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

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