As my time in Haiti has come to an end, I assure those who
have been following my blog: I
have not forgotten. In the midst
of all the craziness that has consumed my final weeks, I felt I did not have
adequate time to attempt to give you the blog you all deserve. Therefore, I have decided to combine my
last weeks into one very long post.
In keeping with my efforts to pretend that I am a writer, I have decided
to break this post up into chapters.
Enjoy . . . .
‘The Honeymoon is
over’
So . . . there I was, the start of my final week at OSAPO .
. . and my concerns began resurfacing.
I know that I may seem like somewhat of a, well, complainer . . .
perfectionist . . . negative Nancy . . . glass half empty . . . you take your
pick. The thing about work in
areas like this, if you aren’t trying to encourage people to make things better
(specifically, if there is nothing to make better), then your work really isn’t
needed.
The weekend before, Judy had come up and had a repeat in
service on instrument cleaning. It
turns out that the solution being used is way too harsh on the instruments,
something she had taught the previous time she had been there. Unfortunately, it was a little too late
as two of our coated speculums had already been destroyed; a couple days into
the week, essential screws to another coated speculum had been lost in the
cleaning process, leaving us with only 2 usable speculums for performing LEEPs.
One afternoon, as I was working with my two assigned nurses,
one of them got board as we were counseling a patient, so she blew up her glove
and accidently popped it. I’m not
one for scolding, but I could not believe the inaptness of the matter . . . I
told her it was extremely inappropriate to do that in a professional setting,
especially when you are in a room with a patient.
All of these things, any time I try to give ideas,
counseling, advice, etc, I feel goes in one ear and out the other. I know I keep on saying that at least
I’m helping the people I’ve seen in my short time here, but the whole idea was
to create something life long . . . something that could continue working even
when I’m gone. Four months may not
be long enough to change the ways people have spent a lifetime learning.
The Haitians I’ve worked with have a tendency of
anti-preparation . . . wait until you are completely out of something, then
scramble to get what your out of, creating a daily struggle to just to have the
essentials. What’s going to happen
when they run out of the things you can’t get in Haiti . . . LEEP loops, coated
speculums, monsels . . . our essential list that is attainable, but it will end
up taking several weeks to get ordered, shipped, and through customs . . . I
would start thinking about it, and wonder: What’s going to come of all of this? Honestly, in that final week, I
still didn’t know.
‘And the band played
on’
[Just to clarify, I did not come up with this name all by
myself.] In keeping with my goal
of reading more than just medical related topics, I decided to do a little
recreational reading during this stint in Haiti. I have always found HIV an interesting topic . . . a disease
still so much in its infancy, but has come so far in treatments. During residency, my first big
publication was all about HIV prevention, a topic that I also lectured on for
my grand rounds. As I was
researching the disease, a friend recommended that I watch the movie ‘And the
Band Played On,’ as it illustrated the surfacing of AIDS in the 1980s, and
focused on the many mistakes that were made in controlling the epidemic. Although I never had time to watch the
movie, in searching for a decent piece of literature, the book (aka, what comes
before the movie) popped up, so I decided to give it a whirl. What I didn’t consider . . . It may not
be the smartest idea to read about the AIDS epidemic when you are working as a
physician in an AIDS endemic area.
My first weeks working at Pierre Payan, there was some viral
ailment that was striking many of my team members. I had gotten a little sick in my first few days visiting the
states, so I was hopeful that I had built up some type of immunity. As I started developing symptoms, I was
deep into the book, which follows multiple characters from the start of their
acute retroviral symptoms to full blown AIDS. Suddenly, I was starting to identify with those symptoms . .
. I had swollen lymph nodes, fatigue, myalgias . . . just like the characters
in the book. All of the sudden, I
was identifying with the characters, I was even writing my own story in my
head. I was convinced that I had
somehow contracted HIV.
Now, I realize at this point, I probably sound crazy. I am very well aware of how you can
contract HIV [and just for the record, I have not been participating in any
‘high risk’ sexual behavior down here in Haiti]. Hospitals in Haiti do not operate under the same
‘cleanliness’ guidelines that they do in the states . . . and I have never been
convinced that everything in my gyne room is 100% clean. I was paranoid . . . what if the
speculums weren’t adequately sterilized and I held one I though was clean with
my bare hand that had a paper cut?
All the dirty instruments are brought upstairs to be cleaned . . . what
if I picked something up off the ground that had a microscopic amount of blood
on it, and then I put my contacts on with that same hand. What if I had a hang nail that time my
glove ripped during surgery, and the patient’s HIV test was falsely negative? .
. . I had become your typical medical student hypochondriac.
I was so paranoid, that one day, I actually mad my
interpreter go with me to an HIV clinic down the mountain to get an HIV
test. Suddenly, going down the
mountain on a moto was not so scary (the last time I had gone down the mountain
on a moto, I continuously though . . . if we hit just one big rock the wrong
way, hello brain injury, goodbye career).
So . . . the test was negative, and in case if you were wondering, I
don’t have syphilis either.
The next time any of you think you are being a hypochondriac,
you can just think of this experience I’m sharing to remind yourself that you
are nowhere near as paranoid as I was!
‘Angels and Demons’
In keeping with the trend of book tittles, I assure this
again is an appropriate one. I
know I have alluded to the fact that this time around has been very different
than my first couple months in Haiti.
The one thing that has made the biggest difference is the fact that
there have been so many missionaries/volunteers here. It seems that the winter months are the trendy times to come
to Haiti. I can’t imagine why no
one would want to come work in the blistering heat of August and
September. There are some people
who just come for a couple weeks with medical teams, and there are some people
who come for a more permanent 6-7 months, and I have had the pleasure of
meeting and spending time with two such people: Annie (from Michigan), who runs an orphanage for handicapped
children, and Judy (from BC), who I don’t think I can adequately summarize
everything that she does (running of ORs, organizing, providing sanitary
products to young girls). It has
been so nice having the two of them around . . . definitely takes out the
loneliness aspect.
Of the many projects Judy has been involved in, one big one
is called ‘Days for Girls.’ In
many developing countries, girls don’t have access to sanitary products, so
they just use washcloths. Many
girls will skip school, and wont go out and work while they are on their
periods because they are embarrassed.
It is my understanding that the organization’s first project started in
Uganda, where disposable sanitary products were provided for all the young
girls . . . it didn’t take long for people to realize what a strain this was no
the sewage system. Disposable products
would not work, so they developed reusable sanitary kits. Each kit comes with to ‘shields’ that
have water proof lining, with 8 reusable pads, made out of flannel. When the kits are distributed, the
girls are taught how to care for them, clean them, and how to properly dispose
of the water that is used to clean.
These kits are being made and distributed in many different
countries . . . now including Haiti.
During my second week here, one of Judy’s friends, Linda, came to join
us in Haiti with the many kits that had been made in Canada. In my final week here, several more
Canadian nurses joined us with more kits.
Obviously, this was a project I found quite intriguing,
given my interest in public and community health. I also just happened to have an interpreter working with me
who was a young female who is now very knowledgeable about the female
body. It turned out that OSAPO had
just started doing youth sexual education on Saturday mornings, for the
adolescents of surrounding villages.
We had a perfect set up for success, and it was. Marceline, my interpreter, interpreted,
Linda and Judy gave the lecture, the girls were behaved, asked appropriate
questions, couldn’t have asked for anything better. I wasn’t aware as to how much I appreciated this crowd until
the following Friday.
Thursday was my final day at OSAPO. We completed clinic, I deemed Ernot
capable of VIA and LEEP on her own, and I headed back to Annie’s to be welcomed
by a full house. Four more
Canadian nurse friends of Judy, Linda, Annie and myself, all laid out on blow
up beds made for an adult sleep over, although the extreme heat and lack of
circulation in the rooms made it a little less fun. We all attempted to get our beauty sleep in preparation for
the adventures we had planned the next day.
We were taking the kits to La Grange . . . I community in
the middle of nowhere in which Annie had been affiliated with. We had a ‘church’ reserved as our
community center for education and distribution, and we brought lunch for the
girls, at the pastor’s request. I
honestly think the place should be renamed la Grunge. After a 2-3 hour drive down windy ‘roads’ (and by roads, I
mean dirt path which may or may not be able to accommodate the big blue truck
that carried us all), we were in the middle of the dirty desert village, where
it was uncomfortable just standing because of the heat.
Just to clarify, my feelings for this place have nothing to
do with the heat, the dirt, the lack of air circulation . . . it was the
people. The minute we got there,
people were rood, grabbing us, the boys were trying to get inside this church
(none of the windows were glass, and there were holes big enough for people to
get in) . . . and it only got worse.
We had thought that things had maybe settled down when we initiated the
lecture, but things escalated to an unbelievable extent. Initially . . . all the boys were just
sitting outside, banging on the doors, trying to sneak in, and by the end, they
were grabbing at me through the windows, trying to steal the food, trying to
steal the hockey bags full of the feminine products . . . it was
ridiculous. And, unfortunately,
they were not the only ones who were inexcusably poorly behaved. Once the kits were distributed, the
women and girls became monsters . . . we had unleashed a beast that was
uncontrollable. They were taking
extra kits and handing them out the window, trying to hide the ones they
received so they could get two, and they were extremely unappreciative of any
of the work that went into making them.
The only thing that provided me with some hope in humanity in this place
were the very young girls. We
allowed them to come in and listen to the lecture, but decided they were too
young to give a kit to. When the
kits were handed out, they were instructed to go to the back of the room, and
they were the last ones to receive lunch.
These little girls were so well behaved . . . not once did I see them
try to steal or cut in line . . . they just sat patiently waiting to be allowed
to get their food.
By the time we got back to the truck (which was a little
walk as the roads got to be so bad we could not take the truck further into the
village), I think we were all ready to get the f*** out of there. I road in the back of the truck on the
way back, which was actually quite pleasant . . . we had little chairs, all I
needed was a nattie light in my hand and you had a redneck Christmas card.
The following day, we wend up to OSAPO, and unfortunately
did not have enough kits for the EXTREMELY well behaved young girls. Their behavior was like night and day
in comparison to the previous day.
On the bright side, we were even more able to appreciate how lucky we
were to work with such nice young girls.
My Legacy
I’m 28. I’ve
still got many years of my career ahead of me . . . in fact, it is really just
beginning. I don’t want to give
the impression that I’m this phenomenal, amazing person, nor that I see myself
in that manner. I’m just a person
who saw an opportunity to possibly make the world a better place, and took
it. Now, whether or not I’ve made
a huge dent, only time will tell, at least I’ve maybe made a small dent.
To different degrees, I think we all have a fear of
failure. To be completely honest,
I’m worried that these past several months will be considered a failure. Things did not go as planned, and the
thought of going back for an extended amount of time is exhausting for me
(especially seeing as I’ve come to realize how much I hate hot weather). I think there is always more that can
be done, and you start asking yourself, ‘am I a failure, because I could have
done more?’ If I decide I want to
go to an orphanage in Liberia, or work in a clinic in Nepal instead of go back
to Haiti, does that make me a quitter?
All of these questions have been going through my head a lot these past
several days.
When I look back on my experiences, I don’t regret
going. That being said, words can
not express how happy I am to be home.
