Wednesday, April 28, 2010

Haiti and some realizations

I've never really come up with airtight examples of how corrupt Haiti really is. In my exposure to local experts and some of the reading I've done, the closest that I can come to describing it is that there is an instituted culture of expecting handouts and taking free aid. That in and of itself isn't bad, but there is strong evidence to suggest that the US gov't has taken steps to transform the country from an agricultural one to "The Taiwan of the Caribbean." The result is that there is an embedded culture of need and dependence that has become aggressive in its demands for assistance.

There was a real plan to change Haiti to a place that could produce our trinkets and sew our jeans for us, but in order to do that we had to shift their focus away from growing food - in stepped USAID. The free food in Haiti has watered down the market so that locals can't sell their own harvests at a profit, and it gets more malicious than that. At 2 different times (now 3) during the country's history there has been enormous need. One was during a US backed embargo and the other during a drought. Both times food aid slowed to a trickle and only resumed in full force after the problems were over and when bumper Haitian crops were being sold at a fair market value. The new crops dropped the price and ended up hurting Haitian villagers and farmers.

To top it off, most of the food never gets distributed for free. It ends up in the hands of an intermediary who is able to sell it to someone who can afford it and the poorest never get much aid at all. This cycle of unwanted and intercepted food aid has created animosity amongst the Haitians. They often resent the food aid and since they have (in an indirect way) been moved off of their farms, they come across as entitled to receive free food. In more than one case during my trip, an American told me a story of having a Haitian demand something from them in an aggressive way - "Give me some food" or "Give me your phone." This comes across as an aggressive entitlement that seems selfish and ungrateful to outsiders.

A brief aside - The bright spot in recent years for the Haitian economy has been the fact that the illegal drug trafficking through that country has managed to trickle down some wealth to some of the poor and middle class Haitian's. Timothy T Schwartz tells a story in his book that I mentioned in an earlier blog about a drug smuggle that got intercepted by Haitian peasants and transformed the lives of almost an entire village. He quips that the drug 'hijacking' did more for that village than decades of government focused food aid. This story actually made me wonder if the reason we still fight a war against drugs in our country is because of foreign drug lobbyists trying to maintain their unique ability to provide an agricultural crop that we don't openly grow in the US.

Continuing - Combine hopelessly entrenched selfishness with the overwhelming poverty that is, unlike some other places in the world, visibly obvious and as an outsider you are left wondering if there is any future for Haiti. I realize after reading my blogs that I tell a story with some hope in it because the trip was hopeful and reinvigorating for me, but in reality I can't really see much hope in store for the people of Porte-au-Prince. The people there are living in the absolute worst conditions that I've ever witnessed first hand.

I managed to accidentally catch this ESPN story about the under 17 girls national team yesterday and was struck (again) by the hopeless future of young Haitians. This story didn't really have much to do with sports for me, it was more the ending that really struck me as a powerful example of how journalists can change perspectives and have their own views of the world turned to the side.

E:60 tells the story of the Haitian under-17 girls' team, from the welcoming arms of the Dominican Republic and Panama for training, then Costa Rica for the CONCACAF tournament and back home to Haiti

Haitian Girls Attempt to Qualify for U-17 World Cup

Friday, April 23, 2010

Thank you to my Supporters

I just wanted to let all of you know that I've been back from Haiti now for an entire work week, and I've been slowly transitioning back into business as usual here.

I feel so honored to have been a part of the relief effort and am dumbfounded when trying to come up with explanations as to how the people of Haiti can move forward.

Whenever I've come back from an experience where I can witness first hand the disparity of wealth between some people on this planet, I can't help but feel some confusion, sadness, guilt, responsibility, even anger at how some are expected to survive. I think in recent years, I've tried to accept that my role is to share as best as I can with people that I care about them and want them to succeed. I can't make a big difference, but I can do something and all of you helped make that possible. Thanks for your prayers and support.

While I was down there I didn't experience any wooziness or even timidness about jumping into various medical procedures. I stayed healthy and have remaind so this week - even my feet stopped hurting by the 4th day into it.

Many Thanks,


Wednesday, April 21, 2010

Some Thoughts; Return Day 5

I'm adjusting back to my life and learning to care about things like the amount of half/half in my coffee again. That seems relatively important compared to some of the work things that I need to focus on.

I had several episodes when I woke up in the middle of the night and had no idea where I was. It lasted longer than normal and I even started to get up and try to find a perscription drug for someone. Then I realized my dog was just barking at my own garage door and we both went back to sleep. The size of my house in that moment just after waking seemed enormous . . . .

I keep thinking about individual patients. There was one guy we saw who'd had a skin graft on his leg that was healing ok in parts and not so ok in others. He seemed really more dirty than everyone else and was probably the only person who acted like he had absolutely no idea what I was saying when I spoke French to him. One of the providers on our trip, Lisa, had to pick at some dead tissue for him with tweezers and Joellen attempted to wash his foot for him. The area above the bandage was swollen strangely, so I don't know really what the problem was. We bandaged him up and told him to come back, but I didn't seem him again. I wonder if he'll lose his leg at some point.

I've been grasping at trying to figure out what I'll do next to help these people. I've made some contacts with those in Haiti, but nothing specific has materialized. I've even asked some of my friends who are also providers if they could tag along on another trip - we'll see. I know that I can probably help provide the school with needed (legal) copies of software, so stay in touch with me if you want to be involved in that. It will probably be something like $30 to provide a copy of Windows or office.

I still haven't organized my thoughts about some of the things I've learned regarding the culture of aid that exists in Haiti. For those interested, I'm reading this book: Its self published which means its either all true or all a 'load,' but its been very informative regarding the impact of food aide on Haiti and the US Govt's involvement in the history of that country.

Monday, April 19, 2010

Back at Work

I'm already back at my desk working today. Thankfully, I've been scheduled for some training over the next 2 days which means I can pace myself to get going up to full speed again.

Part of this trip for me has been actively trying to engage others in the experience. My extravert personality also makes me live through things by sharing them with others, so I've been soliciting conversations and questions from everyone. This also helps me remember things and potentially get different perspectives on the experience.

Some people have asked me some good questions since I've gotten back. I think mostly they've asked open ended questions and I've had to say "The trip was a lot of things, good, bad, painful, rejuvenating." Someone asked if I would do it again and I immediately said YES. I am even sort of trying to figure out how I could go back next month.

I will say that it occurred to me that on other volunteer trips and mission trips I've been on, you deal with a lot of rejection, sometimes boredom, sometimes wondering if what you are doing is actually making a difference or even the right thing - but I don't really think I experienced that at all on this trip. We didn't have time for that. It’s a rare feeling to come out of something feeling so needed . . . . If I'm feeling any kind of difficulty adjusting back it’s because the things I'm doing are so much less urgent here than they were last week.

Some have asked me if I witnessed outbreaks of epidemics. The good news is that after reflecting about it, I don't really think we treated any patients for things like Dysentery or Cholera - others on the trip may remember differently. The bad news is that there was some concern about Tuberculosis but that is often a problem in Haiti. We did see several AIDs patients. Reports of incidences of Malaria are statistically more common than before the earthquake. Also many of the more common diseases have similar symptoms so in one consultation it’s hard to determine what the problem actually is.

To me this means that people are probably getting mostly good water, so at least some of the concerns about massive epidemics wiping out more people than the earthquake have not materialized. Complaints about Diarrhea and trouble breathing were common and can probably be related to uninfected but poor food and water supplies as well as a very large quantity of dust in the air from all the rubble. Several women also reported that they weren't going through their monthly cycle but failed pregnancy tests which could be due to stress and other factors. After explaining this to my wife, she remembered firsthand accounts of WWII concentration camps that reported that no women experienced their cycles even once throughout that horrific ordeal.

While in the tent cities no one is conspiring to actively commit genocide against the Haitians, the comparison to the Nazi holocaust was an interesting one for me to contemplate. People have been forcibly removed from their homes; have no privacy, and no control of their own future or well being. Their health is at constant risk and they have no positive way to occupy themselves.

I mentioned earlier that on our last day we went to a tent community where no Drs had been before. There had been another team close by, but they were the equivalent of multiple suburban blocks away which is too far for someone to walk if they are seriously ill. The fact that no team had been there before created some anxiety in the crowd waiting for us when we arrived. I never felt unsafe, but things could have potentially changed quickly and, at the least, forced us to leave without treating patients.
At one point, I asked a translator if there was a place to go to the bathroom. He went and found one of the local Haitian men and we walked a bit down the rocky inclined street that had tents on one side and concrete homes on the other. The roofs were a combination of rusted metal and plastic. I think they had probably cleaned up the street for us because I don't remember noticing any trash or burned evidence of trash. The man led me to a concrete hallway between 2 homes and I followed him chasing a juvenile chicken into a courtyard that seemed to join several living areas. The courtyard must have been about 8 feet wide and 10 feet long and was open to the sky above. There were two toilets in separated 2x2 concrete walled rooms here and even when I asked in French why 2 of them, I didn't find out the purpose of each one. I think rubble was piled up against the back wall of the courtyard or some kind obstruction(s) that looked like construction clutter to me at the time. The toilets were concrete holes that had been built up so at least you could sit on them and there was an actual toilet seat permanently stuck to the concrete. I don't know where it went, but it was deep enough and dark enough that I could not see the bottom. A lace curtain was drawn across the opening of one of the rooms for privacy. I took some of the women on our team to this place a few hours later and witnessed some twin girls taking a bath in a plastic tub and a woman cooking over fire on something that had been rigged up to hold a pot. I tried to speak some French to the 1 year old-ish twins "Salut les petits." The woman cooking could say Bonjour back, but wasn't able to speak any more French to me, another older child in a doorway behind her said nothing. They didn't react and pretty much all stared at us. I have no idea what they were thinking, but they looked tired and a little afraid. From the looks on their faces, I doubt they'd ever had a white person in their bath/kitchen courtyard. It was time for lunch, and I walked back to the tent area where we were treating patients and ate a pre-packaged meal I'd brought from the states, drank some water and we chatted about some work things and the cute little twins - then we got back to work and finished up our last afternoon of treating patients in Haiti. I didn't really think about it much till later but seeing that family's home was actually a nice bright spot for me; some semblance of normal behavior in an otherwise very chaotic environment.

Sunday, April 18, 2010

Found Some Mission Rescue Links

These are from others who have been there

Quisqueya Crisis Relief blog

I also started a facebook group:
Misión Rescate (Mission Rescue) Haiti

Saturday, April 17, 2010

Haiti Day 7

Its Saturday morning and I'm packing up my things and getting ready to catch the bus back to the airport. I don't really want this trip to end.

At some point yesterday while I was taking an outdoor shower, I realized that I hadn't even thought about watching TV or playing a video game the entire time I've been here. Despite the physical exhaustion, this has been one of the most rejuvenating experiences that I think I could have had.

I've really enjoyed the team of people that I've had the priviledge to spend time with this week. I've remarked multiple times about how we've just got some really solid individuals with us here and its been great getting to know them and learning from them.

I've also really liked being able to test myself learning something new. I really couldn't have told you about anti-biotics before this trip and I actually memorized some of the treatments and dosages while fetching drugs for our wonderful physicians.

Clicking back into French has been nice. I haven't spoken to the patients as much as I would have liked, but there was certainly a time for that along the way. I realized yesterday that my French was equivalent or better than the English of our Haitian volunteer translators and it was helpful to have a native English speaker who could at times bridge the communication gap a bit.

Another thing thats been great is the ease of logistics. The school put together meals and transportation and pretty much everything else. Its hard to come to a country like this and know what conditions are like and how/when you will be able to move around. Frankly there probably is no other way that I would like to visit Haiti than to stay on these school grounds.

Yesterday we went to a tent city and actually saw patients in someone's tent home. It was less hectic than mission rescue and there were no surgical procedures, but those people had not had any Dr.s come to that location yet, so we were really excited to provide some care. I stood right in front of the pharmacy table (3 steps away from both Dr.s) and tried to keep up with the perscriptions they wrote. We were also joined by some Haitian medical students who did triage work and saw patients as well - they worked faster and without translators so I had my work cut out for me filling sandwhich bags with pills.

Since I'm getting ready to leave, I want to sum things up, but its just not time for that yet. More to come . . .

Thursday, April 15, 2010

Haiti Day 5

I've been back to Mission rescue every day this week. I've turned myself into an on the spot pharmacist and the Dr.s I'm working with tell me that I'm doing a really good job.

My day at MR involves filling sandwhich bags with pills of Tums, Tylenol, Vitamins, and other OTC medicine, but it also involves me learning and keeping track of a lot of antibiotics and hypertension medication. That along with anything else that could possibly be wrong with someone - we have to some how have a way to treat them.

Drawing a picture for you, Haitians line up from the tents to the police station and the line is long. We've treated somewhere between 300 to 600 patients each day. They are triaged under a tent where vitals are collected and then sent to wait for us. We see 'General' complaints which means not Women with Ob. concerns or children (although they are next door and I am their pharmacist too). The waiting area is a narrow hall that was also probably a waiting area for the police, they then move in to our general area where they are called by a Dr and a Haitian interpreter for consult. The Pharmacy is a table that is 3 steps from the consultation area and supplies stretch all around the room. I try to make it easier for the Dr.s to find the medication, needles, sterile equipment, and everything else. I also assist with surgical procedures since I'm the one who seems to be able to keep track of most of the stuff and I'm sort of 'good in the pocket.'

There have been a lot of medicines collected in the main MR pharmacy tent which is seperate from our area (in the courtyard style parking lot). I had a chance to help organize it this week. I can't really keep track of all of the new experiences that I've had and all the learning I've had to do.

Some highlights from yest and today:

-Learning that Augmentin is Amoxiciline plus something else (I know it when I see it)

-Learning what Amoxiciline is

-Tons of other drug stuff (Mebendozole kills something like tapeworms)

-Assisting in surgery on a women who had worms inside an open leg wound. It was pretty gross in an awesome way

-Showing up after pickup at MR and being taken to the General Hospital around the corner where 8 trauma victims had just arrived from an auto accident. The power was out in the tent outside the hospital where they do triage and the heroic Dr.s were working with headlamps, practically in the dark - I mostly stayed out of the way.

-Watched some fluid drains including a Pneumonia patient who needed fluid drained from the lungs - and a patient who needed perniel (sp) fluid drained from his scrotum

-Not getting woosy even once the entire time I've been here

Part of our discussions here have been about the problems of providing free health care. There is a long history of dependency in this country on foreign aid and I'll blog about some of the things that I'm learning on that topic next time.

Tuesday, April 13, 2010

Haiti Day 3

Hard for me to organize all of my thoughts from the last few days. A few people asked me if I was able to sleep inside or if we were camping on the grounds of the school. Our group of 8 people were able to secure a school room (6th grade classroom) where we unpacked our sleeping bags and are sleeping on cots and airmattresses.

Work for me has been pretty amazing. I've been assigned to work at a clinic that is operating out of the main police station right across from the crumbled Presidential Palace - It really is falling down.

The clinic calls itself "Mission Rescue." It seems to have been started by an American from Floriday who is trying to maintain a supply of medications and staff it with volunteers. In 2 days working there, I think we've seen more than 1000 patients with various maladies, some are fresh wounds while others are suffering from more ordinary afflictions like upset stomachs and fever/colds.

My role has been as a sort of pharmacist and organizer. I think I've learned the names of more medications in the past 2 days than I knew in my previous 33 years of existence. I package up multi-vitamins, anti-acids, antibiotics and other things so that they are easily distributed to our patients. I'm also working as a translator, but many young Creole/English speaking Haitians have volunteered to translate which is good because while I'm getting complimented on my French constantly, its only really working one-way with some of the poorer people who need treatment. Thats because you have to have some education to actually learn French in this country.

Despite some of the communication difficulties, I don't think I've ever done any work before like this that felt quite as worth while. The people coming to mission rescue line up very early and they come from different places nearby. There are quite a lot of tents (like 10s of thousands) in the surrounding neighborhoods so presumably the people are coming from there.

We've basically got the ground floor of one wing of the police station. We try to do OBGYN stuff in a seperate room, while children are sent to a pedi-care room staffed by som volunteers from Michigan. The team from Quisquea (me) sees general patients and we are staffed by a Dr, 2 very experienced EMTs, a retired nurse, and a Physician's assistant. I stand on my feet about 7+ hours just running around filling pills as I mentioned above, disinfecting and cleaning wounds, and sometimes giving instructions to the patients in French (take this one 3 times a day etc.) Some of the highlights of treatment have been me having to hold down a 'street kid' while we gave in a novacain injection and then stitched up a wound his friend had given him from a broken bottle - I also saw the Dr. lance a really gross boil today that kinda exploded - it was awesome!

Some of you are aware that I can feel a bit light headed from discussions of some medical topics, but that hasn't happened to me at all here. I'm seeing a lot of gross stuff and it isn't really phasing me at all.

One thing about the mission rescue site is that you can go up onto the roof to eat lunch when we managed to pull ourselves away for a break. Up there you get a great view of the crumbled presidential palace as well as the records building with all the adoption information next store (that one is just ruble). You also can take in the scope of the destruction from a high-ish place and its difficult not to be overwhealmed. Not every building has fallen down, but there are more in ruins than you can count. Who knows if they will ever climb back up from this - and they weren't really in a very high place before anyway.

From the roof today I got to see what we thought was Michelle Obama's helicopter touch down on the grounds of the Presidential palace. There were American soldiers up there with sniper rifles pointed toward the landing zone - kinda cool.

All in all I'd say that the experience has been exhausting, but I'm really feeling like I'm making a difference. Thanks to all of you who supported me and are continuing to pray.

Will try to blog again tomorrow or Thursday.

Sunday, April 11, 2010

A first day in Haiti post

-Woke up 2:50am
-Incredible awesome sister took me to Fairfax Community Church where I met up with my team and we headed to Dulles airport for our 6am departure
-Checked in and to my first dose of Larium for malaria (after hearing a team member story of it making them very ill in the past)
-Arrived Miami - NOT very ill from Larium!!!
-Quick bite of breakfast and possibly my last cup of coffee for a week in the airport
-Short flight to Port au Prince
-Customs in Haiti - super easy and all of our bags made it
-Quisqueya Christian School ( right on time, sent a truck with a big cage on the back to pick us up. There was a padlock on the back but they didn't lock us in. JK felt very safe
-Lunch and an orientation - so many doctors and medical practitioners here its amazing
-Short nap
-Walk around the environs, found a bakery that sells pastries and ice cream and is air conditioned, didn't expect that!
-Typing this blog

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