The End and the Beginning

Well friends, it is hard to believe that I have been back in America for almost a month now! And what a crazy month it has been! 

Backing up to right before I left Haiti, here are some pictures from the going away festivities:

This is Pere Michelin, the director of the hospital, and I as he presents me with a plaque for service to Sainte Croix

My going away party included great food, dancing, lovely words, and some fantastic gifts! It was very hard to say goodbye to many good friends, but as they all told me, it was not goodbye but rather “see you soon.”

I returned home into the squealing embrace of my parents and spent the next week getting really excited about things like lines moving quickly and the miracle that is the American grocery store (seriously. They are AMAZING. Take a minute to appreciate it. They are full of EVERYTHING you could ever imagine. None of it is expired. The prices are clearly marked and you can play games with sale items. Bless my mother for putting up with the 10 minutes I would take inspecting the 40 different choices of nuts before selecting the kind I wanted.)

I spoke in 2 churches and gave some variation on the talk recorded here, in case you have missed my dulcet tones. 

 I also had the pleasure of presenting a poster on my and Kyle Evan's work in Haiti at the celebration of 40 years of women’s ordination in the Episcopal Church. What an incredible event!

 

It was such a pleasure catching up with friends and family and I managed to squeeze in a mini-college friends reunion and a Burd family “staycation,” here featuring the Philadelphia Zoo. 

2.5 weeks after returning home, I moved up to Pisacataway, NJ to start medical school. So yes, it did feel like I spent 3 weeks packing and unpacking and I am very happy to be settling into my new house! Here are Devon and I on our porch the first day of school--- Devon being the roommate that I found via Facebook while still in Haiti. Thank God for technology and very trusting new friends!

No, I couldn't open my eyes for either of the pictures we took

After a few days of orientation, we started up classes and then on Friday had the day I have been looking forward to for a long time: The White Coat Ceremony. It was an incredible day and it was such a joy to look at my classmates faces as we donned our white coats for the first time: we each had this ridiculous grin that indicated pride, excitement, joy, and the sense that we have arrived in our vocations. 

I miss Haiti. I miss my friends. I miss my students. I miss speaking Creole and the way you never had to look at the weather forecast and the funny looks I got as I walked down the street and the fish we ate on Fridays. Haiti is and will always be a part of me and I will be forever thankful for this experience. 

Thank you to everyone who helped and supported me this year, financially, emotionally, spiritually, or however else: if I realized one thing while in Haiti it is that dependence on others is not a weakness, but rather opening yourself up to grace, a vulnerable but beautiful place to be.

So this blog now closes but another adventure begins. 

"You'll need coffee shops and sunsets and roadtrips. Airplanes and passports and new songs and old songs, but people more than anything else. You will need other people and you will need to be that other person to someone else, a living, breathing, screaming invitation to believe in better things." 

-Jamie Tworkowski

Give Us This Day Our Daily Rice and Beans...

When people ask me what I will miss most about Haiti, the first thing that jumps to my mind is the food! It is so fantastic. Let me give you a little taste. 

Sunday lunch: rice, bean sauce, and some kind of fried meat. This week it was chicken, but often it is Grilot, which is fried pork. 

My favorite day of the week is Saturday because Madame Dominique, our wonderful cook/mom, makes me Fritay---an amazing spread of fried deliciousness. In the front, on the right, are fried plantains that you eat with Pickleys, a kind of spicy coleslaw. On the left is acra, which is made by grating a root vegetable, adding a bunch of spices and some dried fish, and frying it until it tastes like a gift from the gods. In the back are french fries! Don't worry, I was sharing with friends :) 

Mme Dominique, frying away! 

Breakfast and dinner aren't much to write home about--lunch is our big meal-- but I'll write home anyway. We have 2 of those rolls for each meal with margarine. At breakfast they'll throw in a banana, at dinner a bowl of porridge. 

Rice and beans with beef. It has an awesome, spicy sauce, so you cut up that sweet potato in the lower left corner (yes, a purple sweet potato) and eat it together---so good! 

This is one of my favorite dishes --- Mais with sauce pwa et legume. The yellow stuff is corn meal grits, which you load down with bean sauce. The stuff on top, though not the most visually pleasing, is a mixture of vegetables and meat with the most pleasing spice combination. It is super good.

Other foods we eat each week include Friday fish, Sunday Pumpkin soup, and Saturday dumpling soup! As far as fruits, we see bananas, tangerines, and mango on a regular basis. We also occasionally get a treat of sugar cane, which you chew to suck out the juice and then spit out the fibrous parts (shhhh don't tell my dentist!) Dessert is not a big thing here --- I've only seen it a handful of times, and usually it is cake with a delicious meringue icing or this boiled potato cake. 

I am certainly going to miss this cuisine--- if anyone knows of a Haitian restaurant in Central NJ, let's go!

Happy 4th of July!

I will admit something to you, my loyal blog readers: my patriotism is at an all time high. This has something to do with whoever changed the name of the US Secretary of Defense on Wikipedia to Tim Howard after his stellar performance as goalie on Tuesday (thanks for the terrible present the week of our birthday, Belgium.) But it also has a lot to do with everything I have experienced this year.  

We take many, many things for granted in America. Anyone who has ever traveled to any 3^rd world country will be quick to tell you that. But despite the occasional pork barrel project or Christmas tree bill, let’s go over some things that we (or at least I) take for granted that our government does for us.

1) Roads. In the USA, I can get to point A to point B on a paved road. If there is a pothole, I complain about it because it is an abnormality. In Port-au-Prince, there is a car-sized pothole on one road. Most roads aren’t paved. And those that are are not maintained.

2) Not only can I read, but almost everyone around me in the USA can. There are a few tragic exceptions to this in America, but I never quite realized how much I took for granted that everyone I associated with could read the words in front of them. This has provided difficulties for me in my work. Moreover, someone once posed me the question, can a true democracy exist if citizens cannot read? It is a question worth thinking about in a country where 53% of people are illiterate.  

3) Emergency services. Fire departments don’t exist in most of Haiti: if you have a fire, you better hope you have some good friends with some big buckets. The only functional ambulance I’ve seen in Leogane is owned by the mortuary, which seems like a definite conflict of interest to me. My personal favorite is a song from Karnaval that reminds us all that if you go to report a crime to the police, they will take care of it, as long as you give them “gas money.”

4) Social Safety Net. Say what you will about Obamacare or Welfare or Food Stamps or any other creation of the nanny state: it is terrifying to live in a country without a safety net. If you arrive at a hospital and are unconscious and alone, you might not be treated because they don’t know if you can pay. It is terrible to see severely malnourished children. It is trying to watch parents give their children up as orphans because they cannot feed them.

5) Effective courts. I have a friend here who is on his third try at trying to build a house because he has had two different contractors run away with over a thousand dollars each. And he has no way to prosecute them. 6) Staying out of electricity. I guess this one goes moreso to private industry for not letting the government handle it. But the State Electricity Company of Haiti can make electricity for about half of its paying customers at a time.

All in all, I am thankful to be an American, thankful to all of the people who helped us to establish and protect our freedom, and praying for everyone to someday know all of these freedoms.

I’ll see you in 10 days, America. Until then, there is quite a bit of adventure left to be had! 

Darbonne

I was asked to spend a few days out in Darbonne at a Women’s and Children’s health clinic that is a satellite of Sainte Croix. To get there, it is a 20-minute drive down a road that looks like this. Thank goodness for good trucks and strong vertebrae.

The clinic is really phenomenal and serves around 125 people every day with two physicians and a handful of nurses. These pictures are from the afternoon, because in the morning there is no space for picture taking! 

They have a maternity building for women who are giving birth. Women are allowed to stay for twelve hours after their babies are born but many choose to leave sooner, either so that they can fulfill household responsibilities or engage in traditional post-birth practices. One of these involves sitting over a bucket full of some hot water and some herbs to return everything to its rightful way.

There is also a clinic that sees sick kids and adults.

 And finally they offer family planning services.

I was there to check out how they do their inventory and give it a little modern twist. The staff was fabulous, welcoming, and hard working and it was an exciting couple of days. 

Bassin Bleu

I have been gunning to visit Bassin Bleu in Jacmel since I got to Haiti last summer and, after having worked with a youth group from Minnesota who was staying at the school for a week, they invited me to join them on their great adventure.

You hike out a little ways, over beautiful trails occupied by washers

See gorgeous, blue pools.

Approach an edge where you are told to take off your shoes and hold on tight.

You reach this ledge where you have to jump in, and you think it is beautiful already

When you emerge from your dive, you see this.

It was an incredible, incredible day in this beautiful country that I live in.

Oh, and in case you need a laugh, here is Rigan, an FSIL grad who came with us, bedecked in Packers gear and playing with my ukulele over some stunning vistas. Rigan runs a clinic in a very rural part of Haiti relatively near Leogane and is the sole healthcare provider for thousands of people. 

Fete Gastronomique

Sunday was the festival of Books and Food at FSIL. Students and staff are all asked to purchase a book to help the school to build its library. The day of the event, the books are available to be read and people do passage readings. As this is going on, students sell various Haitian delicacies, and particularly regional specialties.

Selling their wares 

Orpha with the collection of books 

I tried the specialty from Jeremie, called Tonm-Tonm. It was made by these hardworking ladies, who were beating up the root that makes the yellow stuff in the picture below.

This is the dish.

 My instructions were thus: “Cut off a bit of the yellow stuff, put some sauce on it, and swallow. DO NOT CHEW.”

First attempt at “just swallow”

After I got the hang of it, it was actually pretty delicious: the root that they ground has almost the texture of bread dough. Just another day of exploration. 

"Perhaps, Someday, We Will Look Back Upon These Things with Joy"

Last April, I got an e-mail that led my roommate Victoria to recite a rousing rendition of Dr. Seuss’s “Oh The Places You’ll Go:” I was accepted to YASC and was headed to Haiti in a few months. We were sitting with other good friends in Fordham’s Rose Garden, one of the most beautiful places in the world, in my humble opinion. The central feature of the garden is a fountain surrounded by a quote by Virgil: “Perhaps, someday, we will look back upon these things with joy.”

The family and me in front of the fountain on my graduation day. 

The fountain was installed while I was abroad in France to much uproar: students thought the quote was inaccurate. “This is college. It is fun now.” The quote always spoke to me, however. Late nights studying for genetics exams weren't always the most fun, but I joyfully remember my roommates dancing into the room with headlamps on to disrupt my studying. I remember 2 am pizza runs during finals or that feeling of achievement when I finally understood what Plato was saying.

Living in Haiti, I often remember that quote. When the person I want to meet with is 45 minutes late. When I am sweating profusely as I try to eat my lunch (Who serves soup when it is 95 degrees out? The answer is Haitians). When I think I cannot handle another white carbohydrate. When I am having one of those off days where my French suddenly makes me sound like an illiterate five year old or when I really wish that I got the joke at lunch. When it takes four hours to drive me the 26 miles from Port au Prince to Leogane. A thousand little daily inconveniences that make my life so deliciously different. A thousand little daily differences that make life a joy here.

In a little over a month, I will dive into a crazy, incredible, all consuming adventure as a medical student at Rutgers-Robert Wood Johnson Medical School, which will certainly be full of its fair share of late nights and will hopefully include some roommates who will dance with headlamps. But in these final few weeks, I find myself becoming nostalgic for the day to day things that yes, have made my life more difficult, but also less ordinary. That have put things into perspective for me. That have challenged me to think differently and act differently, walk differently and speak differently, to think differently and perceive differently.

No, it has not all been rainbows and butterflies. But in those storm clouds and baby tarantulas, there is a beautiful, well lived life that I am thrilled to have experienced. 

Some Photos

Happy Mango Season... 15 mangos for about $1.10!

Haitian Flag Day Celebration in May. The Haitian flag is a block of blue and a block of red with the Haitian seal in the middle (you can see a flag sticking out of my ponytail). This schema was made by taking the tricolor French flag (vertical blocks of Red, white, and Blue) and "ripping out the white man." We were off to a parade! 

Sunset is consistently gorgeous. But we can also talk about the trash pile... most garbage is burned in Haiti. 

Things that make you exactly as sweaty as you think that they would: ironing in the tropics. And as far as Haitians are concerned (and remembering that power is just a sometimes thing here) everything MUST be pressed. 

We have some beautiful flora

Me with some friends at a talent show/dance following the capping ceremony. Things that are cultural universals, it seems: photo shoots

At the end of May we took a field trip to the Haitian History Museum and Fort Jacques. Fort Jacques is located WAY up in the mountains. And it was rainy.  I WAS COLD. It was the strangest feeling in the world. It was also beautiful. I love how you can see the shape of Haiti from all the way up here (this looks out over Port au Prince) 

Umbrella selfies! 

A while back a visitor brought a bunch of balloons... it was an incredibly entertaining night. 

Welcome to OLTCH/New Vision Orphanage

Me, in my natural orphanage environment: covered in a pile of infants. 

There is an orphanage in Leogane where I sometimes like to go on the weekends. As far as orphanages in Haiti go, it is pretty spectacular. They had more formal buildings before the earthquake but lost them all (but saved all of the children). Now the kids are in plywood dorms. There are girls and boys dorms for each age group, in addition to a special needs room. Children range in age from 1 month to 18 years old. They recently combined with another orphanage (hence the double name) where the children were fed 1 or 2 times a day, slept 8 or 9 to a bed, and didn’t go to school. So what makes OLTCH so spectacular? Each child has a bed and three meals a day, for starters. They go to school (and are getting good grades!). The staff is generally caring and not in it for the money. These are not standards maintained by approximately 80% orphanages in Haiti. There are still problems: there aren’t enough toys, there aren’t enough role models, there aren’t enough people to pick up all the babies. But the kids are alive, fed, clean, and loved.

The baby house

 Many of these children still have parents but the parents do not have the means to support them. I cannot even imagine having to make the decision to give up my child so that they can have a better life than I could offer them. It tears me apart even though I know that, being an American, I would probably never be asked to make this decision. 

This is my little buddy. He is 4 months old and very serious, especially in his Polo shirt. His parents dropped him off when he was 2 days old. 

What strikes me about the orphanage every time I go is how normal it is. The kids run and play and enjoy themselves. They cause havoc and get in trouble and get really excited when someone will read them a book. They live a difficult life, but they are kids and they love bubbles and books and big bear hugs.

Happy guy! 

A new game entitled "Let me see how close I can get my tongue to your camera lens"

For more information and pictures, check out their website! http://oltch.org/

Mobile Clinic

I had the unique pleasure of working with a group of medical students and doctors from the University of Mississippi this week as they went out into rural areas in the Leogane area to provide care. I could talk about it for hours, but I will leave it to a few points.

Confession: This is actually a picture from a different trip, but just to give you a sense of what "rural" looks like 

I have learned a lot in a year here, though it is not necessarily the kinds of things you want to learn. I spent time sitting alongside of doctors as they assessed and treated patients. Sometimes, I was clueless. Sometimes, I was really thankful for my Physiology and Virology that made me sound like I sort of knew what I was talking about. And sometimes, well,  I was a rock star. But not in the way that you want to be a rock star. Turns out, after seeing enough cases of lymphatic filarisis walking around, you can diagnose elephantiasis on the spot and know right away that there is nothing you could do for them. I can diagnose severe malnutrition in an infant with a fever faster than a 4^th year med student (orange hair means that a black baby is so deprived of amino acids that their body has stopped making melanin). And mosquito-borne illnesses? Let me tell you about them. These are illnesses I will see rarely, if ever, in the USA but are incredibly common here. 

Malnutrition is heartbreaking. Let’s go back to this orange-haired infant. She comes in and she is one sick little baby. So we give her medicines and some vitamins but… it isn't going to be enough. You know this baby is going to just get sicker and sicker and there is nothing you can do. Mom doesn’t have money for food, there are 2 other kids at home, and we are highly suspicious that the mother is infected with HIV. So I do what any other else would do: I search around to see what leftovers from lunch we can offer them. Someone finds a container of baby food to give to the mother. But really, what does that PB&J sandwich mean a week from now? How about in a month when the children’s vitamins run out? I did what I could do in the day we saw them, sending them off with toothbrushes and soap and sandwiches and medicines, but I just can’t get this family out of my head. Lottery of birth put us on opposite sides of the table and I would hope that if roles were reversed, she would be having the same thoughts.

Chronic diseases are still chronic, even if we can hand you a month of pills. “Ma’am, has anyone ever told you you have dangerously high blood pressure?” “Yes, I had some pills that the last group gave me but I ran out a couple of months ago.” Medical missions are desperately needed in Haiti and fill a gap in rural and desperately poor areas that the Haitian medical system cannot handle. Still, the gaps remain. Limited supplies mean each person gets a 30 day supply and then these people are out of luck if they cannot afford more medication to carry them between groups. There are some groups that work in conjunction with the nursing school to address this gap: they hire a nurse to go to where they held their clinics on a monthly basis to manage long term care, but this is not an option for all groups.   

Haiti has hooked me. As I walk through my final 5 weeks on this little island, I am immensely and continually happy about its geographic location. I have a privilege that many of my fellow YASCers do not have: the ability to have a long and intimate relationship with this country. Throughout the week, I found myself making notes for when I am back, leading medical groups. Nursing student friends talk about the rural places they want to go and work with me as a physician in the years to come. Someone said to me once that Haiti gets under your skin and you can never truly let go of it once you get infected. But I think it has also gotten into my heart. And I am so incredibly happy that this relationship does not end in a little over a month, but can continue on. 

Sick

I got sick last week. On my back, high fever, “if I don’t leave this exact position the world will be ok” sick. One day, a lot of caring friends, and a handful of medications and I was back in fighting form. But I was thinking about what it took me to get there. There was the Advil and antibiotic that I just had to grab from under my bed. The friend I sent to the market to buy crackers and soda. The fan that ran when we had electricity.  The running water in the bathroom next door that I could use to cool down. Let’s not even talk about the fact that I live with 80 nurses or nurses-to-be who could do basically anything I needed.

The extent of my privilege sneaks up on me some days. Most days, it is the obvious things. I have a computer and an iPhone. I have a car at home. There was never a question of if I could go to school. I have traveled. But as I was curled up in a miserable ball on my bed, wishing for air conditioning and  my mom, I recognized my privilege once again. Everyday at the hospital, I hear about patients who can’t afford medicines, can’t afford lab tests, can’t afford food to take their medications with. It is exhausting and could quickly clear out both my bank account and emotional reserves. So you build up walls and it stops affecting you so much. Great for getting through the everyday. But it certainly does stop you from seeing the human element: until you find yourself faced with it.

As I make my way through the ever-increasing stack of development literature I want to read, there is a lot of discussion of basic rights: people deserve clean drinking water, food, shelter medications. After last week, I want to make this list more explicit. People deserve crackers and Sprite when their stomach is sick. They deserve Tylenol and the occasional dose of Ciproflaxcin. They deserve water to cool their sweating brows and electricity to run a fan by. And they deserve a bed to curl up on.

Women

There was an awesome NYTimes Op ed two weeks ago entitled “What’s So Scary about Smart Girls.” For those of you who don’t feel like reading the article or who have already exceeded your 10 free reads for the month, here’s the summary (but you should read it). Kristof writes in response to the kidnapping of 200 highly educated girls in Nigeria. He says that in this heinous, unthinkable act, there is a high degree of rationality on the part of the fanatics. Educated women, in effect, cause change. We can see countless examples around the world and the reasons are fairly logical. Educated women mean fewer children, both because women are more educated about sexual health and because, frankly, they are busy. Fewer children means more investment in each child, ramping up the percentage of education and ramping down disease in generations to come. Secondarily, by educating women, you are doubling your workforce and adding brilliant new minds to the national discussion. Where would we be as a country if Hilary Clinton, Barbara Walters, and Marie Curie could not read.

I had an extremely privileged education and readily recognize that even in the USA, there is a lot to be done to educate all people, but especially minorities. We need more women in STEM and in upper level management. But let’s come to Haiti for a second.

Compared to Nigeria, Haiti is lucky on two fronts. One, it is a fairly liberal country. In no way are women equal to men: even if a woman works, she is expected to cook, clean, care for the children, and do laundry, all of which here, with limited technology, create a greater than full time job. Domestic abuse is a huge and undiscussed problem. In this strongly hierarchical structure, it can be hard for a woman to get her opinion heard. I could go on. But increasingly, girls and boys are educated side by side with almost the same level of interest in sending them to school (remember that you must pay for almost all education in Haiti.) Secondarily, Haiti is not a war zone. Their resources have been depleted and no one is trying to take their land. Haiti does not have a military and does not need one. They can invest what resources they have in other places. A huge advantage.

Still, it makes me feel good that I teach at a school that is 90% women. Where women’s rights are frequently discussed and how to improve women’s health and women’s positions in society are areas of concern. I live with some incredibly smart girls. And the fanatics should be terrified of them: they will change the world. 

I'm a Movie Star!

Remember when the film crew came back in November? Here is the video! It is featuring the Volunteers in Mission (they didn't like the name "Older Adult Service Corps") but both Ashley and I make cameo appearances.

I am the one wearing hot pink and making jazz hands around 1:40. So, you know, the usual. 

Oops! Apparently there is a problem with the video! Here is a link to the original! 

Prise des Coiffes

On Saturday we celebrated the capping ceremony of our 1st year students. For them, it marks their successful completion of the very difficult first semester and their ability to begin working with patients. I was so proud of the students---many of them had struggled and worked very hard and were just so happy to have this chance to be recognized. Their friends and family were there and it was a spectacular event. 

Pre-Capping!

Alumni capped the new students 

Me with a gathering of the first year after the ceremony!

Some upperclassmen and alumni.