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.