Wednesday, March 31, 2010
Sunday, March 28, 2010
Saturday, March 27, 2010
My time at Diquini was my absolute favorite. I loved going to that hospital. Because I had been there two other days, and had helped one of the midwives organize all the supplies, I could really help the OBs find what they needed. I knew immediately if they asked for something, if we had it or not (mostly not). They wanted to medicate the laboring mothers, but I told them there were none of those medications, everyone delivered naturally. They were astonished. They then let me take the lead in laboring the moms and managing the flow of patients. It was fantastic. We really worked as a team, and they were very humble in the face of such a drastically different work environment. I told them I had homebirths and was comfortable managing natural labors and they seemed to breathe a sigh of relief. I got to say goodbye to my beloved midwives, I ran into them returning from the beach. I so appreciated my experience with them and the OBs, and my time at Diquini. I hope to someday return to Diquini.
Thursday, March 25, 2010
Tuesday, March 23, 2010
It is busy in the compound as everyone prepares for their day out in the city. A small army of interpreters sit under shade trees waiting to be assigned to various groups. Drives gas up their vans and tap-taps from the compound gas tank. Physicians and nurses visit the on-site pharmacy to stock up on needed medications for the day. I consulted with family doc this morning. That illness that was 'going around' that I saw in every baby yesterday was Typhoid Fever. The good doc gave me some great treatment ideas and I was glad we were on the right track yesterday, when we didn't even know what disease we were treating. Very high fevers and diarrhea are the hallmark signs. I did some reading up on the disease process. Most times it will run its course, but for children who are already compromised, the dehydration can send them on a downward spiral. The little girl I saw yesterday was very bad off. She needed IV hydration or she might succumb to the disease before it ran its course. I also saw a 14 year old who was the size of an 8 year old. Chronic malnutrition is to blame. With any hope if he gets better nutrition he can recoup some of that growth during puberty.
Today we are being sent to a different tent city. We will have a different driver, but hopefully the same interpreters. I am quite smitten with KiKi. the is a beautiful and bright young man with a quick sense of humor. He is also quiet and wise and reminds me of my 21 year old. William would have loved meeting KiKi, I'm sure of it. I can hardly wait for the adventures the day holds. I'm trying to post pictues of some of the sites. The city is in disarray, but the school compound is our little paradise. I'm meeting and working with wonderful individuals. A group of school girls cross the campus. I forget that the school is still in operation. All the classes take place in the chapel, in the far corner of the campus. The relief organization has taken over every other area of the campus. There is so much work to be done. Every evening, Mequette (the Haitian school nurse and assignment organizer) begs for volunteers to work the night shift at the locals hospitals. Mequette spends all day on the phones, communicating with hospitals and clinics all over the city and outlying areas. She is the one who assigns where everyone goes and with whom. Art (an American phys ed teacher who has taught at the school for two years) it the camp organizer. He and Mequette bring amazing organization to a place that has new people arriving daily. I have met people who will be here as little as a week, and who have been here for months. There are about 60-80 relief workers at any given time, not counting the military who reside on the other side of the soccer fields. Sadly, I am only one of two African-Americans I have seen here. But of course, I am grateful for whoever comes. Matt, my team leader, is meeting with our driver for today. It's time to grab my suitcase of supplies and hit the road. I do not know what to expect in the new location. It probably won't be as nice as the church yesterday. We also lost YeVonne, our most experience relief worker. She was assigned to another group, and we got a homecare nurse who just arrived yesterday. I guess that makes me the veteran. I'll be showing her the ropes. Thank you for your continued prayers. I'm having the time of my life.
Monday, March 22, 2010
Last night's entertainment consisted of watching the Haitian men who live on the school compound play a rousing game of soccer against the relief workers and soldiers (who reside on the other side of the campus). There is no TV. About half the relief workers choose to reside in a small 'tent city' on the school grounds. The other half of us sleep in classrooms on airmattresses and cots we have dubbed, the "Hatian Hilton". We have electricity and running water, but no air conditioning. The Haitian women that live on the school compound provide laundry service and cook our meals. The school set communal showers, quite a luxury to have water for showers. They have the water trucked in and the tank refilled daily so we have enough for showers. Most workers shower at night after a long hot day. There is no hot water of course, but the cool showers feel exquisite after a long day in the tropical heat.
Last night I was assigned to a team going to a tent city. I thought I might get to go to a prenatal clinic, but I will see what this opportunity holds. Whatever comes to me, I will be grateful.
For breakfast we were served coffee, hot chocolate, croissants, beignets, assorted rolls and fresh fruit including oranges, pineapple, and mango. A wonderful way to start the day. My team is now packing up and we will be heading out shortly. I'm a little bit apprehensive. In the tent cities we have only what we carry in and our wits to guide us. It seems so little to offer, when we don't know what kind of cases we will see today. Our physician is a neurologist, plus one cardiac nurse, plus me, a maternal infant health nurse- kind of a hodge podge team. We do have the ability to make transfers into one of the local hospitals if we deem it necessary, but the hospitals don't always accept the transfers. Yesterday we heard the story from the OB doctor, that a young woman (age 20) came into the small hospital she was assigned to after being hit by a car. (The traffic here is crazy- someone probably gets hit everyday) The OB wanted to transfer her to one of the larger, better resourced hospitals, but it would not accept her, even though she had severe head injuries. She died about 20 minutes later. I felt badly for the OB, who also delivered a baby of a 17 year old with severe pre-eclampsia. They tell us we will see bad things, that we will feel overwhelmed, and that we may return home and need time to heal and adjust. All these things sober me, and yet and will do what I can and what I must to serve who I can. Whatever comes, I recieve with gratitude. My tap-tap awaits.
Sunday, March 21, 2010
Saturday, March 20, 2010
Friday, March 19, 2010
Thursday, March 18, 2010
I feel humbled and greatly sobered by this experience. I don't know if I'll be up to the task, or if an L&D nurse will be useful. (They really need surgical nurses, orthopedic nurses, wound care nurses). All I know is I will go with an open heart and do my best.
Wednesday, March 17, 2010
On a serious note though, more condoms would be greatly appreciated (I promise to protect them from both husband and teenagers). The blog from the crisis center mentions unplanned pregnancy and complications from abortions were a growing problem. As is typical after a disaster, so is sexual abuse and assault and physical abuse of women. Women and children are just more vulnerable after a disaster, as social constructs (and the men) that protect them fall away. Condoms are just one small tool in an arsenal of protection for women. I hope to give them that tool. Condoms protect against both sexually transmitted disease, and unwanted pregnancy. No other contraceptive device offers both.
Tuesday, March 16, 2010
Monday, March 15, 2010
Sunday, March 14, 2010
Saturday, March 13, 2010
Friday, March 12, 2010
I asked him specifically about maternal-infant health and was surprised to hear him mention the importance of breastfeeding. When I pointed out that most disaster relief folks want to rush in the formula after an event, he chuckled and confessed to being an old MCHBer (Maternal Child Health Bureau of Health and Human Services). Then he look very serious and said formula would be disasterous to send formula to Haiti- they barely had clean water before, they definately don't now. I was so relieved to hear someone in a government uniform was getting it. Don't send formula, send lactation support workers!
However, I digress. When I asked Captain Belardo what I should take with me, he informed me that I would be arriving during MANSOON SEASON! Yikes! Not just little periodic rain storms, he tells me, but hard driving rain and wind for days on end- but still in the 90s everyday. Sounds like hell with a beach. I asked about immunizations and was told: malaria, hepatitis A, and tetnus. When I told him I was thinking about skipping the hep A, he leaned across his desk, peered over his glasses and said, "Don't." Okay, then, Hep A it is. When I asked for what I should ask for he helped me to ammend my list to the following:
- baby slings
- folic acid and prenatal vitamins
- antifungal cream
- hair accessories
Ok, the last item might throw you off a bit, but Cap. B assured me that sexually transmitted disease was EVERYWHERE, including AIDS (that shouldn't come as a surprise in a third world country without a public health infrastructure). I did remember from my previous research that STIs and uplanned pregnancy rose precipitously after a disaster (so do sexual assaults, but that's another story). He said he made fast friends when it became known he had condoms to give out. I was just lecturing my students earlier this week about the long term effects on female fertility from recurring bouts of genital infections- it ain't good news. So to promote maternal health, I'm going to pass out condoms to every nonpreg woman I see.
All in all, a very helpful visit. Working with pregnant women seems a little anticlimactic in the face of such devestation, but I know every little bit helps.
Thursday, March 11, 2010
- get immunized (malaria, tetnus, etc.)
- create an event page for facebook for donations
- have two coffee dates with the two folks I know who just returned from Haiti (a captain in the US Public Health Corp who spent two months immunizing people and livestock, and a midwife who recently returned from 2 weeks there) in order to pick their brains
- learn a few Haitian terms
- review the history of Haiti to gain some understanding of the culture
- acquire a digital camera and an extra memory card
- make my packing list- it will be short, I plan to forgo make-up, and live in scrubs
- continue to cultivate an open and accepting attitude (I've been re-reading The Four Agreements)
- organize things at home so as not to unduly burden my husband
- organize things at work so as not to unduly burden my teaching partner
- ask for prayer from my church
- I'll think of other stuff, or you can offer some suggestions
Wednesday, March 10, 2010
1. fabric slings to give to women with small babies
2. unopened bottles of prenatal vitamins and folic acid
3. small vanity items for women and girls such as combs, hair accessories, hair bands, ponytail holders, hair clamps, barrettes, etc. (Nothing bigger than a banana please)
If you feel compelled to give money, please give to one of the fine organizations already set up to take donations such as the Red Cross. My trip will be completely self-financed (I plan to take it off my taxes next year.) I will post more information as it becomes available. My goals for the trip are the following:
1. Serve in whatever ways I can
2. Observe and learn more about the gaps in disaster relief services for maternal-infant populations
3. Document everything (in both words and pictures)
4. Practice maternal health nursing skills
5. Participate in some births
6. Experience and appreciate an entirely new culture
7. Become better and stronger as a nurse and person