Haiti #2 - A Few Weeks Later

Dear Friends,

It is Sunday, August 21st and I am starting this blog as I am finishing a 30 hour work marathon at good 'ol hospital bernie mevs. I am awake but that is subject to change at any moment.
One of my greatest revelations in this job is that many of the volunteers that sign up to come down here for a week or so, particularly the nurse's, decide 48-72 hrs beforehand, that they cannot do it. No reason given, they just cancel or just never get on the plane and never call. I had no idea people could or would do this! I understand the fear and the fleeting thought of not getting on the plane but NOT DOING IT? I had no idea and it's rude AND it screws up my schedule!
This week, 4 nurse's did the above; 1 additional nurse flat out told me that she could not and would not do night shift. And that if I made her do it she would "go nuts" and she would return to the airport immediately. Based on how nutso she was in bending down from her 5'10" frame into my not so big face, I switched her to day shift.
And then one of the ICU nurse's got sick sooooo, I worked a 12 hr night shift that turned into a 15 hr shift because 1 of the patients tried to die. For you non-medical folks, people frequently "try to die" during change of shift. Maybe they think that we are not paying attention to them and it is their only opportunity to get some peace and quiet. I don't know but it happens all of the time. Change of Shift is always "the bewitching hour."
And then, because we are starting some major construction this week, there was a scheduled 1-2 hr power outage in the ICU/ER/OR for some electrical something. And then one of the visiting surgeons had a "fit' about something, summoning me to the courtyard about some impending natural disaster. Please keep in mind that this was ALL BETWEEN 6-7AM ON A SUNDAY MORNING!!!!!! I told the surgeon that I was busy with a woman who was DYING and could not speak to him right now. "Hurrumph" he said and stormed out. Whatever.
A natural disaste in Haiti? Please be more specific. As it turned out, one of the housekeepers in the OR/Recovery room, had mopped the floor with Formaldehyde. Huh?
So here I am, 30 hrs later: dirty, sweaty and tired...
...I have had a 3 hr nap now and am ready to go. Unfortunately, the woman who was trying to die, did die several hours later. It was peaceful.
I have been keeping notes the past 2 weeks for this blog and after looking at the notes, I realized why I never was able to write a blog about my Jan-Feb 8 week visit here: there is no rhyme or reason to my words. No outline or witty repartee; just events that feel schizophrenic and chaotic which is what life is like here.
In the interest of my sanity and based on some of the questions that you have asked, I am going to attempt to outline a few subjects about my life here:
1. Typical day: it begins with the 5:20am barking dog and the roosters in the trees. (I am so not a morning person.) We may have electricity based on the City Power gods and gas for the generator. We have water that comes from cisterns up to large holding tanks on the roof. Because no one has lived in my apartment for months, my water smells like rotten eggs. I guess I have to take longer showers to empty the tank for fresh water and after 3 weeks, it does smell a BIT better. The water is not safe to drink so I have to remember to keep my mouth shut while showering. And to wear flip-flops in the shower because the bathtub has permanent 'nastiness' on it. A driver picks us up at 7:30 or so and I am at the hospital for the next 10+ hours. Two nights a week I stay at the hospital in a small call room on the roof. There is no barking dog so I actually sleep better there than at the apartment.
2. What do I do all day? Sometimes the nursing units have run out of water because 'Jimmy, the water guy' is not there yet and I have to find him. Or the volunteer nurse's are frustrated with the night Haitian staff because they intermittently sleep during the night and need to talk. Or the volunteer nurse's are upset with Haiti. That's a much longer conversation. Or there is no toilet paper or hand sanitizer and Chantelle, the cleaning lady, has locked the main door to administration so she can mop the floor. Or there is no toner in the xerox machine and we have no way to xerox anything, as in, no consents for surgery. There is no place to buy toner here and I guess that we can't fly down toner because of terrorism or something. And the concept of writing MASTER in yellow hi-liter, does not exist here. So we hand wrote a consent and the next day, the administrator sent someone out to make copies, from what I have no idea. And we now have toner but I don't know where it came from.
Sometimes I need to reserve some medical beds for impending surgeries and there are no beds. Or people resign. Or people need to be fired. Or Benoit, the 'grim reaper' who manages the morgue, which is just a series of gurneys in the back, in the sun, is on vacation and no one has picked up the bodies. Or, or or...suddenly it is 6 hrs later. And then it is 10 hrs later. I guess I should be able to account for my time better.
Pauline, the previous Haitian CNO, did resign last week. Unfortunately, she gave me minimal information on her files, paperwork, etc so I have been attempting to decipher all of this while conducting job interviews for nursing positions. Did I mention that everything is in French? Thank God that Sister Somebody taught me some high school French because I can read a bit but I usually need to have a translator with me.
3. What do I do for fun? In Haiti? There are no stores here as we know them, except food stores. All clothes are bought on the street. If there are movie theaters, I am not aware of them. Two weeks ago, 5 of us from the house, went food shopping. We receive 1 meal a day at the hospital so I have had little need to buy 'real' food anywhere. If I do buy food, it is at a local food store which is cheapish and sufficient. I forget the name. It serves the purpose.
BUT it was Sunday so we had one of the drivers take us to the neighborhood of Petion-ville, the high-rent district up the hill, to the GIANT foodstore. It was like another world.
Many local Haitian folks were there but they must be employed to pay those prices. Lots of embassy and NGO folks. Great assortment of foods but very expensive: $7 for a mango. $10 for OREO bits, etc. They even had bottled Starbucks Frappacino's but if it is expensive in the States, can you imagine the price there? $11!!!!
I bought a pink rubber bathmat, made in China, with a label describing it as "Beautiful Niceness."
The most fun item that I bought was......liquid soap! Be still my heart! It is clear and has the scent of white tea and ginger or white ginger and tea, not really sure. This is really quite exciting because we wash our hands with only hand sanitizer so my treat, is to wash my hands once a day with REAL soap and water! So exciting!
The other fun thing that I did, was go to a hamburger joint in Petion-ville, called HANG and have a real hamburger. I even wore a dress! Great food but it gave me diarrhea for 2 days. Oh well.
And sometimes, I have one Prestige beer in the evening. In fact, I was out of cold beer the other day which was close to being an emergency according to Big Dave and Adrien, the guys who live in the apartments.
If I were to buy a beer from the street, with US dollars, even though I would have to send one of the men out to buy it, they would still have to pay the 'blanc price, the 'white price' because it is US currency. Using Gdes. the Haitian currency, a beer would cost 25 Gdes, about 75 cents. If a US dollar is used and I buy it, 1 beer is $1.25. It is $2 at the UN bar and $6 in a hotel. So, of course, I give money to the guys and they buy the beer.
The hospital is a dry campus which means that one just quietly asks the guards to walk out a buy the beer. I gave a $10 bill to Adrien, not really knowing about high finances, and he returned with a 12 pack. His seller is named Spider.
Haiti is a hell-hole and conservation and recycling are unknown concepts here. BUT the one item that they do collect and conserve is beer bottles. I knew this but I was unprepared for Spider to come into the hospital, find me and ask for his beer bottles back, 3 days after I had received them. Not satisfied with my response that I had only drank 2 beers since I had received them, he went to Adrien, in the Logistics office (how do these guys know where the Logistics office is?) loudly expressing his dissatisfaction with my lack of empties. His eyes got really big when I said that I had only drank 2 of them in 3 days. Mon dieu!
I now have 8 empties because Adrien and Big Dave have each had a beer. I hope Spider is appeased.
I am here to be in the hospital so time off or days off are not really thought of, we're just here.
3. Street Scenes: In my last blog, I described the 19 small streets that we drive up and down, to get to the hospital. I am also starting to recognize some of the regular street folks.
There is the woman who I hear but do not see, every morning, loudly yelling out what she is selling. I am thinking that it is bread which she would be carrying on her head. She repeats her refrain every 20ft or so. She 'sounds' in her 40's-50's, slender bordering on malnourished, poor, wearing a dress and flip-flops.
There is the Happy Birthday truck and the Titanic truck. These are water trucks that drive to peoples homes and fill up there cisterns with water. One truck plays Happy Birthday and the other truck plays the theme song from the Titanic, as they drive down the streets.
There are police cars everywhere and UN trucks with men with big guns, at many intersections. The police randomly stop cars, asking for registration or some other paperwork. I think. Whenever I ask our driver about this, they suddenly do not understand English. Everyone is assumed to be dishonest and corrupt here and it is assumed that everyone steals, so I am wondering if the police are collecting money from the cars. No money, no driving. We are never stopped or questioned because we have a sign in the window, saying we are on administrative business. Plus, having a blanc in the car, in the light of day, usually means the driver will not be shaken down. After dark is another story.
Most of the clothes that are worn here, are originally from the US or neighboring countries. Best t-shirt:: man wearing a bright yellow shirt WOMEN FOR McCAIN!
4. Weather: it is god-awful hot and humid and smells like garbage. And as I write this, Hurricane Irene is about 24-36 hours away from us. We have had some great quick moving Caribbean evening storms that produce steamy rain and humidity. Unfortunately, because there is no sewer or drainage system here, a rain like that causes flooding and twice the hospital has been flooded, especially in the Pediatric unit. Most of the hospital is built up small inclines but many areas are not so everything floods. Sandbags do not exist. We just watch the rising torrents of water and clean up the mud and debris afterwords.
5. Contributing to the smell of garbage is the huge piles of garbage at every other corner. This is not a few bags strewn about, this is 20ft of garbage in both directions from the corner, about 3-4 ft deep with mongrel dogs rummaging thru the muck. The piles are frequently on fire. The piles get bigger and bigger and then one day, they are gone! Then they start all over agin.
6. Speaking of fires, I have never seen a fire truck here. There are police everywhere but no fire stations or visible equipment.

And Then There Is The Rest:
In my last blog, I spoke of a very sick 14 yr old girl whose father promised to kill everyone if she died. She did die peacefully with an older brother at her side and her father was OK when the brother called him. The Pediatrician and myself each contributed 500Gdes, about $12.50, to transport the body home in the north.
Last week, I assisted with a transport of 2 children and their mother's, to St. Damien's hospital for some head CT's. One child was a 14 yr old girl who had fallen and hit her head. She laid draped over her mother and aunt's laps. The other child was a 3 month old little boy with a slightly large head and bilateral clubbed feet.
Gideon was the driver and had a tape of church music playing during the ride. As we drove/bounced the wrong way down streets to avoid huge potholes, UN trucks and the general chaos of the streets, the women began to quietly sing with the music. I turned and smiled at them and they sang louder. I cannot describe to you the spontaneous melodies of their voices. All I could do was close my eyes and smile and pray. It was a holy moment.
A week later, an adult patient was desperately in need of O- blood which rarely is available here. For 1 week the Haitian Red Cross looked for blood to no avail. For you medical folks, the patients Hgb was 3.6. For you non-medical folks, the results should minimally be 10 and 12 would be better.
As it turns out, one of the volunteer nurse' had O- blood and she had taken a special liking to the baby with the clubbed feet. The surgeon wanted his patient to have blood before he operated and the nurse wanted the surgeon to fix the clubbed feet SO a deal was struck: 1 pint of blood for 2 fixed feet. And it was done and the mother just sat there and smiled.
Last week, we admitted Tatiana, an 11yr old little girl who had a wall fall on her and who is now a paraplegic. Her parents are dead and she was "dropped off by soneone." This girl is 11 but looks like to be 9 or 10. In Haiti, the kids look younger than their age and the adults look much older. She had been raped and has gonorrhea. Fortunately, she is not pregnant or HIV infected.
Ferla, our social worker, had decided to go to the girls village to see if anyone could care for the girl, when a man showed up who said that he was the girls step-father. Based on how he attrempted to caress her and how she cringed, we are suspecting that he has been raping her.After Ferla spoke with him, he left and has not returned.
All of the ICU nurse's have adopted Tatiana. She has a chest brace on until her spine can be stabilized so a few nurse's put her into a wheelchair, took her outside, found a hose and gave her a bath and washed her hair. Gaby, the administrator, bought her some barrettes and braided her hair. I found a Barbie doll with some clothes and some other 'girlie things' and in the last few days, she has actually started to smile.
After her spine is stabilized, Ferla will attempt to find a rehab place for her. But after that, who knows?
I have much more to tell you but it is now the 23rd, my 23rd day of working, and I am finally tired. Hurricane Irene has missed us and we are happy.
Talk with you soon.

Kathleen