Yesterday was my Goddaughter Sabina's baptism.  Her mother stopped over a couple of days ago and said that it was my job to dress her so they would be stopping by and then we would go to the ceremony together.  I really had no idea what to expect but when I saw her, she was dressed up like a cupcake.

Sabina (didn't get a good shot of her face), her godfather and I.

When we walked in to the ceremony, I discovered that a wedding was going on at the same time.  Not just a wedding but a mass wedding for 27 couples!  Apparently an American pastor pays for a wedding once/year for couples in Haiti who can't afford a wedding of their own.  He pays for everything from suits, to dresses, to bouquets, to veils, to gloves!  It was really a beautiful thing to witness though i can't imagine getting married with so many other people around.  Somewhere in the middle of the ceremony they had three babies come up front (including Sabina), held them up and spoke words of blessing over them.  Apparently it wasn't an actual baptism but a dedication.

The couples sat in chairs directly across from each other and the wedding guests sat or stood wherever they could.

I love the 80's wedding dresses. :)

After the ceremony, Sabina's parents invited myself and Santo (who had accompanied me to translate) to a celebration.  They fed us maccaroni salad, chicken and soda. Unfortunatley we couldn't stay long because it was getting dark and there aren't street lights or anything where we live so when it's dark it's pitch black.  After we got home, Sabina's mom came by to give me my godmother's gifts: two slices of pizza (I have no clue where they found pizza in Haiti), two huge pieces of cake, and two bottles of soda.  It was a very sweet day and I felt so honored to be included.

Sabina's parents.

Parents and godparents with the special little lady. Doesn't she look sweet? Her dress was really hot though, poor thing.

Today Zeenia and I ventured into Cap by ourselves for the first time.  We were so proud of ourselves for getting onto a tap-tap, finding our way to the Justinian hospital, finding our meeting location and then finding a copy shop to pick up some documents we had dropped off on Wednesday.  We met with Eyleen from Meds and Food for Kids who showed us around the Medika Mamba program in the Pediatric ward of the Justinian.  We got to observe how kids are weighed, measured and she walked us through the forms we'll need to use in order to have a program at our clinic.  While we were sitting outside two mangos fell from a tree so Zeenia and Eyleen got to eat them.  Nothing like fresh mangos!  After the tour, we hitched a ride with two of Eyleen's co-workers and got a tour of the MFK factory!  It's really cool to see how they turn Haitian peanuts into medicine for Haitian babies. :)  After the tour she gave us all the materials we'll need to get started with our own Medika Mamba program.  Thanks so much to those of you who donated towards this program.  I'll keep you posted with progress.

Peanuts drying in the sun to avoid aflatoxin.

Peanut sorting machine.

I'm also going to post some pictures of the shade house pics up close for you to see.  I just can't believe how fast things have grown!

That's all for now.  Thanks for reading!

Dokte Sarah

Plants, Motorcycles and Paintings, Oh My!!

It's Easter Sunday and since Haitian traditions are vastly different from American ones (mostly because American traditions typically involve spending a lot of money on food and other things that won't be enjoyed past that day), it doesn't feel like a holiday the way Christmas didn't feel like a holiday.  I don't know what time of year it feels like but with no seasons and no real holiday celebrations to mark the time I often get confused as to which month and especially which day it is.  I made brownies since the power was on and I hear we're having fish to eat which everyone but me is excited about.  The staff members are excited because they could choose to either take the day off or to work and get time and a half pay.  Most of them are working and eating brownies.

We've had a few exciting things happen this week aside from Easter so here are some pictures with explanations

Our garden is growing like crazy! Not just the plants which have been in the ground a couple of months but the ones in the shade houses too!

View of the right half of the garden.

The view of the left half of the garden.

This is one of the new shadehouses Joe, Jaime and Ron built for us. Seriously folks, these plants were put in the ground a little over a week ago!  Things grow so well down here. 

Sean bought himself a brand-new motorcycle which he is learning to ride.  He is taking lessons from  a Haitian mototaxi driver which he said is like learning to swim from a Navy SEAL.  He took me out for a ride out in the country last night and did a great job!  We are in the market for a second helmet for me as well as knee and elbow pads which he absolutely must wear each time he goes out (my orders) because drivers in Haiti are crazy.  Like legit crazy.  I'm really happy for him as this has been a dream of his for a long time and am happy for me because I get to ride along and get to actually leave the birth center once in a while.  After not having a car for over 3 months, it's been feeling a bit like a jail.

This beauty is yet-to-be named but we anticipate many hours of fun and freedom in our future.

This week we had our friend Lucien (not our former employee for those of you in the know) come to visit us with things to sell as he does every week or two.  He is a very talented artist and told us his wife is in the hospital and her meds are really expensive so he was wondering if we could do something to help him raise more money.  So Sean had the idea to have him paint a painting here at the birth center so we could photograph the process and then have the painting taken to the US to be auctioned off at the Benefit Cruise our organization is holding May 13th!  He did a MamaBaby theme and it turned out really well.  We really don't want to send it to the US but I suppose he can probably paint us another one to have in our birth center.  I was really amazed that he painted the whole thing in just a few hours!

Isn't this beautiful? Lucien is the guy on the left and the guy on the right is his assistant (he mumbled his name when he said it all three times I asked so I didn't catch it) who is about 15 and is very talented. Both are self-taught artists.

Tomorrow were are hoping to go to the beach which will consist of a 1 hour ride in a taxi each way with fresh seafood, fruity drinks, white sand and clear blue water.  I'll try to post pictures in the next few days.

Thanks for reading!

Dokte Sarah

Where There Is No Diaper

Caution: This post isn't for the faint of heart.  If bodily fluids gross you out, stop reading.  Continue readingat your own risk.

Being a doctor who works with kids, it's inevitable that you will get peed on, pooped on, slobbered on, snotted on and vomited on at some point in your career.  In school when Dr. Mitchell my attending physician on several of my pediatrics rotations informed me of this, I noted it but since it never once happened to me during school I admit, I didn't really believe her.

Since living in Haiti there has been an ABUNDANCE of bodily fluids landing on our floor.  Fortunately the entire house has a tile floor so it's easy to clean up but still shocking each time it happens.  At least once a week a baby will pee while it's here for a visit and it's not wearing a diaper so it goes all over our floor.

I learned long ago not to judge a book by it's cover and since moving to Haiti I've learned that just because a baby has a super-frilly dress complete with a headband and frilly socks on does NOT mean that child has a diaper on and so I should NOT just pick up the child unless I want to get peed on.  This is an important lesson all of you should learn if you ever come to Haiti.

Also about once a week a child vomits all over our floor too.  Just out of nowhere we're doing an intake and "bhhhlllaaaatttt" there it is.  I wish the parents would tell us right away the child's been vomiting so we can get a trash can ready.

We also have some women who pee in our showers instead of the toilet when we send them to the bathroom for a urine sample because they're not used to using a toilet.  This makes me sad as it brings the realities of Haiti to the forefront: there are no decent places to do your business (you're lucky if you find even a latrine) so grown women are to scared of our toilets and opt for squatting in the shower instead.  I wonder how we can get them more comfortable with the toilets because nobody likes pee in the shower.  Please let me know if you have any ideas.

The other night we were hanging out upstairs after dinner when Santo came up and said there was an "emergency visit" here to see us.  Sean, Zeenia and I must have been bored because all three of us went down to investigate.  We found a young mom and her 6 month old, afebrile son who presented with several bouts diarrhea and vomiting over the past 24 hours.

We knew we needed to rule out cholera so we asked the mother what the diarrhea looked like and she couldn't really give us an answer since she hadn't been caring for the child that day but she told us he was having diarrhea every 15 minutes or so.  So we thought, "great we'll wait 'til it happens and then we'll see what it looks like and then we can decide whether we need to refer him to the cholera treatment center or not".

This baby was super cute, cooing and talking to us and chewing on everything in sight.  After a few minutes we heard him fill his diaper so we asked the mom if she had another diaper with her.  She said yes and took the first diaper off.  The stool was yellow in color and loose but not super-watery with no mucous (cholera stool is sort of a dark tan color, is very watery and profuse with whitish mucous) so we knew it wasn't cholera and could just treat the child for generalized gastroenteritis.  Plus he was playing so much that we knew he wasn't so sick that he was in danger.

We said "OK you can put the new diaper on" but she just sat there with the child standing between her legs on the floor and didn't make a motion to get the new diaper.  We were all starting to get worried as this was a 6 month old with diarrhea and this is a situation where a diaper is ABSOLUTELY necessary but she was not making a motion to get a new diaper on.

I looked around her and saw she didn't have so much as a purse or a diaper bag in the treatment room and I couldn't figure out where this mysterious diaper was and why she wasn't reaching for it.  So I decided to take action and left the room to go grab her one of our cloth diapers when I heard a splat hit the floor and sure enough, this sweet little baby was having diarrhea all over our floor.  I just started shrieking "where is the diaper!?!?!" and Santo was translating this to her, and the mom still just sat there as if her child wasn't having diarrhea all over our floor.  Most moms I know will jump at the knowledge that their child is having diarrhea all over someone else's floor but not this lady.  She just sat there.

By this time it was getting dark and since the power was out and it was hard to see what was going on I knew I had to grab my headlamp as well as the diaper so this allowed for even more diarrhea to get on the floor.  By the time I got back to the room with said items, a man (must have been the baby's father) came in from the porch, with a diaper bag containing the diaper this woman had claimed to have all along.  She got the diaper onto the child's bottom and we bleached the floor like it's never been bleached before (read I put gloves on and bleached the floor...yuck) and all was well.

We still can't figure out why this woman just sat there and wasn't running for the new diaper or asking us to get it for her if she knew it was on the porch all along.  Apparently there isn't a sense of urgency relating to bodily fluids in this culture that we so obviously have in our own culture.  We ended up giving the mother some instructions on how to keep him properly hydrated and gave her warning signs of dehydration and sent them on their way.

As I say so often here in Haiti, life is NEVER dull.

Thanks for reading,

Dokte Sarah

3 Ways MamaBaby Haiti is Working to Combat Hunger

I promised you I would update you with Joe's answer to the question "Why are people in Haiti are always asking us for more money?".  He replied that it's because they live for today, don't usually plan for more than a week in advance at a time and because of this, they want to ensure that they will get as much from us as they can because they don't know when we might pick up and leave.  It made me stop to think that it's not a bad way of living.  In the US we are taught from a young age to save for a car, save for college, save for a wedding, save for kids, save for kids' college, work hard, work harder and it goes on and on.  It's exhausting and we so often forget to just live in the moment.  I'm not saying don't save your money for a rainy day or retirement but there is something to living each day to its fullest and know that tomorrow will take care of itself.

I have been so impressed and inspired by these three guys, Joe, Jamie and Ron.  They are some of the most humble human beings I have ever met.  They have been getting up at 5AM each day, working until breakfast, going back to work until lunch, taking a siesta in the hottest part of the day and then working until dinner.  This is the result of their hard work:

From Left to Right: Nancy, Ron, Jamie & Joe put the finishing touches on one of two shade houses they've built for us.

Thanks to their hard work, we now have two shade houses in our yard which provide a climate 15 degrees cooler than the outside air where we can grow delicate things like lettuce and other greens!  The cover for the shade houses allows 40% sunlight through and has holes big enough to let the rain in.  We are so excited to see what we can get to grow in them and I'll do my best to keep you updated with pictures.  The next step is to have classes with some folks in our area to teach them how to take what we are doing home with them to grow their own food for their families.  We envision providing them with seeds and tools and offering our help as problems arise.  This is one way we are working to combat hunger in our patients.

Another way we plan to combat hunger is by fundraising to buy Medika Mamba, a fortified peanut butter made by Meds and Food for Kids here in Cap-Haitien (www.mfkhaiti.org) designed to provide adequate nutrition for kids suffering from Kwashiorkor, Marasmus and other malnutrition diseases.  Currently we are able to send kids to the Justinian Hospital in Cap, but it's difficult for some of our patients to make the 90minute round trip trek once a week, especially if they can't afford the tap-tap fare (about 75 cents).  So to solve that problem we're going to receive training next week from Eyleen, a woman who works for MFK in proper re-feeding protocols and procedures.  Then we'll be able to take care of our patients right here without having to send them away.  We have the vision, we'll be receiving the training but we can still use some more money so if you'd like to make a donation towards this project, please do so here and earmark it for Medika Mamba.  Each container is 1.1kg and costs $2.50US.  We will most-likely be buying 20kg at a time for $100US.  Here are some facts from the MFK website:

What's in Medika Mamba? Medika Mamba is a RUTF (Ready-to-Use Therapeutic Food) made of ground roasted peanuts, powdered milk, cooking oil, sugar, vitamins and minerals.

How long does treatment take? A typical treatment program for one child lasts 6-8 weeks and takes 25 pounds of Medika Mamba.

How effective is Medika Mamba? Within six weeks of starting treatment, 85% of children on Medika Mamba recover, far better than the 25% survival rate with older milk-based treatments.

How much does treatment cost? $65 covers the cost of a full Medika Mamba treatment, saving the life of one child.

No amount is too great or too small to get some nourishment inside the bellies of some of our most vulnerable patients.  Please consider giving what you can today.

The third way we are trying to combat hunger among our patients is through Operation "Happy Meal" or "Manje Kontan" in Creole.  This idea was born when MBH volunteers Nancy Becker and Susan Moray saw how awful it was for our patients to sit and wait for appointments all day without having a nutritious meal.  The obvious answer was for us to provide them with food but as we have learned free food often causes riots in Haiti or at a minimum patients with fake symptoms just wanting to be fed so their solution was to provide the seed money for a woman from the community to sell healthy food inside our yard while patients are waiting so they can get healthy, safe, reasonably-priced, protein-rich food instead of eating cookies and sugary juice.  They hired Santo to be the manager and Jason (our guard)'s girlfriend (I don't know her name yet) to make and sell the food.  Yesterday was our pilot day and she sold out of everything by mid-day!  She offered rice, saucepois (bean sauce), chicken, salad, juice with NO sugar added (a very rare thing in Haiti) and bags of potable water.  We are so excited for this because it provides more money for Santo, a job for Jason's girlfriend and a good opportunity for our patients to get nutritious meals while they wait to see us.

Thanks for reading!

Dokte Sarah

Navigators in a Foreign Land

This week we are fortunate to have Joe, Jamie and Ron here with us in Haiti.  These guys have spent lots of time traveling around the world and have been to Haiti a few times.  They are good ol' boys from Missouri and have lots of great stories.  They work with an organization that takes people around the world to serve others by helping to build churches, schools, gardens and homes for people.

Joe works on sustainable food projects (he's going to teach classes to interested patients who want to learn about gardening), Ron works with clean water (we're hoping he'll consult with us on our well and how we can help get clean water to our neighbors), and Jamie likes to build.

They have come to stay with us to build us two shade houses for our garden and we are SOO excited.  This will mean we can grow plants about 15degrees cooler than the outside temperature and these plants will have a cover which will allow 40% sun and rain water to soak through.  Apparently they have built these all over Haiti and several other countries and the recipients of these shade houses have had a lot of success.

Here's a photo of Ron, Jamie and the appropriately-named Redheads Without Borders members Nancy, Eve and Susan prepping the ground for the shade houses.

Joe is sort of the ring-leader and has came to Haiti three months at a time 6 different times.  He speaks a bit of Kreole and has so many great stories to tell.  I have a feeling these guys are going to give us a lot of insight into some of the cultural things about Haiti that continue to stump me.  Sort of navigators in a foreign land if you will.

Yesterday I was talking to Joe about how much people want to be paid in Haiti since we almost always have an employee dissatisfied with their salary.  When we first came to Haiti we were advised that $100 USD/month was adequate since the average person in Haiti makes $600/year.  We have paid our employees well above that and we also provide room, board and free health care.  Yet some are still unhappy.

Joe said they will always be unhappy with what we pay.  We were cut off after he said this last statement but I plan to pick his brain to try to understand why.  Is it a cultural thing to try to get as much as you can?  Are they worried we'll pick up and leave and they'll be out of a job so they better get what they can?  Do they see our extravagant lifestyle in comparison with theirs and think they can probably get more pay?  I'll let you know what I find out when I get a chance to talk to him.

I am looking forward to this week not only so we can learn more about gardening from this trio, but so we can also have some help navigating our way through this foreign land.

Haiti is Hot and Humid

I lived in Phoenix for 4 years and tolerated temps up to and above 120 degrees.  I also have a thyroid condition which makes me colder than the average person in most situations.  When we decided to move to Haiti, I wasn't worried about the heat because of these reasons.  I failed to calculate the humidity factor and what that can do when it's over 90 degrees in the cement house where you are trying to sleep and the power is off so you can't use the AC or a fan.  It's hot here.  Really really hot.  It's only going to get worse too.  Fortunately we found a nice little (well, big really) diamond in the rough where we will be spending many afternoons this summer, I'm sure.

For just $5/person we can swim all day at this pool while enjoying cold beverages with ice made from purified water and listening to music on their great sound system to which we can hook up our ipods.  Life will be much cooler than we had anticipated while we try to help our patients without sweating all over them.