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….

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.

4/25-5/29/12

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.

3/31/12-4/10/12

3-31-12
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….

4-5-12
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…

4-10-12
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.

3/20-3/26/12

3/20/12
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…

3-26-12

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!

2/4-3/1/12

2-4-12
Time is passing! I can’t believe we’re already in to February.
Things are getting better, life is happening. Around mid-January I believe is when I started coming out of my depression. It has been slowly receding--still there are moments where I feel really sad about it and when I reflect on the actual reasons and events that led up to this, it can be upsetting, because it is really just so ridiculous--all stemming from lack of communication and misperceptions--it all feels so wrong sometimes--like, this was all a huge mistake--but, nevertheless I want to be happy and appreciate my life for what it is, so I have been trying to move on and look for other things to do.
What have I /we been doing? Here in Jacmel, I am helping at Olive Tree Projects with structural improvements and writing of protocols for the clinic. So, I have been reading a lot which has been good. Also, recently I started going to Leogone (a town south of Port au Prince, it was the epicenter of the earthquake but looks pretty good now)--because a friend of mine named Angela who was a volunteer last year with MWH is there now laying the groundwork for MWH to expand their program there. In Leogone they have these health cluster meetings every 2 weeks where different NGO’s meet & discuss the work they’re doing in effort to coordinate efforts/avoid duplicating each other’s work…the reason I’m going to these is to start putting myself out there, to meet people, in hopes of landing some teaching jobs. I visited a nursing school/hospital with Angela and met with the administrators, who once they knew what I had been doing the past 2 years (teaching Hatiian auxilliares), asked me to come and teach a few classes for their nursing students. This is great--it’s a step in the right direction--but I need to find paying jobs too. All of it is good.
Kanaval has been good…apparently it lasts 1-2 months…we went on the first day and ended up getting painted with black sugar syrup and parading through the streets in a large group of people who were all painted this way…at the end, we arrived at the beach and everyone jumped into the ocean and bathed…so fun!
The people in Jacmel are very easygoing…a lot more friendly and less suspicious than the people in Hinche (in general)…even at Kanaval, no one cared that I was white…it was nice to feel like part of the group…

2-16-12
Things are going well. Kanaval has been interesting. Blada has been out of town for 2 weeks, working with Mackenzie (Kirsty’s partner) on their land in Ti Trou (in the southern part of Haiti). Kirsty is in Canada; she birthed her baby 2 weeks ago and is doing well and hopefully returning soon.
I am lined up to teach a few classes at this hospital & nursing school called Help, in Leogone. Another prospect is that I may be getting a job with MSF Holland, in Port Au Prince (MSF=Medecins sans Frontieres=Doctors without Borders). I met this MSF person at the health cluster meeting a couple of weeks ago and got a contact from her and I actually interviewed 2 days ago in PAP. It would be for an administrative/managerial role, which is somewhat new for me, so it would teach me some things I’m sure. The problem with possible working for them is that Blada and I will have to live apart. For atleast 6 months. I would be able to see him sometimes, like maybe every 2 weeks. This is a huge sacrifice that is really difficult for me to imagine, but at the same time, this seems like an amazing opportunity that I shouldn’t pass up. We will see.

Other good news: our fiance visa petition has been approved, which means that now we are moving into the next phase of the process. The next phase is gathering necessary documents and preparing for the interview at the US embassy in PAP. We are hoping to do the interview around May. After this, if we get the visa, we have to leave Haiti within 6 months. Hopefully getting the visa and working with MSF can both coincide timing-wise.

I have been thinking about what one of the days at Kanaval was like. I never take pictures here--I have very few pictures I’ve ever taken, although believe me all the time I see things that I wish I could record and share with people back home to show what life is like here. I have never felt comfortable taking pictures--I stand out enough as it is, people see me as different enough as it is, they see me as rich and provledged enough as it is…to then be snapping fotos in front of them, it just feels like something someone would do out of complete ignorance or indifference to the situation and power dynamics here. So, this one day at Kanaval, I knew a lot of people would be taking pictures, and I convinced myself to try and take some as well. Jacmel is an historic town, old architecture…Kanaval is interesting…the parade…huge painted paper mache puppets and marionnets and things…I found Kanaval here to be very very touristy…it was clear that a lot of people had come to Jacmel only for Kanaval…lots of white people…just a different scene than I am used to. Well, I took pictures during the day, and then later, during the next few days, was reflecting to myself how I felt about that…actually, it was like I was carrying around a guilty feeling, like I had betrayed something…that was what made me think about it so much…I kind of feel like I missed part fo the spirit of Kanaval because I was taking pictures…and not that anything is so wrong with taking pictures, especially on a day like this, where everyone knows it is a touristy occasion…just food for thought…
Then a few days later I was in a tap tap (public transportation) and there was actually this discussion going on in the tap tap about how NGO’s and white people come here and take pictures of poor people, without asking permission or anything…this guy was talking about it…a lot of people here think that the people who come here and take pictures go back and make money off of them…in some cases that’s true…in some cases they don’t make money but they still are taking something back with them that doesn’t belong to them…and using these images to promote themselves in some way…I have seen people come in with the most entitled attitudes, it is unbelievable…a couple months ago Blada and I were on the beach, and this white guy arrived, and he had a big camera in his hands…he didn’t look at anyone or say hi to anyone, except after a few minutes he came right up to me and shook my hand and started asking me questions….he was a journalist, doing a piece about “tourism in Haiti”--I was feeling uncomfortable because he hadn’t Agno ledged anyone else who was there, just me…I didn’t want to be a part of that…so, he walked away, and then…without saying anything, just started snapping fotos of the kids on the beach who were practicing flips on the sand…we left.
Anyway…just something to think about…
When I was in Port au Prince I saw an image that will never leave my mind--it was the kind of image that would have made a very compelling photo. In a tap tap, crossing an intersection. The road intersecting us was Martin Luther King Blvd. Right next to the road sign, was a very old woman holding a bowl (asking for money) in one hand…the other arm was horribly disfigured…it looked like it had been completely twisted around--and broken--from above her elbow--and never fixed. It was just hanging there, with the palm of her hand facing the wrong direction. We want to think that we have come so far past racism, but seeing an image as ironic as this, seeing such raw suffering right next to the name of someone who brought the movement forward so far and is remembered and honored for that…it is ironic. We have so far to go. The people here are still in chains. Poverty is a form of violence.

3-1-12
February went by so fast. Things are going better now than they were in Dec-Jan. Those were hard months! Finally, things seem to really be picking up and new opportunities are arising.
It has been nice visiting with an old schoolmate from Maternidad La Luz--for about the past month. Her name is Olivia, and we were in midwifery school together like 9 years ago. She is in Jacmel with her beautiful baby, Zora. Strong lady, coming to Haiti by herself with her baby! She has an organization called Earth Birth that is partnering with Mother Health International, which is the org that has been running the other birth center in Jacmel (there are 2). So, they moved locations and Olivia has been working really hard for the past month to make lots of things happen. We’ve been visiting and sharing lots of stories, and it’s been so great. It’s really cool seeing how drastically we both have grown and changed since we knew each other in midwifery school.
She has been hoping that I could work for their birth center--they have 4-5 Haitian midwifery apprentices who need more attention & training…it is nice to be wanted! But I do have my sights set right now on working with MSF in Port au Prince, and it is still uncertain but seems to be in the works. This would be such a good opportunity for me and I feel I can’t pass it by. Of course, I have mixed feelings because living apart from Blada will be hard…and we will have to put off starting a family still…but also, this feels like it will be so god for each of us, because we each will grow & develop ourselves in ways that are important (Blada will hopefully be apprenticing with Mackenzy, Kirsty’s partner, who is a master agronomist).

I taught my first class at Help nursing school a few days ago. It was on breech birth. It went really, really well. The staff was so happy with it (the head of nursing sat in on the class--I think they were already interested in me but wanted to verify if I could actually do a good job teaching)--that they started talking with me about becoming an integral part of their faculty! Teaching more classes, helping with clinical training of their students, attending events, etc. I dropped by yesterday before the Health Cluster meeting, to give them my CV, which they had requested, and the director officially introduced me to people there as a new staff member! They are making a file for me, an ID badge, etc. It is amazing, because all I had done originally was offer to teach 2 classes for them, and everything else from there has been their effort. It is very encouraging.
I really like Help, because it is well-organized and all Haitian-run. It’s awesome!! They have partner NGO’s and they receive funding from them, but, on the ground, it is all Haitian run. They do a wide array of community health services. They do health education, mental health services, rape crisis, community education, among others. Very impressive.

Another wonderful event that has left me in greater peace than before is that I finally met with the directors of MWH face-to-face this week. The reason they met with me was because it was strongly recommended to them by a volunteer who was laying groundwork/networking for MWH in Leogone (they will be replicating the training program there starting this September) that after she leaves, they contract with me to attend Health Cluster meetings as their representative, so that other NGO’s there (who MWH hopes to partner with) will see a continued presence and interest. So, this is happening now and I am glad. Meeting with them, for me, was helpful because I have been longing for resolution and closure. This happened to the extent that was possible. And, the fact that I am contracted to represent them in Leogone is good because it shows that we are not burning bridges.

I am finally going to visit Hinche! Next week. So so excited. Everyone there is too. I will get to see Marthonie and everyone else!

12/18/11-1/10/11

12/18/11

I have not been able to sit down and start writing for awhile. The month of October was quick, and things have been tumultuous since my return. I don’t really want to go into great detail here but basically, when I returned to Haiti in late September, after having been in the US to get my affairs straight so that I could come back and stay for longer, and after having 2 successful fundraisers for my work in Hinche and the work of Midwives for Haiti, I found out that there was a very deep rift that had grown between those of us living and working on the ground, and those who live and manage the organization from the US. This misunderstanding had already transformed into something so complicated and perverse, without my knowledge of its existence at all, that by the time I found out about it, it was too late. Very sadly, for everyone, the way the situation came down was that there was irrevocable damage done and I left Hinche. This was devastating for me, and I am still recovering from the shock of it, and still missing people a lot, such as Marthonie, who was my loved and trusted co-teacher. I had grown so used to working with her, and we had such an amazing, collaborative, tolerant, and trusting relationship. She is not the only one, but the main one.

I haven’t been able to say anything or write anything, because I have just been in shock about how abruptly my life changed, and have been mourning a great, great loss. I had not foreseen this happening, but in a way something like this is not surprising, given the overall situation that the organization was functioning within (such as the fact that I was living full-time with all the short-term volunteers with no personal space/boundaries/privacy, lack of communication between myself and the directors about issues…it‘s complex).

I have wanted to let all of you know that I am ok, and Blada is ok. But, so far I haven’t been able to say anything, because I have just been in a state of perpetual mourning. I am trying to move forward and move through this transition and accept the loss and also the blessings that will inevitably come out of this. I am starting to see it more in this light, although the truth of what happened and the feelings of betrayel and loss that go along with it will always inevitably stand out in my memory and emotional landscape. Perhaps there will be a way in the future to work with MWH, perhaps in a different context or setting, although I miss the people in Hinche so much and had spent 2 years literally building bridges and trust through working daily with the people there.

Often I have felt like I am dragging my feet, and like I should just get over it and continue and have faith, because that is what I see Blada doing. He is doing fine. This has been sad for him too--we lost our community, and he witnessed my sorrow and held me through it since the beginning of this change. So, he is very strong and resilient, and adaptable. One main reason for this is that he is Haitian. Haitians, most of them, have spent their whole lives having to accept many injustices and hardships as normal life events, and have even cultivated an amazing capacity for joy and humor, which they exercise all of the time (they can laugh and have a great time doing anything…) so, as Blada put it to me, so honestly, he has never had the luxury of escaping the reality here (he can’t just take a vacation from it like I can if I want), and for his whole life he has had to accept hardship and if he allowed himself to dwell on things as much as I do, he would have gone crazy by now. It’s really true. Maybe part of the difference is that I’m a woman too, and I process things differently and definetly live more in the realm of my emotions than he does…but I think it’s not just that, it’s also part of my upbringing and life experience as a North American…you have the luxury to ponder and process your feelings….

To illustrate this difference even more, I will give 2 examples of people I know who recently experienced great loss and nevertheless are living their normal lives…a Haitian midwife I know, before we left Hinche, I heard from someone else that her father had just been murdered--hacked apart by someone with a machete--over something that had to do with land rights/ownership. Yes--her father was murdered. I saw her the same week or the next week, and never would have known if someone elsehadn’t told me. She seemed normal, and was working every day. Haitians have a way of compartmentalizing their grief, so that they can continue functioning and living. I think part of this could be the fact that when someone dies, there is definetly an acceptable time and place for intense grieving, with no restraint. People grieve intensely when someone dies. But somehow after this, they move on, and at least seem to be ok. Another time, shortly before we left, we had a friend who was in the house who suddenly we all could hear she was crying--weeping--and calling out to her father over and over. Finally I approached her to ask her what was wrong. She told me that today marked the 10 year anniversary since her father went missing, in Port au Prince. After this day, no one ever heard from him again. Probably on this same day, every year, she grieves this way for him. Maybe this way she is able to function normally the rest of the days. I don’t know, and I’m not attempting to analyze or name anything about Haitians or Haitian culture--I have tremendous respect and humility towards it--I’m just citing a couple of examples of my experience here that gives rise to my small sliver of understanding of the people here.

So, I can’t and shouldn’t compare myself with Blada, because we come from such different cultures and life experiences. Things will work out and I do realize how very lucky and privileged I am, to still have so many choices, in reality, and such a good standard of living…we have a little house, which we love…it’s private, peaceful…just the 2 of us…it has a kitchen, a bedroom, and a bathroom. But it is big enough. It is lovely. We have water, part-time electricity, and even a stove and fridge!!! It is on the same compound and right behind a little birth center, started by a friend of ours named Sarah--she’s a Canadian MW who’s been living in Haiti for about 4 years, and has an organization called Olive Tree Projects. The situation here is pretty relaxed and slow-paced. I am helping her out in the birth center and hoping to make improvements to its functionality. I am also teaching classes for a group of women who she would like to train as MW assistants for her clinic.

In addition to this, I am volunteering part-time at the public hospital here. I miss the hospital in Hinche too much…I don’t want to be completely isolated from what I came to know as my work in Haiti. So, I have started going. The problem is, I am starting over completely from scratch--no one knows me or trusts me yet--it took me a long time to establish trust with the staff at St Therese in Hinche, and now I am starting over completely with a whole new group of people at St Michel in Jacmel…some of them are nicer than others…things could change but there is definetly one Dr, a female OB, who is very angry and hostile (towards everyone--especially the patients)--that’s kind of her reputation overall, so I don’t have any hope of her warming up to me…but, maybe I can make allies with some of the other people…there are a couple of male OB’s, and several nurses…they are much more well-staffed and well-equipped with materials than St Therese…it’s very different…similar but different…I assisted in 2 births there yesterday…I guess I have been partially hardened to the sadness of seeing women mistreated in the most vulnerable moment of their life (labor/birth)--so, I wasn’t surprised by what I saw and am doing my best to remain neutral, nonjudgmental, and hopeful as well…but, I couldn’t help but notice the hostility towards the 2 women and even yelling and hitting of the second…the first one got an episiotomy and fundal pressure (with normal fetal heart tones and the head still not through the bones)…anyway, it is what it is and I am very honored that I am allowed to enter into the space at the public hospital and witness in, participate in, peoples’ care there…it is a new challenge; I have no delusions about changing anything there, but it will be interesting for me…maybe there will be a few meaningful things that can be exchanged, once trust has been established…we will see…
What else is different about Jacmel…I feel like I left part of my family in Hinche…especially the hospital staff and my co-teachers in MWH…Marthonie, Genette…I miss them so much…I have learned so much from them…they are remarkable beacons of light and knowledge…I have so much respect for them and for everyone back there, working in such a hard situation at the hospital…

Here in Jacmel, it is apparent not only in the hospital but everywhere on the street: the standard of living is a lot better than in Hinche. For one, there is electricity. People have their little shops that have lights on at night. People just seem more at ease, like they are struggling less. People have a different attitude towards me on the street as well--they don’t seem to notice me too much. This may sound like nothing but this is huge to me. It is such a relief. I am learning that I don’t have to be so on guard emotionally. It is so nice.

The beach is close, which is a huge blessing and so therapeutic. I love it.
Another gem here is the gay community--yes, that’s right. Jacmel is kind of hip. I was introduced to this art collective--that’s right--where they have these free dance classes (Haitian folklore (vodou) dance--similar to African dancing)--yes, that’s right--free dance practice sessions with most of the participants being flamboyant gay guys--who are so, so sweet and accepting and welcoming--it’s a community that I had missed--and it is here in Jacmel. So refreshing. The atmosphere is all about acceptance. They have art classes there too--all kinds of art--it’s a really really cool place--an old building--funky--like the way a lot of cafes and art studios in the US try to look--this place just is--you go up an ancient staircase (there’s a lot of old French architecture here) to the top level, which lost its back wall in the earthquake…

What else…yes, just trying to be hopeful about things working out, finding my niche, having true resolution and healing with MWH, etc. Since I have more free time on my hands, I am starting again to study French a little (mostly by listening to RFI online)--the internet here is faster so more things are possible…also I’ve been doing a lot of reading and research online, about midwifery and anatomy & physiology…I am learning a lot and it’s exciting--I’m not retaining everything but I’m hoping that some of the concepts will remain and that maybe they’ll be more familiar if someday I am able to go to nursing school…so, I’m doing what I can to make good use of my time…
Blada is making good use of his time…he found an artist to apprentice with and is learning how to paint and helping with other projects…it’s all useful…it’s all progressive…
That’s about all for now. Loving all of you and thanking you for your love and support.

12-31-11

We had a quiet Christmas--very, very quiet. Now, we just got back a couple of days ago from visiting our friends Kirsty and Mackenzy who have land way out in the country (well, next to a small town) in southern Haiti…it was beautiful there…so refreshing…beautiful black earth, sweet air and sweet earth smells…more trees…beautiful. Now we’re back in Jacmel, relaxing and continuing with our activities here. I stayed up all night helping in a difficult labor and birth the day we got back--it was good--good outcome in the end, after a long, hard labor…it’s amazing what some women go through in their labors…I haven’t been going to the hospital as much as I’d like to--I’m too tired sometimes, and also it’s not easy, because like I said I’m brand new there and I’m all alone with no allies…it’s hard.

Working in the birth center is interesting. It is so different than what I had been doing in Hinche. There are things about it that are nice and also things that are hard. Some of the differences are kind of funny, and I don’t mind adapting to them. Each of the births have been interesting and beautiful, and sometimes they remind me of what births used to be like at Maternidad La Luz, where I trained and worked for 6 ½ years before coming to Haiti. In the sense that we know the women, the clients, and it is personal, and they are supported with kindness, and their families are welcomed and encouraged to participate. There is something so special about this.

1-10-12

However, I have not settled into being here, working here--it’s not an automatic thing, and I don’t feel so at ease. I don’t have anyone I can really relate to on the same level as a MW. I miss my people in Hinche. I miss the meaningful work that I was participating in. I still can’t believe that it is all suddenly gone. It doesn’t feel right at all. I feel like I should be there, working and teaching alongside Marthonie and Genette. I don’t have a community here yet. It takes time to find your place and build trust. Plus, the overall approach to the model of care provided is not congruent with who I am as a MW based on my knowledge and experience, so…I am just trying to do what I can to help, reminding myself that this is someone else’s project and I am not responsible for anything more than what I can do. Hopefully I can help to initiate lots of growth and improvement in different areas.

I am publishing this because I know that many of you want to know what’s going on here. Unfortunately I don’t have any better news to give--it is what it is. All I can do is continue on, hope for the best, do my best.

We don’t know what will happen this year and next year--with work, with our life…when our visa will come through…anything…once again I compare my uncertainty and stress with that of the people here, and it looks like nothing…but it is something, it is my experience.