Monday, November 24, 2014

Notorious

November 23, 2014


Hotel Oloffson

Its Sunday evening and the darkness slowly wraps itself around the hills surrounding Port au Prince, and from my balcony I can watch the bats swerving in and out of the palms as they bend in the breeze.  Choir voices waft upwards from the church on Avenue Christophe.  I am guiltily indulging myself in 2 days of hot water, internet, fine food and exhilarating company at this remarkable Victorian Gothic style hotel.  

Decked with creepy statuary made from wood carvings and recycled doll extremities, skulls, hub caps, spray cans, the shady, the grassy grounds are a refuge from the insane traffic, open sewers and dust of the city.
Baby Jane
Tonton Macoute
Baron Samedi 

This place was built in 1896 by the Sam family and housed two of Haiti's presidents around the turn of the century.  It's up a hill,  providing cooler air and spacious views of the sea and city below.  It served as a military hospital in the 20s during the US Marine's occupation, then became a hotel in the 30s, a bohemian hang-out for artists, writers, actors.  Probably best known for the site of Graham Greene's The Comedians, all the rooms are named for the famous people who have stayed here: Jackie O, Edwidge Danticot, Mick Jagger, Katherine Dunham, John Barrymore, Amy Wilents, Barry Goldwater (?)  I think its stunning too! 

 Haiti Say You Will - my room

I know I am digressing and I promise to get back to the point of bringing you all to this blog very soon.  However, I feel like, as with many encounters of this trip so far,  it is a good karmic sign that I met and hung out for a second time with Richard Morse, the hotel's owner and cousin of Haiti's president, Michel Martelly.  Our link is a friend in common (Elizabeth Yoakum) from Lakeville, CT where he went to school (Indian Mt), and one September about 10 years ago he came up to Mt Riga one evening to a place Eliot and I were renting and we had a long talk about kids, music, politics. 


HHP's prez Phil Wolf, HHP's medical director Roberto Peigne, yrs truely, and Richard Morse.  Photo taken on the porch of the Oloffson by Daniel Morel, well known Haitian photographer who lives at the hotel   photomorel.com/

So I came down to sea level after being up in the mountains for a week of clinic services that Hispañola Health Partners and our local partner AMBUF provided for the community in Marjofre. We provided 5 days of gyn, 3 days of dental, optometry, and general medicine.  Final counts are not in but we probably serviced close to 300 people.  Except for me and Erin (last blog), all providers were Haitian and the 100 goude ($2.50) that AMBUF charged for the consultation and meds will be invested into the further construction and infrastructure of the project.  Trying from the start to incorporate locals in decision making, administrative duties, financial managing for the eventual soti po blan yo (foreign aid retreat), they are deciding how to best invest the near $1000 they raised.  By charging the residents of the community for the clinic services, they too are contributing to its future.  "May the circle be BROKEN" of eternal NGO handouts that unintentionally keep poverty entrenched.  
early morning dental demo for the waiting crowd

emergency tendon repair
It is pulling teeth
12 month old Jeudi's cheek abscess, as she calmly lies on her side on the table,
waiting for incision and drainage
Tomorrow I have a meeting with the director of Fonkoze, Haiti's well-known microfinance organization, that is interested in our cervical screening program for their women members in the SE region.  I am also meeting with the head of a cancer program in one of the local hospitals to help tighten up our referral system for women with findings too advanced to treat with cryotherapy. Tomorrow I am back in the boondocks to revisit the Mennonite clinic high up in the pine woods where I did screening 18 months ago to do follow up and help train a new nurse in the procedure.   

So, my dear friends, thanks for finding a little flash moment in your day for peeking under this circus tent.  It's fun to have you along, later, Louise

Sunday, November 23, 2014

Mini Hostage Crisis in Haiti

November 14th, 2014
Set my specula free!!

Hello again friends and fellow wanderers:

I know there are a million things more important than 5 or 6 speculums stuck in police custody, but it was a rude awakening to come back to Haiti after 6 months and find that there had been a turf war between the Ministry of Police (UDMO) and the Ministry of Health (MSPP) in Anse-a-Pitres, and that my gear was caught in the middle.  Last May, the Ministry of Health was enjoying the extra rooms provided by the adjacent UN Peacekeepers' property after the UN had left town. That is where we were doing trainings, exams, and the everyday clinic goings on.  But sometime in July UDMO took over the property, waving high powered rifles around and confiscating all materials that were on the premises.  Sad for MSPP, who lost vaccines, birth control, records, the ultrasound and much more.  Our cervical screening program just lost some records, containers for decontamination, and the speculums we use for cryotherapy.  Luckily a clever nurse was able to liberate a few and I brought one from NY, so we are in business.  And gratefully, the cryo unit and C02 tank were somewhere else when the invasion occurred.  Apparently the standoff should be settled soon. 

I got to Pedernales, at the farthest western edge of the Dominican Republic 4 days ago and did 3 days of cervical screenings up in the hills along the frontier, at the house of a community leader and health promoter, Nansi Calbajal, on her kitchen table. Although she is Dominican, all the people that she serves in her community are undocumented Haitians and she welcomes them with a big warm heart. Considering the decades of hostility between Haitians and Dominicans, this is particularly uplifting.

Nansi at home with the world

The first day I arrived, the men of the community were shaving the hair off a 150# pig they had just slaughtered about 15 feet outside her kitchen door, and during the course of the morning I checked in on the butchering process, which was surprisingly neat and clean.  The women didn't pay it any mind and marched right by into the kitchen one by one.  They have some amazing first names: Macdounize, Kleumanta, Wislet.  Privacy (HIPAA for those in the biz) just DOES NOT EXIST in this culture.  As often as I ask my assistants to register people in private, it never happens - everything personal is a spectator sport in this land.  We are asking them delicate things like how many partners they've had in a lifetime, and when the first time was that they had sexual relations - both have relevance to their risk of human papilloma virus, the precursor to cervical cancer.  Today a 52 year old woman who had 9 children told the crowd she was 42 when she had relations for the first time! When I asked her again when we were alone, she told me she was 12.  Some of us are better with the chronology of our lives than others; one woman yesterday had no idea how old she was when she first had relations, but knew it was during the time of Jean Claude Duvalier ('71-'86)!


Patient Registration - "Sans Souci"
November 22nd, 2014

Meanwhile I was waiting for my soul sister and fellow NP Erin Quinn to meet me in Pedernales before getting swallowed into the throat of Haiti.  She had made a 28 hour Herculean trip from San Diego - red eye to JFK, JFK to Santo Domingo, was grabbed at the airport and whisked off to meet the 8 hour bus to Pedernales.  The next day we were facing the "twisted horseshoe roll" (roller coaster vernacular)  4 hour motorcycle ride with bags upon bags of stuff; we had lots to accomplish in the short time she could dedicate to coming.  Magically, Jeanne, our Haitian nurse who knows everyone but the Pope, found a minister to take us the whole way in Climbing for Christ's comfy Toyota Hilux, someone who also stayed with us and helped out with 3 days of clinical events in Marjofre.  Gracias, Minister Miguel.


Erin with Jesus and his ride

Erin had come to teach Matron yo, or home birth attendants, how to judge a baby's respiratory status the first minute after birth and when the use of a tiny Ambu bag might be needed.  All births in the region are done at home with the help of matron yo, elderly wise men and women who most often blend folk medicine and gently serve the spirits of  the loa (Vodou). The 3 hour course was held in our yet unfinished health center that our organization, Hispañola Health Partners, is helping local Haitians complete and get up and running.  We also made 200 clean birth kits with the help of the matron yo and members of AMBUF (our local committee).  This simple kit, with plastic for the woman to lie on, a clean razor blade to cut the cord, clean twine to tie off the cord, gloves, soap for handwashing, and cute little cap for the baby to keep itself warm, are essential ingredients to help prevent maternal-infant infections with severe consequences. 


To help you get your bearings, we are are located in the Southeast corner of Haiti (Sud-Est), between                                                          Thiotte and Belle Anse
workshop underway
Faktori for clean birth kits

Proud matron with his clean birth kit, Ambu bag and suction bulb

That's it for now, please check in later today or tomorrow for further installations, since I am sitting pretty in Port au Prince with great wifi until Tuesday and will catch up on all the news that's fit to print.  Love to you all, Louise

Sunday, May 18, 2014

Weeds and deeds

Bon nwit, zanmi yo.  As promised in my last blog, I will write a little about datura stratmonium, also known as jimson weed, and other neurotoxins called tetrodotoxins, used in the process of zombification.  Wade Davis, in his book The Serpent and the Rainbow, cites the case of the famous zombie, Clairius Narcisse.  
Clairius on his way to his not so final resting place
Mr. Narcisse, born in 1922, was not well-loved in his community; along with being a womanizer, having children with at least 5 different women, he also was involved in a nasty land ownership dispute with his brother.  He quickly and mysteriously took sick and was declared dead by 3 well-respected doctors from the Albert Schweitzer Hospital here, and buried on May 2, 1962.  He appeared back in his village 18 years later, much to the surprise of his family and neighbors, who all recognized him at once.  Apparently someone (his brother?) had hired a bokor, or vodou priest, to make a mixture of human bones, plants with stinging spines and the bacteria that is commonly found on a pufferfish (watch out, sushi lovers). This mixture was secretly applied to a skin abrasion of his, inducing a coma which mimicked death.  A few days later he was exhumed and force fed a mixture of datura, cane syrup and sweet potato which made him loose his memory and hallucinate.  The regular ingestion of this formula kept him compliant while he worked in the cane fields.  When his master suddenly died after 2 years, Clairius was free to roam the countryside, which he did for 16 years, until the effects of datura faded enough for him discover that his brother had died and eventually find his way home.

Now and then I pass a group of blank-faced field workers in black rubber boots and hoes in hand, all working robotically in a row under the blazing hot sun.

meetings, meetings, meetings
My final week here in Haiti found me transversing the country - I should work for the highway dept here and file a report - 5 of us took motos and a jeep for 11 hours from Anse-a-Pitres to Jacmel to meet with the head of the Ministry of Health for a meeting that never came to be. However, we powered on and spent 4 productive days in Marjofre, gathering with the local folks, discussing administrative issues with our Haitian partners, talking over the final floor plans for how we will divide up the space - patient waiting area outside on the porch and under a palm shaded front yard, 2 consultation rooms, a little ER, pharmacy, lab, maternity, a bathroom and administration.  All in about 800 square feet.
Jeanne talking about cervical screening on our clinic porch
This month we did 105 cervical screenings in 4 different towns, making our total count in the last year 575.  Jeanne is now in charge of continuing the screenings and teaching staff.  Many thanks to the donors for this project.  We will be bringing the trainings to the southeastern towns of Belle Anse and Thiotte in the next year.
Our team - Hispañola Health Partners - Patnè Sante Ispanyola
We have raised about a third of the $12,000 we need to finish the clinic, as we wait for 501 (c) 3 status, please write me at llindenmeyr@gmail.com to find out how you can make a tax-deductible donation now.  Our new, improved website will be up and running in a few weeks - I'll be in touch.  Our motto, created by the founder of the clinic, Fritz Regis (last guy on the left) is:
                                                         LOVE PEOPLE
Cascade Pichon - we had a cool swim on the way back from Belle Anse

Tap-tap gallery - the flora of Port au Prince
Samson and Dalila on bottom, caption "a friend in need is a friend indeed" on top





Saturday, May 10, 2014

Missing virgin

Hello friends and fellow wanderers, you will have to read the entire blog before you get to the mystery for which this entry is named.  Ja-ja, the Haitians are teaching me some crafty tricks!

The finish of week three on the set; the thunder just rolled off the mountains down to the Pedernales seashore with such a resounding KABAMM that it set off a few car alarms down the road.  Probably the Red Cross vehicles whose drivers are loading up on beer and pollo frito at the restaurant a block away.  Rainy season is full on and it took us all week to get smart enough to make it to the beach on time after work before the customary 3 hours of persistent afternoon rain.  Everyone is thrilled despite the flooding and veneer of green is beginning to drape itself over the landscape of cactus and rubble. The air is 10 degrees cooler.

The three ring clinical circus I brought to Sant Santè Anse-a-Pitres has packed up and headed out - I'm super pleased with how the trainings have gone, and relieved that they are over.  I began last week with the didactic part of cervical screening, followed by 4 days of practical application.  The nurses were engaged and are on their way to becoming proficient.  Jeanne will supervise them in continued learning in my absence. 

The Speculators

                                      


The biggest feature was the captivating performance of Dr Mary Gratch, who dedicated a week's precious vacation, away from St Barnabas Hospital in the Bronx, to teach the docs and nurses here how to use the ultrasound machine that has been collecting a generous layer of red dust since it arrived here 3 years ago.  No one had any clue how to use it.  The word spread fast and the clinic has been packed with big bellied women for the last 4 days.  Mary taught staff how to judge dates, head and placental position, moms could see the little baby's heart beating, with directions ricochetting around a hot, crammed room in three languages.  She is a rockstar!!  This can give the providers and families here a chance to do advance planning for perinatal emergencies like breach, placenta previa, fetal non-viability, etc.  Just as a note, the first two births I saw here before Mary came produced dead babies, for a variety of reasons, most being total lack of prenatal care.


Dok Mary doin her thing

The UN Peacekeepers who were living next door to the clinic since the expulsion of Aristide in 2004 moved out about a year ago, so the land and the existing buildings have been lent to the clinic for the meantime.  Problem is, there is no power there so the resident handymen have had to jerry rig a series of generators, solar invertors, twisting bare wires into ridiculous contortions and risking electrocution and the destruction of the fragile sonography unit.  The machine is way tougher than we thought however, and behaved miraculously.  None of this drama was prepared for before Mary and dozens of large women were waiting as 9:00, 10:00, 10:30 drifted by.  Mary was a supa-troopa, Gras a bondye.

There's a little Haitian proverb that might be apt for anyone coming to volunteer here: Si ou renmen grenn anndan, ou dwe renmen po a tou.  "If you want the nut, you better like the shell too."

Using old UN trailer and my battery-powered projector for training

                                      

       When the UN packed up, they took the Virgin with them - they kept the nut and left the shell 
The Hispañola Health Partners team is meeting today in Pedernales to travel to Jacmel where we will further strengthen the collaboration with the Haitian Ministry of Health for our community health center in the mountain region of Marjofre.  Many of you have generously donated to this cause, thank-you, thank-you.  Along with the details of how this goes, my next chapter from deep inside Haiti will include a little more about the ethnobiology of witchcraft and various tetrodotoxins found here. 

This is highly toxic datura which grows up in the hills, the base for atropine and scopolamine


bye for now, Louise


Thursday, May 1, 2014

Goat on the road



     Welcome back dear friends, to my first entry since last November, accompanied by the first rainfall today since that date.  After a searingly hot afternoon, dragging my sweaty body back across the border, I sensed the unmistakeable ozone scent wafting through the windows as I was chowing down an enormous meal of la pechuga, chicken breast with salad, rice and beans. I realized it was pouring outside; the streets flooded with torrents of brown water, whirling plastic bottles, leaves and other detritus of life moving at breakneck speed.  And me without my umbrella!

I returned to the Haitian/Dominican border a week ago - the first part of my month here involves teaching my colleagues at the health center in the little town of Anse-a-Pitres how to do cervical screening for cancer using a simple technique involving vinegar, a headlamp and cryotherapy for positives.

Community health promoters identifying my reproductive organs!!

This week I am doing three didactic workshops for promoters, doctors and nurses and next week will be doing practical training with patients coming to the clinic for screening.  Dr. Mary Gratch, a friend and OB/GYN from NYC is joining me to do a training on pelvic ultrasound at the same time. Cluster-teach Haitian style!!  It has been an arduous job translating Spanish PowerPoint presentations (175 slides), courtesy of an American organization that does similar trainings in Central America called Grounds for Health,  as well as other training materials into kreyol with the help of my Haitian nurse, Jeanne. My search for an organization that does similar work to partner with has been in vain.  Few non-profits access this far corner of SE Haiti, so the lone wolf continues to roam the hills.....

Last week I was joined by Lydia Marden and her daughter Sadie from my beloved old stomping ground, the State of Maine.  Lydia is a nurse practitioner (we've been best friends since nursing school in the 70s) and Sadie is in her 3rd year of medical school. We did some cervical screenings in a remote fishing village about an hour by moto from Anse-a-Pitres.  The "president" of the town owns the only recognizable business there, a bar of course, so we did the gyn exams on tables on the dance floor between the giant speakers, with a gorgeous cliffside view of the sea.

Sadie doing her exam between the Marshall stacks!!

our seaside clinic from out back


     Things continue to improve from my perspective here, granted I am an optimist, but you can't argue when you seen the decommissioned cholera beds, plenty of staff running around and new construction underway at the health center.  The addition is being built by a Spanish NGO, Arquitectos sin Fronteras, and will include labor, delivery, exam rooms and an operating room (can't imagine where the surgeon will come from) for C-sections, etc.   We thought it would be done by now but there has been a little hold up in the funding.  Solar panels now bring enough current to run a computer and the light for the microscope as well as a dull nighttime bulb in the little ER and a light trickle of water runs from some sinks.  
Off the job and hopefully not to come back during the rainy season

Arquitectos sin finanzas

goat on the road

more later, much love, Louise

Sunday, November 24, 2013

Moto mundo



Dear Friends: the patient load was light this week because it started with a Haitian holiday on Monday, celebrating the Battle of Vertieres, which was Haiti`s final defeat of the French forces in their fight for independence on November 18th, 1803.  The hero of the revolution, Toussaint Loverture, was deported to France by Napoleon the year before and died the next year in a French prison.  His lieutenant, Jean Jacques Dessalines continued the fight.  The Haitians heavily outnumbered the French, 27,000 to 2,000 on this day and made Haiti the second independent nation in the new world, and the first black republic.  Dessalines went on to be Haiti`s first ruler, naming himself Governor General for Life.  He was assasinated 3 years later by disaffected members of his administration.

end of history lesson

As an amature blogger, I struggle with trying to make these reports interesting to my readers.  My days recently are so filled with cervixes that I wish to spare you much of the descriptive details, although it is a gorgeous universo in there.  Therefore, I try to choose a different topic that you might be interested as a blog feature for each entry.  This time the world of small motorcycles wins the nomination.

Nothing feels better than turning the corner and seeing this vast expanse of sea at 30 mph
As you might have already gathered, I spend a lot of time for a more-than-middle-aged white woman on motorcycles.  It is the only form of transportation unless you are so poor and have to use a donkey or are lucky, rich, or work for a non-profit and drive a car.  Therefore, I am going to try to celebrate the two wheeler in this edition.  There is so much I do not know, and never will, so I am only prepared to give you the perspective from the back end.  Generally I feel very safe on the bikes, now that my former interpreter doesn`t interpret for me, one of his most important roles is getting me, my associates, and all our gear from Anse a Pitres to our destination safely.  To do this, he chooses our drivers with elite discrimination.

The last blog showed me and Yunior, one of my favorite drivers.  He loves me too because we listen to my iPod, one ear bud in his the other in mine, as we roll along.  Everything from Y0Y0 Ma to the Joint Chiefs!  He straps my CO2 tank on to the back of the bike with old strips of inner tubing, they grip really well and seem to trump bungie cords.  There are no gas stations in the region where I work, so along the roadsides everywhere people sell gas in beer, rum or water bottles, all you need is one shot and you're ready to roll.

Fixing a flat by melting some rubber with a pot of fire on the hole, then putting the whole thing in a press
It isn't too fitting for an older woman to ask a pack of young men in deep concentration exactly what they are doing or how precisely it is done, so many questions remain unanswered about flat tire repair.  There is really nobody or nothing you can not carry on a moto under 180 ccs.  My favorite sensation, which I hear before I see, is the guy on the back dragging a dozen or so 20 foot pieces of rebar along the concrete

guess he just came from a big box store


Returning briefly to the reason that I am here in Haiti:  Jeanne and I have done 108 cervical screenings and 8 cryotherapy treatments.  The cost to you, dear donors, has amounted to $5.21/patient.  Both the women we treat and the communities and health centers where we are received are happy to see us and very grateful for the service.  Jeanne has now done over 100 visual inspections and 6 cryo treatments, well on her way to working independently.  We will be doing a training of doctors, nurses and community health workers in the spring in Anse a Pitres, in the newly constructed maternal-child wing, financed by Arquitectos sin Fronteras.

42 year old mom with dysplasia too severe to be treated with cryotherapy.  We had to send her to the new University Hospital of Mirbalais, built and run by Zanmi Lasante/Partners in Health which has a wonderful cancer center.  Your donations paid for her transportation, a 5 hour bus ride.   

As I finish this entry, I am back home in the cold north.  Thank you, faithful readers, and will reenter this wonderful web again next spring, si bondye vle (God willing).  Much love, Louise

Friday, November 15, 2013

from Jacmel to Jehovah



                                        Any Jungians out there willing to interpret???

A salute to my beloved friends and family back home with an intelligence (?) report and mission update.  Due to who-knows-what snafus in the techno infrastructure, I´ve had a ·$%& of a time trying to get the pictures up and this off to you. I wrote the text last week.

November 8th, 2013
It´s been a wonderfully productive week working towards getting the clinic up and running in Marjofre. Last Sunday Phil and Patrick appeared in Pedernales, president and vice prez of the non-profit we have started to help move the clinic along, Hispañola Health Partners. We had a meeting with the department head of the Ministry of Health of Haiti (MSPP) of the SE province which was surprisingly positive.  After 3 hours on motorcycle and 6 hours in car to get to Jacmel, we agreed we would be happy if he were just THERE and didn´`t blow us off.  Instead Dr Ted Lazarre was enthusiastic and supportive and after we abide by a few not-to-impossible-to-fulfill requirements, we can expect them to partner with us in the upcoming year or so.  That would help enormously in making the clinic eventually self-sufficient; MSPP would provide a doctor and nurse, a network of trained community health workers and the usual services (or lack thereof) of family planning, maternal child health, vaccines, TB, HIV and cholera prevention.  We would continue with salary incentives to keep good staff, as well as supply the clinic with meds, equipment and a functional lab.

From left to right, Fritz Regis (founder of clinic in Marjofre), Phil Wolf, president of Hispañola Health Partners, me, Patrick Howell, Vice President of HHP after a victorious meeting with MSPP

Passing through Port Au Prince for the first time, we buzzed along the outskirts as fast as possible en route to Jacmel. Both hammered by the earthquake, i can´t say either place looks any worse than many other metropoli in the developing world, the usual piles of rubble seem like nothing out of the ordinary.  Jacmel however is a seaside town of distressed majesty, gorgeous colonial buildings in various stages of crumble with salt air and intoxicating breezes/stenches coming off the freckled light blue bay.

 JACMEL



Phil, Patrick ad I stayed there for an extra day and Fritz and his jeep returned to PAP to pick up a team of Haitian dentists who were packing themselves, folding dental chairs and all their equipment to do 3 days of consults in Marjofre.  We 3 had to deal with the devil to get to Marjofre by sea, which looks painfully close on the map, but the roads are barely donkey worthy.  So at 7:30 pm in the drizzle we sought a ride to the dilapidated port of Marigo, where we would take a 6 hour open boat ride up the coast to Grand Gosier. (I have taken you there before a few times).  The only wheels we could secure were motos just a hair above mo-peds, my and Patrick´s driver had to use my headlamp for a headlight. When we got to the boat, which is a hollow hulled wooden structure resembling the Nina or Pinta without any sails, I expected to see it cargoed up to the gunwales with charcoal and plantains but instead the hull was lined with bodies stem to stern, eerily reminiscent of those slave ship drawings. Chuckles ripped along the curled up bodies as they watched the blans stumble their way on board with their enormous backpacks and clumsy feet. When it started to pour, the mates covered us all with a huge tarp under which you could hear a symphony of snoring, gurgling, wheezing, coughing an whistling of passengers in different stages of sleep.  I stood up (there was no more lying room unless I wanted to get really friendly) with my umbrella sheltering me from the storm and watched the sky change from passing clouds to a packed house of stars, then a second light-show below as the phosphorescence was showing off as the wake broke off the side of the boat.  The captain sang as he steered the boat in full darkness, creeping along the shoreline, never more than 40 feet away from the white rocks, cacti and thornebush scrub that was emitting this warm fragrance of butterflies, herb, woodsmoke and dried fish.  A mystery mix of life unknown.
                                        The fleet waiting for nightfall in Marigot

                                                 Agwe, voodoo god of the sea, watched over us
We eventually reached the long wharf of Grand Gosier at 3 am and were greeted by our moto taxis who we presumed were going to bring us up the steep 8 km road to Marjofre where some comfy beds awaited us.  But alas the road was too wet and we would have to wait, and anyway, a young woman in town was having a hard time giving birth to her first baby and they had decided I was going to help with that before I realized I´d dropped my flipflop into the deep water while trying to get off the boat.  The mariners fished out my flop expertly and I was on my way up the cliff to the village.   The 17 year old girl´s water had broken 24 hours before and her labor was ¨piddly´¨ as I think they used to say, 35 years ago when I worked as a midwife.  Yet she was well dilated and almost ready to push, so I told her to walk outside for a while, meanwhile we hung our hammocks on nearby porches and tried to catch a few zzzzs.  The baby´s heartbeat was great, so there wasn´t much for me to do, but ¨let God.¨ We left at dawn and her labor had picked up, I later found out she had the baby at 5 pm, in the company of an ancient matron or lay midwife. 

We only stayed in Marjofre long enough to meet with the local clinic committee and see the dental and medical clinics going full swing, using a roaring generator for electricity and lugging water from the cistern.

Thanks to many of you, hundreds (don´t have the count yet) of dental and medical visits were done Nov                                                   7, 8, 9th in our rustic clinic in Marjofre


Over the weekend I went to visit some old friends in Las Matas de Farfan and Elias Piña, along the Haitian/Dominican border, where I worked years ago.  I visited the priest from St Teresa de Jesus, a jolly soul from Wisconsin who has been there for years.  Just like a Dominican, he rips out his spanish in spitfire speed, all full of jokes and colloquialisms.  In the same way he is supernaturally in touch with the community´s needs, and among thousands of other amazing things he has organized in the community during the last 25 years he has been there, his parish recently finished a vocational school for 432 high school students, in a former mansion of Trujillo, the notorious dictator, mowed down in the early 60s.
El Jefe was more prone to violating than educating young girls
 
On the 20 mile ride back to Las Matas de Farfan, our ¨carrito,¨or jalopy crammed with passengers, first got retained for 30 minutes because we were carrying some contraband garlic.  I saw a few 100 peso notes pass hands with la guardia and we were on our way.  Suddenly, at 50 mph the hood of our car flies up and hits the windshield, already worse for wear, now cracking it into a dizzying roadmap of crooked lines, brakes squealing, zero visibility.


I´ll give 3000 pesos to anyone who finds an intact windshield in a public vehicle in this country

a hip shot from the moto of the high rise tombs here in Haiti

Pretty grateful to Jehovah when I arrive alive, tank and all

November 15th : I just finished doing a whole bunch of cervical screenings in the mountain town of Thiotte, more later, much love and HAPPY BIRTHDAY ROSIE !!!!!