Santo's graduation

Yesterday Santo, who is the much loved translator here, graduated from a health outreach program put on by the United Nations for him and about 20 other health workers in north Haiti. It was a six month class to help with issues of public health. Santo, amongst other things, will run a family planning clinic here one morning a week and do immunizations.

It was in Cap Hatien at a Hatien fancy venue with lots of US elevator music and pomp and ceremony; a part of Haiti I had never seen. Many people from NGO"s with the person their organization sponsored. Networking is awkward but I am desperate for resources and information. They made up their own version of We Are The World - about their work in Haiti which was moving after hearing others sing for and about Haiti in the United States.

There was piles of food, caps and gowns, speeches and picture taking and supplies from UNICEF to take home. Even electricity the whole time!

It was a moment of hope and pride as we all happily made our way home over bumpy roads; the car packed with people and chatter. I noticed keresone lanterns lighting small groups of people who gathered with friends in the cool evening air; small fires cooking the nights meal and children playing there beside them.

I am most often on call at the clinic and so it was a much appreciated outing. We came home and put on head lanterns and told good stories of the day before each found their place to sleep which changes with the weather.

Not yet born

Yesterday a laboring woman was brought to us. I walked into the birth room and saw that the cord was hanging from her and the baby had not yet been born. She had walked here this way. I tried to save the baby but deep inside I knew it was too late and that the baby had died some time ago. The cord was not beating and was cold in my desperate hands. I tried to tell everyone what to do but they didn't understand a word I was saying and really it didn't matter.

Later I just laid down on the floor and watched the storm come in and could not do anything at all but watch the sky and surround myself with quiet.

Prayers

How many prayers do we get in a day or a night? If I use them on one baby do I still get more, later in the day when I need them again, when I don't have the right tools or medicine or hospitals and I feel alone except for that spirit that stays beside me loving and calm and reassuring.

Unexpected twins !

A mother arrived yesterday with one baby on her chest still connected to the cord and another one on the way. She was having her baby at home with a local TBA and when they realized it was twins and decided to carry her into us. So much to consider so fast in such a little amount of time. I cut the first baby's cord and gave her to Zeenia, the naturopathic doctor who has been here and is soon to leave. Listen to the second baby's heartbeat. Great. Head down. Great again. No contractions. The mom asks if she can get onto the floor and stands up and the second baby swooshes out and I have to scoop him up off the floor; all wet and crying. The two placentas lingered and the thoughts that there is no ambulance and she is bleeding filling my head but all went well with prayer and pitocin and in time, mom and the twins were tucked into bed and the family was washing the sheets out back. I was thankful that it was still light out and we did not have to do this by lantern and thankful that they were all well and healthy and everyone worked together. I went upstairs and took a much appreciated bucket shower and laid down outside with much gratitude.

Market and food

On Tuesdays, the cook goes to the market in Cap on the tuck tuck. The tuck tuck is a pick up truck with a top that is brightly painted and honors Jesus by name or pictures. Many people and things squeeze in and the speed along mostly dirt roads with big holes but there is some sign of an effort at paving. The road to Cap is lined with small markets and people walking and visiting and businesses of all sorts. I guess our version of a strip mall and the market in Cap is the big market that takes up many streets and each stand seems to be covered in a single, small umbrella so it looks like many umbrellas all down the streets.

They bring back eggs, fruit and three live chickens that are killed and eaten during the week and live in the chicken coop until that time. I will try to get baby chicks and start laying hens again. They tried, but something got them as can happen everywhere.

There is a place that bakes bread on great charcoal griddles under the trees along the way.

The cook prepares three big meals a day. Porridge spiced with cardamon for breakfast with fresh fruit and then some form of rice and beans with sauce for lunch and dinner. Vegetables are cooked into a sauce. They are mostly potatoes and plaintain and a few peppers in a tomato sauce. There is a stove, when there is electricty, and a propane stove but she seems happiest with the charcoal outdoors. Food is stored in buckets and there is no refrigeration. These plates of rice and beans are filling and overall I think are healthy enough in many ways. Most people I see eat one meal a day and so suffer from a lack of clean water, stomach aches from long hours with no food and a lack of some vitamins and minerals.

They do not have fermented food as many cultures do to help with heat and storage. No dairy or fermented vegetables. Dried fish but not dried fruit that I have seen. I am sure I will learn more about the food and how to advise the women I see within their culture and with what is available.

I am learning about the native plants and their uses and hope that I can make that a part of our pharmacy. I have transplanted some into our garden, much to the amusement of those who helped me.

Movie night with the orpahanage and village children

It was Friday night at the movies with popcorn popped on a charcoal fire and a film about lions on a computer as there was no electricity and the battery back up was too weak for the projector. Still we played jump rope games and then they all sat on the floor and ate popcorn by the bowl full and watched the animals of Africa on the screen with wonder. All the people who work here watched too and it was this moment of peaceful joy and community. The head of the orphanage asked if they ate the lions. It is my hope to teach geography in some small ways through these movie nights. We ended with a fine time of singing. As the sun set golden and pink, they walked back down the road amongst the goats finding a place to sleep for the night on small ledges and crevices of concrete. We waved good bye and promised to do it again soon.

As they walked out one door, a woman in labor came in the other. I put on my head lamp and sat beside her and set out to discover how she was doing and how soon the birth might be. Early labor so I set out to sleep beneath an almost full moon on the porch and slept the whole night and so did she.

When it rains

Marie, the midwife from Hench, who left so quickly to go home when I arrived is suppose to return today but calls to say Monday instead. I worry that she might not return at all as she is so far from her family and young children. This would be, of course, understandable, but still we need more than one midwife here.

It rains though and when it rains they do not come to the center but have their babies under tin roofs with local midwives and come to see us in the morning. Or they do not come because they can not find or afford a motorcycle ride and it is too dark to walk. Yesterday morning a woman walked to see me only a few hours after the birth; the baby's cord bleeding quite badly. I have become accustomed to this and quickly re clamp and cut it and bathe it in alcohol; wrapping the baby back up and handing her to her strong mother. The baby was dressed in a very frilly pink dress and blanket and booties so I was quite surprised to remove the diaper and find a boy.

I try to teach, Audel, the traditional midwife who I have brought to stay with us about washing and boiling the scissors for a birth. I motion to boil them quick while the electricity is on and I find her standing with the scissors staring at the stove and I realize she has never seen one before and I am sorry for my assumptions. I show her how to turn the stove on and boil the scissors. I want her to do this when she leaves here to practice again in the poorest neighborhoods of Cap Hatien but I don't know how she can. She says she will bring many traditional birth attendents to study with me and I say yes but wonder where to begin. Haiti has the highest infant mortality rate in the western hemisphere and most babies are born with traditional birth attendents at home with no training. Adul says they cut the cord with rusty razor blades and I think, at least,w e should be able to give out clean razors and sterile clamps.

Paul Farmer's book the uses of Haiti is his best and quite a lesson in United States history as well.