Tuesday, April 13, 2010

Goodbye Haiti... I Leave Forever Changed

Today is my last full day in Haiti. It's so bitter sweet because while I'm so ready to go and get back to the life I left behind, I also know there is so much to be done here. More than even that, I've build a life for myself here now with friends, favorite hangouts, knowning my way around, and getting used to the culture, the language, the people, and the food. There are so many things I have learned since I've been here. There have been new things I've picked up and other things I'll leave behind.

For the day, I made my final rounds through town on my motorcycle and found a home for many of the things that I pass on to others who will use them. Among those items were the instruments that brought my groups to life... the instruments that my little Katura with the amputated leg first decided to dance to. They will go to the Quisqueya Christian School where other children can play with them for years to come.

The most important way I could spend my day though was with the people here I love and am sad to say goodbye to. I wanted to get away from the noise and chaos at the compound, so I went with a friend to what looked like a pretty decent little hotel. However, as the expression goes... you get what you pay for. The building was half cracked on one side, the electricity came and went, and there was no water. I got in the shower to get cleaned up, went to turn on the faucet and nothing. The lady downstairs brought me up a 5 gallon bucket and a scoop and said that was my shower. It worked alright, and reminded me of how excited I am to return home to warm, running, clean water. I had to brush my teeth with toothpaste and a bottle of Sprite. Yum! When it came to eat dinner, the "restaurant" downstairs didn't have any food. Some young boy went down the street and bought us fried bananas and some kind of fried root. We ate on the floor while watching a fuzzy French soap opera. It's experiences like these that make me so grateful to have the life I will be returning to.

Here's a list of just some of the things that come to mind... things that we take for granted that I am so grateful to have: Continous power, clean water, reliable transportation, my SUV, relatively cheap gas (compared to $5 a gallon here), cold milk, hot showers, short lines, quickness and efficiency, phones that work, safety, clean air (at least in Minnesota), emergency rooms where you can get care no matter what, sanitary hospitals, free education, access to student loans, clean streets, 24 hour stores, fast food, street lights, air conditioning, entertainment like movie theatres and theme parks, parking spots, trustworthy police, functional democracy, ambulances, no earthquakes, sturdy buildings, minimum wages, my home, animals that serve as pets not just food, green trees, clean rivers and lakes, washing machines, cable tv, green grass, garbage cans, recycling, community, barbeques, my church, reliable and quick internet access, microwaves, good plumbing, paved streets, nice sidewalks, landscaping, bookstores, coffee shops, hiking trails, bike paths, welfare, food stamps, community support programs, libraries, taxes, parades, sturdy construction, beauty salons, massage parlors, yoga studios, gyms, playgrounds, flavored coffee, flavored coffee creamer, American currency, camping as a vacation and not as a living arrangement, bubble baths, toilets that flush, interstates, atms, carpet, wood floors, neighborhoods, common language, traffic rules, post offices, pizza deliver, Chinese takeout, public transportation, shopping malls, gumball machines, Dr. Pepper, lottery tickets, bowling alleys, free refills, of course my family and my friends, and the list could go on and on.

The bottom line is that we are so blessed, beyond belief, yet we so easily want to whine and complain and get upset when any one of these things in our perfect little life doesn't work the way we expect it to. Maybe you run out of gas, but at least you have a car. Maybe your toilet gets plugged, but there are 24 hour plumbers that you can call. Perhaps, you get sick, at least there are doctors that can treat you. Maybe you hate your job, but at least you have one. The truth is that we are blessed probably beyond what we really deserve. If we had less then places like Haiti would probably have more. If we consumed less, shared more, spent less, contributed more, reduced waste, and increased productivity, then perhaps the world would be a bit more equitable of a place for everyone. Perhaps the whole planet would be covered in green grass, everyone's stomaches would be full, clean water would be in abundance, and every child would go to sleep feeling loved. I don't know what the solution is, but I do know that it's certainly not about a better life or a worse life, just a different one. It's not that those of us who have need to feel guilty for the sake of those who have not, but rather that we treasure the things we are gifted with and remember to thank our Lord for providing us with abundance. It sounds silly, but you know how its a tradition for many to say grace before eating and thank God for your food? What if we said grace before we took a hot shower, before we got in our cars and went to our jobs, before we went to watch a movie? What if every moment of our lives we treasured as if it truly were our last, as if it were a gift, as it were an enormous blessing? Perhaps then we would be more conscious of what we have, how we use it, and how we share it.

Today I leave Haiti. I close a major chapter in my life and await to find out what God has in store for me next. What a long, strange, amazing, challenging, and unforgettable experience this has been. I cried today as I said goodbye to some of those I have come to love the most. I don't want to say farewell, but I know it is time for me to return to the life I left behind. There are responsibilities and new opportunities that await me. But, I leave here a new person with new perspective on life.

I leave here changed. It's been an enormously long 2 and a half months. I've seen dead bodies line the street, seen babies born, watched babies die, held mothers who have lost their children, treated gunshot wounds and children hit by cars, watched children cry, helped children smile, been in several earthquakes, been scared to go to sleep, and grateful to see another day. I've seen the worst in people and the best in people. I've let myself buckle with both grief and joy. I've been on planes, motorcycles, boats, and crazy bus rides with baskets of chickens at my feet. I've celebrated Easter with a group of parentless children. I've watched amputations and seen many regain the confidence to walk. I've seen tragedy and I've seen miracles. I've prayed for others and been the one others prayed for. I've been sick, I've felt recharged, exhausted and motivated. I've eaten everything from goat to lobster fresh from the sea. I've crawled beneath the rubble of fallen homes and walked atop the flattened roofs of multistory buildings. I've felt unsafe at times and other times felt at home. I've met some people I'd be happy to never cross paths with again and others I hope to walk beside for a lifetime. I've experienced frustration, inspiration, dedication, and constipation. I've been angry with God at times and yet amazed at his love, compassion, and grace. I've been a follower of his call and a leader for others to join. My bed has consisted of everything from a tent inside a crumbling house, a hammock,the floor of a 5th grade classroom, to a CT-scan machine. I've had IVs, given IVs, sedated patients and wished I could have been sedated. I've been through the slums and stood in the back of the palace waving as president Bush and his convoy arrived. There have been moments I've had to step outside my comfort level and opportunities to offer comfort to those without. I've walked through cemetaries, sanitoriums, abandoned hospitals, and rum factories. I've been a counselor, a nurse, a doctor, an anesthesiologist, a mother, a friend, an organizer, a teacher, and a student of life. I've rescued children, transported orphans, and watched people take their last breath. I've learned a little Creole and French and taught a little English. I've taken nearly 10,000 pictures and been in quite of few of others as well. I've been frustrated, rewarded, experienced community and other days felt alone. I have been changed forever! I look forward to returning to my life I left behind and merging these lessons learned with my life that awaits me. I also look forward to one day returning to Haiti to find a stronger, sturdier, more hopeful country filled with people who have continued to allow themselves to have God's grace showered upon them.

Sunday, April 11, 2010

Motorcycles & Pickup Truck Obstetrics

It was great to get back to work today. Not only was it great to be back working, but it was nice to step back from the psychological support and back into more of a hands on medical role. I joined the Vermont team today at Operation Hope. This clinic is setup right across the street from Adventist Hospital. We are a part of the triaging system where we can treat those less serious more acute conditions and help filter the more serious cases into the hospital. The clinic used to be a large home that has been converted into a functioning medical facility since the earthquake. When the team found out I was an RN, they were ecstatic! They said, "Good, we'll have another person to see and treat patients!" Turns out we were about an hour out of town where services are more limited and there was only 1 doctor on site. So, myself another RN, and a new med school grad were asked to step into the role of primary care. It was great! It's just the way things go around here, you do what you can. Sometimes that means stepping out of what you're used to doing, but you do what you feel comfortable with, consult with your peers when need be, certainly don't do anything that could harm the patient, and know that if you don't step up, they may never get the care they need... or have to wait weeks or months to receive it.

I have some pretty incredible resources on my Ipod. They are easily accessible and convenient to use. It allows me to searching correct dosages, confirm diagnostic criteria, and review treatment options. I'm learning so much. Today, I ended up with one patient who I suspect had malaria, another patient that I got to tell she was pregnant, and another with a severe case of impetigo. I really enjoyed the autonomy today and the challenge of analyzing, synthesizing, and playing the role of investigator in sleuthing what might be wrong with each person's individual case. It was complete reassurance that the Family Nurse Practitioner courses that I'll return to next week are exactly what I'm supposed to be pursuing.

Again, today was a day in the field that really challenged my analytical skills as a nurse. I was on a team with one doctor, a PA, and myself who had to treat a line of hundreds of patients. We went up into the mountains to a village called Belot. I had heard from someone on the campus here that there was a resort in this town that they had converted into a relief center/clinic of sorts. I had ideas of this nice clean facility with a pool in the back, etc. When we finally arrived at the site, I realized my expectations were very far off. To start with, we had to take a special car to get to the site with about 12 of us stuffed in the back or a Land Rover. The roads were so treacherous, bumpy, pot holes, and a cliff that dropped a couple thousand feet to the side. We were so high that the clouds were rolling past us and through us in the road. Truly, it is beautiful up here. The mountains are green, the foliage is lush, and the air is clear. It's quite a shocking contrast to the scarred city below. When we finally arrived, we got to the top of this one mountain and up ahead we could see the site. Clouds rolling past, there was a small shelter constructed from bamboo and tarps. This was the "resort" I was so excited about. There was no running water, no electricity, and no toilet... not even an outhouse! At one point, myself and a couple of the girls had to pee so bad and all we could do is walk a few hundred yards away from the "clinic" to a bush along the side of the road and "pop a squat". People come walking by to see these three girls in scrubs taking a pee. Corrine and I are just laughing out heads off, and the best part is that none of the passerbys even batted an eye. This is what people do here, it is completely normal for them. As I continued back at the clinic in my more professional role, I was seeing a lot of cases of scabies. This continues to be a major problem here. As a side note, for people wanting to send supplies, the needs are constantly evolving. Right now, we are in need of permethean cream to treat scabies, any sort of vaginal creams, Diflucan, and adult/children vitamins. At the end of a tiring day, we packed everything up and took the cramped ride back down the mountain. We got back to camp with a good dinner prepared for us... you'd never guess... rice and beans! I've had so much rice and beans in the last 2+ months that it has probably ruined them for life. I'm so sick of rice and beans, but yet I am truly grateful that God is putting food in my stomach each day. I try to say a quick prayer before each meal just to thank him for blessing me with sustenance and energy to keep going. After dinner, I had a friend come over. We watched a movie on my ipod, and then got to bed.

I slept in this morning, and by sleeping in I mean that I woke up at 6am. After a cup of coffee and some bread, I started planning my day. A group of people here at Quiskeya are headed up to this remote place about 7 hours away in the mountains to provide care to groups of people who have yet to receive any. About a week ago, a group attempted to do some outreach there and on the way up the mountain had an accident. The truck carrying 7 medical professionals flipped, and rolled a couple thousand feet down the mountain. Everyone had to be airlifted to the hospital. Many were in critical condition, but latest I have heard, everyone is fine now. If I went with this new group, I wouldn't have been back until Tuesday, when I'm supposed to leave and that didn't sound like something I wanted to do. Besides, I really wanted to take a few days of wrapping up loose ends around here, dropping off some extra supplies, spending time with my newly forged friends here in Haiti, and having an adventure or two.

My friend Chantel and I decided to hang out for the day down with the guys living on the roof at CDTI. I took a nap in a hammock on the porch of the compound while I waited for her to arrive. Then, I had my first real Haitian cross-town transportation experience. We jumped on the back of a moving tap tap and about 15 other people piled in. You never really know where these "tap taps" are going either. If it's going in the direction your headed, then you just hop on until you need to go another direction. It only costs about 10 Gould, the equivalent of about a quarter. For those of you that don't know what a "tap tap" is, it's basically a pickup truck with benches lining the sides, a topper on it, and it stops for passengers when they tap on the side of back of the window... hence the "tap tap". All of these vehicles are decorated with bright colors and say something about Jesus or religion on them. It's a superstitious thing for many of the drivers. They don't feel their vehicle will be really protected until it's properly decorated and adorned with something reassuring their faith. Anyhow, after that long side note... we finally needed to go another direction so we hopped off and waited for a taxi. Now this was interesting! As we drove in the taxi, we continued to collect more passengers. This was a small little sedan that myself and 6 other sweaty Haitians piled into. Complete strangers are sitting on each other's laps and such. I kept looking out the window, just laughing at how this country and culture never ceases to amaze me.

Finally, we got to CDTI where we met up with the roof crew... Alan, Cory, and the Pauls. It was so great because I was able to finally meet Cory Gould. She is a nurse from New York and one of the biggest supporters of my organization. Before coming down, she made it possible for me to bring about 800 doses of antibiotics into the country. Once here, she was able to coordinate with folks back home so I could pickup a shipment at the airport of 2200 more doses. This amazing woman was finally in Haiti and we were on the same team!

We all just hung out at the hospital for a while, made some plans for the coming days, tried to organize some supplies in the back and so forth. This older lady we are friends with showed up and asked if we wanted to come over and hang out for a little bit. Chantal and I agreed and we arrived at the woman's cracked house. She was very lucky it did not collapse as major support columns are buckled in places. We sat on the porch drinking sparkling fruit punch and then we got a lengthy tour of the entire house. She took us through every room, pulled out picture after picture, told us stories about everything from a trophy to a candle. Even though I had nowhere else to be today, I started wanting to pull my hair out. The show and tell went on for at least a couple of hours. Then, she started talking French and Creole because I think she forgot that I only speak English. So, not only am I entirely bored out of my mind, but I have no idea what she is saying. I thought we were only going to be here for a quick stop by and now the sun was starting to set.

Suddenly, the woman's servant comes up from the basement and says dinner is ready. She had prepared a massive spread of food for us all. There's no electricity in the house, so they lit candles and we sat around eating beans and rice and other interesting side dishes. Just as we were finishing up, Victoria called from the place she was staying and wanted to come over. We went to pick her up and brought her back with us. We had already been here for about 5 hours now and I was so tired. As we sat there waiting for Victoria to finish eating, every time I thought we were going to get up and go, they would start talking about something else. I looked down at my watch and thought, we'd probably be there for another 45 minutes... 2 and a half hours later we were finally getting in car to ride back.

That entire I was sitting there at the table listening to everyone talk in a language I didn't understand, staring at the clock, and completely restless I had the worst anxiety attack I've had since I've been down here. I was sweating, my heart was racing, had a headache, and was entirely restless. I had to go take one of my anxiety pills because I thought I was going to lose it. The thing about the Haitian culture is that it is unbelievably slow. Nobody seems to be in any sort of a rush here ever. When it comes to completing a task, instead of going from A directly to B, they start at A, divert to D, then M, N, O, P and finally make their way to B for no logical reason. For instance, at the hospital you need a key to get into the back room. The man who holds the keys has to go to get a key to open a room upstairs, where there is a lockbox inside on the wall to get a key to go downstairs to open the back room. Every time he needs to get in there that's what he has to do. It's so frustrating because I'm all about efficiency, effectiveness, and momentum. Another thing that's interesting here is the lack of attention to body language. I've noticed that people here keep talking and focus on what is being said rather than how it is being said... or how it is being received. In the U.S., I'm pretty sure that just about anyone would have easily picked up on my restlessness and lack of enthusiasm in the conversation after about 15 minutes. They would have become self-conscious that they were being taken as boring or non-interesting and changed the subject or something. It's such an interesting place here.

Anyhow, Just as I'd think we were about to get up and leave, she would want to start telling us about her great grandmothers sailboat or where the silverware came from. There would be little pieces of English that I could pick out of the conversation, but the words were few. Finally, as we got into the car to leave, she said, "where are you going?" We told here were headed to our friend Dominique's house to stay the night. She said, "Why don't you just stay here?" Everyone else seemed happy with the idea, so I just went along. If I had known we were going to be staying here tonight, I would have gone upstairs and gone to bed much earlier.

From here on out things just got more bizarre for me. We did another tour of the house, the lady pulled out about 10 pairs of sheets for us, and then pulled out this cord that she had rigged into the neighbor's power source and turned on a light bulb in the hallway. She truly was so excited to have guests at here house. I think she is probably a really lonely woman. Next, she wanted us to have something to sleep in. She went into the closet and started pulling out silk "grandma" pajama dresses left and right. She gave us a whole pile of them with matching robes for us to wear. I thought to myself, "somebody already forced me into a skirt this week, there's no way in hell I'm putting on grandma pjs now." :-) There I was sitting on the bed and glanced up at the mirror on the dresser. I instantly reminded myself of my little sister. I looked just like her and had the same confused semi-amused look on my face that she would have had on hers. I suddenly really wished she was here with me to laugh about this situation with. I know we would have both really gotten a kick out of the whole thing. Over in the shower, we had to bathe out of a big bucket of cold water. That was interesting. The old lady then starts walking around in her underwear and bra and keeps walking into our room asking if we need anything else. The servant brings in water and glasses, and I decided I was done for the night. I was ready to check out of the Twilight Zone for the day.

Friday's List
Today, I am realizing how much my serenity level is wrecked. My focus here is pretty much gone. I'm ready to go home. I'm tired. I'm getting restless. I've checked out. And, I've got a pretty bad respiratory infection brewing. If I can just get through the next few days with helping a couple more people and having an adventure or two, I'll be fine. One nice thing today is that we started the morning with the servant bringing us hot coffee in bed. After we got up, I made this delicious oatmeal I brought down here with me for everybody, and the servant (by the way, that's what they call them here) brought me some special flower tea to help clear my lungs.

Once we were able to get the day started and get out of the house we walked our way down to CDTI to meet with the roof crew. The old lady we had given the tent to was no longer there on the sidewalk. Instead, the sidewalk was filled with rubble being cleared from the house nearby. I wonder where she went? The rubble from the professional school that completely collapsed is all gone now too. We walked through the new construction site and it was very refreshing to see things being built differently. Instead of using concrete and cinder blocks, they are rebuilding the school using wood. The joints are all reinforced and they are using a tin roofing. This is great to see because it appears they are using lessons from the past to help prevent further tragedy into the future.

When we finally got to CDTI we met up with the roof crew and hung out for a little bit. I don't know where the day has gone, it just flew by. I started myself on a course of Augmentin today from the massive pharmacy that just sits overflowing with medications that are not being used or moved. It's the same story with the rest of the hospital. There are thousands of pounds of supplies that are just sitting and not being used. It makes me sick.

Later on in the afternoon we headed down to the port. Along the way, I noticed something interesting. There are no real imports coming into the country right now. There are certainly no exports going out of the country. The only money coming in is really from the NGOs spending money on food and lodging, but other than that, the economy here is stagnant. What people are doing is attempting to create economy from the very thing that ruined the system. Locals have gone through the piles of debris and are reselling everything. It's become a rubble economy! Everyone has a niche. One guy sells pieces of wood torn from buildings, another sells steel railings, and down the way there's a guy selling broken furniture. They are even selling salvaged concrete blocks! Its nice to see how people are making the best out of the situation. They certainly are doing everything they can to survive right now.

I have been trying to get a sample of the sand that poured out of the massive fissures in the earth. As the plates rubbed together and cracked open, they spit up piles of ground up earth that was "digested" in the grinding. I'm going to use the sand to add texture to paint for a project I'm putting together when I return. While down along the coast, we came upon a fleet of old rickety wooden sailboats. They are all stacked with layer upon layer of charcoal being brought in from the town of Jeremie. It's about an 8 hour boat ride. We talked with a few of them and they agreed to take us along on their boats to the island for 50 Haitian dollars, that's just over $7 U.S. We'd camp out overnight and then take another sailboat back in the morning. We are considering the adventure, but it seems like I'd be cutting things too short with leaving on Tuesday. If we had a day of bad weather that delayed coming back, I'd miss my flight and really make a lot of people upset.

We continued down to the main sea port. It's very difficult to get into. I had to go speak to about 3 different security officers, sit down in the office with one and explain what we wanted to do, tell them about the sand, etc. Finally, they allowed us to enter the port with a security escort. It wasn't the first time I had been down there, but it was the first time the Pauls and Cory had seen the place. They were amazed at the damage and the extent of how the earth just shifted. I crawled down into one of the cracks and got my sample, everyone got their pictures, and we headed back to CDTI.

By the time we got back, the truck had a flat tire. The boys had to swap it with the spare and a few of us returned to the roof to just hang out. That night it rained as hard as it ever has here. I was sitting in the back of the pickup as they were driving Victoria, Chantal and I to our friend Dominique's house for the night. Boy, did we ever get soaked! We came inside the house to now power, soaking wet, and tried to navigate our way through the halls. Luckily, I had an MRE with me, so I was able to cook some food for us. It was the meatball and marinara packet, not bad... kinda like Chef Boyardee. Once you choke down the packaged wheat bread and cheese spread, you can convince yourself that you are actually full.

Falling asleep tonight was kind of difficult. There have been small earthquakes the last 2 nights in a row. You get kinda scared when you start expecting there to be a trend. What freaks me out about this place is that they lock the doors to get out with a set of keys that the servant sleeps with. So, if the house starts to shake and we need to get out, we are trapped. All of the windows have steel bars covering them. Victoria asked if she could sleep with the keys tonight and that left me feeling a little safer.

This morning, I woke up to make everyone some of that yummy oatmeal with cinnamon and brown sugar. Fortunately, we had power, but unfortunately, the microwave plug-in did not fit into the kitchen wall. We had to take the microwave and put it on a stool in one of the rooms. Even then, the buttons didn't work. The only way we could get things to cook was to plug it in, time it out for about a minute, it would shut off, and we'd have to replug it in and it would start the process over again. It was like the possessed microwave, but it ended up providing us with hot food in the end, so that's all that really mattered.

Finally, we were all ready to hit the road this morning and we headed down to CDTI to meet with the "roof crew". They are headed up to an orphanage in the mountains today to assess the facility's needs. On the way, they were going to drop me off at a friend’s house that was going to let me rent his motorcycle for a couple of days. Well, the driver never showed up. The truck the boys had wasn't going to make it up the treacherous part of the mountains they had to go to, so they had to cancel their plans. We all sat around saying, "Well, everything happens for a reason, there's probably a good reason things didn't work out."

Meanwhile, the owner of the motorcycle came with the bike and met me down near tent city. Chantal was with me, we hopped on the bike and a little nervous we sped off onto into the crazy Haitian traffic. We stopped by the Plaza hotel to grab some breakfast and ran into who, but Cory and the Pauls! I also ran into the girl who was on my original charter flight into Haiti more than 2 months ago. After breakfast, we went and sat by the pool for a little while we drank our coffee and checked out internet. Again I started thinking to myself, am I really in the middle of a disaster zone? We hopped back on the bike, I dropped Chantal off at her mom's house and I headed back to Quiskeya.
I was alone in one the Haitian streets now... alone on a motorcycle in the middle of one of the craziest places to drive! I was loving it! Everywhere I go on this bike, people stop and stare. First of all, most of the time I'm the only white person around in my vicinity at any given point of my day. Secondly, I'm a girl. Third, I'm on a motorcycle. The combination of being a caucasian girl on a motorcycle in the city just blows people's mind. Guys wink, kids shout "blanc, blanc", and I just keep moving head up, focused on the road, with the occasional smile. I'm feeling very comfortable here in the city now. It's probably a good thing that I'm going home soon because many would probably say I've gotten to feeling too comfortable. It's a long stretch from when I first got here. I wasn't familiar with the language, the culture, the city, the situation and I wouldn't even go outside the gate of the hospital alone to get a Sprite. Now, I feel pretty connected to the situation and people around me enough to fend for myself. Plus, I always have mace on hand.

Anyhow, let me get to the real guts of the day's events. So, I'm sitting here at Quiskeya planning for my day when I get this phone call. It was my friend Justin from the Kenscoff clinic up in the mountains. You may remember stories I've written about this group. It is the same people who encountered the strange voodoo ceremony in the middle of a woman giving labor on the roof. Well, Justin calls me and explained that they are in the middle of helping a woman in labor deliver her child. Meanwhile, another woman pregnant with twins was at the Farmount Baptist Mission hospital experiencing placenta previa. She needed to get to a hospital in PAP capable of providing her with a cesarean. They needed a medical team to get to her and transport her down the mountain. I got off the phone, called Cory and the Pauls and explained the situation. They were game right off the bat! We suddenly understood the reason things hadn't worked out earlier in the day, it's because God had bigger plans for us all.

They met me here and I led the crew on my motorcycle up the mountain to the hospital. Halfway, we stopped for a moment and I got a phone call from Justin that now we weren't just going to be transporting one woman to the hospital in labor, but two! Things just got even more exciting. Marilyn and her son had been working on the woman at another location. She had been in labor since yesterday. The woman had a bulging vein ready to rupture at any minute and the baby was pinned against the woman's pelvic bone which wasn't spreading. We zipped up the mountain and arrived at the mission's hospital. The father was waiting for us outside, crying and led me inside to his wife in the middle of having a contraction. We gathered their things and got her to the back of the truck.

I threw a line in the first lady and we got fluids running. Paul taped the IV fluids to back window of the pickup. Minutes later, our other pregnant lady arrived in the back of a car from higher up the mountain. We laid the two mothers side by side in the back of the pickup and Marilyn, Cory, and I sat at their feet. As we're riding down the windy, bumpy mountain roads the woman are contracting and trying to push. Marilyn and I are checking the woman's cervix as we fly down the road. I can feel the top of the baby's head and the bulging vein ready to rupture at any minute as we cruise down the mountain passing cars, whizzing along faster than we should. Meanwhile, Alan who was riding back behind us on my motorcycle wiped out on a puddle of water and got some pretty bad road rash. But for the most part, he and the bike are fine.

As we cruised down the road, it hit me. By complete coincidence, things had come full circle. The antibiotics that Cory had given me months ago to bring into the country had gone to Marilyn and the girls up at the Kenscoff clinic. Now, here we all were. Cory, Marilyn and myself... 3 women whose connections came full circle sitting in the back of a pickup helping 2 moms through labor! We are trying to get them to change positions, roll them on their side, Marilyn is talking with an OB specialist in the US who's telling us to put them on their hands and knees- yeah right! Not under these circumstances! We continue checking their cervix, taking their blood pressure, and I sang to them Bob Marley's famous, "Don't worry... about at thing... cause every little thing... is gonna be alright." The women smiled.

Finally, we arrived at Medishare, the Miami University hospital by the airport. We pulled up to the hospital, one of the only places in town suited to take cases like these, and we explained the situation. At first the hospital didn't want to take them because there were no OB docs available. We didn't care. There was a general surgeon available. These women needed a cesarean. And if they weren't going to take these patients, then they were going to die in the back of a pickup. Finally, the doctors agreed, brought the two women into the hospital and immediately gave the mom at risk for hemmhoraging and with the baby malpositioned an emergency cesarean. We stood there watching, changing out IV solutions for the team and praying everything would be alright. Before we knew it, out came the baby... first a bit quiet, then came the beautiful sound of the baby's first cry. The entire operating room erupted in applause and cheering. I cried a bit. It was such a wonderful thing to see this new baby girl come into the world. Meanwhile, mom number 2 was on another operating table getting an ultrasound and prepped for her cesarean. I ended up having to leave because it was going to be getting dark soon and if I didn't follow the Pauls and Cory out on the road, then I was going to be lost in the dark in Port au Prince on a motorcycle alone... not something I really wanted to do. We left the moms in the hands of Marilyn and her son, watched the sun set, bandaged up Alan from his little spill and set off knowing that we had a part in saving a handful of lives... some of those new faces in the world.

The next adventure... the motorcycle ride home. OMG! If I ever had any doubts that I can ride a bike, or that I have earned my motorcycle endorsement... let me tell you, driving in Haiti should earn you a lifetime permit to ride. It had gotten dark by the time we left the hospital, I had sunglasses on, and I have no idea where I am dark. All I'm doing is just following the roof crew's bumper through the packed streets. The traffic here is god awful! Cars going every which direction, trying to cross, pass, backup, turn around and all in one big cluster. A few times, I had cars pushing me from behind against my back tire. Another car came and the side of my bike got hungup on their front tire. People are honking, pedestrians are trying to weave through the cars, and the occasional goat or dog shows up. It's a mess. On top of the traffic, you have massive potholes in the road, places where the road is completely warped and bulging from the earthquake, rubble lining the streets, and then the rain. The sky opened up and it started pouring. There I am stuck in the middle traffic, pouring rain, a red bandana around my face trying to mask the smell of diesel, and a stethoscope still hanging around my neck from the previous adventure. The roads here get slick when they get wet too. Several of the cars were spinning out just trying to get up the hills. Although far from it, this whole thing felt like a video game. It was like a cross between Frogger, Xtreme Motocross, Super Mario Brothers, and some racing game. If I had only had video game music playing in the background, I would have thought I was in the middle of some virtual reality game. Anyhow, I kept praying to God that I'd be alright and that I wouldn't end up hurting anyone else. The last few miles, the roof crew went one direction and I had to go the other. I was so relieved when I finally passed into the gates at Quiskeya with both myself and the bike in one piece. What a long and crazy day it has been. After a cold shower and some beans and rice, I sit here typing and can hardly keep my eyes open anymore. I am exhausted.

I woke up this morning and headed to Church here on the campus. I didn't sleep well last night, so I only made it through about an hour of the service before I had to go crawl back into bed. I think I was just too wound up last night from the day's events. Once I woke up, I had lunch with one of our translators here named Desert and planned my day.

I decided I would make use of the last full day I had the motorcycle and go exploring all the things I had yet to see. I geared up, threw on my Ipod, hopped on my bike, and headed downtown. Of anywhere you could be in Haiti right now, it's the creepiest place you can spend time because it still looks like a complete war zone. On my way down Delmas (a major road through town) I had a scary experience. I was flying along at about 40 kph when a car ran a red light and then stopped right in the middle of the road to avoid hitting another motorcycle in the other direction. Meanwhile, I had to slam on my breaks and rapidly downshift to avoid broad siding him. It was like complete slow motion. The bike fishtailed left, then right, left, right, about 4 more times… every time I thought I was going down, it was like there was someone on the side of the bike that lifted me back up. I was sure I was going down and yet I didn't. Finally, I was stopped and the people on the sidewalk nearby were like 'whoa!' Some of the cars behind me passed me and gave me a big thumbs up. I looked over at the one guy standing next to me and said, 'hey, you believe in Jesus? I'm sure I do now!' He laughed.

With a grateful heart, I continued on my journey downtown. I stopped at the ice cream shop and downed a chocolate cone, walked over to the outskirts of tent city to talk to some folks about the conditions, and then lit up a Haitian menthol and smoked before hopping on my bike. I don't know what it is about third world countries, but I always end up having to smoke a menthol or two while I'm there. I think it's because I don't drink or do anything else and it leaves me feeling a little like a rebel.

I passed the palace, and as I got deeper downtown, one of my favorite places to be, things still appeared to be pretty messy. It's crazy down here. Fires continue to burn in the road as people dispose of their trash, one of the buildings had a fire burning inside, I had to weave through piles of rubble, navigate around and under downed power lines, and keep a sharp eye on the people around me. Meanwhile, I had my favorite song to listen to while in these parts, the theme song from the "28 Days Later" soundtrack and "It's a Mad Mad World." I passed by a group of Asian contractors who I stopped by and chatted with. They were so excited by the fact I was riding a bike around that they all had to each get a picture with me in front of the rubble on my motorcycle. It was so cute. I caught up later with some guys with the 82nd Airborne and chatted with them for a little bit! They said I was brave, gave me the thumbs up, and told me I could come down the the base and hang out with them all any time I wanted.

Eventually, I got tired of aimlessly driving and headed back to Quiskeya. I caught up on some journaling, met a friend later at the bakery Ipador, packed up some supplies that I'll be forwarding on to a pediatric hospital, ate dinner, and am laying in a hammock on the porch listening to the rain drench the city. I hope my friends and patients are dry tonight.

Monday, April 5, 2010

Easter in Haiti- The Ressurection of Hope

It's Easter Sunday and I'm sitting at an orphanage wearing a skirt in the northern jungles of Haiti. Everyone got up at 5am this morning and headed out to the courtyard for an EARLY morning sunrise service. Kids and families from the village all came into the compound to attend the big service. I made a cup of coffee, wandered up to the roof, and had my own little talk with God as I watched the sun creep up from behind teh mountains casting bright yellow rays of light to the ground and ocean below. What a great sight. I then went downstairs and joined in on the morning serivce. I went and got Josh who had just been washed and dressed. They put him in a pair of khaki pantst and a bright blue colllared polo shirt. He looked more adorable than I've ever seen him. He actually hada shirt on that fit him! Once he saw me and realized that we were still there by his side, he got that big smile upon his face and started to reach for my hands. I sat by the little guy's side for the rest of the service.

We keep checking in on Joshua throughout the day. We are all trying to make our visits further between and for shorter lengths of time, so that he can start getting use to the other children and his new routine, so that when we don't show back up after tomorrow it won't be quite as painful for him... and ourselves. He seems to be doing pretty good. I've seen him already get at least 3 baths, several changes of clothes, the ladies here are already starting to try and get him used to using a toilet, and he looks fairly content. I know Carmen had a problem when she tried to leave after sitting with him a little this morning. Joshua started to cry and wouldn't let her go. This is going to be hard for him.

After the kids had a little easter egg hunt and got little bags of easter candy, I came upstairs for some breakfast and worked on some more journaling. Suddenly, I found myself unbelievably tired. I went to lay down and fell asleep for a 2 hour nap. It was great! Funny thing is that I dreamt that we discovered a secret part Haiti that had everything modern like McDonalds, a semi truck of Dr. Pepper, Pizza hut, and tons of stores that were open and functioning like normal. In my dream I couldn't stop taking pictures of the "golden arches" (and I'm really not much of a fan of McDonalds, it's just so symbolic of America to me... sadly). This woman then comes over and tells me that I was never supposed to find this place and that she was going to have to kill me because others already saw I was here. She led me off into the woods and then told me to run, that she would spare me, but not to ever tell anyone I was here and to never come back. I woke up covered in sweat, thinking "what in the hell did that just mean?" I still have no idea and I try not to overanalyze too many of my dreams. It probably just means I miss home and the comforts of a modern country.

It's so strange for me to be here today because the last 2-plus months have been filled with not a moment's rest. It's been working away, organizing, caretaking, scrambling, surviving, etc. What a perfect way to spend Easter Sunday, just having nothing to do but relax! It's almost uncomfortable not having something to distract myself with and be busy with. However, after my nap, I'm really starting to appreciate it. We got a fuller tour of the campus. There is an eye clinic, a nutritional program, a school, an OR, an ER, a pharmacy, a maternity ward, the equivalent of a nursing home called "Grand Moun". The home for the elderly has a big row of rocking chairs along the front. It looks just like a Cracker Barrel restaurant and somebody has the logo painted above the framing of the building. The old people here are so sweet. Every one of them came up to us and wanted to hug us, kiss us, or shake our hands. Their smiles broke into a thousand pieces and it's nice to know that these folks have someone to take care of them. Just down the way there's also a place called the "Rat Hole". When they cleared part of the property, a bunch of rats were un-nested. They found a new home in a giant tire and the rats are apparently the size of cats! We didn't see any, but I can only imagine.

We went for a hike up the mountains today. The view was gorgeous, and the company of the many local children that followed us along the way was even better. It's so sweet how these children just run up to you and are perfectly content holding your hand and walking to wherever you are headed. They'll look up at you with a big smile on their face and just keep following. One kid came over, grabbed my hand, asked me my name, asked me if I loved God, and then asked me if I was his friend. How precious that those would be the first 3 important things he would want to know with his limited English. We stopped at one of the scenic overlooks and a few of us got together with the kids for a big group picture. I had this sudden stark realization that I am in the midst of doing exactly what I was always supposed to do. I settled into that very moment and nearly wanted to cry at how blessed I feel. Bed bugs, dirt, and skirts aside, I'm more at home out here with these people in these foreign lands than I am anywhere else. When your doing the work you know God has planned for you, it feels good. It's like being a top that's spinning on a perfect axis, when you start to stray from that purpose, you start to wobble until you eventually fall. The energy to keep spinning comes from the love that surrounds me and the love from above.

Back onto the topic of Easter and it's significance for the people of Haiti. I can't help but feeling so much hope for the country today. Paralleling with the Easter celebration, Christ was crucified, died, and rose from the dead three days later. Now, three months later from a major disaster and this country is too starting to be resurrected from heartache, devestation, and destruction. The spirit of Easter is alive and well here in Haiti today. It is a time for new beginnings, a time to erase the country's tainted slate and start anew. I believe that this country is on the verge of a major rebirth and a significant renewal of spirits. Conditions may be slow to change, but these people's faith and belief is ever-expanding. Spring is right around the corner, a time of new birth, new life, fresh flowers and fresh starts. The last few months have been dark ones for Haitians. Now they can look forward to the coming spring with hopeful hearts and brighter expectations. Instead of continuing to mourn the dead they can continue to joyously celebrate life, the survivors, and the ability to feel alive.

Tonight, we ate some dinner, played some cards, and then had to go and say our formal goodbyes to Joshua. We went in pairs with a translator and explained to Joshua what was happening. I was able to tell him about the school he will be attending, about his new brothers and sisters, and about what would be happening to us. We had to tell him that we would be leaving, but that we would try to return one day. We told him we were proud of him, that we love him, that this is going to be a safe place for him to start his new life, and that we will always be in his heart and his memories. It was really hard to do, Carmen and I were both crying and he just didn't want to let us go. Justine and Beth came in next and said their goodbyes and once we were all out of the room, the wailing began. He knew. We could hear him screaming and crying from upstairs in the lounge. It was heartbreaking, but this being difficult for him was inevitable.

This morning I woke up early enough to attend part of the morning devotion. It was actually pretty cool. It compared our lives to the geyser "Old Faithful." The woman talked about how valuable it is to be able to stick with a committment. She talked about sticking to your task even when you want out, even when the world's against you, and compared it to Easter.. even when they nail you to a cross. She went on to say, "However small your assigment, however tired you may feel, however unappreciated you are, stay faithful." Make sure that at the end of the day, the man upstairs can say, "I can count on her. I can count on him." It was a nice practical thing to focus on today.

Then, just as I sat down to a cup of coffee, the director of the mission came over and said, "We gotta leave in 15 minutes." None of us were packed, dressed, etc. We ran to the room, got ready, said our final quick goodbye to Joshua and were shortly in the back of the pickup on our way to the airport. It had been a nice couple of days here at this special place where we finally leave our little boy. Oh, it is hard letting go sometimes, isn't it?

We got to the airport and had to wait a bit for the plane to arrive. There was this great old man playing a handmade guitar. He was using wires for strings and whittled wooden pegs to anchor the strings. The thing was really a piece of junk, but so incredibly resourceful and beautiful that it was probly priceless. The man sits there in his best suit, smoking a cigarette, playing the same song over and over, something about "mama, oh, mama." He was fun to watch and listen to. Then, I realized that I had a harmonica in my bag from my kids groups. I don't know how to play the thing, but I took it out, sat by the guy, and played away with him and his music. It was hilarious. Then, I got him to stand up and we marched through the airport, him and his guitar and me with the harmonica. He wanted to dance then with me as we played our instruments. I couldn't stop laughing.

Finally, the airplane arrived, we unloaded a bunch of new medical supplies for the mission and we hopped aboard. I got to be in the co-pilots seat for this flight and I loved it. As we went down the old gravel runway, I realized that the runway was the same road that went right into the middle of town. If we had not gotten air, we would have been in the middle of downtown. Amazing, along the runway walk donkeys, people, goats, and more. I hooked up my Ipod and listened to all of my favorite tunes. My favorite song to fly with, especially in rickety old planes is U2's "It's a Beautiful Day!" I like to time the song so that right as I'm lifting off the ground the chorus breaks in singing, "It's a Beautiful Day, Don't let it get away!" It certainly is a beautiful day. We were fortunate enough to fly right through and in between some great fluffy clouds, the kind that really make you feel like your in a dream. I must have been smiling the entire time. I kept wishing I had a parachute to go skydiving over the beautiful terrain below. What a great jump that would be! Perhaps next time...

Sunday, April 4, 2010

An Extension, CDTI Closes, & Joshua Gets a New Home

I'm starting to get sad because I only have 2 more full days left in Haiti. It's been such a wild journey here and I'm not looking forward to it coming to an end. Truly, I'd extend my stay here by at least another month if it weren't for grad school that I had to go back to. Today, I conducted my final group with the kids at General Hospital. I was just finishing up with a new group of kids here who were much easier to work with than the others had been. They were older, healthier, and more engaged. Hivelt brought his guitar today and we made some real music with the kids. They loved it. When I got back to the hospital, I had to say goodbye to my translator who has been so incredibly helpful over my time here. Without him I would have never been able to communicate with the kids and my program would have been pointless.

When I got back to the hospital tonight, I learned some bad news. I found out that CDTI would officially be closing as of tomorrow. We all knew that things were coming to this, but I think we all had an enormous amount of faith that things would just work out. The healthcare system here is really starting to fail. There's a ton of NGOs in the country, a tidal wave of medical support, but the money is not reaching the hospitals themselves. Many of these hospitals still have to pay their Haitian employees. Because of red tape, many relief organizations are unauthorized to provide financial support to cover administrative costs, especially when it comes to private facilities. While there were extenuating circumstances surrounding CDTI, what is happening here is indicitive of a larger problem happening around the country. The ER up at Daquini hospital had to close, over at Canopy Vert they have had to drasticaly cut services, and rumor has it that April 12th, emergency services at General Hospital will cease. The supplies are here, the people are here, but the financial support to keep the lights on, pay for the diesel, the Haitian salaries, and everything else just is not coming in. Will this be the beginning of the collapse of the healthcare system here in Haiti? Will the country be forced to rely on NGOs support of the country's medical needs. What happens then when the NGOs finally have to pull out? Will the government be ready to handle the burden all on its own? I don't know the answer to these questions, but the reality is a cold one.

Knowing that this would be the last "normal" night at CDTI, I decided to stay the night with the patients. After all the medical staff went home, I settled into the courtyard with all my new friends. I sat with my favorite patients over in Tent 11 and gave them a little heads up that things would be closing tomorrow. We were able to talk about it a little because of my friend there who can translate. "Mama" was talking and then just suddenly broke down sobbing. She was so sad, and was so worried about what would happen particularly to Joshua who she had come to mother herself. I consoled them and reassured them that all would work out and that we would do all we could to help them all find arrangements.

I found a French MRE I had tucked away a few weeks ago and brought it out. It was so sweet. These MREs have just about everything in them and the food is nearly gourmet. Myself and about 10 of the other patients sat in the courtyard, started the little fire stove the comes with the packet and amid the glowing of the embers we cooked dinner. The hospital ran out of food a couple days ago, so many of these patients have not been eating very well. I pulled out some paper plates and after we would cook each new piece of our meal, we'd all get about a spoonful on our plate and have a taste. It reminded me of that scene from "A Christmas Carol" when they are so poor they are cutting peas in half and sharing them. It was really quite adorable. We'd laugh as we'd try a new piece of our meal, and get excited about what was going to go on the little stove next. It was like we were on our own little camping trip. When we made the asparagus soup, these guys were so cute. There were no bowls, so each person just put our their hand and made a little cup. Then, one of the moms went around and poured soup that they just drank right out of their hands. Aside from the sanitary problem here, it was really adorable. After our little meal, we sat around singing our calm melodic hallelujia song and then I stayed up and hung out with one of my friends who has been at the hospital for the last 2 months sitting by her sister and nephew's side for support. When it came time for everyone to go to bed, the kids said, "Jitterbug... sleep?" They kept saying this and pointing to the wooden palate in the tent. The kids wanted me to totally join their little slumber party for the night. I agreed. I went inside, covered myself in bug spray, and headed to the tent where I curled up and slept the night away on my little palate. It was such a sweet night. Probably one of my favorite night memories here in Haiti. I truly felt like they had taken me in as family.

This morning was the start of what was going to be a long day here at CDTI. The administration got to the hospital particularly early, made a sign, and posted it on the outside of the hospital. It said basically that "CDTI is now closed, we regret the decision, but all services are ceasing from here out." The doors were locked and patients were standing outside the gate with sick children in hand, obvious injuries and just staring at the sign wondering what to do next.

Each tent was privately notified about the hospital's closure, and the process of discharging and tranfers had officially begun. I started to notice a growing sense of restlessness and dis-ease among the patients and I decided it would be good to bring everyone together for some prayer. I rounded up all those patients that wanted to participate and about 50 of us came together, hand in hand, to pray for the days that come ahead. I told them how much we all loved them, what an honor it had been for us to work with them, how special they all are, that they have changed our lives, we will never forget them, and that although this transition is going to be painful for them all after building a community and home within the safe walls of the hospital that they would not be alone. I reassured them that while we will do all we can to find them safe arrangements, that God is really the one who has brought them this far and does not plan on dropping them now. I talked about how God is really the papa of us all here. That he has great plans for his children and that he is going to guide each one of these patients into new opportunities, continued healing, and fill their hearts with hope. As I said my prayer, Maxim, one of our translators, translated to the patients. It was so emotional, he started crying as he translated, patients were crying as they listened, and you could tell everyone's hearts were just torn. Beth shared some beautiful words, a few others did too, and then I told the patients that while today will have it's obstacles that we should focus on the joyfulness of our time together, that we should celebrate the last 2 and a half months of life, healing, and community that has taken place in this hospital. I got us started singing the melodic version of Hallelujia and it turned into a beautiful version of the song, with everyone chiming in. Then, we started to do some celebrating. I ran inside and got the instruments, quickly distributed them to this massive crowd we had attracted and we started to sing loud and joyfully. Many of us jumped around and danced, Katura hopped on her one leg with a big smile, it was beautiful. Everyone gave each other hugs and then we got back to the business of clearing the hospital.

This entire day was extremely emotional. It was the most emotional and difficult day I have had here. Joshua has known something was going on all day and was acting very withdrawn and distant. Throughout the day, he would just break out in a wailing cry. I'd hold him and rock him, but he still was very shaken by the commotion and sense of uncertaintly surrounding the camp. It was so sad watching people like mama and her family pack their stuff and leave. Our little miracle girl with the pelvic fracture walked her way to the car, Ippolita with the beautiful smile had her dad take her away, Joseph was sent to live with his uncle, and several other of our precious patients had to locate tents, tarps and shelters as they prepared to move themselves into a new tent city. Oh, how I cried today and cried several times. It's one thing to leave your patients and know they are still in good hands, safe and well taken care of. It's another thing to come to love these patients and watch them all have to leave you. You're left with uncertainty wondering if they will eat, if they will be dry at night, if they will be safe, if they're injuries and illnessses will improve. Fortunately, we were able to coordinate with several other NGOs and rehabilitation facilities to transfer most of our more serious cases, but they couldn't take everyone.

I left the hospital late tonight, spending as much time as I could with the patients still left. My friend Stephanie came and picked me up and she and her husband and I went out for dinner. We had seafood pizza- pretty good stuff here! I finally pulled into Quisqueya and settled into my tent where I instantly fell asleep after my exhausting day.

As I was walking out of compound today to head down to the hospital, a lady pulled me aside and told me how touched she was by her 20 minute stop in at CDTI yesterday. She and her group had just decided to stop in really quick and see the facility. Boy, did they ever walk in at the right (or wrong) time. She explained how she was so incredibly touched by what I had said. She told me that I was truly being the voice of Jesus and that she was inspired to have more of whatever I have working in me. What's crazy, is that I don't really even know what came out of my mouth or where it came from. I've never been one that is good at praying out loud before in my life and here I am praying outloud for the whole hospital. Certainly, it was God using my flapping mouth to carry his message, because is sure ain't me doing the talking.

I was supposed to leave to head back to the U.S. today. It's really been weighing on my mind for the last 24 hours. The timing of having to leave right now is really crummy. As this hospital closes and we say goodbye to these patients, I feel like I really need to be here during their transition. I've been with many of these patients since the beginning of February. It's April 1st now and as I have been here from pretty much the beginning of the relief work at CDTI, I want to be here through the very end. Some of my favorite patients still don't have arrangements on a place to go. I debated it all morning, shot off an e-mail to my grad school professor and some of my family members, and board of directors. In the end, I decided that I needed to extend my time here for another week or two. It would give me a little bit more time to wrap up things at the hospital, get patients transferred and into new living arrangements, and help with inventorying our supplies and distributing them to other facilities. In addition, I would be able to reach out to a few more of the kids around here in such desparate need of psychological support.

By about 2pm, it was time for one of my utmost favorite patients and children in the world Katura to leave. An organization had donated she and her mom a shelter box and transportation to get to the tent city they would set it up in. This was one of the real hard goodbyes. If there were ever a chance or thought that I'd ever be interested or capable of adopting a child, it would certianly be little Katura. She has a mom and is just fine, but I have grown to love this little child as though she were my own. Although she has come along just fine since her leg was crushed in the rubble and had to be amputated, I worry about her rehabilitation. She's just starting to learn how to use her crutches and gain confidence to continue using them. She usually falls about once a day and that's on a nice solid piece of ground with no obstacles in the way. I fear that the dirt, mud, rocks, trash, and shoulder width space between tents will hinder her progress and lessen her confidence in walking. Oh, I just pray that this little girl gets to have all the things in life that little girls should get to have. Next, it was time for our patient Karl and his mom to start getting ready to go. His aunt Chantall had to depart with them as well. I was so sad to see them all go. Things here just wouldn't be the same.

As more patients left, more tents came down. We were rolling the massive canvas tents up, moving big cinder blocks, piling up the tent poles, and pulling massive rivets out of the ground. We had piles of mattresses and cots that once kept our patients safe and warm at night. In between tearing down the compound, we'd discharge another few patients, help some pack, comfort those uncertain of their next chapter in life. By the end of the day, we had only one tent standing.

One interesting observation today was the growing sense of uncertaintly among the patients. Yesterday, it was like we saw the best in everyone. They were all being grateful, appreciateive, cooperative, and compassionate with each other and their impending transition. Today, it was like everyone was overcome with this last ditch effort to get things for their new life. Several people were going around asking for money, diapers, food, tents, tarps, and more. As soon as we'd give them something, they'd go to another person and ask for more diapers or more money. The stockpiling, hoarding, and neediness was kind of exhausting for many of us.

Later in the afternoon, we were able to set up a Skype session between Joshua and his godfather Josh in Wisconsin. He has come to learn that when the computer comes out, it means he gets to talk to Josh. We wheeled him in and up on the screen popped Josh. I wanted him to be able to say goodbye to him one last time before he left the hospital. As usual, Joshua doesn't understand that video of Joshua doesn't mean he's not actually there. He'll extend his hand and try to touch Josh's face by touching the screen. It's really precious! After a little chatting, the lights started to flicker, and we could hear the hum of the generator wind down as the hospital's last remaining diesel was burned away. The reality sets in even more that this is it, the hospital is closing. Finally, it was time for Joshua to be transferred to his temporary facility at an orphanage in Port au Prince. We met with an amazing woman named Carmen who was sent over by Safewater Nexus. She would be in charge of his transition before transit. We had to get him to a secured orphanage before transporting him to his final home because no one could stay at the hospital any longer. Carmen assured us of his care, I had no worries, and we loaded up Joshua and his small bag of things, buckeled him in the backseat of a car, and waved goodbye. We'd be seeing him in a couple of days for the big move north. As the day wound down, we all locked the doors and headed back to the compound at Quisqueya. It was another exhausting day for us all.

Early this morning we discharged the last 3 patients to their new facilities. Entering the hospital compound today was disturbing. What was usually a lively scene in the mornings with hundreds of patients lined up for primary care, the tents full of patients, and the sound of the kids running over in the mornings saying "Jitterbug, Jitterbug", was now a quiet parking lot full of cinder blocks and trash. There were no sick patients, no lively kids, no buzzing nurses... nothing. Today would be a day of closure for the staff.

I had two Haitian cell phones, mine and the one that Josh had given me that still had minutes on it. Because my secondary phone has really become my primary now, I gave Ketura's mom my original Haitian phone and we have been keeping in touch with them since they have left.
I was able to speak with Katura and her mom on the phone I gave them and felt comfortable that they were settling in well. They had stayed their first night in tent city and while I know it wasn't the safe comfortable community of being at CDTI, Katura still had a spark in her voice.

There is so much inventorying, sorting and distributing of supplies at the hospital that now needs to be done. It's an overwhelming task. Just think of the number of supplies that has come in here over the last 2 months- 7,000 pounds from the Mexican embassy alone! All of the organizing, shelf building, and sorting that has already been done now has to be undone and redistributed to other facilities in need. I think that most of us were too overwhelmed by the task and the reality of the hospital's closure that instead of doing too much work, we spent more time just enjoying each other's company and doing some minor cleaning. I sat on the rooftop for a little while with my friend Alan, a photographer here on assignment. we sat up there eating MREs while he told me stories about shooting the aftermath of Jonestown, being in Vietnam, and his extensive travels around the world. As we talked, we realized that we had a mutual friend, Corrine Gould, the amazing woman who has been of enormous support in my organization and in my efforts to bring antibiotics into the country. Again, it's such a small world.

Later on in the day, I had a great surprise. I found a little tiny market that had... DR. PEPPER! I'm completely addicted to that stuff and haven't had one in way too long. It was $2 U.S. for a can, but I didn't care. It was ice cold and it was good! It's amazing how those little things can become so exciting. As part of our lazy day, the translators threw a big celebration for all of the staff. They went out and bought cake, pizza, pop, and champagne. We put all of the chairs in a giant circle and the translators went around and told us what a difference the hospital and the staff had made in their life. A few of those of us who have been there since the beginning share a few of our own words as well. Desert got up and said a beautiful prayer and then the guys popped the champagne and started to celebrate. This celebration was really significant for me because despite all that we've gone through together in the last couple months, we were finally closing together just as much of a team as we had to operate together when we were open. Some of the translators had made a few cards for a us with their hand traced, some wrote poems, and I realized how much of an impact we really had ended up having on not just the patients but our translators as well.

Following our day at the hospital and some drama I had about getting back to the compound at Quisqueya, I settled in for a night of reflection. Today was Good Friday, the day that Jesus was cruficied and died. It was the day his life ended, as an innocent man, all because he loved the world so dearly. I was thinking about the Haitian nation, the earthquake, the hospital having to close and thinking about the hope that perhaps out of the ashes will rise a new stronger country, healthcare system, and Haitian people.

Today was a big day for Joshua. We were transferring him to his new permanant home in Northern Haiti, near Cap Haitian at the Northwest Haiti Christian Mission in the town of Port au Paux. We arrived at the airport to find out that we weren't going to be able to return until Monday. That meant we would be celebrating Easter at the orphanage instead of with our friends in Port au Prince... I was kinda bummed, but trust that it's where I'm supposed to be. We met up with Carmen at the airport to find Joshua smiling and happy wearing a pair of Strawberry Shortcake pajama pants.

We put him on the plane, buckled him in, and you could tell he was very curious about what was going on. As the plane took off, his eyes widened as he realized we weren't on the ground anymore. He looked out of the side of his head, curious about what was going on. As long as he was holding all our hands he was okay. Justine, Beth and I just comforted him and gave him lots of love the entire way. When we'd hit a patch of turbulance, he's really get wide eyed. We tried to get him to color and he took the crayons, put them back in the package and closed the coloring book, and regrabbed our hands. This kid really knows what he wants and it's adorable. A couple of times I glanced back at him and saw a face I've never seen before, I looked up at Beth and said, "He's gonnna puke all over you!" I was kinda laughing and she jokingly grabbed one of the "sic sacs" and just as she opened it, poor little Joshua hurled. Having never traveled in a plane before, I'm not surprised. Fortunately, it was towards the end of the flight when it happened.

We landed at a small airport with a gravel landing strip and found a pickup truck waiting for us. We had to load 12 people, one being our special needs child Joshua, everyone's luggage, a wheelchair, and a giant bag of diapers into one small pickup. It was crazy! I held Joshua tight in my arms as we made the hour long bumpy ride to the orphanage. Riding through town, I'm witnessing a whole other level of poverty. While the earthquake didn't cause any damage here in Port au Pauix (sp?) it looks like a bomb went off. There are dead dogs in the road, mud, green sludge, trash lining the streets, homes made of cinder blocks or steel panels, and all dirt roads. It's pretty bad and the only disaster that has happened here is the tragedy of inequity and poverty. It's really very sad.

Finally, we found ourselves at the gates of what would be his new home, the Northwest Haiti Christian Mission. You go from the dirty, less than poverty stricken village into a compound filled with volunteers, smiling patients, and clean facilities. Instantly, I thought to myself, "this place will be good for our little boy." We were welcomed by the volunteers and staff. They gave us a tour of the facility. Joshua was smiling and appeared to be excited by the excitement. We saw the room that will be his along with about 6 other kids. He will have his very own bed. There is a big shower room where the kids can go and bathe themselves, which gives them a little more independence. The name of the facility Joshua will be living is Miriam's Place. It' attached to the rest of the mission center and named after the daughter of the donor who provided the funding to start it. Next door is what's called "Heaven's Waiting Room", a sort of children's hospice.
It has a sort ofdining room and a physical therapy space in the back where it is completely padded and filled with toys. Kids can roll around, scoot, crawl, and not worry about getting bumped or injured. Justine sat with Joshua for a while and played with some toys. It was amazing to see how smart the kid actually is. He has reasoning skills and the ability to analyze and make the appropriate adjustment far beyond what any of us ever thought. In the group room, I took the prayer flag kids had made and been hung at CDTI and rehung it now inside Miriam's Place. It added a nice splash of color and happiness.
After our little tour, we went upstairs where there was a big plate of spaghetti waiting for all of us. It was the most hilarious thing to watch Joshua try and eat a plate of spaghetti. He couldn't get it down fast enough. He'd put his whole face in the plate and come up with a mouthful of red noodles and that big grin on his face, waving a fork in the air. It's very comforting to see him so content and acting just like himself. Following his big meal, we found a big red tricycle we put him atop of. Someone had sewn a felt horse head on the front of the handle bars and Joshua looked like the Lone Ranger as he tried to balance himself upon the seat.
As the rest of us settled into what would be our home for the next 2 days until we would be able to return to PAP,we learned some of the realities of staying here that were a bit frustrating for me. No one was allowed to leave the walls of the compound alone or after 6pm, there are bed bugs in the facility, and we all had to wear skirts around the compound. Yuck! Bedbugs and skirts! Not my thing. It's kinda old fashioned around here, but we are guests in their facility and so we will follow the rules, attend the daily morning and evening devotionals, and be respecful of their cultural standards. While this seems like an amazingly wonderful facility that really is doing some great work, I think I'd feel like it was a sentence if I had to stay here longer than a couple days. Carmen and I have been having a good time sticking together and laughing about the silly things that leave us both our of our comfort zone. We are like trouble and trouble! It's nice to have someone around who's on the same page and finds more spirituality stepping out on the rooftop at sunset praying as we listen to beautiful music, take pictures of the moment, and cast off all fears and hopes to the Jesus that rests in our hearts as much as the mountaintops.

Before dinner, Beth, Carmen and I had a translator take us out to see the city and the coastline. We walked down the dirty roads and met a plethora of children excited to see new faces in town. The water here along the coast is absolute turquoise blue. It's fabulous! However, as you approach the shoreline you see it is covered with mounds of decomposing trash. The children came and walked along the beach with us, excited to have their pictures taken, doing back handsprings and back walk overs like a team of little acrobats, running down the beach, and laughing. At one point, Beth and I found a group of kids that let us hop into a game of jumprope. Then, we came across a group of kids who wanted to show us their homemade tops. These kid take pices or orange of mango wood, whittle it down, stick a nail in the bottom, and color it. Then they spin the little top on the ground, and flip it up into their hand. It's pretty neat. Carmen and I both bought one from the kids for a copule bucks. It's a pretty special souvenier!

By the time we got back from our little excursion that left me feeling more grateful than ever for the life I have back home, we were all able to sit down for a nice warm dinner. We had potatoes, chicken, and vegetables... not too bad for an orphanage. Following dinner, there was a little devotional service. While it was very stiff, it was hard not to appreciate the efforts of the whole family who had traveled to the mission together and were leading the service. There was some solemn singing and announcements and then day was finally closed. Carmen and I went downstairs to tuck Joshua in for the night. He was already in his little bed, sound asleep, tiny little hands grasping the sheet close to him. He looked peaceful. One of his new friends came over and tapped him on the shoulder, waking him up. He looked up, saw us, got a huge smile on his face, and reached up his arms to us so that he could give us a hug. We sat quietly with him for a moment and then told him goodnight. He smiled, rolled back over, and went right back to sleep.

To catch up on the enormous amount of journaling that I am behind on, I came up onto the rooftop under a canopy of perfectly clear and bright stars and let my fingers dance on the keys. I reflected on the day and thought abotu what Joshua must be feeling. Does he understand that today's entire trip was all about him? Does he know this is now his new home? Does he feel safe? Does he know that he might never see his mom again? Does he realize these children around him will watch him grow up and become brothers and sisters to him? Does he realize that we can't stay? I wonder all of these things. As we were getting all the details pieced together earlier today, the woman was asking about his birthdate. None of us, including the mom, have any idea when he was born so I suggested that we pick April 4th as his birthday, the day Easter falls on this year. It would be very symbolic of the death of one life and the rising to a knew and beautiful one. We all agreed and it was settled. He's our little Easter boy!