Saturday, April 28, 2012

So they say

So they say
Out in the sea, on the edge of the horizon, there is an unusual island. I squint. It is larger than all the small islands and is surrounded by mist. There are small lights all over it and there are no lights here. One minute it is there and later when I go out for a walk in the village it has gone. It is an island that comes and goes.
The people say this is a cruise ship.
The people say that when the moving island comes the people on it do not know its Haiti. They play in the water but that they are locked into that place and are not allowed into Haiti to see the villages or meet the people. They say guards with gun stand by the fence so that they can not get out and so that the people of the village cannot get in. I do not know if this is true but its what people say.
The people say that only two weeks ago a woman bled to death in childbirth and they tried to call a cruise ship van to take her to the hospital but they said no. Later she died and they sent flowers. I do not know if this is true but this is what her brother says. The placenta would not come out and she bled to death while the people on the island that comes and goes ate and watched movies and danced. I do not know if this is true but its what the people say. They said the father of the woman who died threw the flowers on the ground. That is what they say.
There is a massive rubber float toy on the beach where I walk. It sits deflated and crumpled by someone’s house. They say its from the cruise ship but I do not know. They say it floated up on shore along with thousands of plastic soda bottles. I had thought the people just didn’t pick up their garbage but then I realized you can not buy a soda there and I never saw anyone drinking one. Things float to shore. The people say it comes from other islands. Where would they take it even if they picked it up and still the waves will bring more tomorrow.
They say once a few people escaped from the island that comes and goes and went into Cap Hatien. They were not allowed back on the boat. They left them here in Haiti. I do not know if this is true but its what people say.
They say the clinic has no doctor and only two nurses who are not able to do the work. Once the cruise company paid for a Cuban doctor but he went away. That is what the people say.
They say Christopher Columbus’s ship sailed here and that his boat burnt in the cove near to where the ship stays. That is what the people say. They point and I look out in the sea I and can not imagine.
I walk up on the hill and down into a clear cove of bright, blue water. Dogs and children follow along and later there is soccer on the beach and a fire and the last songs of the day.

Monday, April 16, 2012

A Perfect Day

On a perfect day, in Haiti...a day too delicious for words.. I climb up into the mountains and follow streams to where they leap from pool to pool with waterfalls one right after the other. The children who come with me, quickly take off their clothes and swim in clear, clean water; their laughter holding me in quiet rapture; their songs echoing off the hillsides where cows graze and farmers work in their gardens. We lay in butterfly and hummingbird filled meadows.

When we walk home, Islar, finds us all mangoes. I don;t know how she does it but she finds us these sweet, delicious mangoes that drip from our lips and sticks to our fingers. They are the first of the season. We sit in the sun and eat mango after mango and I think, this is a very perfect day.
These are the sounds and images and tastes that I will hold close within me forever. I know that children die and don't get to go to school and are orphaned far more than us fair but I also know that children know the names of plants, how to climb trees, the words to many songs and how to delight in a Saturday afternoon hike....and when we did not have any food, they knew how to find some. This picture is a picture of pure delight and happiness. These children, who I have come to know and love so well, have parents who work hard all day long and so this was a day of celebrating life for us all.

Saturday, April 14, 2012


Lapli , the Creole word for rain. The gentle afternoon rains that cool a hot day or turn them into steam. The rains that call young children out of their houses to bathe in the yards, the rains that water the small farms that spread up the side of the mountains. Lapli- the rains that come and go and come again but never stay very long. Lapli, lapli. I hear the word when the rain drips off the roofs and from the banana leaves.
But now we have a different kind of rain. It blows and lasts all night. It reminds me of a hurricane. Hurricane is one of the last remaining words from the Taino people who first inhabited this island. Of all the words, of all the customs, of all the people – this word survives and spreads and is used on weather channels and news papers the world over. Hurricane.
When I lie in bed, listening to the storm, I can not help but think about the houses that the many people I know are sleeping in tonight. I think of the walls woven tightly, artistically. I think of the best of these houses; how the branches are woven in intricate patterns to keep the mosquitoes out and let the air in. I have marveled at their design. If the rain fall straight down, I think, then they will be dry but if it goes sideways they will all be huddled in their beds in the rain. I can see that some of these houses are made by more skilled craftsmen than others. I know this island has survived many storms but still I think of the people I love out there in this storm.
I think of the mud caked walls of Melove’s little house. I am sure there is a proper way to line the walls with a mixture of mud and plants to keep the rain out but her house appears to have been fashioned with less skill and so the mud is slapped on the walls without ever really covering anything at all. I have no faith it is keeping the rain out. There are two rooms. One for her and her three children and one for her mother. Each room is barely big enough for a bed and little else.
The floor is mud and I know that it is flooding tonight; that they are on two little islands of mattress huddled together, confident that a day of sunshine will come to dry out all the bedding. It sits on the edge of a gully in a sort of ditch where they cook, wash and spend their days. I imagine that the ditch is a pond with cook pots floating around the house.
Her roof is a tin, splattered with many holes. A volunteer came and hammered up a piece of plastic to keep the rain out but I wonder, as the rain beats down all around us and the wind blows, how much that piece of plastic can hold back.
The night before last, I slept at the fishing village where I am training Matwans. The only road into the village is flooded. I had to take a motorcycle in; getting off and walking part way through knee high streams of water. Yards are flooded and children wade waist deep to get to their houses. When the sun comes out, the blankets are all thrown over cactus fences to dry before the next night’s rain.
At Dafka’s house, they are sleeping, as I write, in one bed; Dafka, her Dad and the two older children. The front door of her house and many traditional houses in Haiti, is covered with a piece of cloth or curtain. They are often made of lace and blow slightly in the breeze on a warm afternoon. They offer privacy and shade. They are, it seems to me, a symbol of Haiti’s grace and charm. In a well built traditional house, there would be strong wood doors and shutters but in most they have long since fell into disrepair. Because so many people wish for a concrete house, they often do not repair the traditional houses and so even if they once were designed for these rains, they are no longer.
I think about all the children who have come to see me with “coughs, colds and fevers”. I think of the fungus infections growing on so many children’s heads. When it rains, they may have to bring their charcoal cook stoves into their sleeping rooms, the smoke making the coughs and runny noses even worst.
When I return from the fishing village and tell of my journey through flooding streams, they say I have walked through cholera water. They say this is the season for cholera because all the waste is washed into the swirling stream where people have to walk. The wells are flooded with the contamination. It had felt good to wade in these streams. It reminded me of wading in my old creek and I liked being in the streams with all the other people. My feet enjoyed the cool water, the round smooth rocks and the squishy mud. I am sorry everyone had to look alarmed and tell me it was cholera water. I can see that this is true, however, and recall the nurse giving talks to the people in the fishing village about cholera. I know it is true but I am not sure how they can get anywhere – school , church, work or market without wading waist deep often through water.
The rains beat hard against the clinic walls and blows the trees. It seems it will never end.
But I know come morning, Melove , and others like her, will emerge from their houses, with determination and a smile. With grace, the sun will emerge as well -from behind the clouds, from behind the mountains and dry the bed clothes once again. Feet will get lost in a landscape of mud puddles. Carts and wheels and hoofs will get stuck and need to be pulled and pushed and coaxed out so that they can be on their way again.
And in the morning, children will emerge with neatly washed and pressed school uniforms and matching bows in their hair. The girls will have socks trimmed with lace and there will be no sign of the considerable day to day effort it takes to survive this stormy season in Haiti.

Sunday, April 8, 2012

The challenges of teaching the matwans

I travel each week to a small fishing village where I teach a group of twenty traditional birth attendents. They are mostly an elderly group of women who arrive in their Sunday best clothes eager to learn and enjoy a day away from household chores. There are two male midwives,as well, which seems to be quite common and well accepted here in Haiti.

I have spent as many years in education, as I have being a midwife, and so I am excited to design and teach this curriculum. I research what has already been done and think about all my experiences this year working with the Matwans at the birth center. I think of everything I know about how people learn and am eager and excited.

I have taught Headstart and English As A Second Language and rebellious teenagers.

But I did not understand what it meant to live in a place where there is so little written language.
I did not understand what it meant to not know how to hold a pencil in your hand or to even look at a page of pictures. I knew they had been deprived of an education but I did not know what that really meant.

I had this idea that they could have a book with pictures of things related to birth and that they could share those drawings with others and use it as resource. It would not have words and so I thought it would work well. I copied drawings and then thought they would cut them out and glue them into the empty books. Soon I was faced with the clear reality that they had no idea how to look at pictures. They held them upside down and had no idea what glue was.

The next week there was no electricity to make drawings so I drew one big one on a sheet and had them copy the drawings. I could see that most had never held a pencil before. They tried so hard and seemed pleased to be given a pencil and a book to write in. They bring them in with such pride. I try to practice counting to 40 ( the number of weeks of pregnancy ) with them at the start of each class. I show them the way the baby grows as we count. They had never seen these pictures before and so the numbers are lost in the amazement of fetal anatomy.

I try to think what I am doing. I am there to give them a few tools so that they can save the lives of mothers and babies in impossible situations. If there is a complication they may have to carry a woman down the beach for 40 minutes to find a vehicle to make the 40 minute drive to the small hospital. We do role plays and act out what to do to keep birth safe. We sit in a circle and laugh and sing and even dance. I tell stories using drawings I have made. I try to illustrate cause and effect. I am swimming hard against the current.

I try to get them to show me the basics of a normal birth using role plays; simple steps of hand washing, setting up supplies, asking questions to determine risk, basic exams for position. Some try but I can see that I am asking so much.

I have never seen a home birth here but I have seen many homes. I try to picture a birth. I watch what they do when they come to the birth center. I try to put all this together in my head as I teach.

I have taught two classes so far and am preparing now for my third. I have had time to think it over. I can not give up on the counting or learning to use the pencils or how to read a picture.
Everyone deserves this small journey into literacy.

I have made a pictorial birth chart that is a simple guide towards safe practice and referral. My goal is that they can use this guide, record what they do and make the right referrals in time. It is my hope that by the end they can learn to use a bag and mask and help babies breathe when they do not. There is so much to teach.

But I also recognize that I do not know what they know. I can not swim out into the sea and catch an eel for dinner with a stick or make sails for a boat from sheets and blankets. I do not know all the right words in Creole to comfort and encourage in labor. I do not, even after these months, know just the right way to touch or move a woman to help a lingering baby. I do not know the right prayers and songs that drift from homes and churches; the one passed down when there were no pencils or paper.

I am lucky, as always, to be both teacher and student, and to spend some time with these elegant, graceful, funny, wise women and men who ask me to think as I have never had to think before. To move beyond what I thought was possible and to bend and sway with the breezes of time and place.

Friday, April 6, 2012

Swimming in Caca Beach

Last week, a volunteer and I were at a small fishing village to do a training for a group of local midwives. It was a particularly warm March day and the beautiful, blue waters of the Caribbean looked soft and inviting. We watched, as small boys swam, dove and played in the water. Later we wondered down to what we thought was the same place and sat in the water, letting gentle waves splash against us. All around us were mountains and sea and time to soak away a long week. We talked of births, midwives and Haiti weaving together the stories of our lives.

The village is a small but busy place with people working, visiting and moving about and so the group of children who gathered on the shore did not seem unusual. The children in Haiti are friendly and often wave and say hello and stop to talk. We did not find the group of children gathering on the shore and waving unusual and we waved back; happy in our current situation.

But one little girl seemed very persistant in getting our attention and seemed to want to communicate something of great importance. She kept calling, "Blanc, blanc. Caca Caca " and waving her arms. We happily waved back but were increasingly aware of her alarm.

Then we looked over to where she was pointing and saw a group of small boys going to the bathroom. "Ahh" Caca was not an unknown Creole word but a universal word for pooh. We were, it seems lounging in Caca Beach; a place for going pooh and not a place for swimming. Ooops.

We determined that the salt water made it all okay and picked our way through the piles of Caca and back to the dorm where we showered and had a good laugh.

A few days later, back in Morne Rogue, a mother I know eagerly waved me over and showed me her latrine and then began to make. swimming motions and laugh. A small group gathered and she repeated the motions again with great enthusiasm.

Could it be that our reputation for swimming at Caca Beach followed us down the long dirt road and over the mountains ?

We walked abendazole over to the orphanage ( to treat hookworm ) and then head back to MBH for a game of bi-lingual Bannagrams before bed. Is "caca" a real word? Does it count or is it slang? We all vote for it counting as a very real and most important word.

Monday, April 2, 2012

Palm Sunday in Haiti

On Palm Sunday, in Haiti, the streets are filled with men,women and children carrying woven pices of palm leaves as they leave the many churches that are such an important part of the landscape.  I am aware that I have lost all concept of time and that I am surprised that Easter will be next week.  .

Although Quakers did not make particular note of Palm Sunday, I am familiar with the events related to it in the Bible and the practice of giving out palms the week before Easter.  I look around me and realize  that real palm trees are everywhere and that there is no need to import anyor make plastic look alikes. I am aware these must have been trees of shade and importance in Jesus's life.  I see too the many donkies in Haiti that  help the market women carry charcoal from the mountains.  I think about how over two thousand years ago a donkey carried Jesus as they laid palsm on the road and how little that landscape has changed in many parts of the world where donkies are a common form of transportation and palm trees are a part of everyday life.

In this way, I refelct on Palm Sunday.  At lunch everyone tries to discuss what it means.  I say that I think it was Jesus's decsion to face conflict and not run away from those who did not agee or understasnd him.  He oculd have just kept going the other way but did not. I said I thought it was about not beig afraid to say what you believe despite the consequences and that is is about having faith in something greater than ones own self. 

I think about the many corageous people who came down out of the mountians to speak up for peace, freedom and justice everywhere and ecspecailly here in Haiti. 

Later there is a simple parade by the clinic in which  they carry charcaol wrapped up to look like Jesus's body, they say.  We can't tell wha tis happeing but hurry out to see.

It will be a busy Hioly Week.  They play religious music all  night long and Sunday there is the Baptism of Madame Caluden;s gradnchild of whom I am Godmother. Today, I am expected to go to the big market and buy the baby a dress.  Given how little I like to shop for clothing anywhere this seems a little overwhelming.  She will be Baptrized on Easter morning and afterwards there will be a big meal and a celebratiuon of this baby who has been such an important part of my jouney here in Haiti.

On Saturday, in the clininc, we had a woman come in with  a large, vertical c-section scar.  She was psuhing so we just prayed it would all go well and it did.  I am very thankful for this as they are quite dangerous.   

It is getting very warm again. I am spending some time creating a training program for the Matwans at a small fishing village by the sea which I will talk about another time.