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
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