The kitchen at the CAFOJ (Centre d'Animation et Formation des Jeunes). Tata is one of the cooks and one of the happiest people there.






The president's palace. Yes, that's where the president lives. There are people dying because there is no clean water and this is how the president lives. I don't want to talk about it.






Joelle, a nurse from Switzerland who came to work at the clinic for two weeks. She's fantastic!







Liza, another nurse from Switzerland, originally from Memphis, so I had someone to speak English with! Hooray for her! I think everyone needs a Liza to carry around in their pockets.








One of the smiliest babies I ever met at the clinic. This is what a healthy baby looks like, it made me so incredibly happy. I want this for Haiti...fat and happy babies.

In my last post, I said that I had to choose between buying a house (which was a completely unrealistic idea, by the way, but it would have been an adventure in every sense of the word, that's for sure) or going back to Haiti to continue working in the clinic. The house thing didn't work out, so that is for the best, but that leaves the Haiti option. When talking with Doc Gordon, he agreed that we needed someone to stay at the clinic for long-term and he would like me to be there. I am ecstatic about it, it is just about my dream job, I think it is a perfect place for me right now in my life. But now another obstacle, the health insurance. Will figure all that out tomorrow, the next business day. I would love to just get this figure out so I know which adventure path to take. If Haiti isn't fated for me, I will be looking for a nursing job here in Portland, or New Mexico, or Alaska, or on the East Coast, maybe. Research is required, of course, before decisions are made. But that is where my adventures have led me.

And now about my Haiti experience, a few thoughts and words: I loved it, it was the hardest thing I have ever done, I learned more in those three months than I think I ever have before, never ever will I forget the clinic, nor will I neglect to continue to be involved. Yep, I think that about covers the main ideas. There's so much more to the clinic than I can verbalize...I am still rediscovering English prose after speaking it very little or very poorly for such a long time. I would be overjoyed if I got to go back, although I don't know how I would make it one year without my friends and family. Three months were hard. I think Skype would be my best, best friend. My lifeline, if you will. But I will cross that bridge when I come to it.

Not much else to write here, I'm getting re-accustomed to the States, mostly staying out of shopping malls, admiring my favorite city and all its quirks, and cleaning up my crap-ola. Who knew that I had so much superfluous stuff? That is a topic for a psychologist, not for my blog, I suspect.

which adventure do I choose?

When you don't check your email for a week, it really piles up on you. And all at the same time. And when the rest of your life is just as hectic, it can become a bit overwhelming.

At the clinic, I am packing up my things, cooking Thanksgiving/birthday feast on Friday, getting ready to say goodbye to Carlos on Saturday, another goodbye party Sunday, leaving early Monday morning to head back to Memphis for a week. There is a possibility that I could come back here to the clinic as a head nurse, help to organize the clinic so there is not the threat of the doctors leaving, donations could be used better, personnel need to be managed, etc. Lots to do, I feel like I could do this with a bit of guidance and preparation. And I love the doctors who I have been working with for the past three months and I would love to come back and see them and work with them and help them and the clinic.

Then I learn that a house owned by a neighbor is up for sale, in Portland, and I could move back to Portland and find a great job and get a dog and start living a normal life. It is exactly what I wanted before I came to Haiti. Now, everything has changed and I just don't know what exactly I want anymore.

I'm trying to find a way to have both, the house in Portland and somehow help the clinic here in Haiti, but I think that is not possible. Next week, I will be talking with the director of the clinic, he lives in Memphis, and we will figure out exactly what ought to be done. Do I want to come back to Haiti, live here for probably another year, fix some of the problems in the clinic, work with the doctors and try to get a permanent nursing position here and get the clinic running optimally? Or do I want to return to my home, buy a wonderful house near wonderful people, get a job, and start living a normal life? One adventure or another?

p.s.: For those of you waiting for a really long post, I apologize. For those of you who want words of wisdom, here they are: read Basket Case by Carl Hiaasen.

p.s.s.: I will be coming back! Hooray! December 15th, my plane is coming in from Memphis to Chicago to Portland at 6:45pm! I cannot wait to see everyone! Just 13 days until I see your smiling faces!

This trip just gets better and better. Last Friday, two nurses from Switzerland came here to work, one for two weeks, the other for one month. I thought it would be a good thing to have some people to work with in the clinic, but they are so much more helpful and productive than that. One is the daughter of the man who founded the clinic twelve years ago and she and I are working with the other nurse to try to make the clinic here more efficient and better equipped. Some of our ideas are to reorganize triage, establish a small laboratory here, fix the xray machine (we have one, but it's broken. in Haiti, this could truly save lives. it's very difficult for people to get a consultation at one clinic, xrays at another hospital, take them to the first clinic, all while paying for transportation, xrays, and consultations. we could avoid all that by just fixing the xray machine.), write protocols, etc. for the clinic. Almost all our ideas are the same, and when talking with sister Luz Marina, we are on the same page with her as well.

I am still waiting for a final word on whether or not I will be returning in January. I want to, since I don't feel like I am done with my work here, there is still so much that I can do and I don't want to abandon this project right now. But I am getting really homesick right now, talking with Liza reminds me of home and my family and just how much I miss them. It is Christmas time right now (not that you would know it. Right now, I think it is 85 or 90 degrees outside and blindingly sunny.) and I have always enjoyed this time of year, it is the time I most appreciate and enjoy. I am so glad I will be returning for Christmas, to spend the holidays in Oregon!

This is not the most interesting blog post, I understand that. I have talked about the clinic enough and there are not many new stories to post. I am getting more and more independent, especially since Leo and Pia are on vacation for two weeks. I can diagnose and treat impetigo, lance abscesses, clean wounds, and do consultations and write medications for hypertension. Now when I return to the states, I want to find a job that will allow me to come back here on a regular basis, maybe to continue doing this type of work...public health studies or something of the sort. One of these days, I would like to visit the general hospital; I have heard horrible stories and I would like to see for myself. Maybe on the next trip that will be possible.

Otherwise, everything is going well, nothing else to report. I will be returning to the states on December 7th, staying in Memphis until the 15th, I believe, then flying back home to Portland in the evening. I am happy to tell stories and show pictures. Just ask.

more evidence

Another Haitian Sunset











The road to the clinic in Santo 19












At the beach












Carl and Carlitos, two wonderful guys, will be two wonderful priests.

Haitian situation

The doctors are back! This sounds like a title for a really dumb faux-scary movie, but it´s the truth here. The doctors are back from a required two-week sabbatical and are now back to seeing patients, diagnosing illnesses, and generally being superhumans. It´s so great to have them back and not turn away patients. That was absolutely the hardest part, seeing patients with Impetigo or abscesses and having to turn them away, solely because the licensed person was not at the clinic. It breaks your heart to see people in need and not be able to do anything. To everyone´s relief, that lasted only for two weeks and now we are back to nearly working perfectly.

I feel like all I talk about is the clinic, so I will try to talk about something else now, to keep all you readers out there (I´m assuming there are readers out there?) interested. I don´t believe I have really talked about the situation here in Haiti, so I will do my best to illustrate it.

When I first came here, in March of this year, I really didn´t know much about Haiti. I knew of the situation, but I didn´t do much research into the politics, economy, government, etc. All of this is extremely fascinating, humbling, infuriating information, by the way. When I got here, I saw the people working on the sidewalks, selling mangoes or grapefruits on laid out sheets, squatting since they have no chairs. Drinking water from small plastic bags, then discarding onto the street when empty, joining the various other pieces of trash. Never did I seen a trash can or garbage truck. Kids running up to the windows begging for money, speaking a few words in Créole, French, English to appeal to as many of the passengers as possible. It´s hard to describe how contradictory Haiti is.

Haiti is a post-industrialized nation, meaning it had been industrialized, but has since collapsed, with the economy and government mostly to blame. In 1957, a president was democratically elected, then named himself president for life. While he was president, he morphed into an autocrat and a terrorist of his own people, and managed to scare away a large portion of the educated in Haiti. This caused further desolation of the Haitian people, since a majority could not read or write (even now, about 50% are illiterate). Doctors, teachers, and other highly trained professionals left in droves for kinder and safer countries, leaving Haiti without people to care for it. Papa Doc remained all-powerful until he died in 1971, then his airhead of a son becamse president and further messed up the country. In 1986, Baby Doc fled the country, like the coward without cojones that he was. The uprising of the people was enough to scare him off. This left Haiti without a government, without an economy, and with hardly any allies, thanks to the Duvalier devils.

Anyway, after that short history lessons, Haiti is now getting back on it´s feet, thanks to enormous help from the UN. The new president was elected democratically in 2006 and has been in power longer than most of the presidents here. The Haitian police are being trained by the UN as well, to make Haiti as self-sufficient as possible. Things here are slowly improving, and now the main objective is to teach the country how to manage itself. Haitians are wary of power, understandably so, of course, so suggestions have to be made carefully so relations do not become strained. The UN here are doing a fantastic job and I have had the provilege to talk to quite a few people in the UN and they seem very hopeful about Haiti´s progress, however slow it may be. Programs are being put in place to lower the rates of kidnapping, rape, murders, etc. and the Haitian police are slowly taking charge of these programs.

The streets of Port-au-Prince look the same as they did when I was here in March; I would have been incredibly surprised otherwise. Working in the clinic now, I see these people in the mornings, have consultations with them, clean wounds, sometimes give out food or milk, and pray for them. The people do not seem to be any better off, but you can see signs of progress...men driving motorcycles, taxiing people from here to there, making meager money, but any income is something here; women selling clothes; about a third of the population sells telephone cards to the rest; others set up small stands and sell soaps and medicines and napkins and a strange hodgepodge of various household supplies. There are yet other stores, proper buildings, for car parts, tailoring clothing, photocopying, and at least every five stores you see a Lesly Center, where you can get your gambling fix by buying a lotto ticket and playing the numbers from New York. Haiti seems so close to getting back on it´s feet, but it´s this last shove that is the hardest. Keep praying for this country.

photographic evidence

The waterfall at Saut d´eau. It´s a welcome sight after working at the clinic in the country and sweating for 40 hours straight.

Bonny and his sister trying to get the donkey out of the mud. On the way from their house to the main road so we coulod catch a tap-tap back to Croix-des-Bouquets.
Loading up the donkey with avocados and sugar cane to sell in Croix-des-Bouquets.

The whole clan at the rural clinic: Jorge, Leo, me, Bonny´s sister and brother, Bonny in the front row, and Fernando next to him.

Leo and me doing consultations. That you see on the desk behind the patient is the pharmacy for the day. These people are so far away from any medicine or doctors, this is all they can get.

another story

I don´t want to tell the whole story of what happened here last Tuesday, since I don´t know how much of this story I am permitted to recount. But I will give the basics and the occurrences after the event.

Eight days ago, during triage, we let a woman into the clinic and, while we were finishing triage, (which typically takes 45 minutes to an hour to do a brief once-over of all the children and adults) someone came outside and said one of the patients died inside. The doctors and I, of course, ran inside and found that, indeed, a woman had died. We all agree that she most likely had some serious health problems already; she was 26, but could have passed for 14, which is a major indicator of a long-standing illness. She may have had AIDS, she may have had a congenital problem, she may have had developmental delays. Whatever the problem, she died inside the walls of the clinic, without a doctor present. This is where the problems started for us.

The doctors are here with America Solidaria and this organization wanted to take this opportunity to readjust how it was operating at the clinic, so they pulled the doctors out of the clinic for the rest of the week, and so far all of this week. Last week, I also had two days off, since I find it very difficult to do my job without the doctors around. Friday, I let in patients for wound cleaning and blood pressure checks, since I can do that, for the vast majority, without the necessity of doctors or medications. This week, only one day with patients, and yesterday and today, we did inventory (which, I feel compelled to say, is probably the best thing we could have done with this obligatory ´free time´. We are finding medications that expired two, three, four years ago and I laughed when I found SteriStrips that had an expiration date of 1983. Where they came from, we can only imagine. The clinic opened in 1998, FYI). Tomorrow, if all goes as planned, the doctors will be back and can do consultations with patients again.

I don´t want this to be the only story for this post, since it seems so dreary to me. Last weekend was a welcome break, with the clinic being re-shuffled. I was invited by Carlos, one of the seminarians living here, to go to the beach with Father Edison and the rest of the students here on the compound. It is a public beach very near Port-au-Prince, only about an hour drive away (it´s probably only two or three miles, but the roads are indescribable, except to say that you never want to go more than 30 or 40 miles an hour, the potholes are sometimes hard to see. Once we got up to 65 and I felt like I was in a stowaway in a NASCAR race). It was a beautiful beach, with the expected palm trees and salty water (something which stupidly surprised me, since all oceans are salty. But in Oregon, I don´t often get wet above my knees, thus forget the taste of salty seas.), but also scrawny chickens, empty bottles floating from the beach, Bob Marley blaring from pathetic speakers, and gawking passers-by. Not many blans visit this beach, I assume. And here´s Carlos, Father Edison, and me in our swimsuits. We kind of stand out. We swim for a while, eat the rice, chicken, sandwiches, coleslaw-sort-of-thing, and King Cola, I play a very poor game of checkers with Telo, read a few pages of our chosen books, try to nap in the shade (although it´s tough, there isn´t sand, just big smooth rocks, and the sun still finds its way through the pam fronds), and generally relax and enjoy the beautiful holiday at the beach. After a few hours, we drive home, with all of us trying to sleep without bashing our heads on the ceiling or the windows when we go over the massive bumps in the road. When I get back to my room, I discover I have managed to get another sunburn (on my legs this time, not as bad as the shoulders and face like last weekend), and I take a much-needed nap.

I ended with a happy story and I am satisfied. I will write again when something else happens. Or when I manage to make fried plantains.

Always an adventure in Haiti

Well, I´ll start from Friday.

Another day at the clinic, crying children, infected wounds, etc. but it was better, because I was going, after work, to the house of the doctors I work with. We were going to eat pizza (Leo-style) and relax before heading out to one of their friend´s house, out in the country. Now, when I say out in the country, I mean it in every sense of the word.

Saturday morning, we woke up with the sun (which means about 5am here), ate a meager breakfast, got all our stuff packed for hiking and a day at a rural clinic, and walked toward Route Tabarre, the main road near the doctors´ house. We waited for a tap-tap to take all six of us: me, Dr. Leo, Dr. Jorge, Dr. Fernando, Natella (a Haitian wmoan who lives with the Chilean doctors and has been the cook and tour guide for the house for the last four years...she is marvelous), and Bonny, whose house we were going to stay at and who ran the rural clinic. He is not yet a doctor, but will be starting medical school in the Dominican Repubic in January.

We waited for a tap-tap to take all six of us, which didn´t happen, but the doctors saw a friend driving his moving van down the street, he stopped, and drove us to the tap-tap depot on the other side of town. We were bombarded with tap-tap drivers who all wanted the "blans" to take their tap-tap, because they all think that they can trick us into paying more than the fair share for a tap-tap ride. We´re blan, that´s true, but we´re not stupid.

One of the tap-tap drivers took one of our bags and threw it into his tap-tap, which was already mostly full and could maybe fit all six of us into the covered bed of the pick-up. Stuffed in, we made our way up into the hills above Port-au-Prince. I don´t know how we got up those hills, with about twenty people in the back of the unkempt car, but we made it somehow. Probably just with prayers and not much gasoline. Being jostled around for two or three hours is not much fun, but with beautiful scenery, such as the mountains in a tropical country, it is easy to forget how miserable the cities are.

Stopped finally at a widening of the road, which was the start of our trek into the jungle, as it were. At the trailhead were children dragging donkeys with spindly legs, heavy-laden with bags of charcoal or sugar cane, as well as women trying to sell mangoes and coconuts from their small farms. All six of us started walking, only Bonny knowing which way to go to reach his house. If I ever complained about hiking in the States (which I know I have...), I was getting serious pay-back for it. The roads got narrower and narrower the further we got from the road, and since it is a tropical country, there is plenty of rain and more than the fair share of mud. Leo slipped crossing one of the half-dozen swollen creek beds and his shoe was then covered with the clay-mud mixture. Natella and myself were fortunate to get a piggy-back ride from one of the men from the village (God bless him), and we continued on until we finally reached Bonny´s house, maybe a two hour hike from the road. A gorgeous hike, full of friendly people who are quick to smile and children who have never before seen a white person. It´s an eerie feeling to be gawked at by children, but they are like their parents, polite and curious and all smiles.

Bonny´s house is a small shack, made of concrete walls (quite sophisticated compared with the neighboring huts) and 2x6´s bolted together and hinged for a door. Thank goodness none of us are gaining weight, we couldn´t have fit through the door. Inside was a table with a lace cloth and bread and coffee and cheese. In his neighborhood, we were eating like royalty. We rested just long enough to eat something, then headed out again for the clinic. The clinic was just about the size of a decent size living room, with benches for the patients. We were on one side of the room, separated from the patients with a bedsheet hung from one of the cross beams, and that rectangular room separated into two rooms by another sheet. This made two exam rooms that were private enough for the patients to feel comfortable. (As a sidenote, most Haitians are not the least bit modest...they aren´t rich enough to be. When you hardly have enough money to buy materials to build a shack, let alone a place to go to the bathroom, and you have to pee in the same place as all your neighbors and bathe in the same stream as the rest of the village, you come to be very comfortable with the human body. Comfortable or indifferent.) I worked with Leo in one room and Jorge and Fernando worked in the next room. We saw patients with the flu, parasites, back pain (probably from osteoporosis or herniated discs or other preventable illnesses), consultations for birth control, and one man who I will never forget who came to see us because he had high blood pressure. I noticed he had a bulge in his mouth, like he had chew stuffed into the pocket of his gums. But he obviously did not have access to that sort of thing, so I asked him what it was, He opened his mouth and a tumor the size of his tongue engulfed the rest of his mouth. Leo told him he had to go to the hospital right away, since it may be a benign tumor or it may be cancer, we didn´t know. He seemed more concerned with the blood pressure, maybe because that was more uncomfortable than the golfball in his mouth, and he knew what would happen at the hospital...he would have to pay to get there, pay to see a doctor, pay for x-rays, pay for lab tests, and pay to come back home, without ever receiving treatment.

This is the most infuriating thing for me to see. People who have treatble diseases whose only obstacle is payment. Their lives could be saved if they could get to a hospital who would do x-rays, sonograms, consultations, diagnoses, and treatments for free. It seems like a lot, and it is, but that is for a major case. At the clinic, jsut today I saw a man who sliced open the bottom of his foot as well as the top of his big toe. It had swollen to about twice it´s normal size. He said it had been like this since September 7th, and he went to the hospital and got x-rays and medications, but he couldn´t go again because it cost too much. I don´t know if he had an infection or if he had broken any bones, and since the doctors aren´t at the clinic today, I can do very little. I can clean and bandage and say "come back on Monday to talk with a doctor". Most likely, he will have this wound on his foot for a very long time. It´s incredible the lack of medical treatment here.

But I digress. I was talking about the clinic... At around 2pm, we finished our work at the clinic. Went back to Bonny´s house, changed into our swmsuits, and took a very short walk to a stream where we swam and cooled off and enjoyed cleaning ourselves in the not-so-clean-but-oh-so-delightful water. Went back to the house for dinner and to listen to the small radio to the Colombia v. Chile soccer game. I could not understand anyof it, but by Jorge and Fernando´s reaction, I knew Chile was winning. I think the neighbors probably thought they were crazy (which they are, when it comes to Chile being in the world cup playoffs). Then to sleep on the concrete floor, all five of us side by side in a room maybe 8´wide and 10´long. Very cozy. And a bucket in the corner for a bathroom during the night.

The next morning, we headed out very early because Fernando had a fever all night and the next morning and he felt horrible. We hiked all the way back to the road, with less mud than the previous day, although we had a donkey carrying some coconuts and mangoes that Bonny´s sister was going to sell in Croix-des-Bouquets. That donkey almost didn´t make it all the way to the road, he got stuck in the mud up to his belly at one crossing, and had to be unpacked and pulled and pushed by Bonny and three assistants. Got to the road, took a moto to Sodo to play in the waterfall. On the way there, I managed to forget Leo´s advice about being careful about the exhaust pipe and I got second degree burn on my calf. Also, being stupid, I forgot to put on sunscreen and I got plenty burned, mostly on my forehead and shoulders. I look silly with a sunglasses tanline.

Enjoyed the waterfall, Fernando slpt and still felt terrible, so we took the motos to a nearby town to transfer to a tap-tap for 10 goudes (roughly 25 cents US). Then we began a new adventure. The tap-tap carried us about a mile up the winding road, the stopped because it had no water left in the engine. They can´t use radiator fluid, it´s to scarce, so they use water instead. When they opened the gasket, boiling water cam shooting in through the grate separating the cab from the bed of the moving truck. Nobody was hurt, just surprised and furious at the driver. And Fernando was trying to sleep and did not appreciate it as a wake-up call. This happened twice more as we were trying to get back to Croix-des-Bouquets, as well as a flat tire. So, three hours and 50 goudes later (they raised the price to pay for all the repairs the tap-tap needed), we were in Croix-des-Bouquets. Took another moto back to the doctor´s home, slept very well, although painfully due to the sunburn, and welt to work the next morning.

The week that followed will be in the next post, since I have already written a lot for this update. The next one will be just as interesting, I hope.

Aah, another day in Haiti. Another day at the clinic. Another 7 hours of screaming children and incomprehensible language. It´s hard work here and everyday tries my patience and stamina. Thankfully, though, I do have some wonderful patients. Today, I had 15 patients (a typical day for me) and none of them had impetigo (thankfully), but half needed bandages changed and the other half were children with a high fever. That´s about all the patients I see. Also mothers who are part of the program where we track them and their child. I think I mentioned this in the previous post.

Anyway, I had helped about eight of my patients when a seminarian here, Anderson, came into the clinic (this is fairly unusual since he´s usually at the school teaching or taking classes himself). He wanted to talk with Dr. Leo, but he was in a consultation with a patient with malnutrition and I had just finished with my patient and I went with him back to the school. He said there was a girl there who was sick and I said I would check it out and see if we could do something. When we got there, she was screaming and having what I´m assuming was a seizure. It seemed more like a tantrum, since she wasn´t truly seizing, she was more writhng around and being held down by three or four women. Her eyes shut tight, her teeth clenched, her little brother said she did this regularly, although I didn´t know how long this had been going on. This episode (of what I think was epilepsy) had lasted for about an hour and a half, off and on. This is a VERY long time to be having seizures and is called status epilepticus and we have no medications and no way to help with that at the clinic. Leo recommended she get sent to the hospital as soon as possible for medication and then be sent home once she stabilized. I will ask later if she´s alright.

Another girl at the clinic I referred to Hospital Saint Damian because I think she has bilateral femoral hernias. She´s only 8 or 9 and she needs surgery to correct this. I don´t know how or if she or her family can pay for it (it may be free-of-charge, but i´m not sure), I can only hope. It´s difficult to just send people on their way. We don´t have a lot of medication here and we have to refer people to hospitals to see specialists. It can get disheartening when you see patients like that and can´t help them.

Tuesday, I gave a number to a girl who was being carried by her father, a handkerchief wrapped around her foot. When I finally saw her, I unwrapped her foot, the most awful smell wafted out and she had a gaping wound on her foot, a huge infection that had burrowed into her muscle. She was trembling, but had no temperature, although I am almost positive she was septic. We had nothing to give her, but I put a clean and fresh bandage on her and sent her to the hospital who does emergency care for children. Again, I have no way of knowing if she went or how she fared, I can only hope.

On the bright side, the last patient of the day was a little baby, 7 months old, who was having a hard time breastfeeding. He was the happiest little baby, with a gummy smile, and I was able to give his mother some vitamins and powdered milk so she would be nourished enough to feed her baby. She was very grateful, which makes me all the happier. Sometimes, all the people want are medications and, when we run out of things like Tylenol for kids or Paracetamol (both for fever and pain relief), we can only say to give the kids lots of water and milk and bathe them and let them rest. This is often the best treatment for kids, instead of medication. It´s frustrating since I can´t speak the language well yet (I´m studying every day and trying my best, but with so many abbreviations and speaking so fast, it´s very difficult) and the culture is such that they are relentless in their search. It´s getting better and I´m developing a firmer skin and a better eye for real illnesses and needs. And most days I get to work with smiling children, which makes every day so much better.

Haiti, part 2

I said I was going to dedicate this post to the Creole food of Haiti, but after today at the clinic, I have to use this post to just vent for a bit. If you don't want to hear my rantings and complainings, skip this post.

Another warning, I mention a minor surgery during this post, so if you get queasy easily, you may want to skip that part.

Today started off as any other day at the clinic, I got there a little early, 7:30, and waited for Leo and Jorge to get there so we could go get started on triage. When we were all ready, we headed across the small lawn separating the clinic from the outer road. There were probably 300 people waiting outside and they formed two lines, one for "ti moun", children, and one for "gran moun", adults. Shortly after they were organized into lines and we starting triaging people, a fight broke out at the beginning of the lines, whic merge at the one entrance onto and away from the road. I don't know what exactly happened, but there were bags being flung at others and yelling and shoving, none of which helps the mob of people waiting their turn to see the doctors. Jorge got in the middle of it (Jorge is probably 6'4" or so and not a slight man, by any means. He's a great doctor, but he was almost scary when he tried to break up this right) and he managed to break it up, but we werew all pretty shaken up by it...I almost expected weapons to be drawn.

Back to the patients; we each have our own numbers we hand out to people, they are pieces of wood that have been painted a color (green, black, red, or yellow) and have a number on it. I have fifteen numbers, since that's usually sufficient, but today, I wrote an extra 18 numbers, so I had a total of 33 patients to see.

Triage starts like this: I start in the middle of a line and work backward and Jorge or Leo starts at the beginning and, if things go as planned, which they never, EVER do, we end at the same time. After I had seen about two children, people started to mob around me and shove their children at me and just yelled the kids' symptoms at me. People are grabbing you, wanting you to see their baby next. It's heart-breaking and absolutely infuriating at the same time, I couldn't decide if I felt like crying or screaming or just leaving them all out there.I tried to tell them to get back into line, but my Creole is so limited and they were so afraid they wouldn't be seen that they just continued with their mob.

It took about 30 minutes total, thankfully without another outburst, to finish the triage. By that time, Leo, Jorge, and I are ready to be done for the day. Emotionally drained and physically disgusting, Jorge and Leo take showers before seeing patients, but I had 33 to see and I got started right away.

In order to see patients at the clinic, you have everyone wait in a common room, outside, but covered and with plenty of seating. I go out to call my first numbers and nobody comes forward, so I think those people have left. I just allow the next person with my color of card to come see me and I get started with the day. I saw a man with a huge wound on his foot, he said he had had it for about 2 weeks, it was severely infected, and I got to wash it and bandage it (for all this griping, I will say I am getting MUCH better with wounds. They don't gross me out nearly as much as they did before coming here. And it's only been 7 days at the clinic) and he also spoke some French, which I am much more comfortable with and I also got some Creole words figured out with his help. I saw some babies which I examined for their 1 month checkup (at the clinic, we are keeping a record of some mothers who come to see us during their pregnancy and we follow them throughout their pregnancy and follow their baby for 1 month, checking in on them at 1 month, 3 months, 6 months, and 1 year). I also saw a little boy who has been to the clinic twice before due to a severe burn on the back of his hand (it's healing, but it's slow and it's still incredibly raw). The majority of the patients I see, however, are just babies who their mothers say have "mal a tet" or "mal o vent" or "pa manje". They all say their children have the flu, and indeed, we think the swine flu has hit Haiti pretty hard, but we just don't have the resources for giving medicine to everyone. If we gave medicine to each child who is reported to have the flu, we would be out of medicine in maybe two weeks.

(Just as a side note, if you are able to talk with your doctor or a hospital about providing medical supplies to this clinic, let me know and trust me, the medicines will be used well and will benefit many).

It was not all in all a terrible day, I did get to learn some more Creole and I also had some students follow me today, which is interesting. Although the group from today was not as well behaved as lasst weeks group. They didn't really help, they mostly sat around or meandered in the halls and just took up space. Maybe it's just because this is their first day. I guess we'll see. They did get to see a pretty interesting minor surgery, though, one which I will not soon forget.

Leo works across the room from me and he needed my help to lance an abscess on a baby's head, so I agreed to help. We help each other as much as is humanly possible, since we are all fresh out of school and figuring things out as we go. To lance an abscess, you usually numb it with some lidocaine or something, they you can make the incision. But lidocaine is used very sparingly, so we don't use it unless absolutely necessary. Leo made the incision and pus came out, which is absolutely normal. But the students were watching and I think some of them were ready to pass out. You have to also squeeze and flush out the abscess to make sure it is clean and there is no more infection left and the incision can heal correctly. (Warning: this may get graphic) Leo had to squeeze the abscess, the baby was screaming and wiggling all around, and the abscess must have popped or something and pus and blood flew onto the wall behind the baby's head. The students did not stay long after that. I don't blame them. But the abscess is gone and the baby is healling now.

The rest of the day, I gave out dried milk for babies who seemed under-fed or to mothers who had trouble breastfeeding because they didn't have enough nutrition for themselves and the baby. I also gave out Tylenol, Jr. almost like it was candy, which we also give out sparingly. I listened to so many hearts, lungs, and abdomens, I am hearing them in almost any quiet moment. It was an emotional day and a very, very long day (I was working from 7:30 to 3:15, with a 15 minute break for lunch. Not a typical day, either, since we usually only work from 7:30 to 1).

I promise to dedicate the next post to food, it will be a welcome change to this medically-themed entry. I hope tomorrow won't be so crazy.

Haiti, Part 1

I decided to separate my posts about Haiti into a few different postings. There is altogether too much to include in just one post. In this post, I will be addressing the clinic.

The clinic is made up of 6 exam rooms and a pharmacy, plus a few rooms for storage of books and a few charts and things like that. I am actually working in my own room (it's not a room, really, just part of a larger room separated by the others by curtains which I don't always close) and I have a lot of autonomy when it comes to treating the patients. The doctors from Chile are wonderful and they speak very good English. The two practitioners are Jorge and Leonardo and the dentist is Pia. In the mornings, Jorge and Leo and I do triage for the 200 or so people who show up outside the doors to this compound. Both doctors have about 40 numbers they hand out to the most needy patients and I work with them to help treat problems that come up. I also work alongside a nun, one of whom is a nurse, and we see our own patients, mostly children with the flu or who are dehydrated or malnourished.

Some of the patients I saw: a young boy with partial-thickness burns over the entire back of his left hand, a woman with an asthma attack, helping Dr. Leo lance an abscess above a boy's eye, an infected wound on a girl's forehead. Not a lot of really serious cases, but there are so many people who cannot come to the doctor right away, they may live hours away (one woman traveled four hours to this clinic by tap tap - a sort of taxi/city bus - just to get her blood pressure taken). We are lucky at the clinic to be so close to the UN troops, they are stationed in Croix-des-Bouquets so they can remain close to the airport. They recently donated 7 tons of dry milk to the clinic and we are giving it away to children who are malnourished or have diarrhea.

I did triage this morning, only my second day at the clinic, and it was absolutely mad. The doctors asked everyone to line up according to their needs, one line for children and one line for adults. We then just went down the line to see what was the matter with each person. I need badly to learn Creole and I will be working on it and Spanish while I am here. I am so glad I can speak French, though, because it makes it easier for me to understand Creole. Anyway, triage lasts about 30 minutes, 7:30-8am, then the doctors start calling numbers. During triage, Sister LuzMarina also gives out numbers for nursing care, mostly for the kids and sometimes for adults who need their blood pressure taken.

The entire day at the clinic only lasts from 7:30a to 1:00p or so and then the afternoon is free for us to do what we like. That means there's about 6 hours of free time until dinner. I'm trying to figure out what to do with all that time and I'm usually reading or taking a nap. I am also thoroughly enjoying the meals here, so I'll probably dedicate the next post to the food. I have a lot to say about it.

My thoughts are a little scattered and not very linear, but that's because I'm a little exhausted and the heat is curdling my brains. Can't always think in a linear way. Will post more soon, hopefully with pictures!

I'm leaving on a jet plane

Well, this is it. In two days, I'll be on a plane destined for Denver, then to Memphis. It's quite surreal that I'll be spending three months (or 12 weeks, as I like to see it) in a bloody hot country helping people with God-only-knows what illness, far, far away from anyone I know. That spells f-u-n for me. No, I really do think it'll be a fabulous opportunity and a chance for growth and learning, but it just seems so crazy for me to be doing this. Still hasn't hit me yet, I haven't had any breakdowns or crying fits (which I would usually have before such a trip). I'll bet once I get on the plane, surrounded by complete strangers in an enclosed space, I'll collapse into a puddle. Knowing my luck, this is the most probable outcome.

Trying to keep a record of what's going on and what I'm bringing (which, by the way, is WAY too much). Bringing: scrubs, skirts, jeans, a flannel shirt (it does get relatively chilly at night...into the mid-70's, even high 60's), a fleece blanket, a small inflatable mattress (like one for camping, very thin, packable, but in case I'm sleeping on a concrete slab with a wimpy foam mattress, I won't be miserable for three months), a webcam for skype (will get that working shortly), iPod and speakers, batteries, recharger, books (will list titles later...haven't yet decided), knitting projects (again, will list once they are decided), sandals, slip-on shoes, tennis shoes, cell phone and charger (in case of an emercency), and a ton of medicine (for malaria, intestinal upset, flare-ups, and a few others...odd to be carrying all that).

Books I'm paring down to bring:
The BFG, Roald Dahl
The Witches, Roald Dahl
Mountains Beyond Mountains, Tracy Kidder
Krik Krak, Edwidge Danticat
Jane Eyre, Charlotte Bronte
The Secret Garden, Frances Hodgson Burnett
Le Petit Nicolas, Sempe-Goscinny
L'Elegance du Herisson, Muriel Barbery

So, as you can see, I have to choose between all these...not an easy task. Now, knitting patterns:

Ene's Scarf with a nubby cotton fingering-weight yarn
Flower Basket Shawl with silk/wool blend lace-weight yarn
Hip in Hemp with Hempathy in a stunning red
Lacy Baktus scarf with Cascade Heritage sock yarn
bolero with Linares (I'll be making up that pattern based on Ash from Rowan 36)

So much to bring. I don't know if I'll have enough time to do all this, but I'd rather have too much and not finish it all than finish it all and be bored after two weeks. AND, who knows, I may be there for six months and then I'd be S.O.L. as far as keeping myself busy. (In all truth, I think I'll be plenty busy with working 7a-4p six days a week. We'll just see...)

I'll keep up the posting as things happen. 2 days now and I'll be posting soon after I get to the clinic.

heat and work

I didn't know this sort of heat existed. 106 was the high temperature today, one degree shy of the all-time record for Portland. Not cool (no pun intended...okay, so maybe it was). And more hundreds for the rest of the week, too. At least I know that if I survive this, then I may survive Haiti weather.

I have been applying to jobs around Portland and Eugene and even some on the coast and in Eastern Oregon, but I think all the jobs for new grads are completely dried up, just like this desert of a summer we're having. So, after being rejected from everywhere I've applied and getting no good information from nurse recruiters, I decided to go to Haiti for a few months instead of sitting on my sweltering tooshie for the rest of the summer, throwing pathetic pity parties, and not getting a job. Granted it will be hotter than Hades over there, not to mention the hurricanes/tropical storms sure to hit as soon as I leave (Murphy's law, dontcha know). Anyway, I think this will be the best idea for me, to get some amazing experience, live with a whole new group of people (I think most will be Chilean, the rest Haitian, with the occasional American wandering through), and work and serve some of the most amazing people I've ever met. Currently, I'm working on learning Haitian Creole and Spanish (what was I thinking? I don't know. I rarely do.)

Other than Haiti and stubborn job markets, nothing new with me. Tomorrow, I think I'll spend the day trying to beat the heat by being a recluse in my basement, knitting, and making something for a friend's coming-home party, back from the "even-hotter-than-Portland" country of Mexico. Now off to bed to re-energize for tomorrows good times.

Margo, RN, BSN

Well, I graduated. And I'm licensed. Can I get a high five? Anyone? Anyone? Now to find a job. I've had my license for about 2.5 weeks so far and I've applied to about 10 positions and no bites yet. I've also found out about an opportunity to go to Haiti to work in a hospital for six months to a year (which would be absolutely fantastic!). So I'm figuring out my priorities about where I want to go: Haiti for six months (away from friends and family), move back home to Springfield (I'd REALLY rather not. Too easy to fall back into old habits. But tons of friends back there), or stay in Portland and keep on the quest for a job (this is plan A. Praying it will work out!).

In the mean time, I'm enjoying my summer, working at the Naked Sheep Knit Shop (love it! spend hours around yarn!), and visiting friends back home in Springfield I haven't seen in a long time. And trying to get back into reading my Bible and reconnecting with a God I've put on pause for the past few years. Lots still to think about and far too much to write about at this moment. Midnight is not really the best time to talk about deep and meaningful things, since I'd probably read this in a few weeks and wonder what in the world I was thinking posting at this hour. Now that I'm essentially unemployed, I'll be keeping up with this blog a bit better (at least, I'll do my best. Give it the old Girl Scout try. Girl Scout until the end, it seems...)

last semester

I am so incredibly bad at keeping up with this. I had a whole month off school, so I really have no excuse.

Starting school on Monday. Taking classes with titles like "Leadership" and "Personal Prep for Licensure". I can already feel myself getting drowsy. I am, however, starting clinicals back up and am continuing with my French minor. Graduating in four, yes FOUR, months! And after that... watch out.

After graduation, I'm going to Europe with two wonderful friends from nursing classes, Erin and Allison. I'm sure I'll be writing all about it and include delicious pictures. We'll be going in mid- to late-May and staying for a few weeks in France, then Ireland, then a stop by to England, Scotland, and anywhere else we want to go. I can hardly wait!

But before all that, I'm going to Haiti for a week, March 5-15, to go to a boarding school, teach a class on health, do eye exams for the kids, and do whatever else we feel we need to do. Just got my vaccinations today. Painful. Both for my arms and my wallet.

Now, on to knitting. Another subject at which my wallet winces. I started and finished a hat yesterday, from Modular Knits, the Flat-Top Hat, using Wisdom Yarns Poems. It is lovely and keeps my head very warm. I had to change the pattern in the book, since it was not written correctly. Minor changes, though.

Projects still on needles: Threepenny Pullover, in Elsbeth Lavold's Silky Wool (it's divine, but laborious to knit up. Have to refer to the pattern for each row. doesn't work well with watching a movie and knitting. oh well.); 1824 Blouson, from IK Summer 2007, in an unknown wool/cotton blend, but that will be ripped out and made into something else altogether at a later date; and Brambler scarf in a linen/cotton yarn (i'm too lazy to search for the label at the bottom of my yarn stash.) I think this is the fewest projects I have EVER had on needles at one point. Gasp!

Over the last month (i had four weeks off for school. mwa ha ha ha!), I made about four hats out of worsted weight yarn, a scarf for my brother, and i think three scarves for my mom. All were greatly appreciated and I am currently trying to resuscitate a project for my step-mom that I began as one thing, which were ghastly and thirteen sizes too large. Now, they are closer to her size, but I'm having to make up the pattern. Simple enough, just St st, but tough with the number of sts and the gauge. If anyone reading this is a knitter, you know what I mean. But seeing as how I think I'm the only one who reads this, I can say whatever I want and be completely comprehended. Yay me!

All for now. Ten-four, Gold Leader.