Reports from Haiti

Even though I’ve been back in the states for almost a week now, the events of last week are just too exciting not to blog about.

When BTB project coordinator Janet arrived in Thomonde last Wednesday to check up on our internship projects and transport us back to the U.S., Kelly and I were astonished to find out that Jeffrey Sachs, Sonia Sachs, and an entire UN delegation were planning to visit Project Medishare the next day!

I don’t think I’ve mentioned this in my previous blogs, but one of the villages where Project Medishare’s team works, Marmont, has been selected by the Earth Institute as a Millennium Village. It is the first Millennium Village in the Western Hemisphere. The goal of the Millennium Village Project is to improve the health, agriculture, economy, etc. in one impoverished village at a time in a developing country. The villages are designed to demonstrate how the Millennium Development Goals can be achieved through community-based development.

Early Thursday morning, about 30 conference attendees arrived at Project Medishare’s compound and we began a tour of Marmont’s various development projects.

Our first stop was at the construction site for the Akamil Production Facility and the Childhood Nutrition Treatment Center. Akamil is an oatmeal-like substance (we actually tried it at lunch—it’s good!) fortified with vitamins and minerals, which will be produced locally in order to decrease the prevalence of malnutrition in the area.

Next, we drove up Mourne Sourit to take in a view of Marmont. We could see Thomonde, Hinche, and the surrounding area.

We then met a group of farmers under a tall tree at the bottom of the hill, where we witnessed a dialogue between Jeffrey Sachs and local Haitian farmers. He asked the farmers what kind of crops they grew, where they obtained water, if they had enough water, what they thought the government and other non-governmental organizations could provide for them, etc. He also specifically asked the women, “Do you have enough food?”, and the women in the crowd quickly and in unison answered, “No.”

It was an incredible opportunity to observe this conversation between Jeffrey Sachs and the farmers. It’s one thing to hear such an important figure in international development speak, but to be able to listen in on a conversation between Jeffrey Sachs and everyday Haitian farmers, and really see Jeffrey Sachs in his element, is truly a one-in-a-lifetime opportunity.

The delegation then took a quick tour of the clinic in Marmont and the Maternity Ward construction site, which is expected to be completed in December. A dormitory-like building is also under construction directly behind the ward, which will house physicians and staff so that they can provide 24-hour care for women.

(Dr. Green, Dr. Fournier, Professor Jeffrey Sachs, Dr. Greig, Dr. Malou, and Dr. Sonia Sachs in front of the Maternity Ward site)

When we arrived back at Project Medishare headquarters, Kelly and I had hoped to demonstrate at least one of the backpacks to any of the conference attendees, but we knew that they were on a very tight schedule and understood that we might not get the opportunity due to time restraints. Dr. Arthur Fournier, co-founder of Project Medishare, was able to gather a few people to view the Diagnostic Lab-in-a-Backpack, however, and Kelly and I were thrilled to give a quick demo of the backpack. Dr. Fournier and Dr. Sonia Sachs were very impressed with the backpack and were able to provide us with valuable feedback as well.

(Dr. Fournier, the representative for the Haitian Prime Minister, and Dr. Sonia Sachs examining the user manual of the Diagnostic Lab-in-a-Backpack)

As quickly as they came, the delegation departed for Port-au-Prince, and it was hard to believe that all of the day’s events had actually happened. From schoolchildren, to medical students, to Jeffrey and Sonia Sachs, Kelly and I have certainly met a wide range of interesting and inspiring people in Haiti!

Since this is my last blog, I want to thank Beyond Traditional Borders, Bethlehem Ministries and the staff and students at St. Barthelemy, Project Medishare, Janet Wheeler, Kelly, and all of the incredible people I’ve worked with at Rice and in Haiti for providing me with this amazing opportunity.

A quick story on how the past year’s events have come full circle for me: just last summer, I happened to read a book about a doctor in Haiti, Mountains Beyond Mountains. I came across the name of a hospital that sounded familiar, and after talking to my mom, I realized that it was the same hospital she had worked at over ten years ago. Thus began my initial interest in global health. Soon after, I also happened to read The End of Poverty, by Jeffrey Sachs, which further spurred my interest. In the fall, I eagerly signed up for a Bioengineering and World Health course and took a subsequent course in the spring. Only one year later, I find myself living and working in the settings of these books, meeting the people I’ve read about and experiencing the country I’ve heard about for years, and even meeting one of the authors. I wouldn’t be exaggerating to say that this experience has been a dream come true.

In many ways, this internship has felt like the culmination of months of preparation and work, and it has been, but I also know that this is just the end of a beginning. As a rising senior who’s still unsure about life after graduation, I went into this internship expecting to figure out which post-grad road to take, but I’m surprisingly as uncertain as ever. I’ve experienced the hope in teaching children who otherwise would not receive an education, witnessed the joy in providing sight to the blind, felt the excitement in building devices that improve the health of those most in need, and enjoyed the adventure of traveling and experiencing a new culture. A year ago, I never would have expected to be where I am now, so I’m not too worried about the future—I know it will work out even better than I can imagine.

Thanks for reading! I hope you enjoyed reading about my adventures in Haiti as much as I enjoyed writing about them.

This week, our last in Haiti, has been as amazing and unforgettable as our entire experience here. What follows is a Reader’s Digest version of our crazy week!

On Monday, Jocelyn and I worked at Project Medishare’s clinic in Marmont. We counted out thousands of multi-vitamins and iron pills. While working the pharmacist Nanette played English songs off of her phone – Celine Dion, Elton John, and some other fun classics, over and over. (I am not sure I will be able to hear Shania Twain’s “You’re Still the One” and not think of fun-loving Nanette’s big smile.) The work was very relaxing and it was nice to be doing something that was clearly needed.

Tuesday was an educational day. Jocelyn and I shadowed a Project Medishare Community Health Worker (CHW) while she made her rounds in Marmont. She asked to see children’s vaccination cards and instructed people to see the doctor if they were sick. We gained valuable insight into the role of the Haitian CHW that we can use to help improve the CHW pack, which is, if you remember, one of the three packs we brought with us to Haiti.

Wednesday was very quiet as we spent the majority of the day in preparation for the arrival of our mentor Janet and a demonstration of the Diagnostic Lab-in-a-Backpack to physicians, nurses, and technicians from Project Medishare. The backpack was well-received, with one physician even declaring how the backpack would help him in conduct his mobile clinics.

Thursday was almost indescribable it was so surreal and amazing. Project Medishare invited many influential people to visit the Marmont Millennium Village Project and conduct a conversation with the Haitians about what they want for themselves and their families – and what they need to get there. In all of my time here in Haiti, working with various organizations, it is the first time I have heard anyone actually ask the Haitians what they want. I was honored to be present at this important event.

We were fortunate to be able to demonstrate the backpack to Dr. Arthur Fournier, co-founder of Project Medishare, and Professor Jeffrey and Dr. Sonia Sachs. Dr. Fournier and Dr. Sachs provided us with some valuable suggestions for additions to the backpack.

Jocelyn and I just finished writing a blog for Project Medishare detailing the time we spent there demonstrating the backpack. It should be up soon. Check it out at http://projectmedishare.wordpress.com.

This morning (Friday) Janet, Jocelyn, and I made our way to Port-au-Prince in preparation for our early flight tomorrow morning. The drive from the Central Plateau down through the mountains was beautiful. The varied scenery –mountains, a lake, a dam, and the sea- makes for a ride full of sights well worth seeing. We are staying in a lovely apartment owned by Project Medishare. From our porch we have an excellent view of the city.

Our last week here in Haiti has been a fast-paced, exciting blur. At the beginning of this week I was sitting in Medishare’s clinic counting pills to Celine Dion’s sultry tones, yesterday we demonstrated the backpack to Jeffrey and Sonia Sachs and many other interesting people, and today I am sitting in a comfy red armchair in a beautiful home in Port-au-Prince.

I cannot believe I am going home tomorrow. I am going to miss Haiti so much, especially the wonderful people I have met here and the bananas; the bananas are divine. This has truly been the experience of a lifetime. The knowledge I have gained here has left me better prepared to understand the challenges we face in improving global health and to work toward improving the quality of life for all of the world’s people.

I would like to thank everyone who made this internship possible, including the Beyond Traditional Borders Initiative, the Howard Hughes Medical Institute, St. Barthelemy School, and Project Medishare. Janet, your company and insight have been invaluable. Jocelyn, my other half, I wouldn’t have wanted to be here with anyone else, even if we jokingly argue like an old married couple! Thank you everyone!

This post’s title pretty much sums up the past week in Thomonde. Kelly and I had the opportunity to tag along with the medical team from Morehouse School of Medicine on their mobile clinics, which was very interesting and enjoyable (sidenote: approximately 99% of the Americans I’ve met in Haiti are from Georgia, including Kelly, so I’ve come to the conclusion that Georgians are slowly taking over Haiti. Don’t be fooled by their innocent Southern accents; they’re definitely up to something). Our daily commutes to the clinic sites were an experience themselves, as we had to drive for up to 2 hours through the hills, valleys, and streams of the Central Plateau to reach our various destinations.

But let me backtrack a little: last Monday, we left Terrier Rouge (a bittersweet goodbye) and flew from Cap Haitien to Port-au-Prince. After spending six weeks in Northern Haiti and visiting Cap Haitien several times, I actually felt some reverse cultural shock when we arrived in Port-au-Prince. While I’m sure the area that we drove through was a nicer part of the city, Kelly and I were both surprised at the relative cleanliness and consideration for traffic laws. We even saw several traffic lights.

After meeting up with the team of med students, MPH students, doctors, and nurses from Morehouse, we headed to Thomonde, via the most winding, edge-of-the-cliff road I’ve ever driven on (and considering I grew up in Pittsburgh, the capital of ridiculous road systems, that’s definitely saying something). I can’t even begin to describe the amazing view along the way, so I’ll try to upload some photos in a later post.

Even though I’ve read Mountains Beyond Mountains (like many global health enthusiasts) and tried to imagine the bumpy Rue Nationale 3, the beautiful Lac du Peligre, and other features of the Central Plateau, nothing can compare to seeing it in person. It was like seeing a movie version of one of your favorite books, but in real life and ten times better!

The first night in Thomonde, Kelly and I got to know the medical team, realized just how much we missed conversations in English, and tried to help out with some basic Creole translations. While I really haven’t learned as much Creole as I probably should have after spending six weeks in Haiti, Kelly and I are pretty adept at Creole pronunciation, so we did our best to write out some phonetic Creole (i.e., “M’rele” became “mmm ray-lay”). If all else fails, Kelly and I can start our own phonetic Creole translation business after graduation.

Tuesday through Friday, we drove to four different villages and watched the team quickly transform various churches/schoolhouses/shaded trees into functioning triage, pediatric, ophthalmologic, OB/GYN, and internal medicine stations. Because the team treated hundreds of patients each day and had to make quick, gut-reaction diagnoses, the diagnostic backpacks Kelly and I brought were not applicable to their work, but we were able to observe how a mass-scale mobile clinic works and understand both the challenging and rewarding aspects of such work.

A patient being fitted for glasses

While many patients received medical care that they would otherwise have never received, and some critical patients were referred to the closest hospital for life-saving treatment, there were some obvious limitations to the mobile clinic as well. Patients with end-stage cancer, ectopic pregnancies, Turner’s syndrome, or other difficult/life-threatening/genetic conditions were given their diagnosis, but treatment was out of the scope of the clinic.

Lines of patients waiting to see the ophthalmologist and internist

Observing the mobile clinic work also gave me a whole new appreciation for health prevention and the health and hygiene lessons we taught in Terrier Rouge. I can only hope that our lessons on hand washing, teeth brushing, malaria and typhoid transmission, etc. at St. Barthelemy will prevent at least a handful of clinic visits in the future.

Kelly and I probably spent the most amount of time at the pediatric station, where we measured kids’ arm circumference, height, and weight. Many of the patients suffered from malnutrition, and several times I did a double-take when I read a child’s age on their chart after taking their weight—I might not have a medical degree, but I do know that a 3-year-old should never weigh 18 lbs.

We also tried to help translate at the triage station by asking patients, “Ki kote ou fe mal”?,” which means, “Where does it hurt?,” so that they could be referred to the proper station for further diagnosis and treatment. It was rather shocking how many patients, after saying that their stomach hurt, subsequently said, “M’grangou,” which means, “I’m hungry.”

It reminded me of a quote in Mountains Beyond Mountains that giving medicine but not food is like “washing your hands and drying them in the dirt.” Not that I advocate handing out food necessarily, but the fact that many patients needed the simple treatment of “food” surprised and saddened me. The food shortage in Haiti struck me even more during our drive to Hinche. We saw street vendors selling bagged dirt, and one of Medishare’s doctors explained that Haitians use the dirt to make “dirt pies” that they actually eat. I don’t think I’ll ever look at dirt, or pie, the same way again.

I actually felt the most useful when Kelly and I were given a portable photo printer that the team had brought in lieu of the no-longer manufactured Polaroid camera and film. Throughout the clinic on Thursday and Friday, we took photos of mothers with their children at the pediatric station and gave them a print to keep. It put a smile on my face to see the mothers’ smiles when they saw the photo of them with their children. In a country where many people do not even know what they look like because they can’t afford a mirror, something as simple as a photograph can mean so much to someone.

The portable photo printer.... a nice mobile clinic novelty

My favorite mom-child photo 🙂

Overall, I really enjoyed our time at the mobile clinics, and being able to observe and work with such a gracious and fun team of students and doctors made the past five days some of my most memorable and enjoyable in Haiti.

Today was the dedication of the third and final floor of the school and the graduation ceremonies.  Everything, including the kids’ outfits, was St. Barthelemy colors, red and white. The decorations were beautiful.  There were red and white tissue paper chains and white doves lining the walls. The kids graduating from preschool were so adorable.   The girls wore frilly white dresses with red satin sashes.  The boys looked like little men, uncomfortable in their white long-sleeved button-ups and khaki pants.  Some boys had a piece of red cloth pinned to their shirts like a tie.  The graduates from the sixth grade wore their red St. Barthelemy shirts with khaki pants.  Lots of dancing and singing later, the kids graduated from preschool and sixth grade.  This year’s graduation was especially important because the sixth grade class is the first class to complete its education at the primary school. 

At the end of the graduation ceremonies, gifts were handed out, gifts that Jocelyn and I wrapped in the weeks leading up to the event.  Some of the gifts were oddly shaped, which made them hard to wrap.  Their odd shapes and a shortage of wrapping paper led to some interesting creations.  One particularly memorable gift was a calico beanie baby on top of a sack of jacks.  I wrapped the gift carefully, but did not have enough paper for the head, so I had to cut a scrap and wrap it around the head.  It looked like a green, red, and grey striped Egyptian sphinx.  Jocelyn and I watched to see the kid that would get this special gift.

Music for the ceremony included Britney Spears (the old stuff), the Backstreet Boys, and, of course, Celine Dion.  I am convinced that if Haiti had a Top40, Celine would be all over it.  The Haitians love her!

After the ceremonies we were sitting on our porch enjoying the cool (by Haitian standards) night air.  Joseph, our translator, came over to say good-bye.  While exchanging wishes for good health and hopes for long lives, it hit me that we are really leaving. I am very sad, but Jocelyn and I hope to come back together someday.  Hopefully we will be that fortunate!

Tonight is our last night here in Terrier Rouge, and I have to say it is a bittersweet ending.  We are excited to get started on our projects in Thomonde, but we will miss our friends here in TR.  We will never forget all the people we met here, the things we have seen, and, most importantly, what we have learned about the world and ourselves.  

This is our last weekend in Terrier Rouge and I’m finding it hard to believe that our time in Haiti is coming to a close so quickly. I’m really looking forward to the next two weeks at Project Medishare in Thomonde, but St. Barthelemy has grown on me more and more over the past six weeks and it’ll be hard to say goodbye to the amazing students, teachers, and staff here.

I know that most of my posts so far have focused on my outward experiences and observations in Haiti, and I’ve avoided delving into a lot of my own personal thoughts and emotions. It’s easy for me to describe what I’ve seen and heard, but to describe what I’ve felt seems nearly impossible. Every conversation, interaction, and experience I’ve had in Haiti elicits more thoughts and emotions than I could even begin to describe. It’s almost as if I would need some sort of stock exchange-like live update attached to my blog: Jocelyn is hopeful… Jocelyn is nervous…. Jocelyn is thrilled…. etc. to show my “thought of the minute.” Even though I’ve been in Haiti for six weeks, I feel like I’m just beginning to process my time here.

Thursday’s adventures, however, allowed me to gain a new perspective on Haiti, literally and metaphorically, so I’ll do my best to tie together a narrative of the day and how it represents one of the overarching themes of my experience so far:

At the crack of dawn, Kelly, our translator, and I packed into one of the school’s SUVs and made our way to Milot, via Cap Haitien and a few other modes of transportation (for the sake of my parents’ blood pressure, I’ll leave it at that). When we arrived in Milot, we made our way to the center of town to begin our ascent up the mountain, on top of which the Citadelle, the largest fortress in the Western Hemisphere and one of Haiti’s most famous landmarks, is located.

(the Citadelle is the square-shaped structure in the center of the photo)

After some tough monetary negotiations with a rather questionable “official” tour guide (at times, the Haitian gourde-Haitian dollar-American dollar conversion has required some long division!), we made our way up the mountain via another mode of transportation and on foot. At one point, I began to wonder why we thought climbing one of the highest mountains in Northern Haiti in July was a good idea, but once we arrived at the Citadelle and took in the spectacular view, I realized it was more than worth the climb.

I felt like we were on top of the world—I could see in every direction for miles, from the bay of Cap, to the Grand Rivière in the valley, to the mountains in the South. It was truly one of the most incredible sights I’ve ever seen.

According to a plaque we read inside the fort, the Citadelle was built by King Christophe to defend Haiti against French invasion. In 1820, the king committed suicide after a mutiny arose, and although his body was returned to the Citadelle, to this day, no one knows where his remains lie in the fortress (future Pirates of the Caribbean/Indiana Jones movie plot? I think so).

On our way back down the mountain, we also explored the ruins of Sans Souci, King Christophe’s palace.

The completely different views from the base and the top of the mountain reminded me of the different perspectives I’ve had during my work at the school and clinic. Many times, I’ve had a “base of the mountain” view of my work, but seeing my work from a larger, “top of the mountain” perspective is so much more rewarding.

Some days, I felt so overwhelmed by all of the kids and their bottomless energy in the mid-day heat. I sometimes wondered how we would manage to teach and encourage healthy behaviors in children who are surrounded by anything and everything that inhibits good health. But then I see kids like 6 year-old Didi, who has a smile that could stop an army, and 12 year-old Francisca, who asks such thought-provoking questions, and their smiles and questions remind me why we’re teaching and how fortunate I am to play a role in their education. This experience is not about the insignificant, day-to-day frustrations I may complain about; it’s about passing on some of the knowledge that I’ve been so blessed to receive in my life to the kids whose lives can be changed with such knowledge.

During our work in the clinic, it can be so easy to fall into the negativity trap when a patient’s file has two different reference numbers, or when the language barrier between you and the technician seems momentarily insurmountable. But no matter how confusing the filing system and conversations may be, I try to remember that these patients are so fortunate to even have medical records at all, and the fact that I am participating in their medical care, even in the smallest way, is a huge privilege and valuable learning experience.

So I’m trying to view every obstacle and challenge as part of the overall picture, and to not get caught up in the smaller, momentary frustrations that come with living and working in an unfamiliar place. I think it’s important to gain both perspectives, but the view from the top, while a lot more difficult to reach, allows you to fully appreciate and understand the view from the bottom.

St. Barthelemy’s kindergarten and 6^th grade graduation is tomorrow, and then Kelly and I leave for Thomonde Monday morning, so my next blog will most likely be from Thomonde. This weekend will definitely be our busiest yet.

Happy Fourth of July!