It's hard to believe how quickly things are moving with the project these days. I can barely keep up. We should be done enrolling all 82 babies by Monday. Twenty-seven kids have already finished their 6 months of manba. We had our second "1st birthday party" last week and a third scheduled for this Thursday. The parties are definitely one of the high points in this project - the babies are beautiful. During the last party four of the nine moms started crying - most likely expressing a combination of thankfulness for their healthy children and a little fear about what will happen to them now that they are no longer receiving the supplement.
Saturday, January 31, 2009
getting closer
It's hard to believe how quickly things are moving with the project these days. I can barely keep up. We should be done enrolling all 82 babies by Monday. Twenty-seven kids have already finished their 6 months of manba. We had our second "1st birthday party" last week and a third scheduled for this Thursday. The parties are definitely one of the high points in this project - the babies are beautiful. During the last party four of the nine moms started crying - most likely expressing a combination of thankfulness for their healthy children and a little fear about what will happen to them now that they are no longer receiving the supplement.
Friday, January 30, 2009
Sunday, January 25, 2009
Nap Goumen
Nap goumen – we are fighting. This was our team’s mantra for the last week – probably the most challenging work week we’ve had to date.
For me personally, the fight began as soon as Monday morning broke. As I got ready for work, I knocked a bottle of nail polish off my shelf which then shattered and splattered blue streaks across my bedroom floor. Then I checked my email and discovered that yet another something went wrong in my place back in New York. Since I’ve been in Haiti I’ve had to replace a roof, a major piece of the furnace, a washing machine and now a thermostat. It has seriously cost me as much to NOT live in my Ithaca place as it did to live there. Thankfully I don’t pay rent in Haiti so I can manage it just fine. As we drove to the clinic I thought about Alexander and his Terrible Horrible no Good Very Bad Day. Some days are just like that… no matter where you are. Unfortunately, events quickly escalated beyond personal mishaps fit for children’s books.
Late Monday morning we received word that a baby who had missed his two January study visits had actually died in late December. This is the third death so far in our study - this time likely due to dehydration related to diarrhea. Baby V died in his grandmother’s arms on the way to the hospital.
Tuesday brought more sad news. Last Sunday Miss M had seen one of our mothers sweeping one of the major streets near downtown. As she worked her little baby, our only confirmed HIV-positive child so far, was lying alone on the sidewalk. Right then, Miss M predicted that he would come in that week sick. She was right. On Tuesday morning the baby arrived with fever, diarrhea and signs of a respiratory infection. Our team fought to have him see a clinic doctor right away, be given a first dose of meds, and then referred to one of the better hospitals across town. We provided the mother with transport fees and found another mother to travel with her. We called ahead to the hospital and made sure they knew to expect him…but the mom and baby never showed up. The next morning we sent another person to check at the hospital and a field worker to the home address the mother had provided when she enrolled. Miss M has been driving by the street where she saw the mom and baby every morning and afternoon. Now, it’s almost a week later, and still no word. We do still have hope that the baby is okay. The mother can read and she was given bottles of meds at the clinic before being sent to the hospital. Hopefully the baby has received them. It’s common for mothers to not follow through on hospital referrals. There are a 1,000 reasons why this happens, often because mother has to go to care for other children or is worried about fees at the hospital.
The week continued with more sick kids than usual coming in on Thursday and Friday. We had to fight again to get referral to a cardiologist for a child who had been hospitalized a month or so earlier. Another baby in our program was sent to the hospital due to severe diarrhea and vomiting. This time a field worker accompanied the mom and we know she was actually admitted. In the midst of literally fighting for some of our kids lives, there were smaller battles to keep our supply chain moving – delays in production and delivery of the manba, an unexpected pause in new enrollments to the household food ration program that left me calling around to friends working for other NGOs to see if we could get some donated food , a delay in getting our petty cash request processed.
I’d like to say that I handled each one of these events with an appropriate balance of assertiveness and respectfulness. Unfortunately, by 3pm on Friday, when I received word that our urgent petty cash request had been delayed for 48 hours due to a small error in the way the receipts had been pasted to the paper, I lost it. I yelled at someone in the accounting office. I was shocked at how angry I was – at how the week’s worth of stresses and setbacks managed to explode in one moment.
Nap goumen – we are fighting. Nou pral goumen - we will continue to fight. Hopefully, there won’t we another week as intense as the last five days but there are certainly more battles to be fought - against sickness, against poverty, against bureaucracy, against apathy, against the endless series of obstacles that stand between our kids and a healthy hopeful future. I am also fighting within myself – to become wiser, slower to speak, less selfish, more patient, more compassionate, and more focused. Pafwa map goumen pou espwa - sometimes I am fighting for hope.
For me personally, the fight began as soon as Monday morning broke. As I got ready for work, I knocked a bottle of nail polish off my shelf which then shattered and splattered blue streaks across my bedroom floor. Then I checked my email and discovered that yet another something went wrong in my place back in New York. Since I’ve been in Haiti I’ve had to replace a roof, a major piece of the furnace, a washing machine and now a thermostat. It has seriously cost me as much to NOT live in my Ithaca place as it did to live there. Thankfully I don’t pay rent in Haiti so I can manage it just fine. As we drove to the clinic I thought about Alexander and his Terrible Horrible no Good Very Bad Day. Some days are just like that… no matter where you are. Unfortunately, events quickly escalated beyond personal mishaps fit for children’s books.
Late Monday morning we received word that a baby who had missed his two January study visits had actually died in late December. This is the third death so far in our study - this time likely due to dehydration related to diarrhea. Baby V died in his grandmother’s arms on the way to the hospital.
Tuesday brought more sad news. Last Sunday Miss M had seen one of our mothers sweeping one of the major streets near downtown. As she worked her little baby, our only confirmed HIV-positive child so far, was lying alone on the sidewalk. Right then, Miss M predicted that he would come in that week sick. She was right. On Tuesday morning the baby arrived with fever, diarrhea and signs of a respiratory infection. Our team fought to have him see a clinic doctor right away, be given a first dose of meds, and then referred to one of the better hospitals across town. We provided the mother with transport fees and found another mother to travel with her. We called ahead to the hospital and made sure they knew to expect him…but the mom and baby never showed up. The next morning we sent another person to check at the hospital and a field worker to the home address the mother had provided when she enrolled. Miss M has been driving by the street where she saw the mom and baby every morning and afternoon. Now, it’s almost a week later, and still no word. We do still have hope that the baby is okay. The mother can read and she was given bottles of meds at the clinic before being sent to the hospital. Hopefully the baby has received them. It’s common for mothers to not follow through on hospital referrals. There are a 1,000 reasons why this happens, often because mother has to go to care for other children or is worried about fees at the hospital.
The week continued with more sick kids than usual coming in on Thursday and Friday. We had to fight again to get referral to a cardiologist for a child who had been hospitalized a month or so earlier. Another baby in our program was sent to the hospital due to severe diarrhea and vomiting. This time a field worker accompanied the mom and we know she was actually admitted. In the midst of literally fighting for some of our kids lives, there were smaller battles to keep our supply chain moving – delays in production and delivery of the manba, an unexpected pause in new enrollments to the household food ration program that left me calling around to friends working for other NGOs to see if we could get some donated food , a delay in getting our petty cash request processed.
I’d like to say that I handled each one of these events with an appropriate balance of assertiveness and respectfulness. Unfortunately, by 3pm on Friday, when I received word that our urgent petty cash request had been delayed for 48 hours due to a small error in the way the receipts had been pasted to the paper, I lost it. I yelled at someone in the accounting office. I was shocked at how angry I was – at how the week’s worth of stresses and setbacks managed to explode in one moment.
Nap goumen – we are fighting. Nou pral goumen - we will continue to fight. Hopefully, there won’t we another week as intense as the last five days but there are certainly more battles to be fought - against sickness, against poverty, against bureaucracy, against apathy, against the endless series of obstacles that stand between our kids and a healthy hopeful future. I am also fighting within myself – to become wiser, slower to speak, less selfish, more patient, more compassionate, and more focused. Pafwa map goumen pou espwa - sometimes I am fighting for hope.
Monday, January 19, 2009
a weekendy weekend
Last weekend made me feel pretty optimistic about the way things can come together here. Friday night I attended a lovely baby dedication celebration for some Canadian friends who gave birth to their first son about a week ago here in Port-au-Prince. Then on Saturday morning my neighbor and I had one of the clinic drivers take us to a nice beach about an hour and a half north of the city. I unexpectedly ran into some friends of mine there and ended up spending the night with them in Saint Marc – a small dusty port town another hour up the road. We had a great time out with her Haitian colleagues - eating, drinking and dancing. I returned Sunday afternoon just in time to play some tennis with another group of people and then I capped of my whirlwind weekend by falling asleep on the couch watching The Wire. Lots of time with friends…and not a moment of work. An unusually active and fun weekendy-feeling weekend for me here.
Friday, January 16, 2009
Baby G
I’ve cried a lot over the last 18 months in Haiti, but I’m pretty sure that Tuesday was the first day I cried at work. It was just a tear or two and the only witness was a 12-month old baby girl - Baby G. From the moment we met Baby G and her mother 6 months ago our team knew that they would be very special to us. Baby G’s mother is extremely poor and has some obvious degree of mental impairment. She is the one mother in our program who frequently comes in with her clothes dirty, smelling like urine and with patches of sores on her arms and legs. She is tiny - with wide eyes and small face that looks both younger and much older than 23, her reported age. She already has 3 children including Baby G. She doesn't have a cell phone - a rarity here in Port-au-Prince where anyone who possibly can will find a way to buy or be given a $10 handset.Despite all the obstacles she faces, Mama G is trying to be the best mother she can. Baby G is a chubby baby – sometimes I am amazed that her tiny mom can carry her. Physically Baby G has developed well so far – she can sit up, crawl, and stand. She has been able to feed herself as long as I can remember - most likely a survival skill. One day, we encouraged Mama G to use some of her transport stipend to buy some food for herself. (We give mothers $2.50 to pay for transport for each study visit) She refused, saying she needed to use it to buy milk for Baby G. When she started the program, Mama G would arrive early on her scheduled visit and already be waiting when I arrived to unlock our office door at 8am. As the months went on, we noticed that she started coming one or two days late for her visits - especially on Mother’s Club days. We suspect she is too embarrassed of her situation to want to see the other mothers.
I’ve never seen a baby as serious as Baby G. Her eyes reflect an undestanding that life is hard. Getting her to smile is really difficult – laughing nearly impossible. That’s why I love the photo I’ve posted of her here so much. Despite her otherwise rapid development, Baby G can’t walk. Unless there is some sort of medical intervention I’m not sure if and when she will. When Baby G stands you can tell that one leg is significantly longer than the other. Her knees buckle to compensate. Her feet point out rather than straight. She needs corrective braces. She may need surgery. There is a hospital for developmental disorders here in Port-au-Prince that we plan to refer her to. I already know that Mama G won't be able to afford their $5-$10 fees. I need to figure out what more is possible from our side.
Those who know me know that I have a long history of orthopedic issues. When I was 8 I was hospitalized with a fairly rare condition that caused the cartilage in my hips to break down. For a brief period, my parents were unsure whether I would walk again. I spent the next several years on and off crutches. But living in Chicago, I had access to one of the world’s leading experts in pediatric hip disorders. I had a family with time and resources to see me through the extended treatment and rehabilitation process. Today, like Baby G, I do have one leg that is a bit longer than the other but I have access to everything I need to make up for that.
It’s rare that I recognize pieces of my own story in the lives of the mothers and children I work with. Our worlds are so different that I don't want to pretend to understand how they survive the day to day. Tuesday was the first day I recognized a small piece of what could have been my story - if I had been born in a different place to a different family. So what emotion was behind those tears? Empathy? Thankfulness? Anger? Compassion? I'm not really sure. I do know that Baby G's story has captured a piece of my heart.
Sunday, January 11, 2009
No gas No go
Traffic patterns in Port-au-Prince changed noticeably last week. On our morning and afternoon commutes we saw fewer cars on the road but managed to get repeatedly stuck in traffic jams. Why? Long lines of cars and crowds of people have been assembling at gas stations across the city - blocking entire intersections.
Port-au-Prince has been experiencing an extremely frustrating gas shortage over the last week. Only a handful of gas stations are open for limited hours each day. Public transportation prices have risen to the point that some of our moms missed their scheduled visits. People are standing for hours at gas stations in hopes of getting enough fuel to keep daily lives in motion. (People need gas for both vehicles and generators) Fortunately for us foreigners at the clinic, diesel is still readily available and so we are able to ride in the clinic car to and from work. People with money and connections can pay a doubled-price to get gas on the black market. However the general Port-au-Prince economy is coming to a near halt as people and goods literally can't move.
What's causing the shortage? It's hard to say for sure since different stories come from all sides. Generally it doesn't seem that it's because there is/was no gas coming into the country. Rather the gas station owners went on a strike from selling in protest against a drop in price required by government regulators - which was prompted by the recent global drop in gas prices. (Regardless of the current global market, fuels prices in Haiti are always 2-3 times what most US residents pay at their local pumps). Apparently the dozen or so families/companies that control the gas market here have refused to sell gas at the lower price because they would have to take a loss. Some people say the gas station owners are waiting for the government to step in and change policy to prevent their losses.
To the outside observer this all just seems crazy. Instead of taking a shorter term loss and keeping a new supply coming in, the gas station operators are losings days and days of sales as they hold back the supply. The government is likely also to blame. Regardless - the whims of those few with power are crippling the lives of powerless millions. Unfortunately that is nothing new.
Port-au-Prince has been experiencing an extremely frustrating gas shortage over the last week. Only a handful of gas stations are open for limited hours each day. Public transportation prices have risen to the point that some of our moms missed their scheduled visits. People are standing for hours at gas stations in hopes of getting enough fuel to keep daily lives in motion. (People need gas for both vehicles and generators) Fortunately for us foreigners at the clinic, diesel is still readily available and so we are able to ride in the clinic car to and from work. People with money and connections can pay a doubled-price to get gas on the black market. However the general Port-au-Prince economy is coming to a near halt as people and goods literally can't move.
What's causing the shortage? It's hard to say for sure since different stories come from all sides. Generally it doesn't seem that it's because there is/was no gas coming into the country. Rather the gas station owners went on a strike from selling in protest against a drop in price required by government regulators - which was prompted by the recent global drop in gas prices. (Regardless of the current global market, fuels prices in Haiti are always 2-3 times what most US residents pay at their local pumps). Apparently the dozen or so families/companies that control the gas market here have refused to sell gas at the lower price because they would have to take a loss. Some people say the gas station owners are waiting for the government to step in and change policy to prevent their losses.
To the outside observer this all just seems crazy. Instead of taking a shorter term loss and keeping a new supply coming in, the gas station operators are losings days and days of sales as they hold back the supply. The government is likely also to blame. Regardless - the whims of those few with power are crippling the lives of powerless millions. Unfortunately that is nothing new.
Wednesday, January 7, 2009
Se pa kay pam
Se pa kay pam. "This is not my home" - that's the literal translation of what Mama Evena said to me this morning as she looked over at the other mother in the room who was sitting with a 7-month old on her lap. I think she meant that she no longer felt like she belonged in our little nutrition project space - among the mothers with cooing babies. Two months ago, her 9-month old daughter Evena died suddenly of what we suspect was meningitis. It was the weekend and Mama Evena and her husband could not find the 50 cents or so it would cost to bring their feverish child to a hospital by moto taxi. Instead they brought her to the church where in the midst of prayers she started convulsing. By the time they actually reached the hospital, it was too late. Evena died within hours.
I had meant it two months ago when I told Mama Evena that she was still welcome to come by any time - to talk, to cry, to whatever she needed. Yet this earlier morning, at the start of what already promised to be a stressful day, I felt my stomach drop when I saw her step into the room. I did not want to be reminded of her grief - not when there was so much work to be done. Not when there was another grieving mother due to arrive within an hour or two. You see yesterday we found out that Mama Evena had been joined by Mama Annis - mother of a 7-month old girl who died on December 27th from what we think are diarrhea-related complications.
Working in the country with the highest infant mortality rate in the Western hemisphere I should be more prepared for these deaths. I am not. No one on our team is.
It's interesting to watch how each of us responds. Miss M expresses her frustration that any child could die of diarrhea - something that takes so few resources to combat. She spent most of the day today declaring that the deaths must stop - that we are going to push the mothers harder to make sure they now how to care for their children. In contrast, Miss G's eyes welled up with tears and she let her head fall into her hands. Two years ago, Miss G lost her own 18-month-old son. Most days she displays visible signs of anxiety and grief. Sometimes I wonder if it's healthy to have her continue to work among so many vulnerable children - she has spent more than one sleepless night thinking about the mothers and children in our project. I, in turn, felt about the same as I do most of the time lately - a little numb and a lot overwhelmed. I have come to measure unexpected events by the amount of additional work they create. The death of a child rightly requires a quick investigation and detailed reporting to the university ethics board. I am a bit scared that two deaths in two months will invite criticism of our program. I wish I just felt more compassion.
Evena was a very special child. She was her mother's only daughter. Her brothers are much older - 13 and 16 years old. I get the impression that Evena was an unexpected but very welcome gift for her mother - a gift she was not ready to give back to Bondye. If Evena was with her today, I imagine that our little space would have still felt like home.
I had meant it two months ago when I told Mama Evena that she was still welcome to come by any time - to talk, to cry, to whatever she needed. Yet this earlier morning, at the start of what already promised to be a stressful day, I felt my stomach drop when I saw her step into the room. I did not want to be reminded of her grief - not when there was so much work to be done. Not when there was another grieving mother due to arrive within an hour or two. You see yesterday we found out that Mama Evena had been joined by Mama Annis - mother of a 7-month old girl who died on December 27th from what we think are diarrhea-related complications.
Working in the country with the highest infant mortality rate in the Western hemisphere I should be more prepared for these deaths. I am not. No one on our team is.
It's interesting to watch how each of us responds. Miss M expresses her frustration that any child could die of diarrhea - something that takes so few resources to combat. She spent most of the day today declaring that the deaths must stop - that we are going to push the mothers harder to make sure they now how to care for their children. In contrast, Miss G's eyes welled up with tears and she let her head fall into her hands. Two years ago, Miss G lost her own 18-month-old son. Most days she displays visible signs of anxiety and grief. Sometimes I wonder if it's healthy to have her continue to work among so many vulnerable children - she has spent more than one sleepless night thinking about the mothers and children in our project. I, in turn, felt about the same as I do most of the time lately - a little numb and a lot overwhelmed. I have come to measure unexpected events by the amount of additional work they create. The death of a child rightly requires a quick investigation and detailed reporting to the university ethics board. I am a bit scared that two deaths in two months will invite criticism of our program. I wish I just felt more compassion.
Evena was a very special child. She was her mother's only daughter. Her brothers are much older - 13 and 16 years old. I get the impression that Evena was an unexpected but very welcome gift for her mother - a gift she was not ready to give back to Bondye. If Evena was with her today, I imagine that our little space would have still felt like home.
The Big ONE!
After a very long feeling two weeks with little to no internet access I'm finally back online! To celebrate I thought I'd share some photos from Monday's 1st Birthday party for our first cohort of 7 kids to finish the manba intervention (we started with 8 but 1 dropped out). It was a full-on Haitian celebration with speeches, songs, gifts and food. Check out the photos here.
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