Tuesday, August 16, 2011
Tuesday
Today Chris, Scott, and I stayed at the hospital warehouse and reorganized the suturing pallets and the glove pallets. It was somewhat laborious and uneventful, but because we were going crazy we spent the majority of the day mixing work with jokes. Carla, Will, and his dad went to cite Soleil. They came across a woman with possible malaria and a man with possibly AIDS and TB. The hospital ambulance could not come get them, so they put the two people in the van to take them back to the hospital. We decided we quite possibly saved two lives by staying at the hospital. Chris and I fell between pallets a total of 3 times, though, so maybe we didn't choose the safer option. We weren't hurt, it just gave us another opportunity to laugh.
We got back to the house around 3:30 and were invited to go watch the local boys' baseball practice. They were so funny. Maybe like 7-12 year olds, but they all were total hams. During their warm up running, which some were doing with no shoes, they would try to hide or fall on the grass hoping to get some sympathy. One of the guys from the house, who is from the US, came to help them with their technique. One of the kids came up and asked if I was going to play and I said I didn't know how and his response was "I didn't know there was anyone from the US who didn't know how to play baseball." I had no response because he totally had a point. Practice had just gotten underway and we were bombarded with a lightning storm. So the boys were immediately sent home and we ran to this little cement shack to take cover until our driver came to get us.
On a bright note, the others are starting to catch up with my bite count (16). We are going to do a final tally to see if someone else took the lead away from me. This trip has actually turned into big scoreboards. We play games of dog/goat/chicken (they seem to look alike), cow/horse/donkey/mule, and European import car (I saw two Cayennes and one G wagon so I'm killing them).
Another highlight of the day was Scott and I coming back from the warehouse and asking our house guard if we could hold his shot gun and take a pic. He said yes and then went into his shack and got his other gun to pose with each of us. I have a huge smile on my face and Scott decided to sport the Zoolander look.
We got back to the house around 3:30 and were invited to go watch the local boys' baseball practice. They were so funny. Maybe like 7-12 year olds, but they all were total hams. During their warm up running, which some were doing with no shoes, they would try to hide or fall on the grass hoping to get some sympathy. One of the guys from the house, who is from the US, came to help them with their technique. One of the kids came up and asked if I was going to play and I said I didn't know how and his response was "I didn't know there was anyone from the US who didn't know how to play baseball." I had no response because he totally had a point. Practice had just gotten underway and we were bombarded with a lightning storm. So the boys were immediately sent home and we ran to this little cement shack to take cover until our driver came to get us.
On a bright note, the others are starting to catch up with my bite count (16). We are going to do a final tally to see if someone else took the lead away from me. This trip has actually turned into big scoreboards. We play games of dog/goat/chicken (they seem to look alike), cow/horse/donkey/mule, and European import car (I saw two Cayennes and one G wagon so I'm killing them).
Another highlight of the day was Scott and I coming back from the warehouse and asking our house guard if we could hold his shot gun and take a pic. He said yes and then went into his shack and got his other gun to pose with each of us. I have a huge smile on my face and Scott decided to sport the Zoolander look.
Tomorrow some are returning to Soleil and some are visiting the orphanage, which I am particularly looking forward to. The boys today were so full of life and well spoken that I'm sure it will be a great experience.
Monday, August 15, 2011
Lightning Storm over the Haitian Ocean
I find thunder and lightning storms to be one of nature's most beautiful phenomena. We were luck to catch this light show over the ocean on Sunday evening.
Yin and Yang
It seems that for everything lovely in this world there is something dark and dangerous; For everything dark, there is a beauty to even it out. After spending a few days in Cite Soleil, we took a short day and a half off to go to the beach North of Port au Prince. Although it was only 30 miles outside of the city, it took us nearly an hour to arrive due to the disrepair of the roads. As we departed the crowded city and began our journey through the countryside, the massive overpopulation ebbed slightly. Although, the countryside was still dotted with tents, small houses under construction, and some houses that were still crumbling from the earthquake. The ocean breeze whipped into the van we were in and kept us fairly cool despite the blistering heat and lack of air conditioning. I really didn't even notice the heat until we slowed to a crawl to wade our way through the villages. We travelled rapidly on the "highway" and barely at all through the village towns. One of our Haitian friends, Wilson, told us the name of each town as we passed through. I wish I had thought to write them down, because they're all escaping me now.
We passed plantations filled with banana trees and mango trees, but the sparse housing remained. In the towns, masses of people lined the roads selling everything from pencils to clothing to plantains.
We turned into the hotel area we were staying at and the image changed drastically. Immediately, we were surrounded by lush grass and trees. We walked into the hotel and were greeted with complete chaos at the front desk. It had the air of a tropical hotel with absolutely no order. After about 3o minutes, we were checked in and made our way to the beach. It seemed as though I had stepped into a different world. The hotel was clearly a place where wealthy locals and UN members came for the day or weekend. The beaches were pure white sand that met up with a crystal clear turquoise ocean. It was incredible to think that just outside the walls we had left a world of poverty and need. I felt a bit guilty laying on the beach and enjoying the ocean, but I feel like it also was a good quick break from the endless stretches of people, cars, and pollution in Port au Prince. Returning tonight, I'm ready for my next venture in the St. Damien hospital network!
A little rest
The Beauty of Existence – Part II
A Circus of the Senses
Flanked by mountains and the leeward side of Hispanola, Port-au-Prince streches up receeding hills, ascending in social class with each degree of elevation, with Cite Soleil pressed at its bottom against the ocean and resolutely bordered by a refinery and a river on either side. Haiti's open sewer system makes the flattened low-lands the least desireable. Even the marginal slope, from the top of Cite Soleil until it reaches the marshy bay, helps to define the complex class hierarchy amongst the poorest of the poor. The higher above sea level your house is the less often swelling sewers will flood inside your home. Cite Soleil is one of the most densely populated area's in the world, 200,000 to 300,000 people in 2 square miles. As you descend toward the ocean, the quality of homes detereorates from contrete blocks to corrugated tin to wooden poles with cardboard walls, an area known as Cite Carton. This unimaginable density and poverty intensifies the individual's drive to exaggerate class differences based on miniscule things, perpetuating classist disdain for the ultra-poor in the community. It's density also presumes throngs of kids - playing, yelling, chasing me at times in spurts of curious revelry followed by a shy embarrasement when I turn to greet them. They're like children everywhere, except instead of feeling like one distant cousin you're meeting for the first time, its ten to fifteen every few blocks.
It is impossible to explain the intensity of the poverty. We often conceptualize poverty into a generic form: paucity of things, derelict buildings, encompassed by a over-all feeling of despondency. Yet the on-slaught, the dense and mulitplistic sensorial experience of poverty in Soleil can not be accurately described or imagined. Soleil's sewage filled canals, black with industrial sout, petrol coated mounds of plastic bottles floating motionless in stagnent rows 2-3 feet deep and 1 foot wide, like a grid, slicing between homes that are only 7-12 inches apart in places. The smell compounds disparate elements of the entire city into each inhale, thick and heavy in the tropical sun: coal-fire ash; diesel smog; frying oil; composting waste; smells of livestock like pigs, goats, and chickens; and sweaty human beings. Electrical wires reach out from roof to roof supporting hanging clothes above street vendors selling their wares with often pristine pyramidal mounds of fresh fruit lining the road. The combined sounds of Cite Soleil is really lound 23 hours a day, in part because Haitains are the most verbal and physically expressive people I've ever met, similar to my experiences in southern Italy but even more so. Laughter, singing, joking, arguments that erupt in yells and then fizzle in seconds; hoards of children playing and yelling - competing with their infant siblings muted within the homes; cars honking in morris code; vendors advertising their goods; singing and music coming from multiple directions (one of the most important aspects of Haitian social and religious life). There is a brief respit, as the rising sun breaches the mountains behind Port-au-Prince, slicing through Soleil towards the ocean. During this mystical hour the silence in Soleil is gently distrupted by just the sweeping of brooms, the quiet singing of mothers, and Catholic alms from the daily ceremonies. Haitians are emphatically clean in their clothes and homes, their white blouses and pressed shirts seem to defy the entropy you'd expect. Soleil is the dirties, dustiest place I've ever been and their pride and the sense of dignity is ever apparent in their spotless attire. I would return after a days work looking like I had just stepped out of the mines. I don't know how they do it. Soleil is a circus of the senses – music, sewage, laughing children, malnutrition, and abominable living conditions; and yet, and this is one of the most important personal insights that I've gained over the years, is how strong there is an inclination for me as foreigners to myopically perceive the most severe of, the worst aspects of, a complex environment like Soleil. When I first began living in Soleil in my early twenties, I would walk out my door and I unconsciously saw and heard only what re-inforced my perception of the Haitian's condition of misery and hopelessness.
I remember when this began to shift, and it wasn't just the broadened perspective that comes with prolonged experience. In the next segment, I'll go into the internal process that facilitated a change in perspective. During my later trips, from 1996 to 2000, I would live and work at a hospital run by Mother Theresa's Missionaries of Charity brother's in Cite Soleil. Although the brothers were from all around the world, the compound was mostly Haitian staff and patients. I enjoyed the immersion of livinging amongst Haitian's, working on my Kreyol and creating relationships. I also appreciated the brother's monastic lifestyle as many of you know I spent some time as a Buddhist monk.
I awoke one morning in the usual cacophony of sounds, except this time my consciousness singled out the gentle singing of our neighbor as she hung the morning's laundry. Every morning hence, I awoke to her singing. A new layer of perspective slowly began to take root, to spread into my moment by moment experience of Soleil. Day by day I'd notice things like teen age couples flirting on the front stoop, people singing together, parents gooey with joy over a new born child. Soleil in all it's glaring poverty and suffering came to have an evenly balanced spectrum of the same human experience that we all share, yet until then I hadn't quite seen it. Not that I was oblivious to this side, but that it that my perception focused on the difficult. The average life span in Soleil is shorter, there's more sickness and hunger. But also, like everyone, they fall in love, they laugh and joke with friends, infants beam at the sight of their parents, soccer games form amongst friends, they dream of better lives and hope the same for their children. It's the same human condition - the routine of work, the responsibilities of parenting, the emotional symphony of daily life…and bit by bit it occupied a balanced portion of my experience in conjunction with the difficulties.
We just got back from our vacation from our vacation. We headed an hour and a half away to Club Indigo for two days and one night of beach. The ocean was amazingly beautiful and we all just lounged on the beach and floated in the water. The majority of the group are now various shades of lobster, but it was worth it. It's funny though because we all discovered that we missed Relax a little and are happy to be "home." Tomorrow we go back to work, some to City Soleil, some at the local hospital. We are all safe, happy, and eating a little too much
Sunday, August 14, 2011
Tap-Taps
French Colonial 'Gingerbread' Architecture
French colonial hotel in Jacmel
Cite Soleil and The Beauty of Existence Series
History of Cite Soleil and My Early Years – Part I
During my first few trips to Haiti my family accompanied a group organized by, Bob and Jane Corbett, who had started an organization called 'People to People'. The group consisted of other families, health professionals, and often a big contingent of high school seniors doing their 'senior project', a common, mandatory volunteer stint required by St. Louis high schools. At the time, I was fourteen and as naïve as any adolescent, so when we had a family meeting (a first for us) about whether or not to go to Haiti, all I really took in was sandy beaches and palm trees. I didn't have a clue where or what Haiti was like. This was 1987, only a year after the deposition of 'Baby Doc', Jean-Claude Duvalier, Haiti's second generation dictator. Haiti had always been one of the poorest countries in the western hemisphere, but as ruthless as the Duvalier's were, they ran a tight ship. Crime was very rare, besides what had been done and perpetuated by the Duvalier's themselves, and the Haitian's spent the 1800's and 1900's highly isolated from external influence. Originally, because it was the first successful slave revolt, in 1804, and were hence blacklisted by the surrounding, still slavery dependent countries. Agricultural practices, especially in distant rural communities functioned in almost a medieval simplicity – hand plowed, hand carried water, and subsistence living. This is still the case in much of the country. Even Port-au-Prince, a city of 2 million in 1987, had an old world feel, a place out of time. Colonial French 'Gingerbread' buildings of saturated colors and intricately carved wood work peppered downtown. Equally vibrant Tap-Taps, public transport, carried us around to our various volunteer sites. The open warmth and curiosity of the Haitians that I met was so palpably a unique deportment. Haitian internal emotional life is infinitely more expressed outward than that of my American culture. During my early trips to Haiti, the Haitian expressiveness - singing out-loud, laughing, effortless talks with strangers, and a playful way of interacting made these trips not like daunting excursion into a small foreign country, but more like being welcomed into a really big neighborhood.
We organized a clinic in the main slum called Cite Soleil, 'Sun City' (or 'Site Soley' in Haitian Kreyol). Francois Duvalier 'Papa Doc' built Cite Soleil in order to concentrate a cheap labor force, originally naming it Cite Simon after his wife. The Duvalier's invited American companies to set up factories, making use of the cheap labor force. For example Disney had garment factories in the 1980's and all Major League baseballs were hand-stitched by women for decades. Unfortunately, the stretching of the leather would eventually debilitate the worker's chest muscles. My early medical experiences during these impressionable years (early teens) were surprisingly not over-whelming, shocking, or disturbing at all. It was invigorating!
Saturday, August 13, 2011
Tarantula Part Deux
Comfort zone expansion
First and foremost, I want to to thank Will and his father, Dr. Boyce, for sharing this experience with us. Everyone should know that Will and his father have been doing humanitarian work in Haiti for several years. They consistently make substantial sacrifices to help improve the quality of life for some of the least fortunate people in the world. Watching them in their element has been a great experience for me. I came from up an upper-middle class upbringing in the suburbs of LA and have never really made any significant sacrifices for other people such as those that many people down in Haiti are doing on a daily basis. Part of my decision to go back to school and become a doctor was to develop skills that would allow me to make those kind of sacrifices for other people. When Will asked me if I wanted to go on this trip with him I thought it would be an excellent way to see how I responded to this type of work.
The organization we came to volunteer with was started by an american priest turned doctor, Father Rick. He runs a handful of sister hospitals in one of the nicer (relatively speaking) parts of port au prince across from the UN compound. His children's hospital is apparently the best and well respected children's hospital in the city.
Recently he started a new project in Cite Soleil, the poorest slum in all of Haiti. He's building a small hospital within a few hundred yards from the ocean...... and in Haiti, the closer you get to the ocean, the worse off you are..... shit literally runs downhill in a hillside city with open air sewage. His committment to serve the poorest of the poor is truly inspiring. Without a healthcare facility in Cite Soleil, the people of the community really have nowhere to go for their healthcare needs. However, operating in such a slum does come with some substantial safety concerns. The area has a history of substantial violence and gang activity, just like any other slum. Father Rick's approach to operating in an area like this is to get the local community involved and to ensure they know that if their family members become ill, his hospital will restore their health.
While the Cite Soleil hospital is still under construction, they decided to start a tent clinic right next to the construction site to start seeing patients. Since this clinic was new, this is where the organization needed the most help. Dr. Boyce jumped on the opportunity to see patients at the clinic upon arrival and had gone down to Soleil with just an interpreter and a few duffle bags of medications. When we arrived, we were asked if we wanted to go down to Soleil as well. Will thought it would be a great experience for us so we decided to go.
Driving into Soleil the first day was completely shocking to me. I'd never seen anything close to the poverty level that is present in Soleil. We went down with two of Father Rick's personal security guards and were also told that all of the construction workers on site were instructed to serve as security as well. Both our personal security guards and the construction workers had considerable ties to the community. The significant security presence gave me some sense of comfort, but I was as far out of my comfort zone as I'd ever been.
We set up the clinic and the first day went very smooth. We probably saw about 50 patients. A Spanish surgical assistant treated wounds and Dr. Boyce saw all of the other patients. We helped out by setting up, taking vitals, organizing and dispensing medicine for Dr. Boyce, performing urine tests, and helping out as needed. Since Will speaks Spanish and Creole, he was able to do some interpreting for the Spanish surgical assistant and his father. We also came with a young Haitian interpreter, Jean, who speaks five languages, and a young Haitian man, Junior, who is getting ready to start medical school in Haiti. We saw many diseases that day. One elderly woman was suspected to be in an advanced stage of a cholera infection and probably would have died that day if Dr. Boyce didn't come down to the clinic. Dr. Boyce called up the hospital and had them send their ambulance (possibly the only one in the city) down to pick her up. We saw a handful of children with suspected malaria (a highly curable disease), many men and women with urinary tract infections, a lot of body pains, wounds, common infections, scabies, malnutrition, and some common colds.
A few things really stood out to me that day. It felt great to be part of a team that truly made a difference in other peoples lives. I also noticed that for being incredibly impoverished, the patients we saw, for the most part, maintained great hygeine and appearance. If you took many of those patients out of Soleil and put them in any of the major cities in the US, they would not stand out at all. Despite their desolate conditions, poor Haitians have a lot of pride. Lastly, as we were getting ready to leave, the ambulance had not arrived yet for the woman with cholera. Many of the team members were ready to leave, but Dr. Boyce refused to leave until the ambulance arrived. Some of the team members objected to this, but Dr. Boyce stood his ground and even said he'd stay by himself if everyone else wanted to leave. I was really touched by this gesture. What a man!
We went back to Soleil the next day and everything was going great until a few gang members started a little altercation outside our tent. I could feel the tension in the air. Our security guards and the construction workers were able to prevent the altercation from getting ugly and we continued to see patients, but during the moments when the tension was high, I really began to question the prudence of my presence. We were warned that Haitians were very demonstrative in their interactions with each other, but I still felt incredibly vulnerable, more so than any moment in my life. We made it out safely, but the rest of the day and night I thought long and hard about how I felt. Was jeopardizing my own perception of safety worth it? I was presented with the dillemna that all global health workers working in a high risk environment have to face. I feel a little guilty about it, but I reached the conclusion that my sense of safety isn't something I am willing to jeopardize and that I wanted to stick to the confines of the more established hospitals for the remainder of the trip. It really takes a very special person to go into a situation like a tent clinic in Soleil. At this point, I don't think I am one of them, but I will continue to reevaluate because God knows these people need the help. Maybe I am just a few more experiences away from having the comfort zone of Will, Dr. Boyce, and Carla, or maybe I just wont get there. Regardless, this has been a great slice of life and I am grateful to Will and his father for sharing this experience with me. These are the type of lessons you just can't learn in a book. You have to feel them for yourself.
The organization we came to volunteer with was started by an american priest turned doctor, Father Rick. He runs a handful of sister hospitals in one of the nicer (relatively speaking) parts of port au prince across from the UN compound. His children's hospital is apparently the best and well respected children's hospital in the city.
Recently he started a new project in Cite Soleil, the poorest slum in all of Haiti. He's building a small hospital within a few hundred yards from the ocean...... and in Haiti, the closer you get to the ocean, the worse off you are..... shit literally runs downhill in a hillside city with open air sewage. His committment to serve the poorest of the poor is truly inspiring. Without a healthcare facility in Cite Soleil, the people of the community really have nowhere to go for their healthcare needs. However, operating in such a slum does come with some substantial safety concerns. The area has a history of substantial violence and gang activity, just like any other slum. Father Rick's approach to operating in an area like this is to get the local community involved and to ensure they know that if their family members become ill, his hospital will restore their health.
While the Cite Soleil hospital is still under construction, they decided to start a tent clinic right next to the construction site to start seeing patients. Since this clinic was new, this is where the organization needed the most help. Dr. Boyce jumped on the opportunity to see patients at the clinic upon arrival and had gone down to Soleil with just an interpreter and a few duffle bags of medications. When we arrived, we were asked if we wanted to go down to Soleil as well. Will thought it would be a great experience for us so we decided to go.
Driving into Soleil the first day was completely shocking to me. I'd never seen anything close to the poverty level that is present in Soleil. We went down with two of Father Rick's personal security guards and were also told that all of the construction workers on site were instructed to serve as security as well. Both our personal security guards and the construction workers had considerable ties to the community. The significant security presence gave me some sense of comfort, but I was as far out of my comfort zone as I'd ever been.
We set up the clinic and the first day went very smooth. We probably saw about 50 patients. A Spanish surgical assistant treated wounds and Dr. Boyce saw all of the other patients. We helped out by setting up, taking vitals, organizing and dispensing medicine for Dr. Boyce, performing urine tests, and helping out as needed. Since Will speaks Spanish and Creole, he was able to do some interpreting for the Spanish surgical assistant and his father. We also came with a young Haitian interpreter, Jean, who speaks five languages, and a young Haitian man, Junior, who is getting ready to start medical school in Haiti. We saw many diseases that day. One elderly woman was suspected to be in an advanced stage of a cholera infection and probably would have died that day if Dr. Boyce didn't come down to the clinic. Dr. Boyce called up the hospital and had them send their ambulance (possibly the only one in the city) down to pick her up. We saw a handful of children with suspected malaria (a highly curable disease), many men and women with urinary tract infections, a lot of body pains, wounds, common infections, scabies, malnutrition, and some common colds.
A few things really stood out to me that day. It felt great to be part of a team that truly made a difference in other peoples lives. I also noticed that for being incredibly impoverished, the patients we saw, for the most part, maintained great hygeine and appearance. If you took many of those patients out of Soleil and put them in any of the major cities in the US, they would not stand out at all. Despite their desolate conditions, poor Haitians have a lot of pride. Lastly, as we were getting ready to leave, the ambulance had not arrived yet for the woman with cholera. Many of the team members were ready to leave, but Dr. Boyce refused to leave until the ambulance arrived. Some of the team members objected to this, but Dr. Boyce stood his ground and even said he'd stay by himself if everyone else wanted to leave. I was really touched by this gesture. What a man!
We went back to Soleil the next day and everything was going great until a few gang members started a little altercation outside our tent. I could feel the tension in the air. Our security guards and the construction workers were able to prevent the altercation from getting ugly and we continued to see patients, but during the moments when the tension was high, I really began to question the prudence of my presence. We were warned that Haitians were very demonstrative in their interactions with each other, but I still felt incredibly vulnerable, more so than any moment in my life. We made it out safely, but the rest of the day and night I thought long and hard about how I felt. Was jeopardizing my own perception of safety worth it? I was presented with the dillemna that all global health workers working in a high risk environment have to face. I feel a little guilty about it, but I reached the conclusion that my sense of safety isn't something I am willing to jeopardize and that I wanted to stick to the confines of the more established hospitals for the remainder of the trip. It really takes a very special person to go into a situation like a tent clinic in Soleil. At this point, I don't think I am one of them, but I will continue to reevaluate because God knows these people need the help. Maybe I am just a few more experiences away from having the comfort zone of Will, Dr. Boyce, and Carla, or maybe I just wont get there. Regardless, this has been a great slice of life and I am grateful to Will and his father for sharing this experience with me. These are the type of lessons you just can't learn in a book. You have to feel them for yourself.
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