Home Sweet Home

Thursday, May 10th 2012

Well I'm home now.  I've been home for almost two weeks.  I never wrote an entry for Saturday, because I was just too tired.  And once I got home, I became really sick and couldn't muster up the strength to write a final entry.  So I'm a little late with my final entry for this trip, but maybe the time for reflection will be beneficial.

We said our tearful goodbyes to the orphans early Saturday morning before getting on the bus for one last time.  As we were saying goodbye, I noticed that most of the girls had their braids and pony tails undone in preparation for washing their hair.  The older girls get to do the younger girls and I think every girl anxiously awaits for her opportunity to show her creativity through hair.  It dawned on me that when I got there a week ago, all of the girls were doing each other's hair, after the weekly washing. It seemed appropriate that things had come full circle in a week.

I don't know if it was the perfect combination of team members, my heart breaking, the obstacles we overcame or just the constant reminder of hope, but this trip was my most rewarding so far.  Most likely, it was a combination of all the above.  I never know what to expect on my Haiti trips, but I never expected to climb through mountain valleys in the rain, never expected to push a Land Cruiser out of a foot of mud, never expected to sob on the shoulder of a new friend amid the clouds and definitely never expected to love it all so much.

On my first trip, I left feeling that I wasted time acclimating to my surroundings.  I'm ashamed to admit that I couldn't get as far away from myself as I had hoped.  The odors, heat and humidity consumed me and I regretted letting that happen.  I didn't feel that I had done enough and kicked myself for it.

When I returned a few months later, I felt better about my work, but felt under utilized.  We spent days in lock down due to civil unrest and life was easy in air conditioning and a never ending supply of Coke's and Prestige.  Not that I minded, but once again, I felt that I could do more.

I did more this trip.  More than I ever imagined, especially emotionally.  Usually, I don't let patients into my heart. They stay in my head where I can give the best care.  It's harsh, but emotions can get in the way of nursing and as a Charge Nurse, I try to remain objective and often have to put my emotions on hold.  If you ever work with me, that explains my crude sense of humor in dire situations.  It's inappropriate and I know it, but it's the only way I know how to cope. Something happened during that dire situation; I let Cousonal into my heart. And it hurt.  It still hurts.  I'm beginning to tear up as I write this, just as I do every time I pause to enjoy my children.

It wasn't until our lengthy lay over that I realized how blessed I was to be on a trip with such a great group of people.  I laughed, laughed and laughed some more with these phenomenal people.  While we were getting close to be getting kicked out of the most amazing candy store ever, I realized that my teammates were a blessing themselves. It usually takes people a while to understand my quirky personality, but it felt different this time.  We had a wealth of medical knowledge, support and love within the twelve of us and dare I say, we made an impact on Haiti.

The team minus Marty! 

My adjustment back to life with first world problems wasn't as severe this time around either.  Most likely it was because I was forced to slowly re enter my normal life.  As I mentioned before,  I became very ill my first day home and was pretty much out of commission for over a week.  I saved up all my energy for work and avoided grocery stores, Target and even most people.  I couldn't do the mundane housework chores that make me despise all of our American goods and needs.  I slept, looked at pictures and reflected.  It was almost the perfect transition (minus needing IV fluids).

It's always hard for me to leave the boys for a week.  However, I hope that they will someday realize how important this is to me and use my example to follow their own passion in life.  My children always end up sacrificing more than my absence; as I have a hard time justifying any extras.  However, we end up doing more as a family and spending better time without material items.  I took Jace to the zoo today, just because we could.  It was a great day, as I didn't stress about the small things and let him lead the way.  I love being reminded of the important things in life.

Will I go back?  Absolutely.  Of course.  Without question.  I'd love to go in October, but don't think it is feasible.  April?  Probably.  Guess we will see where God leads me....

Never underestimate the fun of a jetway...

Cramming it all in...

Friday, April 27th 2012

I just got sung to by one of my favorite Haitians, Phinton. He has such a smooth embracing voice we (all the women at least) were in tears by the end. I can't imagine a better way to end my week in Haiti.

Today wasn't as tough as I feared. The clinic in Port Au Prince ran the smoothest yet. Tony started more IV's for dehydration, Katya bounced around helping us diagnose and treat the various ailments and the support team ran amazingly.

Curing dehydration one IV at a time..

We were set up in in a half church/ half house like structure. The team was pleasantly surprised because on the last trip the entire area was nothing but tents. The tents had been replaced by tool shed like structures. In fact, I'm pretty sure I could buy the same exact thing at Home Depot. But it works well for it's owners and worked well for us.

Triage in a tool shed

We were able to triage in the house, then swing the patients through the house into the church. And of course, we still had a healthy supply of all of our medications and assorted kits.

I saw one boy who had what looked like a yellow fungus growing on his head. But his mom said that had gotten red and yellow pills from the drug store and crushed them up on his head. Huh. I tried to take him to outside to scrub it off, but the poor boy jumped a mile in the air when I just poured water over it. Not to mention, the crowd was pretty excited to see a "blan". I was drawing a large crowd rather quickly. I had to make the tough decision to stop my attempt at shampooing. I handed his mother the bottle of shampoo and told her to wash it off and treat it with the medicated ointments we had on hand. I am really curious as to what was under the crushed pills though....

There was a beautiful little girl in a white dress that stands out in my memory.  She stood out because she had the slightest tinge of auburn in her hair.  Her mother told Russanna at triage that she wanted us to cure her red hair- as red heads are seen as cursed.  It's true that malnourished children will often exhibit red hair.  And while we saw some of that, it wasn't this case in this beauty.  In this culture, red hair is so unique, it's really a shame that it is frowned upon.


There was also a boy who had an extremely high fever and we feared he had meningitis. When we told him we would like to start an IV for fluids and IV antibiotics he left AMA (minus the paperwork). Tony told him he must go to the hospital, but I'm not sure he was eager to take our advice. We can only hope our advice was followed.

This trip is teaching me how important it is to have faith. I have to trust what the patients and translators are telling me, I have to believe my instructions will be followed and most importantly, I have to trust that it will all work out in the end. We have encountered both big and small hurdles and have graced over them with relative ease. As a team, we are unstoppable and that it is an amazing blessing.

We used almost all of our remaining supplies and medicine by the time we needed to pack up and go. Our departure was the way I prefer: uneventful. We simply left the random items we had left with the Pastor of the tiny church we inhabited and walked to the van like vehicle we were riding in.

I think this vehicle deserves it's own paragraph. It was a high profile mini-van meant to hold 12 people snugly. It even had "jump seats" that folded down for those unfortunate enough to be seated there. We crammed 19 people, personal bags and water in it. We even had our green bags of supplies strapped to the roof.  When you factor in the sweltering heat and humidity, it's not a pleasant memory. When you add in Haiti traffic, it becomes borderline miserable. I know I thought yesterday was stifling, but that was nothing compared to today's travels. After already being hot, dehydrated and tired from working a clinic, getting back into this mode of transportation was less than appealing.

My disbelief at cramming 19 people in here...

We handed out a quick lunch of peanut butter and jelly sandwiches, beef jerky and trail mix to keep our energy level up for the rest of the day. I have never really eaten while sitting in someone else's lap after caring for some of the world's poorest people in a 100+ degree van before. As usual in Haiti, I guess there is a first time for everything!

We were on our way to Mother Teresa's Hospital and needed to essentially just go to the other side of town. Of course, nothing is just a short drive in Haiti. We stopped at a plumbing store (more on that later) which took about an hour I'm guessing. Since I had actually been a good girl and drank my entire liter of water during the clinic, I was in dire need of a restroom.

You think that I would learn that bathrooms aren't easily marked, clean or even within reasonable walking distance in Haiti. We were led up three flights of stairs, walked across planks of sheet metal deep into the bowels of this plumbing store to a bathroom that didn't included running water or toilet paper. Of course, out of habit, I had grabbed a handful of trash to throw away. A trash can was also missing. Oh, Haiti.

Hardware Store

While we were waiting for the boys to finish up, we took the chance to spread out and some of us spilled out of the van.  This little lady came up and reached inside our van; causing a little bit of panic among us.  We thought she was reaching for one of our water bottles and we didn't want her to be successful.  As harsh as that sounds, giving out water or food to the locals is dangerous.  If you give one child or woman something, a crowd will appear very quickly.  And since there is no way you can feed or provide water to all of Haiti, it is likely not to end well.

But she didn't want our precious water, she just wanted the empty bottle.  Much to our delight, Haiti has started a recycling program! In a city that is notorious for being overrun by trash, it was a welcome sight!  We had noticed a bright green wall advertising the new system and were happy to see in it work.  And this lady just wanted to contribute to the cause.  How admirable! We also noted that most of the tent cities had piles and piles of recyclables on corners.  More evidence of improvement!  Maybe we should not have thrown away our empty water bottles this last week...

Once we were on the road again, the fun continued. I noticed I am seeing the police officers with more men in the back of pickups with their face covered. Phinton said this was due to the large amount of gangs in Port Au Prince. They have to cover the arrested face to keep from alerting the gangs to the event. We also got stuck behind an accident. That, in itself, is not unusual, but sitting within arm's reach of a hogtied goat probably could qualify as unusual. It reminded me of being next to a semi load of hogs back home. Only we were at lot closer to said vehicle, the semi was replaced with a beat up S-10 truck and the pigs were goats tied by their hooves hanging upside down.  Maybe not so weird after all. Nah, still weird.

We also drove by a new type of market.  It had all the components of the usual markets, but with a twist.  There were these little pens full of chickens for sale.  Sometimes we were even lucky enough to see one get butchered, right there in the middle of the street.

Once we pulled up to Mother Teresa's excitement set in for me. I don't know why. I knew what I was walking in to, and I couldn't wait to see it. Maybe I had been away from work too long. I all but ran into the place.

I think it was because I was just relieved it was there. After seeing Cousonal in the mountains, I was even more appreciative of it. Yes, children still die of starvation in Haiti. That is the ugly truth. But, because of Mother Teresa's, not as many. And that is the beautiful truth.

Of course, I was immediately drawn to the smallest baby. I picked her up and looked at her ID band that said she was four months old. She was the size of a 34 weeker at work. I held her until she fell asleep, then put her down to nap. Instinctively, I made her a little nest and felt at home for the first time since I landed in Port Au Prince.

I went to the next smallest baby, an 8 month old. This child was about the size of a preemie when they are getting ready to go home. She had an IV and glazed over eyes. I caught her attention and played peek a boo with her behind her blanket. I didn't get a smile, but I did notice a small change in her expression. I seriously don't think she had enough energy to even smile. I longed to hold her, but the employees don't like visitors to hold babies with IV's. Knowing how hard it is to get IV's on babies, let alone dehydrated babies, I can appreciate that.

By now, most of the team had taken a couple of kids outside to hold. I picked up another tiny 8 month old that was in better health and joined them. Tina had a 2 year old with a fantastic personality. She laughed every time she saw a new pale face. Her contagious laughter continued any time our fingers even got close enough to tickle her.

She was the poster child for Mother Teresa's. This little girl represented the hope that a place like this provides. She came in a deathly sick child and will soon be going back to her parents a healthy, vibrant toddler. God Bless.

At one point, Dan and I went upstairs were the older children were. He wanted to see if a girl he saw 6 months ago was still there. She wasn't; she went home! Another glorious moment!

However, one tragic moment did happen upstairs. As soon as the children saw Dan and I, the ones who managed to break free of the cribs scrambled to wrap themselves around our legs. The ones who couldn't muster up the strength to break free of their cribs screamed for us with their arms outstretched. All of sudden I was surrounded by children desperate to be held. I knew once I looked at Dan that he wanted to hold them as much as I did. But we knew that holding one child would break the other 20 children's heart. We pried sick children off our legs and walked downstairs, feeling like crud. We had hindered more than helped, always my biggest fear.

When we all piled into our clown car for the trip back to the orphanage, I knew that I should probably feel sad. But I couldn't. I was at peace knowing it was there. I could only smile when I found out they had room for Cousonal. We provided money for his transportation down the mountain. I hope to keep in touch with Pastor Ron to follow his progress...

By the time we reached our house at the orphanage, we were hot, tired and mentally exhausted. But our work wasn't over. Katya set up an impromptu clinic for the children and workers at the orphanage.  Katya had noticed a growth on a small boy's chin. With Pastor Ron's blessing, she removed the growth and stitched it up.  That was just the beginning, as soon we were giving away almost the rest of our meds. We ended the clinic by popping blisters that had erupted on Phinton's arm.  Earlier in the week, Phinton had been hospitalized with a fever and had since developed these blisters.  We loaded him up with antibiotics, as Katya feared it was MRSA.

As a plumber, I don't think Tyson knew how much he would be needed around the orphanage. Not only did he fix the girls' toilet, he had major work outside that held exponential pay outs.

A while back, a tractor ran over the pipe that provides water to the orphanage. That meant the orphanage and all 56 kids and 12 staff were doing dishes, bathing, using the restroom etc. all without water. When we stopped at the hardware store, Tyson was picking up supplies to fix this monumental inconvenience. So with the mosquitoes swarming their headlamps, Dan and Tyson fixed the water line. As much medical care and supplies that were provided, I don't know if anything could have meant more than those two providing water to an orphanage. How many people can say they have done something as big as that?

It was actually pitch black; this light was only the flash.

As you can tell by this lengthy entry, today was busy. It was also enlightening and gratifying. I ended the day with the children singing and couldn't thing of a better last day in Haiti.

Traffic, Tourism and Turkeys

Thursday, April 26th 2012

 I started today thinking it would be another taxing day for the team. Mother Teresa's Hospital was on the agenda. Walking into Mother Teresa's changes one's life for eternity. It's a hospital that specializes in malnourished children.

However, once we got to the hospital, we learned that they weren't allowing visitors today. The regular staff of nuns had the day off and the covering staff wasn't qualified to allow us in. Luckily, we are becoming accustomed to wrenches being thrown in our plans. We quickly decided today would be a rest/tour day and we would knock out both a clinic in Port Au Prince AND then go to Mother Teresa's from 3-5. Tomorrow is gonna be a killer.

We went into downtown Port Au Prince where the earthquake was the most damaging. I was actually very refreshed to see the progress that has been made since I was last in Haiti 15 months ago. The rubble in the streets was greatly decreased, the tent city across from the broken Capital was obsolete and I saw signs of new construction.

I specifically remember this house by the souvenir markets. It was a yellow house with one entire wall was missing. Even with the missing wall, you could see a family in there, attempting to cook lunch. It's one of those memories you just don't forget. But today, the building was not only completely demolished, but the groundwork was started for a new building. I liked seeing that. There was also a entire section of the street blocked off that was filled with umbrellas indicating market activity. It looked bustling and promising.

Televisions as shingles?

I love the chaos of the souvenir shops. We are usually spotted a mile away and the merchants are very eager to show us their goods. Within in a matter of minutes, we were surrounded by more jewelry, paintings and wood workings than we could fit on the bus. It's always fun to browse and I always end up wishing I brought more money to spend on the goods.I always have to buy something for the boys at the markets. I found some pretty cool maracas to compliment the Haitian drum they have at home. Only a few more days to I get to see them! Thinking of the boys is bittersweet though; as I can't think of my boys without thinking of Cousonal from yesterday.

Remember on Saturday when I said I don't recall driving by any tent cities? I'd like to retract that statement. We drove by quite the tent city today. It had a market in front of the shantys, 6 foot high piles of rotting food and was at least a mile long. This is one of those moments when I wish I could bring the smells of Haiti to the Internet. Just imagine, smoke, spoiled food and sweat all rolled up into one glorious ball. You can't describe it, but once you smell it, it's forever burned into your nostrils. Ugh.

Believe it or not, some people call this place home. 

It was entertaining to watch the activities occurring in this civilization. My eyes kept jumping from transactions being completed to kids playing with sheet metal to so much more. However, it did not look like a great place to be. Pastor Ron even said that it was so unsafe, he would not enter it. I asked if we were in Cite Soleil again. He replied, "No, but that it's very close. We spent what seemed like an eternity in traffic; therefor an eternity in stifling heat. I think there are few things more suffocating than sitting in an old diesel bus surrounded by a gazillion other diesel vehicles in 80% humidity. But hey, we were explaining Haiti, getting to be a fly on the wall in everyday Haiti life and you just can't beat that! (Ok, you can, in the back of truck!)

That's a lot of books to balance.

Another improvement I saw was police officers directing traffic. Apparently they have resolved their differences because they were in full force throughout the city today. We saw arrested Haitians in the back of pickup trucks with armed guards more than once. There was also an interesting scenario at the market locations today. There are certain areas were markets aren't allowed because of heavy traffic. We followed a Police "wagon" as they pulled up to such a market. All of the women scurried to get their goods and escape the impending arrest. Some made it away and others didn't. But I'll tell you one thing, if I saw an officer approaching me with a sawed off shotgun, I would leave the goods! :)

Market Raid

This might not sound like an improvement, but I do think that a society is much better off with a system of law and order that is enforced. Most of you know how much I like structure, so of course I think it is a good thing! On the way home, we stopped at a grocery store and picked up cupcakes for the orphans. This was a new grocery store for us, so we took some time to browse. I picked up some coffee (Haiti's main export) and can't wait to share with the coffee drinkers at work. Of course, I couldn't turn up the opportunity to buy a cold coke. I even splurged and didn't go with Diet, but full on Coca Cola. It was the most refreshing thing I have ever drank (since the last time I had a Coke in Haiti at least)! It also helped my growing headache immensely. It was all I needed to refuel after a long, hot day on a bus.

"Courtney on Coke"

The kids also benefited from my caffeine burst.  Knowing tomorrow is going to be draining, I wanted to use tonight to get some quality time in with the orphans before it's time to head home.  Annanya and Eugenia took turns running to me so I could toss them in the air.  I haven't heard laughter like that since I was last able to tickle Jace back home.  Of course, playing with the orphans brought back the ache in my heart for Cousonal...

Annanya and her giggle!

I even jumped rope!

It was a joy to be able to treat the kids with the cupcakes. Clearly, the kids weren't familiar with cupcakes, because they kept trying to eat around the wrapper. As I showed them how to unwrap the cupcakes and eat with their hands, their eyes lit up!

Cupcake Frosting

Robin, Kelly and Tina also had made goodie bags up for each orphan. It is always so much fun to give these little guys dollar store items. Stickers, hair ties and cars will be cherished by the orphans and that is beyond rewarding.

I wrapped up my night by facing my biggest fear here in Haiti.  Not the mosquitos, not the threat of tarantulas or even those flying bugs in the mountains.  I am terrified of the turkeys that roam the ground of the orphanage.  Especially this one grumpy looking bird.  He has a huge disgusting,wiggly, turkey gobbly, thing and is missing more than a few feathers.  I can tell he's been in a few tufts and he wouldn't mind taking me out.  I can just tell by the way he shuffles his feet when I walk by.  It's his version of a turkey attack and I hate it.  I have to admit that I have screamed and ran when he's come up from behind me.  Then I remember that I shouldn't let it see my fear, so I turn to look it in the eye.  Then it looks at me and I run to the nearest adult in fear.  This happens on a daily basis.  I don't like him, and I'm not ashamed to say I hope I eat him before this trip is over.

My nemesis

Sorry my entry is so short tonight, but tomorrow is going to be grueling and I need to get some sleep!

The Day Haiti Broke Me

Wednesday, April 25th, 2012

I can't believe how long ago this morning was. It feels likes eons ago. I am mentally and physically exhausted. I hope I can do this blog justice because today was monumental for me and I just don't know if I can convey the day properly.

We decided to get up before sunrise this morning to see the sun come through the clouds and over the mountains. We had an alarm set, but didn't need it thanks to all the barking dogs outside our hut. The sunrise was breathtaking and a beautiful way to start out a clinic day, always the hardest of the trip. Looking back, I'm glad we started our day off with such a beautiful prayer. I needed it.

sunrise

The church today was a fraction of the size of yesterday's church. Except for the small door in the back and the front of the building, it was also void of natural light. When we factored in the overcast skies, we knew that we were going to rely heavily on our headlamps for the day. We quickly set up our clinic in our dimly lit, dirt floor church and got set to work. We knew that we had to get to work quickly. If we had any hope of making it home tonight, we had to leave before the afternoon rain came and turned the roads into mush.

Again, our morning started off with a bang. My first patient had yet another cyst. This one was on the side of her head. It was difficult to get the full story, as so much seems to get lost in translation. It seemed that she was in an accident 10 years ago and it had gotten bigger in the last 3 years. Or something like that. Initially she stated that she could feel it move when I pressed on it. I have heard from previous teams of similar stories where they lanced it to find a family of worms living underneath the skin.

Again, I called Katya and Tony over to look at it. The story then evolved a bit to where she couldn't feel anything move and she may or may not have had an operation or something. I really need to learn Creole since I can't seem to stay away from this land. It would make me so much more effective. It's the least I could do for all these people who would move mountains for me.

Anyways, I regress. Katya thought for a minute about how to proceed. She decided because we weren't sure what we were going to find and it wasn't affecting her life that it wasn't worth the risk. Also, yesterday we were comfortable knowing the patient would be able to have her stitches removed. We did not feel as comfortable that would happen in this quaint village.

So we decided the best option was that of no intervention. We encouraged her to go to the hospital, as we didn't want to do more harm than good. It was hard to not be able to do anything, but I'm sure we made the right decision.

My next patient complained of a bump in her stomach. I felt around her belly button and felt what a nice rounded lump, similar to someone who is in the 2nd trimester of pregnancy. But this woman was adamant that she wasn't pregnant. I called Katya (who I am highly dependant on if you couldn't tell...) for her opinion. We grabbed a couple of benches to help her lay down. Of course, the benches weren't the same height.

Ok, I think I need to clarify my use of the word "bench". When I say bench, I mean 3 pieces of wood haphazardly nailed together. The pieces of wood may or may not fit together to make a bench. And there is a high likelihood that there is at least one nail sticking out in a random spot. 

Alright, back to my scenario. When Katya laid her down, we discovered that it was a mass, not a uterus. And not a small mass, but one the size of a small watermelon. Again, we could do nothing for her, but advise her to go to a hospital to have it removed. I was off to a swell start.

Then my heart broke. Matt signaled to us that there was a little boy who needed to be seen because he was really sick. I looked over to see a very small child, Consonal, struggling to stand. I put my hand on his arm to guide him to our bench. My stomach fell the minute my hand felt his bone. Absolutely no muscle or fat, just bone.

I then heard the scariest whimper. I have never heard such a frightening sound. I initially thought he was wheezing, but I was wrong. It sounded like a child in great pain, but not strong enough to tell us. The child was frail, hunched over and in immense pain. I was terrified.

I reached down to pick him up and put him on my lap. It felt like I could easily break a rib. I looked at Katya and told her I was afraid the child was going to die in my arms. We lifted up his shirt to see a very distended belly and the child wither in pain when we tried to touch it.

Naturally, the first instinct is to offer IV fluids. But when a child is so severely malnourished, providing IV fluids can cause much harm. Because electrolytes are usually highly compromised by this point, you can easily fluid overload or cause other imbalances if not monitored carefully.

So Katya mixed up a little electrolyte solution while I cradled Cousonal in my arms. He was able to sip a few ounces slowly without vomiting and we allowed ourselves to be slightly encouraged. Especially since mom had said that he never ate without vomiting.

I held this boy with as much love as I could physically muster without causing more pain. He cuddled up right next to me and laid his head down on my chest. We prayed over him and the tears couldn't stop. He was 7 years old and smaller than my 4 year old, maybe 30 pounds at the most. Here in my arms, was a dying child close to my son's age. Even now, I have no words, just tears. I felt so helpless as I held this child on what could easily be one of the last days of his life.

I gave him re hydration fluid little by little and just held him in between. We alerted Pastor Ron to the direness of the situation and asked if there was a hospital we could take him to. He said that this is exactly the type of child for Mother Teresa's and maybe we could arrange something.

So we loaded him up with antibiotics (he had a fever as well) and hope that he will be accepted at Mother Teresa's. I hope he can handled the car ride down if it all works out. Those bumps, rocks and mud flung us grown woman around like rag dolls. I can't imagine weighing 30 pounds and already being in severe pain. I don't know what is going to happen and am trying to be at peace and let God do his work. It's not easy.

We were lucky enough to find a little area of thigh with enough muscle to give him a shot of Rocephin. As I braced Cousonal for it, I tried to not break any bones. Tony braced me bracing the boy on the unsteady bench, and I was falling apart quickly. I was trying to not cry in front of his mother, as I didn't want to alarm her.

I still struggle with that part of it all. I don't know if these parents understood how sick their child was.  I didn't want to scare them, but I did want them to know how serious this situation was.  I still don't know if they realized he was dying in front of their eyes.   Should I cry openly to convey how worried I was, or do I act strong?

This mother and father were also very frail looking, so I'm not sure I believe her story of the child being ill and vomiting every time he ate. I don't think they could afford food for their family. Part of me wanted to shake this woman and yell, "Feed your child!" I wanted to yell at the rest of the well-fed community to rally around this family like they rallied around us and ensure that this child got food.  Every ounce of me yearned to carry this child on my back over to the Domincan Republic and nurse him to health.

As a NICU Nurse for almost 5 years, I have had more than my fair share of dying children. Not just children, but babies who have parents that have spent months dreaming of their child's arrival, only for that child to be taken days or hours after birth. Truth is, my job can be devastating and maybe more than most could mentally handle. And as heartbreaking as my work is, Cousonal rocked me to my core.

I think it's because usually there is a genetic defect- something that went awfully wrong during fetal development. Something that is devastating, but unpreventable. As hard as it is to believe, I can accept this. I have to be able to accept it or I wouldn't be able to work in the Denver Health NICU. But I couldn't accept this. It's not like malnourishment was a common sight here. While the diets may not have been the healthiest or contain the biggest variety, it looked like the vast majority were getting their most basic nutritional needs met. But not Cousonal, this boy who instantly and instinctively curled up on my lap. He had been failed and I could not accept it. I don't know if I ever will.

After the painful injection, Cousonal became inconsolable and reached for his mom. This broke my heart further. I had lovingly held this child for an hour and could feel his trust. Then I betrayed that trust by holding him while we caused such pain. I handed the frail, crying child to his mom and sat them away from everyone so we could keep on eye on him and ran out of the clinic.

Dan followed me out, as I leaned against the cinder block and sobbed. Dan held me tight and I let my emotions flow out of me. The weird thing is, it wasn't just Cousonal I was crying for. I was crying for all the babies at work that I never let myself grieve for; the triplet I had last week, the child born with a major brain defect, the 24 weeker born in the screening room, for Edison, for them all. It all came and there was no stopping it. I thank God for Dan and his intuition to just hold me tight. As I type and relive this painful moment, I could use another hug...

But the day had to keep moving. Villagers were coming over the hills faster than we could see them. We handed out more med kits, baby kits, medicine and glasses and tried to be patient as the workload piled up on us.

We handed out all but one pair of our eyeglasses as we were wrapping up the clinic. This little elderly man walked up to Russanna, complaining of his eyesight. She handed him our one remaining pair, a pair with big thick lenses meant for someone that can't see their hand in front of their face. The man gingerly slipped on the glasses and his eyes lit up! He nodded eagerly with wide open eyes and couldn't believe his good fortune. Neither could we! One strong pair of eyeglasses left and one needy villager- what are the chances!

Throughout the day, we listened to the rain hit the tin roof of our clinic. While I love the tinging sound of the drops hitting the metal, I know we were all worried about the drive home while we worked. We knew that it was very possible that we could end up staying in this village for another night. And strangely enough, we were ok with that.

But we decided to press our luck and forge forward.  We made mental preparations that we may not make it all the way out of the mountains and could spend the night camping. The villagers appeared to take our remaining supplies to the truck (which was only a speck from where we were standing). As we slipped, fell and plodded down the muddy, steep hillside, a barefoot elderly lady with a Culligan water jug booked it past us. We continued to get passed by children carrying our supplies. And once again, in the rain.

Heading back to our vehicles

We made it (in one soggy, wet piece) to our vehicles and climbed in for the four wheeling adventure of a lifetime. I'm not sure how many times we climbed in and out of our Land Cruiser so it could make it up a hill. I don't know how many times we hit a bump that sent me into the air and onto Tina's lap.  I lost count of how many people pushed our vehicle out of a sticky place. I was covered in fire ants and mud by the end of it.  I do know that somehow, someway, we made it back to the orphanage safely.

One of the highlights of my day involved a hitch hiker we picked up on the way home, Gaston. Phinton, our beloved translator, was given a chicken by the first village we stayed at. Phinton was so excited for his chicken who he first named, "First Chicken". He gently slid him under his seat and acted like a child with a new puppy. He was excited because he was given a rooster, which are valued higher. It would be easier for him to get a hen so he could start a sustainable source of food for his young family. Somehow, the group decided that a more appropriate name would be "Gaston" and Phinton easily complied.

Phinton is a funny, lovable, hard working Haitian who the whole team adores. On top of that, he has an amazing voice and is working on a Christian music album. He has been with the orphanage for a while and was a translator for my first trip, 18 months ago. Since then, he has met a beautiful young lady, gotten married and now has a 3 month old healthy baby boy, Phindy. Similar to many young couples in America, he is conquering the struggles of starting a family and it was a joy to see how appreciative he was over a rooster that cost $6 to buy in Haiti.

I know that I didn't do our drive home justice. I know it was a joyride and we saw things you only get the pleasure of seeing in the mountains.

Not another stuck truck!

But I can't recall it. My mind is on Cousonal, the child that will keep a piece of my heart in Haiti forever.

The Work Begins

Tuesday, April 24th

Huh. I actually slept pretty well last night. Maybe I'll consider Benadryl more often. We woke up to the hustling and bustling of about 100 villagers who were waiting for us to get up and get moving at about 6.

We were able to display our educational canvases in the front of the church for the villagers to look at while they were waiting to be seen.  Not exactly what we had in mind for an educational clinic, but better than nothing.  Hopefully they helped some people, just a little bit.

We set up clinic very quickly and were about to get started when Tony and Katya found a woman the villagers had laid in the back of the church. She was severely dehydrated and breathing really fast. Tony and Katya took her into our procedure room (a part of the room partitioned off by a tarp where we placed two pews together to make a bench) and started IV fluids on her.

The rest of us followed their lead and started taking patients. My first patient stated she had a cyst on her back. I took a look at it and was surprised to find a 2 inch fluid filled mass below her neck. It was rather disgusting and glorifying to feel. Katya and Tony came over to consult and we felt that trying to drain it was the best option. I grabbed a bunch of gauze hoping to squeeze out something of YouTube proportions.

Tony (who loves this gory poking stuff) poked the with a large gauge needle with Katya's guidance, while I stood anxiously by with my gauze. Nothing. Nothing came out! We weren't sure how far we should extend our scope at these clinics, so we asked Pastor Ron what he wanted to do. He thought the patient should make the decision, so we asked her. She said it was very painful and kept her from sleeping at night and asked us to fix her. We explained that would involved cutting it open and sewing it back together, but she was eager to get it taken care of.

Once our dehydrated patient was finished with her fluids, Matt swooped her fireman like style and moved her to an area where we could continue to monitor her. We moved the cyst patient back to the procedure room and got started. We laid her on her stomach and injected her with lidocaine. Tony and Katya sliced open the top of the cyst while I again stood anxiously by with the gauze. As they dug a little deeper, we realized that this was not fluid, despite it's squishiness. It was a tumor of some sort and it had to stay. We couldn't risk cutting any further and hitting vasculature. So we stitched it up and wallowed in pity. But this woman handled it like a champ. She never budged, winced or complained throughout the ordeal. The day was certainly off to a jump start.

We had quite the clinic going, with three stations seeing patients, and the extra medical people helping out with advice and supplies as needed. The team members without a medical background supported us by doing triage, crowd control and making sure the rest of us had everything we needed. Our pharmacy was stock full of antibiotics, ointments, vitamins and of course the Hatian standard, Ibuprofen and Tums. We were also blessed with a plethora of medical kits (a bag of amazing things such as band aids, alcohol pads, toothpaste, gauze, soap, etc) so were able to give every family one. We also had a decent supply of eyeglasses, so we could help out those with a tough time seeing.

One of the thing I love about these villages is all the babies. They come to us in these beautiful, elaborate dresses and are as adorable as can be. It was extra exciting to see the little patients because we had an extra goodie bag for them. Tony set up baby bags through a great organization and it was so much fun to give them to these beautiful tiny human beings. Inside the ziploc bag were cloth diaper with safety pins, a baby blanket, baby soap, Prenatal Vitamins and Baby Vitamins. I hope next time I go, I see a blanket I recognize!

We ran through as many patients as possible and treated more headaches, stomachaches and rashes than I can count. Before I knew it, it was time to pack up and go, my least favorite time of these trips. We could see the rain coming over the mountains and wanted to stay ahead of it. It's always hard to leave when there are more people not seen than seen. It makes it impossible to feel that you have accomplished anything at all. It doesn't matter how many generous smiles were directed at me, the disappointment I see erases any sense of accomplishment I have.

Enjoying one of the views before heading out

We backpacked to our vehicles, while the villagers balanced our packs on their heads and loaded up our truck for us. We loaded in the cars clown style and headed up the road to our next destination. We didn't stay ahead of the rain. The problem with rain in the mountains is it makes the roads extra extremely difficult to pass, if passable at all. Our lead vehicle, the truck with all our supplies, got buried in mud. It took about 20 villagers and our men pushing for a good amount of time before we were able to keep moving forward. Once freed, we were told that the truck wouldn't make it any further and that the church was right around the corner.

The surviving trucks (barely) made it around a couple more turns and up a few more hills when we were told we were there. By this time, we had climbed in and out of our Land Cruiser numerous times to help get it out of tough spots. We had bounced until our heads hit the roof. So were kind of confused to stop in the middle of nowhere. The closest church looking building was a good hike away. And not just a hike, but a hike down a hillside and up another. And it was down pouring. We discovered that we weren't going to that closest building. We were going to the one further away. And another hillside away.

We strapped on our packs, ponchos and can- do-attitude and started our trek. It actually wasn't that horrible, as we just followed the well worn path. We got to the church and unloaded out stuff. I went out to see if anyone needed help and met a girl of about 9 years old. With one of our bags on her head. A big green bag full of supplies. Supplies from the truck that we could barely see- probably a good 2 miles away. 2 miles of mountain trail climbing. With our bag on her head. In the pouring rain. I couldn't believe my eyes. I don't feel that I have ever done anything to deserve that treatment.

And she wasn't the only one. She was just the one leading the way. All of our bags were following behind her. Villagers of all sizes could be seen with large green bags on their heads throughout the mountainside. The only way I can think of describing it is to compare it to ants marching through a maze. It was yet another phenomenal sight.

Yep, those are chickens

We are about 20 minutes away from the Dominican Republic. You can see a marked change too. There are more trees and flora in these parts. We passed many women carrying chickens on their heads and many other villagers taking their goods to the market. One of the oddest things (and that's saying something when you are talking about Haiti mountains) we saw involved piglets.  We would see donkeys carrying numerous items to market, sometimes wearing saddle like apparatuses. But when we saw little piglets in the pockets of these saddles, we couldn't believe our eyes! And of course, I couldn't get a picture!  It's almost a different culture from the earlier part of the mountains. Things seem to be thriving here with all the hustle and bustle on the side of the road. I want to contribute it to the intact forest.

There's not a lot of areas to sneak away in this quaint village, so we are forced to make friends with the local latrine. Latrines are actually very valued in these areas. A well dug latrine will prevent many illnesses and the villagers are very proud of these structures. But that doesn't mean it's an easy adjustment for us to make.

Although, the experience is more pleasant than a Port-A-Potty, it's a bit of a feat to use. Once you step into the grass hut, you have to to get the flimsy piece of corrugated metal door shut. Depending on your luck, you may have to ask your partner to help hold the door shut. Then you will find a concrete stump with a hole over it. But this stump isn't small enough to fit legs around, so you have to somewhat gracefully step UP onto the stump. I don't really want to go into much more detail, but you can only imagine.

I had this jacket (and the matching pants) in 8th grade.  It was weird seeing it again...

The other adjustment I am having to make includes bugs. I am relieved for the mosquito break, but less than thrilled about their fist size replacements. Ok, maybe fist size is an exaggeration, but only a small one. Whatever these flying creatures are, they seem to have an infinity for our hair. One girl reached up to pull a "crunchy bug barrette" out of her hair. When one landed on the back of my neck, I calmly flicked it off and wished it a merry life. Or I smashed it, screamed like a sissy and jumped on top of the roof. You can chose. (Chose the 2nd option if you want to be right).

We got our supplies settled and our fill of rice and beans and goat and were led to our accommodations for the evening. Our hosts had removed all of their furniture and gathered all the finest mattresses in town. They took 3 Queen size mattresses and laid them wall to wall for us to sleep on. Not only that, they had tacked white sheets to the ceiling and the walls to make cover up the cinder block.

And of course, they slept on the dirt floor of the church. Again, I don't deserve this treatment.

The Journey within the Journey

Monday, April 23

When I said I had a feeling things were going to get interesting yesterday, I pretty much hit the nail on the head. I started the day hearing our plans were on hold because of roads being barricaded in protest and ended with a big sleepover on the concrete alter of a church while hundreds of villagers sat in the pews waiting for us to wake up. Perhaps I should explain more...

At 6, I got up to go get rent cars with a couple of the guys. Pastor Ron greeted us with a worried look on his face. He explained that a police officer was shot and killed on Friday and today the police officers were protesting, as they felt that the government was involved. And of course, since safety is our first concern, we weren't sure if we were going to make it to the mountains, because if without the rental cars, we were stuck in the city.

We got the all clear a few minutes later, so our spirits lifted. Pastor Ron's solution was to take an alternate route, through the outskirts of Cite Soleil. In all honesty, I was relieved that Pastor Ron had earlier strongly suggested I sit in the cab of the truck. I breathed even easier when the driver discretely rolled up my window.

Cite Soleil is essentially the Five Points of Port Au Prince. Actually, a Cite Soleil dweller would consider Five Points a paradise. Often considered the poorest slum in the western hemisphere, it is not a place I ever thought I would find myself. Gangs are rumored to control this area and violence is rampant. Up to 400,000 Haitians call this slum of about 8 square miles home. With only shantys and no sewer system, the stench burns at your nostrils. I didn't see anything terribly disturbing that I can verbally describe, but I can tell that it wasn't a happy place.

We were hoping that renting the cars would just take a couple of hours at most. When we returned to the orphanage over 4 hours later, our spirits had taken a beaten. Nothing is easy in Haiti and renting cars is no exception. I'm not sure why, but Avis decided to "try harder" and repainted one of our trucks before we could leave with it. Then it needed three new tires. Then a different car needed more gas. Then we needed to get water for our trip. Running errands in Haiti can easily be a day long task. And although I didn't do much besides watch "Father of the Bride" in French and try to read newspapers in Creole, I was exhausted by the time I got back to the orphanage.

Because it was past noon by the time we finally reunited with the rest of the team (who had graciously cleaned our host house!), we knew that we had to omit what I was looking forward to most. We had planned to arrive in the mountains in time to hold an education clinic.  I personally was excited at the prospect of educating expecting moms on the basic care of taking care of newborns, while others touched on subjects such as hand hygiene.  Using canvases, we made displays depicting the information in Creole and I think we were all more than a little proud of our hard work.  But because we faced at least a four hour drive to our destination, we knew we wouldn't have time before the sun set.  It was a disappointment, but I have to learn to expect such circumstances.

Despite our exhaustion, resting wasn't an option. We needed to get going if we were ever going to make it to our mountain destination. We knew that a trip to the mountains rarely is without a few obstacles along the way and we needed to give some leeway for whatever lay in our way. We loaded up our truck and 2 Land Cruisers with our 20 something bags and 20 people AND their personal belongings AND water AND rice and headed off (like sardines).

Dan tying down our supplies

As soon as the tires of the Land Cruiser hit the dirt roads, my spirit was lifted. I continue to be in awe of the Haitian mountainside. I just can't describe the serenity of it all, which is odd considering the utter poverty. Children often run out to yell, "Blan Blan Blan" wearing only shirts, mothers are bathing with their children in a stream next to the dirt road, and you can't help but wonder how the huts continue to stand trip after trip. I love to see little children run out playing with a stick and a wheel.  The same "toy" my grandfather played stills entertains children in these parts.  It's so serene and simple, you feel like you are intruding with your vehicles.

Typical part of the road

As promised, the road is such an adventure. I think last time I wrote that it was like Independence Pass, minus the pavement with the addition of randomly placed rocks and sometimes boulders. Still can't think of a better example. Luckily, Tony and Dan love to four wheel and took to the challenge with an awesome attitude and amazing driving skills.

I shared a car with three Haitian translators who had never been to the mountains before.  Actually, they didn't even know this part of Haiti existed!  They kept passing around my camera taking pictures of every sight they saw.  They were in awe of this beautiful part of Haiti and I was in awe of their amazement.  It would be similar to living in Denver and never going to the mountains.

Taking a break from driving

As beautiful as the mountains are, a sadness lies in the hillside.  The vast majority of Haiti's mountains have been deforested.  There are many reasons the trees were cut down, ranging from logging to clearing land to farm.  Without trees, the land was not able to handle the torrential rainfalls that occur in a tropical environment and erosion caused many problems. It is said that 98% of the country's forest has been chopped down.  When you catch a glimpse of the rare land that was spared, your heart aches for more similar scenery.  Basically, you would have the Dominican Republic.

Missing Trees

Those that had been on the previous trip were nervous because the road was underwater 6 months ago and they weren't able to reach Cornillion, our destination. It was so fun to see the jubilation on their faces as we drove past (not through) the lake that overflowed last time. We pulled into Cornillion just as it began to rain.

A villager

Pastor Ron ushered the women into one of the houses while the men figured out the next task. I have a hard time using the word "house" because it would never be considered a house back home. People have tool sheds bigger and more finished than these. I can't wait to go through my pictures, but am a little concerned because it was so dark. As you can imagine, electricity is not exactly a standard in these parts. I hope they turn out! But if they don't, I promise you that it is straight out of movie set. Dirt floors, mud walls and proudly decorated. 

We asked the Pastor's wife if it would be ok to take her picture and she ran out of the room. Turns out, she wanted to get herself gussied up before we took her photo. She came out in her Sunday best with her hair styled. It was hilarious, but proof that women are the same everywhere in so many aspects. Plus, showing people who don't get the luxury of cameras, let alone digital cameras, their photo is a joy!

The rain let up, so it was decided that it was time to backpack in to the church. We strapped on our personal gear and followed the trail that lead to a rather large church on top of a hill. It was a beautiful hike and one you can only find in the rare undisturbed corners of the world. We passed an old cemetery with old tombstones above the ground. It was so far in the distance, it looked like a miniature replica. I also loved passing the grass huts used for kitchens. The dark green leaves they use are so beautiful and I have yet to figure out how such a lovely leaf can form such an important structure.

Kitchen

 It was amazing to see our bags had already been hauled up and were awaiting us in the church! The Haitians are so strong and so willing to help us. They don't let us do anything! At one point, a barefoot teenage girl took my bag from me to carry it. Really? I have access to great health care, a gym, a physical therapist, shoes fitted especially to my feet and a square meal whenever I want it, and YOU insist on carrying MY stuff?!? For some reason, I find this extremely humbling.

Per village standard, they offered us a delicious meal of rice and beans (and perhaps goat) and settled in for church service. We were introduced, sang and worshipped, then tried to rest before our long, challenging day tomorrow.

All 12 of us inflated our mattress pads, rolled out our sleeping bags, swallowed some sleeping aids, prayed and attempted to turn in for the night. Turns out when the church is filled with people lining up for a clinic in the morning, you have two security guards watching you and they provide you with a pot to use should you need to use the restroom, sleep doesn't come easy.

Ahhh..the mountain villages of Haiti....

Day of Rest

Sunday, April 22

 Ahhh, a relaxing Sunday. The week is about to get crazy, so I know to enjoy these down days while I can. Not to mention, I think we all need to recoup from our 24+ hours of travel.  My "down day" started at 6 am for church. I took a quick cold shower and headed out bright out and bushy tailed (ok, maybe that is an exaggeration). 

It was comforting to know that not much has changed at church. The only change was the exterior of the building. Instead of being welcomed with broken steps, we got to view the front of a beautiful building. It makes me smile just thinking about it. The worship was as passionate as ever, the songs were as glorious as I remembered and the sermon (through the interpreter) was just as relevant to our life as what was probably being said in America.

I continued to be amazed by the clothing Haitians were to church. Everything is not only church dress appropriate, but cleaner and more pressed than you would find in any American church. As the team was reflecting tonight, we realized the big difference between Haitian and American worship. In Haiti, church is the highlight of the week. In America, it's something we go to if we can fit it in. This difference shines through beyond words.

After church, the widows were bussed out to the orphanage, where we served them lunch. I felt a little bad, as the cooks were the ones who had slaved over the food for hours and we had the glory because we simply plopped it on a plate and placed it in front of them.

We then passed out tote bags for the ladies to decorate with fabric markers and paint. At first, we just had 27 widows looking at us with blank stares. But once a couple of girls demonstrated the idea with the markers, the idea took off. It was fun to see their faces light up as they made their own art. And as an added bonus, they got an decent accessory to help carry items home from the market.

We were blessed enough to have a ton of crocs donated to us (much to Customs' chagrin). And when I say Crocs, I'm not talking about what image probably popped into your head. These things could easily be fooled for regular shoes. There were flip flops, heeled sandals, dress shoes and even moccasins! So we displayed about 40 pairs and let each lady pick out a pair. It was one of the most rewarding experiences to help them fit shoes onto their battered feet and receive an English "thank you." with a kiss on the cheek and grateful hug.

Once I took a picture of one lady proudly displaying her bag and showed it to her, all the ladies wanted to model their bags. It was so fun to see these ladies who had been through a life of hardship to giggle like children when they saw their picture. All in all, I couldn't ask for a more grateful, graceful group of women (and even a couple of men).

Later in the afternoon a handful of us ventured into town to get supplies for our upcoming mountain trek. As usual, the streets of Haiti didn't lack in interesting sites. From people sleeping on the sidewalk, to market transactions to what is appearing to be the standard walking naked man, I will never get enough of everyday life in Haiti. I also tried to learn the Haiti currency system and understand the exchange rate, but apparently you need a masters' degree in finance.

I heard today that a common Haiti catchphrase is "Haiti is more complicated than meets the eye. " Yep. And the monetary system is visual proof.

I know that yesterday I wrote that trash still litters the street.  However, today with the benefit of being in an open truck, I got to see how much less trash is in the street.  We used to have to zigzag around rubble and hold our breath to prevent breathing the odor of rotting trash.  It wasn't that bad on our Sunday drive.  Dare I say that some of the streets are just a few street cleaners away from looking like some of the streets in America.  Ok, maybe you won't find a bull walking down the street or women carrying baskets of good on their head, but you get the point...

I'm about to run over to hear the orphans sing their nightly devotional. In the morning, we are gonna get our rental cars and head up to the mountains. Stay tuned, I have a feeling things are going to start getting interesting!