Saturday, March 13, 2010

Empty Bags, Full Heart

Departure day from Haiti is always emotional…how could it not be, when a week has been so full? We had a 6 am ride back to Port au Prince, so were up sipping coffee by predawn candlelight as the orphanage stirred quietly to life. Leaning over the second story porch railing, I watched the night watchman in a hooded sweatshirt, cross the porch below me, carrying his small mattress across the dusty courtyard to store it for the day. He sleeps on the ground by the gate, for security. Sunrise glowed gently in the east, over the banana trees and the school, another dry and clear day in Hinche. My group of nurses, midwives, and daughters, and the Richmond Haiti’s Kidz Healthcare team had drunk beer and hugged and traded emails last night, but hugged each other and said goodbye all over again. After sharing the work of the week, we’ve forged friendships through the unforgettable experience, and the spiritual journey of trying to serve and help the poorest of the poor. Luggage that once was 3 or 4-50-lb bags each, now collapsed into empty bags within bags. Only clothing, personal items, and the artwork we purchased from the street vendors occupied the space. We did our best to give away all our money to good causes or individuals that we can trust to help and share with the Haitian community. Incoming M4H –Doctor Steve got up to wave us off….he tried to the bitter end to get me to stay and work with him and Nadene for the next week, but I imagine I may not remain married if I don’t show up at Dulles tonight, and rightfully so. I’ve barely seen my husband for 2 weeks. My midwife partners wouldn’t be too happy, either! But it’s nice to be wanted.

Haitian music on the radio as we left Hinche and began weaving the dusty path through the usual parade of dogs, chickens, and donkeys, going “fastly,” per Moliare, to make good time for our flight out of PaP. Everyone’s nausea calmed down after a couple hours when we got to the paved road in Mirebalais. Our driver, Moliare, has been helping the Midwives for Haiti program for years now. He works for the Episcopal church and lives in Port au Prince, but came out to Hinche to drive us in. Time permitting, he wanted to drive us through downtown PaP; he feels strongly that the world needs to be aware and stay aware of the depth of this disaster. He cares for his people, and has demonstrated his heart and integrity to us many times. Some volunteers have stayed at this house, met his kids, and seen the family and community members he supports. On the previous ride out, he had given me a good lecture on his opinions of what will help Haiti (education, infrastructure, education.)

So we got to PaP on time, and headed into the downtown and some of the worst earthquake damage. The roads are cleared enough to drive, but often only 1 lane due to the rubble. So many concrete homes, businesses, cinder block walls, crumbled, collapsed, gray wreckage with rebar and dust. Lives were lost inside them, not just bodies injured or killed, but the life contained in places of work, commerce, and education. He brought us past a school where 5 stories fell on 300 students; no bodies have yet been recovered; it’s just too deep a pile. The oldest cathedral of Port au Prince looked like it was hit by mortars. Then the “tent cities”; oh, this is too tidy a term. Yes, there are some areas with many tight rows of nylon tents and tarps set up by USAID and numerous international aid groups; but many, many city blocks between buildings are now fields of makeshift shelters with sheets, sticks, plastic, and cardboard, filled with ragged Haitians and the smell of poor sanitation. And in the city, in the street, around and under the tarps, life goes on: cooking on fires, frying of plantains, carrying buckets of water, repairing of tires, selling of vegetables. I try never to leave Haiti with more than a few dollars in my pocket, so planned to give all my leftover cash to Moliare to provide aid to the tent city in his neighborhood. I began to mention this to my team, to ask if anyone else wished to add their cash, but it caught in my throat and I started to sob. Money is help; probably the most liquid and useful help, but my heart was too hurt for my Haitian friends to feel like it was adequate. I was so sad to see this country and this people suffer this way. I wish I could do more, and the giving of cash humbled me. My sister nurses hugged me as I wept, and cried too, and added their money… and Moliare, the Haitian, said “Oh, don’t cry. It will get better”. Trust the Haitian to be the strong one in the car, and to comfort me. Dear Lord. So we assembled our money, and when he left us at the airport, about $200 was also sent to help the tent city north of Petionville.

The needs are so great, and the problems of Haiti so profound, that the possibility of despair and grief is always a shadow in the background. The Haitians hang on to hope, though, and I believe God commands us to do what we can. Moment-by-moment acts of grace and love will never be in vain, and we must hang on to them. One of the loveliest moments of my week, was at the mobile prenatal clinic in Bonabite. Jammed in the sweaty shack, I met the 20th woman of the day: Pregnant for the 8th time, she had one living child. Besides other early losses, she had given birth to a stillborn at 8 months of pregnancy, and another child who did not live to see 9 months of infancy. She was about 4-5 months along in this pregnancy, and said she still hadn’t felt this baby move. I checked her weight, blood pressure, and her belly size…all normal. Then I put my Doppler on her belly and we heard a nice strong heartbeat. She broke into the most beautiful smile. I smiled back, and through the interpreter, she told me she was so happy—she had been worried she would lose this one, too. I reassured her that she’d feel more kicking soon, and reviewed how to take her vitamins and iron, and return to the clinic in a month, if she could. She now has some hope and some life to hang on to. It gives me life, too, and fills my heart. It is why I do this work.

Each trip to Haiti is an exercise in flexibility, perseverance, and a spiritual adventure. I am reminded powerfully how my own small efforts and understanding are only a little part of the picture. Things happen that are clearly not all “human engineering”. My heart breaks and is filled, over and over. I cannot imagine how one can see the tragedy and beauty of places like Haiti and yet deny the presence and the essential need for God. The Haitians are all believers: they have to be. Connecting to this need and this faith must be why I keep coming back. So much is unknown: I didn’t know I would ever in my life see a hospital without any running water, or help deliver a baby on the sidewalk. I didn’t know, this time, that we’d discover a building that could be our new school and maternity center. I didn’t know that I would mourn so deeply for the people of Port au Prince, or how that woman’s smile would melt my heart. I didn’t know the girls dancing and drumming would lift me up so much. I don’t know, so many things. I know that I came with a lot of stuff, and left with empty bags and a full heart. It is worth doing. Thank you to everyone who helps me do it.

Friday, March 12, 2010

Busy Day in Hinche; Almost Done

Our day started with rounds at the hospital today; I saw a baby who is 14 months old, and the size of 4-month old. He can't sit up or talk, and has obvious neurological delays. Maude, the translator who was with me last year for my first birth in Haiti, showed up, recently arrived in Hinche from Port au Prince. I started with the question I ask all my Haitian friends: are you ok? Is your family ok since the earthquake? Most of the answers have been pretty good, thank God. Maude, however, said she had been living in PaP and lost 2 of her 5 sons in the earthquake. Her oldest, and another. I have a cute photo of those little boys lined up in a row, in our truck, last March. I started crying, and Maude did not. She just said, well, we go on. I quit with the tears; if Maude doesn't cry, what business do I have to shed some? The stoicism of the Haitian people was never more clear. If they start crying, I believe they will never stop. So I gave Maude $20, a day's pay here for a translator, and told her God Bless You. She may have some work next week in Labor and Delivery.

Then a happier time: While my fabulous team of volunteers from Minnesota and New York organized our chaotic supply closet (THANK YOU!-Kelly, Sue, Jamie, Nancy, Katharyn!), I met Steve and Nadene's flight from PaP. Then I had the joy of showing them the building where we hope to house the Midwives for Haiti program in the near future. We're already teaching class there, and now hope to move over our storage, and soon, start a prenatal clinic and birth center. In the musty cinder blocks and dust, we see pink paint and a safe place for women in labor. Then, a load of donated military MRE's (70 cases) arrived by airplane that we signed for and directed to the orphanage. They will feed the families of the poorest kids who attend the school. The Marines get big props from everyone we hear talk about the earthquake after PaP-- they held it together. Proud to be from America.

Time to pack and go home. My luggage is empty; bags inside bags will be light and easy to check through. Tomorrow we'll view Port au Prince, God Help us/them. Then we'll fly home to where life is safer, the weather is colder, and the stars not quite as bright. The kids are loud tonight. This orphanage had 140 kids last December,now they are over 200, and kids are sharing their beds.

I will miss them, but be glad to see my husband and my home. I've dropped off a lot of money and aid, from a lot of friends: hired drivers, translators, bought handicrafts and artwork, and given donations to the feeding center where the poorest children are taken, and to this orphanage where the happiest kids in town are partying and playing soccer because they have a bed, a shower, education, 2 meals a day, and even a basketball court and a soccer field. And a big chunk of money to Flower of Hope school-- but that's a story for another day. I catch a ride to PaP at 6 am and better get to bed. Bon Nuit from Haiti---

Thursday, March 11, 2010

Life in Haiti Goes On

Mid-morning today, I had my hands on a Haitian woman's belly, inside a steamy-hot wooden shack under a mango tree where we had our mobile maternity clinic for the day. A gecko was skittering through the pile of medicines and I had almost tripped over some little kids underfoot. As I worried over the baby's position (not head-down) and whether I should advise her to deliver at the hospital, my doppler picked up a nice loud baby's heart beat, and my Haitian cell hone burst into a musical chime of a call coming in. Definitely a a "What now!?" moment...could we get any more hot and chaotic right now? Maybe a stampede of oxen or a hailstorm? But it was just a call from the nurses & midwives we had dropped off at the hospital, checking on our plans for the afternoon's class on Neonatal Resuscitation that Chuck Marting, the NNP volunteer, is teaching for our students and all the hospital staff.

Today at BonaBite, we had 4 midwives: 2 Haitian(trained by M4H), and 2 American, 2 bags of meds and equipment,and a 10'x10' shack with banana-leaf roof, but we managed to initiate prenatal care and examine 26 pregnant women. The sickest one with high blood pressure (pre-eclampsia), we loaded in the back of the truck with us and took to the hospital on our way home. Our "clinic" so hot and sweaty that eventually, you don't even notice it or the body odor of the 6-8 people crammed in there. A thin boy wearing a worn out, dirty scrub top as his only garment reminded me that this represents the poorest of the poor. Folks don't get much poorer than this and stay alive for long...we know the line between life and death here involves a few meals, good water or bad water, help or no help. We try to be some of the help.

Back at the hospital,in the afternoon, Chuck taught his Neonatal class, very well-attended by the hospital staff and our student midwives. Meanwhile, the only maternity nurse left on duty sent a laboring woman "out to walk" the outdoor area near the delivery room, and she gave birth on the concrete walkway outside; helped by our midwives who just came around the corner as she hollered and started to push.
My cold shower at the end of the day was probably the most welcome and desperately needed one I think I've ever had... between the dust and the sweat and the scooping up a wet baby off the sidewalk, I just don't know if I ever was in greater need.

There is a building here, on the grounds of the hospital, that could be a perfect headquarters for our work-- big enough for Midwives for Haiti to teach our students, run our own prenatal clinic, and deliver babies in a clean and safe environment, without running out of soap, Clorox, or hand sanitizer. We could even have paper towels...the ultimate symbol for me, now, of luxury and cleanliness, and something I never see here. I set up a meeting with the Ministry of Health to discuss it next Tuesday.

Back at the orphanage, about 40 girls were singing really loud and dancing and drumming. Fried Plantains, hot dogs, and cabbage salad for dinner-- I threw in some rum and cokes! Quite a party. Life goes on here, in big way. Earthquake or not--People suffer, they struggle, get sick, get help, give birth, dance, and celebrate. Haiti goes on, and gives me life, too.

Tuesday, March 9, 2010

Miracles Still Happen,( Even after Earthquakes.)

Internet seems harder to get in Haiti than anything, so now that I’ve got some, 4 days into the trip, there’s this overwhelming pile of images and ideas I’ve been saving up to communicate!.... and how to spill it all out, before the generator stops cranking out the diesel-fueled electricity?
I forsake complete sentences….descriptions will have to do:

Port au Prince airport/Post-Quake: Most of the old building is not safe, cracked concrete, not being used. Imagine the baggage claim of Dulles or LaGuardia, smashed into a cargo area, minus the carousels… the luggage carts just stop at the garage bays and throw in cart after cart of bags thru the doors onto the concrete floor, to be sorted through by airport staff, who can’t really organize it because the crowd’s already climbing through it. Miracle #1: My group of 8 found all their bags, nothing stolen or lost, and then got it out through customs, even with bunches of meds, no problem. Outside the airport: Utter, Complete, Chaos. Trucks at the curb, surrounded by men trying to get work loading bags, beggars, injured people, pickpockets, puddles of mud, and driving through the street, a few reassuring US Army humvees rumbling through. As bags were thrown into our truck and the chaos milled around, the comforting thought that, in a pinch, we could raise our arms and wave desperately at the soldiers and they would stop. No need for that. Miracle #2...We got out and eventually onto a truck ride into the Central Plateau heading for Hinche. PaP had tent cities and rubble, but I don’t think we saw the worst areas as we headed west and north right away, out of town.

Maison Fortune Orphanage, Hinche: My “Haitian home” with the Xavieran brothers at the guesthouse welcomed me back with beans and rice for dinner, even though we were late and dusty and tired from the long drive. The mango tree is beginning to bear fruit, and due to the earthquake, 50 more kids have joined the “family”; an entire new building has been rented for boys from Port au Prince, and more girls, too. Jean Louis happy to receive rubber clogs, boys navy slacks, and light bulbs—the highest-value, lightest-weight stuff I could bring in my luggage.

Walked to Hinche Cathedral of St Mary, Sunday Mass; the beautiful bright colored clothes, the singing, the zillion kids who sit nicely for 2 hours, stained glass, white plaster, the breeze blowing through the open doors; definitely a welcome back to Haiti.

The hospital, Monday: Overwhelmed with people, low on supplies. Puddles of blood and amniotic fluid on the floor under the tables, students/staff waiting for someone to bring Clorox from a remote hidden stash, and eventually clean it up. The bravest thing I have done all week was to wring out the nastiest mop even seen, with my gloved hand (bucket has no wringer-device)and mop up the bloody floor, so we could walk on it without making tracks. Then we set about working with our students to teach compassion, respect, and assessment skills. Glimmers of progress coming Oh, so slowly.

Sleeping better this time than ever; maybe third time is the charm. Barking/fighting dogs, roosters crowing, generators humming, seem not to faze me too much with a little Grand Marnier on board and some earplugs. Comfy and secure inside my little bedtent where the giant (6 cm!) spiders or mosquitoes can’t get at me. Up with the sun, a cold shower and some strong coffee in the morning and I’m good to go. (My sisters say this getting-up-early thing would be Miracle #3.)

Next Miracle: I think we found a birth center building right on the property of the hospital! only obstacles would be permission and money, and that’s not anything that can’t be overcome....toes and fingers crossed and prayers sent up. The Midwives for Haiti program desperately needs its own space so we can control/protect our own equipment, protocols, and the quality of our care. We need to stay connected to the hospital...this could make that happen.

I know that this journey is held up and protected and blessed by the kindness and prayer and good wishes of many good people. Sorry it took so long to get internet! You are in my heart as I crawl into my bednet and breathe a deep sigh, tonight.

Friday, March 5, 2010

Trip 3: Post-Quake: Courage, Clarity, Kindness

3/5/10, 2 am
I leave for Haiti this afternoon but have a woman in labor at the moment. I was lucky during the day and had no one in labor til now, so had time to do a re-pack and wrap up office details. Now my bags weigh in properly to avoid extra fees, and I feel as ready as I'll ever be. I am taking a very different load this time, "post-quake", and I guess I pack differently since I've been there before. My clothing is just about nothing but scrubs and a house dress and a dress for church. I go this time with more "equipment"-- 2 dopplers were donated, one of them brand new. Thermometers for all the students to have in their bags. Plastic baskets to organize the supply areas of the hospital that we are using in Labor and Delivery. Some precious, carefully wrapped and stashed anitbiotics, and a lot of dressings, gauze, tylenol for the hospital. Bookbags and notebooks for the kids at Flower of Hope School. Diapers, chux, onesies for moms and babies in Port au Prince.

So many generous friends and family have funded this trip to Haiti and given donations toward disaster relief and rebuilding....and what a weird mix!! ..My sisters, Loudoun Community Midwives' patients, my colleagues at the hospital,...good grief! my financial planner! The Moms Club of Ashburn-Broadlands! Finnegan's Irish Pub! Quakers, and other friends, and some people who just found my blog somehow, and cared. I am humbled that you feel this project is worthy of support, and promise that I'll try hard to make wise donations that will do some good. My thoughts of how to support the people in Haiti are very on-the-ground and direct:
Midwives for Haiti program: equipment, meds, learning/teaching/organizing supplies.
Heartline Ministries: in the middle of Port au Prince, feeding the hungry, nourising pregnant women, treating the sick, teaching women to support themselves, running a birth center.
Flower of Hope community school that my friends Theard and Manno have started in their village outside Hinche: notebooks, book bags, and money to build some walls to keep it secure.
Maison Fortune Orphanage: They believe that feeding, housing, and educating Haiti's children is how to build Haiti's future leaders. Funds will go to buy them food, clothes, books, and build another building so they can take in more kids since the quake.
It's difficult to prepare emotionally to return to Haiti after the earthquake. There is happy anticipation to see my friends there, but mixed with a deep dread. Similar to the fears one has when about to see a loved one after they've had a car love them and want to see them. But you also dread seeing them in their weakend, injured state. And Haiti is weakened and injured...I love her and want to help, if I can. It feels very big. Some friends worry about my safety in Haiti, and I do try to be very wise and careful. I don't have great concerns over my physical safety, however, I do believe this trip may be very hard on the head and the heart.

It takes me back to one of my most frequent spiritual meditations:
Courage, Clarity, Kindness.
is certainly needed. Haitians are so brave and persistent, they lift me up, too. We all have to believe that our efforts will make a difference, the way can get better, that wounds can heal; that there is hope for a better day.
Clarity is really needed for this trip. The primary reason I began trips to Hinche was to help train Haitian women to be skilled birth attendants. With the great influx of refugees in the town, and a surge of new personalities and faces and even styles of practice among all the new volunteers, there is confusion and tendency toward chaos even greater than the usual level in Haiti. I pray to have a clear head to function effectively to help the students and the program succeed.
Kindness. I hope to remember to tap into kindness, despite stress, frustration, fears, angst, or disorganization. Kindness to others, and to myself.
If anything is ever to heal, it does so when we connect with kindness in, and from, the heart of God.
Next post: (hopefully) Monday, when I can get internet at the Ministry ofHealth.