*Monty on the donkey path*Today was Mobile Clinic day. Over the last month, our mobile clinic schedule has been off and running, taking Miss Fanor and I to two poor farming neighborhoods outside of City Solei, to a mountainous village outside of Port-au-Prince, and today to a mountain-top church in an extremely rural area in the general zone around Petionville.
The morning started slow and frustrating, leaving Miss Fanor and I with doubts that it would be a successful clinic day. The pastor was an hour and a half late to meet us at CONASPEH, and the sun started heating up the city with gusto despite the morning hours (we were to find out later that with the heat index, Haiti felt like 108 today). We were even more confused when the path to "Petionville" (where our schedule said we were going) instead took us up a rag-tag route vertically up the mountain.
Today "Monty" got initiated. I can say with a sigh of relief that the 4-wheel-drive works miraculously well and that this car will be our new trail-blazing friend.
As we climbed up a precariously steep mountain road, over loose rock and gravel, the landscape turned quickly into open, rural scenes of hills folding over each other, mountain vistas looking over flat valleys, and sparsely scattered homes tucked between cultivated and terraced fields. Despite the beauty and serenity of the surroundings, I was feeling anything BUT serene as I was steering Monty along crags and ruts, over rocks and through shifty gravel, narrowly missing wholes and cliffs as the road fell away, tumbling down the mountain. I narrowly dodged one such landfall only to spot the remnant corpse of a car not as lucky, laying rotting in the sand, picked clean by vulturous hands leaving only an iron skeleton behind much like a cow skull in death valley. The most pulse-raising moment of the drive came when we encountered a part of the road that had been hour-glassed by two cliffs, leaving just enough room for the car to traverse if I hit it EXACTLY right. I was immediately sent spinning back to my reoccuring nightmare of driving along a mountain road where the road progressively narrows until I'm skidding along a train rail, wheels spinning in the air eventually leaving me soaring over a cliff as the road dissolves into nothing. The pastor got out to help guilde my wheels on the road. We did it, but had little time to celebrate because the route marched promptly UPWARD, and the wheels spun in the sandy incline. With panic I realized that instead of FORWARD with acceleration, I was slipping backward towards the cliffs I had just narrowly missed. There came a moment when I felt paralyzed. I looked at Miss Fanor and we started laughing the laugh of crazed people. I asked her to start praying. She got out to cheer me on (praying out loud the whole time). I decided NOW was the time to try out the 4x4 action.
And then a calm descended. It was a do or die moment... and I was hoping for more of the do. This was Monty and I's first test together, and I was about to see what Monty was made of. Honestly I wasn't worried about dying... more worry about getting our new, beautiful, well-functioning car horribly impailed or stuck out in the middle of Haitian nowhere, about how I'd find a donkey to hitch home, and just exactly how I would explain to Global Ministries, CONASPEH and all donors how we lasted only a week with new wheels.
But apparently life has more work for Monty and I to do. In 4x4 setting, Monty buckled down, slid for only a split second (cue heart-stopping breathlessness), then in a spray of rocks and groan of the engine, we motored UP the mountain leaving the tightrope driving scenario in our dust. Meci Senor.
Smiles all around. Applause and instant in-car celebration. I then noticed how incredibly gorgeous our surroundings were. Worth it? Absolutely. Adrenaline and Adventure. Almost as good as skydiving. "Good driver" said the back-seat pastor who had insisted all the way up the mountain that cars drive here all the time despite us not seeing a single one for 45 minutes up the donkey path.
*pastors of the church*We arrived to the clinic of the day--a church on a mountain top with a grand view of the valley below. My knees were still shaking a little as we unloaded our supplies and got set up in the makeshift clinic space. The "neighborhood" was fields of cabbage and carrot, trees loaded with avocado and grapefruit. We parked Monty to the side of the road to allow the local traffic to pass--women and their burrows loaded with produce and supplies as they headed to market miles below. I told the pastor that next time we come, he can provide donkeys in place of wheels. :)
*make shift exam space in the corner of the church*Despite houses scattered over the mountains, the people came. The closest medical clinic to this community was near Petionville --40 minutes away by car. We saw almost 50 patients in the heat of the afternoon, restricting numbers because we were only two and we needed to get back down the mountain before dark. But as might be expected, I met a tough breed of beautiful people in clinic today. My first patient was a toothless grandfather of a man with probable heart failure who laughed when I suggested he go to the heart specialist for some tests. He instead thanked me profusely for bandaid medicine I could offer.
One woman had hiked 2 miles from her home with a “horrible” head ache. I thought she was being overly dramatic until I checked her blood pressure and found it to be 240/120--a certain ICU admit in the states. I told her that she needed to go to the hospital. I was expecting to see her face sag before my eyes. She said, “oh yes, oh yes doctor.” I knew better. I gave her everything I had for blood pressure: nefedipine and hydrocholorothiazide. I decided to hold on the aspirin since I was fearing an impending bleed. I told her to go home and find some family to sit with her while she rested… and that she needed to find a doctor tomorrow to check her blood pressure if she wouldn’t go to the hospital. “Oh yes, oh yes doctor.” Mmm-hmmm. I’ve been around this block. An hour later, as I left the clinic exhausted, she was chattin’ it up with her neighbor. “Why aren’t you in bed?” I asked. “Oh, the walk is long…but my head is feeling so much better, thank you doctor, thank you.”
My favorite patient came at the very exhausted end-of-day when I was in task-master mode, already worrying about the trip back, feeling hungry and tired. The 3 year-old boy lay content in his mom's arm, long braids sprouting from his head and warm, dark eyes accenting his round face. I commensed in collecting information from mom while starting on my heart and lung exam. The little boy promptly sat up. I expected the normal fear and crying that my white face and touch can sometimes bring on to kids not accustomed to "blans." But instead he gave me a huge smile and leaned in for a smooch. Talk about unexpected joy breaking through exhaustion! He put a new bounce in my step as I laughed and said, "I love you too!!" The mother smiled with pleasure at her little charmer.
Beautiful people.
My day came as a welcome relief. This week in clinic, I've sunk into one of those lulls that can catch me from time to time, challening me to question what kind of good I’m really doing. I often get bored and frustrated with practicing BandAid medicine, treating gastritis and presumed anemia while bemoaning failed attack at the real issues behind the disease, unable to dive into deeper pathology and healing due to lack of patient and country resources. I'm sure I over treat the flu with chloraquin for fear of missing a potential malaria when fevers soar and patients can't afford a simple lab test. I get tired of handing out a stale set of medications when more sophisticated treatment is really indicated. But today, even though the medicine didn’t change much, even though the referrals and advice felt just as empty, today was a day where I was reminded how much I loved the people I’m working for. Today I had fun teaching, interacting, letting the charms of my patients entertain me to no end.
Maybe it was the adrenaline rush of the drive that awakened me back to the fact that I live in an incredible country full of survivors despite the odds against them. I am surrounded by rugged natural beauty and people who have a lot to teach me about perseverance, adapting to environment, and slowing down. If my time here is nothing more than getting to know some strong, amazing characters and traversing rugged terrain in the spirit of adventure, then life will be well lived.
*view from the church over the valley*
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