Wednesday, October 10, 2012

Some Numbers: Me + Haiti = ___


Just thought I'd try to enumerate some of the things I got to do while in Haiti! Let's see, I...

...helped take care of (at any point, not necessarily continuously or all at the same time)
     6 babies
     2 toddlers
     3 children
     3 teen girls (2 of which were pregnant)

...watched and helped with (sometimes even translated)
     13 deliveries
     countless prenatal/postnatal consultations

...learned how to
     measure the baby bump's size and compare it to its gestational age
     palpate the baby bump and figure out the baby's position
     listen to and measure the baby's heart rate, both before and after birth
     take someone's blood pressure
     provide lots of back-up assistance at births
     do the charting at a birth
     give nipple stimulation to a woman in labor who needs more contractions
     keep women in labor changing position and moving around

...worked with
     2 Haitian midwives
     2 Canadian midwives
     1 American midwife

...spent 10 weeks (69 days) in Jacmel, Haiti

There's plenty more to list and describe (especially in the "what I learned" category, of course), but I think this is a good little summation or summary. And this doesn't include all the things about Haitian culture I learned about... That would take too long to write out and describe in a list like this (so I just focused on the clinic). Good times! It's all been incredibly satisfying and fulfilling!!

Thursday, September 27, 2012

Reminder!!

Just to reiterate... Here are some very affordable options if you're interested in contributing something to this incredible place:

Please take a quick look at OTP’s wishlist for 2012. It’s an easy, tangible way to help OTP in the coming year. Of course, they also really appreciate cash donations, monthly or otherwise! (Check out the website or send an email if that's your style.)

Thanks!

Wednesday, September 26, 2012

What will I miss? (or not)


After waking up at 7:30am to a kid practicing drumming on a big, echoey, plastic bucket next door (this isn't the first time)... I decided to think about some of the things that I'll miss, and some of the things that I really won't miss. This idea came first out of frustration, but then sounded like a kind-of nice/interesting/reflective post, so... there ya go. I'm leaving on SATURDAY, in just a few days, after all!! (so crazy.) These are listed in NO particular order.

Things I've enjoyed and will miss:
- all the people; Sarah, Melinda, Ninotte, Sabine, Gislaine, Shela, Cahle, Danaelle, Ismani, Dada, Franky, Linda, Marita, Craig, Brian, Yvette... the list goes on.




- constantly feeling like I'm in discovery/learning mode
- late-night hang-outs with the midwives after we put the kids to bed
- the nights and mornings that are blissfully cool, and made all the more special by how hot it gets during the day
- the busy times in the clinic that were filled with consultations, lessons on checking/feeling a baby (inside and outside of the mom), and births



- watching Danaelle do everyone's hair in the neighborhood



- Danaelle's cooking
- trips to the beach to swim in warm water, drink beer, and eat delicious fish & bananes


- Bassin Bleu; I would have loved to go there at least once or twice more



- all the colorful art!
- the beeeeautiful island, both on the beaches (when there isn't too much trash piled up) and up in the mountains, where green seems to stretch forever



- Sarah's affectionate cat, Cat


- speaking Haitian Creole, since by now, right as I'm about to leave, I'm finally speaking and understanding quite a lot (yay immersion!)
- the fruits (and fruit juices) of Haiti


- COCONUTS, fresh coconut milk, coconut meat (either young and soft or mature and crunchy), all coconut-flavored food and sweets...


- the relaxed, slow island lifestyle
- being a part of the clinic, helping out, knowing how it all works and flows
- getting to watch and help with the deliveries in the clinic
- tagging along on various adventures to places like Kay Joe, St Michel Hospital, the Alliance Fran├žaise, clients' houses...


- the gorgeous blue of the Caribbean


- hilarious moments with Danaelle and Dada, those goofballs
- quiet moments on the roof, especially in the evening when it was cooler (and maybe there was a sunset over the mountains, too!)
  

 - having a great mix of English speakers (so I didn't ever feel overwhelmed or homesick for the mothertongue) and Haitian Creole speakers (so I was still extremely immersed and was able to practice/learn Creole really fast!)
- moto rides (aka Haitian taxis)
- sitting/napping/reading in the hammock at the volunteer house
- Ayiti (Haiti)



Things I'm really not sad to part with:
- the little drummer boy next door, who has woken me up early on numerous occasions
- the loud party music that blasts late into the night at the restaurant nearby
- the fact that people burn their trash sometimes (if they don't just dump it in the river), which a few times happened in the morning at my neighbor's... Melinda and I were "smoked out" of our own house, since the smoke came in the windows, woke us up, and sent us outside.
- people assuming I'm rich and trying to cheat me when I buy things (although I'm pretty good at getting the right price now, which can be satisfying!)
- everyone here calling me BLAN because I'm white
- the association between voodoo and everyday life, which can sometimes convince people to stay home with a voodoo priest instead of going to a doctor (this is often life-threatening)
- the trash that is scattered (or sometimes piled/heaped) anywhere and everywhere
- the humidity and heat, especially at its peak
- Sarah's puppy, Crab (and all the puddles it would leave INside the house)
- needing a mosquito net to sleep; it makes it even hotter!
- MOSQUITOS and all their dasterdly little bites
- the risk of getting sick with all kinds of exciting, different maladies
- the girls' DVDs, because every single one is horribly scratched and constantly skips or freezes
- COCKROACHES. especially the huge ones
- being just a little too long for my bed, which isn't ideal for the mosquito net set-up
- the frustration of a long struggle of a day with the kids (only sometimes)
- the risk of getting weird bleach marks on your clothes if you give them to Mona to wash
- struggling with internet and phone connections

Personal Health in Haiti

So... I hope it isn't awkward to talk about one's personal health on a blog. But everyone always worries and wonders about health and safety and whatnot when people travel to developing countries, so I thought I'd just enumerate my brushes with less-than-perfect health while I've been here.

I came with the knowledge that there was a huge number of big, scary things that could happen to me here, health-wise. There are the obvious, well-known ones - malaria, cholera, tuberculosis, dengue, etc... and then there are some lesser-known ones like leptospirosis and histoplasmosis (and I forget the rest of the long list). Before the trip, I had to make sure I was vaccinated against all the usual routine things, plus Hep A, Hep B, typhoid, and rabies.

I escaped the cholera because it seems to be a bit less of a risk these days (or at least around Jacmel) and because we're always very careful about only drinking the super-clean, treated drinking water. I escaped all those nasty mosquito-borne illnesses (malaria, dengue, etc.), although I haven't got a CLUE how I did that*. There were days when I would look at my calfs and count over a hundred little pink bug bites - it was truly awful! Despite my use of Permethrin and DEET (on clothes and body, respectively), it wasn't until a couple weeks before I left that I started to feel that the mosquitos were starting to get tired of me. Ugh. That wasn't fun. (*I was taking chloroquine as a malaria prophylactic the entire time I was in Haiti, although I guess there's still a small chance of getting infected. Especially if you get bit as much as I do/did.)

Despite all the warnings about traveler's diarrhea and the like, I arrived and was essentially in perfect health for about 4 weeks! I suddenly got hit with a bad stomach bug that kept me in bed, unable to eat anything, and having diarrhea (even vomiting once) for about a day. It took me a couple more days to recover fully, but I was eating normally after that first day. It was far from pleasant, but it didn't last long. Melinda and Sarah took good care of me, and gave me pills of grapefruit seed extract and activated charcoal to kill off the bad bacteria in my gut. Not the end of the world, and not dangerous.

A couple weeks after that, I had the strangest experience! I was in the clinic, late at night, and we had just finished up with a birth. I had eaten plenty, and I'm always sure to stay super well hydrated, and I've never fainted. But as I was standing in the birth room, I very suddenly felt as if all the blood had just rushed, or dropped, right down out of my head, and I was certain that I'd fall over if I didn't go sit myself down first. I left, sat down, put my head between my knees... it helped a little. I drank water and lay down flat for a while, dozing off for almost half an hour. When I woke up, I thought I still felt a bit weak, but normal enough to go home to my real bed and sleep. The moment I sat up, I instantly felt SO cold and got goosebumps all down my entire body! I started shaking with cold... and this is Haiti, mind you, where shaking with cold in the summer is out of the question! The other really disconcerting thing was that my face was pasty white, and my hands were ghostly white, with a bit of bluish-purple under my fingernails! I was seriously cold. The way I felt at the time was like all the blood and heat from my head, arms, and legs had rushed out of them and into my core, which made my extremities SUPER cold and weak (or at least I perceived them to be) and made my core way too hot, as I discovered later. After curling up in a quilt, drinking some Emergen-C, and huddling into the smallest ball on the floor that I could, I gave up on getting warm enough. Instead, I curled up in a clinic bed, triple-wrapped myself in quilts, and finally went to sleep. I woke up asking Melinda for another quilt, but she correctly guessed that I was, in fact, just way too hot and needed to extract myself. I eventually was able to get the blankets off and started to feel more like a normal person in Haiti with a tiny fever. (By the way, this entire time of shaking and teeth-chattering, the thermometer showed that my fever was never very high! so weird.) I woke up the next morning feeling mostly fine, and by midday was feeling completely myself again! I had a slightly runny nose for the following 5 or 6 days, so I'm guessing it was just a crazy weird virus... There was a moment in the middle of the night that Melinda suggested it might be the beginning of malaria, but it THANKFULLY turned out to be a much nicer pathogen than that. whatever it was.

Other than all the mosquito bites, and those two bouts of short-lived sickness, the only other thing was this weird rash on the top of my left foot. It's about the size of a quarter, and only itched sometimes (very rarely, in fact), and has taken its TIME to heal up! Around the time it started, Sarah and Melinda were both struggling with a bit of scabies (i.e. teeny tiny bugs living in your skin, and whenever they pop up out of the surface, it makes a red/inflamed bump... hence the rash. gross, I know)... so I figured I had just caught a bit of that. Everyone agreed that that's what it looked like. Melinda came back from Canada with some permethrin cream, which is supposed to kill scabies off after a single application, so I used that on my foot and sandal (and also changed my sheets). Nothing happened. I used it probably 4 or 5 times over the course of maybe 4 days, and it didn't do anything! I tried a few other things, and... gave up. Time went by, and it eventually dried out and seemed to go away. Then it came back. Then it looked like it dried out again... We realized, as it was fading, that it was pretty round - it might be ringworm! gross again. My seemingly untreatable scabies/ringworm/mystery skin rash has taken its time but appears to finally be on its way out, after countless weeks!

...exciting! (?) gross! But all in all, it was really all quite manageable and low-impact. :)

Monday, September 24, 2012

Woah. Things just got real.


Well, I've officially surpassed what I ever expected to be doing while in Haiti! I spent an entire night as a birth assistant AND an English-Creole translator for a birth...!! 

Quick background: Sarah is about to come back, but Melinda and Ninotte had to leave for a midwifery conference and Ninotte's midwifery exam (Good luck!!), so another midwife has come for a short while to help hold down the fort. It's her third time doing midwifery work in Jacmel, and she worked with Melinda and Ninotte back when they were at Jacmel's other birthing center. This midwife, Yvette, is a lovely person who seems to have truly found her calling in midwifery, and it's been a delight getting to know her and living with here here! 

Yvette has a bit of basic Haitian Creole from her previous time here, but she didn't really have a chance to learn much in the past and it'll take a bit of time for it to all come back. This means that... in the clinic, as I'm the only other English speaker, I'm suddenly in the position of translator! We thought that maybe I'd translate in French to Gislaine, who could then translate into Creole, but given that I haven't been using my French at all... it turns out that it's somehow less of a headache if I just try to keep it in pure Creole instead! Crazy. 

So back to the story. Yvette and I were just getting ready to lay down to sleep in the clinic with the girls - we had put them to bed, showered, and had just turned out the light - when Gislaine called with the news that a client was in active labor! Yvette and I got back up, grabbed the birthing kit, our client's chart, truck keys, phones... Gislaine lives close by and managed to meet us outside the clinic by the time we had everything ready to go, and we all quickly piled inside. With Gislaine's directions, Yvette's driving, and also, suddenly, my first need to be translator, we made it to the client's house just as they were bringing her outside to meet us. 

Although it wasn't marked on her chart, it turns out that the client also goes by Yvette! ha! She and her brother got in the truck while her husband (boyfriend?) followed on his moto. The truck ride was uneventful, and she still wasn't very loud or distressed yet. 

While Gislaine checked Yvette-client in and took her vitals, Yvette-midwife and I made sure we could find all the things in the clinic that we'd be needing over the next several hours. At first, Yvette-client was pretty restless and uncomfortable, but it was only a matter of time until she found her zone, or rhythm. I think it helped her to have baby's papa there to support her, since Gislaine was the only other person she really knew in the room. And luckily for the girls sleeping in the next room, she mostly had a pretty quiet labor, only speaking in low tones up until right before the pushing started.

During all of this time, Yvette-midwife is in charge, making decisions and suggestions, while Gislaine and I tried to make ourselves as helpful as possible. We both helped with translation - when the sentence was simple enough as Yvette said it in English, Gislaine could relay it in her better Creole, but I still had to do a lot of quick thinking in order to communicate all of Yvette-midwife's other messages to Yvette-client! This is already way more Creole than I've spoken so far here, so as I thought about this all in retrospect (I was way too busy and focused to realize it at the time)... it's really quite shocking and lucky that it all worked as well as it did! 

We had arrived back at the clinic around 11:15 pm or so, and after only about 2 hours or so, Yvette-client was starting to push! She was very uncomplicated, other than an extra water-filled amniotic sac that made it a little tricky to feel the baby's position early-on. After pushing for a bit while lying on her side on the floor, with head and leg propped up, she changed position to be squatting on her feet and leaning forward against the bed (and later against her man). I think this helped the baby get a little extra pull downwards from gravity, because pretty soon after that, we started to see some hair peeking through! 

At this point, I mostly recorded notes as Yvette-midwife caught the baby and Gislaine was an extra pair of hands for her. And boy, was it a good-looking little boy! It was obvious that he was in great health right off the bat, and good-sized, too (about 7 lbs)! Hooray! We got Yvette-client down into a sitting position so she could relax as I held her little baby snuggled up against her stomach/lap. The placenta took its time detaching and coming down, but with a little encouragement and fundal (sp?) massage, suddenly it came right on down! We had been sitting and waiting for about 15 minutes before Yvette-client had any little cramps that she could use to push the placenta out, so it was a bit of a surprise when suddenly she took care of that placenta with one well-timed push!

The rest went off without a hitch, and we got mamma and baby snuggled in bed to rest for a while. Gislaine, Yvette-midwife, and I took turns helping take vitals or record the numbers every so often, and Yvette-midwife had a pile of forms to fill out with all the information and stats from the birth. But we got to bed eventually, and napped from maybe 4:30 am onwards. Yvette-midwife got up to burn the cord before I was up; I think I woke up around 6:30 or so to help out with other clean-up and preparations to take our client home. (Needless to say, we were getting pretty worn out by now.)

We needed to go down a big long checklist that OTP has in each file for a thorough postpartum education about mama care and baby care and what to expect over the next few days and weeks. This meant... more translation! SOMEHOW, we managed to get through it all, and Yvette-client claimed to understand everything. I'm still somewhat in shock that I had that much Creole in me. Language is cool!! Just sneaks right up on you before you know it. (or just sneaks right into your brain?) I'm so grateful to Yvette-midwife (and Yvette-client, for that matter) for her patience with me while I had moments of language confusion. :)

After we took our new mama home and got her settled, we dropped a sleepy Gislaine at home and finally came back to get some long-needed rest! I was still in the scrubs that I had put on as pajamas in the clinic (right as we were about to go to sleep; right before we got the initial call from Gislaine), so when I finally was woken up by Dada around noon... I was STANKY!! Seriously, I think that might be the worst I've ever smelled. Sorry to provide nasty, TMI-type information, but it was such an ordeal that I couldn't not mention it! Haiti's heat/humidity + all-nighter + birth + excitement + too many hours in way-too-hot scrubs... It's really not a good thing.

But all in all, it was a really satisfying, fulfilling, surprising, great birth experience! We got lucky with a client who was really good at being in her zone and just taking care of herself, and then a little baby who was just about perfect! I can't wait for our next birth... I almost hope it happens before Sarah gets back, just so I can practice my Creole again, big-time! :D Hooray for life.