You know the song “Pants on the Ground?” How about “Cracks in the Walls?” That was the airport terminal. Large vertical cracks from floor to ceiling,…and large horizontal cracks near the roof line. We had to wait directly under this area,…for 10 of the longest minutes on earth. It was a relief to finally step outside.
We were directed to go into an awaiting tiny bus. This bus took passengers to the customs area. I was happy, happy, happy to see we would be in another building for customs. No complaints from me at all! We went to a building that might have been an airplane hangar. The heat and humidity was intense. Patience was the word of the day. I was sweating big time. Large drips of sweat. It was oppressive heat especially when combined with humidity and the huge numbers of people who were milling about waiting for luggage.
Then, I saw a regal United Nations soldier, fully covered in his uniform, wearing gloves, a helmet, flac jacket, boots,…etc, and he was barely breaking into a sweat. No more whining thoughts for me again.
Luggage was hand tossed into a pile in the hangar and it was every man for himself. It was my first real lesson about “personal space.” Apparently, personal space is not a known in Haiti,…crowding, milling about, bodies touching bodies, is daily life.It was an attention getter as it was something we constantly experienced.
We were in a group of 10, consisting of 4 doctors (two from Hudson, FLorida area, one from North Carolina,and one from Brazil) a nurse manager(North Carolina), and the rest of us from Pasco County, FLorida) a social worker/mother, a pharmacy rep/dad, a housewife and mom, a hopeful soon to be pre-med student, and myself an’ occupational therapist/grandmother.” Our journey was finally a reality.
Gathering luggage was the first challenge, and once it was all collected, with a great amount of effort and help from Haitians, we were next led to our awaiting truck and van. We had 14 huge duffle bags filled with mostly medications, a few toys, flips flops, and some clothing such as underwear and socks for the kids and some food for our group. Plus, we all had carry on bags packed to the max with personal supplies such as bug spray, antibiotics, antiseptics, personal snacks, clothes and supplies we needed for our duties.
Our bags were thrown on carts designed for maybe three or four suitcases,…but ours were loaded to the top and beyond. Each cart had its own adventure getting through the obstacle course of milling people, wrecked roads, crazy drivers, old cars, and total insanity as we edged toward our parked vehicles. We had a designated driver waiting to take our luggage and us to the place we would be staying in Bercy
Just taking the luggage out of the airport was an amazing experience. Think dirt, mud, rocks, stones, holes in the dirt road, ditches, puddles of “mucky water”. Add a lot of noise, screaming shouting people and horns blaring constantly, and think “CHAOS”. Now, add uncontrolled traffic, with drivers who knew no driving rules and were unconcerned for safety. Add to that the feeling of reality waning, confusion, maybe some fear of getting killed (run over by drivers intent to get somewhere regardless) and you might have a glimmer of tour first outside moments of our journey.
We had a truck and a van waiting for us, come of the team had to ride in the truck. (I will post a picture of them as we (the truck and a van) were parked in a gas station, hoping to get fuel,…which, BTW, did not happen at that gas station. ) So, as we were attempting to leave the airport, it didn’t take long to realize people were living next to the roadways in lean to’s, three wall huts, no wall huts that simply had some plastic thrown over the top of something available,…Naked children everywhere.
As we moved slowly out of the airport, I saw an older woman, from a distance, breasts exposed while she was bathing in murky water outside. People all around. No need for privacy, and no availability of privacy anyway.
Clothes hung wherever they could be hung. Cactus are a great favorite way to hang clothes., as are tree branches, concrete, rocks, tents, etc. Anything goes. Tent cities were every where, and I never saw a port-a-potty. Not one. There was no running water. There were no drinking fountains, there were no hoses. People walked into a a puddle of muddy water to wash, or into a “gully” which is a word I say loosely,…to pee and to wash. That’s right,…pee and wash.
I think it would be fair to say the surroundings were shocking, but I expected it, having been in Haiti once before in the 80’s. Things were different. They were even worse than 30 years before). As we drove toward our destination, we rode through some of Port Au Prince. We were able to see through grimey windows on our van, some of the dreadful conditions of homes that simply flattened like pancakes. I was told by some of our interpreters that there were still many people left under the ruins.
We saw women carrying huge bowls on their heads, people riding donkeys carrying their wares, we saw people selling gasoline in coke bottles and anything they could retrieve in the trash. we saw people selling 5 or 6 small mangoes, or a couple of batteries, or a few pair of flip flops. Water was sold in little plastic bags,…5 of the little bags for one Haitian dollar.
We eventually drove through a sulpur springs area, where the local voodoo doctor lived. We were probably 300 yards from his outside lean to and the stench was incredible. Guess he was used to the smell of strong sulphur. It seemed like a nasal assault.
And as we were getting near our orphanage, the sun began to set, and in an eery, isolated, sad and pathetic way, it was a most beautiful sunset. I quietly thought here truly was abject poverty, yet the beauty of nature still exists. The strength of mankind shines through as people struggle to exist because it is the way of their life. It is what it is. And, they thank God for what they have.
Haiti: Arrival at the Orphanage in Bercy
We made it to the orphanage in early evening. I remember when the van turned right into a dirt road, my mind thought, oh, no, this can’t be it, can it? Well, at the moment, it was not much to look at. When the van stopped, I looked around and thought, OMG, what have I gotten myself into? As we were unloading the van and truck, I was looking around. The first thing, little naked kids all over the place. Cute little boys with bald heads, and the most beautiful big eyes. Little girls with beautiful complexions and smiles.
Chickens, baby chicks and roosters were walking around on the ground, in trees, and wherever else. Sounds like (LUKE-KEY) the dog was tied and looked as if he were sleeping. Picnic tables outside and a little area for cooking with two outdoor grills (but not like what you are probably thinking!) Anyway, we were then directed to walk up a flight of wooden stairs. We had arrived.
The women’s room was the first room you walked into as you came up the stairs. So, everyone walked in and out of our room to do anything up stairs. Kids were running up and down the stairs, throwing the door open whenever they felt like it. They wanted to look at our “stuff” . They wanted to touch everything.
Interpreters coming in and out,….so, long story short,…no privacy. There were about 10-11 beds in this room, three of which were bunk beds. There was still a group from Jacksonville there the first night, so we were lucky to have gotten some nice tips and suggestions about the way to bathe, prepare for night time, etc.
So, the girls in our team picked out their beds, and I decided to go for an upper level bunk bed. The mattress was great. The climb was not. It was hard enough the first night to climb into that darned bunk bed. Little did I know then just how hard it would be to climb up there after a work day. But, I digress.
Once I got up there, I didn’t want to get down again. So the first night, the lights went out maybe around 9:30 or ten (Not too sure as time was sort of irrelevant)So, my little portable fan from Walmart was amazing,…6 inches of magic……beautiful cool air. So, that little fan kept me cool all night. I was in love. ANd, the next best gadget, was the L L BEAN baseball hat with lights in the brim, that my husband lent me. THAT HAT WAS THE GREATEST. I could read at night even tho the lights were out.
The first night I had a bunch of People magazines which I left at the foot of my bed (rather than get down to put them away) Apparently, the first night, I kicked off a few magazines, which proceeded to fall on Guiga’s head! To say, ” SCARED” was an understatement. then, apparently shortly after that, I knocked off a flashlight,..so it hit the floor pretty hard. That was pretty loud. Well, I didn’t make many friends that night. LOL.
That was the first day.
Our First Medical Clinic
This day began with a cacophany of roosters “cawing” or “cah-cawing” or whatever unbelievable noise they make at 4 AM,…which was a subject for some interesting discussion,…just what sound does a rooster make? Anyway, whatever the sound, we learned that roosters like to use their power packed voices not just at 4 AM, but 3 AM and every time, all damn day long. But, oddly, I enjoyed it all times, and actually enjoyed the morning symphony. Somehow it was “other worldly.” I tuned it out and tuned in whenever it felt right or fun or homey. It began to feel homier every night. Hard to believe but true.
So, we had a pancake breakfast with syrup and bacon that the lovely people from Jacksonville cooked us. They made us a warm breakfast. Warm breakfast was not something I expected. They did that for us, as we prepared for our first clinic day at the orphanage.
They also showed someone from our group how to make coffee with the 1940’s coffee perculator. (Anyone who knows me will now be laughing and thinking what a good thing it was that I wasn’t responsible for coffee making) Anyway, the coffee was delicious. Strong, black and perfect.
I looked about our kitchen area with all the team from JAX, our newly developing team and our Haitian interpreters, and thought what a mixture of wonderful people. Some were there to “just” love the kids, others to build,….our team to promote health and Haitians there to help their fellow Haitians.
Everyone there would make some difference to someone, maybe not noticeable in the US,…but, still a difference in Haiti. It was one of my quiet moments, realizing the goodness in people.It was one of my quiet, but happy moments.
So, we left to go to our first clinic. It was to be about 100 yards away, adjacent to the Orphanage’s outdoor church. I was looking at this area, and wondering where will the clinic be? People had already filled the church, and were filling almost all of the available spaces, before 7AM. So, a gate was opened to a storage area, and voila, our clinic.
If you can imagine the shape of a wide H,…with either side of the H being a small square room and the the center area was a corrider that had old barrels in it. This storage area became a functioning clinic. Dr. Shawn looked around, and asked some of our Haitian friends to find a rope and some blankets or fabric,…anything that would work so the docs could offer a private examination room. That space became a reality, and it it gave me another quiet, but happy moment. I realized then that Dr. Shawn demonstrated a sensitivity and compassion that honored and respected our patients. It wasn’t a pretty room. It was not a clean or antiseptic room, it wasn’t anything like you see or expect in the US, but it was private. It meant respect. That was another sweet moment for me.
We set up our pharmacy for the first time. It took us a good part of the day to try to get an efficient “system.” so we could get faster, and make the process more efficient and effective. It needed to be because we had to see so many patients. It seemed as if the Church stayed filled all day long!
A triage area was set up outside. Our pre-med hopeful, Ayden and our wonderful nurse manager Kathy and Janet were mostly responsible for triage. Triage consisted of a weighing a person, making an observation, and based on that, a blood pressure, or temperature check. They would ask the person what their reason was for coming to see the docs. Once they got things moving along, our two doctors, Dr. Amee and Dr. Shawn looked around and got to work. A couple of chairs was all they needed, plus our very important interpreters.
The morning raced by, but yet at the same time, it seemed like a lifetime. We stopped for lunch that day, as we were so close to the orphanage. Guiga prepared a hot lunch. It was nice, but it was almost too hard to get started again. I would rather have continued without stopping. My appetite was gone anyway. And, no need to pee.
On that first day, we saw (I believe) almost 300 people. Ah, I better check that first…it seemed like 1000,….they just kept coming and coming. It was hot, hot, hot! I sweated like a man (And I don’t mean that in a bad way,…wait, yes, I do,…it was disgusting. ) No need to pee that day.There was nothing to pee.
Anyway, we made it through the day. The docs worked their tails off, but neither Shawn or Amee looked like they broke a sweat. They were brilliant. The rest of us looked a bit “rugged” but I definitely looked like hell. My hair was a wreck, no make up, and I stunk. My clothes were soaked. I haven’t worked like that in YEARS!
So, the day ended, we packed and returned to the orphanage. The steps leading to our rooms seemed like they were leading to the top of the Statue of Liberty. I was so unbelievably tired, each step felt like the weight of the world.
Despite my condition (aroma included) I could not bear the thought of taking a shower right away. I just had to drink water, and I rocked on the blessed rocker, enjoying a slight breeze of the fan, and miraculously, we had some ice, which I applied to my head, then to my mouth. No shame. Eventually, I took a shower, but was the last one to do so…Then we counted pills, and prepared for the next day.
So, the last thing I had to do that night was climb into the upper level of my bunk bed. Guiga had moved to a different bed (wonder why) so I was now able to climb the bed, with less worry about falling backwards on top of her. Once I got in that bed, I seriously doubted I could get out again, if I had to. No worry there. Still no need to pee.
I got my LL Bean hat with lights in the rim, turned my little hand held fan on, turned on a little hand held lantern and got to spend a few glorious moments relaxing, reading, writing. Then, apparently I started to snore. Another special night for the ladies.
That was the first work day.
The Mountain Clinic: TUESDAY
OUR AWAKENING: The symphony of the night was amazing. The cacophony began with the roosters, but then all of the dogs in the countryside from Haiti to Santo Domingo seemed to join into a chorus of decibels. It was awesome really. It woke everyone up, but like I said before, I liked it in another worldy sort of way. We had surround sound. Then the donkees started to bray. I think it was the loudest wake up call of the week. Distinctly Haiti, and those sounds will always remind me of this other world.
Once the animal symphony began, other daily life sounds, like beeping car horns (which was something that apparently is required whenever driving!) would begin and become more ferocious as time progressed.
Time became somewhat irrelevant. You woke up with the roosters around 4 AM and you go to bed as the sun sets and the moon rises. Who needs a watch? The roosters and other animal time keepers apparently are responsible for awakening the people, and they do an excellent job. Nature provides.
I usually noticed the clock in the kitchen at night when I headed for bed, otherwise, I did not notice it. We worked until we were done.
We usually woke up in the “relative” dark, so it was important to plan ahead the night before to have the day’s clothes and personal products ready, with the flashlight within hand’s reach. I felt good, because along with my through the truss view to outside, and spectacular evening view of the brightest full moon, I had little 2 X3 shelves, to place some important things like bug spray, tiny lantern, eye glasses.
It would have been a pleasant luxury (for more than me) to have a wider piece of wood somewhere up there in the trusses near the upper bunk beds, to hold the things like a book or journal, or the clothes for the next day. It would serve to prevent future “killings”! GUIGA knows what I am talking about. LOL, and it would make it easier to get dressed in the morning (at least for the folk on the upper bunks.) HINT, HINT!!!!
There was even an old ugly nail that turned out to work just fine as a towel hanger. I learned to use the shelves at night after the night time disruptions I caused. Adaptations and adjustments are a part of daily life in Haiti. And God knows occupational therapist’s adapt. LOL.
On this day, I can’t remember if we had breakfast or as a group decided to just eat a powerbar. I think that was how it was. I still had no appetite. The coffee was made and enjoyed, but I skipped it after the first day. Menopause and heat are not friends. While the coffee was delicious, I couldn’t bear the extra heat and sweat it caused me. However, the glorious smell of it was just as good, if not better. I reveled in that smell.
Then preparations began for our trip, and we were out the door I think by 7 or 7:30. Herby or Stanley and Mike, I believe, had worked out the arrangements and we followed their lead. Guiga and Janet made sure lunches were packed, and cared for the rest of us in that way. It was nice. We had peanut butter and jelly sandwiches, peanut butter and jelly sandwiches, peanut beutter and jelly sandwiches and tuna sandwiches. I love tuna, but passed on that. We also brought along power bars or cereal bars, pretzels, apricots, and I had some small containers of peaches or mandarin oranges which were the best, most delicious fruit I ever ate. (As a side note, I usually ate the fruit in the van, on our way back home, because I simply could not bear to eat in front of the Haitians. No appetite and no desire.)
Our team worked on the theory that we would be out and packing up and ready to go I think between 7 AM and 7:30. We all climbed into the van, pushing the limits of internal space and weight, and headed out to our second medical clinic. We really did not know what to expect in advance. Each day was truly a complete new adventure.
Before we left for Haiti, Guiga and Jim, Amee, Janet and Ayden and others pre-packed duffel bags for each day we were there, with a complete day of medications. This was no easy task, because it was impossible to determine in advance what the need would be, and of course, we did not have an endless supply of meds.
But, thanks to Dr. Leo’s original team, it made it easier for Guiga to know what to buy and bring. Dr. Leo had said his trip happened so quickly, it was never easy to locate medications and such, as they had to dump bags over and over again to find stuff. Guiga and team solved that problem, by developing a daily inventory of medications, and packaging them in daily duffle bags. Fabulous idea!
I believe Janet had found some duffel bags for a dollar at a local dollar store that was going out of business. It was a good deal. HOWEVER, knowing what we know now, the few bags we had that had wheels were so much better. By the end of the day, it was an added strain to carry, rather than pull. Just an ergonomic thought there.
Guiga also got clear plastic shoe boxes which were a great help, especially each day as we re=packed our bags. Medications were put into small dosage bags and labeled in English and Creole and easily placed in the box, then lids on and we were ready to go. That really worked well. Easy stacking. She made a list of medications for each day, so that doctors knew what was available for treatment.
Our pharmacy team were not pharmacists (it would be so nice to have a pharmacist go along with the team) we had some issues trying to first find the medication, then to know if we had the right ones as some were similar in spelling. The triage team always wrote the person’s complaints at the top of a slip that was given to each person. On the slip had a place for name, age, complaint, doc’s assessment and treatment plan. At the end, the slip became the prescription, and it became our record of medications dispensed, type of problems we saw, genders and ages of people. Very valuable information for future trips. Also, for some competitive doctors, I won’t say who, Marcello, to see who were able to see the most….assessment times were usually done within 5 minutes. Not an easy task, and certainly not the way the doc’s wanted to do it, but the demand was astonishing. SOOOOOOO many people,…so little time. The docs did an outstanding job, as did the triage team and pharmacy and interpreters. it was quite an incredible process.
So, back to medication disbursement, Eventually our system evolved, and was more organized. Medications were placed more into categories such as antibiotics, anti-inflammatories, allergies, skin care, etc.
But, as our team became more cognizant of efficiency and need, it was decided to modify the process in the future to make medication distribution easier for the non-pharmacist teams. One thought was to develop a list by catagory, then put the names of all available medications in that catagory in alpha order. This would make it far easier and faster to disburse, and would save the docs time looking on a long list without order.
Another idea was to put all medications in alpha order and then number them. Then, all the doc’s had to write was a number, rather than writing the full generic name and dosages, which took too much time….reducing time to see patients. All the pharmacy would have to read was a number, and filling the prescription would be so much easier. I don’t know what process will be chosen for the next time,..but, I am sure Guiga and crew will make it work.
TO THE MOUNTAIN CLINIC: We moved along through the countryside, the driver made a turn at a particularly odd place. We headed up a hill that kept going up and up. We had a few moments where I wondered OMG. Where are we going? What was ahead of us was an arid hilltop, with weird looking cactus trees, rocks, and dust. But it was large enough for us to call it a mountain. It was so desolate. As we climbed the hill without a road, people were standing within inches of the van as we moved past.
There were a few huts dotted along the hill as we advanced. At one point, the team made a joke to move forward in unison to help the van continue the climb up and up. For a moment, it seemed like it wouldn’t happen with all the gear and us.
Then, we stopped. We were where we needed to be. There was a beautiful view of ocean in a distance, and we were on an arid hill, with rocks and a couple of puny little trees that offered puny shade, but shade none the less. As we walked down the hill, with the 50 lb duffle bags in tow, there was a little bull tethered to a rock, not 15 yards from a hut. As it turned out, the hut would become our medical clinic!
The hut had a pieced together palm frond wall. Three or four sections had been woven then woven together (See photo) The rest of the hut was made from sticks, table clothes, sheets, string. It was tiny, but 4 doctors, Amee, Shawn, Michael and Marcello were able to set up shop, with as much privacy as possible within the hut . Dr. Amee spent most of the day outside, with Ayden and Kathy in over 100 degree weather with direct sun, uneven terrain, and a crowd that did not know anything about personal space. Crowding is the norm. In fact, while these folks were outside standing in the hot sun, all day, waiting to get in to see the team, I noticed as the day progressed, more and more people began to move down the hill, and sit next to our hut. The reason? SHADE. So literally, there were three rows of people, sitting side by side, elbow to elbow, like a crowded can of achovies, staying cool in the sun.
Our triage team were amazing. Our docs were amazing. Our pharmacy was amazing. Our interpreters were amazing. What an unbelievable day. I know we saw more than 400 people that day (check the numbers on www.peopleforhaiti.com on the blog. It was an event, and the best day. The best day because it felt like we were seeing people who had not been seen by a doctor before. Unbelievable.
People seemed to wear their most beautiful clothes to see the doctors. They recognized the day as a special event in their lives. It was so sweet to see the (Ladies with their little daughters. It was special. I took a picture of one little girl with an orange headband that I just love. Check out my photo album when you can (I haven’t put my collection of photo’s up yet, but will soon) but PeopleforHait.com has some of my collection, as well as the photos of other team members. I understand Guiga has 1500+ photos.
We saw so many people with skin rashes, lethargy, stomach aches. We saw a baby that got burned legs, and a few kids with wounds from falls. So many babies that looked limp, bloated, with glazed eyes. We saw mothers with new babies and no milk. Mama’s looked dazed, tired,…no joy in this group.
But their was thankfulness from many. Kids still had interest in the goings on inside the clinic, and we spent much of the day trying to cope with kids peaking in, but at the same time pushing in our walls,….we never knew when someone was behind us or in front of us….or to the side of us. I worried all the time about causing a fall or falling myself.
It is difficult to detail just how silky our little system went with everyone doing their jobs and whatever needed to be done, as it needed to be done.
The people were patient, and many walked from some serious distances up the mountainside to be seen.
At the end, it was good day.
BACK AT THE ORPHANAGE: Once we got back, I felt like it was a bone crushing day. I was exhausted. Then, one of the doctors asked me to go with them to look at a disabled gentleman in a village close by to see if there was anything that could be done with him as far as rehab. So, Dr. Shawn and Dr. Marcello and Mike from the orphanage and Herby and I trekked into the little hut of this young man and his mother.
They had a house that had three walls, and an open front door, There were two full side beds in the hut, that were literally on the floor. Both beds had sheets on them. Interestingly, the young mans sheets had a white powder around the bottom perimeter. It turned out it was used to detract ants. There was no refrigerator, no cooler, no bathroom,…just mattress on the floor, some cooking bowls, and odds and ends like bottles, etc.
There was also a very nice wheel chair in the hut. It appeared to be a wheel chair for a child about 6 years old. While our young man was small (his muscles were severely atrophied, and his hips and knees were severely contracted, and his hands were deformed, it was way too small for him.
His devoted mother cared for him. Miraculously, despite his condition, the doc’s said he had no skin breakdown anywhere else on his body. They were there to deal with an abccessed toe that was giving him terrible pain. It was in the best clinical jargon I can think of,…a MESS. The young man had so much pain. He anticipated more pain with movement and you could see fear in his eyes. He was so contracted. Hip and knee contractures were so bad, I could barely stretch them a half an inch. He could barely open his legs, as adductors were contracted. His mother apparently took him out of his bed regularly. She did a good job, because she had to lift him from a mattress on a floor to put him on his wheel chair. She had to struggle to move him out of the hut, as their was just enough space to roll the wheel chair outside. Then, she struggled to push his w/c anywhere, as everything was uneven, rocky, barriers everywhere. More unnecessary burdens for her to handle. At that moment, they needed a magician.
1) Elevate his bed so Mom could transfer him out of bed with less strain. It would also give them more storage space under the bed. That would help them get rid of inside obstacles that must make it so hard for the mother to get him into and out of the w/c and hut.
2) If only a nice level little area could be made leading from the hut to outside, to where they cook and eat, It would make it possible for Mama to push son outside, with less physical effort. Her effort must be huge every day. Perhaps such an even surface could be made one day by the Jacksonville church members.
3). A hospital urinal would probably make Mama’s life easier for son.
4) A new wheel chair that fit his proportions would be nice. WHY? The leg length was too small for this young man. Over time, because the distance from the foot pedals to the seat is so short, the position forces his hips to flex, which means his knees, when sitting in the wheel chair, probably come up close to his chest height. Thus, the wheel chair really isn’t helping at this point. It is just harming him.
Those few simple things could make a big difference in the quality of their lives. COuld I do anything about those contractures? No. But these adjustments could help.
The docs did their toe surgery, with flashlights (no light or electricity in the hut) and they removed a toe nail and cared for the wound and promised to return the next night. Then, we walked back to the orphanage, whereupon the docs were asked to look at another young man who had a problem, with his knee.
OMG. The pants had to be cut vertically, because they were too tight. What we saw was unbelievable, (see photo on future album) The boy had a swollen knee, with exposed skin and bone. There was something green inside. It turned out to be a leaf placed on the wound. he was told to do it by someone. The good docs cleaned and debrided the wound, and wrapped it, saying they would check on him the next day as well. What a day! It was a happy moment watching the doctors, do what they do, do what they can, for whatever it was worth.
We got back, and ate dinner, prepared by ladies from the orphanage. Beans and rice and some tostones,…and one nite we had chicken with onions, and maybe carrots and some potato; andother night was “goat” and another night, I am not too sure what it was. But, no matter, it was food, and it was good.We then prepared medications for the next day.
The shower is another story, and maybe later I will write about our showers. Bed never felt so good in my life.
As an occupational therapist (OT) of 35 years, I have studied, analyzed then worked to maximize human occupation, performance and skill.
Essentially, this is the ability to “do” whatever is most important to a person within the person’s level of skills, life demands, personal factors and contexts. “Doing” is also dependent on the environment, attitudes, health and a complex interaction of many other factors.
What we “do” as a human being is central to personal identity, competence and adaptation. In Haiti, human occupation, performance and skill are centered around one major thing. SURVIVAL! In the Haiti I experienced this past week, the major occupation is finding adequate food and water to simply live. From what I could tell, there was relatively little of both food and water.
Think about this. A huge portion of the human body is water, maybe 60%, if I remember correctly. (My mind is still fuzzy from dehydration, perhaps?) Blood is something like 70% water. Blood needs water for normal circulation. Without water blood pressure rises. The heart works harder, and as a result, as circulation slows, every other body system is affected including breathing, digestion, elimination, etc.
When various body systems do not operate efficiently, health changes happen.The results are anything from lethargy, fuzzy thinking, headaches, stomach aches, skin rashes, muscle pain, fatigue, disinterest, apathy, dehydration, lack of appetite, decline in the ability to resist disease, seizures, etc. This list can go on and on ending in death.
Food adds vital minerals, nutrients and vitamins that maximize the efficiency and effectiveness of the miraculous body. Plus, food does make you feel good, right?
My point is, when food and water are limited or not available, the ability to “do” changes. This affects every aspect of quality of life and human performance. It is an essential requirement for life. It must be available.
One more thing, before I close this. There is another major occupation in Haiti, and that is the strong belief in God and spirituality. The Haitian people have God in their hearts, in their souls and in their minds. They truly believe and they ask for so little. I heard a number of people say it is God’s will they survive. Now, I believe, how they survive as a culture must have something to do with their strong and devoted belief in God.
As an occupational therapist, my work role is essentially to assess, analyze, implement to create change that will enable, enhance, modify or maximize a person’s ability to do valued life tasks. So, I have said the above, now I offer some recommendations.
Recommendations from an Occupational Perspective
I understand that billions of dollars are entering Haiti, from caring people and governments all over the world. Now, to be perfectly clear, I did not tour the entire country, and cannot speak for everything that is happening in Haiti. Nor am I a politician or any one of importance.
What I can comfortably address is what I did see in and around Bercy and Cabaret areas. I did not see the application of such dollars. What I did see is a hostile environment without food or water, and people that simply live to survive.
I believe the monies coming into Haiti should first be used to provide the basics needed for survival. Food and potable water is first and foremost. Then, people will gradually be able to think about more that simply living to the next day.
So, at the risk of sounding naïve, I do think monies from the world should be applied to help the people of Haiti in the following ways.
A. BASIC SURVIVAL MUST FIRST BE MET
1. Systematically and regularly provide potable water throughout Haiti, every day.
2. Systematically provide vitamins and high nutrient foods
B. BEGIN WORK TO CHANGE CULTURAL EXPECTATIONS
1. Systematically remove all trash
2. Install port a potties around the country
3. Provide people with a personal identification card, with name, age and photo. (Beginning the process of identity)
4. Develop business and work opportunities such as:
Water filtration system
Bank lending or small grants
5. Systematically establish major educational programs
through the Haitian churches beginning with:
Maternal child health care
6. Develop jobs training areas through the churches, such as :
b. Trades such as mechanics, masonry, plumbing, etc.
c. Health care
d. Child care
7. Develop community recreational programs, also through churches, such as:
Playgrounds for child
Little league programs: baseball, soccor, football for boys and girls
Add nets for badmitten, volleyball, basketball
Encourage group activities
CONCLUSION: It was a joy and a privilege to work with the People for Haiti’s second team. I know and love Dr. Leo as a wonderful and compassionate doctor. I believed in his desire to help and was thrilled to be able to join the next group that went with this fine developing organization.
As a result, I am honored to have met Dr. Leo’s wife, Guiga. It was easy to see and feel her deep passion and interest in actively making a difference in this forgotten world. They are an excellent, caring and compassionate couple, that together, I am sure will lead the way for People for Haiti to do remarkable things.
I was also very privileged to meet many of Guiga and Leo’s personal friends who went along on this mission. Janet, Dr. Amee, Dr. Marcello, Ayden and Dr. Shawn Wan,..all very kind, caring, loving and compassionate people.
I also was privileged to meet Kathy and Dr. Michael both from North Carolina, both offering medical expertise in a passionate and wonderful way to behold. I knew the first day this was an incredibly special group of people. All of these people represent what the People for Haiti organization is all about.
While at the Cabaret orphanage, I also was pleased to meet some of the wonderful people from the Jacksonville Baptist church, as well as many fantastic Haitian men and women, who also had a deep passion and love for their people. It was, as Dr. Leo said it would be, a life changing experience.
People for Haiti plans to be in Haiti as a long term mission. They can and will accomplish great things. I know it will not be simple, but one person, and another person, and another person and another person, day after day, do and will make a difference.
Find a way to make a difference with the People for Haiti. Support their effort. Support their desire. Join the group and offer your skills and expertise, and “do” something to make a difference.
If you prefer to make a difference closer to home, do it. Don’t wait. You will find you get back far more than you ever gave.
Wednesday in Haiti with People for Haiti
The nightly environmental symphony continued, only this night, it started a bit earlier. How about 3 AM? Some crazy guy was driving on some road, honking his horn to beat the band. What is it with those horns? It seemed as if the car horn awoke the rest of the countryside noisemakers, and our good friends the roosters, dogs and donkeys and the skinny pig in the back field, joined in the unscripted concert.
Once I awoke on this night, I did have to get up for the first time to use the bathroom. You already know, if you have read some of my previous notes, that bathroom use was more than a hassle. I might have let slip a cuss word or two while climbing off the bunk. Now as I remember, I believe Dr. Amee heard me.
Anyway, once my flash light was in hand, flip flops on foot, and antiseptics were found…I was wide awake. So, I made the trek to the bathroom and checked the clock in the kitchen. Yep, it was only 3 AM. So, it was back to bed. It was actually nice to have a few quiet moments to read a magazine for a bit, then fall asleep again to the light of the moon. It turned out, that extra sleep time was important, because our team was to have our biggest work day to date.
The medical clinical this morning was in a town, in a very nice abandoned house. It looked luxurious to us! It seemed as if our team was especially excited to have such a lovely place to work, after the experience the day before on the mountain side. We thought this place was phenomenal. This is ironic, if you think about it, because we were only 5 days away from the US and health care as we know it,….and this house , in our minds was already a medical taj mahal.
We were actually able to set up triage inside in a room with plenty of space (comparatively speaking, of course). It had a side door, so people could come into triage, and be assessed in privacy. There was even a little desk to write information. It was great. Our triage team was able to work in the shade, without the sun beating down on them. They could work without large excited groups of people amassing around the team as they did their jobs. Our team, consisting of Kathy, Ayden, and quite often, Jim and Janet, always worked with great patience and great calmness, no matter the environment or situation. But, they, too, were pleased with this special little triage room.
The four doctors had a lovely large room to do medical evaluations. There was even a bit of a breeze in the room. There was extra standing space for family members and our interpreters were able to sit down. That was a luxury for them.
We had a large separate pharmacy adjacent to the doctor’s eval room. That location made it nice on the occasions when the doctors needed to get creative and develop an alternative treatment when their preferred medications were not available. Toward the end of the day, this became more frequent as medications dwindled. This location made it possible for them to quickly look at available medications, losing precious little evaluation time. We were able to ask questions when needed, without dramatically stopping the work of everyone else.
We were even able to hang up our “Thank You” New Port Richey ELKS # 2284 poster above our pharmacy. It was a nice reminder of the generosity of the many people back home who made it possible to bring health promoting medications to the people of Haiti. It was sweet.
We also had a room that was used as a surgical operatory. That’s right. Surgery! It was determined that one of the people we saw had a pretty nasty skin cancer, that the docs felt really needed to be removed. The room was prepared, and Dr. Marcello, Kathy and Dr. Shawn did their miracle. Ayden was also a part of the team, I believe. The patient was brave and tolerated the surgery very well. It was amazing to observe.
This group may have saved a life that day, and it is doubtful the patient even realized there were angels there that day for her. It turned out she had a very young baby and I am thinking 5 other kids. Anyway, our teams’ actions that day were very inspiring. It was another happy moment for me.
We also had another surgery when a young woman came in with a stab wound. It was handled as an emergency, with great efficiency and care. Nice.
The house was relatively cool in the morning, but, by late afternoon it was back to hotter than hell. This again was another day of outrageous sweating for me. So, if you wondered if the built homes are tolerable, without electricity or air conditioning, the answer is, yes, if you don’t mind heat! I am still not complaining. It just added to the “aura” and aroma of the day.
As the day progressed, more and more people arrived. It was staggering . We were beginning to run out of some very important medications. But, amazingly, the docs used some deductive reasoning, changed dosages, used some “unusual pharmaceutical choices” in different ways, to develop a useful treatment, with the resources they had. Their creativity and passion was apparent, fascinating and wonderful.
We saw almost 400 people on this day. We were a precision team at last. Things were as organized as they could be given the situation we had, and everyone knew the tasks that needed to be done. Janet and Jim, Guiga and I were doing pretty well with generic medications, understanding certain doctor’s writing (Marcello you know who you are) and understanding certain doctor’s intentions (Dr. Mike). We had it down!!!! We understand the medications and were able to competently explain how and why to take the medications, and asure the person understood directions. That was nice, but it was too bad we had to leave once we figured it all out!We will be awarding the very lovely Dr. Amee with the handwriting of the trip certificate of appreciation because her writing was just beautiful, crisp and clear. Good going, docs and team mates.
Some of the medical conditions that were seen included malaria, dehydration, skin cancers, malnourishment, failure to thrive babies, thrush, stab wounds, stomach aches, worms, arthritis, fatigue, nausea, pregnancy, high blood pressure, headaches and many different types of skin conditions and infections. Interestingly, we did not see any one on crutches or in a wheel chair during any of our clinic days. HMMMMM. Just where are they?
Thursday in Haiti
Thursday would be our final clinic day in Haiti. We were disappointed with the turn out, but apparently, very little word had gotten out. Despite that, we still saw over 100 people by noon. By this time, we were feeling pretty good about what needed to be done and were quite excited as we arrived on site, thinking this would be the day we achieved our goal of 1000+ patients. I honestly thought we would make it to 1300 patients by the end of the day.
We were happy to see the number of people we did. However, after the previous two days, this day seemed like a walk in the park. It was just a bit too slow for us. As the day ended, the leftover supplies were inventoried, packed nicely and stored at the orphanage in our designated trunks. (They will be there waiting for the next visiting team from People for Haiti.)
As we left our last clinic that day on our way back to the orphanage and plans to play with the kids, many expressed their feelings that they knew this trip barely scratched the surface of an enormous behemoth. So much other infrastructure must be designed, developed and implemented before the people of Haiti can hope to live a healthy life. We all intuitively knew Haiti could not be fixed in one 5 day trip, by any one person or group. But, I doubt we realized just how deplorable conditions really were.
People for Haiti will continue to seek funding to promote health and wellness. For this, I am glad. I personally hope we can help to bring water as well as medications to the little communities we experienced this week. That would be a great thing, and would do tremendous things for the health, lifestyle and welfare of the beautiful people in this country.
THE KIDS at the ORPHANAGE
Kids are kids the world around. They like to laugh and play and smile and have fun. They love to be hugged and held and loved. The difference is these kids at the orphange are orphans. They have no known responsible parents or families. They lack the basic nurturance a loving mom and dad give their kids. They depend on and enjoy the kindness and compassion and brief interactions “lavished” on them when visitors come by. (Too bad the visitations aren’t permanent)
On this night, we had toys for the kids such as dollar store jumping ropes, Frisbees, little cars, crayons and coloring books; there were dolls, checkers and jacks and marbles. We also had some flip flops and underwear and socks and a variety of things little kids like.
I thought it was ironic that in a group of 45 kids, the first item that was given away and chosen was a pair of dollar store flip flops. OMG. Function before fun, even with the little kids! It was fun to watch the kids get their toys.
Once the toys were distributed, I saw a seemingly heart broken kid. He was crying huge crocodile tears. (One of the kids had apparently punched him a few times. This was pantomimed to me by another kid) Anyway, I did not understand Creole and he did not understand English, but he did understand a big fat hug.
Finally, crocodile tears child settled down. So, here is how it went. I quietly, without any fanfare AT ALL, gave him a wrapped life saver I had in my pocket. Immediately, another little guy grabs my attention and wanted one, so I gave him one. The next thing I know, all hell breaks loose. Team members were trying to get the first boy then the next one to take the candy out of their mouths.
Well, these kids weren’t about to do that. It took a second for me to realize, that this little 5 or 6 year old did not realize he had to remove the wrapper before putting it in his mouth. Cripe! By this time, I had handed out a few. So, doctors are screaming,…”take it out of your mouth” (in English, hahaha) and chasing kids,…so, I didn’t make any friends that night either!
Dr. Amee sweetly admitted she was thinking about the surgery she would have to do to extract the plastic paper from their little throats and bellies before they expired! You might be relieved to know, once this was brought to my clueless attention, I unwrapped all future lifesavers!
Then, it occurred to me that there must be at least 1000 kids, all running toward me. Twice, I had to catch myself from the little mob, screaming my name,…Vanessa, Vanessa, Vanessa. It turns out they assumed Vanessa meant “candy”. LOL.
As they all collectively ran toward me, mostly with their little mouths opened, like little birds waiting to be fed,…they reminded of Florida sea gulls. When you give a seagull a tiny cracker or crumb, next thing you know, you have attracted millions of them.
These kids were beyond excited. They knew a good thing when they saw it. By gosh, some little pirates led me to believe they never received a candy, even though their little tongues looked purple or green or red! They made me laugh. Drama, pleading and seduction is what I saw when certain little actors wanted more.
Still despite their collective eagerness, I remember one child that I offered a clear lifesaver. She absolutely refused it. So, I pulled another life saver out of my pocket, and it also happened to be clear. She refused that one, too. Well, apparently I finally hit pay dirt when out came an orange life saver. That one was perfect and she took it with ferocity!
After the life savers were done, I had some oreo cookie packages. I broke each oreo into ¼ th of a piece, and gave the Haitian ladies who cared for the kids and cooked and did laundry, etc, each a piece. They were thrilled and just as excited as the kids. Sigh!
OUR LAST NIGHT: As I climbed my bunk bed (hopefully for the last time that night) I could not help but think about the kids, and their beautiful little faces, with their big eyes, beautiful skin, bubbly personalities, and all the energy in the world.
Kids are kids are kids. They need parents. They need guidance and emotional nourishment. They need behavior modification!!!!! LOL. Anyway, I went to sleep hoping that would be parents from around the world could spend a few moments with these kids. it would be so nice to know there will be a loving parent somewhere for each of these kids.
As I am writing about these recollections, I just remembered our first evening in Haiti and in the orphanage. The Jacksonville Baptist church group was sharing their thoughts, tips and experiences with us after dinner. One of the gentlemen announced that after two years, he was thrilled to announce that he would be taking two of the children home with him the next morning,…as he and his wife’s new son and daughter.
That was my first happy moment.
PREPARING TO LEAVE: On this final day, I was packed and ready to go the night before. I thought of our interpreters, Christiana, Stanley, Abraham, Antony and their friends and cousins who helped us. I thought about their families who many brought for us to meet. I thought of Michael who is soon to be the orphanage full time director and who will soon be joined by his wife.
It occurred to me that each man and woman in their own way was doing good things to help mankind. They had an occupation, purpose, drive. They enjoyed what they were doing, they were proud of their work, their goals, and were happy to be able to give. Each had a sense of self and pride (Another happy moment in this realization) Each appeared to be filled with a love of God and an appreciation for their life. It made me realize how much I admire them, their strength, their love and their devotion.
I saw that in Haiti, religion is treasured. Yet, survival is the major occupation of life in this country.
Water and food and decent shelter are essential for life and safety, yet barely within reach for most of the population. Why is this a world with such limited resources? I don’t understand it.
So, as I was preparing to leave, I realized Haiti was definitely another world, but it is still my world, a small part of a whole. I also realized the time in Haiti flew by. It seemed like an instant, and at the same time, it was a lifetime. I was ready to go home and happy that I could.
ARRIVING at the HAITI AIRPORT: Most of the week, it was my choice to wait to eat, wait to use the bathroom, wait to get dressed or undressed. But, I have to say, I was the first of our group to go through customs to leave the country. I was giddy with relief.
I looked forward to ice water; a wonderful fresh water shower; having an unlimited supply of ice, electricity, and a great hot stove to make stunning meals. I looked forward to sleeping in my bed, in my wonderful home.
I looked forward to using my swimming pool, and using my car, and washer and dryer, and dishwasher, and garbage disposal. All that I previously saw as “creature comforts” now, I realize are not. Yes, indeed, I was ready to go home, never more so in my life!
ON THE PLANE: Our first plane took us to Miami. I had wanted a margarita all week. So, in Miami, the first thing I wanted to have was a nice, cold frosty margariety. I got one and it was the worst margarita in the history of the world. No lie! I ordered another one! I had a fresh mahi-mahi sandwich, with no worries about where the fish had been swimming. It was remarkable! And, it wasn’t peanut butter and jelly.
On the plane to Tampa, I had a wonderful nap (hope I did not snore) Then, we were back. Just like that. SNAP!
AT HOME: So, here I am now, sitting in my own private living room, happy to be here, happy to be back home with my husband, family, friends and my little dogs. Haiti is now a memory, but one that I will not forget. I can’t help but think how being there in Haiti for 5 short days has changed my life.
I am thankful for the many happy moments I had in Haiti, and the many reflections it gave me.
For instance, It is 3:30 AM and I know I do not have to worry about ROOSTERS or DONKEYS waking me up at 4 in the morning. NICE!!! That is something I did not know I should be happy about, but now I do! I can flush my toilet even if it is just yellow,…”no need to let it mellow.”
I am happy I can work. I am thrilled I chose a profession that values and enhances human performance. I made a good life choice. I AM happy for the creature comforts I have. Perhaps it is shallow, but, I gotta say, it feels great. Give me the comforts.
I am thankful for my health, and happy that we have the health care that we do. I am very thankful for sterile doctor offices and hospitals, and rules and regulations that enhance safety and aim to assure quality of life.
And I am especially thankful for the very many happy moments I have had in a life that has been rich with experiences of all kind; comfortable and exciting and fun. I have had the privilege of a wonderful education, and continue to have the opportunity to learn new things every day.
I am thankful for the opportunity to have been involved with such a wondeful group of extraordinary people doing ordinary things that may have somehow, (hopefully) positively influenced the lives of the people we touched, just as they influenced our lives.
I am very happy to be a part ofthe history of People for Haiti and I hope to be a part of it’s future.
So, I can rest now, because my story has been told. I shall look forward to the future stories of all the new people who will be journeying to Haiti, and who will also have life changing experiences. I shall also look forward to hearing the stories of the people we left behind.