Some Pictures for your Perusal

Hi folks! Here are some (possibly low quality) pictures for your enjoyment. The first picture is the view from the balcony here. It's where I've spent many an afternoon packing medications and studying for the MCAT. Oh, I've also relaxed a bit up there too!

 This is the clinic's current home. Dr. Wolf's consultation room is on the left and the waiting room/admin/pharmacy/triage is to the right. Patients wait on the benches outside on the far right. You can also see the back end of the Toyota we use to get here!

 Clifton (on left) and Gemy (on right) as we walk into neighboring communities to meet with promoters of the Water Project that Gemy oversees. It took us 2 hours to walk here and many of our patients come from further distances.

Yours Truly on a hilltop above the new clinic. The day had been spent painting the ceilings in the new pharmacy/lab - hence the paint in the hair. (Shout out to my LCC EMT friends! I sacrificed the T-shirt knowing I had the same exact one waiting for me at home.)

Some local flora above the new clinic.

The stages of construction - on bottom is a corner of the laboratory. On the top, in the roof-framing stage is what will be the residence. Yes, that's bamboo!

A Day in the Life

Greetings friends! We just had a group from New Jersey and the week absolutely flew by! Dr. Wolf had asked me to write a little article for the Friends for Health in Haiti newsletter and this is what I've thrown together. I'll try to write more about the past week soon, but we had a little incident with tiny ants moving into the laptop for a few days and now it's touch-and-go with this poor little Dell.  Anyway, enjoy the article!

When I met with my friends Drs. Garry and Mitzi Barker in April 2013 and asked if they had any suggestions for medical experiences in Haiti, I didn’t realize how fortunate I was that they knew Dr. Wolf. Now that I’m here I realize I’m even more fortunate that Dr. Wolf and Cherlie agreed to let me come and stay for 11 weeks this winter. Not only am I being given an invaluable opportunity to improve my Creole and my EMT skills, I’m fortunate enough to bear witness to the incredible amount of work that these ladies do each and every waking moment – which, for Dr. Wolf, is quite a few moments!

Mornings here start shortly after dawn with a simple breakfast and a strong cup of coffee. By the time we have arrived 12 miles up into the mountains and grown an hour older, the caffeine is fully circulating and we are set to open clinic. Despite drinking the same coffee, Cherlie seems to have an extra source of energy. She always arrives ready to give her invigorating morning message to the waiting patients. People laugh, they nod amen, and best of all they come away with an understanding of the heart of the clinic.

What follows can be anyone’s guess. Patients arrive for follow up visits and treatment plans are altered as needed. The day continues in this fashion, with patients varying from chronic hypertension to acute synovitis, along with a plethora of adorable, occasionally febrile children. People often arrive on stretchers made of wood and banana leaves, the bearers sweating beads in the cool of the morning. It’s a testament to the difficulty of the terrain, the distances people are willing to travel, and the incredible respect the Centre de Sante de Gatineau has earned. The day up at the little clinic ends when the last patient has been given careful instruction from Cherlie on how to take their meds, return precautions and loving reprimands on whatever each person needs to hear – somehow she always seems to know exactly what that is.

We next spend time at the new clinic site, the magnitude of which is heightened by a comparison to the amenities currently available in the area – no electricity, no running water, no two story buildings, few roofs made of anything but tin or thatch and certainly no other health facilities of this caliber. It is a testimony to the power of belief and perseverance. Construction continues on at an encouraging pace. The roof is being framed with a maze of bamboo supports and the masons continue to smooth and beautify the seemingly endless concrete structures. Through it all, Dr. Wolf documents and compares the physical clinic with the architect’s plans, patiently keeping everything progressing.

The workers clean up around four o’clock and we tend to leave Gatineau by 4:30. The day is far from over, with many more moments to work. We are home and setting the table for dinner by 6:00. Cherlie is an excellent cook and her enthusiasm for produce has us all eating well. Once the table is cleared, it’s time to pack medications for the next day, record the finances and double check the log books. My day’s work has ended and I often retreat to the balcony to study and relax. From there, I see the light of Dr. Wolf’s office on until the wee hours of the morning, taking advantage of the quiet and what seem like endless waking moments. 

Mikwòb

This week was full of ups and downs – literal up and downs as we went up to the clinic Monday, Tuesday, Thursday and Friday, and sentimental ups and downs as well.

On Monday, Gemy, Clif and I built a tipitap in front of the clinic for all to see and hopefully, to use. For those unfamiliar with Tippy Taps, they are a simple solution to hand washing in places without running water. They require 4 pieces of wood, a gallon jug, a bar of soap and some string. A little ingenuity and the ability to dig 2 holes and presto! Hands free hand washing!

Our Tipitap, it all its glory

The highlight of spending the day explaining the tipitap to patients and people passing by was a conversation with one petite, middle-aged woman. She approached the tipitap without hesitation and seemed receptive to my stump speech. Being slightly hyper by nature I spoke quickly and quite possibly incoherently. Explaining the benefits of hand washing to kill microbes and prevent diseases like cholera, I spouted off my somewhat rehearsed monologue. I asked if she understood everything I was saying and she responded “no.” This in and of itself thrilled me. People ALWAYS say yes, they understand what I’m saying. This is clearly untrue as half of the time I don’t even know what I’m saying. I asked her what she didn’t understand and she answered “what’s a mikwòb?” This was too good to be true! I was then able to explain to this woman in very simple terms the germ theory of disease, encourage her to create her own tipitap at home and to spread the knowledge to her family and friends. Public Health for the win!

The low of the week was on Tuesday when we said goodbye to Clifton, my new fast friend from New York. He returned home in time to beat the blizzard but he left behind a quiet house only his infectious laughter could fill. Thanks for letting me share your family time Clif! Tout moun isit ap sanje ou.

The rest of the week has been beautiful as always. I never cease to be amazed at the vistas here and at the incredible amount of work Dr. Wolf and Nurse Cherlie accomplish. The construction at the clinic site continues on at a steady pace and we are all eager to start seeing patients in the new buildings. A team from New Jersey is coming in tomorrow to help paint and build shelves and bring the Sant de Sante Gatineau (Center for Health in Gatineau) into its new home. I anticipate the upcoming week to be full of more ups and downs, and per usual, always more highs than lows.

Already Two Weeks In!

Hey hey everybody! Thanks for the patience with the slight delay in posts. The goal is to try to have something new every Friday since we don't have clinic over the weekend. However, routine here is hard to maintain.

The architect who designed the new clinic and lab/residence is coming to check on things next week and do some carpentry. In order to prepare for his arrival, Friday was a Work Day. We drove up to the site early Friday morning, gloves and tools in hand. For the next 8 hours we shoveled mountains of clay and gravel to smooth out the land around the new buildings. We piled up trash and dried-up bamboo to burn in giant bonfires we could see from the road half an hour away from the clinic. The day was long and the work sweaty, but I feel like it broke down the small cultural barriers between me and the rest of the crew. Swinging a pick all day earns a girl some street cred!

Earlier this week was also a change from the routine. On both Tuesday and Thursday, Clif, Jemi (the community health educator) and I ventured into the country surrounding the clinic to meet with promoters of the water project and inform them of the meeting on Saturday morning. We journeyed at least two hours in each direction both days, up and down countless hills and valleys. We passed capped springs that people come to from miles around for water. To walk into the rural countryside with the tiny footpaths and tied up goats and free range chickens everywhere was such a joy. The Oregonian hiker in me was ecstatic.

Today is our one day of rest this week as we spent Saturday at the clinic meeting with 15 promoters and discussing their efforts at educating their communities about the importance of clean water.
I'll be spending it at the nearby beach. It's pretty rough. :)

This upcoming week should be a bit more calm, clinic Monday, Tuesday and Thursday and then guests arriving on Sunday. But, as I've learned from previous trips and am continuing to be reminded here, roll with whatever happens because in Haiti you never really know what the day will bring. 

Week 1 Musings

Hey everybody! I made it to Jeremie!

I'm staying in an insanely beautiful house with an ocean view and a balcony I can't get enough of. Dr. Katie, Nurse Cherlie, Cherlie's mother and Cherlie's nephew Clifton are all in the house and yet the place is so large there are still so many empty rooms. We all eat breakfast around 7: white bread, PB and coffee. Shortly thereafter we leave for our hour drive up into the hills. The road is brutal. It takes 6 gallons of diesel to get up it in the 4WD Toyota Land Cruiser. I can see why this type of vehicle is so popular here. On Wednesdays we have the day to work on house repairs, pack medicines and prepare for whatever's next. That said, this Wednesday I went into town with Dr. Katie and Clifton to buy internet access and then spent the afternoon floating in the Caribbean blue on a nearly deserted white sand cove. Tough luck!

But we're working too: we saw 17, 38, and 51 patients on Monday, Tuesday, and Thursday, respectively. We saw everything from a little girl with a likely left humerus fracture secondary to a fall, to an older man who was last seen 2 years prior. At that time, Dr. Wolf had suspected tuberculosis. He went to the hospital for a TB test. It was positive and he followed the 6 months of treatment as prescribed. He stood before us fully recovered and even 11 lbs heavier! A true success story.

The most frequent complaint is hypertension in the form of headaches and “tet ki vire” or dizziness. The problem stems from a salty, low fluid intake lifestyle and medical noncompliance. Dr. Katie explained that when people receive bad news the often stop taking their meds because they’ve heard of people dying after bad news secondary to taking their meds. Unfortunately, it can be a self-fulfilling prophecy. People arrive in hypertensive emergency and the causes are plenty: pa gen kob (no money), they feel well, can’t make it to clinic to refill their meds, they sell their meds, they don’t want to take them, or worst, they believe a rumor that convinces them to stop taking them.  For each, the treatment is the same: refill of their meds, an explanation/reprimand and encouragement to go to the hospital in Jeremie if their symptoms worsen or persist.

I’ve really enjoyed my time here thus far. We work long, hard hours, but my responsibilities are minimal. I’m the first moun ki kap pale Kreyol asse byen  (person who can speak Creole well enough) and take vitals. This is a great relief for Cherlie (the nurse) whose current responsibilities include intake and med consultations/outtake. I do intake now and she has the freedom to speak at greater length with people, as Haitians are wont to do. She also can give more young women advice, as older women are wont to do! I love being able to do this as the backlog in the wait time is due to the MD consultation and thus I have no reason to hurry. Instead, I can ask patients about their symptoms and past medical history and try to understand their responses without the pressure of having to do anything with the information except say “ok, tell the doctor what you told me, because I’m not the doctor, no?” This always gets a smile for some reason. I don’t mind one bit. 

Hope you're all well. I'll try to add pictures soon.

En route

Happy New Year! I hope this season finds you healthy and in the company of those you love. I'm  grateful to have spent the last month doing exactly that, from Eugene, OR to Vista, CA.

I now find myself in Dallas, TX awaiting my second of three flights that will eventually take me to Haiti.

If all goes well you can expect an average of a blog a week. I'm still unsure of what my internet access will be once in Jérémie, but I can promise my best effort!

Thank you all for the best wishes and encouragement along the way. Hopefully you'll be hearing from me soon!

Lanmou,

Hannah

P.s. I hope you enjoy my last California sunset until March!

An Update

Bonjou Bonjou!

I'm back in Eugene, trying to finish a thesis in the next 3 weeks and also tying up loose ends from the Haiti trip y'all accompanied me on. One of the things I have to do is prove I was actually there, so this is the list I came up with; it left me feeling incredibly blessed to have had such a diverse and unique experience.

While there I worked with:

King's Organization in Port-au-Prince for 2 weeks doing hospital administration (translating documents and making employee name badges) and teaching English to the children in the orphanage.
http://www.lumiereministries.com/KingsOrganization.html

PAZAPA in Jacmel for 3 weeks working with mentally and physically disabled children, assisting at the school for the deaf, and doing minor office work for the director, with whom I stayed.
http://pazapa.org/

Forward Edge International in Carrefour for 1 week serving with my church in a tent village helping to build a security perimeter and translating between my church volunteers and the locals.
http://www.forwardedge.org/opportunities/haiti.shtml

All Hands Volunteers in Leogane for 3 weeks volunteering with Haitians and other internationals building schools, making bio-sand water filters, painting murals, economic development at a women's co-op, playing with kids at an orphanage, and rubble removal.
http://hands.org/2011/03/08/help-build-a-school-in-haiti/
(I'm actually in this movie! You can see the back of my head as I'm painting a quote on a school wall).

Haiti Foundation of Hope in Terre Blanche for 10 days translating for the nursing volunteers, working in the pharmacy and around the clinic: doing sonograms, giving shots, and talking patients through procedures.
http://haitifoundationofhope.org/give-hope/
There are two great video clips on this website too that show where we were and how you can get involved too!

For those not already on facebook - here's a link to my photos!
http://www.facebook.com/album.php?aid=353390&id=729155967&l=628a18c901

Until next time - possibly this July!

Ana