Who delivered your baby? Was it me ?

August 1

We had a meeting with the Matrons today who came together for their monthly reunion at the beginning of each month. They came together—both men and women— for this meeting. Matrons is the essential Haitian-Creole term for “Midwife.” These women and men were packed into this meeting room. At the beginning of each month, they are given additional supplied and 50 Gourdes (Haitian currency) for the needs. The 50 Gourdes and the additional supplies are also given by HAS. These Matrons or Matwons stay until the end of the meeting for the supplies. Some of which have been Matwons for decades. They seem to have part-time jobs on the side to supplement. As I gazed across the room, I saw young matwons who beamed with youth and old matwons who seemed so tired. The young matwons—as I later found out—delivered 9 children in the community. For her business was booming. Some delivered so many babies that they forgot their names of their clients and their children. As for the others, not so much. Maybe the busy matwons decided that it was a waste of their time. Regardless of this, I saw a new trend of fashion amongst the matwons: the church hat aesthetic. The women in the room had their church hats titled to the side, setting the trend for all of Haiti. They were a quite interesting group of individuals. I was most impressed by how passionate and humble they were when they received their items. Their meeting began with a prayer and a song of praise. These matwons meant business because they sat so seriously and listened intently! When asked to over their steps of how they deliver a baby: they stood up and went through step by step. When their peers heard something “out of the ordinary,” they stopped and said “Ki sa?” meaning “What?” Their peers were quality control. When the meeting coordinator pulled me talked to me to the side to ask them if their was anything that she need to mention in the meeting (that I felt should be mentioned) I told her my concerns. As my research comes to a close, I have been seeing a lot of neonatal cases with children who have infected umbilical cords, conjunctivitis, fever, and jaundice. All of which are preventable— some by the matwons and some not. Their area of concern should be the infected umbilical cords. There is a large percent of these deliveries that are being done at the homes of these mothers. There should be no reason or excuse as to why these umbilical cords are being infected. I could feel the room tense up when I told them that I have access to information about who are delivering these children. Part of my research is going to the root of the problem and addressing it. We need to be quality control for each other. We need to check the information of each other.

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Reflections on Zika, P.S. The Mosquitos got ME.

July 28

Zika. Lord have mercy upon my poor soul. Never would I have thought that I would have gotten Zika. Towards the end of the day, I remember being in the office itching. I just thought that maybe I was itching as a result of my needing to take an after-work-bath. However, the itching did not subside. In fact, it worsened. I decided to go to sleep. That has been my answer to everything for this entire trip—sleep. It is always too hot to do anything else. Eat. Sleep. The other day, I felt so tired that all I could was sleep. I slept from 4 in the afternoon to 3 o’clock in the morning the next day. One thing that I do well is listening to my body. If my body tells me to sit down, I sit. If my body tells me to stand, I stand. I felt abdominal pain; I felt like there were 10 people jumping up and down on my stomach. There is nothing wrong with taking time for yourself.

Now when I woke up, my roommate broke out with this horrible rash. Even before that, he was experiencing extreme fatigue, lack of appetite, fever, and joint pain. I knew something was off, but I stayed away from him. Part of my problem was the complacency that I built over the time that I have spent here. I started to sleep less under my mosquito net and put less mosquito repellent on.

For me, it all started with an itch. After that, it all went down hill. Rachel, my project coordinator told me that she noticed I had pink eye. I went over to the mirror and I looked so crazy. As that day progressed, the rash became more apparent. But I had to push forward because I meeting that day with the Community Health Care Workers.

This meeting that I did with the community health care workers was crucial because it would be the last time that I would have to speak with them about cleaning up the work that they are doing and the errors that I have been finding in their work. This meeting was also about motivating them and encouraging them to continue to the positive work that they are doing in their community. More importantly, I wanted to show them that the work that they are doing has real-life applications to the analysis and painting a holistic picture of the community that they work in.

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How did the meeting go ? It went well ! From what Madame Roline said, the manager of the community Health Care Workers, it was “Captivating and Elightening.” I am sure it was because I wanted the community health care workers to walk away feeling motivated about their job. I even ran into one of the workers in the meeting who told me “Thank you.” Normally, when I am in a place, I am always aware of my surroundings , but for some reason I did not recognize this CHCW. It was almost as if he was a Chameleon, blending into his surroundings. I wonder if other workers assume this position in their communities? Do they stand out ? Do they make themselves known ? Although I was itching throughout the entire meeting, these community health care workers made me forget about Zika. All the pain that I was feeling for that day simply went away.

 

When the entire world is a “Salle de Observation”

JULY 25

When the entire world around you is a “Salle De Observation” or a Room of Obversation, you have no choice but to sit and listen. Whether it is listening to a patient’s question, their answers  to my questions, their pain, or their silence, a doctor must have a keen ear. Often times I find myself leaning closer to their beds to hear their voices. Not because I need to hear better, but because their voice needs to be amplified with my translation. From my ears, to the words that I speak, I am responsible for their voice. It is not an easy task, but I know that it is an important when I am translating for these patients. As they speak, Doctor Close looks at the patient and sometimes our eyes meet, but it is as if her eyes never move from the patient. All that matters with each consultation is the voice of the patient. I find, that we need to be the voice for each other. There are sounds, questions, pains, and silences that can not reach other people if it were not for an intermediate personnel. We can reach those who have not been given a chance to listen. We can amplify voices that are often muted and marginalized. All we have to do is listen and lean in a bit closer.

Today was my last day working with Dr. Close because she was leaving today. I met her in the “Salle de Observation.,” and we quickly got to work. The name of the game was discharging patients. The less time these patients spend in the “Salle de Observation,” the quicker more patients can be brought in to be seen. After a while, Dr. Close and I built a system: we were going to provide name-bands to every patient and then get to the work. Naming the patients are a very important component to providing adequate care to them because if the charts get mixed up, the patients get mixed up. Patients are sometime lucid and cannot advocate for themselves, they can not say their names, their family members (if they are around) has to speak up for them. So before we get to work, we name the patients and get them organized. Afterwards, I started a new system where I would go around and get their charts organized. We have to get the system organized and spend less time finding the patients and more time treating them. I feel sad that Dr. Close was leaving because I felt that everything she did was to make sure that the care that each patient received became better.

Today we visited the Palace of 365 Doors created by Former President and successful rebellion leader King Henri Christophe. One of Petite-Riviere’s popular site is the 365-doors palace built in 1816 by former King Henri Christophe. However, the palace is now undergoing renovation works by the current administration that will hopefully give to the area its former glory. This site is being refurbished and renewed to highlight the beauty of this palace. We were lucky enough to see it after gaining permission to enter from a local community member who had “The Keys.” The people of Haiti are starting to slowly realize the beauty of maintaining these historical sites in their state. The pictures on Google do not do it justice. It is beautiful. I can just imagine how it was back in the day. When you start to look around, you see new communities that have erected, children running away these places, and their elders sitting around and watching them.

I looked at the Fort and thought about the power that must have been needed to stand up for something and follow it through. There are so many of these sites all around the country of Haiti. It is nice to see the progress that is being made around these sites, but certain things need not to change. It was disappointing to see the lack of care that was being applied to this Fort. How a community member can just unlock the door to the Fort just because he had the key. Regardless of the lack of care, I stood at the Fort amazed by how history was made by my ancestors. Whether the people of Haiti realize it or not, this was history.

After which, we drove over to Lester Beach and enjoyed some of the water. It was not really a beach. It was more organized water— meaning that there was a steady stream of water that slid down concrete in a man-made fashion. The water was cold and fun.

When you get a new language down-pact.

JULY 22

I feel like I have mastered the language of Diabetes. To offer adequate services in translation, I needed to learn the language of Diabetes because of the huge amount of diabetes patients that she has. I spent one day away from the hospital and a couple of patients who came back were looking for me. I almost thought that something was wrong because they were looking for me. But then I remembered that I was translating for them the other day. They were so happy to see me as I walked through the hospital looking for Dr. Close. Being away for a day, it felt different being back after such a long time.

Important to shadowing Dr. Close was being able to speak the language of Diabetes. I have never taken insulin, but now I know what it means to take a 25 in the morning and a 15 at night. I know the questions to ask a diabetes patient to make sure that their insulin/ medication is working. The line of questioning has become a second nature to me. At first I was getting tripped up with all the numbers in creole, but when I pulled out my notebook and wrote down everything the patient said, it seemed like the patients opened up more about the experience with diabetes. The patients speak so fast when they talk about insulin! Also, I had to build my creole medicinal vocabulary because it was crucial. Certain questions about does the medicine gives you headache? Or does it make you go to the bathroom often— I knew. I always reminded the patients to moisturize and lotion they feet to avoid infection each night. Dr. Close gave me the lotion and I knew what to say.

What do you do when you don’t have the key

Today was another intense day. The importance and lack of medication in Haiti is a major issue that has to be addressed. A lot of patients have the issue of hypertension and high blood pressure. Most of the patients today encountered a stroke that has left them paralyzed. It was just the most heartbreaking thing because this could have been prevented. The root of the issue is the lack of importance placed on taking medicine and remaining calm. As Dr. Close explained to me, the patients are used to dealing with issues that “go away” such as infections. However, the patients do not understand that high blood pressure and hypertension do not go away. As a result, the patients do not understand that they have to come back and get more medication once their medication is finished. They think that once their pill bottle is empty, their problem has gone away. This is not true. But another problem is the lack of access to the medication. These patients do not have the money for this medication and they are facing the consequences for it. It was heartbreaking to see a father who can barely talk or walk and tell his daughters that he will need a lot of love and support at home. His daughters told me that it has been months since he has taken his medication and he complained of headaches all last week and blacked out this morning.

It has been an interesting experience understanding how patients with diabetes manage. They tell the doctor how the stress of not having a job has factored into them not eating and following their regime. Some patients struggle with not having access to insulin. There was another patient whose needed dialysis in Port Au Prince—an entire three hours away. The distance was a roadblock and the lack of funds was a roadblock too. It is tough seeing patients who could be treated and healthy but are so far away from medicine that could change their lives.

All we need to do is walk

Now today was the first day of my work with Dr. Close. Doctor Close is no joke. See the other day, I was sitting down catching up on my blog and she needed help with her internet stick. She didn’t come to see me though. She came to visit a medical student whom she knew from way back in the day. She called me over to help saying “You are young, you know these kinds of things.” I spoke creole with the Pierre, a medical student, who comes to help on the weekends about the internet stick. Dr. Close’s eyes lit up ! She asked me if I speak Creole, I hesitantly said yes. And before you know it, I was engaged to provide my translation services for her. What did I do?

I know what I did. I was going to be doing some translation services for Dr. Close. Dr. Close created the Diabetes Clinic for Hospital Albert Schweitzer and has been coming here ever since. She is no stranger to HAS ! She see over 60 patients a day, 80 even. Translation is such beautiful thing because I became the voice of medicine and the voice of the patient. I could feel my voice as a translator growing after time passed. What ever a patient felt, I had to vocalize it. Whatever the doctor suggested, I had to amplify it. I had to ask the tough questions and get difficult answers.

For instance, we had a patient who had a stroke in America, came back home to Haiti with a stomach that was rock hard. She could barely talk and was in great pain. Her children could not figure out what happened to her. My job was to figure out what happened to her and find out more information regarding when and where the stroke took place and determine what happened to her between the time she left America and returned back to Haiti. Her family was so concerned about her well-being was dedicated to guarding her health.

Some patients came to hospital for malnutrition, looking for something to eat. There is no food for them at the hospital either. These patients are hungry and often come back in weeks looking for more food. Access to medication is not easy for patients with HIV, finding that even if they have medication, sometimes only the first forty patients will be seen to be given access to refills for this medication. These HIV patients have little to no access to ARVs, the medication needed to help the size of the red blood cells. Specifically, this patient has HIV and suffers from Anemia. Double whammy. Anemia is manageable sickness in the US, but in Haiti, it is not. Not only does this patient have to chase after medicine for HIV, they need to find medicine for their anemia.

Another patient was bed stricken with typhoid fever and the only thing that could alleviate the pain was the him walking and allowing himself to move throughout the hospital. There was nothing else that he could do. I told him to do as the doctor advised. Sure enough, on my out of the hospital, I saw him walking around the hospital with his mother. Trying.

All we have to do is try. All we have to do it walk. No matter how hard or how difficult. We have to make a way through.

Liancourt

Today we went to the Liancourt Health Center to retrieve some more data. This center was newly refurbished, given by the fresh paint that still lingered. I also witnessed the beautiful new labels that stood on each door as well. There was freshness to the place. Check out some photos down below:

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This banner reminds mothers of the community to give their child breastmilk only. Often times mothers provide their children with many other foods that are not good them.