable. But I have often thought this when I see parts of the slum of Cite Soleil. The smell of rotting produce composting in the gutter along with sewage and what else I can not imagine. It is a horrible smell, and people are LIVING here. I will go home and they will LIVE here. No bathrooms, no privacy, no comfortable place to lie down when you are sick or tired. They LIVE here.

We walk over to the statue of the slave that was freed, a beautiful sculpture that shows the strength and history of Haiti. Tents are all around it, close as they can be. We stare. A tiny little girl, her hair woven in tight brades, about the age of 6 is peering at me. She has a pink sundress on and no shoes, in the middle of all this sewage and squalor she like hundreds of thousands of children here have no shoes. She approaches me and grabs my hand, squeezing tightly, a million watt smiles stares up at me, her eyes and her smile so bright against the dark, smooth skin. I smile at her, genuine and touched that she has taken my hand. Haitian children frequently do this, they love to hold your hand, and its one of the thousands of reasons I have become a haitiphile, in love with it all.

But then she did something I've never had a child do before- she kissed the tips of my fingers. I don't know why she did it but I melted. I automatically take her chin in my hand and I tell her in Kreyol that she is beautiful. If its possible I get an even bigger smile in return.

I want to tell her so much more- to tell her that she is smart, and resilient, brave and kind and that she has a good future because of all that. That God does love her, and that he only loves and forgives, never punishes. I hope that she does have someone in her life who tells her all that, tells her everyday. Because she needs that, and she deserves that, after all she has survived and the fact that she is living in inhumane conditions and likely always wondering if she will eat today- she can still smile and take a stranger by the hand and show love. It's time for us to go back to Walls so I wave goodbye. She let's go of my hand and actually, for real, skips away down the grimy street off into the tent city.

Children everywhere amaze me. I wonder if that little girl knows what an awesome memory she just gave me, how bright and hopeful, and how blessed I feel to have met her. I don't know exactly how, but some tiny peice of me softens and changes because of it. Just human kindess.

Plannings, meetings, organizing the artwork we have had a friend, Jaqcui Labrom gather for us so we can sell it at a fundraiser. Coordinating a food shipment with Joan back in the US so the children of Abner's school can still eat, until some small part of a normal life returns in a few weeks. We talk about shipping costs, containers and ports underneath our outdoor living room by the light of the lantern. We repack and reorganize medication bags.

I call my friend Rachael in the US who is got her grad degree in art thearpy and is an emotionally wise soul. I tell her I have brought drawing paper and colored pencils for the children and I want to give them a therapeutic activitiy to help heal from the quake- or at least encourage a dialogue. Seeing a three store building split in half and turned on its side- I can not imagine how frightening that was, especially as a child. Your whole world actually falling down around you. Rachael advises me and Abner. Adner and I talk about how he will do the activity at his school and he tells me he will talk with them about HOPE and it will tie in nicely with our theme of creaing a wall to of pictures to metaphorically show how we can all together rebuild Haiti. The children will draw pictures of what they dream of when they think of rebuilding their school, homes, lives. Sherman has provided Abner with a published manual on how to talk about traumatic incidents with people, and Abner is going to have a meeting with the parents of school students so they can feel safe to discuss a subject that they are still frightened to talk about.

Time for bed, people singing, more people protesting somewhere far way, just light chanting. It's dying down now. Just the usual hum hum of the generator, my friends chatting in Kreyol, and the crickets trying to dround out the dogs barking.

Bon nuit

Back in this Land of Contradictions

by Mary Lou Larkin

Here I am back in this land of contradictions. Warm breezes, sunshine, people greeting us with smiles and warmth, while their whole world has fallen down around them. The welcome we received at the guest house tells the story of Haitian hospitality. We are sleeeping in tents supplied with mattresses they pulled out of the guest house. We can use the shower and bathrooms and we were served spaghetti and hotdogs as the sun went down.

We had a full day of seeing people who literally have nothing left and live in tent cities, a step up from a soccer field. Once you are in a tent city you are eligible to get food and water. I don't know what they thought people were living on in the meantime. It was very weird to diagnose a depressed skull fracture with nothing but my hands and weirder still to tell the mom that the baby would probably be fine. A cement block fell on his head. He was 2 months old. Thank you Steve Blumberg for the mini lesson on gangrene.

I saw a 21 year old girl who was initally treated at a US clinic but couldn't go back when she was moved to a tent city. A cement wall fell on her foot and completely denuded the skin on her foot.Thanks to our generous donors and supporters we have had most of the medicines and supplies that we've needed so far. It was a hot, exhausting day, but more satisfying than you can ever imagine. There is so much to be done, but the people themselves are out chopping up the cement, sweeping the streets, singing in the churches, selling their wares. They are unbelievably resilient. I am typing on a computer that is set up in the parking lot next to my tent, with light supplied by a generator. Jim is reading by the same light. Papito has just returned with ice cold drinks for everyone.

For Tom and Joan, Jana and Rob who worked so hard to get us ready for this trip, thank you so much. It has been worth all the work.

Tuesday, February 9, 2010

Cite Soleil Day 1 - Working out of Abner's school

Patients gather outside the school, waiting to be seen.

Dr. Jim seeing a baby with pneumonia. Sherman Malone translates.


Megan Cavanaugh seeing a patient with Papito translating.



Some healthy young girls who came to basically see what was going on and because their siblings are sick. They come all dressed up to see doctors always- which sort of hides the poverty they live in. Beautiful smiles.


From left to right: Kris Beckman, Jean Eric Massena, Megan Cavanaugh, Mary Lou Larkin and Jim Morgan


pictures sent by Megan Cavanaugh

First Day Impressions of Port au Prince

by Megan Cavanaugh

February 9th 2010

I woke up last night to a cat pawing at my head through the mesh of my tent. Better than the way Mary Lou woke up- hearing the roar and buzz of huge cargo planes and all the nuts dropping from the trees thinking we were experiencing an aftershock. She told me she got out of her tent thinking " if this is an earthquake I want to SEE it." I agree. I will admit to curiousity, though I would definitely not say I WANT to experience an aftershock. We are told that there was one today late in the afternoon in Petionville, and that it was small and people are ok. We did not feel it at all, though the electricity flickered for a while.

Everyone else woke up when the Baptist preacher started mass at 6 am. It is usually held in the church across the way, now held in the street. I asked Papito what he was yelling so angrily about to his congregation- apparently he was telling them Haitians are being punished by God because they have lost their way. This makes me angry. Haitians, I know are the most God loving and selfless people I know. And despite the poverty and distress they go through, they continue to praise God and love him and believe in him unfailingly. How many of us have had our faith tested that way I wonder. I don't think I ever have. And the dialogue I always have with God when I come to Haiti begins again.

This morning we gathered as a group underneath what is usually a garage but has become an outdoor living room. The staff here at Walls have been gathering the furniture from the wreckage and digging it out of concrete over the last week. It is odd to see the table we usually have group meetings at now sitting intact outside on the driveway... when we arrived only a few pieces of its oval shape were here. Tonight when we returned from work it was almost complete. So we had a breakfast of peanut butter and bagels we had brought with us at our table. Off in the tap tap and down the bumpy dusty streets to La Plaine, an area of Cite Soleil where we worked for the day. In the traffic of the morning it takes about 45 minutes. But we discuss that traffic is probably a good thing- it means people are moving about, doing things, traveling and hopefully- working.

Jim spoke to our experience working today so I will not, suffice to say we are already seeing the detrimental effects of people living outside and so close together without sanitation. People with high fevers of 105-107 and diarrhea. A lot of what I suspect, but can not confirm, is malaria. So we treat for malaria. We work in Abner's school building, in rooms they have cleaned of rubble and fallen concrete for us. We have a makeshift pharmacy we set up. Simple chairs to sit and see patients in. It was a good but frustrating day; frustrating because you think of all the tools and medications you have available at home that you are aching for because you can not help someone the way they deserve to be helped. But I think we make a difference. We saw about 60 people today, between three providers with translation taking a lot of time I think that is a success. I saw about 17 myself, and the first case was undoubtedly pneumonia. The second I'm fairly certain malaria. Hopefully not typhoid. It gets insanely dripping sweaty hot around 1:30 in the afternoon. We come home in our tap tap about 4 pm. Stop at a local market. I go into my first Port au Prince mini market and am actually pretty surprised by the array of goods considering all that has gone on here. I take a nervous glance at the on huge crack through the ceiling of the super market. I do my usual- if there was an aftershock right now what would I do? But I'm starting to worry about it a lot less.

We sip cold coca colas, well earned I think, in the back of the tap tap on the way back to Walls. I look around at the markets on the side of the road and amazed by the fact, and encouraged by the fact, that life is starting to go on here. A Haitian friend points out the fact that yes, life is going on, even though bodies still need to be recovered by the rubble. But people need to eat, and so they continue to work- or at least try to. Employment is hard to come by. Poor people here used to live day to day here for the most part, on about a dollar. Now I think they live hour to hour.

We get home and enjoy the cool evening air. We eat a meal of spaghetti with hot dogs, a pretty traditional Haitian meal. We talk about human rights and the UN in Haiti and debate the good and bad of their presence. We talk about our patients and how most of them will be sleeping under the open sky tonight, trying to fight off the same mosquitoes that gave them malaria. Sometimes you do honestly wonder if you make enough of a difference.

After dinner we all shower- and I can tell you this is one of the BEST feelings after a hot sweaty day here. You can actually FEEL the heat, dust and sweat come off your body. I sit down to read some of the book I brought and just as I am thinking about how this is my absolutely favorite part of the day here- the cool evening air after a hard days work- singing begins, strong and beautiful in the street. A Catholic mass is being held just over the wall. People sing as one, praising God and being thankful for all they have. (All they have?! I think initially- but someone points out- yes they have life and that is something to be thankful for). They come together in the street, not caring that their church has become a pile of concrete, they just want to be together and pray and sing. Beautiful singing! It honestly does my heart a world of good to hear, Haiti is still alive and as strong as ever. They just need some help.

Another day of work tomorrow. Looking forward to it. Bon nuit.


~ Megan