November 13, 2008

Mornings are starting to feel like the perpetual first day of school. Light nerves wind themselves around our stomach with the anticipation of what the day might hold.

Today, I felt more relaxed in clinic. Maybe I did because the first patient of the day, an adult, allowed me to deliver a bug from her ear. It took some doing. Madam Fano and I lavaged and tweezed and finally the bug was evacuated from the ear canal. We did a little happy dance, big smiles all around. I felt like I FINALLY did something for a patient while she sat in my office. Instant gratification. It was a great way to kick off the clinic day. And by the end of the day, I had retrieved a second wee bug from a student’s ear. Now I’m on a roll. Makes me want to sleep with cotton balls in my ears.

Today I saw 3rd and 4th graders, ages 8 to 11. Although the complaints still weren’t far from the standard, the children seemed sturdier, less fragile. Most had some of the telltale signs of anemia and malnutrition, but somehow they had little by little made it this far and it gave me a little more confidence and hope. The children took part, this time, in the sharing of their symptoms, and I trusted their reassurances that “no, it doesn’t hurt.”

The teachers have started working themselves in for consultation as well. One sat in front of me with a swollen thyroid and a racing heart. She seemed calm, and her complaint was “body aches.” I discussed my concern about her thyroid and the need for a prompt work-up. She seemed agreeable. I hope she is able to follow through.

I always wonder about the lives and the homes of the teachers and staff at the school. Yesterday, Patrick and I randomly stumbled upon the home of one of the cooks in the guesthouse. It was a small, two-room cinder block building, the entire size of it smaller than most American bed-rooms. A little shelter outside was used as the kitchen, and a latrine was on the other side of the house. It was made of concrete, had a roof and a door; compared to most Haitians homes, the house was a step up. But the size of it shook me a bit. Both she and her husband have stable jobs and work everyday. I assumed that the family would be able to afford a little more sophisticated living. But when we stopped by, her two children were sitting around the yard in plain clothes during school hours. I wondered why her children weren’t in school. If a family with two working adults can’t afford to send their children to school, or live in a simple home, then there is something terribly wrong. They were rich by Haitian standards: employed, fed, and had a home that wouldn’t blow away with a strong gust of wind. But still, basic needs were still out of reach.

After clinic today, I took a walk behind the school through a lot of land that CONASPEH is hoping to purchase. I needed to escape the clinic a bit; it seems the minute I stop seeing patients, stop seeing the smiles and the big brown eyes, my heart sinks. My frustrations and doubts surrounding feelings of jumping in before I am ready flood my mind and heart. My yearnings for a mentor take over my thoughts, and I am haunted by children I saw earlier in the week—wondering if I failed them, wondering if their parents will ever get them the much needed exams, wondering if I will interpret the results right if they ever bring them back. I fear I am not giving any real much-needed health care, not doing my job well.

The lot is full of trees, shady, and refuge to many goats, several pigs and chickens. Like most of Haiti, the yard is littered with trash; the animals nose through the piles looking for treasures. But the shade is a welcome treat, and the area sheltered from the coughing fumes of the traffic on the street.

A little old man lives in a lean-to in a corner of the lot. I discovered him by surprise. He was sitting on a chair outside his tin shelter, naked in the sun, washing himself quietly using a bucket of water. He didn’t seem at all bothered by the path that passed by his humble home that carried a constant stream of children and adults walking two and from the street. And none of the passerby’s seemed to even notice his nakedness. He went about his washing, finished, and slowly dressed his thin, frail body. He was forced to share such an intimate ritual with the all who passed by. I assume it’s the same for many. The fact that he was not a spectacle, not even noteworthy to the other people passing through the lot spoke that privacy is not a luxury many have here.

His lean-to was tiny; I doubted there was enough room for him to even stretch out at night on the earthen floor. And I wondered if he had any family, a wife, children who looked after him. By his extreme thinness, I concluded that food was scarce. His existence is stationed across the wall from a school, filled with the sounds of children laughing and chanting and playing in the yard. I wondered if the sounds of the children bring him happiness. I wondered if he watches over the animals happily lounging under the trees. I wondered how he’s survived this long, and what kind of stories must fill his life.

I am continually amazed at the strength of the people here. The children are particularly awe-inspiring. Today I needed to check the blood sugar of a little girl. She patiently let me prepare her fingertip, and pulled away slightly after the poke of the needle. She let me take back her hand and retrieve the drop of blood I needed. But the machine malfunctioned. My heart sank. When I grabbed another finger, she quietly shook her head no, but allowed me to take her finger. No crying out, no twisting away from me. Her resigned nature made the whole tortuous process even harder to bear. At the end of two pokes, two band-aids and a kiss on each finger, she smiled at me. I was forgiven so quickly. The children all have to put up so much, and they do so quietly, patiently, with more strength than I have in my big toe. At the end of the day, when I crumble. I try to think of those children. Those children who don’t dwell on the pain, but smile moments after a poke. Children who sit quietly in class with hunger eating at their tummies. If they can do it, certainly I can find strength somewhere. Certainly I can figure out how to make their lives a little healthier. This is my commission, and today I found a mentor, with braids tied in blue ribbon, knobby little knees and a bright toothy smiley.