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.

Clothes

In Haiti, the clothes donated by other countries, are sold in small markets and so most of the women come to the clinic in the cutest and most fashionable outfits and I always think they look better on them than the first time around in the US. Tight jeans and sweet skirts, shoes and hats. They live with no electricity or running water and show up just as cute and done up as can be. Recently a young woman had her baby and was back in her skin tight jeans lying in bed nursing 30 minutes later! The houses are often no larger than our garages, with many people so I am deeply in awe. A traditional house is painted bright colors and in a cluster with perhaps a pump and outdoor cooking area. Work, including wash is all done in the "yard" where children play. I suspect the houses that share one yard are related.

A concern, I try to share, is that US baby clothes are too hot for Haiti and so babies are arriving in wool and layers with temperatures of 102 ! so this is not working well for babies. Their own baby clothes are light, brightly colored and perfect.

My own clothes are washed outside and perhaps over bleached as the flowers fade away. I can barely stand to wear a sundress it is so hot. I feel badly about so much handwashing and it is easy for me to rinse out many of my own things. The families are expected to do their own birth laundry so they are out there scrubbing away, even the fathers.

There are cactus fences and it is common to see the clothes hanging from them as i walk down the road.

The children in the orphanage do not seem to have access even to the second hand markets so i am sure some nice clean t- shirts would be appreciated.

I hear a birthing woman approaching. Sounds like better run fast!

Party at the birth center

When some of my children were teenagers they discovered the many benefits of having a midwife mom; one of them being the use of the birth center for social gatherings or "party tonight at the BC." This went on happily, without our knowledge, for some time until they were discovered and good times such as those put to rest.

Party at the birth center has taken on a new meeting here in Haiti as the women begin to gather outside the wall at 4:00 am to wait for the clinic to open. Most walk or take the tap tap or some arrive on motorcycle taxis. They laugh, talk, joke and pass the time. In time, the market women will come to sell fruit or other food, littering the ground with this and that. It is, I can see now, a place to gather and meet friends. They come in small groups, leaving children it seems at home, for what must be a relaxing day off from so much work.

The women describe their work as working in the yard - getting water, washing by hand, cooking on charcoal and growing some food.

I had felt badly about the long wait ( and still do in many ways ) but here in the early morning as they laugh and talk, I understand its " a party at the birth center" and all are invited. We have started filling old vitamin bottles with clean water for the long walk home in the difficult heat of the afternoons.

A woman has just arrived in labor and the clinic needs preparing for the day and so my day begins.

A knock on the gate at 2:00 am

I sleep, when I can, on the porch where the skies are full of stars and the breezes are cool and sweet. The frogs break the silence with a rowdy burst of conversation that wakes the roosters, that wakes the cows. But even in one week I have grown accustomed to these noises and wake only to the knock at the iron gate as a woman in labor comes to our door. Yesterday four women came; the last at 2:00 am. The little head appeared the moment she lay down and she was tucked in, babe in arms, by three.

In my first week, I have delivered eight babies and sent two to the hospital; one who arrived in bloody sheets and another who I feared a cord prolapse. An average clinic day is about 20 prenatal appointments and another 10 or more babies to see. Sending a woman to the hospital, at this point, means back out onto the road to find a ride on a motorcycle so it is a hard choice to make.

Although I am still sleepy from the birth I have gone for my morning walk and will soon be treated to breakfast prepared each day for us by the cook who creates amazing dishes with very little and an art for the use of spices.

I have quickly become accustomed to this life, grateful for the wonders I see and offering the sorrows to my prayers before bed. I sleep early, preparing for the knock on the gate that may soon awaken me.

Morning walks

The mornings are soft and beautiful with the sun rising over the mountains as I wake on the sleeping porch. The women come very early to line up for the clinic; laughing and talking for many hours before they can be seen. They begin to arrive at 5:00 am and the clinic does not begin until 9:00 am. I walk out into the road and greet them and then go for a short walk practicing my creole; passing farmers with their cows and goats and the women who are going to and from the market. I try to begin to try to understand the plants and the families and the traditional uses. A local midwife ( madrone ) has come to stay and is wise in the use of plants so I ask her many questions and am taking rootings in old vitamin containers and hope to soon plant a small medicinal garden. By afternoon I will be hot and tired from seeing so many patients so I value the time of my little walks and the many things it teaches me.

Papaya leaves for a vaginal infection and almond leaf tea for high blood pressure.

Yesterday I delivered two babies - two fine little boys