Saturday, July 25, 2009


Saturday, July 25, 2009 at 7:30 PM

This evening marks my first 24 hours back home. What a luxury to return to my own place and the comfort of my own bed. Em quickly reestablished her place in the easy chair, then at the foot of the bed, then IN the bed with me early this morning to sleep in a bit.

As unaccustomed as it may sound, the phrase that keeps running through my head is God bless America. I am tired and glad to be home. My "gratitude fix" has been replenished after a month surrounded by dire poverty with too few solutions in view.

I am slowly making my way back into my normal routine. I return to work on Monday. It will take me a while to reconnect with everyone. I do want to say THANK YOU to all who supported my work, read the blog, and let me know that you were thinking of me back here. Special thanks go to Patty Smith who took care of all things at home, and John and Hannelore Daniel who provided a wonderful 5 star doggie foster home for Em!

I hope to eventually put a few pictures on this site. Until then, thank goodness for HOME. Judy

Tuesday, July 21, 2009

Winding Down

Tuesday, July 21 at 4:40 PM
Still not sure when I will be able to post. We are in the middle of a HUGE tropical rain storm that is cooling off everything nicely. The wireless is back up if I can get to the library and log on before our guests arrive for dinner this evening.

Yesterday saw the return of Dr. Rolf Maibach, a Swiss Pediatrician, and Medical Director at HAS. This is the position formerly held by Dr. Duane Dowell who was back here volunteering with me the first 2 weeks of my stay. Dr. Maibach has started the morning conference in an interesting way these past 2 days. He puts a Haitian proverb on the screen in Kreyol and English. Then the staff (primarily MD’s and other managerial level staff) discuss the meaning of the proverb. It is an interesting exercise in culture and language. One of the proverbs today had a slightly different meaning for “blans” depending on how you translated one of the verbs. You could argue for either one, but the meaning is changed. I recommend going over proverbs as an interesting exercise in a cross cultural group. (In people of the same culture, it becomes an SAT test!)

Today I returned from lunch to find 2 white men going around with a cart and passing out food to people in the hospital, apparently both patients and visitors (remember that families must bring in their own food for patients). Out of curiosity, I asked my translator to inquire about them and he came back and reported that they were from “a church in Port au Prince.” They were working feverishly so I was unable to talk to them, but I do wonder what their purpose was on this apparently rather random mission.

Until later, Judy

Monday, July 20 at 6:30 PM (posted on July 21)
Only 3 more days of work to go, then I will be heading home on Friday. Once again, the time here has been what I have previously called a “gratitude fix.” So many large and small things that we take for granted--I will notice more of them when I return home. The list starts with drinkable running water, and goes on and on, large and small, to include air conditioning, infrastructure, and health care.

On the plus side for Haiti, doing without TV is not such a bad thing. I have read 3 books and started a fourth.

This week, though, I am wrapping up, giving away most of my clothes (purposefully brought primarily well worn items) and I am getting ready to head home.

No wireless access on campus today, so will post this when I can connect to a cable somewhere. See you soon, Judy

Saturday, July 18, 2009


Saturday, July 18 at 6:30 PM
WOW! That was a rainstorm!!! Palm trees blowing, branches on the ground, rain coming in sheets, huge puddles in the grass and flowing down the sidewalks. Of course the power went out, but it is back on already! I have turned off my AC. When the rain slowed down, I opened the door to my little balcony to find that it is actually COOL outside. I still have the door open enjoying the fresh smell of the rain that is now coming down lightly along with rumbling thunder and lightening. When I saw the rain moving in, I almost went to the outdoor bar to sit under the overhang and read a book while sipping on a Sprite. Glad I brought the Sprite back to my room! I would have blown away! II imagine that dinner will be quite delayed while the staff puts the outdoor dining area back together. They were moving fast to take it all away earlier--one reason I decided it best to return to my room. What a display by Mother Nature! Now I’ll see if the wireless access is up and running again.

At the Beach!

Saturday, July 18 at 2:15 PM
At the Beach!
Made it! With Shaun’s help, I was able to negotiate a ride with Levy, the main Haitian gardener at HAS, and a friend of the Dowells. We spent over 2 hours late Friday afternoon slowly bumping over one of the dustiest poor quality roads I have ever seen. I arrived soaked in sweat and exhausted, but VERY happy to be here for a break. As I mentioned in my last post, there is a cumulative effect of the heat that left me exhausted by Friday. There has been no rain in Deschapelles for several days to break the heat. Nights are a wrestling match of tossing and turning with the sheets half way off the bed by morning.

Right now, though, I must STOP complaining. Last night and today are GREAT! Some things change and Moulin Sur Mer where I am staying is one of the few things in Haiti that is better than when I last saw it 3 1/2 years ago. (Check it out at The grounds have improved and they have chased away the beach people trying to sell you stuff, except for a few that have a vendor badge. All food is served buffet style which is faster and it is plentiful. There is wireless access throughout the resort, including here in my room. That is definitely the biggest change of all.

There is a greater percentage of Haitian visitors here this time--in the majority--as opposed to more ‘blans’ in the past. There are also Americans who appear to be of Haitian descent. I just met a group of young people who are in Haiti to put a new roof on an orphanage, and there are other ‘blans’ here and there.

My little room has an air conditioner and I slept COLD last night for the first time since leaving Dallas. There is a warm shower. I will soon be crashing for a cool nap.

So this weekend begins my partial re-entry back into the world of the USA. I needed this rest to have the energy to finish off well with the students and, I hope, leave them with a positive impression of my help.

Problems to Solve
Morning conference with the medical staff was very interesting on both Thursday and Friday. On Thursday, the 3 Haitian internists on staff talked about risks/procedures related to accidental exposure to blood. As all my medical friends know, this is a common problem but so much more difficult to deal with here where resources are limited, conditions are crowded, and access to even soap and water can be delayed.

On Friday, the MD in charge of the conference reported that the UN had found a case of swine flu in Cap Haitian. This sparked a discussion on how to manage patients at HAS in the event that there is an outbreak of swine flu. Space for isolating patients is almost nonexistent. There is no tamiflu available at the hospital. Crowded conditions and past history indicate that many staff members are likely to be infected if there is an outbreak. No one mentioned if N-95 masks were available (the more protective kind needed in this situation for staff). I doubt that there are resources for fit testing (another procedure needed to ensure that the masks are providing complete protection against airborne infection). A negative pressure room in Haiti (used for airborne diseases in the US) consists of a room with a window fan that blows air outside the room---onto the campus!

In 6 days I will be heading home. The month has gone by quickly as I knew it would. There is still work to do, so posts may be few. Thank you all, again, for your support. Judy

Thursday, July 16, 2009


Thursday, July 16 at 4:00 PM
The little boy with burns on both legs has returned! The story from his Mother is that she took him home (no reason asked by me or stated by the Mother), and left him in the care of his father while she went to Port-au-Prince (again no reason asked or stated). His burned legs were left open to the air while she was gone. This remedy of letting a wound dry out is exquisitely painful for a burn. When she returned, she somehow realized that he needed more care and brought him to a clinic in Petite Riviere. His legs were bandaged there yesterday and the staff told the Mother to bring him back to the hospital and fortunately she did so this morning.

When I first went in to see him with my students, he was sleepy and I was afraid that he was really sick. However, later he was awake and eating a snack. His legs are contracted in about 45 degrees of flexion. Stretching them back out with Physical Therapy will be agonizing. Some of the areas of deep partial thickness (second degree) burn may have converted to third degree after being left open to the air; this will mean more extensive skin grafting.

But he is here! He has a chance. Thank goodness his little body was tough enough to HANG ON.

Moving at a tropical pace . . .
These last few days, I find myself moving more at a tropical pace. The heat has a cumulative effect. I am slowing down much below my usual speed of moving and doing. I wonder how this effect of the heat must affect the culture of a place like Haiti when it occurs for a lifetime.

There is still much to do and as time runs out, I realize that I need to start making a list of priorities. However, with any luck that list will be neglected this weekend and I will head for the beach. The determining factor will be transportation. There is no regular public transportation in Haiti, only tap taps and private arrangements. The hospital can no longer afford the luxury of taking people back and forth except when absolutely necessary. We will see what happens. If not the beach, then I will plow through my third book and hit the pool when it is shaded (the water is too hot in the sun).

Wireless access seems to be down on campus, so there are email messages just sitting in my outbox. I will try posting this blog on an old computer in the library. I hope it works! Until later. Judy

Monday, July 13, 2009

Time Flying By!

Monday, July 13 at 3:30 PM

Today begins the second half of my work with the students. As I said at the end of my last post, time is flying by! After finding my student here with his elderly Mother on a stretcher Saturday morning, I returned later with Shaun to get the full story. His Mother apparently had a change in level of consciousness around 1:00 AM. My student had been up with her since that time, most of it sitting and uncomfortably waiting at the hospital. He had not had anything to eat. I broke the rules. I went back to the house and gathered a small snack for him. His reply in beautiful clear English was “Thank you for your support.” His Mother remains in the “Overnight Ward”, a gray zone for those who are not necessarily in need of admission, but still too uncertain to go home. My student just told me he will spend the night here, probably sleeping under her stretcher on the concrete floor. Maybe she will be discharged home; the main problem appears to be a fever. We can hope.

On Saturday afternoon, Shaun and I took a tap tap to the market in Verette. A tap tap is an open pick up with passengers riding in the back. When you want the truck to stop, you pound on the side--tap tap--to alert the driver. Riding one is a classic Haiti experience!

The market was, as in Vera Dowell’s original description to me, a complex almost overwhelming sensory experience---crowds, activity, sights, sounds, potent smells mix with dust and the ever present heat. I took a picture or two, but there is no way to capture the experience except to be there. Vision alone is not enough. A video would add sound, but still leave out the dust, the heat, the smell, and the touch on your skin of people pressing against you as you pass in the crowd.

Sunday morning at 4:00 AM brought Duane’s departure, and a last minute save. In the front pouch of his carry-on bag, Duane found the cookies that I had requested and that we thought had been lost in a mix up when he arrived. So yesterday and today, I have been enjoying a little sweet taste from home. I miss Duane, but we had a wonderful visit here.

Some things change--
At 6:30 AM Sunday morning, I decided to try one more time to get on the internet in the guest house where we stayed. From midnight to 7:00 AM, the “sonic wall” is lifted and internet access is available in a number of places. The remainder of the time, short term visitors must come to the library and use a code for access. (This procedure is to limit use of a system that has little bandwidth available.)

Lo and behold, it worked! I immediately pulled up the NY Times on line and quickly began downloading as many articles as I could before the sonic wall shut me down at 7:00. Despite the lack of coffee, I got over a dozen articles on my laptop and spent breakfast looking over the NY Times, a treat that has only become possible in the last few years.

Some things stay the same--
Later Sunday morning, Shaun and I went down to the PT Department at the hospital to do some cleaning, to inventory supplies and to organize handouts left here by many different people. I had taken a brief look earlier in the week and was concerned that some usable materials were buried, unused in a closet. We found lots of supplies in the closet, some that I recognized from 3 or more years ago. In this place of so much deprivation, it is extremely difficult to convince the Haitian staff to GIVE AWAY the supplies that we bring, with the assurance that more will come. This has been a problem the entire time I have been here. My only guess is that when you have so little, it is extremely difficult to make the decision to let some of it go, and to decide who will and will not receive the supplies. In one conversation with my students, she referred to these supplies intended for patients as a potential “gift” for the patient. I tried to convince her that these supplies were not a gift to the patient, but a means to accomplish the rehabilitation goals. Only time will tell if that helped.

Among the supplies and papers that we uncovered were handouts written by my students for my first trip here in 2000. There was a large box of toys intended to be given away for use with children who need motivation and stimulation to move. The box had rat droppings in the bottom. We took the toys back to our house to be washed.

This morning on Surgery Rounds, we found that a small boy with extensive burns to both legs had gone home AMA--against medical advice--his Mother simply took him and left. While this sounds terrible to us, from his Mother’s point of view she could do what the hospital was doing. He was receiving “cream” and bandages that she probably felt she could do at home, having no idea how crucial the correct topical medicine is for a burn. The boy could walk with only a little help to get up on his stiff legs. She did not understand that the Doctors were prudently waiting a few days to determine the full extent of the burn that is third degree before doing a surgical skin graft. There is little chance that the child will survive without medical care. He will become infected very soon. Our hope is that he will become increasingly ill, his parents will realize that they cannot manage the problem and will bring him here or somewhere for help. There is no Child Protective Services hotline in Haiti.

Despite this sad start to the day, it has overall felt optimistic to me. The students are slowly learning to be more independent. They are treating their patients. With any luck and the dedication of many people who have worked on this program they will bring rehabilitation services that were not here before to at least a few people.

Off to my Kreyol lesson--if it stops raining! Judy

Saturday, July 11, 2009

Back up!

Saturday, July 11 at 7:00 AM

Late Wednesday evening brought the return on Shaun Cleaver, Physical Therapist, to campus. He stopped by to chat with Duane and I around 8:00 PM. Shaun has been in Haiti for 2 years or so and is a model for PT’s who might strive to do this kind of work. He is completely fluent in Kreyol--amazingly so. He is well known on campus and at HAS and much liked and admired for the work he has done. Note to academic programs everywhere--are we encouraging our students to consider international work? Providing experiences for them while they are in school???? Are we, as licensed professionals modeling that behavior???

From my standpoint, though, Shaun’s return has meant that I had BACK UP. He has provided much needed and appreciated help with the students. I had been struggling to find activities to keep the students occupied at the hospital for what I perceived to be a full day of clinical work. It turns out that the students were expecting to be there no longer than the number of hours that they had been in class. They took the student contract that they signed at the onset of the program very literally. Shaun was able to negotiate freely with them in Kreyol and we have come to a compromise that involves moving the start time earlier to accommodate ward rounds, a longer lunch break, and finishing within the total number of hours that they expected. This type of negotiation would never have been possible through the substitute translator that we have had for the past 2 days. Back to the need for more skill in languages . . .

So my Kreyol lessons continue with some rescheduling for the days that it rained around class time. My instructor arrives on a bicycle and pedaling in a tropical downpour just doesn’t work. I have much empathy for the ESL students that I see struggling to learn at NDSM each week.

Thursday brought a shared laugh that I will treasure. There is a Haitian LVN who has been trained to do some limited physical therapy services and is doing so while the more formal program continues to prepare the Rehabilitation Technicians (my students). She was on the surgical ward helping the nurses there by putting in an IV. The details are too long to ramble on about, but the bottom line is that I watched and wondered about what exactly was going on with the patient. Then in the most calm, nonjudgmental voice I could muster, I asked my translator to ask her a question about the situation. She told me and laughed. I, too, laughed at the answer. It felt like a breakthrough. She was comfortable enough with me to answer my question about something that looked a little amiss without becoming defensive or evasive.

Overall, Ghislaine, the LVN above who is doing some physical therapy, has been remarkably open to having me around invading her world. The first week here, I shadowed her a couple of times to familiarize myself with the patients in preparation for assigning them to the students. After she saw one patient who became dizzy after walking for the first time, she gave me a brief lecture on postural hypotension. I did my best to look concerned and grateful for this “new” information. Apparently it worked, as she has answered “pas gan problem” to all of my requests. Would I do the same for a foreigner who suddenly began buzzing around in my work space???

Thursday evening Duane and I hosted Dr. Daniel Perez and Danny Malebranche for dinner. Dr. Perez is a surgeon from Switzerland who has returned for a 3 week stint, and brought along Danny who is a third year medical student. Danny is of Haitian descent, both of his parents are Haitian, but this is his first trip to Haiti! We had a fascinating evening talking about their lives and bemoaning the rapidly decaying condition of the orthopedic surgical instruments here that turned a simple 45 minute femur fixation into a 4 hour improvised ordeal. Dr. Perez is determined to return to Switzerland and talk to a manufacturer there about some new donated orthopedic equipment. Anyone out there have some connections???

Last night was wonderfully cool after the rain and this has been a cool early morning. I am afraid that is rapidly changing, so will head to the library to get this posted, then over to strategize with Shaun at 9:00.

“Mom” has been receiving frequent updates about Em from her new best friends, John and Hannelore Daniel, who are generously caring for her while I am gone. She is feasting on dog food with chicken broth, has learned to use the dog door and finds this quite convenient, and takes daytime naps on John’s bed! She is having such a good time with her new person friends and their 2 dogs that I am not sure she will want to move back to East Dallas! We’ll see.

Thanks for all your email notes. Half of my time here is done and time is flying by. See you back in the USA. Judy

July 11 at 8:45 AM
As I entered the hospital to post this entry and passed by the intake area I ran into one of my students who was standing by an elderly woman on a stretcher. It is his Mother who is here with severe vomiting. I helped him push her stretcher and the IV pole to the lab for tests ordered by the MD. Life here is so uncertain . . . . .Plsease add them both to the prayer list.

Wednesday, July 8, 2009

Toto, I don't think

Wednesday, July 8 at 4:15 PM
Toto, I don’t think . . . .
we’re in Kansas anymore. Just a stream of consciousness this afternoon about all things Haiti. I let the students go home at 3:00. After keeping 4 of them busy all day, my creativity for keeping 4 balls in the air at once had reached the absolute limit!

I could not help myself this morning on rounds! I jumped in and watched and talked to the MD’s about the patients. Beyond that I couldn’t hold back any longer---that patient needs to take off his sling and elevate his arm in bed (I did just that). This patient needs a volar splint--the surgeons will make one during the next surgery. This comatose patient needs to be turned--the MD helped me do it. I tried to pull in the students whenever possible, but today surgery rounds were, selfishly, for me.

The first tiny room on the pediatric ward (emphasis on tiny) has SEVEN children in it, each with at least one family member there to provide for food, toileting, and bathing. When the surgery team walked into the room, all the toddlers, about 4 of them began to wail. The older children held off as best they could, but they too joined in when their bandages were removed. The sound was overwhelming.

Two hours later one small boy with burns still had no new bandages. His Mother chased away the flies hovering over his legs. I could stand it no longer. I asked my student to please find his nurse and ask that his bandages be replaced. A little before noon, she finally did so.

I continue to struggle mightily to get my students to talk to me. It often feels like pulling teeth. Translation is an ever present problem. Even the best translators are limited in English. This morning it took 4 or 5 attempts to get across a question that I posed to the students. I finally had to stand and act out the process that I was talking about. Practicing patience . . . .

On Sunday night about 9:00 PM, just as we were getting ready for bed, we were literally blasted out of our chairs with loud Haitian rock music that shook the walls of the house. My bedroom window opened directly to the side that the noise was coming from. I moved to the living room to stretch out on the hanging swing, but the music was still overwhelmingly loud. I finally fell asleep. It continued until after 1:00 AM. Someone said today that the police chief had a party. Don’t know if that is true, but it may explain why nothing was done!

I started Kreyol lessons yesterday and second one is today. l I have a wonderful energetic teacher, but I am afraid it will take forever for me to be fluent. I am the solo student sitting at a desk in an empty classroom with the teacher up front conducting with great energy. I hope I can get a picture!

There are ants crawling on my computer. Talk about debugging.

THANK YOU to all of you who are keeping Duane and me on the prayer list. It has worked! Last week I left my fanny pack with my camera, money, and keys in a public bathroom in the administration building. Yesterday, Duane left his iPhone in the library. Both places have somewhat limited access, but they are still open to many people. Both of us realized what we had done only after some time had passed. Miraculously, we both got them back--they were waiting where we left them. The prayer list is working. Please keep it flowing.

Until later, Judy

Practicing Patience

Tuesday, July 7 7:45 PM (not posted until Wednesday afternoon)

It is my understanding (with very limited knowledge) that all the great spiritual traditions value patience as a virtue. if so, then I am luckily getting a lot of practice cultivating patience.

On Monday the 4 Rehabilitation Technician students began their first Clinical Internship treating patients on the wards at HAS. I knew I could not juggle 4 of them, so I divided them into two groups, AM and PM. I had no real idea what to expect about their performance.

The hardest part of the task was patience---standing back and watching them ever so slowly step forward and begin to work. A snail’s pace would be an exaggeration of the speed of the work. I waited. I tried to stay back and give cues only when needed and only in the most general way possible.

In one case, the second patient of the day, just standing and hesitating actually paid off. The young man did not want to get out of bed. He said “I can’t” over and over again. Somehow the student finally managed to get him sitting on the edge of the bed. The “I can’t” continued. I was more than ready to throw in the towel and try again tomorrow--but the student hesitated and waited. Somehow, some way she finally got the patient to stand up and take a few steps with crutches. Waiting worked, much to my amazement. When I told his Swiss Surgeon this morning that the guy walked yesterday, he also was amazed.

Throughout yesterday and today, my emotions have been on a roller coaster, nonstop up and down. One minute I see a student finally move forward and do some treatment and I am jubilant---multiple foreign teachers have trudged to Haiti and given these students a skill that could not be found anywhere else in Haiti--and they will take these skills and use them. The next minute I crash as their inexperience and lack of knowledge shows up in their hesitation and inability to plan how to structure the treatment.

Yet, just briefly this morning during rounds on the wards with the surgeons, I had a moment of thinking--this is fun! Of course rounds provides the best opportunity to interact with the MD’s and others and to learn about the patients--part of the heart of clinical work. I must confess that I would rather be DOING the treatments than watching and supervising and teaching the students. That is why I am a full time clinician and a part time teacher.

My job here, though, this time is to teach. To prepare others who live here to do this work. I am practicing patience.

Sunday, July 5, 2009

Unexpected Pleasures

Sunday, July 5 10:20 AM
Yesterday brought unexpected pleasures as the hot day wore on, and fufillment of the saying that "things in Haiti don't always work, but they work out." I spent a lazy morning while Duane worked in the wards all morning while being on call. At noon, the cook informed us that our house was out of cooking gas. She had told us the same thing the day before, but it turned out then that it was just a matter of switching from one cylinder to another. Yesterday neither cylinder would work. So we went to the Suresh house to check with Raji about what to do. (Dr. Suresh is the CEO and his wife Raji is in charge of housing). Raji immediately invited us to dinner. The cooks at our house, the Suresh house and the Alumni house (where most short term visitors stay) quickly collaborated and set us up for lunch and dinner today at the Alumni House. We had plenty of hand for breakfast and an electric coffee pot for the most crucial part of breakfast! Things in Haiti don't always work, but they work out.

Dinner at the Suresh house was delightful delicious Indian fare, along with much conversation about all things Haiti. I actually got to spend quite a bit of time conversing and enjoying Prestige on the porch before dinner. Duane was called back to the hospital at 5:00. I went on over to the Suresh house at 7:00 where we waited for Duane until 9:15. He was amazed that we had not yet had dinner! Our hosts were gracious and the evening worked out . . . . .

In the late afternoon, the shallow end of the pool became shaded and I went out for a swim. The water was warmer than I would usually use for a bath in summer, but I discovered that sitting on the steps half in and half out of the water was quite pleasant with a slight breeze blowing. i read a book there. Duane joined me after returning from rounds again on the wards. I stayed there until it began to rumble enough that I decided I better get out of the water. I went back to our porch and was treated to a tropical rain storm while sitting under the wide veranda, an unexpected chance to enjoy the majesty of nature right in front of me. It was immediately cooler, and stayed that way (relatively speaking) for most of the evening (warm, but not pouring sweat).

Around 9:00 PM, one lone fireworks display blazed in the sky to mark the Fourth.

So today is quiet and slow, the kind of day that we often wish for at home but can seldom manage. Tomorrow begins the real work of supervising the Haitian Rehabilitation Technician students as they begin to work with patients on the wards.

If you have posted to this blog, great! Unfortunately, I have no idea how to read the posts, so please send a copy to me via email. With gratitude, Judy

Saturday, July 4, 2009

Fourth of July a world away

Saturday, The Fourth of July! 11:00 AM
Happy Fourth of July! By my count, I know of about 6 or 7 Americans on campus so there is unlikely to be much going on here. There are probably others--I see ‘blans’ here and there but not sure they are all American. There is a large very supportive Swiss contingent here.

So I am continuing to deal with the HEAT. I didn't know it was possible to sweat this much. Usually I don't feel much older than I did in 2000, the year I first came here, 0r 2002 when I was here in August. But I do feel that much older in Haiti!!! When your body is pushed to the max, you do notice the decreasing ability to adjust to conditions that comes with age.

This morning I did a short round of light mental stimulation--LONG division. Not exactly rocket science, but something that calculators have made virtually obsolete beyond grade school. I graded the student exams from Friday and had to figure the percentage out of 43 points. I thought about waiting for Duane to come back in with his i-Phone which I think has a calculator ap, but decided that was silly. So I can still do it. Not sure, though, if I had to do something like a square root . . . .

Duane Dowell is on the wards now admitting 2 children and tending to the wrap up for a small child who died this morning. I wrote up many e-mails in Kay 12 (House 12), then came down here to the cool of the library to gain internet access to send.

Kreyol lessons have finally been arranged and start on Monday in the classroom where Vera Dowell once taught. (The school is, I assume, closed for the summer.) I NEED them, but is is amazing how much immersion in a language helps. I am remembering many common phrases; enough, I think, to at least be polite and greet people.

I am being followed on the grounds by a man who looks somewhere between desperate and crazy (Parkland is actually good training for this). First he asked my name, then he wanted to be my friend. I brushed him off. Next time he was more direct: he asked for money for beans and rice. He told me that he was hungry. There are no easy answers .. . .

I enjoyed a wonderful dinner last night of beans and rice and squash casserole. Ironically in this country of hunger, i am never worried about having food. This is, I suspect, the arrogance of being an American and perhaps a clue to why so many people in the world wish us harm. It is very hard to wrap my head around this. There are no easy answers . . .

I will try to live the questions.

Please let me hear from you. Use my earthlink address:
Please pass that email address and my blog address on to anyone who is interested in my ramblings.
Thanks for your support, Judy

Friday, July 3, 2009

Back to the Wards

Friday, July 3, 5:15 PM (I worked today, did you???)
Welcome to this site and please pass on this address I have tried everything in the world and cannot post to

So this morning was spent back on the wards. Rounds with the surgeons after morning conference which was an interesting public health presentation comparing TB rates in Haiti and Ethiopia.

The hospital is packed with stretchers in the hallway and in the middle of already crowded 6 bed wards. There is no privacy. Men and women are not segregated. Dressings are changed out in the open. No one seems to mind; that is just the way that it is.

Every Parkland therapist would have cringed today to see the dry extensor tendon on the back of a hand that has not yet been grafted. The area was dressed with a normal saline wet bandage (I hope it is soaked off, but can't be sure). There is little hope for that tendon. The young Swiss surgeon that made rounds with us today agreed.

That Swiss surgeon is the same one who was here with his wife when Beth Ellsworth and I came here in 2007. It is really good to see him again. His wife did not come this time because she is pregnant.

The hospital sees many patients suffering from various forms of trauma, including a lot of broken bones. Today I found out that there are no crutches available at HAS! There are only a couple of pairs in the PT Dept that are used for teaching patients. Families must then go to another town to buy crutches; there are none in Deschapelles. No one adjusts them for the patient, and some that we saw with out-pts. today are so worn that they can't be adjusted anyway. I can only shake my head.

I spent some time late this afternoon poking around in the PT area and trying to organize supplies. Everything there is covered with a thick layer of dust and neglect. I found some supplies that I left here long ago. I put up an overhead pulley system to use that was just lying tangled in a box. I brought a lot of stuff, but as usual, there is much more needed.

If anyone is interested in the history of PT at HAS, there are piles of old notes dating back to the 1990's. They are pretty much just rotting away.

Last night around 1:00 AM we had a huge tropical rainstorm and it looks like it might be getting ready to let loose again, so will go.

Happy Fourth of July! Judy

Thursday, July 2, 2009

Thursday, July 2, 2009
Slowly, painfully . . . . .
The work of teaching moves forward. The review session this morning went slowly with questions that were even one half step from simple memorization being very hard to grasp. The language barrier remains huge with the constant waiting for every word to go back and forth.

I need more language skills. Will hopefully start Kreyol lessons soon, but the time to do so was in grade school. The world is too small now for American children to learn only English, and we cannot expect the rest of the world to learn English for us. The Europeans on campus are multi-lingual--our education system has got to aim higher if we are to succeed in today’s world.

Duane Dowell is here now and it is fantastic to have a friend to talk to and share the misery of a hot evening together. It is also good to have a sounding board for all the questions and situations that incessantly arise here--people asking for money for food being high on the list.

In Dallas it is easy--go to the Bridge, or North Dallas Shared Ministries, or Parkland, or ask for help from the Minister’s Discretionary Fund. For a friend, a student, i would loan money for food without a moment’s hesitation. But ironically in this place where hunger is an overwhelming problem, that is much harder to do. Handing out money on the street or in the hospital could cause a near riot of others wanting the same. How to decide who is really in desperate need, and who is taking advantage of a sympathetic ‘blan.” Then how much do you give? There are no easy answers to these questions. Many spiritual traditions implore you to give all that you have. But if you do, then what?????? i suspect that this instruction may refer more to the spiritual than the physical, but in a place like this you cannot be sure.

I think I may be droning on longer than interest allows so will close. Let me hear from you! Judy