an exclusive on where all those unwanted clothes go in your local drop box

deaf mute boy who ran into a fire and burned himself severely around the eye.  His family put toothpaste and blueing on it, which took me a good half hour to remove!

Not sure what fish showed up at the clinic, but it was beautiful.  Looks like a barracuda to me.  I forget what they called it in kreyol

women´s empowerment meeting at the office of Batey Relief alliance, AAP

nice spray of orchids outside my door

 Patience, my dear, Christ can do it......these kind of trucks bring huge bundles of used clothing in from Pedernales every day

downtown saloon and barber shop a few steps away from where I  work

clothes sorting center in Anse a pitres

a virtual garden of clothes, on the outskirts (sorry) being considered for sale

clothes for reinforcing trenches, among umpteen other uses

La Loteria; you never know!

cute little joint

Before I launch into my expose about the fate of used clothes being sent to the developing world, I want to thank the people who have so generously helped the cause here- the people of St John´s Episcopal Church in Salisbury, my coworkers at Hudson River Health Care and Kathy Brieger´s Catholic Church (sorry I don´t have your name with me here in the cyber place) in Orange County NY.  I have been using the money to buy badly needed meds, vitamins and medical supplies.  The other day I gave $250 to the woman with the horrible eye I photoed in the last entry, she went to Barahona, DR in order to get it removed. More on that when she gets back. We even got the UN soldiers from Peru involved, who were able to drive her 2 hours in a airconditioned jeep instead of her having to taking the harrowing 7 hour nighttime boat ride, plus 30 minute Tap-tap ride to Jacmel.  I´ll keep you posted.  I gave the orphanage that I wrote about earlier $100 for food to feed the family of the lady with the eye problem and the kids in the orphanage. Another $100 went to a young woman whose husband chopped her hand with a machete, it busted an major vessel and was bleeding profusely, tendons and bones mangled, way beyond our ability to repair. The family was able to shuttle her across the border to the ER in Pedernales, and money always helps make the impossible happen.  She came back the same day, repaired.

It is striking when you come to this western edge of the island to see how many old clothes are hanging around.  I´ve been to many other parts of the DR, Africa, Nicaragua, etc and I´ve never seen anything like this.  Not only are they a common addition to the usual styrofoam, plastic, coconut husks, beer bottles tossed aside in plain view, but once you get into Haiti you see them used for all sorts of things:  strung up for fences, dams and bridges for irrigation canals, structures for outhouses, to name a few.  Every day huge bundles of clothing cross the border on bright colored trucks with a pile of Haitians riding on top.  You see mountains of these bundles, tied tight or bursting onto someone´s yard all around town. 

A Canadian expatriate that is living here in Pedernales gave me the inside but told me that if I said anything, I could get killed, so please, all of you keep your mouth shut!  It appears that these clothes, some of which must have been lovingly discarded by each of us in the parking lot of nearest convenience, are shipped to an old Alcoa wharf in this lonely corner to the island.  There they are apparently sent to a sweatshop here in Pedernales where they are sorted for market value by locals paid a lousey wage.  The creme de la creme are sent to places like Malasia, Singapore, and apparently the sweatshop owners make millions.  The discarded clothes are what get shipped across to Haiti which are further sorted and sold by Madan Sara´s or market sales women.  My translator´s mother makes her money this way. 

Thank you to everyone that is reading this and much love to those who have written me responses, and even to those who have not!. I think of you as I try to catch a few shots with the i-phone while riding my bike.  Two wheeled photojournalism, risking my limbs for your enlightenment is my pleasure.

coffe beans drying in the sun

Dr Alexandre with school children while we were distributing water purification in the mountains

 Haitian house

vaginal lesion on a one year old, mom thought she was possessed by spirits and put some herbal oil on it which made it worse, it is much better now with gringo ¨white magic¨¨

balcony outside my room where i AM STAYING

LADY WITH PROBLEMATIC INFECTION OF THE EYE

RECENT BORN

Alexandre with teachers (note that the teachers both have switches) after talking about cholera prevention

A sure sign of becoming accustomed to your environment is when the bizarre not longer undoes you, that I might find people wailing their songs of mourning outside my clinic window just a normal part of daily life, as I did yesterday when a woman showed up with her eye literally popping out of her head like a slimey golf ball.  I knew what to do within my limits and did it.  Rather than wrestling with these challenges, I now find myself confronting the bigger ones that begin surfacing, some of these might be the root of Haiti´s problems.  Beyond the obvious problem of poverty and lack of resources is their fatalistic look at things, that one has no control over one´s destiny, so why try too hard.  There is also the fear of exciting the Lwa if you act in a proud or bold manner, so being more passive is the safer way to go.  Theres a lot more to it as well, of which I have no idea.....
 
NURSE  There is nothing wrong with sitting all day with your head on your desk, saying that you are working while others are scurrying around, because the Haitian government is paying you and what they pay is not enough and sometimes not on time anyway.  Anyway, the Ministry of Health has not delivered polio or measles mumps rubella vaccine for months, so they´re inefficient too!

DOCTOR  There´s nothing ironic about telling a woman whose children are severely malnourished that she needs to go to Jacmel, a 7 hour boatride, to see an optholmologist so she doesn´t loose her eye, even though its obvious there is no money to pay for even tonight´s dinner.  You are convinced this is a rational plan for her, because right behind her is a kid that just fell off a burrow, his ear is mangled, and you have to go sew it up and you haven´t eaten in 8 hours.

PATIENT  a woman chooses not to use free birth control and is having her 4th baby, 8th month of pregnancy and has not been for one prenatal visit.  She is not taking any vitamins and states she can not pay the $6 for basic blood tests for pregnancy.  She is well dressed and her husband works.

VOLUNTEER  FROM USA  You see essentials that are missing, available sources not utilized, people functioning inefficiently, better methods of organizing the materials at hand so they can be accessed easily and quickly, and a population that has extrememly low expectations of itself and is used to getting hand outs.  As you see these things repeat themselves over and over, you try not to blow up, split for the beach, or take over.  Is your way right, anyway?

If any of you have advise or experience dealing with similar situations, I would love a little input to balance my perspective.  Don´t get me wrong, I am not tortured about this, just recording some of my thoughts, particularly as I am about to send my first monthly report to the head of the NGO that I am working for. There are many great things about this clinic, it does offer people the dignity of health care at almost no price, I work with doctors and at least one nurse who are dedicated, forever cheerful and tireless, and the physical plant is better than the majority I have worked in in similar settings.

Its begun to rain at night here, pour, in fact, which is early for this time of year and the ER has an uneven floor that lets the rain in.  I didn´t think it was going to happen again last night, but this morning for the second time in a row I´m going to have to sweep out the water and probably dry the boxes of supplies that I rescued yesterday.  A few more days like this and I´ll probably let them rot!!

I am sending pictures to do the rest of the talking

Party time

This last weekend I took the 7 hour bus ride from Pedernales to Las Matas de Farfan, a town where I have spent a lot of time working over the years and have Dominican friends to visit and stay with.  It´s another town near the border, and for some reason has a little rougher feel, a fair amount of ¨tigeres¨´ or juvenile deliquents roaming the streets, but I always feel at home there, and I feel grateful to have learned how to bachata and meregue because of their funky, welcoming open air discos and plenty of willing partners.  Like Pedernales, it is no tourist destination and if you see a white person here they are either a missionary or a Menonite, of whom there are quite a few doing dairy and other types of farming in this lovely valley.   I have seen incremental civic improvements over the years; at least they spruced up the central park and now there is a roundabout with a wierd sculpture in the middle as you enter the town.  But they still have blackouts every day, usually around the most incovenient time, 6 pm which last until 2am when the lights suddenly flick back on when no one needs them.  By the time you get up in the morning, the lights are out again and come back on around 11am.  No one seems to be able to explain this phenomenon.... its worse during election time which is coming up in May.

I was invited to a party Sunday afternoon of one of my friend´s compadres´¨ out in a village called El Naranjo.  I knew there was going to be live music and dancing, so I decided to sacrifice Monday morning´s clinic for a little indulgence.  It was way out in the hills, about 45 minutes up dusty rock strewn paths on motorcycle, in a humble family compound nestled under some limestone cliffs the formed a ridge above us.  The band was playing when we got there, a great tipico merengue band of country boys; accordion, bass, and tambora, a typical dominican drum with two sides played with sticks and the guira, a percussion instrument that looks like a cheese grater, played with a scratcher.  The whole scene reminded me of some blowouts I used to go to in Maine with live music, people of all ages, food cooking for the masses and the usual inebriates.  Dozens of people, kids and grandparents were grinding away on a dirt floor under a straw roof, shading us from the intense sun of mid afternoon.  chickens, donkeys, horses, goats, all wandering around ad lib.  Just next to the dancefloor was another small building with a candlelit altar full of images of the virgin and St Miguel, Antonio and others unknown to me, as well as bottles of soda, rum, wine, cigarettes and large bowls of rice sprinkled with colorful bits of fruit, candy, nuts and adorned with a candle on top.  People sat inside singing call and response prayers in front of the altar and intermittantly standing up to ring a little bell at the altar and restart some incantation. After a few hours of singing, praying, drinking and dancing a huge meal appeared in the backyard, cooked camp out style in huge caldrons for the 100 or so attendees.  Goat, beans and rice and chen chen, a dish i´ve never seen before, looking and tasting like a rough hewn polenta, delicious.  They use plastic bags to cover the pots of rice and beans as they simmer away, but with rum, aguadiente, and parasites, who minds a few PCBs ???

As the sun was beginning to set we all marched about a half mile through the woods to a river, originating out of the white cliffs, where a little spring came up from the earth and between the root structure of this enormous ceiba tree.  There was the rezadora, or ¨prayer lady.¨¨ I had seen her before in the little altar building and in the pavillion doing some gestures reminicient of vodou, provoking the crowd around her as she danced with a cup of water on her head.  she was dressed in a little girls´sailor dress with a wide collar and pleated skirt and began to set up her altar by the edge of the river, flanked by her assistants who were chanting and waving flags in her direction.  With the band reconstucted themselves over the rocky edge of the river and with 100 people looking on in silence, the rezadora began tossing rice from the bowls into the river, and at all of us bystanders, muttering prayers, pouring rum, wine and fanta into the river, tinting this clear  virgin spring blood red.  She was blowing air through her lips as if she was trying not to push while giving birth, twirling around and around barefoot in the river with a large bowl of rice and chicken on her head. Someone handed her a lit cigar which she puffed fervently, spueing smoke everywhere.  Eventually she got herself into such a state, egged on by her cotarie that she started having a seizure that landed her down into the shallow waters covered with rocks, so her dress was ballooning up out of the water and she was entirely submerged, her body triggered by spasms that resemble fornication. 

Senor Santana and his grupo

everyone can move their hips!

the altar in living color

a party animalita

plastic works as a pot cover in a crunch

chen chen

la rezadora whirling

twirling

calling saints and sinners

Santana squeezing

puffing 2 cigarettes

Many people casually looked on and my friend was chattng with one of his buddies during the whole production,  but I was pretty transfixed and also pissed as hell that my iphone camera battery had run out just as we neared the river.  So sorry!!  But here are a few shots, woops, they landed up above

Rated X for the squeamish

A rather quiet day yesterday turned into a hurricaine by evening.  I had decided to spend the night at the clinic, in a little tent that Dr. Alexandre had proudly bought when he was in Vermont last year.  He set it up next to where I hang my hammock, just downwind from the cholera compound, a distinct smell of chlorox trying to hide something else, but on some nice cushioney grass.  He even has a camping mat.  He felt regretful because our original plan was for me to move into the doctor´s ¨dorm¨´ which would have saved me the $750 I´m spending over 2 months in this pension.  But suddenly now with no warning the Haitian Ministry of health sent three lab techs to work with us, expecting them to use the spare room, which was gonna be mine. As Alex put it in his exclamatory Kreyol accent, ¨¨that´s just how the Haitian government does things here, Luisa, you never know!!´¨  Oh well, nice to have TV and my own bathroom back here in Pedernales, although the shower is a chilly trickle.

But last night I decided I should christen the tent and brought a stash of Klonapin just in case.  As it turned out one lady came in labor at about 300 pm.  Its funny how my experience from delivering babies in 1977, fresh out of nursing school and working at a hippie birthing clinic in Strong Maine is coming back to me, like a slow rising fog.  I can remember how those cervixes feel at different stages of labor pretty clearly.  anyway, hers wasn´t ready and we told her to come back later.

After wandering the streets with Pete, my kreyol tutor looking for something to eat, we settled for a satisfying dinner of plantains, a hot dog and some cabbage salad and fresh orange juice on a bench on main street, prepared by his aunt.  He talked more about the evil of vodou and that his father does good things as a vodou priest by sending the evil spirits out of people.  Pete himself is an evangelical and is sure that he is free of all the evil of vodou because he is in the hands of JC.  But there seems to be no problem with them all living together, worshiping different dieties.  Anyway, we kept talking on the stoop on Rue Principal, the only paved one in Anse a Pitres, until it was dark.

I got back to the clinic to find two boys suspiciously wrapped in old clothes over their heads and limbs.  Apparently they both had been severely kicked by a fierce horse.  No one but me was around, so I started taking a look.  The light in the ER when I have all my stuff was dead, pitch black, no bulb in the overhead light fixture.  I took my headlamp which was running low and fished around for all the stuff I needed and moved it all into my exam room, which has dim light.  The little guy had a scalp laceration that ran from his forehead to the back of his noggin, about 6 inches long, with gaping scalp you could peel back for a few inches, which I had to do to irrigate it.  a couple more gashes of the eyebrow and chin and the other kid had a nasty abrasion with a central gash in the inside of his leg.  Amidst their squirming, the sweaty heat )I´d just had a beer), the usual cluster of rubberneckers at the door way, I strugged in the lousey light of my room, glassses slipping off my nose, dad holding an otoscope for me to see better, to sew up this kids´ head.  finally after two hours both boys were sewn but we agreed to take a break before dressing and bandaging. 

Simultaneously some bystander yells to me that the pregnant woman is back, flanked by her two sisters, who are just barely holding her up.  I run to find someone to help me because I have no idea of the routine or where anything is, and I finally drag LaMartine, toothbrush and toothpaste in hand and towel over his shoulder to come to the acouchement, trying to explain excitedly in kreyol that she is really gonna have this baby.  by the time I get into the room she is onthe table, legs up in the stirups and pushing.  In two seconds I see the little wrinkled black haired head pop out from between her legs.  I yell for LaMatine who is still holding his toothbrush and he takes over just as the baby comes out with a gush all over the floor, since the bucket to catch all the goodies was not in place.  It was a girl, I mananged to remember to suck out her mouth and nose, luckily one of the sisters brought a towel because we didn´t even have anything set out onthe counter )no crib in this room), and she was breathing fine, yet looked rather purple to me, but I realized I have never seen a black newborn, and maybe this dusky color is normal.  Hummmm.  She was fine, LaMartine cut the cord and tied it and I slid back through the room flooded with blood, amniotic fluid and other body contents to finish bandaging my boys.  when I returned no one was there, the placenta was sitting by itself on the floor amidst the puddles already described, looking like a neglected and forgotten family member.  I wondered who was going to clean up the mess so I half heartedly got  out a mop but finally Alexandre came back from having dinner with his family and misssed the whole thing saying, ´¨oooooooooh, I didn´t think she was coming back so soon, Luisa, stop doing that´ telling me not to clean up, the family will, and sure enough a  half hour later one of the sisters returned and spent an hour making everything spick and span!

i had a peaceful night in the tent and today we bumped over the mountains distributing water purification, bleach, hand sanitizer to rural communites in attempt to help control cholera.  Some breathtaking vistas and roads that even a donkey might have trouble traversing.  We had a nice early model toyota land rover that is partially financed by US AID, but I still lost my balance while trying to take a picture out the window while we were climbing a particularly bumpy area and I fell flat into a big pile of soft bags, cracking everyone up.

The little girl with hepatitis is getting worse and after staying with us for two days and getting nowhere, her family finally agreed to take her to Jacmel.  I tried to bargain with the border to let them into the DR but failed this time, actually I think its better she stay in Haiti. 

Girl with jaundice, eyes as yellow as her dress but you can´t tell in the photo, she probably has sickle cell anemia.

Life has started to feel somewhat routine as I settle into a rhythm of walking along the dry road to the border every morning and back every evening, craving a shower, a beer and a cigarette.  I read or watch spanish telenovelas at night.  I am staying up on the second floor of a building that surrounds a very green, luscious courtyard in a pension run buy a family who have now become friends.  They always have the coffee, strong dominican brew that needs sugar to cut the bite, and they have great taste in music which wafts through the thick air of the morning.

This weekend was slow, all I really did was sew up a few lacerations, a knife wound from a young guy who smelled distinctly of kleren, Haitian moonshine, and someone else that managed to mangle his hand on some bamboo.  I hang my hammock outside the clinic under some fig trees )no figs) and study kreyol or just listen to the clucking of the hens, waiting for some action.  Breezes make it pretty bearable in the shade.  Alex and I or Peter, my translator often go to La Belle Anse a Pitroise, the only restaurant in town which is about a mile through the humble village from the clinic.  There a pleasant buxom lady with a magnificent smile who serves you a mountain of rice under a shaded tent, the kitchen is outside too, under a grove of guayaba trees.  Each time you are served a small piece of meat of some sort and a bowl of brown ¨pwa¨which are supposed to be beans but is really more like a brown soup that tastes a lot like cinnamon.  I actually dont like it at all, so my choices are limited.  The ¨sos¨that you get for your meat is red, rich and and delicious, they serve it separately in a big bowl with a piece of raw onion in it but it is only about a tablespoon, just a tease. 

Lydia and I saw this little girl in the yellow dress a few days ago and we were shocked to see such a little person with such yellow eyes and a very palpable liver peeking out from under her right rib cage.  Her dad was very caring and intelligent, she had apparently been in Santo Domingo for the same thing last year and from what we could surmise she was supposed to get a test for Sickle Cell and never did.  She had vbeen fine up until a few days before. LaMatine, one of the doctors I work with sat down with him and tried to convince him to bring her to Port au Prince.  You would think that with all the organizations there, there would be some great resources for her.  But when I saw her dad yesterday, he told me she is much better, less jaundiced, because a family friend came with some tea made from a leaf that made her poop a lot and she´s been improving ever since! 

In everything I do here, I have to weigh what makes clinical sense, common sense, cultural sense and so on.  For instance, although we do not give children in the US zinc, they have a ton of it here in the pharmacy.  Neither of the doctors seem to be using it, but when I read about it, it seems the perfect thing for everybody around here  pregnant women, lactating moms, etc. helps boost the immune system, growth of bones and muscles, prevention for diarrhea, on and on.  When I ask them why they don´t use it they just say, Öh, you can go ahead !¨ So I plan to gently begin using it, although you have to be careful with the dose, parents could make their kids toxic with too much.  And there is no tetanus vaccine here for adults here, so when you sew up a laceration, you just hope that vaccine they received in childhood is still hangin in there.

I´m trying to memorize some useful expressions in kreyol to make my conversation a little more colorful

Ala gason antchoutchout!       What a nasty boy!!

Se touye máp touye ou!       You´re killing me, you´´re really killing me!!

Ala traka pou yon malere!  What tribulations unfortunate people have to bear!!

  



pictures

Alexandre Widner, medical director of the clinic

UN Contingent from Peru that are camped right next to our clinic playing soccer - lots of free time, no women

Another view of cholera tent, cots with holes and buckets underneath, Dr LaMartine in the background, my coworker

feeling lousey inside the cholera tent

Cristina, cleaning lady

my mysterious rash

my exam room

Zombies

I am beginning to gather information about the Haitian Lwa, or dieties of Vodou, but I want to get a more complete picture before I transmit too much to you. My translator, Peter, comes from a family of Vodou priests and priestesses. He is an intelligent and motivated young man but a very deep believer inthe powers of Vodou, and fulll of fears and superstitions, as is probably everyone else here. Just one little example of this is that people here are not to greet one another in the morning before they have brushed their teeth, or it is very bad luck.  Maybe that is why their teeth are so nice, I wish my patients in Amenia would have the same fears!!! One should never go out after 8 pm wearing white or shining a flashlight upwards, or you might be mistaken for one of the evil night dieties. Basically Peter doesn´t go out after 8 pm anyway. They also have a book they sell in the places where you play the lottery that gives the corresponding numbers to play according to the content of your dream the night before, for instance, if you dreamed of a dog, you would find that number and play it.

So in drilling Peter for his knowledge of the pantheon of Vodou, we started talking about zombies. He has seen quite a few, he says one works in a pharmacy!! He has heard them walk around at night, they make a continuous nasal humm, they shuffle as they walk with their head bowed. His relatives apparently have the power to contribute to the making of a zombie, which I don´t understand very well, but somehow these people can facilitate someones death and then get by Baron Samedi, the Vodou god who guards the cemetary and controls the ebb and flow of zombies. Zombies come back as slaves, so I guess they are useful.....there is a great book by Wade Davis, ¨´The Serpent and the Rainbow´¨ that talks about a potential scientific explanation. Here´s something from Wikipedia

In 1983, Davis first advanced his hypothesis that tetrodotoxin (TTX) poisoning could explain the existence of Haitian zombies.[2] This idea has been controversial and his popular 1985 follow up book (The Serpent and the Rainbow) elaborating upon this claim has been criticized for a number of scientific inaccuracies.[3] One of these is the suggestion that Haitian witchdoctors can keep “zombies” in a state of pharmacologically induced trance for many years.[4] As part of his Haitian investigations, Davis commissioned a grave robbery of a recently buried child.[5][6] (Dead human tissue is supposed to be a part of the “zombie powder” used by witchdoctors to produce zombies.) This has been criticized in the professional literature as a breach of ethics.[7][8]

The strictly scientific criticism of Davis’ zombie project has focused on the claims about the chemical composition of the “zombie powder”. Several samples of the powder were analyzed for TTX levels by experts in 1986. They reported[9] that only “insignificant traces of tetrodotoxin [were found] in the samples of ‘zombie powder’ which were supplied for analysis by Davis” and that “it can be concluded that the widely circulated claim in the lay press to the effect that tetrodotoxin is the causal agent in the initial zombification process is without factual foundation”. Davis’ claims were subsequently defended by other scientists doing further analyses[10] and these findings were criticized in turn for poor methodology and technique by the original skeptics.[11] Aside from the question of whether or not “zombie powder” contains significant amounts of TTX, the underlying concept of “tetrodotoxin zombification” has also been questioned more directly on a physiological basis.[12] TTX, which blocks sodium channels on the neural membrane, produces numbness, slurred speech, and possibly paralysis or even respiratory failure and death in severe cases. As an isolated pharmacological agent, it is not known to produce the trance-like or “mental slave” state typical of zombies in Haitian mythology, or Davis’ descriptions, although one might consider the effects of set and setting in combination with the drug. However, Wade Davis did not suggest that the zombie powder containing tetrodotoxin was used for maintaining "mental slaves" but for producing the initial death and resurrection that convinced the victim and those who knew them that they had become zombies. The effects of Fugu tetrodotoxin poisoning in Japan agree with the reports of zombification. The zombies, such as Clairvius Narcisse, were kept biddable by regular doses of the poisonous zombi cucumber, Datura stramonium which produces amnesia, delirium and suggestibility.[13]


To finish, here are a few more of my favorite medical terms in kreyol
Gaga sluggish
Piki injection
Zo bisket sternum
bouda buttocks
toudi dizzy
emowoyid hemmorrhoid

Child slaves in the DR

I met a woman from Madrid here at the pension where I am staying who is helping her neice who has stared a home for street kids in Anse-a-Pitres)AAP), ex-slave children, who have run away from their Dominican owners.  They are sold into slavery by their own Haitian parents when they are 2or 3 for about $30, this is done at an early age so they become attached-dependent on the family.  Then from an early age they work for the family, sleeping on the floor with the dog and often, both boys and girls are raped repeatedly by their owners or others .  Of course this is against the law in the DR, but I guess the blind eye rules.  Way out in the hills, 20 miles from here, it is very common to find single men living with slave concubines that they have ¨raised¨ from an early age.  These kids that this spanish woman is taking care of have no surname, no idea how old they are or when their birthday is.  They are pretty wild and violent, and I think this young woman is both an angel and a maniac to get so involved in their lives.  She takes care of about 10 of them, has restored a house for them  in AAP, and is doing it just out of the kind donations from family back in Spain. These kids kick, bite, steal, obviously have trust issues, PTSD, and are also sexually precocious, to put it mildly.  This woman has to hire watchmen to sleep with the boys to make sure they don´t rape one another.....

Sorry to open another grim subject, but there were at least 5 deaths from cholera at our place yesterday and over the weekend.  One I saw yesterday, a girl of about 3 who was so dehydrated when she came in that no one could start and IV, she seized and that was it.  Mom was howling the moans and groans of grieving as is done here right outside my exam room window and lots of rubber neckers were trying to get into my room to see the coffin, the men in full protective gear dealing with the body, etc.  PLease don´t worry about me, I just pass through the compound every morning to see what is going on, but as I described before, I really have no role in the care of cholera patients, thank God.  I see what is now becoming a usual parade of deep lacerations from vehicular accidents, high blood pressure, pregnant women, a bizarre dramatization of some kind of diety possession where they come in convinced they are dying of something very wicked, fortressed by the whole family, with amulets around their waists )this woman yesterday came in like that and had a tight piece of cloth squeezed around here diaphragm, yet there was nothing clinically wrong her.  I have seen this several times in the past, and once you  see it you never mistake it.  Of course after doing a full exam, I found she had a cold and high blood pressure  Placebo works well, but a gave her appropriate meds and everyone left smiling.  2tylenol and see me in the morning!

My friend Lydia is stay for 3 extra days because of the storm you all are having....sorry about all that snow, but I´m kind of jealous.  The sun here has given me this allergy that makes me look like Ihave measles and I itch so much I have to take prednisone and benadryl at night in order to sleep.  Otherwise I am safe and sound and content.  Much love to all