Pocket Change

Last Thursday Miss Fanor and I headed out on or first Mobile Clinic as a team of two. We drove outside the city to a tiny and very poor town along a busy stretch of road. As has become custom, we walked into a church that had transformed into a makeshift clinic. The pastor had arranged for a bed to be brought in, sheets hung for privacy, desks set up for consultation and for a pharmacy as well as chairs lined up for waiting. As we unpacked our supplies, members of the community slowly filtered in.

During the day we saw patients young and hold, relatively healthy and those near death. One such sickly man was our second patient of the day. He came shuffling up to my desk, skin stretched taught over bones, a hollow look in his eyes. He had all the signs of immunodeficiency without an official diagnosis: extreme weight loss, oral thrush, many fungal and bacterial skin rashes, shingles, a chronic cough and persistent nagging fever. He had spent most of his life in the Dominican Republic working, but had come home to live with his sister when he got sick. After examining him, I told him of my fears about his health. He pretended not to know, but there was no surprise that danced across his face. Instead, a quiet resolve was all I could read in his eyes leading me to believe he suspected more about what was causing his decline than he admitted. Often I’ve found that people usually know when they are dying.

We made a plan for him to go for diagnostics at GHESKIO, the local research center that does a lot of work with HIV and TB. I sent him home with some medicines to help treat his symptoms, but our little pharmacy is nowhere nearly capable of bringing him back to full health at this point.

After he staggered away, Miss Fanor came up to me and asked if I had another thermometer. I did, and handed it to her, confused. She wanted a replacement since the (presumed) HIV patient had used it.

Inside I fumed. I made a mental note to have a little educational talk with her after clinic.

On the ride home, Miss Fanor beat me to the punch. "That man has AIDS. You knew it, I knew it, and everyone in the room knew it. There was whispering, gossiping already going on. The people were watching our every move. I needed to change thermometers so they wouldn't be scared to get care because they all don’t yet understand how the disease is transferred. There is still a lot of ignorance." Once again, Miss Fanor proved to me her infinite wisdom and insider-knowledge that helps me stay afloat in a community where I’m still in many ways just getting my feet wet. My annoyance dissolved into gratitude for having such an observant and capable teammate.

The last patient of our mobile clinic day was similarly dramatic. After strings of children with runny noses, coughs and symptoms of poor nutrition, old men with "acid" and "gas" and women with headaches and back pain, a pregnant woman sat down before me. She was 43 years old and on her 11th pregnancy. She came to see me because of a headache, back pain and stomach upset. I looked at this woman who was 9 months pregnant with 10 kids at home, and was not surprised to see immense fatigue in her eyes. Her husband accompanied her looking equally as tired. I started with my history and evaluation, noting that her blood pressure was sky high--a very ominous sign in the end of pregnancy, worrisome for preeclampsia. My exam showed a kicking and active baby, but her stomach was sore in all the wrong places, and given her headache, red flags started waving in my mind. I discussed that I wanted them to immediately travel the short distance into town to the free maternity hospital to get evaluated. I discussed my concern honestly and frankly in hopes that I could convey this was a matter to be taken seriously. We could even find a ride if needed.

The husband--clearly concerned about his wife-- let his eyes fall to the floor in apparent embarrassment as he said, "tomorrow we'll go, if God wants." When I pressed him that tomorrow might be waiting too long, he informed me that his brother had recently been in a motorcycle accident and was in the city’s general hospital. The family was pooling all their resources to get him the care he needed, and there was nothing left, no money. Pockets were empty, and those who weren’t helping at the hospital were trying to work to make up for the funds lost; no one was available to help get them in to town, much less watch over their house full of children. He needed his wife to help at home. While trying to come up with strong, calm, diplomatic words in Creole to persuade him otherwise, I thought of the looming disaster in this man’s life if his wife’s symptoms turned into a worse-case-scenario in their home in the middle of the night. What would this man do if suddenly left without his partner to raise 10 kids by himself?

We slipped the couple a little tap-tap money hoping they'd use it for a ride into town. I instructed the mother that under no circumstances was she to work or to walk; if she insisted on returning home, she needed to be lying down. She looked at me like I was an alien, but mouthed agreement.

They left our clinic hand in hand. I could only hope they took to heart what I was trying to convey, were convinced that maybe this blan doctor venturing out to the countryside was there to help and knew a thing or two. I now can only pray she has had the baby by this time and both are well.

Today in the CONASPEH clinic, a couple of patients from our mobile clinic came in with their pastor for follow up visits. The walking skeleton-of-a-man was one of the faces waiting on my bench. He had come in to see if there was anything that we could do to help him, for he had nothing, nothing to buy food, nothing to buy a tap-tap ride to the hospital, absolutely nothing.

In general we don't give money to people. It is not our role, nor the best way to empower people, and there are those that argue hand-outs encourage dependency. But some days it is impossible to look death and suffering in the eye without offering at very least the change you have in your pocket if it can offer a little hope. And for an unprecedented second time in a week, Miss Fanor and I reached into our pockets. After consultation with Francois, we three females decided that we'd offer this gentle man enough money to send him to a special hospital for patients with HIV and AIDS where he'd receive not only HIV medicines, but food, potentially a job when he was strong enough, and a heaping plate full of hope. When we slipped him the envelop with hushed whispers, his eyes gleamed. He started to cry. He wrapped his bony arms around our necks and whispered a choked thank you.

Tonight I have new patients to pray for. I pray for the woman who was anticipating birthing a new life amid a clinically dangerous, life-threatening circumstance. I pray that her husband isn't now left alone with no one to help raise his huge family. I pray that the man with hollow eyes finds his way, pray that at the very least he finds comfort in his final days of life. For all I pray that its not too late, that just this once or twice, pocket change can make a difference.

Church in Lebou

*View of church*

This morning we were guests at a church in a very poor neighborhood outside of town. The building was designed by a network of wooden poles and billowing, patchwork walls of plastic and cloth creating a tent-like atmosphere. Unlike in more sturdy, concrete churches, light illuminated the walls and a breeze danced through the space. The poorest of churches seem to have the warmest of hospitality. I sat in the women-with-children section and soon had several rows full of new acquaintances who were more than happy to help me take care of my overly energetic 10-month-old as he walked from pew to pew, balancing on strangers knees, holding all sorts of hands, and being scolded by many a concerned face as he tried to put rocks in his mouth. The church was as ragged as we've seen, but full of spirit and fresh air.
*Childcare help from the community*

I have to admit, I love my new "mom" status that allows me a realistic excuse not to sit up front and center, but in the pews with the people (usually toward the back in case a quick escape for an emergency diaper change is needed). In this new vantage point, I'm allowed quick bonds of friendship with the people of the church, and I relish that. I can't tell you how quickly the status of "mom" takes me into relationships with women here. I have somehow passed a test and am admitted into a warm community of women who take care of each other's children, have incredible patience with baby-antics, and delight in the silly thinks our kids do.

Today is my birthday, and Patrick leaked the news to the preacher. As my cheeks blazed red (heat or embarrassment? hmmm probably a combo), the entire church sang me the "happy birthday" song, first in French, and then in staggering English that sounded a lot like, "hoppy berf-day to yoooouuu." It was great and loving and energetic. I was newly amazed at how quickly a church we've never been to before can feel like our own community church in a single visit, such is the hospitality and welcome here.
*Paying attention to the sermon, Soloman?*

Patrick preached on the palpable spirit of worship found as the people in Haiti lift up their voices in song. He celebrated all that we have come to love about the people and the spirit of this country. His message evolved into what the Haitian people have taught us about our call to be the mind of Jesus, to walk as Jesus walked.

I greeted the congregation giving them a little ditty about Sol and about our work in Haiti. Curiosity and whispers are easier dispelled when we can explain to a group at large how Solomon came into our lives. We've heard (usually amongst children) whispers debating whether Solomon is really our biological child and he just looks like a Haitian because he was born in Haiti. I like this rumor.
*Post-church consultation*

After church I had a mobile consultation time. Sundays I offer a session after church if requested by the pastor to simply be available to answer medical questions, do quick exams and write prescriptions if indicated. No meds are passed out, no money exchanged. It is instead a time where I can offer a little education, push some to seek a further medical evaluation and reassure others. The time has proven to help introduce communities to the CONASPEH clinic, and some of my "regulars" there came after we met in church. These sessions, however, are always potential minefields if the pastor doesn't do a good job of educating the congregation about the nature of the consultation and what was being offered. But this pastor was well informed and did a beautiful job.
*Patiently waiting a clinical exam*

I saw what felt like the entire congregation, but in a quick and efficient way... mostly giving advice, reassurance, writing a few prescriptions and recommending several follow-ups in the CONASPEH clinic. It was a happy morning. Hot, but happy. The pastor was pleased, and scheduled a mobile weekday clinic for later in October.

While I was seeing patients, Patrick started up some games with the neighborhood kids to pass a breezy Sunday afternoon. *Patrick starts ball game with neighborhood children*

*jump ball!*

The kids in the zone we visited don't have much for toys, so the beautiful orange basketball in our car caused quite a ruckus. Always up for a little pick-up game, Patrick had fun letting the children toss and kick and bounce the ball around a field next to the church. He's a favorite with the kids here with his relaxed style, expressive face and easy laugh. And true to form, by the end of the day, mothers were bringing their babies for him to play and hold.

*Patrick loving on the kids*

Now I'm settling into a lazy Sunday (birthday) afternoon. Patrick is off running errands. Sol is sleeping soundly--an early afternoon nap after entertaining the entire church sans lunch or milk all morning long. He was exhausted, hungry and grumpy when we got home, but after water and food he sleeps soundly giving mommy some down time to. Thanks baby boy.

I wasn't sure what to anticipate on my first birthday in Haiti. Wanted to treat it like any other day, fearing that homesickness might sink its teeth into my celebration. However, I was pleasantly surprised how "at home" I felt today in a church of sticks and cloth panels, in a congregation of folks with worn shoes and warm faces.

My brother, sister-in-law and nephews Skyped this morning and sang me happy birthday over a plate of candle-adorned cupcakes they had made for my special day (if only skype could share tastes too, it would be a near-perfect world!). After leaving church, my voicemail was filled with "happy birthday" songs sung by family and friends. Thanks to modern communication, the world shrinks a little when you need it, bringing loved voices to your ear, precious faces to see and talk to. Tonight Patrick is making a special dinner, Solomon will provide our nightly entertainment, and I will sink into that special feeling of being happy exactly where I am.

Creative Engineering

I could have sworn “put metal things in light sockets” was on the NOT To Do list, but maybe I am confused.

We’ve had some electricity challenges as of late. Per report from our twitchy landlord, we fell victim to some “bad electricity” which apparently fried a couple of vital parts on our new inverter. So the inverter is in the shop, and this little gizmo is connecting our apartment to our landlord’s power source. Voila.

I just hope Solomon is too young to learn this trick. And Patrick.

Bravery in Small Packages

By the time I arrived at CONASPEH this morning, the clinic bench was full. I'm starting to recognize faces as they come back promptly for follow-ups. The woman with unrelenting hypertension was back with eyes hopeful I wouldn't stock her purse with new fists full of pills. The young man with alcoholic hepatitis voiced concern over a new bout of stomach pain. A little girl who had suffered a nasty scalp infection showed me her new hair growing in with a toothy smile. Fresh faces introduced themselves to me through the course of a busy morning including a newly pregnant woman who hopes to get part of her prenatal care through our simple clinic.

The atmosphere of the clinic is now charged with the sounds of the CONASPEH school in full swing. Class songs, lessons chanted and the shrieks and laugher of students serve as happy background music to a clinic day. Folks from the community saunter in with their urgent and chronic issues while kids from the school wander down with headaches, tummy pains, bumps and bruises. Pastors coming in for a CONASPEH meeting greet me through the open window. My 88 year-old "VIP" patient who sees me every 2 weeks came by today just for a kiss on the cheek and a hug, calling me "petit mwen" (my child) and reminding me that she prays for me every day. Even the teenagers, who gave us a run for our money last year as they tested us for cool points, seem to be a bit more respectful and friendly (although the year is still fresh and new).

The bravery award of the day goes to my 9 year-old friend Jean. While running an errand up to one of the classrooms, I was distracted by Jean calling to me from his desk. He declared matter of factly, "I have a cut." Jean is well known to me, frequenting the clinic for a little conversation, a drive-by English lesson or a hug. I breezed in thinking it was just another call for attention, but when he uncovered a filleted palm, I gasped and dragged his scrawny legs down to the clinic for a proper inspection.

He'd cut open his palm on a broken bottle no less than a week and a half ago. After bravely sitting and allowing me clean and inspect the wound without so much as a peep, I discovered that the slowly healing laceration went all the way down to the muscle. Yet not so much as a Band-Aid had covered it all this time. The real miracle was that it didn't appear to be infected, despite lack of stitches and the exposure entailed in a little boy's life.

Patrick and I arrived home this afternoon to a jovial Silvia and her daughter. I imagine its fun for them to spend the day together after a long time of living apart. They described to us the silly things Solomon did today, gave me feedback on what they thought of my leftovers (I'm not so sure they are recommending me as chef of the year), and insisted on fixing Patrick and I a late lunch treat (maybe to show me what food is SUPPOSED to taste like?). While Silvia proudly stood by, her daughter whipped up plantains and eggs with a side salad, and topped it off with grenadine and lime juice. She laid out a place for us at the table, and served the juice in wine glasses. I felt like a guest in my own house! We shared a Haitian treat together, chatting over the yummy food at our tiny wooden table reminding me of family meals around the round table on my parent's farm.

Now the thunder clouds are rolling in this evening, showering the neighborhood with a gentle mist of rain. Patrick is off to the gym and Solomon sits with me munching a cracker and spackling his face and hair and arms and shirt and MY shirt with the shrapnel of soggy brown goo. "AHHH!" he squawks, grinning and flashing me his new exaggerated BLINK. We just finished Skyping Nana where Solomon clapped in time to her "patty cake" song. I can't help but laugh at our silly boy as I wait for the cool air that follows the rain to breeze in the window and get us settled for evening.

A good day-in-the-life. And now I wish you a good night.

Looking Again

Despite just shy of a year living in Haiti, Patrick and I are constant observers to all we are immersed in. But once in a while we have to remind ourselves to look again, to see anew the vibrant activity of the life around us.

A friend of mine recently moved to the UK with her family for several months. Although the daily routine of life with two small children in essence was similar to days at home (waking, snuggling, playing, naps, snacks, meals, bath time) she was able to look at her life, at her family with new eyes, with renewed wonder as they explored a strange and wonderful neighborhood and foreign surroundings. I think that spells the magic of travel, that same magic that inspires Patrick and I to risk living in a place like Port-au-Prince. Stepping out of your comfort zone allows you view everything creating your environment intently and with wonder. Focus settles on self as well--dissecting, celebrating, challenging, questioning, discovering that which makes you (or your loved ones) tick. Even home can be appreciated in a different light, with a new bird's eye view. The art of living becomes fresh, vibrant, intense and intentional.

Yet as time passes and the routes we take to work look more familiar, the faces recognizable, the routine, well ROUTINE, I have to kick myself now and again to take note, to continue the active observation, to not let where we live, what we see become commonplace in a place that is anything BUT common.

Today's quiet clinic allowed me a few hours to run downtown to buy some materials for the CONASPEH lab on my own. We have found a technician willing to essentially volunteer her time as we get a stationary and mobile lab underway. I had a shopping list of stains and solutions to buy, so when a free moment presented itself, I had to jump! I didn't know exactly where I was going to find the lab supplier, but at this point in the game, I felt pretty sure that if I asked enough people, I'd find my way.

Since I'm not often in the car by myself, I had some time to reflect. Port-au-Prince is a place that inspires frustration and awe, revulsion and respect, shock and amazement, sorrow, hilarity and joy--sometimes all in one vista. Yet after all this time it is a place where I find comfort and pleasure in the chaos and teeming life all around me. Although it in no way feels yet like "my town," it is a city that finally feels familiar. In fact, I started to smile thinking of all the things I see a version of every day that, if I'm not careful, I get too accustomed to seeing.

Barnyard animals mingle with foot traffic in neighborhoods, sans gate, corral or coop. Graffiti paints walls with political slogans or tributes to Aristide or (most recently) Michael Jackson. Children in dirty t-shirts and bare feet huddle along a median in the road, playing cards or wiping down cars for change. A passerby lifts his shirt, shows me a cut on his stomach and asks for $1 to help fix it. Buildings line every neighborhood in various stages of crumbling construction or deconstruction. Palm trees bend around giant Digicel billboards. Roads wind up and around steep mountain inclines and through neighborhoods stacked like blocks, one building shouldering the other. Sidewalks bustle with faces of every age, wearing all colors of the rainbow, and sporting T-shirts with bizarre American slogans or catch phases that read ridiculous in context. Vendors crowd every corner and alley selling every thing from livestock, garden produce to canned and packaged non-perishables. If I pull up to a curb and ask for directions, someone always stops what they are doing to show me the way. Fruits and vegetables of all shapes and sizes fill baskets in markets, and the selection changes as the season dictates. A kaleidoscope of colors swirl on tap-taps that wave me by, flashing their catch phrase philosophy such as "Love Eternal" or "Meci Jezi" as they pull over to a curb to pick up another passenger.

I eventually found my destination after stopping and asking, turning around, choosing a street, getting out to walk, discovering that suddenly the driver's side door of the Galloper refused to close, finding rope and tying it closed, recommencing walk along a crowded sidewalk, asking another woman who directed me to a man for directions, following a young boy who after introducing himself showed me his ID (?), squeezing between vendor and parked car, hopping over streams of sewage, weaving around cans piled with charcoal and saluting the saleswoman with her sooty merchandise, kicking a pop bottle, inhaling some fumes, and FINALLY doing a wee dance of joy when "PROPHOLAB" emerged from the milieu. As I approached the store hidden behind a metal barred wall, doors were opened by a gun-toting security guard who nodded a welcome as I entered.

I made my order, paid the bill and waited for the supplies to be collected. I sat and chatted a bit with one of the two security guards wielding very large shot guns, and thought--again with a smile--that even the site of men with guns in public no longer inspire a second look or a shiver down the spine. With the UN toting threatening artillery on the backs of their trucks and security guards of banks, guest houses, labs, and anywhere else packing heat to ward off potential threats, the shock value of such sights has ebbed. One of many such desensitizations following acclimation to life here.

Back to the Galloper, I didn't even curse the door hanging open-and-tied ajar. I was just grateful that no passing opportunist attempted to break in and clean out its contents. I'm guessing that the Galloper had heard through the grape vine that Global Ministries has finally raised the money to buy CONASPEH a new vehicle for outreach and projects, so she will be sold for glue soon. I could hardly blame her for throwing another trick at us in her final days as we dream of brighter, shinier, less clickity-clackety wheels. So with one arm holding the door closed, and the other taking care of wheel, then shift, then wheel again, I navigated the creaky, clunky beast back into traffic with a smile on my face. Of course a million and two people pointed out that "Miss, your door isn't shut," (in case I or my fatiguing biceps hadn't noticed). One man offered to help me fix it as we drove in parallel down the street. Maybe later, I told him and waved with my pinky goodbye.

After returning home today, Patrick and I greeted Silvia who has returned to "light duty" around our house. I'm so thrilled she is back, although scold her to take it easy and let Solomon crawl to HER. She insists on bringing along her daughter to do the laundry while she tends to Solomon. Despite us reassuring her that sick days were ok to take for as long as she needs them, she wasn't having it. I have to say I'm impressed with her daughter. She dropped whatever routine that normally comprised her days we to take over and help her mom. I smiled thinking if OUR sick days functioned similarly in the States. I'm not sure the Nebraska school system would be overjoyed for substitute KIM in for an English lecture. I know for sure my dad would raise straight out of his sick bed to protect his way of life from me "helping" by such methods as cruising the farm in his large Case tractor and potentially taking down another electric fence OR tending to the livestock just long enough to form an emotional attachment to little Bessie who happened to be next in line for the slaughter, thereby making his life as a practical farmer and businessman more difficult 'cause his daughter found a new "pet." Silvia's daughter has a warm face like her mother, an easy smile, and she moves fast. She just finished school but doesn't yet have enough money to go to university, so is sitting the year out. We've chatted about her dreams. I tried to talk her into nursing school, but she assured me that medical anything wasn't for her.

I took Silvia and her daughter home today, and stopped for a home visit with one of their elderly neighbors. She lives in the top story of a creaky, crumbly cement home, and access to her living space lead me up a treacherously steep, thin-stepped and uneven staircase. The wiry, grey-haired 76 year-old-woman woman welcomed me into her home and commenced with describing for me the aches and pains that keep her awake at night. Her husband sat listening on the balcony. He reported they'd been married for 48 years, a "long time" he said grinning. They were a delight, and I thoroughly enjoyed doing a little clinical exam for my new cheerful and feisty patient. She proudly related that she'd had 10 children, and lived with one man all her life. I thought (and commented) how remarkable I found their marriage. Elderly people are a minority in Haiti, but elderly COUPLES, well, I just don't see them! For both to survive illness, poverty, a tumultuous political climate, and to have stayed married through it all... well that's worth celebrating! After creating a little therapeutic plan for my new patient, they both thanked me generously, and the woman escorted me down the mountain-hike of a staircase (sans hand rail!). Despite low back pains and creaky knees, she navigated the cement grade like a nimble mountain goat, flashing me smiles all the way down. "I'm scared" I said (partially joking), so she held my hand as we descended together. The community, now gathered in interest of a blan in their midst, waved me goodbye as I not so gracefully "trotted" into the distance yaw-yawing the galloper to lurch on as I steadied the door from flying open and navigated back along rutted, cratered, twisty-turny neighborhood roads.

Today was one of those days that I was entertained by it all. The work, the roads, the situational comedy, the bravery, the community, the hodge-podge and calamity, the chaos and the joy. Nice to see it, once again, with eyes wide-open in wonder at the adventure of it all.

Grippe

The flu season is officially upon us.

I laugh now remembering how I naïvely let a silly thought traverse my head earlier this summer, "I bet I'll miss the cough and cold season this year since there is no COLD in Haiti!" Oh no. Haiti may not usher in spring, summer, winter and fall, but it boasts its hot-and-dry and hot-and-rainy seasons which hosts a wealth of allergens, mosquito vectors and weather pattern shifts, thus serving to efficiently weaken folks' defenses to the change in the season all the same.

Yesterday's clinic in Carrefour was staggering. Earlier this summer I actually complained that I was making the hour drive all for naught when only a few patients showed up to clinic. Now, I'm begging for reinforcements. Today I saw over 35 patients in the span of 5 hours. I don't mind being busy and actually like the steady stream of faces, but when mid-day comes and the sun pounds down from directly overhead transforming all tin and concrete buildings into large, highly efficient microwave ovens, I get a little antsy. Claustrophobic. Down right cooked-in-my-skin hot and dehydrated. So it was a long day.

Yesterday's patients ran the family practice gamut from young men blushing over their inguinal hernias to newly pregnant women anxious to hear a fetal heart beat. Children by the dozen marched in with runny noses and congested coughs following old women sporting aching joints and upset stomachs. Always among the bunch is the mother hoping that the "foreign doctor" will be able to slip her a wad of cash to buy food and medicines for her kids. And the man who lives neighboring the clinic once again offered me his infant granddaughter to take home so his family of 15 can be decreased by one hungry mouth. Counteracting such sorry-I-failed-you interactions are ones that I convince myself I'm forming a true doctor/informed-patient relationship. Mom's look hopeful when I suggest a treatment strategy and a plan for follow up, glad that they won't be left option-less if the medicines fail to cure the first go-around.

By and large, it was the "grippe" that kept us hopping today. "Grippe" is a term that describes medical diagnoses ranging from cold symptoms to flu, asthma to pneumonia. Patrick and I have had our personal dance with the Grippe as of late, and I'm telling ya, colds are no less fun in the suffocating heat. Or maybe its just the lack of a Wall-greens around the corner. Then again, we might just be feeling sorry for ourselves. In clinic, I simply attempt to not let the "grippe" hide more ominous diagnoses like Malaria, Typhoid or TB. Largely, it was a little refreshing to be able to reassure, to prescribe antihistamines and cough syrups, and catch a lung consolidation here and there. When symptoms are described as occurring in the last 2 weeks instead of 12 years, I have to smile. So often I am met with folks who sit down and give me their entire health litany as I'm the one and only doctor they've seen in the last 40 years. "Oh yes, I have had a fever before, no, not recently, but I know how it feels."

So tonight after tucking in my sneezy, achy, grippe-ridden husband and popping a few extra Vitamin C tabs, I head for bed knowing that tomorrow will be full of seasonal sneezes, snot and shortness of breath, just like any clinic in the fall-welcoming States.

But I do miss that crisp chill in the air that transforms a cup-of-soup into a steamy home remedy. We prefer more icy versions these days. :)

Too Sexy

I have no fewer than, count 'em, one... two.. THIRTEEN mosquito bites under my right arm pit. There must have been a wedding party for Mr. and Mrs Bloodsucker last night, and my pit was the most happenin' place in town (ew). Of course their cousins made stops at knee-pit, ankle, thigh and waist band as well, so Tour-de-Kim was complete to every curve and crevasse. But the pit? Really? Is Secret Ultra Dry really that delectable? It certainly didn't make the table at OUR wedding buffet (between the little smokeys and potato salad).

All this despite the fact that every night Patrick battles the flying vampires with our mosquito tennis racket (think bug zapper designed in the form of a bad-mitten racket). He can ZAP enough mosquitos in one swipe to create an orchestra of pop and crackles worthy of a 4th of July hurrah!

I'm bring sexy back. There is nothing hotter than a sweaty 30-something clawing her pits to death fighting the histamine flair of 13 inflamed bites. I think its time to dust off the Chloraquin.

No really, come to Haiti. Its lovely. But don't forget the DEET.

Emergency Call

Today was interesting, to put it blandly.

I had a nice and busy clinic this morning that was dominated by visits from little children around the community. Just as I was prescribing my last bottle of Amoxicillin, Patrick and I received a call by Molout--the teenager who works in our apartment complex-- with an anxious message to "come home quickly," because of some urgent problem. Patrick couldn't get the hyped-up teenager to clarify what exactly was wrong and thus turned to me and said, "either the pipes have broken, Silvia or maybe Solomon was in an accident or someone else in the apartment building is hurt." Are you kidding me???? (insert worry-inspired explicative here) I closed clinic, Patrick canceled his afternoon classes and we drove like bats out of hell. On the not-so-quick-thanks-to-Port-au-Princ-traffic-jams drive home, my mind was racing through the worst case scenarios, wondering what kind of trauma I'd walk into, scared to death. I admittedly had a moment when a calm came over me as I pondered, "I wonder if I will think back to this drive as the moment before it all changed." Morbid, I know. But what am I supposed to DO with such limited information???

We finally arrived home and rushed into the apartment to find Silvia sitting on the floor of the bathroom, her foot in a pool of blood, holding quiet and stoic Solomon in her arms. My son looked like a little bird concerned about his babysitter. Silvia looked relieved that help had finally arrived.

Solomon was fine. Meci Bon Dye! I would have loved for someone to have said "Solomon is ok" specifically in their "come quick" call, but I just thanked God for happy discoveries and moved on to the injured.

Silvia had been in the bathroom, slipped in some water on the floor, fell, grabbed the sink on her way down which promptly ripped out of the wall and came crashing and shattering down on her foot. The result was a hugely lacerated ankle exposing fat and nearly bone. So of course she bled like crazy which scared her as much as it hurt, I imagine.

Patrick grabbed a tranquil Solomon out of Silvia's shaking arms, and I got busy inspecting and cleaning the wound, dressing it and helping Silvia up. We got her things together, helped her hobble down the ridiculous amount of stairs we have, piled her into the car, and took off to the Doctors Without Borders Hospital around the corner which is open for minor and major traumas. They had her cleaned and stitched up in good time.

While I waited for Silvia in the waiting room, I was entertained by fellow family members-in-waiting. In true Haitian style, everyone commenced in conversation together as if we all were old friends at a bar. Today, people were sharing battle stories. One man said he had to be sewn up once without anesthesia because the hospital had run out. Another man reported he had to have 4 shots all at one time. A woman winced a reaction and stated she didn't like shots. "Oh, then you've never been sick, because when you are sick, you WANT shots." They came just short of showing each other their scars. Silvia emerged all stitched up shortly there after and I bid farewell to the war heros around me. :)

Silvia was obviously shook up. Thanks to medication donations, I was able to give her some good pain medicines since that cut is going to THROB soon. I told her not to come to work, but she insisted on sending her daughter to finish the washing and to watch Solomon for us for the rest of the week until she is back up and on her feet again. She has a beautiful family, and after I helped her hobble into her home, I felt her surrounded with love and concern. She got teary only then, probably relaxing and letting the stress of the afternoon go. After all these months, Silvia is starting to feel like our Haitian family. She takes good care of us, brings us fresh avocados and mangos from time to time, cooks up beans and rice every now and then and loves Solomon like her own family. He adores her in return. In fact, she continued to take care of Solomon this afternoon while bleeding on our floor. Last Saturday I sent her home because she had a fever (flu season is upon us here), and she worked late on Monday to make up for the work lost "because I helped her." Sick days aren't heard of here, and for us not to garnish her wages for a sick day off was sort of a surprise to her. I could see the concern in her eyes after the accident; it took some convincing that I understood it was an accident and we'd patiently wait for her to get better, no matter how long it took. Her job isn't going anywhere. She wouldn't (and couldn't) be replaced. We've come a long way together.

While Silvia and I were at the hospital, sweet Patrick, who has also been struggling with the flu, fought back dry heaves as he cleaned up the blood spill that looked sort of like a crime scene. We are hoping the landlord can replace the sink in good time since our water has been shut off and we are now hauling up water in buckets in which to bathe, and wash dishes and hands. Nothing like a cup and bucket shower. Ahhhh freshness. Like a daisy.

Ever the drama and adventure, even outside the clinic. :) But I'm happy to report tonight that all are well, safe, stitched up and in their beds.

And with a heaving sigh of relief, I bid you good night.

Family Day OUT

On our days off, Patrick and I try to muster up enough energy to avoid lounging around the house all day and instead venture out and about to explore a different part of Haiti. Getting out of the city is usually reward enough for pulling off the pajamas and packing for a day trip. Not long ago, we found the most recent Lonely Planet for Haiti and are using it to find some recommendations of hidden away finds we'd otherwise not know to stop.

Usually a day out takes us to the beach because after a long hot week, nothing sounds better than cooling off in the ocean waves. But today, we headed up the mountain for a drive, a hike, and a picnic.

We continued past our usual stopping point at the Baptist Mission, headed over the pass into Kenskoff, then followed the twisty roads to the little village of Furcy. After climbing the first pass, a whole new mountain range opened up before us, a vista of dramatic peaks and valleys for as far as our eye could see. "Mountains beyond mountains" was illustrated in a visual feast as we nudged the galloper (newly serviced) over the mountain roads. As we climbed higher, each vista seemed to be more lush, more green, more beautiful than the last. The air cooled the higher we climbed. Our sweat glands sighed with content at their first vacation in a while, and with windows down and air billowing in the galloper, all riders were happy.



For a small country, Haiti has many diverse landscapes: mountain top to ocean side, plains and valleys, lush tropical vegetation and dry desert like fields. Today's trip took us into a green and fragrant part of the country filled with small pine forests and mountainsides criss-crossed with cultivated fields clinging to steep inclines by terraces and other creative farming techiniques. Instead of land covered with colonies of cement communities, homes were hidden in groves of plantain fronds, behind trees, and in between interlaced fields. As we passed by the heavily farmed mountainsides, we watched farmers, both men and women, working the ground with hoes, a cow or pig being lead by a rope to town, little boys following their fathers down a foot path with machete in hand. As we drove further from the city, trash dissapeared from the roadside, greens deepened, the air cleared and cooled, and we all felt lighter, cleaner, refreshed.



Even the livestock looked fatter, happier, and sported a healthier sheen to their coats.

We drove through the tiny village of Furcy. Today looked like a sleepy day for the villagers. Kenskoff had a huge market day and the streets were congested with vendors and merchants selling their fruits, vegetables, grains, meat and household items. Furcy, in contrast, had empty market stalls and a few people lazing about the bigger buildings in the town. We passed famliar sights of men working on broken down trucks, women walking along the roadside with baskets of vegetables on their heads. We passed a man slaughtering a pig, a woman asleep--head in her folded arms--while tending to her refreshment stand.


After passing through Furcy, the road got more narrow and rutted, and since we'd given the Galloper more of a ride than she was in shape for, we were quick to find a place to pull over and have a picnic. Much to our good fortune, we found a large tree-lined, grassy field on the side of the road which hosted amazing vistas of surrounding peaks and valleys. Perfect.

I was elated. The peace and quiet of our magical find elevated my spirit like a fresh spring breeze after a long winter. Quiet is a luxury no one can find in the city. But here, only the sound of the wind whistling through the feather pines and the occasional crow of a rooster found our ears. We settled down for a little lunch in the grassy field. Solomon wasn't so sure at first what to do with this tickley stuff all around him. I suddenly realized with a start (and a tinge of horror) that this was Solomon's first experience with grass! He is 10 months old and is just now discovering grass for the first time. We're not in Kansas anymore!!! Tile and cement far behind us, Solomon initially sat staring at the earth and grass as if it might bite him. We giggled, reassured him, and eventually he let his curiousity win him over.


In time, he was taking to this "nature thing" as quickly as any child should. Mommy made a mental note to increase frequency of mountain drives so her child doesn't experience extreme culture shock when exploring the fields of Kansas and the hillsides of Colorado for the first time!


After a light lunch, we set out on a walk down a foot path leading from our picnic pearch. By this time, our foreign presence had been recognized, and a few locals had gathered to ask questions and show us the way. Our new friends took on the "job" of protecting our car for us as we wandered off for a little family hike.

We followed women returning from the market, carrying their purchases on their heads. I was amazed at how quickly they navigated the rutted and slick foot path we followed. True to my nature, I nearly took a few headers while skirting over rain soaked rocks and slippery slopes. Patrick, with Solomon riding Tandem in his Snuggly, watched and learned from my discovery of "slick spots."

I loved getting out in the fresh air, exploring the country side, conversing with passers by as they eyed us curiously and with big grins. A young boy wielding a machete helped show us the way to his school, his brother introduced himself in broken English and invited us into his family home. We followed him down a hill, behind a plantain grove and found a neat and tidy little yard where a blue-washed cement house stood. Two beautiful young girls were sitting on the porch and smiled at us in surprise when we came through. Greeting the mother and the father as we came in, we introduced ourselves and indicated their son had invited us. You'd have thought we were long expected guests. We all sat in the yard, talking about the kind of crops the father grew, the good work his children do for him, and the favorite foods of the children. They discussed how difficult it is for children in the area to go to school. Although a Methodist mission houses a primary school not far from their home, the secondary school is in the town of Kenskoff and is much more expensive. The oldest son, who had greeted us in English, had to sit out this year from school due to lack of funds. But they were hopeful that next year he could return and continue his studies.

We were offered a fresh papaya as we left and invited to return if ever on their corner of the mountain again. Given the perfection of the drive, the picnic spot and the beautiful tree-lined walk, I would not be surprised if we wandered their way again.

We had a perfect day with an escape from the heat and the city into a part of the country with extraordinary beauty and tranquility. We (re)discovered grass, quiet, pine-scented air and were embraced with hospitality true to Haitian culture. Now back to the heat and congestion of the city, I'm aching for more moments in that field. If only the commute wasn't so long, I'd pitch a tent and move!!! But now our dreams will carry visions of cool green mountain escapes dancing through our heads to sustain us through another week. That is something worth smiling about.

Home and Happy!

Mobile Lab

Dear all,

I was recently asked to give a little more detailed update on the progress of the clinic and mobile lab. Since there are so many of you who have given money, sent supplies, purchased equipment and/or lifted up prayers, I thought I'd share yet another newsy message with you all with specific information regarding the lab.

CONASPEH and the people of Haiti have a lot of friends in you. We are amazed at how often people gather a few of their resources together and share them with people here. Such actions are a beautiful witness of a global community. I've seen a church soup supper purchase enough medications to run our little clinic for 4 months. Letters from Sunday school classes have reached us and it warms Patrick's and my heart to know that even our youngest of friends have the people of Haiti in mind. Church fund drives from across the country have helped CONASPEH purchase land. There are a lot of people to thank.

I just want to send out a universal thank you to everyone who has thought about Haiti, read a book, kept up with recent news events, followed this blog, sent school supplies, collected medical supplies, donated money, or planned and participated on a trip here. Every effort, no matter how large or small, makes a huge difference. And we, representing CONAPSEH and the people of Haiti we work with, thank you.

With that, greetings from Port-au-Prince! The school year has started, and activities jumped once again into full swing at the busy school and CONASPEH headquarters where Patrick and I work. Its nice to have the echo of the voices of children reverberating off the walls again. The air is charged with energy renewed.

I'm writing to also give you an update about the mobile lab that many helped purchase with their offerings. We received the lab in June when a group coming to visit Haiti was able to carry it over and deliver it directly to us. The lab is really something, capable of a lot and quite mobile, set up to run on solar and battery-powered energy no matter where the clinic is located. Since a lot of the mobile labs we have run are held in dusty dark corners of concrete churches sans any modern convenience, freedom from a wall outlet is really a blessing.

I don't know how many of you are familiar with the kind of work the clinic is doing. So I'll be brief. Essentially I arrived to Haiti and set up shop as the only doctor in a largely non-medical organization that recognizes health care education and outreach as vital in order to attend to the dire needs of the Haitian people. Upon arriving to Haiti, the "clinic" was a barren and empty room without much more than a box of Band-Aids. It was functioning largely as a first aid station for the children at the CONASPEH school. After several really frustrating months of clinic visits that entailed making a lot of recommendations to patients who had neither the means nor motivation to follow up, we realized that in order to provide affordable and safe health care in Haiti, a fully stocked and capable clinic needs to be in place if any difference is to be made the the health of the patients who come for evaluations. There is just not a broad enough medical infrastructure here that can meet the needs of the sick and impoverished.

Currently our clinics (Port-au-Prince, Carrefour and Artibonite) see patients ages 0 to 104 (that's the current age to beat) years in age with complaints covering every organ system. The clinics have no running water (yet) and only one with spotty electricity (currently MUCH improved), but we make do surprisingly well. Despite an overwhelmingly high number of clinics in Port-au-Prince, most are not able to offer prices affordable enough for the average poor person living in the city. Therefore our clinics receives people who suffer ailments largely from their low economic status: problems of hunger and malnutrition, poor sanitary conditions, and chronic lack of access to care. Services are not always free, but for the equivalent of a US dollar, patients get evaluated and sent home with the medications they need. If the price is too steep for the extremely poor and ill, the price is waved. Students and staff at CONASPEH are not required to pay.

With the help of friends and donors, we've been able to keep the pharmacy stocked with basic medications that at least cure things like ear and lung infections and other basic, easily treatable illnesses that should not lead to significant morbidity and mortality (but do in cases of lack of access to care). Then, with the help of several individuals and churches, we were able to purchase a mobile lab.

Not being trained in lab sciences, I used most of July to read the lab manuals, discuss with my team the logistics in toting a lab around to mobile clinic sites and to other stationary clinics, and how we would handle stocking and restock of supplies needed to keep the lab consistently functioning. Because our clinic staff now consists of myself and one nurse, I've had to choose to either be a lab technician or a doctor. So as a compromise, I've selected the most quick and user-friendly tests in the pack that can be done in the space of an office visit and can influence treatment planning.

For example, I can quickly and easily utilize urine chemistry and microscopy, blood glucose and finger-stick hemoglobins that have helped me rule in or out urinary tract infections, diabetes and anemia. Through the urine analysis, I was able to council a young man that his conglomeration of symptoms was likely due to an acute hepatitis (that otherwise I would not have been able to be very certain about) and was able to council him accordingly. This was a potentially life-saving discovery from a simple urine exam.

The lab is capable of so much more. It is capable of malaria and rapid TB screening, blood chemistries, and early infection identification. However these labs require staining and a more involved process of both blood draws, sample preparation, and careful evaluation by a trained eye.

We've started the search for a lab technician that can work alongside us and turn a lab that is partially functioning into one that is fully functional and efficient. We interviewed two people Tuesday who seem very promising and have a work day planned with them tomorrow to further evaluate their flexibility, availability, skills and willingness to work along side us. I pray that whomever we find will have patience and a secondary income since they likely will have to initially start working for pennies and out of the goodness of their heart as CONASPEH has little to no money to pay much of a salary.

The nursing school starts in October, and the nursing director and I have been discussing the formation of some practical learning labs to teach the nursing students through the use of the lab. Up until we received the mobile lab, the school had a single working microscope (thanks to another donation!). Now we have another beautiful new one. You might imagine how much more punch a lecture about microbes and pathogens in the water can deliver when students can look for themselves at what swims in a sample under the microscope.

So the use of the laboratory is evolving slowly and thoughtfully. It has already changed my own ability to deliver health care, and has the capability to provide an even broader spectrum in months and years ahead. My current goals now are to continue training myself in the skills of laboratory diagnosis in my spare moments in case a lab technician is harder to find (in that case I'd dedicate an afternoon or a day a week to be "lab day" and just process the samples myself), to begin a science and learning lab for the nursing students, and find a helper for our clinic system to broaden our outreach and services.

Thank you for the gifts of your consistent support and your prayers. It makes projects possible, outreach more meaningful, and a ties of partnership strong.

Grace In Action--A Newsy Update

Friday CONASPEH heald its annual "Grace In Action" assembly for member pastors at the CONASPEH headquarters. As summer vacation comes to an end, a new school year begins and projects are attacked with new energy and inspiration. The leaders of CONASPEH invited pastors and friends to a day of information sharing, celebration and prayer for work ahead. I thought I'd use the opporutnity to share with you an update on CONASPEH projects as well.

A huge crowd of pastors responded to the invitation, flooding the usual meeting room in the school auditorium. Instead of acquiescing to cram within the confines of 4 walls, everyone grabbed a chair or a school desk, carried it out to the open land neighboring the CONASPEH school, and congregated in the open air under the shade of many trees. The meeting area was perfect as it took place on a piece of land CONASPEH has been working a long time to obtain. This month, thanks to generous contributions from partners in the States, that dream looks like it will finally come true.

The morning started off with a worship service kicked off with song, deepened by prayer, and accented by a sermon. The final prayer asked God for blessings on the work of the many pastors in their many locations all over the country as well as for the projects of CONASPEH as a whole. The prayer asked for blessings on an upcoming school year, the lives of the children, the teachers and administrators, and the all work to be done ahead.

After the worship service, Patrick Villier conducted a meeting serving to share information about the many CONASPEH projects, and invited discussion on ideas to improve or fortify them. The acquisition of the large plot of land adjacent to the CONASPEH headquarters and school was discussed. Dreams of future projects on that land include the construction of a university, medical, science and language laboratories, a guest house and a large meeting place to hold such congregations of CONASPEH pastors and partners. Pastor Villier invited everyone to give thanks to God for sending the friends, partners and patrons who have helped CONASPEH purchase the land in the service of a greater vision.

The CONASPEH seminaries were discussed, active now in Port-au-Prince, Leogane, and Jakmel. The seminaries were a big point of interest for all the attending pastors who are anxious for the opportunity for more education, both in theological studies, church administration, and language. Discussion about theological education dominated the meeting agenda. Challenges with the seminaries, as with most CONASPEH projects, is largely economic. Currently students can't afford to pay tuition. Without tuition, teachers can't be paid; without teachers, classes are sporadic and unreliable. A new director has been hired for the Port-au-Prince seminary and Patrick Bentrott will be working with him to help coordinate a yearly curriculum with the minimal resources they have.

Highlighting events from the last CONASPEH Congress, Patrick Villier was glad to report that the peace march and demonstration held last February successfully caught the attention of the minister for culture and sparked the approval for a franchise for CONASPEH. This means that gifts and supplies sent from outside the country can more easily be received as well as further validating CONASPEH as a reputable organization in the eyes of the government and international organizations.

The problem of CONASPEH's budgetary crisis was addressed. A "insurance" system was proposed asking pastors to consider a monthly monetary donation to a CONASPEH pool--the equivalent of about $4US--to be used as a reserve for emergency relief and as a resource to allow CONASPEH freedom to respond to member church requests for aid when implementing projects. With 6,000 participating churches in CONASPEH, $4/month would add up to a significant reserve. But as little as that membership fee seems, interest was not overwhelming. For many of the very small, extremely poor churches, $4 a month is a huge percentage of total offerings.

School starts tomorrow, and the primary and secondary schools are expecting around 600 students again this year. The seminary resumes classes this week in Port au Prince. The nursing school will kick off in October with one class newly starting didactics and another splitting time between class and clinical work.

What I appreciate about CONASPEH meetings is that any of the members in attendance can stand, offer their opinion, their question, and their ideas freely. So the projects above were discussed with great fervor and interest, and as a reward for everyone's participation, the day ended in a huge shared meal of Kreole rice and beans, chicken and a cool, cold beverage.

So what are Patrick and I doing these days? Despite 10 months here, we still are adjusting to culture and language. We can now navigate the streets of Port au Prince with more confidence, can ask for directions and understand them better, we know who to call when the car breaks down, where to go when we are sick, and have friends that stop by for a shared dinner and conversation.

Our jobs continue to evolve as does our understanding of what are roles are here.

Patrick will start teaching English and Computer Skills to the seminarians this quarter in Port au Prince. He is already well into his New Testament course teaching at Leogane (a town about 1 1/2 hour drive along the coast south of PaP), and hopes to one day travel as visiting professor to the Jakmel seminary offering classes there as well. However such outreach is dependent on acquiring a more reliable means of transportation as the Galloper continues to smoke and sputter its way around town keeping most of our mechanic friends gainfully employed. He'll be getting to know the new director of the seminary and helping organize the curriculum, drawing in resources from visiting friends and professors who can augment the curriculum by offering seminars on theological subjects. He will likely continue teaching English to a class or two in the primary school and engage the kids in games of basketball after school. He has weekly invitations to member CONASPEH churches each Sunday where he delivers a sermon and gets to know the pastor and the community surrounding the church. When he has free time, he often stops by to volunteer some time with the kids at Solomon's orphanage or at the orphanage in Leogane. He continues to study Kreole (is a much better student than I am) and explores various theological subjects through reading and research at home.

I continue to work in the CONASPEH clinic 2 days a week, the Carrefour clinic one day a week and the Artibonite clinic one day a month. We are starting our mobile clinic outreach again to sites around the city (again, postponing more rural outreach until we have better means of transportation) one day a week. Tomorrow I visit a maternity hospital on the edge of City Solei as a potential place to volunteer one day a week in order to keep my labor and delivery skills fresh as well as keep my foot in a broader medical community. After church, if invited by the pastor, I give 1-2 hours of free consultation time, helping to plug in the members of the church to CONASPEH's healthcare outreach. I'll be teaching 2 classes to the nursing school this semester while working on offering some practical skills learning labs to augment the student's education. The nursing students volunteer in our clinics as a means of practicing skills, and we hope to develop that teaching opportunity better in the year to come. Currently with the medical lab, I am using the tests that can be done quickly in the span of an office visit. I recieved a potential lead on a lab technician at the Grace In Action meeting Friday, and am hoping that with her help we can start to better utilize the full capabilities of the mobile and stationary laboratory, offering affordable lab diagnostics to our patients.

For rest and recharge, Patrick and I escape to the beach or up to the mountain. We take turns hitting the sportif center to sweat out our fatigue and frustrations.

The highlight of our lives continues to be a 20 lb ball of energy who is crawling at new high speeds, eating cheerio's all by himself, and entertaining us with enthusastic soliloquies in baby language. Solomon smiles easily, loves to be held, and is a great snuggler when he's sleepy. He pulls himself to a stand, motors around the apartment in his kiddy cart and is just shy from walking on his own. He can make us both spontaneously laugh and sigh in a single moment. He's our favorite reason to come home and inspires us to be better people.

We've been here for almost a year, and have learned a lot. We've taken part in some projects, dreamed up others, and still struggle with how to have a positive and meaningful presence here under a liberating model of mission. Some days we feel inspired, others frustrated, and are always searching for balance, meaning and inspiration.

For those of you who continue to check in on us, follow the ramblings of this blog, I thank you. For those who have sent money and supplies, CONASPEH thanks you. For those who hold us up in your thoughts and prayers, we thank you. If we've learned nothing else here, we've learned that we can do no great things alone, we can make no big change by ourselves. We live on a small planet with great divides, but can bridge those gaps better with love and support from partners, family and friends.

Waxing Philosophical

Tonight I ran by the light of an almost-full moon.

After a week of running in the evenings to the backdrop of storm clouds, orchestras of thunder and lightening, and winds kicking up the dust and stirring the humidity a bit, tonight the sky was clear and refused to hint of looming dramatics on the horizon. Last night I had to hide my keys under a rock for fear that one of the many lightening streaks in the sky might find my sweaty self. I tried to improve my chances by ditching the jingle-jangling metallic invitation to be struck. Despite ignoring a bunch of mom-taught-me-better warnings in my head, running with a storm approaching gives tremendous adrenaline behind each foot-fall. Waiting for the rain to fall and for the winds to cool down the night air has been an exciting distraction to my exercise outlet of late, and my pace has quickened in the thrill of it all. So tonight I found it strange to suddenly find myself running under a clear night sky, stars like pinpricks in a black canopy, dimmed by their neighbor the moon who shown down like a spotlight on me as I ran.

Most nights when I run, I run in darkness. I enjoy the sightlessness of track running because the black night fools me into thinking I'm running somewhere, along an interesting path that I just can't see clearly. It hides the reality of the series of circles I am truly running, like a hamster in a wheel.

Patrick and I have recently become hugely addicted to the TV series on DVD, LOST. Aside from the fact that it is an entertaining show full of suspense and one unanswered question after another, we can't help but draw some metaphors to fit our life these days.

We too are on an island. We too felt disoriented at first, not sure how to find food, drinking water (or rather ask for it using Kreole words that communicated our needs). We too have flashbacks to days before Haiti, walking and working in a world that made sense most of the time, that functioned under rules we understood. In hindsight, our past seems logical, predictable. Not at all like the present. We, too, were met by island inhabitants, and it took a little while for trust and friendship to develop (I think we have been more successful since we haven't employed guns, violence and paranoia into our island living). And just like some of the stranded survivors, we are coming to feel that we were meant to land here all along, that despite how absolutely unpredictable the future feels, that our past lead us here for the things we are to learn while living on this island.

But even more than the action and suspense the tv series offers, I appreciate the philosophical themes the show incorporates into the plot. As the story unwinds, the writers propose that events and encounters of life may not be as random as they seem. Concepts of fate and destiny color the lives of the characters whose past seems as interwoven as their present. At times you get the feeling that the characters are living lives that have been pre-destined, carrying out their duty or their part in the scheme of things.

No matter where we were born and under what doctrines we were raised, at some point or another, we as individuals have to reconcile some sort of peace with our understanding of the meaning of life and the workings of the universe. Some believe in fate, others random chaos. Many feel comfortable walking under the protection of a life designed by God's will, others embrace the idea of man-made destiny. If I'm honest, I'm still not sure what I think to be true, but I know some ideas ring more true to me than others.

I was reminded tonight, running around the track illuminated by the oh-so-honest moon that seemed to say, "wake up silly, you are running in circles. You can't pretend any longer" that I prefer to live thinking that I'm heading somewhere, ready to discover something new, even if the truth is that I'm passing the same point every 2 minutes. Like life, I guess I like to think that I'm forging somewhere for myself, making contributions to a cosmic consciousness, creating some sort of wave in the waters. I know that my actions and decisions are inspired by relationships, life experiences and divine inspiration. But if the truth is that I'm more of a rat on a wheel moving under the forces of fate because "that's what I'm supposed to do," well, I guess I'm less interested in such a reality, even if it does take some of the responsibility out of my hands.

My run tonight was shorter than others. I love the moon. I love a clear night sky and stars that hint of galaxies and mysteries far into the deepness of night. But I love when the moonlight reveals a path into an endless horizon. I am only so inspired when the moonlight uncovers magical, silvery details in the darkness and highlights the freedom within a mysterious night. Tonight, however, the moon was giving me WAY too much information about my destination-less run. It did inspire me to wax philisophical, and my legs couldn't keep pace with the workings of my thoughts, especially when it was clear I was "going nowhere".

What I love most about life is the mystery of it all. There are things we know to be true because we can see and touch them, others we trust to be true because of how we feel. Some of us believe things to be true for faith alone. Yet ultimately there are some big questions that will remain mysterious in this life at least, no mater how many stabs at the truth taken by philosophers, great thinkers, religious leaders, scientists or hollywood writers. I like the not knowing. I like the room for imagination. I like knowing that life is wrapped in mystery. Sometimes, like the plot of a well-written movie or tv series, little hints are revealed to us as we learn and experience and discover. Makes me want to tune in to the next new day, makes tomorrows worth living and death just an opportunity to have more questions answered. Even if the truth is that we are finite and nothing more. Puts a little suspense and adventure into our existence. And I'm just a sucker for that kind of entertainment.

Gwosi

The contrast of life in the States and life in Haiti is a topic that can span all sorts of subjects over many serious, thought-heavy hours. On the more light-hearted end of such subjects, body image is an area where popular ideas differ.

Yesterday, while sorting through things in clinic, one of the teachers came in for a blood pressure and weight check. She is a robust and feisty lady, loud and boisterous. When she stepped on the scale, it quivered a little. I read her weight out loud, but got my numbers mixed up and accidently took 20 lbs off of her real weight. Her face fell; she was crestfallen. "Oh, I had hoped... I thought I was.." I realized my mistake and corrected myself, giving back her excess 20 lbs. She started jumping up and down, arms raised in the air singing "thank you thank you thank you", face bright with smiles. I think my jaw may have been hanging open a little. I'm not sure I've ever done a happy dance after personal news from the scale. Especially over excess poundage.

Case in point. Sunday we visited a church we had once visited before in December. At that time we were eating one or two simple guest-house meals a day, suffering from diarrhea every other week and still trying to get adjusted to the heat which killed our appetites for anything other than salt and water. For me, it was better than Jenny Craig, South Beach and the "maple syrup cleanse" combined. Apparently I've come around since then, my gut has made peace with Haitian microbes, and I'm once again utilizing the healthy nutrition in the food I eat (and deeply enjoy). Sunday one of the church goers came up to me, recognizing me and said, "You are growing! You are BIG!" She meant it as a compliment, her face beaming. I knew this and therefore did not kick her with my enormously growing leg. I also refrained, however, from doing a happy dance.

I find it a bit fascinating, yet not surprising, this cultural difference in the picture of superficial beauty. Refreshing, really for frames favoring curves, that the skin-and-bone look is "out" here. Because, lets face it, that means you are hungry (and here, poor). In a country where people don't have the luxury of eating excess calories to compensate above and beyond their hard physical labor, the curves of a little "winter storage" are a sign of wealth and wellness. The secretary at the school is always excited to tell me when a shirt or pair of pants make me look bigger (a compliment mind you), which still takes me by surprise. "Wait, you aren't supposed to SAY that! Ask my husband!!"

Being publicly called out for my expansion, I hit the track last night with new fervor, laughing in spite of myself at how I can't seem to kick my own culturally-bound concepts of superficial beauty. BMI's and medically-related "healthy weights" aside, I still hail from the world of Cosmo and Glamour, a world of Hollywood red carpet affairs where it is publicly ok to rag a woman for a "softer" look and look the way when she's purging her dinner in the bathroom. In all honesty, I've always been angered at our American sub-normal, sub-healthy standards of what makes the runway. Regardless of my opinion, I've been influenced. And just like many an American females, I've been known to scrutinize my image in the mirror, looking past what makes me pretty and dissecting the things that aren't Hollywood material (ask my husband). In truth, the run was more because my head was starting to feel muddled and heavy from lack of exercise... but my pace was DEFINITELY influenced by post-church events, as was my choice of "passing" on the after dinner chocolate. Maybe one of these days, I will learn how to better celebrate my genetically-inclined tendency to "grow" at any opportunity I get. But really I should just celebrate the fact that my family and I have the blessed luxury of eating three meals a day, that I can choose tasty and nutrient-rich foods to put in my body, and that I can turn that nutrition into fuel both for my daily work, play and for recreational sports that keep mind and body strong.

Eat that Kate Moss.