Monday, January 14, 2013
23 October 2012 Yesterday I caught a baby with only my right hand. A woman was wheeled into the delivery room who was already pushing . As she came through the door, the head was coming out. I followed her in—the midwife who had been with her in labor was also by her side, but no one was doing anything to prepare for the birth. The midwife was yelling at her not to push, and even threatening that her baby could die and if so it would be her fault (for pushing in the wheelchair instead of on the table). The head was out, and I got ready to catch the body, which I had a feeling was going to fly out. The only thing was that I was holding a stack of papers in my left hand—in the fastness of the moment, I didn’t think of letting the papers drop to the floor—but instead, as the baby flew out of her as she sat on the edge of the wheelchair, I caught the flying baby with only my right hand. For a moment I thought that this would be my first baby to ever fall on the floor, but instead what happened was that my finger hooked inside the baby’s mouth and this helped me to keep the baby straddled on my right arm, while I kept holding the papers with my left hand. I told the mother that she didn’t need to worry—everything was okay, and I also gently told the midwife that it was not the mother’s fault for pushing—in fact her body was pushing on its own, without her effort. Actually, perhaps she was wheeled into the delivery room a little too late. It was a fun catch—my first one-handed catch (usually even if you were to have a one-handed catch, you would probably have a surface close by where the baby could gently land—like for instance if the mom was squatting on the floor). 27 October This month has gone by very fast. Each week flies by. Things are going okay, not great but definitely better than they were a few months ago. The arrival of Devon, the expat nurse, was a huge blessing for me. She has been helping me to implement things, like the temperature protocol in the delivery room, and is supportive and spends time with me in the wards; we do births together and she’s someone I can talk to…finally… I wouldn’t say that things are going so well with all of the national staff midwives but they are a little better than they were a few months ago. I feel that I have been in an impossible position, stretched between 2 worlds, always the person in front of the staff who receives the blows of their frustration, which is rooted long before my arrival. This week, I was so happy to have some cooler, cloudy and rainy days…but the rain, which was light and lasted 3 days, completely paralyzed the transportation system in Port au Prince…the roads have no canals which drain the water, and many of them are dirt roads…this light rain created a disaster—we had to work for 3 days straight organizing pickups of MSF staff by the MSF trucks, so that people could come to work…finally today the sun is out, and I am actually relieved and happy to see it, because now I can relax and know that people will come to work with no major problem… We find out about the date for our visa interview in a few days… 1 November Well, our interview was set for the 4th of December. So, another month away. This is somewhat disappointing for me because I am really ready to be finished with the whole process, which has taken the past 1 ½ years. But, it is okay. Blada and I are going to visit his family in Cap Haitian for about a week starting next weekend. It has been over a year since I’ve seen them. It will be so nice for me to have a break from the current situation of living in a way that feels segregated from the Haitian population. I am a homebody and don’t mind so much being closed in all the time at the house—I’m not really interested in going out to restaurants like everyone else here—since I’m not allowed to walk anywhere, there’s nothing I can do except work and hang out at home. Blada has been around here more because we were preparing for the visa interview, which we thought would be really soon, not the 4th of December. 3 November Luckily, this week had 2 holidays (Day of the dead) in which I was able to rest and recuperate a little. I was going to go in to work the first day, but instead I ended up working at home, working on these 2 reports I wanted to write, mostly to get some things out of my head and onto paper, which has always helped me. The first one, about the history of the problem of neonatal hypothermia in the hospital and the development & implementation of the strict temperature protocol, I wanted to do so that the new expat or few expats would hopefully not undo the work I have done in this area and would be able to see the complexity of something so simple as protecting newborns from getting cold. It was more straightforward and is mostly finished. The other one, it is about the complexities of working with the national staff here. This one has a long way to go, and it is mostly for myself, to get some of these absurd stories and events out of my head so I can stop thinking about them. It would be too long and detailed to give anyone else…it is more for me, something cathartic. This week I had no tolerance for the expats and felt I barely had the energy to interact with them at all. There is this one person who I like and is really nice, but who talks a lot and who requires a lot of energy to interact with. I think she took it personally that I could not interact with her but at the same time, when I am around someone who is giving me signs that they are not interested in talking with me, I follow the signs and go my way. This person, she never follows peoples signs but always has the exact same, long-winded, needing to have the last word kinds of conversations. This is not so bad though—I really like her, I just couldn’t spare any energy to interact with her. The bad part is that I am super fed up with some of the expats in the house, because they are completely unaware of others and are complete slobs. It is unbelievable. These are adults! I just don’t understand this mentality. Group living is hard, when you are living with people you would have not chosen ever to live with, who has completely different values from you. Mostly I am very tolerant, but there is one guy who really grates on my nerves, because he is so arrogant, he just does whatever he wants all the time, since he first arrived. And, he is unapproachable. Luckily, my vacation is coming up, in one week. Blade and I are going to Cap Haitian for 1 week to visit with his family. It has been over a year since I’ve seen them. I am so excited to be out, to be free, to be able to walk in the street, to be in a normal Haitian house, etc. I can’t wait. 2 December 2012 The month of November went by fast. I now have only 2 ½ months left!!! I know it will go by fast. Our fiancé visa interview is in 3 days. Once we are finished with this and have the visa in our hands, we will truly be in the last phase of our existence here. I am still enjoying parts of being in Haiti, of the Haitian people, which I know I will miss later on. But, in general, I am really ready for a change. It will have been 3 years for me here once we leave in February. I can’t wait to experience a totally different climate, to experience changing seasons, to eat other kinds of food, to reintegrate into my old community which supported me 10 years ago when I was preparing to go to midwifery school, and to be with my family again. I can’t wait to experience different things with Blada, like visiting NYC. I think about these things all the time. Work has been a lot better and easier the past couple of months. People have been a lot easier on me and seemingly more accepting of me. I also stopped vocalizing my observations, which was what they wanted in the first place (for me to leave them alone). But, nevertheless, things have been moving in the right direction because most of them now believe in the necessity of having a temperature protocol in the delivery room to protect the newborn babies, and I have been able to furnish all of the midwives and auxilliares with good quality reading material which supports my points. I found an excellent WHO booklet which talks scientifically and quantitatively about the short-term and long-term benefits for mother AND baby of immediate skin to skin contact, immediate breastfeeding, and delayed cord clamping (this one, I wasn’t pushing at all but now that I have a really good reference to back me up, I can talk to the midwives about it). Anyway, in general things are a lot better and less dramatic—also because one person who was really horrible to me has been gone for almost 3 months, but she is coming back in 2 weeks and will be here for my last 2 months. Maybe since many other people are more on board with me, she will be easier on me too. We will see. Either way, it is not an uphill battle anymore—I am now on a flat plateau—no new changes—just following up with the same things as before, finishing things up, and moving towards having closure. Our trip to Okay (Cap Haitian)/Hinche was great. Just getting away from the reality here…I was feeling really fed up with everything, and just needed a break…well, being in normal Haiti for 1 week was enough for me to forget all the stresses of work…This is how our trip went: We took a schoolbus from PAP to Okap. We got seats in the way back of the bus, right over the back wheel. We arrived at 6:30am and waited for 3 hours for the bus to fill up so we could leave. I thought it would be a good idea to pee before taking off, so we went to the only place we could find in the “ station” to pee: in a trash pile behind some vendors’ stands. There were flies everywhere and it smelled like poop. There were old tires, trash, and oily black mud. It was really gross but there was nowhere else to go. I kept thinking that someone was going to see my white feet from below the vendor stand, and call me out, as usual in my life here, and so then I couldn’t relax enough to pee. Finally, I was able to pee and we then went back to the bus. There was another white guy on the bus now, in the row next to us. He was backpacking through Haiti for 3 weeks, and spoke not a word of Creole. Wow. He was nice though. We got going. Things were going well. We went on the road along the west coast, through Gonaives. The trip took probably about 7 hours. Each row of seats has 3 people crammed onto one seat. The last 1/3 or so of the trip though was horrible. This bus obviously had no shocks, and we were sitting in the back. The driver was driving over all the potholes, not slowing down for them, and everyone in the back was bouncing all around. The road apparently had been good once, but like everything else here, was not maintained and is in ruins. I started getting pissed, just thinking about how this is one of the MAIN ROADS between 2 MAIN TOWNS in Haiti, and it is in this shape. And people are subjected to this, as if they do not deserve any better. How is this possible? To not even have normal roads? So, we were bouncing so much that our heads were hitting the metal grate thing above, where you put your bags, and then some people in the back started cursing at the choffeur. This part was really funny. Since he was not paying any attention to them, they started cursing him and making fun of him, calling him an animal, a pig, and saying that he eats shit, not real food. Then, we stopped somewhere along the way and he loaded onto the top of the bus a bunch of huge sacks of stuff. We started going again, and then suddenly we noticed that there was this weird liquid dripping onto us through the window from above. It wasn’t water. I couldn’t figure out what it was. It had a chemical smell. Finally I realized that it was ammonia. Liquid ammonia. They call it “ kanpe lwen”—stand far away. They use it for people who faint and for headaches. We tried to close the window, but it was broken and wouldn’t close. Then, a little while later, it started raining and all the rain was coming through the windows on our side, but again nothing could be done because the windows couldn’t close. Once again, typical Haiti. I didn’t mind too much because I was so relieved to be away from my closed in existence in PAP. So, we arrived to Blada’s mother’s house. This time it was a lot easier for me to stay there because they have built another room onto the house, so we had a room with a mat on the floor, which I had requested them to get for us in advance, instead of sleeping on a damp mattress. So, having the mat, which was made of some kind of tall dried reed/grass (they make them from other materials as well), was amazing. My body was sore though for 3 days after that bus ride. Luckily we had bought some tiger balm while waiting for the bus to fill up, from someone who came onto the bus selling different things like this, for 50 cents and so Blada massaged my back and neck with this and also we got some for his mother. This trip to Okap was really sweet. His family was just so sweet, his younger sisters were more into me than they had been before, I understood everyone’s Creole with no problem this time (the Creole in Okap is a lot different). It was great. We just made food together every day, and hung out. We didn’t go anywhere. The place where the house is, you can hear sounds from all over, from other houses. Maybe because there is a lot of cement. Each morning, I could hear children screaming while their parents beat them. I’m serious. There is no escaping the reality here. It’s all over. Being in Okap was great, seeing his family and really enjoying them, but also because I was so much in touch with the real reality of Haiti, it was also discouraging. Okap is so, so dirty. As soon as you go out into the street, you are in a cloud of dust. Most of the roads, even in town, are unpaved. People look at you like you’re an alien. I went to the market with Blada’s mom and sisters and it was unbelievable. People act like they’ve never seen a white person before. Someone asked his mom: “ ou gen blan nan fami a?” You have a blan in the family? When we were leaving Okap, the way to the station is over a bridge which goes over a bay. The bay is lined with shacks, pieced together with rusted pieces of tin. The banks are piled with trash, and the water is black and oily. With trash floating in it. I just kept thinking of how it could be. How beautiful and amazing it could be. Yes, leaving Okap, I felt discouraged about living in Haiti, and all I could think of, despite how wonderful of a visit I had had with Blada’s family, was how I can’t wait to leave. So, we got to the bus station. We were going to go through Hinche (a different route than on the way up) and spend a few days in HInche). There are pickup trucks that make this route. The road is not good enough for the minivans or the schoolbuses. So, we got seats in the cab of the truck, with a driver who always makes this route, who everyone knows, named Pisket. As we waited for the truck to fill up, we ate sugarcane that Blada had bought. I felt happy. So, we left Okap and before taking the road to Hinche, took an hour-long detour, to a little place in the country closeby, because Pisket was going to load a bunch of sacks of pottery onto the truck to make extra money (he didn’t tell any of us beforehand, we just went there.) This was actually really nice, because in contrast to Okap, the countryside was really beautiful, and this was encouraging to me. And, another thing that was really encouraging was seeing the people actually being industrious in something. Making pottery. This was very encouraging. So, finally we made the trip to HInche, and it was uneventful. Being in Hinche was great. We saw old friends, and had enough time to visit with people. We had to leave one day early because MSF called me and was concerned about us coming back on Sunday because there were planned protests in PAP over the shooting of a student. So, we didn’t get to see Jamlex, our baby (when we lived in the MW4H house, Jamlex came everyday with his mother, Diunney, the cook, and we grew very attached to him). We also didn’t get to see Blada’s godmother, who is a Catholic nun. It really would have been good to see them both. But, oh well. Overall, the trip was full and very satisfying. If I don’t go back to Hinche or Okap before we leave Haiti, that is fine. I also don’t know if I’ll make it back to Ti Trou or Jacmel. We’ll see. I was satisfied with my exposure to real Haitian life. It felt totally normal and natural, as if I had never left. Coming back to PAP was fine. I had been feeling really apprehensive about returning to work but things have been smooth and I know I will make it through these last months fine. December 16th So…exactly 2 more months left. That is 8 weeks. Each week passes quickly. I am really anticipating this change. I have been ready for so long! 8 weeks is perfect…now I am just wrapping up things at work…I need to write my end of mission report, I need to revise the obstetric protocols…I will be very bust until the end…which is fine….I am so thankful that I am at this point…. We don’t have our visa yet…Blada has an appointment to pick it up this week….I can’t let my guard down and rejoice until we have it in our hands…it has been so long since I have been working on this and feeling trapped in Haiti…now it is almost over…we think and hope…I wish I could just buy our tickets right now, but we are supposed to wait until we actually have the visa… The house is kind of quiet…it’s really nice…people are on holiday…I’m listening to music in my room, fully enjoying being in my own reality… Blada is in Okap visiting his family… It seems that every day things get worse in Port au Prince. Every week you hear of killings, usually robberies that end with shootings…honestly I don’t know if I’ll ever come back here…when you think about the reality here, how as soon as people leave the airport, they may have someone following them, ready to rob and kill them…just last week, there was a very sad story…a very kind woman, a patient at the hospital whom I had had the chance to get to know a little. I had talked with her the day before, it was her birthday. She was pregnant with her 4th child. Well, the next day I heard that her husband had been murdered. He was on a public bus in Port au Prince, and there was an armed robbery, and the robbers made everyone empty their pockets. When he emptied his, they saw that he was a police officer. They shot and killed him. I heard the news, and of her reaction-- instant intense mourning, as everyone does here when they first hear that someone has died. I went to see her later that day, to sit with her , but she wasn’t in her bed. I returned the next day, and she was in her bed, smiling and cheerful. We talked matter-of-factly about the fact that her husband had just been murdered, that she has 3 kids at home and one more coming, and she told me that they had been married for 13 years. She asked me about myself, when I was going to have children, if I was married. She seemed completely “ normal”. This is the thing that I have seen in Haiti time and time again: people mourn outwardly and strongly in the first moments, and then they immediately carry on with their lives and act as if everything is okay. They are unbelievably stoic. I cannot interpret it or explain it, but I have seen it time and time again. It’s like a switch is turned on and off. Maybe it’s because people don’t have the luxury to mourn for long periods and get depressed, because they have to survive. There is a culturally-accepted time for mourning, people do it and then continue on. This lady was also Christian, she mentioned this to me, and I think in times like these, this is something that really helps people to get through the tragic events of life that are so common here. That’s another thing: the amount of trauma that people experience throughout their lives…trauma like this is not a once in a lifetime event. It is part of life. December 23, 2012 We are doing well. The waiting, the certain amount of uncertainty, the dragging on of our visa process was somewhat excruciating for me. But, we made it happen, we got everything in order, we had the last missing form FedEx’d from the US for $86, Blada brought it to the embassy, they gave him a return appt. in 8 days, and each day of the 8 days was an eternity for me. Finally, the 20th of Dec. arrived, and he went, and…HE GOT HIS VISA. This is the closing of a chapter which has lasted almost 2 years, from start to finish. Finally, we are moving through the threshold of waiting and wondering, to knowing. This is a huge transition for me, because I have had to keep my guard up and survive here for a long time, never knowing for sure if the visa would work out or not. I am so relieved, I can’t express it. At the same time, I am still here, in the reality of my work, still surviving in my own way. We have about 8 weeks left till the day that we leave. I just want to forget everything and leave…I feel impatient…all I can think about is leaving, arriving in NC, seeing everyone, reuniting with everyone, bringing Blada into the family… 12/25/12 Can’t sleep..last night, I got woken up at midnight to the loudest music I have ever heard, from one of our neighbors’ houses…it was horrible DJ/mix music…it was so so loud…it went on for hours…I get it, people are celebrating, 24 Dec is a big deal, basically the whole month of December is a huge party, leading up to 1 + 2 January, when they celebrate their independence, then soon after that Carnaval starts, which lasts a couple of months…I get it, and I accept that in Haiti people make lots of noise and no one cares, but last night I was pissed, because the volume was so exaggerated…and of course I was tired all day today..Christmas day…quiet and somber…imagining next year, being with my family… Now that I’ve passed the 8 weeks left mark, and we are almost in January, I think the time will go really fast…January will be super busy, at work and at home, finishing up everything…that’s good. My replacement arrives Feb 2nd. I will spend the last 2 weeks here doing a handover with her, which means that everything else must be done before then. 2 days ago I was able to attend a Christmas dinner at my friend Beth’s house…it was so nice…I ate traditional American food…a welcome break…we sang Christmas carols...I am so glad I could go. Beth and her husband, John, have been living and working in Port au Prince for 22 or 23 years. They do really good work. Beth is a midwife and has a birth center where she provides excellent prenatal, intrapartum and postpartum care..parenting classes, lots of other services. Anyone who is interested in helping Haiti I welcome you to check out HEARTLINE MINISTRIES. I can personally vouch for them. They are grassroots and their work directly affects peoples’ lives in their community. They are extremely generous and despite all their years here, I have never ever gotten the impression that they are bitter or desensitized. They really care about people. Beth, despite being super busy with all of the work she already does helping people, has been coming to the MSF hospital every 3 months and donating blood. I mean, these people are hard-core, and they really walk the talk. There was something that hit me while I was at Beth’s house…there were 2 other interracial couples there…they were so in love, sitting close together, just glowing with their love for each other and apparently so open and uninhibited. Seeing this, I thought about me and Blada…how we used to be at the MW4H house in Hinche…how we were comfortable, because we thought it was our home and it was safe…and how the whole time, (white) people (visitors) were uncomfortable with our relationship, talking behind our backs, and how in the end it all exploded out into the open…I experienced a lot of trauma when things fell apart in this way and we chose to leave Hinche, because we did not feel safe anymore with the organization, after the all the lies and betrayel…it is a long and unbelievable story, and in the end, I know that I have unresolved trauma around losing the safety that we had trusted to exist there for us, in our own home…now, living in the MSF house, it is very different in some ways because the people here I would say are a lot more cultured and international than most of the volunteers who used to come to HInche…my housemates accept Blada and don’t seem to mind his presence…they’re not shocked or offended by us together…but at the same time, this is not our house and we do have to be extremely careful. Watching these other couples at Beth’s house the other day, it reflected to me how guarded I have had to become. I look forward to living in a place where my home is safe for me, for Blada, and for our relationship. Where people like us and accept us for who we are. I appreciate the safety that I have felt here, with MSF, in this sense…but I have never been able to trust it fully or let my guard down, after what happened in Hinche. I hope that in NC, we will feel free and open, completely. Don’t be fooled by all of the “do-gooders” who travel to poor countries like Haiti to “help”. Most of them are looking for an experience, or to prove something to themselves, their friends, their coworkers. I have had so many people come up to me when I am visiting the US who don’t even know me, who thank me for the “amazing work” that I am doing in Haiti…(they assume that if you would come and work in Haiti, that you must be doing “amazing work”). Don’t be fooled. There are plenty of demented people who come to places like Haiti precisely because these populations are vulnerable and anything that you do will look like help. Or because they have specific scenarios that they need to play out in order to feel good about themselves, and they can do that here…in the meantime, often taking advantage of the population or stepping all over those who are already there…I have seen multiple variations of these scenarios myself and have heard stories of people who have come here and done even worse things. 6 January 2013 I am so happy about the new year. The year of 2013…it brings many long-awaited for transformations. It was a fun time to be here as well…a very special time in Haiti…when their independence is celebrated…people are happy…luckily I slept well the night of the 31st…I thought there would be al of noise…it was the most wonderful thing: there is this little church right next to our house. People gather there, and sing and pray, both Sunday mornings and Friday evenings, in the dark…well, the night of the 31st, they sang beautiful slow hymns all night long…I could hear them in my sleep…it was so, so wonderful. I felt so happy the next day. Things are changing…we are getting ready…wrapping things up here…soon we will be in the US, starting a whole new chapter…I look forward to seeing those of you I can…and I thank all of you for your continual support over the past 3 years. This might be it…my last blog…those of you who would like to keep in touch with me, please email me at email@example.com. Again I thank all of you for your immense support over the past 3 years.