day 4 in Hinche

It has taken me a little while to get good access to the internet, so i apologize for the delay in posting.  I hope that you are all doing well and i want to thank everyone who donated money to help me get here, I raised a significant amount beyond what i needed which will enable me to donate a large amount to the organization. 

It is great to be back even though I am not feeling so good today and a small cut that I got on my foot appears to be infected. I am working through it and loving seeing all my old friends here. Today was our second morning in the hospital and tonight will be our first night shift, we have been keeping busy since we arrived in Port au Prince last Friday morning.  The first 24 hours were spent visiting with friends in Port au Prince, seeing the city (which looks a lot better, much of the rubble from the earthquake is cleared up and many of the tent citites have been dismantled) buying some local art and eating great food. 

 We traveled in the big pink jeep to Hinche on Saturday, arriving at Maison Fortune mid afternoon.  The first night in Hinche welcomes us with a thunderstorm of epic proportions.  The streets smelled fetid and rank the next morning as we walked through town to the market an beyond.  Goats and pigs, seemingly belonging to no one in particular, rooted through the trash strewn on the sides of the road and in the occasional empty lots between the houses.  Women sat on the ground in the market selling everything from charcoal to pig parts, boullion cubes, wash powder and rock salt sold by the cup full from wheel barrows.  As usual we found ourselves dodging motorcycles and the occasional begger as we looked for vegetables and manioc bread.  We stopped briefly at the Azile (the feeding station for hungry, dying and sick people who have no where else to go, run by Mother Teresa's order of nuns) and saw some of the children and babies, just enough to have a few climb up into my arms, clawing at me as if i was a jungle gym and desperate not to let me go.  We spoke with the sisters and got the feeding times for the children so that we could make sure that we could come back at the best times to help them.  

Night 2 at Maison Fortune and I found myself in the clinic at 10pm with Brother Mike and a sobbing child who has just fallen down a flight of stairs (we were brought to where he fell the next morning and he actually free fell about 8 feet onto concrete stairs and then rolled down another flight after that!) with the two older boys who brought him in.  He has only been at the orphanage for a month and the poor little guy was scared half to death.  Being the only nurse around, Brother Mike looked to me to help determine whether he needed to go to the hospital immediately.  This is the things about working here, one is often asked to go beyond their comfort zone to help out simply because you are the best help around even if you are wholly unqualified for the task, something always seems better then nothing here.  The boy amazingly had not hit his head, and was complaining of pain in his low back (he had landed on his bottom which had saved his life i am sure). He could move everything, although gingerly and was not responding badly to my probing fingers and hands. We decided there was nothing the hospital could do tonight that we couldn't so we kept him there with an ice pack, an ibuprofen and a handful of tootsie rolls.  I fell asleep wondering if we had done the right thing.  If I was going to get woken in the night only to hear that something terrible had happened.  The next morning we checked in on him.  After Brother Mike told me that he had gotten up and walked to the bathroom to urinate on his own, I asked the boy what color his urine was, "rouge" (red) is all he said with a forlorn look on his face, and we decided to send him to the hospital.  Later that day we got the news that his x-ray had come back clear and he was just badly bruised, a tragedy narrowly averted.  I am happy that I was able to provide a little reassurance along the way but these sort of events also make me painfully aware of how very little I can actually do for the people here, I am humbled every step of the way.

Yesterday was our first day at the hospital.  Maria and I were told that there were two students in the program who were struggling and in danger of not graduating with the rest of their class at the end of October.  We have each been assigned one to work with while we are here.  At the beginning of the day we met all of the students, they are a good looking group, excited and energized.  There are two men in the program, the first they have had.  I made the mistake of referring to them as Saj Fanm (wise woman) which is what they call midwives here, and i was corrected that it is Saj Nomn (wise man) and I again, insert foot into mouth. I met my student Sonise, and we were off to the labor ward (which is really just outside the door of the storage closet/break room where we were meeting).  Unfortunately, for the third year in a row, the first birth i attended was that of a dead fetus.  It is an unfortunate occurrence but a constant reminder that I am in a very different place dealing with very different circumstances.  It was for the best that this particular baby did not survive, he was very premature and had congenital deformities that weren't compatable with life here.  He may have had a chance has his mother been in the US but even that I am not sure of, his condition was one that i have only encountered in text books at home. The student and I were together with our translator and the heat.  Nursing students filtering in and out and people disturbed but relatively unconcerned by what was happening in our little curtain enclosed cubby hole.  The mother, just minutes after the birth, was washed by us then stood up off of the 3/4 length gynecological table that she had delivered on, collected her soiled sheets into her own bucket, got dressed and walked over to the postpartum room with all the new mothers and babies around her.  It is sad that they have no place to put these women where they are not with new babies, fetal death happens so often here i wish that they could find them a place where they could rest away from the cries of other peoples healthy children.  But space is at a premium in the hospitals here and there is not always room for compassion.

The day was thankfully not all sad.  I was able to use my lactation skills to help a first time mother express milk for her baby who was too small and premature to nurse effectively. She was engorged and in pain and the baby could not latch onto her flat nipples.  I got her a hand pump from the Midwives for Haiti storage room and was able to teach her to use it so she does not have to give her baby any more formula.  I sat with her and her family for over an hour making sure they all knew how it worked, how to keep it  clean, how to store and give the milk, how often to pump etc.  She was able to pump over 5 oz of milk at that time and she and her family were delighted because they thought she had no milk and now they will not need to give the baby formula, which is incredibly expensive and puts the baby at increased risk for dying related to bad water and lack of ability to get enough.  I checked on her today and she reported that all was well, she was pumping every two hours and the baby was happily taking her milk, she was sleeping peacefully beside her young mother as we talked.  

We returned to the orphanage to the news that the house cat, Noose, had delivered her kittens while we were gone (she had been in labor when we left in the morning and i was reluctant to leave, but cats generally don't need midwives :-) 4 healthy kittens for us to ogle over while we are here.  We finished the night with a slide show for the girls featuring photos of them that Maria and Dina took the last 2 years when they were here.  They were delighted to see themselves and laughed and cheered while sweet little Wilma played with my hair.

This morning the hospital was quiet but we will return tonight so more news to come.  Feel free to send me emails, it's nice to get them :) I am off to rest and hopefully feel a little more fit for our night to come.

be well and lots of love

Ami

Dina's short documentary from their trip last year: