Never the same 2

Publishing trouble so I'll do it in sections.
Wanted to tell you about last night.
We drove the 5.3 hr ride, in pitch black, in a little under 2 hours. I hope I can describe as I did in what I presume is a lost blog.
Imagine driving through a dark city. No or few house lights, no or very few streetlights. The roads are full of holes and bumps, large rocks, trees and hills of building materials. (Everyone is ALWAYS building). Around the corner is suddenly an ocean of little lights. I was instantly transported into a novel by Charles Dickens. The market stalls lining all the roads and selling the oddest items, from chewing gum to inner tubes to hats, were more alive than during the day. Children were playing, old women, sitting on crates with their knees out wide in comfort, a grandchild leaning into her. Men bantering on corners, teen boys eyeing groups of beautiful teen girls, younger women in roaring, squeeling laughter. And every stall had one or two candles in a can, which resulted in an ocean of warm, yellow dots of lights winding, rolling as we left the city. I will never forget that.

Thanks, Haiti

It's Sunday, the last of a 3-day holiday weekend. It was nice to have a few days without running around. Sander's comment on "Haitian time" is right on. You do get used to it. It becomes an issue only when you deal with other nationalities. When meeting a Frenchman, for example, you will meet the person perhaps 10 minutes after the decided time. When meeting a German you better be 5 min. early. Funny how we don't blend in.

Explain Kwasiorkor, Sander asked.
It's known in short as "Kwash" and is basically a child with malnutrtion. The child has started to loose hair, with the mohawk on top left, and the hair is often (not always) orange. Not all kids with orange hair have kwash, however. Severe malnutrition shows very fat, healthy kids. in fact: the fatter the more ill. This isn't fat but oedema, when the body retains too many fluids. When you punch the child's legs and feet, the dent may be 1 cm (about 1/2 inch) deep and stays. With other symptoms this is a +3 (highest) level kwash. When the dent is deep but goes away, it's a lvel +2. The children are treated with high protein etc levels of fluids (IV if needed) until the oedema goes away. It is the same with the "healty" babies with big bellies. When the eodema is gone, you have a very skinny, ill-looking child left. Some are close to comatose.
With the Medika Mamba or PlumpyNut, these +3 children can leave the hospital in 5 days or less. A miracle. The +2 children receive, instead, high protein etc milk, called MP3, which has the same effect. The +1 children are treated on an out-patient basis in their mountain villages.
So these two meds I have fought for and we're getting it FOR FREE, which saves many children and so much faster, while saving the hospital thousands and thousands of $ annually, to be used for other causes. One of those is the Ti Foyer, or "little hearth" in each village, where mothers are taught nutrition that is within reaach and within their means. Such as a food co-op.

Now I am on another project: a school for the hosp children ages 5-15 and for their running around siblings, run by volunteer spouses and students as available.
The proposal has been written, as is the list of items to be used (self-directed, Montesori style for all ages) and where it should take place. I am meeting with Dr. Maibach, hosp. med director, and Ian Mello of the Mellon Grant Foundation this week and I intend to get what I want. The fact that the Medika Mamba (med. peanutbutter) came through should help!
I am going to send some photos if I can. I'll do so separately, since I screwed up the last blog I wrote. Or maybe you'll get two. Should keep you off the street.
Thanks for your comments, Sander. Much appreciated. I don't always knowwhat people know or what should be explained.
Love to all. Another 10 days and I'll be home. I hope they'll be productive.
Love, Mom/Marianne

Disappointing

Hey everyone. Some days are up and then others are reality checks. Full of hope ad excitement, I rode a particularly painful ride to Port au Prince today. Five hours of the worst, with a bump against my back that left me with bruises. There were 11 people in the max 7 van, plus luggage. Add heat and it's not pretty. I mean a van organized like Tjitske's limo, with the benches on the side. Minus the champagne and beauty.
We had left HAS at 5 am and were in PaP by about 10:30 am. The driver dropped everyone off, then took me to UNICEF. That sounds simple. It isn't. Nothing is simple here. After waiting for over an hour (so did the driver) I was called in only to be told by a secretary that it "impozzible " (French lady) to get the PlumpyNut today. She needed three signed copies, and why didn't I know that (nobody emailed me that info, nor to Erlantz. Etc etc.) I was about in tears. Finally one of the two people in charge asked me to join an interesting meeting. And indeed it was. It lasted an hour and a half (couldn't find my driver to tell him) and was held by about 20 people from many nations. It was in French, but I could follow most of it, and easier as time went on. The organizations were Save the Children, Catholic Youth Services etc etc etc. Each wanted to coordinate efforts to help the children caught in the hunger and hurricane devastation (many go hand in hand). I had no intention to open my mouth, but when they asked I was surprised and proud how much I have learned these last 2 weeks (1 week??) and how many statistics I had correct. They were 'impressed' with the severity of our situation. Right now we have 19 severely malnourished children (ages 0-5), two intermediate and one critical.
For us the situation was just utterly frustrating: "but you need this form, and that paper, and this letter head, and such and such in triplicate..." It all made sense, but why hadn't they told us? I again stressed the need and severity. Now we need a specific letter and when we bring it next week (we're going Tue) we will get the PlumpyNut for the severe patients, and MP3, which is a highly enriched milk product, for the intermediate malnourished children. And that is more than we have now. MUCH more. Betsy: I'm using your money to transport the PlumpyNut. Thanks!!!!

After that we went 'bump' in the night, all the way home. My driver ended up patiently waiting until 4:30 PM and then took me - what all women in frustration apparently do: shopping!
I went to the international supermarket (Starry's request) and bought ham, Dutch cheese, tostido chips and salsa, wine, beer, whatever. A big box full and my gift to them for staying here. I hadn't eaten since lunch yesterday and was S-T-A-R-V-E-D.

Many funny things happened today on the way, but I am too exhausted to remember them now.
Except the 5 tiny goats butting and playing in the middle of the road. We were going 90 mph and the driver honked loudly. All the little goats jumped 1-2 feet into the air and then scattered. We all burst out laughing! Tomorrow more. I am taking a day OFF! (It's a holiday here)
My kreyol is really improving! I could speak a little and now, through all the confusion of languages, I know nothing. OK. Au whatever. Love you.

Going to school.

Hey everyone. It's nice to see that the blog is being followed. Thanks!
Today is not/appears not to be so hot, for which I am grateful.
My first thing this morning was to hear that Erlantz and Starry (my hosts and friends) new German Shepherd (imported) puppy died during the night. They, maids included, were really distressed about it. Very sad.
At 8 am I had my first Kreyol private lesson. Wesley, professe, has written a book to learn Kreyol and it is excellent. i think I will finish book 1 before I go home so I will pass it on the Sander. Very logical-I like it. I bought one for you too, Carl, and already signed you up for lessons: 1 hr/day for the two weeks we're here.
After this I went to the malnutrition ward and established the manner in which infants need to be measured (if they're strong/old enough to stand up they can be measured by the scales.)
We measured all the children, some under immense protest with the mothers looking on with smiles: something imporrtant was being done by le 'blan' and it didn't hurt for a change.
I took a ton of pictures this morning and thank good ness for digital: they all had at least (the mothers) 2 shots each. I also took photos of the women washing clothes, mothers nursing babies with kwasiorkor, the measuring etc etc. In addition to that I visited an adorable kindergarten class with a ton of colorful pictures there as well. So much fun and a healthy contrast.
As I was walking down the hall, I saw a man all alone on a stretcher. I went to say hello to him, only to find that he was dead. That was a bit of a shock.
Our letter is going out in about 30 minutes and then I will set up the new protocol for the malnutrice ward. I don't know who I think I am or, for that matter, who they think I am, but Erlantz, the pediatrician has faith in me so I forge ahead and learn.
There is a very tall guy who waits for me everywhere and is "the village idiot" as Starry explained. He scares me a little. He actually speaks quite decent English but I can't get him away from me. I told him that I was married and he let out a long "ooooooh!", followed by "Can I take you for a walk on Saturday?" Oy. Better keep him at arms-length and on my good side.
The food is great, but a little hard to have only one meal (midday) per day. The maid figured out (how??) that I should eat something in the morning and she made me toast over the open fire and this was presented with a jar of the most delicious pineapple jam and...a jar of Prego spaghetti sauce. I had a little of both, of course.

OK. Enough. If Erlantz can help me unload my pictures, I will send a bunch to look at today or tomorrow. Love to all. Do not worry: I feel more safe here this time than any time before.
Mom/Marianne

ouch

I am wearing anklets now. Courtesy of mosquitos.
I admire them all night long.
This morning another staff meeting, at which I still have nothing conclusive to present.
It takes time. Haitian time.
Hard to sift though the real and pretend numbers.
Erlantz and I are going to compose the letter to UNICEF this morning, which means that there is no mountain trip for me yet. I am disappointed, but this is a priority.
Miss you guys but also not. Too much to do to think about missing people.
The 'maids" (Hate that word) are so good with laundry that they turned my light blue and cream underwear into absolutely sparkling white. Nice to have something new.
Yesterday I gave their children some of Keri's beautiful clothes. They were as happy as I was to see their kids in those bright colors.
It's 6 :30 am. Short words. Much love.

First few days at HAS

No pictures to show today, but tomorrow they will be here. Too much trouble with the computers and SoooooooooooSllllooooooooooooooow.

All is well here and the hospital is entirely different from my/our last visit. Last time everything at Hopital Albert Schweitzer (HAS) was in shambles. Not only did the left hand not know what the right one was doing: nobody KNEW there was a right hand. Nurses slept through the night and patients died which was discovered in the morning. No longer so. Dr. Rolf Maibach, an elderly gentleman from Switzerland is the new Medical Director. He looks like Schweitzer, has very kindly and patiently (in a hurry) turned everything around and the result is astonishing. There are only four employees left from the original, plus the administrator. The place is clean, obedient, responsible and works like a charm. The first time we were here patients were disappearing and no-one knew why. Now they have all returned and in large numbers.

My work is mainly in and with the malnutrition ward. At this moment there are about 18 children admitted, several severe cases. four year olds are really nine and babies all look like premies. It turns out that it is not only extreme poverty. There is a hirarchy in each family that runs from father to mother and down age-wise to the youngest when it comes to food. Therefore the youngest gets little to nothing. There are two excellent programs: one to teach nutrition according to what it available and secondly a co-op system where all contribute equal amounts of money and what is brought back from the often VERY far away market is distributed equally among all.

These outreach clinics are called Ti Foyer and is open a few days a week. Most are very far into the mountains and difficult to get to. On Monday I will have my first experience. That is to say: I am already up to my ears in work (in the fanned library :-) with statistics, creating a different system of recording information which was neatly recorded but inadequate. In addition I am figuring out overall percentages of weightloss/gain.

The problem is that only age was recorded, but not height AND age AND weight. UNICEF wants all three in order to have the PlumpyNut distributed. It makes perfect sense, when you think about it. A child who was born underweight and has failure to thrive will have different relative weight and height than one born healthy. So I am in the process of making new charts and guidelines. Fun and going well.

On the way here, from Port au Prince (PAP) to Deschapelles, I saw some of the lesser devastation. Water had come rushing down from the mountains and when it reached the ocean wiped away entire houses and villages. The holes in the roads are deeper and larger than ever.
It was good to see that, even in the dark of night, the American crews were working with large, shipped in equipment to repair the roads. Especially the sides were dangerous with 3 feet deep (1 meter) shoulders. In Saint Marc, where my Jean and mother Gladys live, roofs had blown off shanties and I was so happy to know that they now live in a real house. The park in the center of the city was locked because trees had fallen over. The last thing they need: losing more trees.
I don't know whether I will make it to Gonaive, the town on the coast north of Saint Marc.
That city was hit worse than any other place in Haiti. My (new) friend here, a very wonderful endocrinologist, told me that the city has been wiped away. She has visited twice but said that, without large equipment, many people and an amazing amount of money there is little that can be done. And disease is brewing.

On a more positive note: I am staying at the house of the brother of (:-) our friend Dr. Nathaelf Hyppolite. Erlantz (the brother) is almost married to Starry (is proposing Sunday night) and they have an adorable and beautiful 4 mo old daughter named Jasmine. They also have a new puppy, a German Shephard who pees as much as Jasmine and is equally loud at times. Both adorable, though and a good step away from it all.

The malnutrition ward is a bit hard to take. However: a volunteer over the summer convinced the nurses that cheerful music, activities and colorful pictures would change and improve the atmosphere. And indeed it makes a difference. This afternoon Erin, a college volunteer who took half a year off to do this work, and I will begin to distribute the colorful and soft sheets you all donated. And the little blankies. All have to be marked HAS with permanent markers or the mothers will become the sole owners. That isn't the idea.

Dede: thank you for your idea for a fund raiser. What they need most right now is scales to weigh the children as well as height-measuring sticks to take out to the Ti Foyer. I have thought of using the new digital suitcase weighing aparatus sold by the AAA. I bought one and they are extremely fast and accurate and hand-held. All I need to do is make some sort of heavy-duty sling/swing to attach to the bottome. They cost $14.95 if you are a AAA member. We need at least 10 of them, one for each Ti Foyer and for future expansion of that program. The measuring sticks are also VERY important (Sturdy tape measures if need be that can be mounted to the wall) so we can start/continue receiving FREE PlumpyNut from UNICEF. Now all children can receive it, rather than a control group. Needless to say much more is needed, but those are rather urgent items.

An additional idea was born. The parents will take the take-home food to the market to sell. It tastes great and they're all hungry. Solution: cut the tip off so it is open (can't spoil) to prevent selling. Let's hope it works.

Let's also hope that sending this blog works.
Sending you all my love. It seems like I have been in this so different world forever. There isn't a moment rest because everyone needs something or some help all day long. I am glad to be useful rather than spending my day twiddling my thumbs.

Tomorrow 'my boy" Jean-Marie and his mom Gladys are coming for an overnight visit. I look forward to snuggling him again! I'll take pictures of your godson, Sander!

Marianne

Testing-testing..1-2-3... So far I have made it to Sander's in Brooklyn, where I'm spending the night before zooming off tomorrow, October 8.
Hopefully more soon.