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