Mesi anpil St John's

USE OF FUNDS FROM ST JOHN’S

Medical supplies and overweight charges………………………………………………$160

Medications purchased in the DR......$626

HIV and syphilis tests………..………….…$471

Food for orphanage………...........……..…..$56

Boat to Grand Gosier………….……………$120

Aid for special patient problems……..$292

Total…………………………………………………..$1725

Parting thoughts and images

Women parading, singing and dancing down mainstreet Anse-a-Pitres on the International Day of the Woman

RESPECT THE RIGHTS OF WOMEN, THEY ARE WHO GIVE LIFE

Carnival street demons

Flapping papillon

Each pair of papillon would fight with these pirates, doing kung fu type moves

Carnival princesses

Arriving at Grand Gosier

Catholic church high on a peak overlooking the beach at Grand Gosier

Local department of justice

Large, pristine clinic in GG,  waiting for several years for doctors, electricity and plumbing

We did a "shake and bake" clinic in the facility, seeing 40 patients in 2 hours

A little cutie looking unconvinced even though I assure her "mwen pa gen piki," I don't have a shot!!

My colleagues in AAP my last day in the clinic.  Dr.  LaMartine is holding a brand new Dell laptop that Kathy Brieger from Hudson River Healthcare, my employer, donated, which will hopefully connect them to teleconferencing and many other functions

This will be my last entry for this year, as I had to leave abruptly because of the death of my dear 97 year old father on March 4th.  I am writing this from my desk overlooking the ridge of the southern Taconics, getting back home late last night.  I want to thank you all for following me and supporting me and I will certainly be back next year, God willing.  I feel like this place perfectly fuses my interests and abilities with their needs and future plans.

Last week was packed with adventure.  Tuesday was both MartiGras and the International Day of the Woman and AAP was bubbling, as you can see from the above pictures.  It was particularly moving to march and sing along with the women throughout the community, since I have personally seen and treated the sad results of so much violence against women in my short time there.  These proud, brave and capable women of all ages sang out this song, call and response style for several hours.  It's telling all the men; husbands, sons, president, deputies, senators to wake up to the abuses of women:

Fanm oooo  k'ap pase mize
Rele fanm ooo  k'ap pase mize
Misiye yo pa konnen si fanm ap pase mize
Menm gason nan kayla pa konnen se fanm ap pase mize
Prizidon pa konnen
Senate yo pa konnen
Depite yo pa konnen
Majistra yo pa konnen

Both Nicolette, who went to Benin with me when she was 13, and I were struck by how absolutely African their voices, song and styles of movement.  It is a long hard fight.

The Papillon troupe was a kick, they had these wonderful hinged wings made of wood which were ingeniously attached to their elbows with rebar so that they could flap them back and forth, making a scarey racket.  They marched through the street and then staged battles, 2 by 2 with a handful of rogues, all rather theatrical.

The next day, on the urging of Dr Alexandre, we rented a boat to go to Grand Gosier, an isolated community about half way down the coast to Jacmel, to do a clinic.  The place is rustic and beautiful, I fell in love with it right away.  Apparently there are about 10,000 people within reach of the place by burrow, boat or foot.  It is quite unaccesible by car, only really by dirtbike, but has a clinic larger than ours that was built by the Haitian gov't years ago and then recently given a big facelift by some NGO.  However it is still not up and running with a doctor, or regular care.  There is an axillary nurse, with the equivalent training here of an LPN, who does all the consults, suturing, delivering of babies, etc.  The evidence of melted candle wax on the windowsill of the room where I was seeing pts was a telltale sign that she does all this at night without electricity.  I left my headlamp for her with a dozen AAA batteries!!  Although the place is plumbed out with 5 or 6 toilets, showers, sinks, there is no running water either. There is enough room here for a whole operating room, lab, inpatient rooms, dorms for personnel, but the place is totally vacant.  Haiti seems rife with these kind of frustrating ironies.  The president of Batey Relief Alliance, the organization I work with which has taken over the administration of my clinic, has expressed  interest in taking this clinic over in the future.

I leave with many of the same unanswered questions I had when I arrived; is there really any hope for Haiti?  does a volunteer like me give more than she takes?  is what I do adding or subtracting to sustainability?  is this culturally right?  Yet the beauty, simplicity and grace of the people uplift you in this cloud of confident expectation that your doubts can't deflate.  I'll be back.

Update on the Gods

I´ve been waiting to write this desciption of the Haitian pantheon until I knew a little more, gathered more information from varied sources, but I keep hearing the same stories, so I guess I will just relate what I have heard so far.   There are many wonderful books on the subject that go into fine detail which I will leave up to you to search out if you are so inclined.  Maybe because I work in the line of blood and injury, I am told repeatedly that accidents happen because the Lwa, the Haitian gods, are hungry for flesh or thirsty for blood.  So some motorcyclist doesn´t mangle your leg because he was carrying 100 pounds of coconuts and a few stalks of platanos at 40 mph and you happened to be in his way, but because the Gods are constantly looking to feed themselves, and you did not feed them daily with prayer and libation.   There´s also the possibility that someone out there wants to get back at you, so they paid a Gan Gan or Mambo, male or female voudoo priest, to get the gods pissed off at you and pay you  a visit.  One of the most feared goddesses is LOUGAROU who flies around at night in the form of a turkey and looks for newborn babies.  One guy I met could hear her on the roof of his house, making noise in the middle of the night when his daughter was a baby and had to put a bwa pini or wooden cross at the door with a bag of tobacco seeds attached to it.  My translator told me that Lougarou visited his little brother the other night who sleeps next to him.  He saw him in a dream trying to pursue his brother but woke just in time to scare her away.  He feels he has special protection because he belives iin Jesus who makes you impermiable to the Lwa.  Other male and female flesh eating and bloodthirsty Lwa are Bizango, Sanprel, Zobop, Dambala.  People do not go out late at night in Anse a Pitres because this is the time when these Lwa are out on the prowl and it is very, very dangerous to walk around.  I didn´t know this but I somehow survived when I went out dancing and walked back through town, which has no electricity, at about 11:30.  It seemed serene to me, sky packed with stars, streets silent, but as the Haitian proverb goes, "what you don´t know is bigger than you."

Besides all these bloodsuckers, there are a few colorful superstars, and they are not all bad.  There are at least two female goddesses named Erzuli; Erzuli Frida is the black goddess of love, she is capable of giving you love, riches, power and a break in life.  Her day of the week is Tuesday and her favorite color is pink.  You can see altars set up for her with bright pink satin, perfume and lipstick., sweets and cakes in different shades of pink and of course,  lots of hearts.  Erzli Danto is her white counterpart, her day is Saturday.  There are a handful of saints - Miguel and Rafael that are good spirits that protect you from these bad spirits as do Oganbatagi, a warrior that bears a sword and Ogon je rory,  who protects the whole family from bad spirits.

One of the most famous characters is Baron Samedi.  BS is chief of the graveyard, and if you want to get someone out of their grave to turn them into a zombie, you have to get clearance from him.  He is kind of a sexy trickster, smoking a cigar, wearing a top hat, tails, sun glasses, and a bare chest.  Apparently Papa Doc and his tontons macoute, or henchmen,  used to imitate his likeness to get their point across. 

I´ll leave it at that, not being any expert.  Things at the clinic truck along, now my wonderful buddy Julia is here, another nurse practitioner from New Mexico who I met years ago here in the DR.  She is adapting brilliantly...The woman with the hideous eye is recovering well from surgery and soon will be fitted for a glass one.  We found out that her husband is a curandero, or folk medicine man of questionable rank, and put some drops of chlorox in her eye which might have explained its bizarre condition.  The woman who got her hand machete-d is also doing amazingly well except that she lost so much blood that she has a hemoglobin of 5.7!  We are seeing her everyday to change her bandage, give her painkillers and iron.  She can move her fingers! Her story also changed - the guy who went after her with the machete was actually going for her neck and she put up her hand to protect herself.  He apparently was bothered by something she and his wife were talking about.

My daughter Nicolette is arriving in Santo Domingo to join me for a week.  I am leaving tommorrow on the 5 am bus, trying to buy some meds and medical supplies while I am there.  Can´t wait to give her a big squeeze and turn her on to this wild world.

A few more closing favorite words in kreyol:

Dodo   sweetheart
plop plop   quickly
roket      hiccup
bouche flobop  toothless              I have a long list and could go on.......

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