Welcome to my blog!

This blog was created with the intention of sharing my life and midwifery experiences with my community as I branch into international midwifery. I hope to keep people up to date and in touch with me, and with the places and people where I'll be.

Monday, January 14, 2013

October 2012 to January 2013

23 October 2012 Yesterday I caught a baby with only my right hand. A woman was wheeled into the delivery room who was already pushing . As she came through the door, the head was coming out. I followed her in—the midwife who had been with her in labor was also by her side, but no one was doing anything to prepare for the birth. The midwife was yelling at her not to push, and even threatening that her baby could die and if so it would be her fault (for pushing in the wheelchair instead of on the table). The head was out, and I got ready to catch the body, which I had a feeling was going to fly out. The only thing was that I was holding a stack of papers in my left hand—in the fastness of the moment, I didn’t think of letting the papers drop to the floor—but instead, as the baby flew out of her as she sat on the edge of the wheelchair, I caught the flying baby with only my right hand. For a moment I thought that this would be my first baby to ever fall on the floor, but instead what happened was that my finger hooked inside the baby’s mouth and this helped me to keep the baby straddled on my right arm, while I kept holding the papers with my left hand. I told the mother that she didn’t need to worry—everything was okay, and I also gently told the midwife that it was not the mother’s fault for pushing—in fact her body was pushing on its own, without her effort. Actually, perhaps she was wheeled into the delivery room a little too late. It was a fun catch—my first one-handed catch (usually even if you were to have a one-handed catch, you would probably have a surface close by where the baby could gently land—like for instance if the mom was squatting on the floor). 27 October This month has gone by very fast. Each week flies by. Things are going okay, not great but definitely better than they were a few months ago. The arrival of Devon, the expat nurse, was a huge blessing for me. She has been helping me to implement things, like the temperature protocol in the delivery room, and is supportive and spends time with me in the wards; we do births together and she’s someone I can talk to…finally… I wouldn’t say that things are going so well with all of the national staff midwives but they are a little better than they were a few months ago. I feel that I have been in an impossible position, stretched between 2 worlds, always the person in front of the staff who receives the blows of their frustration, which is rooted long before my arrival. This week, I was so happy to have some cooler, cloudy and rainy days…but the rain, which was light and lasted 3 days, completely paralyzed the transportation system in Port au Prince…the roads have no canals which drain the water, and many of them are dirt roads…this light rain created a disaster—we had to work for 3 days straight organizing pickups of MSF staff by the MSF trucks, so that people could come to work…finally today the sun is out, and I am actually relieved and happy to see it, because now I can relax and know that people will come to work with no major problem… We find out about the date for our visa interview in a few days… 1 November Well, our interview was set for the 4th of December. So, another month away. This is somewhat disappointing for me because I am really ready to be finished with the whole process, which has taken the past 1 ½ years. But, it is okay. Blada and I are going to visit his family in Cap Haitian for about a week starting next weekend. It has been over a year since I’ve seen them. It will be so nice for me to have a break from the current situation of living in a way that feels segregated from the Haitian population. I am a homebody and don’t mind so much being closed in all the time at the house—I’m not really interested in going out to restaurants like everyone else here—since I’m not allowed to walk anywhere, there’s nothing I can do except work and hang out at home. Blada has been around here more because we were preparing for the visa interview, which we thought would be really soon, not the 4th of December. 3 November Luckily, this week had 2 holidays (Day of the dead) in which I was able to rest and recuperate a little. I was going to go in to work the first day, but instead I ended up working at home, working on these 2 reports I wanted to write, mostly to get some things out of my head and onto paper, which has always helped me. The first one, about the history of the problem of neonatal hypothermia in the hospital and the development & implementation of the strict temperature protocol, I wanted to do so that the new expat or few expats would hopefully not undo the work I have done in this area and would be able to see the complexity of something so simple as protecting newborns from getting cold. It was more straightforward and is mostly finished. The other one, it is about the complexities of working with the national staff here. This one has a long way to go, and it is mostly for myself, to get some of these absurd stories and events out of my head so I can stop thinking about them. It would be too long and detailed to give anyone else…it is more for me, something cathartic. This week I had no tolerance for the expats and felt I barely had the energy to interact with them at all. There is this one person who I like and is really nice, but who talks a lot and who requires a lot of energy to interact with. I think she took it personally that I could not interact with her but at the same time, when I am around someone who is giving me signs that they are not interested in talking with me, I follow the signs and go my way. This person, she never follows peoples signs but always has the exact same, long-winded, needing to have the last word kinds of conversations. This is not so bad though—I really like her, I just couldn’t spare any energy to interact with her. The bad part is that I am super fed up with some of the expats in the house, because they are completely unaware of others and are complete slobs. It is unbelievable. These are adults! I just don’t understand this mentality. Group living is hard, when you are living with people you would have not chosen ever to live with, who has completely different values from you. Mostly I am very tolerant, but there is one guy who really grates on my nerves, because he is so arrogant, he just does whatever he wants all the time, since he first arrived. And, he is unapproachable. Luckily, my vacation is coming up, in one week. Blade and I are going to Cap Haitian for 1 week to visit with his family. It has been over a year since I’ve seen them. I am so excited to be out, to be free, to be able to walk in the street, to be in a normal Haitian house, etc. I can’t wait. 2 December 2012 The month of November went by fast. I now have only 2 ½ months left!!! I know it will go by fast. Our fiancé visa interview is in 3 days. Once we are finished with this and have the visa in our hands, we will truly be in the last phase of our existence here. I am still enjoying parts of being in Haiti, of the Haitian people, which I know I will miss later on. But, in general, I am really ready for a change. It will have been 3 years for me here once we leave in February. I can’t wait to experience a totally different climate, to experience changing seasons, to eat other kinds of food, to reintegrate into my old community which supported me 10 years ago when I was preparing to go to midwifery school, and to be with my family again. I can’t wait to experience different things with Blada, like visiting NYC. I think about these things all the time. Work has been a lot better and easier the past couple of months. People have been a lot easier on me and seemingly more accepting of me. I also stopped vocalizing my observations, which was what they wanted in the first place (for me to leave them alone). But, nevertheless, things have been moving in the right direction because most of them now believe in the necessity of having a temperature protocol in the delivery room to protect the newborn babies, and I have been able to furnish all of the midwives and auxilliares with good quality reading material which supports my points. I found an excellent WHO booklet which talks scientifically and quantitatively about the short-term and long-term benefits for mother AND baby of immediate skin to skin contact, immediate breastfeeding, and delayed cord clamping (this one, I wasn’t pushing at all but now that I have a really good reference to back me up, I can talk to the midwives about it). Anyway, in general things are a lot better and less dramatic—also because one person who was really horrible to me has been gone for almost 3 months, but she is coming back in 2 weeks and will be here for my last 2 months. Maybe since many other people are more on board with me, she will be easier on me too. We will see. Either way, it is not an uphill battle anymore—I am now on a flat plateau—no new changes—just following up with the same things as before, finishing things up, and moving towards having closure. Our trip to Okay (Cap Haitian)/Hinche was great. Just getting away from the reality here…I was feeling really fed up with everything, and just needed a break…well, being in normal Haiti for 1 week was enough for me to forget all the stresses of work…This is how our trip went: We took a schoolbus from PAP to Okap. We got seats in the way back of the bus, right over the back wheel. We arrived at 6:30am and waited for 3 hours for the bus to fill up so we could leave. I thought it would be a good idea to pee before taking off, so we went to the only place we could find in the “ station” to pee: in a trash pile behind some vendors’ stands. There were flies everywhere and it smelled like poop. There were old tires, trash, and oily black mud. It was really gross but there was nowhere else to go. I kept thinking that someone was going to see my white feet from below the vendor stand, and call me out, as usual in my life here, and so then I couldn’t relax enough to pee. Finally, I was able to pee and we then went back to the bus. There was another white guy on the bus now, in the row next to us. He was backpacking through Haiti for 3 weeks, and spoke not a word of Creole. Wow. He was nice though. We got going. Things were going well. We went on the road along the west coast, through Gonaives. The trip took probably about 7 hours. Each row of seats has 3 people crammed onto one seat. The last 1/3 or so of the trip though was horrible. This bus obviously had no shocks, and we were sitting in the back. The driver was driving over all the potholes, not slowing down for them, and everyone in the back was bouncing all around. The road apparently had been good once, but like everything else here, was not maintained and is in ruins. I started getting pissed, just thinking about how this is one of the MAIN ROADS between 2 MAIN TOWNS in Haiti, and it is in this shape. And people are subjected to this, as if they do not deserve any better. How is this possible? To not even have normal roads? So, we were bouncing so much that our heads were hitting the metal grate thing above, where you put your bags, and then some people in the back started cursing at the choffeur. This part was really funny. Since he was not paying any attention to them, they started cursing him and making fun of him, calling him an animal, a pig, and saying that he eats shit, not real food. Then, we stopped somewhere along the way and he loaded onto the top of the bus a bunch of huge sacks of stuff. We started going again, and then suddenly we noticed that there was this weird liquid dripping onto us through the window from above. It wasn’t water. I couldn’t figure out what it was. It had a chemical smell. Finally I realized that it was ammonia. Liquid ammonia. They call it “ kanpe lwen”—stand far away. They use it for people who faint and for headaches. We tried to close the window, but it was broken and wouldn’t close. Then, a little while later, it started raining and all the rain was coming through the windows on our side, but again nothing could be done because the windows couldn’t close. Once again, typical Haiti. I didn’t mind too much because I was so relieved to be away from my closed in existence in PAP. So, we arrived to Blada’s mother’s house. This time it was a lot easier for me to stay there because they have built another room onto the house, so we had a room with a mat on the floor, which I had requested them to get for us in advance, instead of sleeping on a damp mattress. So, having the mat, which was made of some kind of tall dried reed/grass (they make them from other materials as well), was amazing. My body was sore though for 3 days after that bus ride. Luckily we had bought some tiger balm while waiting for the bus to fill up, from someone who came onto the bus selling different things like this, for 50 cents and so Blada massaged my back and neck with this and also we got some for his mother. This trip to Okap was really sweet. His family was just so sweet, his younger sisters were more into me than they had been before, I understood everyone’s Creole with no problem this time (the Creole in Okap is a lot different). It was great. We just made food together every day, and hung out. We didn’t go anywhere. The place where the house is, you can hear sounds from all over, from other houses. Maybe because there is a lot of cement. Each morning, I could hear children screaming while their parents beat them. I’m serious. There is no escaping the reality here. It’s all over. Being in Okap was great, seeing his family and really enjoying them, but also because I was so much in touch with the real reality of Haiti, it was also discouraging. Okap is so, so dirty. As soon as you go out into the street, you are in a cloud of dust. Most of the roads, even in town, are unpaved. People look at you like you’re an alien. I went to the market with Blada’s mom and sisters and it was unbelievable. People act like they’ve never seen a white person before. Someone asked his mom: “ ou gen blan nan fami a?” You have a blan in the family? When we were leaving Okap, the way to the station is over a bridge which goes over a bay. The bay is lined with shacks, pieced together with rusted pieces of tin. The banks are piled with trash, and the water is black and oily. With trash floating in it. I just kept thinking of how it could be. How beautiful and amazing it could be. Yes, leaving Okap, I felt discouraged about living in Haiti, and all I could think of, despite how wonderful of a visit I had had with Blada’s family, was how I can’t wait to leave. So, we got to the bus station. We were going to go through Hinche (a different route than on the way up) and spend a few days in HInche). There are pickup trucks that make this route. The road is not good enough for the minivans or the schoolbuses. So, we got seats in the cab of the truck, with a driver who always makes this route, who everyone knows, named Pisket. As we waited for the truck to fill up, we ate sugarcane that Blada had bought. I felt happy. So, we left Okap and before taking the road to Hinche, took an hour-long detour, to a little place in the country closeby, because Pisket was going to load a bunch of sacks of pottery onto the truck to make extra money (he didn’t tell any of us beforehand, we just went there.) This was actually really nice, because in contrast to Okap, the countryside was really beautiful, and this was encouraging to me. And, another thing that was really encouraging was seeing the people actually being industrious in something. Making pottery. This was very encouraging. So, finally we made the trip to HInche, and it was uneventful. Being in Hinche was great. We saw old friends, and had enough time to visit with people. We had to leave one day early because MSF called me and was concerned about us coming back on Sunday because there were planned protests in PAP over the shooting of a student. So, we didn’t get to see Jamlex, our baby (when we lived in the MW4H house, Jamlex came everyday with his mother, Diunney, the cook, and we grew very attached to him). We also didn’t get to see Blada’s godmother, who is a Catholic nun. It really would have been good to see them both. But, oh well. Overall, the trip was full and very satisfying. If I don’t go back to Hinche or Okap before we leave Haiti, that is fine. I also don’t know if I’ll make it back to Ti Trou or Jacmel. We’ll see. I was satisfied with my exposure to real Haitian life. It felt totally normal and natural, as if I had never left. Coming back to PAP was fine. I had been feeling really apprehensive about returning to work but things have been smooth and I know I will make it through these last months fine. December 16th So…exactly 2 more months left. That is 8 weeks. Each week passes quickly. I am really anticipating this change. I have been ready for so long! 8 weeks is perfect…now I am just wrapping up things at work…I need to write my end of mission report, I need to revise the obstetric protocols…I will be very bust until the end…which is fine….I am so thankful that I am at this point…. We don’t have our visa yet…Blada has an appointment to pick it up this week….I can’t let my guard down and rejoice until we have it in our hands…it has been so long since I have been working on this and feeling trapped in Haiti…now it is almost over…we think and hope…I wish I could just buy our tickets right now, but we are supposed to wait until we actually have the visa… The house is kind of quiet…it’s really nice…people are on holiday…I’m listening to music in my room, fully enjoying being in my own reality… Blada is in Okap visiting his family… It seems that every day things get worse in Port au Prince. Every week you hear of killings, usually robberies that end with shootings…honestly I don’t know if I’ll ever come back here…when you think about the reality here, how as soon as people leave the airport, they may have someone following them, ready to rob and kill them…just last week, there was a very sad story…a very kind woman, a patient at the hospital whom I had had the chance to get to know a little. I had talked with her the day before, it was her birthday. She was pregnant with her 4th child. Well, the next day I heard that her husband had been murdered. He was on a public bus in Port au Prince, and there was an armed robbery, and the robbers made everyone empty their pockets. When he emptied his, they saw that he was a police officer. They shot and killed him. I heard the news, and of her reaction-- instant intense mourning, as everyone does here when they first hear that someone has died. I went to see her later that day, to sit with her , but she wasn’t in her bed. I returned the next day, and she was in her bed, smiling and cheerful. We talked matter-of-factly about the fact that her husband had just been murdered, that she has 3 kids at home and one more coming, and she told me that they had been married for 13 years. She asked me about myself, when I was going to have children, if I was married. She seemed completely “ normal”. This is the thing that I have seen in Haiti time and time again: people mourn outwardly and strongly in the first moments, and then they immediately carry on with their lives and act as if everything is okay. They are unbelievably stoic. I cannot interpret it or explain it, but I have seen it time and time again. It’s like a switch is turned on and off. Maybe it’s because people don’t have the luxury to mourn for long periods and get depressed, because they have to survive. There is a culturally-accepted time for mourning, people do it and then continue on. This lady was also Christian, she mentioned this to me, and I think in times like these, this is something that really helps people to get through the tragic events of life that are so common here. That’s another thing: the amount of trauma that people experience throughout their lives…trauma like this is not a once in a lifetime event. It is part of life. December 23, 2012 We are doing well. The waiting, the certain amount of uncertainty, the dragging on of our visa process was somewhat excruciating for me. But, we made it happen, we got everything in order, we had the last missing form FedEx’d from the US for $86, Blada brought it to the embassy, they gave him a return appt. in 8 days, and each day of the 8 days was an eternity for me. Finally, the 20th of Dec. arrived, and he went, and…HE GOT HIS VISA. This is the closing of a chapter which has lasted almost 2 years, from start to finish. Finally, we are moving through the threshold of waiting and wondering, to knowing. This is a huge transition for me, because I have had to keep my guard up and survive here for a long time, never knowing for sure if the visa would work out or not. I am so relieved, I can’t express it. At the same time, I am still here, in the reality of my work, still surviving in my own way. We have about 8 weeks left till the day that we leave. I just want to forget everything and leave…I feel impatient…all I can think about is leaving, arriving in NC, seeing everyone, reuniting with everyone, bringing Blada into the family… 12/25/12 Can’t sleep..last night, I got woken up at midnight to the loudest music I have ever heard, from one of our neighbors’ houses…it was horrible DJ/mix music…it was so so loud…it went on for hours…I get it, people are celebrating, 24 Dec is a big deal, basically the whole month of December is a huge party, leading up to 1 + 2 January, when they celebrate their independence, then soon after that Carnaval starts, which lasts a couple of months…I get it, and I accept that in Haiti people make lots of noise and no one cares, but last night I was pissed, because the volume was so exaggerated…and of course I was tired all day today..Christmas day…quiet and somber…imagining next year, being with my family… Now that I’ve passed the 8 weeks left mark, and we are almost in January, I think the time will go really fast…January will be super busy, at work and at home, finishing up everything…that’s good. My replacement arrives Feb 2nd. I will spend the last 2 weeks here doing a handover with her, which means that everything else must be done before then. 2 days ago I was able to attend a Christmas dinner at my friend Beth’s house…it was so nice…I ate traditional American food…a welcome break…we sang Christmas carols...I am so glad I could go. Beth and her husband, John, have been living and working in Port au Prince for 22 or 23 years. They do really good work. Beth is a midwife and has a birth center where she provides excellent prenatal, intrapartum and postpartum care..parenting classes, lots of other services. Anyone who is interested in helping Haiti I welcome you to check out HEARTLINE MINISTRIES. I can personally vouch for them. They are grassroots and their work directly affects peoples’ lives in their community. They are extremely generous and despite all their years here, I have never ever gotten the impression that they are bitter or desensitized. They really care about people. Beth, despite being super busy with all of the work she already does helping people, has been coming to the MSF hospital every 3 months and donating blood. I mean, these people are hard-core, and they really walk the talk. There was something that hit me while I was at Beth’s house…there were 2 other interracial couples there…they were so in love, sitting close together, just glowing with their love for each other and apparently so open and uninhibited. Seeing this, I thought about me and Blada…how we used to be at the MW4H house in Hinche…how we were comfortable, because we thought it was our home and it was safe…and how the whole time, (white) people (visitors) were uncomfortable with our relationship, talking behind our backs, and how in the end it all exploded out into the open…I experienced a lot of trauma when things fell apart in this way and we chose to leave Hinche, because we did not feel safe anymore with the organization, after the all the lies and betrayel…it is a long and unbelievable story, and in the end, I know that I have unresolved trauma around losing the safety that we had trusted to exist there for us, in our own home…now, living in the MSF house, it is very different in some ways because the people here I would say are a lot more cultured and international than most of the volunteers who used to come to HInche…my housemates accept Blada and don’t seem to mind his presence…they’re not shocked or offended by us together…but at the same time, this is not our house and we do have to be extremely careful. Watching these other couples at Beth’s house the other day, it reflected to me how guarded I have had to become. I look forward to living in a place where my home is safe for me, for Blada, and for our relationship. Where people like us and accept us for who we are. I appreciate the safety that I have felt here, with MSF, in this sense…but I have never been able to trust it fully or let my guard down, after what happened in Hinche. I hope that in NC, we will feel free and open, completely. Don’t be fooled by all of the “do-gooders” who travel to poor countries like Haiti to “help”. Most of them are looking for an experience, or to prove something to themselves, their friends, their coworkers. I have had so many people come up to me when I am visiting the US who don’t even know me, who thank me for the “amazing work” that I am doing in Haiti…(they assume that if you would come and work in Haiti, that you must be doing “amazing work”). Don’t be fooled. There are plenty of demented people who come to places like Haiti precisely because these populations are vulnerable and anything that you do will look like help. Or because they have specific scenarios that they need to play out in order to feel good about themselves, and they can do that here…in the meantime, often taking advantage of the population or stepping all over those who are already there…I have seen multiple variations of these scenarios myself and have heard stories of people who have come here and done even worse things. 6 January 2013 I am so happy about the new year. The year of 2013…it brings many long-awaited for transformations. It was a fun time to be here as well…a very special time in Haiti…when their independence is celebrated…people are happy…luckily I slept well the night of the 31st…I thought there would be al of noise…it was the most wonderful thing: there is this little church right next to our house. People gather there, and sing and pray, both Sunday mornings and Friday evenings, in the dark…well, the night of the 31st, they sang beautiful slow hymns all night long…I could hear them in my sleep…it was so, so wonderful. I felt so happy the next day. Things are changing…we are getting ready…wrapping things up here…soon we will be in the US, starting a whole new chapter…I look forward to seeing those of you I can…and I thank all of you for your continual support over the past 3 years. This might be it…my last blog…those of you who would like to keep in touch with me, please email me at parterachida@hotmail.com. Again I thank all of you for your immense support over the past 3 years.

Tuesday, October 23, 2012

August-October 2012

2 Sept 2012 Things have been really, really tough for me in my work here. I have found myself getting to the place of just wishing to leave, because I have felt so hopeless. I have felt this way from time to time before, in my time living in Haiti. I remember feeling this way in Hinche for at least the first several months after I arrived, having a language barrier and witnessing the care that birthing women received. I remember seeing a woman get slapped because she was squirming and screaming too much while getting a D&C(dilation & curettage) with no pain medication, and having an argument afterwards with the person who slapped her. We disagreed on this, but continued to work together, and nothing ever festered. The next year, there was one day when I walked into the delivery room only to see this same person slowly rocking together with a laboring woman, the woman’s head on her chest, her stroking the woman’s hair lovingly. I would have never believed that this was ever possible, the year before. This same person has become one of the people that I most love, respect, trust, and miss the most in Hinche. I came to accept many things about Haiti, and about the hospital where I worked, and the people I worked with. I came to appreciate many things. Acceptance was the key, after a long period of adjustment. Since being in Port au Prince, I have seen that the acceptance I had cultivated for Haiti, and for Haitian healthcare professionals, was not as everlasting as I had thought. I have seen that it actually comes in waves. Sometimes it is easier to be completely calm and accepting, and other times, I feel unhappy, isolated and frustrated. My experience in the project here in Port au Prince has not been as smooth as I had hoped for. There have been a combination of factors that have made it feel even excruciating at times. These have been: the workload (I am spread too thin—too many areas for one person to cover), and the relationship with national staff, the history and collective memory of the national staff in this project, as well as their overall resentment of white people, NGO’s, etc (which is justified). The relationship with national staff: there are reasons why this has been hard. I am used to working with Haitians and love working with Haitians. But I have never worked with a group of people like this. I have come to see a different side of the Haitian people up close. The proud, defensive, angry, passive-aggressive side. I have tried to be the perfect communicator, humble, kind, gentle…and it has seemed that nothing has ever been good enough, because some (not all) of the people in this project, are not interested in communicating if it has to do with improving things, which means that their work may be altered slightly. The whole point is for me to work together with the people here, who already have a long history in this project, in order to make sustainable improvements in the quality of care. But, it is hard to have normal communication about this when people see you as a representation of everything that they have come to resent about MSF. There is a long history for many of these people (6 years), and this is great, but it also has its downside, because many people are burned out—they have given up—and here I am, coming in, and trying to communicate about ways to improve the services, which is annoying to them because they have a comfortable routine. It is not such an easy thing to balance. I am an “expat”, but I speak Creole and live here already. It’s not like I’m sweeping in for 6-9 months and then leaving, never to return . I DO care what people here think about me—the key to my survival in Haiti has been building trust with Haitians. But what am I to do, when there is already such an intense distrust? People see you as a spy. They see you as a blan. This situation has been a painful reminder of the ever-present reality in Haiti: no matter what I do, I will always be seen as a blan, which represents many things to the people here. I will never be fully accepted or seen as a normal person. The problem with this is that I am tied to Haiti—Blada is Haitian—and, I still don’t even know when we will be leaving, because we are not yet finished with the visa application process. I really hit rock bottom with these realities, especially after receiving a lot of anger and aggression from some of the staff, despite all of my attempts to mold myself to their needs, to be slow, to communicate well, etc. It felt like no matter what I did, people were angry with me. It is draining. It is exhausting. People do not take responsibility for their own attitudes or actions—they even blatantly lie about things they have said or done. But, they will easily blame me—I am the representative of everything they have come to hate about their job. It goes even deeper than this. People see everything through the eyes of their history with slavery/colonization, and then the long fight for freedom. So, they are not afraid to fight, and it’s like some of them are reliving a perpetual battle. It is very complex. I feel caught in a complicated web of history and peoples’ personal and collective anger, which they themselves are not even willing to agnowledge or take responsibility for. It is intense. I am hoping for an easier time, hoping to step back a little from the intensity—it is just too stressful. Too much stress. There was finally a breakthrough, a couple of days after I had really lost all hope. I am hoping that this breakthrough will carry through and that things really will get and stay on the right track, a tleast with the person concerned. I can’t make everything perfect with every person who already resents what I represent, but if this one can continue on a better track, I will be very relieved. I have felt like I am suffocating with the stress. It’s not good to live like this. I just want to live somewhere where I am accepted and seen as a normal person. I am tired of having to prove myself all the time. I am tired of having to be ultra-positive and upbeat in every single moment, in the face of anger and hostility. I am tired of it. I just want to live. 11 sept 2012 Things seem to be continuing on a tentatively better path than they were. Relations are positive with the national staff supervisor I was having problems with, and this is wonderful, but it also feels tentative, because the layer of trust here is so fragile. It is so hard to weigh the importance of speaking up about problems that I see, both directly to the staff and to the supervisors, even when to me these are very important problems, because you must balance this thin layer of trust and tolerance. There is a new expat nurse. I like her a lot—she speaks Creole and has lived in Haiti before. She will be helping me and the pediatrician with some of our work. I am so so so happy for this, and I really think that this will enable me to have more time to focus on the problems that are the most urgent. She is going to take over 2 of the postpartum services that I am responsible for, which I have not had much time to work in because of all the things I’ve been working on in the other services. This is such a relief for me. She is also going to help me to come up with continuing education for staff in needed areas and to streamline postpartum education in the whole hospital. I am really happy for the help and the collaboration at work---this is HUGE. But, apart from this, I am also really happy that I will have a friend at the house. I get along well with everyone at the house, but I have never felt close to anyone here. But with her, I just feel at ease, and like I can be myself and talk without feeling like I need to be formal or polite in a certain way which fits with other peoples’ expectations or cultural backgrounds. All of this hopefully means that the second half of my mission here will be more fulfilling, less frustrating, and smoother than the first half. I have been spread so thin this whole time, I have felt like I have all of these unfinished projects with no real accomplishments to show for my work and the stress I’ve been through. There have been some improvements though. There definetly is more of a tendency now to leave babies with moms and initiate breastfeeding in the delivery room. I have organized an area for neonatal resuscitation with a daily checklist of the supplies, which is being followed. My national staff supervisor is also making more of an effort to participate with me in the follow up of these changes. There are others too. Small steps. I visited Hinche this past weekend. I spent some time at the hospital where I used to work…watched the way the midwives there interact with patients…it was so different there when I first arrived 2 ½ years ago. I remember feeling like a knife was stabbing into my heart every time I would walk in and see the way the women were being treated—slapped, yelled at, made to labor on the tiny delivery tables… Now, it is so different. I felt like I was surrounded by a community of like-minded midwives, for the first time in a long time. They were encouraging women to walk around in labor, were talking gently with them, were doing labor support, were encouraging moms to breastfeed. I don’t take all the credit by any means!!! But, seeing changes like this gives you hope. If I had 2 years to invest in this project, I know that I would be able to build trust as I did in Hinche, and that I would be able to steadily address all of the major problems, and to follow up the implementation of changes, and to mentor the national staff and support them in their growth as midwives. But, I don’t have 2 years to give here. I feel that I don’t have sufficient time to address the problems and create deep relationships with the staff here which would support our working relationship. It is unfortunate. I will do what I can. Perhaps what I am able to do will be more far-reaching than it appears at the present moment. 21 October There’s not much new to report. Things have been going slightly better—for the first time one of my national staff supervisors is standing behind something I am working for and is defending it—it is a solid, spelled out protocol for the temperature in the delivery room, which became necessary because after months and months of talking about the risks of hypothermia in the newborn and people still putting the A/C unit on really low, to make themselves comfortable. Miraculously, one of the supervisors I work with finally bought into the idea that hypothermia of the newborn is a real medical problem at our hospital. I finally this week started feeling somewhat satisfied and happy in my job. But, this happiness was short lived when there was some drama that went down with one of the midwives…nothing is simple here....something as simple as implementing a temperature protocol can be interpreted in so many different ways..I am tired…I want to push forward but part of me also just wants to withdraw and not say anything about anything, because whatever you say to people here, no matter what you say and how you say it, inevitably gets turned into something else and transforms into a huge dramatic thing… Only 4 more months. I am trying to stay strong. I have never worked with a group of Haitian midwives quite like this one. The group of people in this project is very angry. I feel like I am caught in the crossfire, simply by being in the position I am and by doing my job, which involves correcting problems. So, like I said, nothing really new to report. Just doing my job, getting through each day and each week, trying to hold my head up despite the challenges, the cross cultural misunderstandings which given the fact that I’ve already lived and worked in Haiti for almost 3 years, is disappointing and disheartening…it is like there is this rift of distrust that will never be bridged, no matter what you do… Trying not to think about work so much…I just want to enjoy my last months in Haiti…I wish I could be carefree and just enjoy the things I love about the people here…unfortunately I am faced with living in a reality that I don’t want to be a part of…being part of a group of people who resent my presence because I am white…that’s always how it’s been in Haiti though…it just plays out in slightly different ways… On a brighter side…really, aside from the shattering reality that the midwives here don’t like me or trust me, let’s see…aside from that, things are going well I guess. Things are good at the house…everyone is making effort to get along and compromise....there are about 10 of us…from different countries…it’s quite interesting…. I hope to have more interesting stories to tell next time…unfortunately, the way I am describing my work here is the reality that I have been living in now for many months…but, I am still trying to have hope that things can improve, and am counting on those at work who are silently supportive of me, and who don’t buy in to the drama and accusations…these allies certainly do exist among the national staff… Blada and I are doing great, staying strong together, getting closer and closer to having our interview at the embassy for his visa…hopefully this will take place in the next 2 weeks or so…our plan is then to move to NC in March of 2013… Sending love to all of you and thanking all of you for your constant presence and support….

Tuesday, June 26, 2012

6-11-12 to 6-25-12

June 11th 2012 I am reading about hypothermia and hypoglycemia in the newborn, in order to be better-equipped to explain these things to the midwives here as I try to improve the conditions meeting newborn babies in the MSF hospital. Actually, there have already been small improvements since I first started talking about this (hypothermia—haven’t tackled hypoglycemia yet) with the 2 MW supervisors who oversee triage/delivery room/antenatal/normal postpartum. This is great. I will be starting to teach neonatal resuscitation (it will be a review for many of them) to all of the midwives and auxilliares very soon, and I also wanted to use this opportunity to talk about cold stress and hypoglycemia in the newborn. (The delivery room actually has an air conditioner and it used to always be super cold in there, plus the other issue is lack of early breastfeeding. Babies are having a hard start in life here. I need to remember not to get into the expat mentality of being in a rush and trying to accomplish a million things in 6 months-- I see some people doing this around me, which makes me doubt myself sometimes, but I also know myself and know that I need to be realistic and pace myself. AND, another huge reason for not being super crazy and in a huge rush is because the Haitian staff are not like this at all, and it won’t help me in my work AT ALL if I act crazy and stress them out. So, I have to stay relaxed and combine speeds—a combination of expat speed and national staff speed. We had a woman die in Cholernite on Thursday night. It is sad…it is always sad and strange when people die…something that Haitian people have had to deal with their whole lives…this woman was 22 years old…her case was complicated, and in the end, no one knows for sure what the main cause of her demise was…several of us worked very hard to save her on Thursday, during the day—but at that point, she was already in a coma and was getting worse and worse…when I left, I knew that she was dying. The saddest part for me of this situation, was witnessing her husband as he had to deal with the reality of her death…the thing is that here, people are struggling to get the money together to even have the body picked up and buried. So, the day after Delia died, her husband of 7 years was in the street, running around, from here to there, trying to borrow money so that he could have her body picked up (we don’t have a refrigerated morgue) so that he could have his beloved wife buried. He had no time to grieve, or to hold his 4 year-old daughter who was also realizing the fact that her mother was not coming home…he had to be matter-of-fact, and tend to the nitty gritty details of having his wife’s body picked up…not just any ambulance will pick them up, because people who have died with cholera are still infectious, even after the disinfection process that is carried out after the death…(which is why MSF additionally provides a body bag and coffin to reduce the contamination risks). Friday afternoon, he had been out all day, trying to make necessary arrangements, hadn’t eaten, hadn’t sat down…I was present in the discussions between him/his sister (who were both by Delia’s bedside for 3 days until her death) and the staff who are in charge of dealing with the dead bodies as they discussed logistics…it was so sad…towards the end of the conversation, someone showed compassion and solidarity by saying something like, “It’s something you grow up your whole life with, but you never get used to it (death).” Then, the sister said something like, “yeah, you never can get used to it, but it will always be in your blood”—what she meant by this was that it is something you cannot escape. Unnecessary death, such as children dying from malnutrition or diarrhea—moms dying from eclampsia—things like this, if you’re Haitian and live in Haiti, you will always be exposed to it, and it will continue to happen. It’s in your blood, as in, you cannot get away from it. As we were walking away after this final conversation, I felt so incredibly humbled before this man and his sister, who were dealing with the reality of Delia’s death because they had no other choice. I was so incredibly humbled, and wishing to give some kind of consolation to them, wishing that I could somehow offer some support, besides my presence and my patience. I had no words to offer, no blessing to give that could possibly compare to their courage. I felt so inadequate, although I knew too that simply being present and compassionate meant a lot to them. Still, I could see myself there in such a priveledged position, having a window into their suffering, watching them and learning from them, as I have done in with so many other people here. Not one word could I give them that would possibly suffice. As we parted ways, the only thing I could think of that was encouraging and that would make sense to them was, “I’ll pray for you.” That was all I could say. I will never be able to understand or quantify the strength of the Haitian people. People notice it, but so many people overlook it. I remember in Hinche, people would always notice the “lack of compassion” of the Haitian care providers at the hospital. It was shocking to me in the beginning as well. It was hard to understand how midwives and other healthcare workers could be so cold and callous. But, I came to see many things in my time there, and one of them was the realization that there were many other acts of compassion that I had initially overlooked, because I didn’t perceive them as such. I didn’t understand the culture enough to see them. People in Hinche (short-term volunteers) always used to try to ask me to analyze with them “why” there was such a “lack of compassion”—perhaps because people see so much death and suffering on a regular basis that they are powerless to fix—that was one hypotheses…I always remained neutral and not really willing to agree upon a certain analysis, because in reality, who am I to give a reason for anything? What do I know? Al I know is from my own observation, which is shaded by my own cultural assumptions. I didn’t grow up here. How could I possibly be an authority on the Haitian mentality? It makes you think of all of our own mortality, of how we are constantly walking such a thin line between life and death…I try not to think about it too much…those of us who are living are so lucky… Blada came here this weekend…he left this morning…we hadn’t seen each other for about 3 weeks, and I was really starting to miss him a lot…it was such a relief to see him and be with him…so joyous…so so full of joy. I miss being around him. I feel so balanced, centered, and happy when we are together. This is good, what we are doing now…we are both accomplishing important things…working on our own…but, we are going to try to see each other more often, because 2-3 weeks each time is really hard for us. He has been cultivating our little piece of land in Ti Trou. Planting trees, and making gardens. For instance, he has planted like 40 coconut trees all along the perimeter of the land. He is planting mango, cashew, almond, soursap, breadfruit, things like that. We started a little garden here too. With seeds that my mother sent down with someone for me. Basil, tomato, tomatillo, chile peppers, melon, cucumber, sunflower. So exciting!! June 16th So…this was a pretty good week at work…the people I work with (both expat and national) and the work itself (everything it entails) is so interesting…sometimes I find myself in the moment, while at work, just savoring the moment and feeling so content and optimistic, knowing that I both have a lot to contribute and also a lot to learn…and knowing that both of these things will happen….and are happening…other times, sometimes, I still feel overwhelmed, both at the massiveness of all the work that still needs to happen in all the different services I am involved in overseeing, and then sometimes feeling really inadequate, and then sometimes comparing myself to other people who appear to be accomplishing big things/making huge steps…then wondering how people see me…but in reality I know that people trust me and respect me, and that part of this insecurity I have is because I am still new and figuring out the ropes…I can see the problems, the hard part is figuring out multiple strategies to approach the problems. I am accustomed to working directly with midwives and teaching/coaching as I work together with them…but, I can’t just have this one approach…I can do this too, and in fact must do this, in order to improve some of the care, but I also need to do research, plan continuing education modules, and be more of an administrator. I see all this, but the pieces are still falling into place for me, as far as how to work within the structure of MSF and use the tools available to me. I am starting neonatal resuscitation classes on Monday. I have a feeling that this is an area that needs improvement in the delivery room. I am going to keep it really basic and practical—what to do and how to do it effectively. Blada is here this weekend again! Some of our little seedlings that we planted last weekend are coming up. Last night we had a really fun time, we went out with 2 people I live with, Charles and Adriana, to a little party at the house of an old friend of mine, who is now living in Haiti for the next 2 years. My friend is named Elisha, and we both grew up in Saxapahaw, and used to play in the woods together all day with our other friends, when we were like 9-10 years old. Then I didn’t’ see her again for like 20 years, and now suddenly she is living in Haiti. She is a really fun, exuberant person. It was really great last night because she got to meet Blada, and also my friend Charles, is from DRC, where Elisha lived for 3 years. So, really great. At the end, before we left, we were all dancing in the living room—so, yes, my kind of party. Blada brought me 12 green coconuts from Ti Trou. I was literally in heaven earlier today as I drank the sweet coconut water from 3 fresh coconuts. And then eating the flesh…soft, sweet…coconuts are amazing. June 18th Back to work today…I was sad to let Blada leave this morning…it was easier last week because I knew I would see him the next weekend…it’s hard trying to cram everything into 2 days… This morning I did my first neonatal resuscitation class here at CRUO (the MSF hospital: Centre de Reference des Urgences Obstetricales)----doing the class was really fun—really natural and enjoyable for me—I guess I miss teaching…it was partially a review for the midwives but partially new, because I really focused on doing each thing correctly…so, I think the result was good…simple, practical…how to do ventilation and chest compressions: correctly. I wanna give a big shout out to Maternidad La Luz, where I trained and worked for 6 ½ years before coming to Haiti…I got such a good grounding in midwifery skills (such as neonatal resuscitation)—and in birth, suturing, prenatal care, newborn exam, so many other things. I am eternally thankful to MLL for the opportunity I had to learn and practice what I did during that time. And MLL is still so much within my consciousness (or subconscious) that it really embodies/represents many of my ideas and feelings around midwifery… For instance, the other night I had a dream, in which I was in the rose room (one of the birth rooms) at MLL, and there was a beautiful laboring woman in there who was doing amazing, handling her own labor and taking care of herself, changing positions intuitively…I was just watching her, holding the space…she starts pushing, and soon the head starts emerging…well, next to me is a Haitian midwife (who I know in reality), who, once the head is coming, starts telling the woman to stop pushing so she can get her hands in there and pull the baby out for her. I gently tell her to wait and just watch, without interfering. The woman catches her own baby in front of us, with no interference. In reality, it is really hard to watch sometimes how the midwives practice, because it seems as if most of them have one single way to handle birth especially. One of the things that annoys me (since forever) is how people always make the mom stop pushing after the head is out, and then they proceed to pull the baby out by the head, with no help from the mother. It doesn’t make sense to me. But, it’s the one way that everyone learned at the one midwifery school. I’m not complaining…I’m just being honest about one of the many zillion tiny things that have been challenging for me, for the past 2 ½ years since being in Haiti. I think that I have done well accepting Haitian culture and reality and realizing that I am a guest here anyway, so why get all bent out of shape…but still, it can be hard. And I think that the dream I described above embodies some of this frusturation. The thing is that here, it’s not like at MLL where all of us held the basic principles and understanding around the way we treat pregnant & birthing women. I feel very alone sometimes. I remember in Hinche, when I first arrived, what torture it was. But, as Marthonie came to trust me and became my ally, I wasn’t alone anymore. She was amazing. I have said this before—I don’t know if I will ever find someone else like her again in Haiti. Another little dream from this same night that is kind of funny and again embodies some unspoken feelings was that I was in a group of people and everyone was speaking French, which I understood perfectly, and then one person turns to me and translates the whole conversation over again in English. In the dream I am like, “God! You don’t have to do that! I UNDERSTAND FRENCH!” In reality something like this had just happened that day, and I wanted to be polite so I didn’t say anything. Remembering the dream was funny. One thing that I really like about my house is that I get to hear people speaking German and French a lot…it is so interesting…just listening to the sounds…the French is fine, I understand it very well and am starting to speak it more and more…the German, I don’t understand it but I love hearing it. If is finally cool (for Haiti) and cloudy for the past couple of days…so so wonderful…I miss weather like this…I wish it could be like this more often. Cool and cloudy, instead of hot and really sunny. It is really nice. I have been missing my old girlfriends from MLL. Old midwife sisters, from years ago. Those who spanned the 6 ½ years that I was at Maternidad La Luz. I wrote to many of them this past weekend, (after wanting to for a long time), and I have received some responses that have been so touching and helpful to me after the almost 2½ years that I have been in Haiti. One of them was from a classmate of mine when I was a student…she is in Canada and we never saw each other again or wrote very often but she was one of those who wrote me back with enthusiasm…it helps so much, to feel that you are part of a global network of people who believe in and work towards the same thing…. Thank you, to all of you who have been with me during this time, who have been present with me, who have posted comments and feedback to me during this time…friends and midwives sisters alike…. 6-25-12 Blada spent this weekend with me—he left this morning. It was so good to unwind with him. He has come each weekend for the past few weeks. This weekend, I felt satisfied. Last weekend, I was really sad to see him go, and I felt like we didn’t have enough time to do everything we needed to. Like, simply spending time together, embracing or whatever. I was really sad when he left. 2 days is not really long enough. And it is not really feasible to do every weekend, because he comes from far away. When he left, I missed him so much, and I couldn’t talk with him for long enough on the phone either, because phone cards here are sooo expensive. That’s why Haitians have really short, direct conversations usually, like, “Did you get the thing? Eh? Ok Ok.” Anyway…this weekend was wonderful. We had a really fun going away party for one of the expats, with drinking, socializing, and dancing, national and expat staff together. This woman, who the party is for, is usually to total hardass (but is also pretty funny a lot of the time), but she really loves her national staff, and as soon as everyone left, she sat down by herself and started crying (hard). It was really sweet. Yesterday, I was tired, but I wanted to practice some salsa dancing with Blada. So, we went up to the rooftop terrace of the house, which is all covered with tile, and is very nice, and we danced up there. It felt magical. I felt so happy. There was a constant breeze….palm trees…mountains all around…gliding around together, dancing salsa…it was one of those moments. Things at the hospital are going well. Today was a good day….the sessions with the midwives for neonatal resuscitation (NNR) are going well…they all seem to know the theory well, but it’s the actual technique/practice that they are weak in…so, it has been good to work with them. I am talking with the one of the Haitian midwife supervisors to get her interested in helping me to improve the NNR area of the delivery room, so that it’s more functional and organized, and I have also been working with her on the issue of keeping the room warmer. When I first arrived it was always really cold. The temperature issue has already improved a lot. Which is really encouraging. This needs to be continued and encouraged continually---another big area to improve is the maternal-infant separation that happens and the lack of early breastfeeding. So, hopefully these areas will be possible to really improve as well. Instead of having hypothermic infants that are separated from their mothers and not BF early, we can have babies staying on their moms, breastfeeding early, and not getting cold. This will make a huge difference in the outcomes of these babies. So, things are possible and promising…it’s just hard to have patience sometimes, because you have to go so slow with people and really take time to talk with them…there’s a certain kind of etiquette in a way…I get it, I accept it, but like many things about Haiti and Haitian culture, I also get frusturated again from time to time again and really annoyed, about things that I had thought I had already accepted pretty well. One good thing for me is that the 3 SF (sage-femme, midwife) supervisors who I work with, they are not hard people to get along with, or communicate with, or work with, etc. I just have to remember to follow the etiquette and not lose patience. But, for instance in the delivery room, there has already been a huge improvement in the temperature. I got ahold of this awesome WHO publication all about cold stress and how/why to avoid it in newborns, and got it printed out (in French!), and one of the SF supervisors asked me to borrow a copy to take home and read. This is so great. Another good sign was this morning, one of the SF in the NNR session told me afterwards that I should give them continuing education sessions every month. That was great because she had initially seemed somewhat uninterested in the class. So…my next big subject to address with all of the SF (not only the supervisors) is cold stress and hypoglycemia (which can both be avoided by not separating moms and babies and helping with early BF). There are many other things I see especially in the delivery room that I would love to help the SF to change—but, I have to pace myself, give them time to digest what I am putting forth, have patience, and choose my battles wisely. I understand perfectly well that there are many things that I will have to completely ignore because there are more important problems to address, but at the same time, being a midwife myself, witnessing how some people manage birth can be very frusturating. It’s frusturating when it’s things that are being done that are completely unnecessary or even harmful, and then other things that should be done that arecompletely ignored. It’s like, a lot of times, things are done in the wrong order, or the priorities are wrong. This is probably since midwifery school. The nursing aspect is strong, but the midwifery aspect is weak. It’s interesting that I am getting so involved in noticing the details of how the SF manage birth too, because I am already used to seeing how birth is managed in Haitian hospitals. I don’t think that I’m losing the greater perspective though. I am “overseeing” and participating in many areas of the hospital, and each has weak points and strong points, that I am coming to understand and coming to see paths I can take to address them. My friend Kirsty, who I met and became close friends with last year when I lived in HInche, is coming to visit with me this weekend. I am so excited. She is a MW who also worked with MWH and we lived in the same house together for several months last summer. She is married to a Haitian man named Mackenzy; Blada lives with them in Ti Trou and is doing agriculture with Mackenzy and his team. So, I’m really excited to see Kirsty again…she had a baby in March…so cute…she’s coming with him…. The next weekend, hopefully I will be getting a ride on a MSF truck that is bringing people to Jacmel. I will visit my house, see friends there, get stuff to bring back here (since I live here now, not there), and maybe even go to the beach. So, that’s what’s going on right now. Some days, I have a lot of energy, like today, and I can write and enjoy my time at home in the evenings…other days, I am just so tired….i lay down at like 7pm…. Up and down energy-wise, but in general feeling good about the job and myself…doing what I can…it’s hard not to compare myself to others though…not that I actually want to be like them…there is this one expat, who is always so busy, always kind of in a frenzy to get things accomplished…if I want to talk to her about something at work, I feel like I can't approach her...there's always some big crisis she is dealing with….that’s fine for her, and I think the service she works in has needed a strong push…but, I don’t want to be in a frenzy myself. I want to be calm and at a speed that makes sense for the people I am working with (even though this is a struggle sometimes)---I am doing my best to remember to follow the Haitian etiquette of communication, however annoying it can sometimes be (that you have to be this way all the time, each time…) And I also need to remember not to think that I am being compared to others and that it’s not like we’re in a factory or something. I know that if I continue building trust and following the etiquette, things will have the possibility of improving from the inside out.

Monday, June 11, 2012


4-25-12 I am in my second week in my new job with MSF in Port au Prince. I am so tired, and overwhelmed, that I have been on the verge of tears a lot of the time. It is really hard. I have never worked with MSF before, so there are a lot of details that I must learn in order to function within MSF. Plus, I am meeting like 200 new people whose names I am trying to learn…plus, the hospital is new to me, and I am responsible for supervising not one, but 7 areas within the hospital. This hospital takes only complicated maternity cases, and has strict admission criteria. There are experienced Haitian midwife supervisors in 3 of the areas that I am to oversee, which is a good thing. I am not responsible per se for direct coaching of staff, however once trust has been built, I will be trying to improve problem areas both through directly working with the midwives and also through collaborating with the 3 MW supervisors who run triage, delivery room, prepartum (antepartum) & postpartum, in order to make improvements. One way to do this is through creating a platform for continuing education in needed areas. There are many good practices and areas of strength and there are also areas of weakness that deserve attention. However, the first thing is to stand back and validate what is already happening, and build trust with the national (Haitian) staff. I have already been welcomed warmly by them, and have even felt like I am becoming part of a close, loving family. However, I strongly miss Blada, who instead of seeing every day, I will now see every 1-2 weeks—this is a huge adjustment for us. When I am lonely, I go and sit outside with the guards (at the house), instead of crying in my room. Another person I dearly miss is Marthonie. She is still in HInche, still teaching by herself. What I had with her was truly amazing—our collaboration and trust—and I don’t know if I will ever forge something this deep with another Haitian midwife. Marthonie was my ally, and I couldn’t have functioned at all without her collaboration & support. I miss her so much sometimes. We were such a good team, both in classes and in the hospital. Such trust. We both learned so much from eachother. The situation here, it is a much better situation to be starting off from than when I started in HInche. I am so much more prepared, I speak Creole, have had experience in public hospitals in Haiti, etc. But, it is still hard… The national staff is amazed that I speak Creole. I think I have never seen another group of people in Haiti who has been so delighted and appreciative of the fact that I speak Creole. It means so much to them. In fact, this is the most accepted I have ever felt by any group of people in Haiti. I still don’t know how I will perform my job satisfactorily, given that I have such a large area to cover. I just have to trust and keep going, and let it happen. 5-1-12 I was feeling a little less overwhelmed for a few days and now am back to feeling super overwhelmed. I am supposed to be supervising many areas of the hospital, but it seems like I will never have time to spend time in each area to assess the needs for improvement. There are 2 areas I have barely stepped foot in: postpartum pathology, which has 7 rooms with 6 beds in each, and OTP, which is postpartum appts for women with problems like post-op or high B/P. I have spent more time in triage, the delivery room, normal postpartum and antenatal pathology. Now, there is another area to supervise: Cholernity. It’s a unit for pregnant women with cholera. It opened yesterday. Today I helped the 1 midwife all day, who had 13 patients. It is nonstop work. Hopefully some of these areas I am supervising will need less help than others, but in triage and the delivery room, there are some definite problems that need to be addressed, and some of these problems will take time and multiple approaches to have any improvement. There are midwives here who are very competent, which makes things a lot easier, but despite that, there are still some very basic problems that need to be addressed. 5-8-12 So…this is halfway through the second week since the Cholernite opened. (Cholernite=pregnant women with cholera). Things are going a little smoother each day. However, it is still in the beginning stages and there aren’t any real systems in place yet, which means that I am running around searching for everything, each thing that comes up, all day long. But, things are slowly taking form. Each day a little more. I have been absent from the other services, because I have just been immersed in getting the Cholernite going. I have been so tired, since I arrived here. I am absorbing and learning and taking on SO MUCH all at once. A lot of it is stuff that I have never done before—like, more administrative stuff. I need to learn how to use Excel. And I am learning French. (I communicate with the national staff in Creole of course but all of the meetings—of which there are a lot—are in French.) I understand it well, but am just not used to speaking it, so when I need to speak it, I can’t communicate what I want to. Blada was allowed to come and spend this past weekend with me at the house. That was so nice. Unfortunately, I was so tired the whole time, we mostly just laid around while he comforted me and reassured me that everything is going to be ok. It turns out that I also have some kind of infection in one of my teeth…it suddenly has become acute—probably this is one reason why I have been so tired. I think the tooth is going to have to be pulled, because I think it is in a wisdom tooth that already had a root canal and a crown. I have an appointment tomorrow to have it checked. So, there is a lot going on at once. I am not able yet to step back and relax, and see the whole picture. I am still learning the small parts. And, there are two areas I have not even spent time in yet—postpartum pathology and OPD, where 2 midwives do postpartum checkups for moms/babies with problems that persisted after the birth. What else…I do feel very fortunate to have landed here, in this job, with this group of people…I feel very, very fortunate. I can learn a lot here, and the structure and support from the organization makes it possible to move forward with positive changes in the hospital. Also, with the national staff, I feel very comfortable. This goes for all of the staff—drivers, guards, cleaning people, midwives, etc. everyone. It feels like a family. It is a family, because many of these people have been working together for years. The expat staff comes and goes, but the national staff is constant. We moved houses 1 week ago. This place is better because it is really close to the hospital. Easier in the morning, more relaxed. It’s also nice for me because we are closer to Haitian life—you can hear sounds of people living their lives. There is a church close by and sometimes I can hear the beautiful hymns being sung. Haitians have a gift for singing in harmony. It is really beautiful. 11-may-12 So…I had my tooth extracted 2 days ago…I am feeling a lot better today than yesterday. Things have been nonstop since I arrived here and started this new job. Hopefully after this I will have more energy and things will continue to become easier. I think the infection (which was in fact below my root canal) was sucking all of my energy. Today has been a relaxed Saturday. Next weekend I get to go to Jacmel and visit my little house and the beach. So excited. Then right after this, I go to NY for a few days for this MSF thing called Information Days, which normally people attend before their first mission. I hope that I will learn some useful & practical things about the organization while I am there. It will probably take a few months to settle in and understand how to function within this job/hospital in my role and also how to function within MSF. There are so many things to learn. Anyway… Love to all of you, and thank you so much for all of your support… May 29th… There has been a lot to write about and many details that I’ve wanted to share but I have just been so tired…atleast before leaving Haiti for 1 week last week..i just got back today…I went to NY for an MSF informative event for new MSF workers…usually it happens before the first field position but in my case I had started working first…I stayed in Manhattan…in a hotel room with 2 other girls who were really fun…the experience was really good for me. I got to sit for 3 days and learn more background information about MSF—things I had already read about in some of the readings they sent me, but it is really different having someone explain it to you…everyone who talked had extensive experience working with MSF and so had many stories…stories to illustrate any example they wanted to make…it was really rich…I enjoyed this a lot…sitting back and listening to them…I also really enjoyed spending time with many of the people who participated in this event…many of them were really interesting, had already worked internationally, and already seemed to get some of the other levels that were on my mind, that I would have liked for the group to talk about more—things relating to cultural competency, but that’s not the right term actually…neocolonialism…a broader discussion of all of the implications that we have when we work globally…anyway, it was really uplifting overall and the icing on the cake for me was that at the end, I had the opportunity to sit down with a trained mental health professional, who specializes in working with aid workers, and I recounted to her in a timeline the entire experience (starting the second year) of what happened last year when things fell apart with Midwives for Haiti. Just explaining it to someone, like this, was something that I have been wishing I could do since last summer…actually since before I left MWH---there were already some really intense things to process…but I never had the opportunity to really sit down with someone like this…we talked for 2 hours…it was a huge relief…perhaps my raw feelings will always exist as I know them, but…perhaps time will also help me to achieve a distance from all of it as well. I have barely written about happened in this blog because I have wanted to keep things professional. But, it is quite an unbelievable story. Being in NY was also a very interesting experience for me because, as you all know, I have been living in Haiti for over 2 years now. NY is so, so different. I was just in awe, and walked around as much as I could in the evenings. The skyscrapers. The old buildings. All of the languages you hear as you pass people on the street. Absolutely fascinating. Something else was the impersonality of the people you pass on the street…I’ve always known NY to be this way, but, it’s just such the opposite in Haiti…sometimes you literally greet almost every person you pass on the street…like in Hinche…I remember this…Blada seemed to have a unique way of addressing each person we came across…always something a little different, and right for that person… After being in NY for 3 days, I spent 2 ½ days in NC with my family. I was there the day of my birthday. I didn’t tell anyone I was coming, because I knew I was only coming for 2 ½ days and I have already been so so exhausted the past month, learning the ropes of my new job…I just felt that talking to people would be too much for me. I am sorry to everyone that I didn’t call or write to before coming. I literally only saw my family, plus one friend, plus Emma, who is like a grandmother to me, and may not be around the next time I come. The good news is that hopefully I can come again for a week this summer, because MSF does give people breaks every 3 months. At first I thought I would stay in Haiti, but now I am not sure. I really miss my family. Having a moment to breathe in NC was very refreshing to me. I love it more than I used to. When I left 9 years ago and moved to the desert in El Paso, I was ready to leave. But now I am enchanted with NC. The smells…the earth…multilayered smells of nature…the gentle breeze…wild green grass and flowers everywhere…trees…birds singing…the only things missing when I am there is Blada…we have to get our visa this winter! In the meantime, I am so thankful to have this amazing new job…there is so much opportunity for growth and learning here…I feel very very lucky…and I like the people around me…I’m not best friends with everyone but there is no problem…things are good enough…most people are quite reasonable… Getting back to some of the things I had wanted to write about earlier, before I went to NY…basically what I had wanted to say was that I am humbled by the Haitian midwives who I have been working with in Cholernite (Cholera + Maternity= Cholernite—i.e. pregnant patients with cholera)--- These MW’s work tirelessly…with cholera you are constantly moving…never sitting…what impresses me the most about them is not their technical skills and their speed (which I am impressed by), but their kindness towards the patients. In general, my experience in Haiti has not shown me that Haitian midwives are especially compassionate or kind towards their patients (in fact they can be mean, even abusive). I have worked in 2 different public hospitals in Haiti and I saw some pretty heartbreaking things. These cholera midwives give me hope. I am pleasantly surprised again and again, when I see how they talk to people, how they don’t lose patience, how they don’t blame anyone for their illness…how they even use humor… Cholera is unfortunately still a very stigmatized illness in Haiti. People are deathly afraid of it. Perhaps because it is newer than other things, like tuberculosis, AIDS, Hepatitis, Syphilis, etc. it is scary to people. One amazing component of this MSF hospital is that they have a mental health component, and people from there actually come every morning and speak with the women/their families, and a lot of it is about not feeling ashamed for having gotten cholera. Peoples’ lives are so hard here…even here, in this hospital, which is probably as good as it gets, people still of course experience loss…there was this woman in the Cholernite, who was really dehydrated and not quite stable yet, and she also had 3 children in the normal cholera treatment center (CTC). Well, one of her children died there. They were waiting until she was more stable to tell her. This is so sad. It’s already such a hard thing to deal with, for your whole family to be on the edge of death with cholera, but then to lose a child, just like that…. There was another woman, who went into premature labor at 8 months gestation. (The dehydration from cholera causes a lot of abortions, premature labors and stillbirths). This woman had her baby (in Cholernite), the peds were there already in case we had a premature baby needing resuscitation, and they admitted the baby into neonatology because of the prematurity, although the baby really looked good and hadn’t even needed resuscitation. The next day, I saw the mother and father again, and they were very eager to hear news about the baby. The father was allowed to visit, and look at the baby through the glass. The baby was doing very well. The prognosis was good. Then, suddenly, about ½ hour later, the baby died. They resuscitated for a long time, but they couldn’t save him. This news was so hard for the parents to hear, after they had had hope. I again saw them the next day. (I learned about the baby death after returning home the day before). The mother looked at me as I came inside, and just put her hands up, as if saying, “there was nothing that could be done. There is nothing I can do about this, except accept it and move on”. She cried on my shoulder for a few minutes, and said these very things to me. She was resigning herself to moving on. She had another child at home. All of this because of cholera. There have been other women, other stories…because I have been so involved with Cholernite from day 1, I have also been close to the patients. The atmosphere in there, it is a small space with 13 cots crowded in, but people are making the best of it. They talk to each other, they make jokes, they laugh, they make fun of eachother. It becomes a sort of community. They tell on each other to the midwives, when someone tries to fake it because they want to go home. Once again, the instant intimacy and community that I have experienced time and time again in Haiti, in all sorts of circumstances. Mainly in tightly-crammed buses. People make the best of it and always seem to manage to have a good time, and to find things to argue about or laugh about. There is something so special about the people here. Maybe this is part of why I already felt so welcomed by the Haitian staff from the very beginning, because they are already like a family together. I feel as if I have been adopted into an extended family.

Tuesday, April 10, 2012


Just a couple of observations/situations that I couldn’t help but think were interesting and telling…
The first, I have noticed a couple of times: when we go into our bank, Fonkoze...in a couple of places on the wall there is a tattered piece of paper taped there…I didn’t pay attention to it at first, but then one time I started reading it…it is instructions on how to bury someone who died from cholera. It describes how one must put the body in a plastic bag, and also stuff all of the orifices with something. It gives examples of orifices that would need to be stuffed: ears, mouth, butt…
This is just taped nonchalantly on the wall at the bank, in front of the tellers…on a tattered, faded, typed page…
Interesting and sad…that cholera is so common still that they have to put up signs at banks explaining how one should bury their dead…
Today, we went to the photocopy place…a very interesting place, each time I go…I have been going a lot recently because I was making copies and handouts for a class I will be teaching sometime soon at Help Nursing School in Leogone, on neonatal resuscitation…so, anyway, each time I go, it is an interesting experience, culturally—even something so small as going to a photocopy place here is quite different than in the US, and you see those differences clearly…you have to go with a lot of time on your hands…no one is in a hurry, and in a way this is good because the people working there, they focus on one task at a time without getting stressed out about all the people waiting—no running around frantically multitasking. So, it is always like this—people are having conversations while they make the copies—there are lots of pauses in the work…that’s fine. What was funny today was that when I arrived, the place was packed! Blade went with me…we soon saw that the reason it was packed, was that people had gone there to watch the soccer match…they have a TV there…so people were standing at the counter and sitting on boxes of paper—crowded in—watching the game—not only watching, but having animated conversations across the room about the game and the players…a group conversation…really fun. The guy who was scanning my papers for me was also watching the game…so, starting and stopping with the scanning….it’s just such a good lesson in being relaxed! It’s so easy in the US to get so caught up in being busy and multitasking all the time, and being as efficient with our time as possible…always on to the next project…
Here, you have to take a step back, relax, and slow down…

The past few days, I have been super busy (and enjoying it) basically organizing my stuff into different categories and packing for Port au Prince. I am trying to get all my papers for MSF in order as well…hence the scanning of forms today…it’s been busy but good…
Blada and I are doing great…both mentally preparing for our upcoming separation…we both feel that this is the right move for us right now…I can’t pass this up with MSF, it’s such an amazing opportunity (to he hired in-country for a specific position). I probably cry about 4 times a day when I think about not living with him…about being separated from him…it has been such a blessing having our little house in Jacmel…living together, having privacy (we have been living together since summer 2010 but not with privacy)…having our little kitchen…it has been a huge blessing, and was totally facilitated by our friend Sarah, whose clinic and house are on the same compound as our house…thanks to her we got the house, and have internet, water and electricity…
Anyway, this will be a new chapter for us…we will each be learning things on our own this year…
Blada is going to be living mostly in Ti Trou, with Mackenzy and Kirsty…Kirsty recently returned from Canada with their 2-month old baby…they are still building their house and Mackenzy has massive gardens that he maintains and sells produce from…so, Blada will be learning agronomy with Mackenzy….
We are also buying a little piece of land, right in front of Kirsty & Mackenzy…so, this year, Blada will be working on our land, planting trees especially….
Currently the land is treeless…well it does have one tree, which Blada thinks is an olive tree…apparently olive tree leaves are very nutritious…
He will be planting mango, cashew, almond, papaya, soursap, breadfruit, orange…things like this.
So, there is a lot of work to be done…and a lot of skills to be learned….

This is my last week in Jacmel before moving to Port au Prince and starting my new life, working with MSF. I have been savoring all of the little aspects of daily life in Haiti as well as aspects of personal freedom that I know I won’t have after I start working.

We went to a beautiful beach a couple of days ago…oh, it was just so so beautiful…the water, the mountains in the background…I spent hours collecting rocks to bring to our land in Ti Trou (which doesn’t have round rocks—only sharp rocks) to one day do a project…
I have made hot chocolate with local cacao a couple of times this week…and sat there are grated coconut to make coconut milk to put in…like gathering the rocks, I felt no hurry, just a peace of mind, knowing that I can spend my last days here doing even the most tedious or slow of tasks and that it’s okay…there’s no rush for anything…there is time for everything…

Well…I am starting my life with MSF in 4 days. It’s hard to believe even though I know that it is about to happen and it makes sense. It feels kind of like a dream, like an idea, that is a good idea and will be amazing, but perhaps will never materialize. Saturday the 14th, Blada is going to escort me to Port au Prince, to the house where I will be living with other expats. Shortly after arriving I will be taken to a different MSF place-an office I guess—where I will spend the next 2 days having briefings about the project, security, etc.
I have been enjoying the slowness of my life here, in Jacmel…making good food…we are making bouyon today—it is a kind of soup—
I have been making hot chocolate with the local cacao…and grating coconut to make coconut milk to add to the cacao…oh, it is so amazing…an energizing drink with lots of good fat from the cacao and coconut…I have been doing things like this, while reading documents sent to me by MSF and preparing myself and packing…

I was reading one of their documents yesterday—a briefing document about Haiti—its history, politics, health situation, etc. I started thinking about what it was like working in HInche, at the public hospital there…the beautiful things and the heartbreaking things…the stark reality of being grossly, unimaginably understocked, understaffed…all of the severe and classic manifestations of disease that you see in settings where people have had no access to any kind of preventative healthcare, for their whole lives…
I started thinking about this one woman, who I will never forget…she was around 20 years old, in her second pregnancy…28 weeks (7 months) pregnant. She had severe preeclampsia, with really high B/P, facial swelling, protein in her urine, etc. I was talking to her, explaining to her why our only choice right now was to induce her labor and cause her to give birth—to a 7-month baby who will definetly not live. But that if we didn’t do this, she was only going to get sicker, would probably end up having eclamptic seizures, and could die. Women dying from eclampsia was commonplace at St Therese hospital.
Well, this woman, she was willing to make this choice to save her own life, but she was so torn and so sad, because she wanted to have a baby so badly. She was attached to this baby already and from time to time kept saying how she could feel the baby moving in her belly. She was wavering between the logic of saving her own life and the feelings and love she had already developed towards this baby. Then she started saying, “Why am I incapable of having a baby? I just want to have a baby.“—In her last pregnancy, the same things had happened: she was preeclamptic and lost her pregnancy around 7 months.
This experience of sitting with her through her grief and acceptance of the need to save her own life by getting rid of the pregnancy was heartbreaking for me. I cried and cried yesterday as I remembered this. The choices women have to make here…she had 2 options, and either one of them entailed either herself or her baby dying. There were no special (routine in any 1st world country) tests to give us an idea of how severe her preeclampsia really was—we had to rely on gross evaluation of her outward symptoms. There was nowhere we could send her that would most likely be able to save her 7-month baby. There was no system to transport someone like her in case there was a place to send her.
Now that I know of the MSF hospital where I will be working, I know that if we had been able to get her there, they most likely would have been able to save her premature baby.

Peoples’ lives are so hard. You see it in so many children…stress. They are not carefree and innocent. They are hungry. They carry water everyday. They sell gum in the street instead of going to school. They work as indentured servants.

Blada and I were in the market the other day (where people sell produce, clothing etc. on the street), and it hit me that I will miss going to the market…the experience of it is a microcosm of Haiti in some ways…it is so interesting….going with him is interesting too because of the etiquette he has while buying, which I have not quite mastered…there is an etiquette of buyers and sellers…a lot of bluffing while debating on prices…arguing, debating the price or quantity, walking away if not satisfied, getting called back, buying the thing at the price you wanted…
Flies everywhere…meat sitting out all day (people have a special way of washing meat here which neutralizes the fact that it was sitting out all day with flies on it)
As we were leaving, we were looking at sunglasses and for like 10 minutes could hear this guy who sounded really annoyed, speaking in English…demanding to buy something for 5 dollars. After like 10 minutes or 15 minutes, we ended up standing right next to him and I realized what was happening...he was being SO RUDE to the merchant…speaking in English, demanding to buy a watch for $5, and then demanding that the merchant GIVE HIM CHANGE IN US DOLLARS. He is standing there, arguing with the merchant, who is doing his best to communicate with this person who is practically yelling at him, in a language he doesn’t even speak. I decided to try and help. When I got close, I saw that the guy who was being super rude and disrespectful was someone with a UN uniform. Oh, big surprise. It all fell into place. He was from somewhere like Sri Lanka or Nepal. Yelling his broken English at this poor merchant. Many if not most of the UN soldiers here, they feel completely entitled—to everything. You can see it manifested in all kinds of circumstances. Anyway, I tried to explain to this guy that the merchant DOESN”T HAVE change in US dollars. It should have been so obvious to him. But it wasn’t.
Many people here feel that they are living under an occupation. To top it off, there have been child rapes ( Blada even knows of a boy this happened to in Hinche---his parents had to take him out of school because people constantly tease and taunt him, calling him “Madanm Minusta”---
Then as we are walking away from the market, we see this group of white people, who obviously are going to the market for a purely touristic and voyaristic experience…one of them has a big nice camera around her neck…I should have said something to them…who do people think they are, just walking in and taking pictures of people as they go through the motions of their daily lives…without even asking permission? Even if they did ask permission, as I used to see in HInche with the short-term volunteers who wanted to take pictures of patients they had helped, THERE IS A HUGE POWER DIFFERENTIAL that exists, and many people will not feel EMPOWERED TO SAY NO. This is such a basic reality—yet people walk into Haiti so blind to it.

So…I feel optimistic about this year, about working in Port au Prince with MSF…I am so thankful, so so so thankful for this opportunity…it is amazing that this was possible…
Any situation, any blessing, always entails sacrifice. I have been immersed in midwifery since 2003, and consequently have had to live apart from my family for the past 9 years. I have learned so much and grown so much as a midwife, and am so thankful that this path was possible for me to embark upon. Likewise, working with MSF is a huge blessing, that entails a huge sacrifice: living apart from Blada. I know that this is going to be really hard for me.
My beacon of light, my hope, is the vision of obtaining our fiancé visa without problems, and moving to NC in the spring of 2013, and being reunited with my family and community there, while also finally being able to start a family of our own. This is the goal. There has to be a goal in order to make it through.

Monday, March 26, 2012


Things have been going well. Better and better. There have been some recent events that were interesting and I thought I would share.

I went to HInche a couple of weeks ago and visited with everyone there. It was wonderful. I spent every day with Marthonie (who I used to teach with), and visited a lot with Genette, the other midwives, the MWH house staff, etc. Jamlex, who we used to spend every day with when we lived in Hinche, was really fun to be around again. He has changed so much in 6 months. He is about 2 years old now! The first moment he saw me, the first thing he said was “Blada”. He is used to seeing us together! He knew my name, but the whole time I was there, he always called me Blada. It was funny. I went to their house and spent a day there, with him and Diunney, his mother (the cook at the MWH house). It was so nice having time to sit with people. Marthonie and I miss eachother a lot. She is doing the classes mostly on her own now, with some “help” from the American volunteers.

Visiting the hospital was very interesting, as always. Man, I really miss working there. I got to see all the people I used to work with—the OB, the head ofmaternity, the midwives, some of my old students, etc. The first day I went, I just hung out and socialized. The second day, there was no one working in the prepartum room (antepartum) so I worked in there by myself all morning. Almost every single person in there was either preeclamptic or eclamptic. I couldn’t work on everyone so I chose the 3 worst cases, who needed the most immediate attention. It was 2 women who had already had eclamptic seizures, and one preeclamptic woman with a splitting headache (bad sign) who needed her labor induced and had super high blood pressure (like 190/130). I got all their IV’s and meds going, and just kept going between them checking their B/P, making sure the IV’s were running correctly, etc. I induced the preeclamptic woman. I also spent most of the morning running around, looking for the materials I needed to work on these very sick women. I went between 3 or 4 places all morning, getting things as I needed them. It is ridiculous! It’s just as bad if not worse—the access to materials and the porganization of materials—as when I used to be there. Yes, there are some more things that seem to be more in abundance now than before (because of the new director of the hospital), but the organization and access isn’t any better. This lack of access to basic supplies and medications is why preeclamptic women don’t get induced and then go on to have eclamptic seizures.

The new director of the hospital seems to be very proactive and forward-thinking. He is also very accessible and not a sociopath, like the last person. I like him a lot. However, there are people who DON’T like him, or the order and progress he represents (he has also been cracking down on hospital staff when they are lazy and apathetic about performing their jobs), and there has actually been a subversive wave of propaganda against him. No one actually knows who is behind it. But, there have been death threats, things on the radio, and there is red graffiti spray painted on some of the hospital walls. When I saw him and asked him how things are going, he smiled and calmly replied that there have been some “ti pwoblem”—“small problems”, that are always to be expected in a situation like this, but that things are going well. When he first arrived to Hinche last October or so, he used to always have these 4 large bodyguards with him—everywhere he went. Now, it doesn’t seem that he does. I guess he anticipated trouble before he came, I guess this is normal. People like to create chaos and impede progress. The last person who had his job, everyone was just too scared of him to ever try to intimidate him or speak out against him in any way.

The day I travelled from Hinche back to Jacmel was also pretty memorable. It was just another pretty normal day in Haiti, especially travelling such a great distance. Shortly after leaving HInche, one of the tires on the papadap (like a minivan—faster than a tap tap, which is a pickup truck) exploded, so we all had to get out and wait for another machine (general term for different kinds of vehicles) to pick us up. When the next machine came, everyone trampeded in, pushing and shoving (totally normal), and since I didn’t want to take part in that, I just waited and then got in. Well, my seat was now occupied—I didn’t say anything, and just started unfolding the little side seat with no back support that was now to be mine. As I was doing this, the metal support attached to the seat slammed down onto my big toe like a hammer (I am used to the seats just unfolding easily, not forcefully). So, I had a pretty severe injury to my toe, and was in great pain the whole way to Port au Prince.

I hadn’t planned to take a moto taxi in Port au Prince to the Jacmel station (you get dropped off in one place and have to traverse the city to get to the place where you can board a machine for wherever you are going)---I was planning on taking a tap tap, but now I couldn’t walk and I had 2 backpacks with me. So, I took a taxi. I chose the guy with the most innocent-looking face. He was nice enough, but was incessantly flirting with me the whole time, in a way that was really annoying. Like, “I may as well just die if I can never see you again.” Stuff like that. We drove past the national palace, which is still in ruins, all fallen and crumbled. People living in tents all around. The president doesn’t live there—he lives in Petionville, a part of Port au Prince where the rich people live. Anyway, the other thing was that this guy’s motorcycle must have stalled out like 4 or 5 times along the ride. One time I had to get off and walk across the street, which was hard because I couldn’t walk at all. Another time, we stalled out right as we were driving through a stream of muddy sewage water that smelled like shit. I had my injured tow, and really didn’t want to expose my injury to sewage water. He kept pushing the moto, trying to make it restart. He took one of his sandals off, his foot now in the sewage water, trying to give his moto a push start. Well, finally we got out of there.

Like I said, just another day in Haiti. It seems like it would have been stressful, but it wasn’t. Everything was normal. Just that I had a bad injury and couldn’t walk. Even the scenery in PAP is seeming more and more normal. I am pretty used to Haiti, but PAP is pretty bad. Most people who haven’t lived here wouldn’t be able to imagine it at all. And I don’t want to make it sound bad—this is peoples’ daily reality and daily lives. But, to an outsider who has not been forced to accept this as their life, I perceive Port au Prince as a hellish place to live. What I see is trash everywhere, piles and piles that people have to walk over, piles of trash burning while people are picking through it, tires burning, air pollution, sewage water in the streets, beautiful well-groomed schoolchildren carefully and nimble stepping through the dirty water and trash and mud as they walk to school…huge traffic jams…loud noises…decaying buildings…
Once again, this is not to say that this IS how it is. This is how I perceive it. I am less affected by it now. It used to depress me more.

Blada made a wonderful traditional Haitian food today: bouyon (boullion). It is a kind of soup, with starchy root vegetables, amaranth greens, meat…really special. We don’t know when I will get called to start working in Port au Prince, but I am just enjoying the present moment, living our little life here, making food together in our little house, going to the market and getting produce, negotiating prices, stopping and talking with people in the street…


So, things are moving fast now. We are packing up our house because I did get the job with MSF and will be starting on April 15th. We will still have our little house here but will hardly ever be here—it will be more like a storage room. Hopefully, I will be able to leave once in awhile and we can come here for a weekend. Blada is going to be living mostly in Ti Trou, apprenticing with Mackenzy (organic farming)—he is also probably going to start holding dance classes twice a week in Ti Trou.

We have a lot of organizing to do before we move. When I start with MSF, I will have to follow their security protocol, although they are willing to be somewhat flexible with me about leaving once in awhile. Normally, expats can only leave the residence in an MSF vehicle, to go to work. No walking around Port au Prince, no taking public transportation. This will be very different than how I have lived in Haiti, but it will be a new experience and I accept it. It is part of the new situation, and this new situation is such a blessing and I am so thankful. Blada will be able to visit me at the house on weekends, as long as my housemates and coworkers are not too jealous and upset about it (they don’t get the same flexibility). So, we will play it by ear. I am savoring my time with him, trying not to think about missing him later on.

We went to PAP a few days ago for a final meeting with MSF—I met with the head of mission there. We recently bought a motorcycle—we will sell it before we leave Haiti—now that we will be split between 3 places, it’s more of a necessity. So, we took the moto to PAP. Oh my god, driving in PAP is a nightmare. It is unbelievable. Motos there simply weave between all the other vehicles—huge trucks, cars, other motos, etc. They weave in and out, between vehicles—black smoke everywhere, people darting in and out between lanes—vendors—so much activity. It was stressful but we made it. We got stopped by the police on the way and had to bribe them to get away. Totally normal for here. The whole reason they were stopping people was to fine them—they don’t care if people don’t have all their papers in order or their drivers license or a license place—they make a big deal just to make you pay money so you can go. We had to stand there for like 30 minutes while things worked themselves out. (we don’t have all the papers in order yet for the motorcycle). At first, they were like, “madanm, misye arête”—like, “madam, he is under arrest.” Then it went from that to “you have to leave the motorcycle with us until you get all your papers in order” to Blada talking with one of them over to the side (what they had been waiting for the whole time) and offering a bribe of 300 goudes (about 7-8 USD). The guy was like, “come on, there are 3 of us (3 police sharing the bribe)—so then Blada gave him 500g (about 12.50 USD). After this, their whole demeanor changed, they were friendly, they were understanding, they even gave him their phone numbers in case we got stopped by someone else down the road. So funny. About halfway through PAP, I wiped my face and it was just covered with black soot. Luckily I was travelling with a rag and water, so when we arrived I wiped my face down. Black city grime. Blada’s beard was white from all the dust.

So…yes, things are suddenly moving forward…I am so grateful for this…this means that we will be putting off ourvisa interview until a little later than we thought—I am signing a 9 month contract with MSF—this means we will hopefully be coming up to NC next spring. If all goes well with the visa interview, which I hope and pray it will.

Thank you to all of you for your support and love!