Sunday, March 16, 2014



Our first full day in Haiti is behind us. We arrived to Port au Prince to find some positive changes. There were new shops in the airport, less 'pushy' men wanting to help you for a buck at the baggage claim. It was a welcome surprise. We met Jackie, a Frontier Nursing School instructor, and quickly made friends. We thought at first that we were going to spend three hours sitting in the airport waiting for the last of our group to arrive, but soon found out there were other plans. We were picked up by Ranel and taken to La Maison Hotel, a quaint little establishment not far from the airport. Two of our friends from our last trip would be headed to Hinche with us this trip and they had spent the night at this hotel. Another friend from our last trip, Sarah, was on her way out, but stayed with us through lunch. It's only our second trip, but we are already making lifelong connections with other volunteers.

Over lunch we discuss past trips, current goings on and our lives in general. We find out that Jackie knows of two of our friends from Alaska through Frontier, she knows a good friend from residency as another instructor at Frontier and an OB residency friend of mine that practices in Athens, GA where she lives. I am struck by what a small world it is. Are we playing a game of 6 degrees of Glen Elrod here? It seems like everyone is either a friend already, or knows someone I know. Crazy!

The trip back is much the same. Dangerous drivers, winding narrow streets. It doesn't look like much has changed in Port au Prince, until we come up to the river bed. The last time I was here I distinctly remember this river bed. There were tent camps still set up from the earthquake in 2010. They are now gone. This WAS an entire city of displaced men and women. Now, they were gone. No sign that they had been there. Nothing really has taken their place, but there were no tent camps. One of the groups say that it has been mentioned that they were simply told to leave. It's not as though they miraculously found housing elsewhere, they were just told they could no longer be there. I'm hopeful that at least some of them found housing.

At the house in Hinche, much is the same. Ina May has had at least two litters of kitten since last we were here and rumor is that she is likely pregnant again. There is commotion from all of the volunteers, some transient, some more long term. The food smells the same. The layout is nearly the same. There is at least one new wall to make an upstairs area a dorm-like room, giving added privacy. The wi-fi has been upgraded and is actually very nice indeed.

In a lot of ways, it seems like we never left. The streets are the same, the people are the same, but behind the scenes, much is different. We, of course, are not in the need to know about the inner workings of Midwives for Haiti or any other agency in Haiti, but we know enough to know that there are significant challenges with the local hospital and other agencies. Typical issues; money, protocols and staffing seem to be a high priority.  
What struck us particularly though, is just how diplomatic everyone is regarding this change. Don't say exactly what you feel because that will likely put an end to your cause. Tread lightly, respectfully, and through small steps you may make change and progress. The system will not change overnight, it simply won't.

One of our friends from last trip, told us about an exciting event at her local hospital. They had asked the staff what they could do to improve their maternity section. One of the options proposed was to build a free standing birth center, staffed and run by nurses but without the 'hospital' extras- IVs, continuous monitoring, and with the option of waterbirth if desired. She talks about the support she got from the hospital, so far as to travel from her home state to Boston to see two working free standing birth centers that operate within a hospital system. But, she also tells of the backlash from the rest of the OB staff for promoting this center. Again, what struck me in her explaining the planning and development of this birth center, is the diplomacy with which she has gone about getting this off the ground.

Maybe we can all learn a bit about diplomacy, not because we are going to become Senators or commanders, but because you 'collect more flies with honey,' as the saying goes. The struggles to provide maternal care in Haiti go well beyond decisions we make on a day in and day out basis in our own practice, but yet we can still learn to do things more diplomatically and with more grace and humility.

Tomorrow starts our full and, hopefully, exciting week. Tara goes off to the mobile clinic and I head to meet with the Chief of Staff to see where I am needed this week. Until then, Bonswa.


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