With 6 Days Left...Final Thoughts on Haiti

After the moving incident a few days ago I began to think about different experiences and interactions I have had here- both positive and negative. I have thought about my expectations of Haiti and if I have really accomplished anything during this trip. And well, if I didn’t accomplish anything- I can certainly guarantee that I ate the most peanut butter in 7 weeks than anyone ever has. I have been dreaming about fruits, vegetables and whole grains for weeks now! First, I will explain the moving story. As a disclaimer- I apologize that this blog will be all over the place- I think it will take a while until I can really wrap my head around everything- this is just the beginning to my summary of thoughts.

A huge truck pulled into compound and parked next to the porch of the mission house. A crew of movers began unloading boxes- a lot of them- behind the truck- about 25 feet away from the porch. Most of us were doing work on the porch for our projects and didn’t notice this all going on. Then it started to rain and David- who is down here for his 6^th time and helps out all over the compound- noticed that the boxes were getting wet. He asked us if we could help out and move some of the boxes onto the porch. We all hopped up and began helping- until we quickly noticed that we weren’t helping the movers- we were doing the moving. At first it was only a few of us and it was clear that it would take too long and the boxes would be wet- so the boys (who had been working really hard on their data analysis) jumped up to help. Through the entire process- probably 10+ minutes- the hired movers stood leading against trees relaxing. They never moved to help- even when asked. It was upsetting that we were doing work that other people were getting paid to do- but it was more upsetting that I wasn’t surprised with the situation. Again, I have had so many wonderful experiences here, but unfortunately this was one of the bad ones.

When I told my family and friends that I would be traveling to Haiti, their first response nearly 100% of the time was: “be safe”. To be honest, I was nervous. Media coverage often highlighted the dangers of life in Haiti. After being here and also reading an opinionated book of the history of Haiti from an anti-US standpoint, my fears have really dissipated (mostly from being here, but reading the book definitely helped me consider the other side of the story). There is definitely a caveat associated with this feeling of safety and that is Milot. Milot is a very unique place and is overall very safe. We are sheltered from the violence that tends to occur in the cities- Port-au-Prince and Cap Haitian. When driving through Cap we are always in a CRUDEM vehicle and are told to leave before sunset, again keeping us out of harm’s way. I don’t think that it is unreasonable to think that Cap Haitian is dangerous but from our experience, Haiti has only felt safe.

For the most part, with a few exceptions, the patients and staff at the hospital have been very welcoming. Of course, we are only medical students, so there is less opportunity to step on people’s toes, but overall I believe that our group has done a great job respecting the system that is in place and worked hard to work with the HSC staff and not around them. Thinking of accomplishments- I would hope that we leave Haiti having furthered the relationship between Tufts and HSC. At our final meeting with the head of the hospital, Dr. Previl, he was very excited about the results of our projects and was eager to welcome more Tufts students in years to come. We must have done something right to keep us off the “do not return list”.

As for the project that Sophia and I worked on, we reached our goal of 50 surveys and did so by working through some significant barriers. As I have mentioned before- the first 3 weeks we were here- we waited around for a female translator to become available. Luckily, our survey needed some more work, including a translation into Creole that we were expecting from a person in the US and never received. So we began our search for a translator after quickly realizing that depending on a community health agent was not our best bet. Sophia did a great job working with the head of nursing to secure nursing students that spoke French (thank goodness she is fluent in French!). In 2 weeks we were able to visit Thibeau and Carrefour des peres twice to get 25 surveys done while also spending afternoons at the hospital to complete 25 surveys we needed done there. Although it took some time, and involved some frustrating days, it was a great experience. Some of the stories that women told were truly heartbreaking and it was a privilege to have them open up to us. Many of these women welcomed us as foreign strangers into their homes and often carried out chairs and demanded we sit. It was a little gesture but for me showed that they trusted us and really wanted to be part of our project.

We have spent this week staring at 0s and 1s on the computer, analyzing our responses to the 40 question survey. With some questions having 10 answer choices- let’s just say it’s a lot of 0s and 1s and my eyes hurt. Dr. Forrester and Steve (via skype) have been SO helpful in narrowing our focus and helping us with the analysis. Sophia and I hope to have our poster (that we need to present when we start back at school) completed by the time we leave so that our 3 weeks at home can be spent relaxing, decompressing, and reflecting. Well, I guess I speak for myself on the relaxing part- Sophia planned a 3 weeks backpacking trip to SE Asia- I chose the beach and the couch!

So what else did I accomplish in Haiti? Although I did not actively treat anyone here because I am not a doctor- I hope that by working with physicians in the clinic and the hospital I was able to be part of a team that helped make patients’ days better. Working with several Tufts doctors in the outpatient clinic was great and gave us all a chance to work on our interviewing and physical diagnosis skills. Although the doctors actually prescribed the medications and sent patients for labs, X-rays, or further consults, I hope that I was able to convey to the patients that even though I couldn’t actually give them the medication doesn’t mean that I don’t care. I hope I showed how much I respected them and was willing to listen to their concerns in order to help in any way I could, even if that was just running over to the hospital to check with another staff member about what treatment was available or to show a patient where they needed to go.

Some of my favorite days here were those that included a visit to Santos- the pediatric burn patient who arrived at the hospital days before we arrived in Haiti. Although the visits are usually short and without many words because I don’t speak French or Creole- just seeing his smile is incredible. Although he has undergone dressing changes almost daily and surgery to fix his contractures- he never complains or cries, just continues to smile. He often visits the families that sleep outside the pediatric unit at night waiting to be the first in line for the following day’s clinic. I like to refer to his visits as “Santos Rounds”. Today Santos brought the nurses who change his dressings to see his 5 day old sister. Eric and I were lucky enough to join and observe him with the proudest smile on his face when he introduced her to us. I think being here has made me appreciate the little things you can do to make someone’s day just a little better- even if that is just lending a helping hand, stopping by for a visit, playing a fun game of soccer, or bringing people to meet your little sister.

With so many frustrations, it would be easy for me to leave Haiti with a pessimistic view of this country. There are certainly very hard working, skilled staff at the hospital that save many lives and treat many patients daily. They work in a setting with limited resources but never complain and make do with what they have. But then there is the story of the movers a couple days ago that unloaded the boxes but would not finish their job. It would be unfair to group people by work ethic because in a country with an unemployment rate as high as 75% at times- it’s very hard to know what someone might do if they were given the opportunity to work. It is just difficult to watch so many people suffer because they are unemployed and can’t afford to eat, when those that are employed are doing half the work and getting full pay.

I think it’s hard to make a lasting impression in only 7 weeks. But, from the reverse angle, I certainly think Haiti will have/and already has had an enormous impact on me. Selfishly, I think I will take more away from this trip than I gave. I hope to bring back stories and experiences that I can share with others to keep Haiti on everyone’s mind in order to continue the awareness for the need here. When speaking with a worker on the compound today he asked when I was leaving. When I said “Next week, but I hope to be back.” His response was, “I am really glad”. I didn’t understand at first but he clarified that, “I am happy you want to come back.” A short conversation made me realize how many people have come and gone, especially recently after the earthquake.

With so many NGOs, volunteers and foreign aid, it is not surprising that Haitians expect people to just come for a week or two and leave without ever returning. However, what Haiti needs is sustained support systems from organizations and teams willing to continually send volunteers that will work with the staff here and help to further their training. I hope that by sharing our experience when we get back, we can recruit interest for years to come and Tufts in Haiti can be one of those sustainable groups. I think my Life is Good book has a perfect quote, “If you don’t go, you don’t see.” We all know that Haiti is the poorest country in the western hemisphere burdened with poverty, violence and disease. But without coming here, I would not have seen the beauty of the Milot valley, the kindness of so many welcoming people, and the resilience of the Haitian people. Although it is cliché to say: a piece of my heart will always remain in Haiti and I certainly hope to be back.

Some highlights I will never forget: Chris and Briony’s consistent and inspiring hard work, soccer games with Haitian boys, our trip to Children of Promise Orphanage, moments with Santos, visiting homes in Thibeau and Carrefour des peres, the days in clinic with Tufts faculty, being welcomed by other volunteer doctors into clinics and ORs, torrential downpours and rats in the rafters, screaming children: “blan, blan, blan” throughout our runs, Dr. Previl’s daughters daily visits soon accompanied by all the children living on the compound (including Dr. Bernard’s “mini-me” son), IVs given on the porch at all hours of the day to Grace and Spencer, the hike to the citadel-both of them, Eric and Andrew’s completed dares, our makeshift workout room, trips to the beach and into Cap Haitian, multiple cakes, peanut butter, cards, and bananagrams. And some pictures to end this novel of a final blog post…

Eric, Spencer and Alex's final presentation to community health agents. Andrew and I got the chance to participate and present on water sanitation and pregnancy respectively.

One of many soccer fields/grazing sites along the road from Cap to Milot

Mural outside the hospital depicting scenery of Milot and scenes from the earthquake

Briony's Goodbye Dinner above and Dr. Salem and Dr. Forrester's visit below

A house in Milot

Eric learns from Emmanuela how to hold a chicken and then proceeds to chase me with it...