In Their Flip Flops

Sunday was our first full day in Cabestor. We woke up early prepared to go to church…or so we thought. Cabestor is out in the beautiful countryside of Haiti and surrounded by mountains. We had been told that it would be a bit of a hike and that on our way back we would go on a few home visits. We grabbed our water bottles and supplies for the home visits, tried to dress somewhat nicely, and set out to go to church.

About thirty minutes in, we realized that getting to church was much more of an adventure than we anticipated. The journey could be compared to the stages of labor. The first stage of labor is from the time labor beings until dilated 10 cm. We were in the stage one, trudging up a mountain over rocks, through soggy mud from a storm the previous night, and through the plants on either side of the narrow path. We took multiple breaks to catch our breath and refresh our dry throats. Finally we made it to the top of the mountain, our entire bodies and clothing drenched in sweat as if we had just swam through a river (which would not be totally out of the question.) We continued on down the other side, as I sheepishly passed by women carrying buckets on their heads up the mountain with grace and ease.

Eventually we arrived at a little Catholic church near of the bottom of the other side of the mountain. We laughed at ourselves as we observed others arriving in heels, dresses, and dress pants free from dirt, as we sat there caked in mud with clothes discolored from sweat. We stayed for part of the service but left early to do a prenatal check for a woman at church and then journey on to the home visits.

Unfortunately, it turned out that only one home wasn’t a multiple-hour walk away or didn’t involve somehow crossing the river. We arrived to the home, and I cannot imagine how it was for the mother to have a group of seven white Americans show up at her home, especially in our condition. We completed a postpartum assessment on the mother and her five-day-old baby, who was delivered in her home. One of the valuable aspects of the home visit is to see the home and setting in which the mother and baby live. The home was simple, with two small beds that took up almost entirely each of the two rooms they were in. The only other furniture in the house was a tiny table with a few things on top. A separate building held the kitchen. This mother was beginning to raise her eleventh child in this small space. Some of the other children were scampering around or watching us with curious gazes from the doorway. It was exciting to see that the mother and baby were looking healthy and doing well.

We continued on with the hike, headed back to the birth center in Cabestor. By this point, it was getting to the hottest part of the day, and the air was so thick it almost seemed unbreathable. I trudged along, one chaco after the other. Going back to our labor analogy, we were in the last part of the first stage of labor: transitional labor, which is intense, painful, and difficult. I think those types of words were going through our heads as we continued to climb up rocks up the mountain, getting low on glucose and water. This is when a woman in labor might start saying, “I can’t do this anymore.”

Miraculously, we were saved by a man who had been trying to catch up to us since the church with a bucket full of coconuts he had found for us. I was shocked by the effort he put in for us, a group of strangers. We graciously drank and ate the delicious coconuts, reenergizing our bodies. Time for the second stage of labor: pushing. The reflex kicks in and you just push. We pushed ourselves as we made it the rest of the way up to the top of the mountain, thankfully, with no one passing out.

Stage three: the baby is out, you just have to deliver the placenta, and it’s downhill from here. From the top, we had a glorious view of Cabestor and the surrounding mountains. I breathed a heavy sigh of relief and took in God’s creation with amazement. As we walked along the ridge, we sang together hymns and other songs about journeying and walking. (We found this week that it’s not uncommon for women to break out in song once the baby is out.) We enjoyed the rest of the downhill, passing through the community and soon reaching our destination.

While the hike was rewarding for the view at the top, it was valuable for so much more. It gave us a small glimpse into the daily lives of the Haitians we are working with. For them to get water or go anywhere, they walk these mountains. For the midwives to go on home visits to check on mothers and babies, it requires hikes such as this. It puts into better perspective the effort that must go into providing this type of quality care in an area of Haiti such as this and how that care is very difficult to come by. In the majority of our day, we were only able to make it to one home. There were thirteen on our list of patients needing to be visited. One of my motivations to get through our laborious hike was that many of the women we have been seeing at the clinic walk the entire distance like our “hike,” or from farther way – even four hours. Not only that, but they walk while pregnant and even in labor when coming to the center to give birth. We had our tennis shoes and chacos, but many of them walk barefoot or in flip flops. It was a challenging day but a vital experience to gain understanding of life here and to have a moment to walk in their shoes, or should I say, to walk in their flip flops.

– Leona

 

 

Becoming Culturally Aware

For me, this trip to Haiti was not only a wonderful chance to serve and learn more about nursing and healthcare in a different country. It was a chance to explore a new culture and see for myself “What is Haiti like?” Throughout my childhood years I have heard much about the Haiti from missionaries in my home church who worked on drilling wells and founding Christian missions in the countryside. I heard about Haiti from the earthquake and my father who played a part in the ensuing recovery work. Now there was a chance to put all thoughts, generalizations, and questions to rest in having my own taste of Haitian life.

One of the books on the reading list for the trip is titles Haiti: The Aftershocks of History by Laurent Dubois which covers Haitian history from its beginning to the late 1960’s. It has been a real eye opener for me on this trip. As I continued reading in The Aftershocks of History, it became very clear that the Haitian people have been scarred culturally and politically by U.S. intervention and occupation. The injustices and grievances are many and were repeatedly without consequence, both from the U.S. and other foreign powers. The U.S. stood by while many were massacred, as racism and a contorted, coercive picture of Haitian life were planted in the national mind, and as the Vodou religion, a big part of Haitian culture, was degraded and persecuted from within the country and without. Reading this account of history has led me to examine my own prejudices and thoughts concerning the Haitian people that I had before experiencing a small part of Haitian life firsthand. Despite all of the stories I had heard and what I thought the trip would be, I still had little to no idea of what to expect when I personally went.

A first generalization that I had before coming and asking the Haitian staff in Hinche and Cabestor had to do with whether or not Haitians ate cat. I had often heard in the past that cat was somewhat a delicacy in Haiti and that they were mostly raised to be eaten. On the trip I have seen many cats that have been pets in the peoples homes and learned that not everyone eats cat, but there are many who will and do. A second generalization that I connected with from the book was that Haiti was like an exotic island country and painted for most of history as a land inhabited my native savages with little intelligence. While I never thought of it to that extreme, I had questions of what to expect as far as education and standards of living in Haiti. Despite the lack of infrastructure, there is a strong community presence everywhere we have been and there is widespread use of cell phones and technology in most places. There is still a large portion of the population without electricity and running water though and the roads and countryside are littered with trash. Although there are many who are poor and have meager homes and poor living conditions, these people are nowhere near as poor and helpless as I and many other Americans probably have had them painted in their minds.

I find myself awed and never on this trip has the thought “I am superior” crossed my mind. If anything the Haitians I have seen, met, talked to, and interacted with are superior to me in their love, pride and self confidence, and willingness to lend a helping hand. I have watched as they toiled in the field under the blazing sun and as they carried their produce or dragged their animals for miles to be sold at market and I admire their endurance and work ethic. This people is not lazy or ignorant. They are beautifully and wonderfully made and I have had the privilege to have this small look into their culture, life, and being.

~Lamar Kiser

Back on the Grid

We just arrived back in Port Au Prince, which means we are back online, and almost done with our trip (we return tomorrow!).  It has been a week of different pacing – Cabestor is a small, fairly remote mountain community and the site of a new birth center opened by Midwives for Haiti last November.  Women are slowly starting to come there to have their babies, although many are still born at home, either by preference or circumstance (look for Leona’s post later today about our Sunday hike).  There is a daily clinic at the birth center, and the midwives make home visits for postpartum follow-up and baby checks.

Hinche gave us lots of exposure to healthcare in Haiti, but we were basically in a bubble when it came to the culture and community.  In Cabestor, we slept on the 2nd floor of the birth center, essentially in the town square.  A school and the Catholic church make up the other 3 sides of the square.  So every day, we had women and children coming to us.  And 4 of our 6 nights, we had laboring moms and new babies!  I believe we were there on the busiest week since the birth center had opened, in fact.  We had 5 babies, which includes one set of twins (a first for the birth center!).  I personally caught 2. 🙂  And we went to women’s homes in the community to do home visits.  And sat under the mango trees in the front yard talking with the staff, the incredible midwives and nurse who staff the center, and anyone else who came along.

It was also wonderful to be offline for the week.  Our pace slowed down.  We played games.  We talked.  We napped.  We marveled at the dedication of the two MFH midwives – Michelle and Nelta – who live at the birth center almost full-time, only returning to their families for 2 weekends per month.  We saw the cooks making our meals over charcoal fires.  We conferenced about medical challenges and how we would solve them, since calling for backup and help wasn’t an easy option.  We caught babies and did their home visits and then saw them later in the week at the clinic for well-baby checks.   We also woke to the church bells as they rang (32 times) at 5am for morning services.  And some of us played soccer with local youth and got a bit schooled in the heat (sorry Lamar and Leona!).

And now it is almost time to go.  This trip has given us much to think about – a process I suspect will go on for awhile.  This has been an amazing group of young adults to be traveling with.  All of them met every experience head on, and aside from occasionally venting about the heat and bugs in our mosquito nets, I didn’t hear a cross word the entire trip.  If these people are the future of healthcare, indeed if they are the future, we are in good hands.  I wrote them each an entry in their journal, and assigned each one a word that, to me, describes them.  Those words are:  Heart, Authentic, Conviction, Spark, Soul, and Steadfast.

Amen.

–Ann

 

How to Honk: A Simple Guide to Horn Use in Haiti

(as promised)

If you should find yourself to be the driver of a motored vehicle (Land Cruiser, truck, moto, etc.) while in Haiti, here is a list of times when it is appropriate to use your horn*:

  • If someone cuts you off
  • If someone in front of you is going too slow
  • If a horse/goat/chicken/dog is in front of your vehicle
  • If you are about to pass another Land Cruiser/truck/moto
  • If you see someone you know
  • If you see someone you don’t know
  • If there is a person walking on the section of road where you want to drive and you wish for them to move
  • If you are picking someone up and want them to know you have arrived
  • If you have arrived at a gate that you would like someone to open for you
  • If you are coming up to an intersection and want to let any traffic from the opposite direction know that you are coming and do not plan to stop
  • If you are going around a corner and want to let other vehicles know you are turning
  • If you are playing chicken with another Land Cruiser/truck/moto and you want them to know that you are not going to pull out of their trajectory
  • If you want to express your anger at another driver who shattered your mirror by squeezing too close to you in Port-Au-Prince traffic
  • If another vehicle honks at you first
  • If your engine is running (optional)

*list not comprehensive

– Leona & Mariah

Will you let me be your servant

Yesterday morning before us six students went to a country side school full of 500 students. We spent the morning teaching five year old children how to wash their hands, colors in English, and animal names in English. We had three wonderful interpreters to help us communicate to the clueless stares we received. After our “teaching lessons” we played soccer and jump rope with a chaos of children for an hour. It was interesting to see a functioning school in Haiti, they do a lot of rote repetition.

After two hours of recovering from the school and eating the big afternoon lunch Ann, Lydia and I went to the hospital here in Hinche. I had an idea of what I was going to experience there – very small rooms with splattered walls. No one in our  group yet had experienced a birth yet and I was really hoping for one. As we entered the court yard and approached the labor and delivery unit our ears perked up to sounds of howling screams. Our interpreter turned to Ann and said “I guess we’re in business”! Walking into the tiny labor and delivery unit the source of the howling was seen in one of the four small rooms on a beat up and stained table. The rooms in this unit only have battered curtains as doors and privacy is not a thing, meaning anyone walks in without a thought and normally doesn’t close it on their way out.

With a slight nudge from Ann, Lydia and I within minutes were on both sides of the young woman ready for the long home stretch of this marathon. And within seconds this beautiful Haitian woman accepted our bodies, hands, massages, and belly rubbing. A common theme has been popping up in our blog posts, love and care can transcend any language barrier. After a contraction, Lydia was wrapped up in the laboring woman’s arms she began to hum Come Thou Fount. She stopped for a brief second and was immediately hugged firmer as a sign to keep singing. Another hymn, which has always been my favorite, came to mind Will you let me be you Servant. Will you let me be your servant, let me be as Christ to you. So we sang, hummed, rubbed, and said words of encouragement in creole such a tré byen (very good) bon travay (good job) and ou ka fel (you can do it), until the time came for pouse (push)! Lydia and I locked eyes in amazement and disbelief when holding the woman’s legs as Ann was allowed to catch the baby. She did a rockstar job of directing the two clueless and amazed nursing students and helping the gorgeous baby girl out safely. It was truly an empowering and awe inspiring moment of women’s strength (I almost was pushed over holding the woman’s legs during delivery). The mother shouted out in praises and songs once her daughter was out and we were rushing to complete the delivery and clean up. I helped hold the newborn as Lydia cut the umbilical cord. After the chaos the mother thanked us in creole for being so patient with her. As Lydia stated in the previous blog post, we were her person for that life changing moment. People she wouldn’t have had otherwise.

We went to see her in postpartum. She was well and glowing with her new baby girl.
– Martha

I’ll Be Your Person

The past few days in Haiti have been like the calm around two thirty as we sit down for lunch, followed by the swell of rain that always arrives at just about three — wonderful, challenging, sobering, and heart-filling.

While in Hinche, I have met many people who reminded me of people at home.

Like the intern with the brown curly hair and sparkling personality of my sister,  the midwife I worked with on Monday with the same sensitivity, intelligence, and wide smile of my mother, and the bright eyes of the girl at the orphanage who flashed the face of one of my six year old campers last summer in my mind.

I love the variety of our human family, but it’s comforting to draw on our similarities. It’s a gentle reminder that home can be anywhere, and love transcends languages. 

And there have been some experiences that have taken me back to being gone on cross cultural.

Like listening to another language fill my ears all day and hardly take in a word, drinking endless amounts of Coke, and ending the day with messy hair, dusty feet, and full stories.

Then, there is so much that turns back into nothing I have seen before.

As we ride on the back of moto’s to get to mobile clinic, I see endless houses that I wonder how they are strong enough to stand.

Poverty in Haiti is not in pockets. It’s everywhere. 

On Tuesday, I spent the morning at Azil – a feeding center/chronic care facility run by the Sisters of Mercy.

I spoon fed three year olds who looked about the size of an 18 month old. Their lethargic eyes barely held open as they solemnly opened their mouths for me to give them small bites.

While feeding, one little boy sat in front of me crying out his tired little lungs. I placed him on my lap, in an attempt to soothe him. He very quickly calmed down and rested one little arm around the back of my neck. It seemed all he wanted was my physical touch.

The sisters serve so many children at Azil making it essentially impossible for each child to receive the amount of physical touch they need.

When it was time to head out for the day, I placed my friend back down and he began to wail and my heart ached. How badly I wanted to go back and hold him – to offer him some more of me, more of my time.

Another piece of the day required starting IVs in the littles for rehydration. This is a fairly traumatic experience for them to be stuck with a needle in their tiny hands. As the nun would place the IV, one of us would be what my profession deemed the child’s “person.” We held their bodies still as they squirmed, gently rubbed their head, and whispered small words of reassurance that they had no chance of understanding.

As the nun placed an IV in one little girls hand, I stood at her eye level to draw her attention away from the needle. We locked eyes and just as the fattest tears rolled from her eyes, mine did the same. 

It was an overwhelming moment of need. There is just so much of it. Everywhere.

In front of me was this sweet two year old, malnourished and in tears, with no understanding of what was happening and no family to be there for her.

But this moment offered a new insight into my nursing role.
Be their person. 

When no one else is around, I’ll be your person.
I’ll hold your hand.
I’ll comfort you in your pain.
I’ll change the dressing for the burn as long as your arm.
I’m there and I’m yours.

When I stood to leave for the day, after the feeding was over, I suddenly noticed my very urine soaked scrub bottoms from my little’s wet diaper and I thought I would probably never be so happy to smell of baby pee.

For a few moments, I was his person.
And there was no where else I’d rather be.

 

— Lydia

 

 

On a lighter note…

Ann here!  Mariah suggested that our blog might possibly be a bit on the heavy side…and while that is entirely appropriate most of the time, We realized that there are some other aspects of being in Haiti that might be interesting and entertaining to discuss.  I believe Mariah intends to write the definitive “how to” guide for using your motorbike horn, so I will leave that to her.  But here are some other indications that you might be in Haiti:

  • It starts raining, and you run for cover not from the drops, but from the falling mangoes
  • You have just lathered up your shampoo and soaped your body when the water stops flowing.
  • You are organizing the cabinet of donated medical supplies in L&D, and shake your head at what other countries have sent – veterinary IVs, a frighteningly large urinary catheter (like really, enormous), sublingual nitroglycerin, a safety pin with elastic loops in a sterile instrument packet (purpose unknown)…..notably absent:  linens, washcloths, water….
  • As you round at the hospital you dodge the flock of chickens that resides on the ward
  • You bring your headlamp to the hospital because the afternoon thunderstorm often brings power outages
  • You get bugs in your teeth from smiling wide during your moto taxi rides
  • You are starting to suspect that you are “needing” that daily bottle of coca cola a bit too much….
  • Your water bottle is like another appendage
  • You amend your personal list of powerful, fearless female role models to include the Sisters of Mercy.  Actually, they now rank pretty much toward the top.
  • You get peed on by a toddler at Azil feeding center but decide not to change before going to the hospital later, because urine dries really fast, and it’s just scrubs….
  • The doctor in L&D keeps talking on his cell phone while performing a vaginal exam (not really funny, but definitely outrageous….)
  • 3 or 4 people on one moto taxi seems completely normal
  • The coffee is strong, the food is fried, and rice and beans are abundant.  Yay for brown foods!
  • You go Konpa dancing and quickly become an expert at maintaining your personal boundaries
  • you have embraced your hair in its natural, unstyled state
  • As cliche as it sounds, you realize that smiles and songs transcend almost all cultural barriers.

Hope all of you are well!  We are almost at the halfway point of our trip and are doing great.  Love to everyone!

The beginning of Hinche

Yesterday completed our second full day in Haiti, but the beginning of our time here in Hinche. Hinche is where Midwives for Haiti is located, where volunteers stay and where classes are held to train Haitian women to become midwives. The people who live here at the house have been more than welcoming and so great at helping us ease in. Most of them (the Americans) have been here for a few months, some years; others on staff are Haitian. The first two days had included lots of travel, and although we didn’t do much, we were still pretty tired and still soaking in a lot of our surroundings. It has also given us lots of time to read our required books, which have started to open our eyes to what impact our country had, and continues to have, on Haiti. Personally, I’m ashamed to realize how little I knew about how we were connected so intimately with Haiti, and how much of this poverty we’re witnessing is a direct result of what the US has done. (We also watched a documentary on Saturday evening that I would recommend: Poverty, Inc).

Sunday morning we attended a local Episcopal church service. We didn’t quite understand any of it, but it was still nice to get a feel for what their service was like, and be a part of their culture.  We also got a quick tour of downtown Hinche, including the main square, a church built in the 1930’s (or 40’s) during the American Occupation , another local church, and a cemetery. The cemetery might’ve been the most interesting stop…we got some looks as we entered the cemetery, so I’m assuming that people don’t just normally walk in there (at least more so than you would back in the States I guess)… I could go on about what our tour guide/Creole teacher talked about, but that might be a little too much for a blog; there were other components of their faith and culture that I was not aware of that are still practiced.

We also had our first Creole lessons yesterday afternoon! It was roughly about 45-50 minutes of some simple conversational phrases. We’ll have 3 more lessons, and hopefully that will help get us by. Last night before dinner as we were sitting doing some more reading and journaling Lamar had the great idea of practicing our Creole some more. We also went ahead and taught ourselves a little more vocabulary, we’re hoping to impress our teacher. So far we’ve been using it quite a bit as we’re interacting more with those around us. I had the chance to try it out last night as I was journaling and was joined by some Haitian staff members that came to have a late dinner. They had a little hard time understanding my accent…but they got what I was trying to ask. And I think that’s all that matters at this point.. 🙂

Today was our first day going out to our assignments. Currently, 3 of us are still out on mobile clinics. The other three of us, and Ann as well, have returned from our morning spent at Azil, a place run by the Sisters of Mercy where they provide such amazing care for such a diverse group of ages. To say that what the Sisters do there is astounding and completely amazing, is an understatement. I was beyond impressed at the things they accomplish and the amount of needs they attend to. From what I encountered at my time there so far, there is a feeding clinic upstairs; there are several rooms set up with lots of cribs, filled with babies and toddlers. Below them, there are beds set up where there take care of adults. We helped them with admitting new patients (Mondays are their admitting days), rubbing special ointment on some kids who had scabies, preparing their mid-morning snack and feeding the many babies, feeding them lunch an hour later, I was able to start an IV in a patient, Mariah and Ann did dressing changes, Martha and I helped the Sister administer some B12 and iron to women who needed it, etc. It was definitely a busy place, with lots to do and not quite enough hands. The Sisters do have some other help there too. We will have the chance to send a few of us to Azil everyday, depending on our assignments. I’m grateful that I was able to go and experience that, to be able to do what we did and help them. But we also came back with heavy hearts; that wasn’t easy to experience. The malnourished children, all those women downstairs who had HIV/AIDS…it’s not something we’ve experienced yet in clinicals back in Harrisonburg, and  it’s something else when you experience it in this sort of setting and supplies are so limited.

Every afternoon we switch to different assignments and we’ve been assigned days to go to the  Hospital with Ann as she can only watch over 2 of us at a time. This is the portion of our time where we’ll experience more of the childbirth experience and what some of us are really looking forward to. First up to go to the hospital with Ann: Mariah & I.

-Juni