Haitian parenting, gender roles and the story of dimples

Since noon, a tropical storm has perched its horrible, languid self over Montrouis and buried Canaan in somber grey. It’s the kind of idle day I long for at home. Staying indoors, reading, taking naps. But in Haiti, it’s miserable not being able to get out and explore.

Especially when it’s Friday when work is finished, and the beach is a 15-minute walk down a mountain.

Since beach-destined paperbacks and my iPod’s indie rock genre were re-routed to my bunk bed and absorbed most of today’s boredom shockwaves, I’ll share a few things I’ve been saving up.

Last week, we drove a mother and her 8 mo. old daughter to St. Marc for an X-ray. Tired bodies crushed together in the truck, cramped with our mobile Mamba clinic supplies.

Haitians stuck out their thumbs like hitchhikers or waved at us with both arms as we passed, asking for a ride in the empty truck bed. Younger children jumped in as it bumped along, some naked and careless and not bothering with any gestured formality.

The young mother breastfed her daughter and shielded her baby’s eyes while the truck lurched up and down the mountainside. After working the Mamba clinic for the past two weeks and seeing so many young mothers or female caretakers detached from their children, I was struck by the tenderness of the gesture. Cradling the tiny girl’s head under her breast, clucking softly to the baby, and of course the willingness to cram herself in the truck alongside strangers to drive to a far-off hospital, seemed almost beyond the call of duty for the typical mother.

Affection is often treated like it's impractical.

My first week here, Elsie told me a “good” mother provides enough food for her children to live without starving; that’s all that’s required to meet that guideline. I refused to believe that can be true, at least not entirely.

She told me a story about a young missionary woman who went to the beach and saw a Haitian toddler alone. She played with the child while the parents watched not far away. When it was time for the missionary to leave, the parents emerged and, seeing the young woman absolutely adored the child, put the baby back into her arms and asked her to “keep.” Shocked, the young missionary refused.

However, the next morning, the parents arrived at Canaan with the child dressed neatly in her best clothes, clean and perfumed, to ask the missionary to, please, take their child. For real. To keep. The parents had discussed it seriously all night and decided they wanted to give their baby to the missionary. They did not love the girl, and knew she would be better off with someone who did. Once again, the missionary refused – she couldn’t just put a baby in her carry-on back to the states – but Elsie said it was a lesson in Haitian parenting.

Detachment is a survival mechanism. Show someone else’s baby love, she warned, and they might just try to give their child away.

But there are exceptions for everything.

Single mothers make up the bulk of Haitian family units from my experience in Montrouis. Women of some relation raise the children, commonly older daughters or grandmothers, while the mothers are at the market during the day, bartering and selling. Fathers are absent from the picture, some working their cattle under the banana trees, some in odd-jobs in Port-au-Prince, while the kids grow up.

The women at Canaan hired to take care of the babies at the nursery are my age. Early 20s. No experience with children. Yet they’re living like many Haitian women that age— 24/7 single moms.

It’s been rare from my experience so far, but there are some fathers actively raising and loving on their children. For example, every week, this adorable Haitian dad proudly totes his all-pink bundle of a 5 mo. old girl. The baby’s mother died shortly after giving birth of infection. Malnourished and sick, she was enrolled in the milk program at CESANOJE – open to infants under 6 months who do not qualify for the peanut-butter based Mamba. This dad, however, took all responsibility of child rearing. The baby’s finally alert and putting some chub on her little cheeks, only months ago hollowed with starvation.

Most of the “orphaned” children at Canaan are actually just motherless. Many have fathers or older siblings that live in Montrouis and the surrounding towns. But without a mother, the family unit crumbles. Just this week, a father asked us to take his little boy and presented us with his mother’s death certificate.

Dead mothers make orphans. Dead fathers make hungrier bellies.

Working at Canaan, I’ve noticed distinct gender roles. The men are laborers, in charge of maintenance and construction around the orphanage, clinic and school. The women do the cooking, the cleaning, and all the laundry. None of the men here do their own laundry, not even the boys in the orphanage – the girls inherit that chore. Ironically, the women at Canaan hold the powerful leadership positions when it comes to leading incoming missionary groups and negotiating donations with non-profit relief agencies.

Even the clothes here are gendered. Men wear pants and jeans, while women wear dresses and skirts paired with Ts and the occasional tank top. Some of the bolder 20-somethings wear tight Capri pants. I’ve never see shorts, except on hairy white legs of missionary men and on young girls chasing through slums of Port-au-Prince’s.

Just yesterday, Doctor Jean Robert and I were sipping our black coffee after breakfast, when we received a call. Without a goodbye, he shoved his dirty dishes in my direction and walked off, leaving me fuming. Was he handing me his dirty dishes because I was a woman? Everyone took care of their own dishes and did their own washing, and I pointed this out to the doctor later that day. He seemed unruffled, and I decided to resign myself to cultural norms. If I didn’t pick up his dirty dishes, one of the overworked Haitian women would have to do it.

Doesn’t make it any easier to swallow without resentment.

The gender distinction is particularly interesting when Caroline and I are on Mamba duties. Two white woman driving through town to pick up food is met by laughing men, partly in surprise and more in rude amusement, following us in a herd as we load up the 50 lb sacks of white Texas rice and pinto beans. Women, in our festive skirts and poker faces, carrying our heavy loads to the truck bed while they shake their heads and grin as if to tell us, this ain’t no women’s work.

Cute Haitian Folklore: The Origin of Dimples

The Haitian doctor working at CESANOJE (nickname for Canaan’s community clinic, Center de Santé Nouvelle Jerusalem), shared with me some cute folklore: The story of dimples.

When Haitians talk about dimples, they also point to their lower backs, where the spine curves into the buttocks.

To get dimples, a mother has to push her fingers hard into her baby’s cheeks and lower back during those formative days. Then, voila! Dimples. If someone doesn’t have dimples, their mother either didn’t take an active role in the dimple making, or push hard enough.

Every time I see a Haitian with dimples, I can’t help but smile and imagine a mother’s fingers prodding the cheerful indentions.

Mango guts, melon cores and chunky Mamba thighs

Posing with the fruit purchases... so happy!

Mangos smell rich and womanly under their soft yellow skins, sweet and steamy and damp like fresh mountain rain. Their perfume mesmerized me as I zigzagged through Montrouis’ open market, skirts swishing as women bargained and young boys begged, their hands held open like empty prayers.

After dulling my palate with two weeks of rice, pasta and white bread, the flavor almost choked me. There’s something embarrassingly sensual about biting into a mango, tearing the skin with your teeth. Juices dripped down my chin, and I felt like a child. Or a vampire, sucking zealously on raw flesh.

The texture of a mango is similar to a fine pâté once you get past the stringy bits near the skin. The hard core is a palm-sized heart, emerging from the goopy fruit almost alive, like the trembling meat in an oyster shell. I saw children sucking on the mango hearts like lollypops, leaving the cores smooth and brown.

I had never peeled a mango before, and some of the younger Canaan girls laughed as my fingers clumsily stripped the fruit to keep the precious orange heartstrings intact. The 12-year-old, Marceline, took the mango from me and stripped it meticulously with a knife, peeling it like a sweet potato. Under the swaying tungsten kitchen lights, the naked mango looked and felt like a slimy fist of raw chicken.

Our purchases from the market, minus a couple of mangos we couldn't wait to devour.

Caroline, the full-time director of the Medika Mamba malnutrition program in Montrouis arrived back at Canaan this week from a month-long hiatus. She picked up Creole after only four months mission work thanks to her background in French. I would have been lost without her navigation through the Montrouis fruit venders.

The key, Caroline said, was to play the vendors against one another and let them compete for business. We drove the Mamba truck to the middle of Montrouis to exchange USD for goudes. A bare-chested Haitian man lazily flicked at flies as he did the transaction: 800 goudes for $20 (40 goudes for every dollar).

The market starts on the curb of the winding highway of down-town Montrouis and extends a hair's length from honking tap taps or gestures of high-speed passers-by, filling the market with a stench of diesel. Haiti's Rte 1 cuts through the market's bustle, while a tangle of merchants with massive bowls or cracked tupperware aggressively wander like auctioneers. The more relaxed of the vendors sit under lopsided shelters, displaying everything from glass-bottled beverages to raw meat dizzy with flies.

As soon as we had money, women with huge bowls of melons, avocados, limes, mangos and spiky green and brown fruits I’ve never seen before swamped us. Unable to negotiate in the chaos, with fruits thrust under our noses and rubbed against our skin amid yells of “bon bagay!” (meaning, “good thing!” in Creole), we climbed in the truck and rolled down one of the windows. Caroline bargained ruthlessly, chastising the women as they advertised their wares at twice the street value to us blancs.

When we finally agreed on a fair price, the rapidly truck filled with fruit:

For $5 (US), we bought 13 plump, healthy avocados, picked that morning just miles down the road.

For $1, a handful of fragrant limes. For $2.50 a piece, two swollen and aromatic melons.

For $5, a bucket of mangos, warm from the afternoon sun, that made us drunk and salivating from sweetness.

Total price: $16 US, and we watched as two of the women strutted back home, finally selling all their goods after a long day at the market.

Caroline, Amy, Robin and I devoured the fruit, speaking only with “mmm”s and “ahhh”s.

The avocados need a few days to ripen, but with some garlic, lime juice, salt and pepper, we plan to make guacamole to eat on chips that a missionary team is bringing for us Saturday, per Caroline’s request. We prepared a fruit salad with the mangos and melon, juices marrying in a ceramic mixing bowl and nestled in one of Canaan’s industrial-sized refrigerators. I hope we can stretch it out over all our meals tomorrow, but we put such a dent in the mangos we might be back at market tomorrow.

Today was incredibly fulfilling, in addition to belly-filling. Canaan operates on routine, and I’ve fallen into the predictable cadence as I start my third week in Haiti. Wednesday means Medika Mamba at Rousseau, the rural hospital in the mountains. 

We had quite a few babies graduate from the peanut-butter based malnutrition program today at Rousseau, and Montrouis Tuesday. I love seeing emaciated babies transformed into giggling bundles of meaty arms and chunky thighs. We document these transformations with photographs, and the difference is astounding.

Graduation from the Medika Mamba program is the difference between shriveled, stunted bodies and those healthy rolls that make me smile. It’s death conquered by vitamins, protein and crucial calories.

Women and babies line up for Mamba assessments at Rousseau Hospital.

Twins get undressed to be weighed and examined.

I am exhausted, though. Caroline led us on a 2-hour hike into the mountains. My sweat glands were on overdrive as we climbed the steep rocky path. Like most afternoons, the air felt smarmy and damp and made my glasses slip incessantly down my nose. Out of nowhere, the mountains in the northeast echoed with thunder, and my sweat mingled with dense raindrops.

It’s so peaceful here, watching lightning blaze in the mountains while the coast is serene, untouched blue.

Haitian bourgeoise and fast food cravings

I lived one night like a Haitian bourgeoisie. It was an interesting opportunity to experience Haiti’s frightening rift between the rich and poor.

It’s the difference between mud and mansions.

We drove into Port-au-Prince Saturday night with Sister Glady to her deceased mother’s home, up in the mountains overlooking a portion of the earthquake-desecrated residential areas.

As we passed through Port, every wall and building is splashed with ugly political graffiti from the recent election, bearing candidates’ names and ballot numbers. The rich residential area was also violated by spray paint, but all the ugly melted away as we pulled the truck behind barbed yellow gates.

The house was gargantuan and stately, two-stories surrounded by curling flowers and bushes. It had elegant windows covered in ornate metalwork, scrolling hearts and crosses painted a lovely shade of yellow.

The stairs and floor was covered in colorful glazed stone with the same smooth texture as bathroom tiles. Every room (the rooms seemed endless, with multiple bedrooms and bathrooms and parlors) was decorated in Haitian paintings, hammered metal artwork, and tight woven baskets and vases. The furniture was inviting and cozy under the towering ceiling.

Two of Sister Gladys’ brothers were fixing up the house and were there to greet us. They have been adding bunk beds and accommodations for large missionary groups that come to Port-au-Prince to do relief work and construction.

Like most Haitian households, the windows were carefully positioned around the house to maximize ventilation and airflow. There was a constant breeze that chilled the house in the absence of AC. I love how careful construction can eliminate the need for AC and conserve a ton of energy, especially in a place with notoriously hot weather.

Sunday transformed the city. Port-au-Prince was tamed to easy traffic, well-dressed churchgoers, and crows strolling lazily to the market. There was less honking, less chaos, and a colorful city at ease. Besides a man jumping in the bed of our truck and attempting to steal Katie’s suitcase (VERY unsuccessfully… we had that sucker bound right under a tarp!), the drive was much more peaceful than my past ventures.

We dropped Katie and decided to take advantage of the vacant streets and tour Port-au-Prince by truck. We passed the rubble of downtown, and Sister Gladys pointed out a collapsed third story of a school, where more than 300 children perished to falling cement and earthquake tremors. We drove by the presidential palace, still in ruins and surrounded by matchbox-shaped tents and shacks where the most beautiful park in Port used to flourish.

I remembered a conversation I had with Sister Gladys’ brother, Jean, who was born and met his wife in Port. His wife came back to Haiti after spending 40 years in the U.S., and cried as she walked the streets of her childhood. Cherished memories were replaced by pain and ugliness.

I visualized her tears mingling with the trash and filth of tent city and wished they were enough to make it go away, to heal this broken community.

The English church, Port-au-Prince Fellowship, was a solid reminder that faith can bridge cultural differences. For every foreign missionary, there was a Haitian dancing, clapping and joining in the worship. The band was led by an American man playing guitar, but backed up by an all-Haitian band: 4 women on vocals, a man on keyboard, a man on drums, a woman on saxophone.

I felt at home. The sound of English swelling out the open windows to mingle with the Creole voices at the Haitian churches in service next door made me feel united. I was reminded that Christians bridge the gap between Haiti and home, in this culture different in so many ways from my own.

We ate Haitian fast food after church and met up with Shirley and Alex, a young couple and friends of Sister Gladys who opened a young boys’ orphanage in Port-au-Prince last year. The sandwich, French fries and vanilla cupcake was delicious, but loaded with Mayonnaise and other condiments. Epi d’Or is an extremely popular fast food joint in Port, and offers everything from bacon cheeseburgers and ice cream to traditional Haitian food and cakes. Like the grocery store we visited in Port, the building was huge, packed with people of all nationalities and walks of life, and guarded heavily by security officials carrying impressive guns.

But I’m back to reality now, listening to someone’s donkey braying and the soft whack of a machete in the garden.

I’ll be up late tonight typing a clinic report for the organization overhaul I hope to finish soon. It’s looking fantastic, and we have a huge donation of surplus supplies, including Lactated Ringer’s for cholera, for the hospital in Petit Gôave. Montrouis is not well equipped by any means, but it’s great to see medical supplies pooled where they’re most needed.

Tonight, I have had education on my mind. For a Haitian family to put their child in kindergarten, the cost is around 1500 Haitian dollars a month – a sum out of reach for most families. Education is not free here like it is in the U.S. Many of the schools are pumping money directly into the pockets of corrupt government leaders. Without education, these kids will not be equipped to move Haiti forward. Please pray with me for available primary education and an end to government corruption.

Petit Gôave, kerosene lamps and culture shock

The blanc, white girl with glasses and eyes that squint in the unforgiving Haitian sun. A source of comedy. I watch, numb and awkward, as an old woman seizes my hand and pumps it up and down, shouting a mocking “Bonswa, blanc!” and calling out to her neighbors, forming a tight circle around me and the Canaan kids I have been walking with through the tent city of Petit Gôave, a coastal city south of Port hit hard by the earthquake.  

Singled out, shouted at, grabbed and jostled. It was culture shock Friday. Temporary paralysis and humiliation followed.

It’s an area wrought with cholera and parasites. I pulled my face into an awkward smile and fought the urge to pull out my hand sanitizer. The kids I escorted stared at the dirt as the people hurled insults at me and the three other American women I walked with. It started out as a harmless greeting – white people are a rarity in this area and blanc is more to identify someone as non-Haitian than a charged racial comment.

Two boys who lived at an orphanage in Petit Gôave were leading us to see the new houses their Christian alliance has provided for the broken community. I imagine we looked like a mismatched parade. I held some of the younger girls’ hands as we walked through shacks bearing USAID tarps and the. Men and women clad in clothing castaways from the U.S. (graphic Ts from every forgotten Middle School team to College fandom, cheerleader uniforms, even torn Barbie ballgowns) would occasionally shout blanc and point a finger our way, mouths gaping and then erupting in laughter.

One of the older girls instructed me in succinct English to keep my eyes low and ignore their Bonswas. We were now attracting a large crowd. Anxiety bloomed with the lush banana trees and mimosas. I saw a man walking our way heft his machete in our direction—the tool of a worker, used to slash through the thick stems of banana trees and not an uncommon sight—to point us out to his children. I felt a lurch or fear as we finally stopped and turned around. No one wanted to see the rest of the houses anymore. We were already to get away.

I was exhausted, and what had started out as a day promising the beach and relaxation had somehow brought us here: in the midst of rural Chaos and unsettling poverty, walking through the slums of Port Gôave and trying not to stare at the tattered clothing and stink og feces. Six hours in the back of a bouncing truck, south past the traffic of Port-au-Prince, simultaneous dehydrated and needing to pee, and finally arriving at Sister Gladys’ city of birth alongside 20 Canaan kids, all coated in smoke and dust.

Then, the climax. The old woman who had put my handshake and glasses on display had followed us. Now, she straddled the dirt path, blocking us from passing. As she balanced a large aluminum tub on top her head, she gave me a toothless grin and started shouted to another woman nearby. She shouted back, and they started gesturing one another aggressively.

Still clinging onto the hand of a little girl, I felt myself pushed around the shouting woman and running down the path alongside 20 others. Through closed teeth, the older Canaan girl told me the woman was saying she wanted to fight us – to fight the blancs who had arrived in their part of town. She said if we crossed her path and touched her or any of her neighbors, she would fight us.

We half walked, half ran from the tent city, past a dried up river where some cattle and goats were tied, through sludgy green sewer run off, and down crusty streets to the safety of Sister Gladys and the orphanage.

Later, when we told Sister Gladys what had happened, she tutted her tongue in disbelief. "The people of Petit Gôave are warm and welcoming people. They must be getting restless." She said it was doubtful any harm would come to us, but we all felt uneasy at the display, the drama.

Could it be boredom? Or is there something brewing in Petit Gôave. It's been two years since the earthquake, and still half the city is leveled and confined to tent city. Nothing has been done for these people. They are another sad story, buried in rubble as deep as Port-au-Prince.

We ate Haitian food at a long table accommodating pastors and their wives. I found it interesting that while they all spoke Creole as their langue maternalle, their meeting was conducted only in French -- the language of elite education. It was ironic that a group dedicated to building homes, providing medical care and food for earthquake survivors, many illiterate and Creole speaking, chose to express themselves with the golden tongue of the Haitian bourgeoisie.

Sister Gladys herded us to the steaming bowls of rice, stewed greens in a flavorful sauce, and a small dish of tender meat. It was the most delicious meal I have had here. We washed it down with Coke in glass bottles, made from real sugar and not high fructose corn syrup. It reminded me of my trips to Mexico in high school, and lugging our glass bottles back to the small shops for a few pesos refund. I finally felt the life creep back into my legs, and it was already time to make the drive back to Montrouis and Canaan.

The drive back was even more jarring, but just as long—hours of retracing the grime and alternating scenes of towering mountains, glaring ocean and bustling commerce. The church bench we had put in the back of the truck collapsed from all the jolts, so Katie and I sat on the floor where the dust from the road slapped our tired faces.

Port-au-Prince is sensational at night. The women, crouched next to their market stalls since early in the morning, light kerosene lanterns to display their wares into the evening. Stereos boom like thunder. The flames burn high and seem to lap at their faces, mysterious and reminding me of the gypsies and fortune tellers in New Orleans’ Jackson Square. I wondered how easy it would be for one overturned lantern to burn down the entire tent city—people and booths and their dwellings and the trash are so packed together they’re sometimes indistinguishable.

As we rumbled over the last stretch of highway to Montrouis, I looked out behind me. The city lights bobbed and hovered like stars – an arm of cosmos molded in the arm of mountainside stretching to the coast.

The crowds did not seem to thin, but less children walked the streets at night. Men strolled loudly on the sidewalks and swerved through the streets on loud mopeds. Police men with rifles strapped to their chests and pistols in their fist stood stoically on intersections. Waiting.

I hastily rinsed off and collapsed in my bed. I felt like I’d never wake up, but rose with the sun (and the barking dogs) at 5:30 this morning.

It’s nice and breezy this afternoon, although I’m dripping sweat. I just hung up my laundry to dry, and I’m so glad I packed few items of clothing. It took me hardly 20 min to scrub finish. I read while the other missionaries labored at least an hour over their clothing. We might be heading with Sister Gladys to Port again this afternoon. I’m praying for some more rain and a safe and less painful ride.

Haitian hospitals, Medicine food and Creole lessons

Child with Kwashiorkor symptoms.

It has been a week and a day since I arrived in Haiti, but it feels like longer. There was a funeral at Canaan for a man of Montrouis, and I have part of the tune stuck in my head. It reminded me of a New Orleans jazz funeral –- several trumpets and a trombone player played a lively waltz rather than a somber melody. It was a colorful affair, which I peeked at through the steel-barred clinic windows.

I had my first Creole lesson today! Pastor Joelle’s wife taught us the Creole Alfabét, which is almost exactly the same as French, and some basic classroom vocabulary for the women working as English teachers.

Here are a few works of the day that will be useful for the clinic, especially when directing patients to their place while taking vitals:

Chita (la) = sit (here)

(Pa) kanpé la  = (don’t) stand here

Sòti  = go out

Rantré/ antré = come in

My morning was rather monotonous. Katie and I resumed cleaning the clinic storage room and sorting supplies that we think need to be donated to the local hospitals. I’ll be typing the list for Sister Gladys this weekend.

We had to put a lot of supplies in a trash pile for being either trampled in the chaos, covered in dust or bug bits, and some once-sterile containers chewed through by rats. It was also frustrating to see so many surgical supplies YEARS past the expiration date, thrown messily in rotting boxes. It’s fantastic that American medical supply companies are donating to Haiti, but medicines and wound prep kits “good until 2001” aren’t ideal.

View of the mountains through the Mamba truck window, on our way to Rousseau Hospital.

We sang along to Adele from my iPod Touch until our feet were gray from shuffling around in dust.

Here’s my reflection of the day: Why in the world would a rural primary care clinic need Foley catheters, sterile bone saws with leg amputation bags and around 1,000 surgical gowns? It may be a dream down the road to offer care in emergency situations, but for now Canaan doesn’t have the resources (or the space!) to store these supplies. They need to go where there’s a pressing need or them, like the hospitals in Pierre Payan, St. Marc and Rousseau, with specialty doctors on staff to address these needs. Otherwise they’ll end up like the pile we trashed—dirty, rat-eaten and unusable.

Yesterday I woke up with nausea and abdominal pain. I had to sit with my head between my knees so I wouldn’t start dry heaving at breakfast. The change in diet has disrupted my digestion, but who knows exactly what set it off. However, it was a busy day and I had no time to take it easy.

Doctor Jean Robert prescribed me some medication that the pharmacist, Henry, only gave me after teasing me in drawling French. Katie and I, along with Mis Elise and a translator from Canaan, hurriedly loaded the Mamba truck and drove 45 min to Rousseau, a hospital and health center deeper into the mountains than Montrouis.

It was the bumpiest drive I’ve ever been on. We passed a thick river, with naked children washing laundry and stretching linens to dry over skull-white stones. With their thumbs out like hitchhikers, people from Montrouis hailed us to stop so they could jump in the bed and catch a ride along the steep road.

The hospital was nice, but crammed with people waiting for consultations. We set up the Mamba supplies as mothers and grandmothers lined up on a crooked bench. Some of the children were so malnourished that their ages were indiscernible. A mother brought her 5-year-old son, smaller than the 2-year-old I babysit back home. He weighed a shocking 11 kg. An 8-year-old girl weighed only 14 kg, but could not be admitted into the Mamba program because of her age. The nurse gave her bags of rice. We also gave every family we saw to large bags of dehydrated soup – aid for parents as shriveled as their sick babies.

Here, food is medicine.

Rousseau Hospital. My camera was fogging up all day.

We admitted a new baby into the program that had severe edema (swelling) of his legs and belly. The edema is a symptom of Kwashiorkor, a form of malnutrition when the diet doesn't provide enough protein. He looked like a cartoon, his skin suctioned to his rib cage, while his legs and belly swelled like balloons. He was burning up with fever, but we were out of antibiotics. It was horrible feeling to let him leave without proper medication. 

We finished the Rousseau Mamba consultations at noon. After a quick lunch at Canaan, Katie and I drove one of the young mothers and her sick 6 mo. old baby to the hospital in St. Marc for a chest X-ray. A doctor living in the states who serves Canaan in his spare time agreed to take on the baby as a patient. She has strange dimples in her chest, as if her rib cage has been pushed too far back. There’s strangeness in the way it juts, and the baby sounds like she has pneumonia or some kind of lung infection.We didn't have to wait too long for the X-ray, and there were no lead coats for protection. I stepped outside to put a cement wall between my body and the radiation.

I saw my first Emergency Room in Haiti at the St. Marc hospital. It was a large room, smaller than a waiting room from one of the hospitals I work at in Baton Rouge. Mismatched beds were squeezed together like an infirmary. The room was hot and still, except for a single ceiling fan. I can't imagine laying in that stagnant heat for treatment.

I was exhausted and still felt sick after the long day. After dinner, I fell immediately asleep and did not wake up until 6 am this morning: 11 hours, through the generator being turned on and off, without moving. I’m feeling better, but the pain comes and goes.

Mamba clinic, tap taps and collossal clutter

 
More than 100 patients checked in at the Centre de Santé Nouvelle Jerusalem since 6 am. By 1:21 pm, 75 were still waiting to be seen by a nurse or doctor. 

The numbers alone were discouraging. As much as I am an aspiring med student, I don’t have the credentials to step in and help see patients. I know I am needed in other areas, but helplessness pains me.

The clinic is understaffed, especially on Tuesdays and Thursdays when the Mamba clinic is open. I helped Katie and Mis Joanne, the RN who runs the malnutrition program year-round, weigh babies and check-in children (aged 4 and under) who qualified as malnourished to participate in the 8-week program.

This little pink house is perched on the hill above the clinic. Empty, but with an amazing view.

Depending on the child’s weight that week, they receive lime-green plastic pouches of Mamba: essentially peanut butter and vitamins. It was disappointing to see some graduates of the program once again returning as malnourished.

It’s absolutely crazy to me, but the program never worries about peanut allergies. There are none. Katie told me that when the babies are malnourished, they have no immune system. Without a functioning immune system, there are no allergies.

Christian Aid Ministries (CAM) made a delivery of medicine, which lifted our moods and even made the stern pharmacists smile. Katie left for an hour, and I took some infant patients on my own. Scary, in the sense that I was expected to pick up the process immediately, but also exciting!

The communication barrier has crumbled a bit today, too. I’ve picked up little phrases in Creole, and Christiane, one of the girls from Canaan, translates at Mamba each week. It was immensely helpful when explaining the program to the new Mamba initiates. Sister Gladys got back from the states yesterday evening, and she has promised to start daily Creole classes for the American staff. I’m starting to feel at home here, and I’m so encouraged to have a willing teacher.

When I finished taking vitals and checking patients in, my final number resting around 104 with people still registering. People are usually turned away at number 80 or so, except for children and elderly. But today that’s all I saw – mothers cradling their babies too sick to cry. An old woman curled into the fetal position on the concrete slab of sidewalk, ending abruptly at a field where goats and chickens wandered.

I heard one of the nurses whisper in exasperation, “We have an old woman outside, dying before she sees the doctor!” I felt so frustrated that there was no way to speed it up.

The shaded waiting area was too packed with others, like the old women, sick and waiting. They possess a disturbing patience with the slow-progressing consultations, something I hardly see at the Baton Rouge hospitals.

I suppose it’s better than the alternative: Nothing.

Today was also the start of a colossal inventory of the clinic’s supply room(s).  The clutter was overwhelming. Katie and I spent a few hours of lunch digging through boxes of IV fluids, bandages, 52 pairs of crutches, and misc. medicine bottles (some in Hungarian!) among other things.

The storeroom is a classic example of how a plethora of cluttered medicine and supplies can actually limit resources. The staff often has no idea what medicines are available to treat patients. Katie told me that last week, there were several instances of antibiotic creams and medicines found only days after patients were sent away empty-handed.

There are stacks of surgical equipment and specialized machinery delivered in CAM shipments useless to the rural clinic. It might be better off donated to a Haitian hospital than gathering dust and bug casings.

If there’s a shortage, it’s in organization. I need patience if Sister Gladys passes this job onto me when Katie goes back to the states Sunday.

Here are a few photos of the chaos: 

On Monday, I finally had the chance to check over the EKG machine that’s been gathering dust in the X-ray room at the clinic. With the X-ray stuck in a shipment of necessary medical supplies in customs at Port Au-Prince (2 years as of this summer!), the room is used for spillover storage of supplies. It’s missing leads and the clinic has no electrodes to use. Unless they find parts, it’s useless. I would love to see the clinic receive a gently used EKG machine for the clinic. There are a lot of heart patients in Montrouis.

Burning garbage is becoming a familiar smell in Haiti.

Although the clinic was busy, I tap-tapped with the three staff women into St. Marc, about 30 minutes of lush land and sweaty bodies squashed together, thigh-to-thigh. We needed cleaning supplies for our non-flushing toilet, and I needed to exchange some dollars into Haitian goudes. The sickly sweet smell of burning plastic smoked the streets. The entire population spilled onto the streets, selling every kind of car part and mattress size and cell phone charger and bootlegged French film imaginable.

I mostly walked with my head down, watching my feet as the sidewalk became a sludgy ditch, a potholed reserve of rancid water, and a muddy slope of garbage. We walked, in line formation, straight to the grocery store and back from the tap-tap station.

Horrible green facials from our impromptu spa night.

I enjoyed St. Marc, but felt like a circus act with my loose blond hair. Strangers reached out to pat my head, poke my arm and pull at my plastic bag of snacks. I would not have felt very safe without Jacques, a 19-year-old from Canaan who went along to translate and chaperone. We returned and immediately treated our blackened feet to a dip in the paraffin wax machine. Impromptu spa night, complete with masques one of the missionaries left behind!

The sun has gone down and I’m getting mauled with mosquitoes right now, so time to reapply nasty deet to my body. The “all natural” repellant doesn’t work for me against these tiny heathens (they really are smaller than any ones from Louisiana!). Katie and Amy baked a chocolate bundt cake, so we invited the doctor Jean Robert and a couple of the older boys to help us enjoy it in the garden next to our house.

It could just be the scenery talking, but chocolate tastes so divine here.

Enjoying cake in the garden, while I hid behind the camera!

Creole worship and a rainy Sunday

The female staff house, where we spent most of today out of the rain.

It’s Sunday already, and my first time at a Creole Christian worship service. The Canaan church is a squat concrete building painted powder blue. The tin roof, coupled with short windows covered in mosquito wire, heats up the building like a convection oven. With no power during the day, the metal fans were lifeless and taunting on their wall mounts. I fanned myself with cardstock as we sang for an hour, repeating lines of gospel translated into Creole to different drum rhythms and pats of tambourines, and listened to Pastor Joelle’s sermon for another hour—the longest I’ve ever been in a church service. Breakfast had upset my stomach, so it felt even longer.

I had difficulty enjoying the new experience. The service was in Creole, and I caught snatches of the sermon when the Creole resembled French. One of the older Canaan girls was translating on and off, but I was too far away to catch what she was saying over Pastor Joelle’s bellowing voice as he paced back and forth behind the pulpit, his bible held high. This, like the singing, was very repetitive and met with generous rounds of “Meci, saviour!” and “Hallelujah, amen!” with upturned palms.

Half way through the service, a baby from the front pew started pulling on my skirt, so I pulled her on my lap and bounced her until she squirmed free and crawled to another woman in the row behind me. It melted my heart.

Again today, the clinic is closed. The three other staff women and I planned to go to St. Marc after church, but the tap taps (trucks you “tap” on the back of to catch a ride somewhere, like a public bus or open-air taxi) don’t run late Sunday afternoon and Pastor Joelle forbade us from leaving, in case we might be stranded. Since, I’ve had a lazy day that’s only made me a little homesick.

The sky was dreary and looked on the brink of a storm all day.

I tried interacting with some of the kids, but my duties as a clinic worker separate me from their chores and summer reading school schedules. Jessica, 13, took my arm and chatted with me in French and, without luck, tried to teach me “Leave me alone!” in Creole. I couldn’t quite nail down the syllables to repeat them correctly to her. Rosalie, 7, taught me “pays boire” and “za” (spelling?), to describe in Creole a “skinny tree” rooted outside the cafeteria door. 

I relieved one of the young girls of a baby she was carrying, a 16-month-old with saucer-sized, exploratory brown eyes, as she wiped down the cafeteria tables. The baby just stared at me, putting tiny, endearing fingerprints on my eyeglass lenses. Anyways, they’re constantly smudged and slipping down my nose as I perspire.

I’ve read for hours today and have a headache. There’s no happy medium for my eyes—reading in either squinting sun or mosquito/ dog-inhabited shade. Our house is dark, but we burn candles to keep out mosquitoes and gnats. Wearing glasses here has also it difficult in the sun because I can’t wear sunglasses AND see. If I were to do this again, I would definitely have brought a couple pairs of contact lenses and risked getting eye infections. Wearing glasses (and toting my flashy Canon camera) makes me stick out even more and feel pangs of guilt for owning these luxuries.

Our toilet is broken. We spend the afternoon waiting for Pastor Joelle to come help us with a repair, but turns out we’ll have to manually flush with a bucket of water and the occasional cup of bleach to prevent gagging episodes. That’s another thing taking adjustment – scarce water for bathing and flushing and other hygiene rituals that often seem so mindless back in the states, but are regarded as wasteful and luxurious here.

We missed lunch since we had originally planned to eat in St. Marc. To tide us over until dinner, I went with the women to make a sandwich in the kitchen, where thousands of flies were diving leisurely around the entrance. I had never been in the kitchen other than to put my dishes away, but we were met with the fierce stink of rotting food. Since the generator has been broken, the kitchen’s fridge and freezers have not had power. I almost went into an episode of dry heaving when I opened the fridge door to spaghetti sauce rimmed with a thick sponge of mold and the reek of decay. We tried the cupboards, and a very tubby rat ran screeching up the wall into a hole in the ceiling.  Appalled, but not yet totally having lost my appetite, we found some instant rice to snack on. The moment we poured the package into the pan, out dropped about a hundred tiny black squirming insects.

That’s when my appetite completely left me.

Needless to say, the meals are usually simple but flavorful. Other than some expected digestion issues, I have enjoyed everything that’s been prepared—usually varieties of pasta and rice with beans for protein. We ended up being called down for an early dinner around 4 pm, and my stomach is already grumbling as the sun goes down. Being hungry often is something I hope I’ll adjust to soon. It’s not pleasant, but here it’s a necessity. Food is expensive and not available to everyone.

Black expresso, Haitian style (minus the scoops of raw
sugar I've seen the older men and women drink!)

 

The most exciting thing that has happened today is the thunder and rain, plus my cup of morning black coffee. Rain means the week will be cooler, and the past few days we’ve had dark clouds… without the storm. But now, it’s a pleasant downpour. I’m glad I took my laundry off the line in the garden before it was soaked. It’s calming to hear the steady pings of rain on the tin roof of our house, and the earthy green smells it flushes into my bunk.

Tomorrow my duties at the clinic resume. I just want today to end...

Haitian Tourism: Egg Sandwiches and Club Indigo

Haiti is beautiful. This is a view from the beach of Montrouis at Club Indigo where I swam and walked all day.
The water feels delectable -- and so shockingly clear. 

Have you ever heard a pigs scream? It’s a pretty horrifying thing to wake up to, like vultures screeching. Katie told me later that she passed by a group of men standing by the pen, possibly preparing to harvest some meat. Amy said she thought it was a wild female pig, seducing Canaan’s male-only pigs, which made us all laugh.  

At least I’ll know where the bacon is coming from.

I slept in until 8 this morning and listened to Florence and the Machine on my bunk. It feels like camping out – the couch cushions and draped sheets of childhood sleepovers – with the mosquito net draped over me. No air conditioning, but my body is rapidly adjusting. I enjoy the heat.

The clinic, as well as the rest of Canaan, is closed on weekends. Most of the staff has families that live in St. Marque, Montrouis, and Port-au-Prince, among others, so the weekend is their opportunity to go home.  They stay in the dorm adjacent to the nursery during the week—free room and board, if they can rest with the screaming babies.

My delicious egg sandwich from the Haitian street vendor.

We also gave the kitchen staff off so we could sleep in and eat egg sandwiches from the vendor on National Route 1, which leads from Port to Montrouis. The egg sandwiches are the size of hamburgers, with thick po-boy style buns, ketchup, mayonnaise, hot sauce, straggly lettuce and “picklies” – a spicy salad of raw onions, jalapenos, pepper and vinegar. The woman who made our sandwiches came out and danced for us while Haitian radio blared, her arms outstretched wide as the horizon, her black body swaying as the food warmed on the press.

I’m rosy cheeked and raw after spending all day outside, near the beach. We drove the Mamba truck to Club Indigo, where Elsie is living with her (almost) adopted son. It’s one of the nicest resorts for miles. Before a hurricane hit Montrouis years ago, it was known as Club Mead and one of the largest gay beaches in Haiti. The beach was a hot spot for sex tourism, and HIV spread rapidly. Today Montrouis has a high concentration of SIDA, according to some clinic staff.

This is definitely one of Montrouis' tourist areas. Local men sold coconuts on the beach, and I caught snatches of
English from white vacationers (or possibly relief workers?) lounging with import beers.

Most of the Haitian vacationers here spoke French rather than Creole -- a symbol of status, education
and power in Haiti.

The sand on the beach was burning my feet, so I walked to the pool to cool off. As you can see, life here is
constantly enveloped in rich mountains. It started raining shortly after I took this photo.

Club Indigo was packed. I drank a frothy cappuccino and reapplied sunscreen almost religiously. It was wonderful and peaceful, and I was able to swim out in the crystal blue to a raft bobbing about 100m from the beach. I heard more French spoken than Creole, and even some English, as French is a sign of status and education in Haiti. It is a shocking transition from the slums of Sous-Bogne to Club Indigo.

I was able to treat my caffeine fix to a cappuccino at Club
Indigo, one of Montrouis' resorts. 

We ate dinner at the snack bar, which served greasy American foods like hamburgers and Cokes, and watched a movie at Elsie’s house. I snuck outside to watch the sunset on the ocean.

Breathtaking? Heck yes.

A boat was tied up just a short walk behind Elsie's home at Club Indigo.

The waters look so much more mellow at night than under the blazing equatorial sun.

The sunset was vibrant and so quick. The sun goes down here around 7, much
earlier than I'm used to since Haiti is so much closer to the equator than Louisiana.

The past couple evening the other three staff women from the U.S. have watched Friends episodes and painted their nails. A paraffin wax machine was, quite randomly, donated to the clinic from Christian Aid Ministries, so they’re planning on using it to sooth their calluses tonight.

The kids like Rihanna as much as Justin Bieber, and I’ve heard  “Oh nah nah, what’s my name…” sung from the cafeteria to the stoops of the water pump where the young men hang out and kick a semi-deflated soccer ball. Only snippets of the songs, never full verses.

A Haitian couple watched the sunset from the little raft off shore from Club Indigo's main beach.

I haven’t heard any American pop on the Haitian radio stations at Canaan, just Christian music in Creole, so I suppose they’ve heard the songs from the iPods and CDs of missionaries passing through. Katie said some Haitian radio stations play only American pop and rock, and many of the older Canaanites receive allowances for chores and good behavior to purchase their own laptops and iPods from the states. The DJ at Club Indigo today blasted techno versions of everything from Ke$ha to the Black Eyed Peas.

I’m in need of some silence right now. I am missing home a little bit. Making friends here is difficult because so many people pass through—and many goodbyes.

I’m praying for friendships and peace with my own transience.

At sunset, small motor boats hung their lanterns and bobbed between the mountains surrounding Club Indigo.

Sous-Bogne: The village down the hill

Just an anecdote I forgot to mention about yesterday: I walked to Sous-Bogne — a little neighborhood down the mountain from Canaan — with Katie, an Alabama med student and volunteer for the Mamba clinic, to meet with the mother of a 7 mo. old patient with an ectopic bladder. Katie needed their original birth certificates and ID cards to bring to the U.S. Embassy to get the family Visas. Without immediate approval to travel to the states, the little boy might miss the opportunity for surgery and risk disease and death.

The trash in Sous-Bogne (pronounced “sue boy”) was the first thing I noticed. The smell was next. The path was more shattered glass than dirt. Soggy cardboard and clothing, plastic detergent bottles and paint tins were strewn around concrete dwellings.

Tarps and screens woven from dried palm leaves crackled as groups of boys burst out, snickering and energetic as they played with plastic suture wrappers discarded from the clinic. Wiry, patchy-feathered chickens clucked under the walls of cacti and twisting succulents.

Katie told me Haitians build only when they have money, which explained the incomplete skeletons of cement and plaster scattered across the landscape. The missing slabs of concrete were often plugged with the woven-palm mats, worn blankets or even plastic jugs and garbage.

Just half a mile walk brings us into a staggeringly different living space. Just down the road, the resort Club Indigo houses upper-class Haitian vacationers, missionaries’ families, UN officials and foreign soldiers working in Montrouis. The gardens are pristine and manicured compared to the dismal grey, brown and muted greens of Sous-Bogne.

When we reached the house, Maddie, a 17-year-old from Canaan, translated. The baby was rolling on his back in the shade while his mother washed clothes in a large aluminum basin.

Le garçon has a grin-shaped slit on his belly where urine oozes from his kidneys. Since he is prone to infection, doctors are arranging a private jet to take him to Indiana to construct a bladder, close the opening, and possibly reconstruct genitalia. His penis never formed, and he has hernias on his testis. I don’t know whether or not his growth will be stunted, but he was a giggly, clingy baby with deep dimples and thin, loopy braids on his head.

It was sobering to realize the hurdles this infant and his family have to overcome to obtain adequate medical care.