November 14, 2008

Oh the power of ice cream. Do not underestimate it. It is a divine gift. Tonight ice cream brought Patrick and I from the brink of near retreat to hope. We've taken notice lately that our English-Creole dictionary lacks translations for such words as "delicious," "fantastic," and "wonderful." I think if ice cream were more readily available to the Haitian public, such words would emerge. There are only so many expletives to describes beans.

Although trying not to indulge our every craving, Patrick and I have dreamed about a tad bit of ice cream to lighten our mood over the last two weeks. We were about to concede that God did not want us to have the cold, sweet delight since each of our ventures to obtain it has left us short handed.

Our first attempt was last Friday. We have designated Friday night as date night. You may remember our venture up to the infamous Baptist mission last week for burgers and ice cream, only to arrive minutes after closing, having to head home through crawling traffic with smoking breaks, and much more wound-up than relaxed at the end of it all. This afternoon, we ventured back up the mountain again for a similar purpose, starting out a little earlier. We stopped first to check for mail, and then the car wouldn’t start. (a story in itself… see below). When finally arriving to the guest house, we decided after dinner we’d walk to the ice-cream store we found randomly when lost in the neighborhood. By the time we arrived, closed. –sigh-- It was clearly not meant to be.

The walk through the neighborhood was well worth the venture. Although we hesitate to go out after dark, early dusk seemed safe enough. The streets were still bustling with people who seemed unaware that night had fallen. We headed out after dinner and around the corner. The local market opened up before us. As the sky faded from pink to dark blue to black, one-by-once candles flickered to life on the little vendor stands that decorated the sidewalks. Women selling soap and toiletries had their basket of goods illuminated with a single candle. Others selling fruits, vegetables, and sweets had their own tiny light. The street scene quickly was twinkling with candle light, reminding me of midnight Christmas Eve service in my hometown. It was beautiful. And instead of feeling scary, the early darkness and the people buzzing about felt intimate, safe, alive. The trash was erased by darkness. The dirt and pollution and breaks in the concrete concealed. Only softly lit faces, illuminated by warm, flickering candlelight arose out of the darkness. The soft rumble of conversation filled the air, activity buzzed all about. The evening was dressed in a soft glow. A beautiful walk.

Nearly home after returning from Strike 3 in our search for ice cream, we happened upon a little family grocery. There, they sold all the basic necessities INCLUDING little 8oz cups of homemade ice cream. We happily bought the treasure, we learned the Creole word for our purchases from the friendly shop keeper, and declared this our favorite market in Port Au Prince to the check out girl (better than Deli Mart!!!) who beamed and thanked us out the door. It was a gem of a find. Date night was saved.

Patrick and I just returned from happy time spent together spooning in deliciously sweet ice cream, toasting to hope in tomorrow while perched on the guest house roof. We spent hours letting go of the built-up sorrow and stress, frustration and helplessness that had compiled over the week. We found our laughter.

I am incredibly lucky to have a partner in Patrick. And although its only been over 2 weeks, being here together has already matured our relationship. Patrick and I had lived such independent lives for most of our courtship and marriage. It worked for us, it was healthy. Here, in two weeks, I've recognized my utter dependence on him. He has become the bulk of my support system, the person I vent to who understands what my heart is going though, what my eyes sees, what my desire hopes for. The dependence on him feels a little strange for me, but necessary. I got scared this week, with his fever. My brain told me he was ok, that it was just a cold. But my heart feared for the worse. What if it was malaria and I was ignoring the presenting signs? I didn’t know where the hospital was to take him if he got worse over night. My dependence on him has always been there, but it is illuminated here, clear, stark. When he was sick at home and I was at work, I felt unsettled all day, worried about him, felt disconnected. We’ve always gone about our own business, traveled independently, lived separately without a second thought. But in Haiti, its different. All that I love about him is enhanced. His easy manner, his calm under pressure, his sense of humor, his passion for justice, his perspective, his sensitivity and ability to see through another’s eyes; all are brought out in technicolor here.

The week has been hairy. There were many moments when Patrick and I looked at each other and wondered what on earth we were doing here. The need too great, the task too large, the country too foreign, the ways too different.

Patrick has been struggling with a cough, congestion and weakness all week; he's tired of feeling poorly in a city that doesn't nurture health well. When at school, he is feeling his way into his role there. He was arbitrarily declared Dean of the Seminary, but isn't sure how to go about his Deanship. Speaking theology is well out of the realm of our survival Creole at this point, and so he paces the office, focusing on helping the kids with their English lessons, teaching when needed, and trying to find perspective on these first three learning months here.

In clinic today, my first patient was a woman from the community. Half of her jaw was completely swollen and deformed with a purulent infection; scabs had feebly crusted where infection had seeped, and she was clearly in pain. She'd had the "inflammation" for 7 months. I wanted to drain the infection, but I had neither the tools nor the hygienic clinic to do so safely. I wanted to put her on antibiotics, but she could not afford them. She was the face of agony, the face of need. And I had to look at her with nothing to offer. I suggested warm packs, gave her ibuprofen, asked her to come back next week to see if we could milk some of the infection to the surface where I could more safely drain it. I had to retreat half way through our session to dash into the office where Patrick was studying in order to regain composure. Tears of helplessness and anger were hard to reign in. It was so unfair, so unjust. This woman needed care, and she had no access.

The next woman showed me a large mast in her breast. She noticed it 9 months ago. She was only 26. I urged her that it was important to seek out the referral to the surgeon that I recommended, but her downward gaze indicated that this was not in her cards. Her father was a pastor. She would pray about it.

Again the children filed in. Same complaints. Tummy’s hurt. I’ve learned to ask if pain is better with food. Usually, yes, these growing children experience hunger pains. Two meager meals a day is not enough. How do I tell the gaunt parents that look at me for advice that really, all their children need is good, frequent nutrition? With it they will no longer cry at night. If only it were that easy.

I barely got through the clinic day. My perspective was shot. If it weren’t for the love of children, the beautiful smiles, the giggles, the hugs they eagerly give, I would have thrown in the towel and called surrender.

In the U.S., I had adopted a healthy attitude about disease, death and dying. In the States, people usually die because of poor life decisions, the inevitability of disease progression, or tragedy. But even the poor, if they show up to the ER, usually get medicine’s best fighting chance. In Haiti, that’s not the case. Medicine can’t begin to fight for the people here because of the severe barriers to access. And when I look at the women, children, young men that should NOT have to suffer with no hope, should NOT be malnourished, should NOT be wasting away before my eyes I want to scream at the injustice at it all. The woman with the infected jaw should be able to be on antibiotics, should get a surgical debridement, should be able to move on with her life and continue to care for her 4 children pain and infection free. The woman with the breast mass should at least be able to get it evaluated, diagnosed, and receive a prognosis. Children should be able to go to the lab, no questions asked, to find out what specifically is causing their wasting, their anemia. Doctors should be able to use diagnostics to gleen enough information to treat well, specifically and with chance of the least harm. Students should not have to sit in class fighting pain caused by hunger. But the world is not just.

After clinic, I found Patrick in the yard with the kids. He had hung a basketball net he brought from the States, and the children were eagerly taking advantage of the new accessory. The balls in the school were flat from overuse and tears. Instead the kids shot empty plastic Coke bottles into the hoop, laughing and passing the bottles between each other. Basketbottle. They make lemonaid out of lemons so creatively here.

We fled the school in order to escape to the mountain. We planned to check for mail, and then meander up the mountain to indulge in some fresh air and possibly a milk shake. We arrived to our mail office with only a few detours, checked the mail, hopped back into the car ready to go in search of something tasty, turned the key in the ignition and nothing. Really? Didn't we do this already? So we popped the hood, found a rock and started banging on the connection to the battery as we'd seen done by our Haitian teachers. At least the engine groaned a little when we attempted to start it, but no roar to life. Soon, street children were congregating all around us watching us bang, sweat, look for a bigger rock, wiggle wires and kick the dirt. We of course had parked next to a spot that many a man had peed on, and the smell of hot urine in the afternoon heat was nauseating. If only Scottie could have beamed me up at that point, I would have hopped the first spaceship out of that moment. The street children inched closer until all were bent with us under the hood, sticking fingers here and there, offering their advice. One found a tool and tightened some lug nuts for us. I started to fret: "PLEASE don't stick your fingers there! ATENSYON!!! Be careful!!!" The children smiled at me, humoring my fussing over their welfare. We finally threw in the towel and called Patrick and Francois when our best rock banging wasn't winning us a happy car.

Poor Patrick and Francois--having to bail us out yet again. I'm sure they are tired us troublemakers already, but they never show it. They raced up the mountain to our rescue.

So we waited. The street children circled us, introducing themselves, asking us questions, some practiced their English. One told us that he was a singer, but he loved rap. He performed for us a few of his favorite songs. Another spoke pretty good English that he proudly told us he taught himself; he'd never been to school. Eventually one declared that we should give them each $6. And really, why shouldn't we? We are in constant battle with our pocketbooks and our hearts here. But everyone needs money, and Francois has warned that we put ourselves in danger, at risk by doling out money to anyone who asks. So Patrick gently told the kids that we work here for free, and that we couldn't give them the money. They took the news without so much as a blink, and continued on with conversation.

One of the kids had an ugly gash in his finger, so instead of money, I gave his finger a little TLC. I pulled out my medicine bag and busied myself cleaning the wound, putting some antibiotic ointment and wrapping it in a band aid. Suddenly pant legs were being raised, boo-boos were being exposed. Everyone wanted a little street-side triage. So I went from kid to kid smearing on cream to well-healed scars, putting band aids on scratches. When I left, the kid who had asked for money had a band aid stuck in the center of his forehead covering completely healthy skin; he was all smiles. Pulling away from the curb after Francois and Patrick arrived, I felt strangely connected to those kids, happy for the encounter, glad to have found a way to care for them in a very tiny way.

Patrick Villier had got the car started. Voodoo? Maybe. I'm convinced HE has magic fingers. He actually popped the clutch and got the engine roaring to life. Patrick didn't want to attempt such a task as it would have been his first time, and we were precariously parked on a very steep incline. He didn't want to risk slipping the car into neutral, letting it roll down the hill gaining momentum, inevitably flattening passersby and wrecking the car if his coordination wasn't perfect. So we let Patrick perform his magic and no one got hurt. :)

Another crazy Haitian day. But we could do nothing else but laugh down the hill. We'd already cried going up it. To fuel our laughter, we beheld a motorcycle gang that passed us heading up to Petionville. A motorcycle gang? Here? Most looked very similar to the Hells Angels, but less facial hair. They wore all the leather trappings and were sweating profusely. A lot of big bellied white guys were mixed into the bunch, some looked more Latino or from the Dominican Republic. They created quite a spectacle with their roaring engines and serious scowls. I wondered what the occasion was to bring this international mix of Hog riders. Haitian Sturgis? We got the giggles. You never know what you'll see on the streets of Port Au Prince.

So our night was ultimately salvaged thanks to a corner store tucked away in our neighborhood and time carved out to let the heat and exhaustion of the week evaporate into the night air. We found our smiles, and retrieved our hope with the help of some cold, creamy deliciousness tonight.

The week has been nothing less than eye-opening. I think, despite realizing that I jumped in too quick, that I needed the insight that this week provided. I needed to know the complaints of the children, the suffering of the community, their perception of their health. I needed to recognize barriers to care, the capacity of the clinic, and the perception of CONASPEH towards the clinic’s abilities. With my new information, I hope to be able to step back, re-evaluate, and propose a plan of action that can better lives instead of placating complaints. I hope that my presence can be one that brings justice and health, and not just a smile and a handshake. I hope to weave my own gifts in with those of my coworkers to create something good, healthier children, a place where health can be taught and care can be provided. This is my dream. The specifics are still in the making.