sorting through the heaviness

Photos from a walk through our own tent city after the rains last week; the boy pictured above is putting down coarse sand to keep the mud down in his "home". Photos Wendy Miyares.

I left Haiti last Thursday- one week tomorrow- and still I go through my daily routines with such heaviness, such emptiness, such flatness. It is a strange feeling to feel so much for a place so far away. Every day I shed tears for Haiti, for Haitians, for friends left to survive in that world. Every day I try and shake the feeling of guilt- for leaving, for being born into luck. I am like you- every one of you reading this knows this: that we were lucky to be born into a place of wealth, health, and relative political calm. We live in places where we complain about building codes. Places where we drive to the store down the street because they sell the specific kind of yogurt or cheese or produce that we are looking for. We complain about our politicians, our healthcare, our social programming. And I am not waxing on here about the fact that we SHOULDNT be doing these things. But rather, I ask you all to reflect a moment on the simplicity of the fact that we have these choices, these luxuries.

I've felt reverse culture shock before. I've felt it hard, fast, and furiously. I remember all too well the feeling of returning to Canada after 5 years in Nepal and being a tormented teenager who hated materialism and wanted nothing more than to go back. I'm sure it was pure agony for my parents at the time, who wanted me to find happiness in the place of my roots. This place. My roots.

But I've never felt this before. I've never felt so flat. I could care less about most things in this world of my roots. I try to imagine myself before Haiti, caring more about what goes on around me here, and it seems ridiculous to me. My priorities have shifted in such a drastic way that it appears my reality is no longer here. How can this be my reality, when others are simply trying to survive? When I take a long shower I think of Haiti. When I open the fridge and pull out some milk for my tea I think of Haiti. When I bike to work and cars sideswipe me into fear I think of Haiti. Every other minute in my life I am thinking of Haiti. Choices mean nothing to me here- sushi or mexican? How can I make that choice? How can I decide that knowing that people are getting just rice- again- for dinner?

I'm trying to rid myself of the element of guilt that is necessarily imposing itself on my values. I'm trying to be reasonable with myself: yes, I was born here, and yes, I am lucky. Its really just luck of the draw, though, isn't it? And it makes me want to go back, to help more, to aid more, to prove to Haiti that I am committed. Not just now, as other aid organizations are promising, and not just this year. But I a committed for a lifetime. Because it will take longer than my lifetime to rebuild.

People keep asking me if things are better there now. I cannot express the depths of poverty, of stress, of need that exists there now. No, things are not better. People have lost their houses, their children, their parents, their siblings, their money, their schools, their banks, their hospitals, their communities. They have lost EVERYTHING. No country in the world can fix that in three months. There are over a million people homeless, and one in ten is dead. What do you do with that information? Where do we start? Aid is pouring in, yes, but we need more. We need commitment. The rains start in May, the hurricane season hot on its tails. They live under tarps, ten, twenty people to a tent. Their struggle has just begun. Their desperation will get stronger, much stronger. Already when I left the stress was starting to show itself: domestic violence, abuse, rape, suicides, poisoning babies just born into their desperate world. Imagine how much worse it could get.

Haiti needs a commitment to aid- without debt- for a generation, or more. I can only guess as to the effects of this disaster on the generation of children who have survived this. I hope that we can help them to start over, to build strong schools and hospitals and communities where leaders will be born.

But for now, I move slowly back into my own life. I gain moments of happiness in the simple things, the little things, the beautiful things. Rain on a window. Flowers in concrete. The windchime on my pear tree. Riding my bike. Listening to the trees blow in the wind. Simple, honest, smiles from strangers. And I dream every day of returning to the place that touched my heart for life.

xo

Donations: please send email transfer to guineveredorward at gmail dot com or mail cheques to five five six nine culloden st, vancouver, bc, V five W three R nine. Thank you for continuing to support Haiti. Much love.

Crying for mama

(sunrise from JP HRO camp)

Waiting to board my flight out of here, after saying goodbye to so many amazing people. Feeling very emotional at the moment- there was so much sadness yesterday. Our lovely little girl who has been adopted by our camp started crying last night and couldn't stop, and she never cries. All she could say over and over was "mama, mama, mama" while she cried her heart out. The tears streamed down my cheeks as I held her close to me. Today I grieve for all those who lost mothers in this country, as I return home to the safety of my own family. And I say goodbye to this amazing country with a heavy heart- may your strength and resilience see you through this. Je t'aime, Haiti.

Last day of sadness

Today is my last day in Haiti, and I spent the morning crying in the bathroom with a young haitian med student who lost her mother late last year and now has no family left. Her father was killed a long time ago and she has no siblings. Out of respect for her I will not mention her name here, but I will say that in the few days that I have known her, I have seen how smart, compassionate, and amazing she is, and so it was a shock to me to learn that she was depressed. I know that we see time and time again that people hide their feelings so well that no one picks up on it, and this is definately one of those cases. She seemed so together, so on top of things, that I didn't even question her emotional stability. Or think to ask about her family. She told me that a person is all alone in this world without a mother. And I cried for her. I cannot even imagine what pain she must be going through, and then a few months later to survive an earthquake. There is so much stress in this country, everything is so hard here. A woman came to me in triage yesterday saying she was feeling a lot of stress since the earthquake. And I had nothing to give her, I couldn't even take the time to listen because I had a long lineup waiting. We hope that a psychologist who speaks french will come soon- because the PTSD here will likely show itself a lot in the coming weeks, now that survival has been taken care of.   

Final days

My final days in Haiti are drawing near, and i'm feeling saddenned, relieved, exhausted, and excited all at once. Sad to leave so soon, when my body is finally adjusting to the heat and humidity, my mind is adjusting to the work and the languages, and my heart is falling in love with the country and it's people. I'm relieved mostly bccause I miss the comforts of home, and can't wait to see my husband again. And I'm exhausted. Last night I fell into my bed at 8pm and didn't stir again until this morning. I'm excited too- the work being done here has been smoothened out by our team, to the point where consistency and continuity of care will (hopefully) be achieved. For all you medical people, this is much harder said than done in a place where a new team arrives every week or two, completely replacing earlier staff. It has been extremely frustrating at times, but our team, after arriving from leogane, set to work to achieve this. And I think we have succeeded.
Yesterday I watched and assisted with a new birth, and then watched the tears being sewn up. In the other gyne section a woman who was 20 weeks had gone into labour and I watched the tiny, imperfect being lose it's short life. It was such a duality, and we talked about the sadness of death a few feet away. Natures way of saying "this is a bad time to be born". Indeed it is, but it's still hard for mum. At the time in my life when I am wanting to start having children, I was strongly reminded of the emotional and physical challenge it will be.
Despite this, I'm in love with the children here. They smile, laugh, and cry with such intensity that they melt your heart. We have seen so many children here, and having no pediatric experience whatsoever, I'm scared of nursing every single one of them. But
I'm learning. I'm getting better. I've learned so much from the rest of the team here. Every day I'm learning, and it makes me want to go home and learn more. Being here is the reason I went into nursing, being able to provide direct, meaningful care, to a population that needs it. And I see it every day, and I deliver it every day. And my heart still aches for Haiti.

New mama in love

New papa in love

Love love love

The rains are coming...

the road waiting to slide....a few more rains should do it.

where we go to dispense our meds, with portable xray machine in front.

supplies and more supplies

So last night there was a massive rainshower, tropical style. It poured and poured and poured, big fat heavy soaking wet drops. I ran to the bathroom, a space of about 3 meters, and back, and was completely soaked. It was unbelievable. It took six men to hold the flaps on the large tent together while they zap strapped them to the frame. And we are inside a massive tent, on floorboards, safe from the rain. We could only imagine what was going on down the hill from us, where the 100,000 person tent city is held together by nails and tarps. Rumour had it there had been a washout and people were freaking out, shelters were being ripped apart, and everything was chaotic. We were told to get ready for some influx of patients, but we only ended up getting one patient, who had stepped on three(!) nails trying to get out of his house in the rains. Tetanus shot!
This morning we went on a recon mission to he tent camp, and it was great getting to see it all and walk through the tiny alleys (1 person wide). The entire camp is a mud pit, reminscent of those terrible northern Alberta/BC treeplanting camps. Gumbo heaven. That clay just sticks to your shoes pike nothing else. We slipped and slided our way through the city, falling into each other and occasionally into the structures, for which we were yelled at (of course). It's hard to imagine everyone living like that, but they seem to manage. The kids directed us onto the better paths, laughing when we slipped. Everyone walks around barefoot, and I don't even understand how they get up and down that hill without breaking bones. The entire camp is set on a sort of bowl, funneling into the market at the bottom. Which is of course, where everything drains to. All the mud, water, piss, shit, and who knows what else, pouring down the main drag into the market. Where people buy their food. We even saw a battery pouring out acid down the hill, and people walking past it (downstream) in bare feet. Awesome.
People throughout the camp were rebuilding, digging ditches, and laying down sandy soil to keep their shelters clean. Shelters had collapsed into each other, peoples beds were soaked, and we could do nothing for them. Heartbreaking.
We trudged back up the hill to witness a woman being stitched up in our hospital, she had fallen on a broken broom handle while doing some community work and had lacerated her bum about a centimetre from her rectum. It was a deep, painful looking wound. Of course to make matters worse her husband had died in the earthquake, leaving her with four children to care for and no way of earning money. We asked her to phone someone to come help her get down the hill but she couldn't think of anyone to call. We gave her a can of ensure-like substance, and she guzzled it. We gave her five more to take home to her kids, and instructed her to come back up the hill tomorrow for follow-up, hoping she doesn't get infected. Can someone look after her kids? I hope so.
Other than that, clinic was very quiet today. Yesterday we triaged 177 patients, today we had 4. All haitians are focused on survival right now- fixing their shelters. The weekend is also coming, which slows down. I'm sure Monday will be insanely busy!
At least the rain has cooled everything down, but humidity is up, and I'm sure the mosquitos will be happy with all this extra habitat. Malaria, here we come. Water-borne diseases ditto. E Coli will be rampant, as if it wasn't already. And the rainy season hasn't even begun yet, much less hurricane season. There will be a LOT of work here in the coming months.

Guin does triage!

Day 3 in Haiti was a long day with lots of change. This morning I was on triage with John, one of our paramedics. We triaged about 130 patients by 3pm. It was exhausting work, and now that the main traumas are dealt with it's all primary care. Lots of wound care, diarrhea, nausea, fevers, chest pain (which is further discovered to be acid reflux), STDs, and general hygiene issues. The lineup seemed to be endless, but the Haitians are so patient, it seems at this point they just want someone who cares. There was only one minor argument which seemed to sort itself out without any incident. I am becoming quite adept at lifting one leg and demonstrating how to douche, and how to wipe from front to back, NOT back to front! It's quite the scene.
We were supposed to pack up and head out at 12, which got pushed to 1, then 3pm, due to the volume of patients needing to be seen. When we finally started out for PAP we all fell silently and exhaustedly into the seats of the bus, staring in sombre sadness at the broken, torn, buildings and rubble lining the streets. We all took photos, and we all know that photos will not do justice to the scale of the decimation here. It is so hard to convey the magnitude of damage that has been done. Things have normalized a lot, don't get me wrong, but everywhere there are signs of the earthquake. I heard a stat that 1 in every 4 lost a family member, and I don't know the accuracy of that, but I would not be surprised.
We arrived at the hospital funded by Sean Penn, met the man himself and a bunch of others, and got a tour of the tent city that has sprung up beside the golf course. This refugee area houses some 50,000 people, and at night swells to between 80,000 and 100,000. Quite the population. The hospital here seems to be staffed by a plethora of teams of volunteers, from a group of Chicago ER nurses to med students to surgeons and other medical professionals. We all met at 9pm this evening to discuss where people will be working tomorrow; you have the option of the mobile clinic or the field hospital itself. The hospital is very well equipped, and we were all impressed with the facility. I'm looking forward to trying out some skills in it! OR anyone? Just jump in!
  

Arrival in Haiti

After a 40 hour journey, including a 9 hour delay in santo Domingo (American airlines had neglected to get clearance to land the plane), I have finally arrived. The delay was the hardest part; imagine a plane full of aid workers, medical professionals, and Haitians with family members in the hospital, stuck in an airport. Tensions were high and frustration was rampant: to us it seemed a day of help was wasted, a day of precious resources down the drain. To the Haitians trying to go home to see injured family members it was like torture; we were so close, yet so far away. 
Even arriving at night, I could still pick out the piles of rubble, the fallen concrete walls, and the tent cities that seem to have sprung up all over Port au  Prince (PAP). My heart ached for Haiti when the earthquake hit, and it ached even harder driving through the city last night and seeing the decimation.

We arrived late, past 10pm, so everyone was asleep already. Camp is reminiscent of treeplanting camps- cook shack, shitters, kitchen, and a heap of tents within a tight perimeter. In planting camp the perimeter is the bear fence; here it is the army perimeter, since we are provided security by our own French Canadian military group. They camp outside our perimeter and patrol at night. We are camped in a field, surrounded by the rubble of once-schools, and a tent city. A generator powers our camp. 
The major difference, of course, is that we treat patients here. Triage begins at 8am and the lineup outside is slowly brought inside for assessment and treatment. We have an OR, a private room curtained off by a flapping tarp in a corner of one tent, and the treatment tent houses some 8 cots, a random assortment of medical equipment and a whack of meds. 
This morning, between 8 and 12, we treated 77 patients. The acuity has lessened since the first team arrived; we don't use the OR much at all, and the majority of patients have colds or coughs or vaginal infections. Or malaria. 14 cases yesterday and 3 today. Thank goodness for coworkers who have just returned from asia with antimalarials!
Our field hospital is set in Leogane, about an hours drive from PAP and about 10 miles from the epicenter. 80% of the homes here were destroyed.

Despite all the horror, all the terror, I'm loving this. I'm loving the assessments, the people I work with, the work itself, the Haitians, the camp life, all of it. My body is protesting the intense heat, I think I'm currently working on my 6th or 7th liter of water! I'm filthy, covered in dirt, gloves are rare, and I'm learning so much. It feels so good to be doing this, to be helping in a meaningful way, to be useful to people who need it.  
On Monday we move to PAP to another field hospital, where our 7 person team (2 doctors, 2 paramedics, and 3 nurses) will treat the tent city near the golf course. That tent city is estimated to have 30,000 people, homeless and starting from scratch, living within it's shelters. More on that when it comes.....

Heading to Haiti

I'm writing this from San Juan, puerto Rico. I am overnighting here before boarding a plane tomorrow morning to port au prince, Haiti. Luckily for me Ryan happens to know someone here and so I am comfy and well fed on a couch in he beautiful old colonial part of Sam Juan. My body is adjusting to the intense heat and humidity by sweating profusely, and I'm thinking that Ry was right when he said I didn't need that wool sweater. What can you do though, it was snowing this morning in Vancouver!!

I'd just like to thank everyone again for supporting me through all this, it's been an intense 48 hours! The story is this: my good friend Livi got back from Haiti a few weeks ago, and I was inspired by her experience to put my name down on their website, which I did last thursday. I didn't really think they would accept me, since I don't have emerg or OR experience, but I figured my overseas experience and Spanish might come in useful I'm Chile. I got an email on Monday. Tuesday I went to work and traded all my shifts, thanks again to all the amazing coworkers i have! That same day I called up the organization (CMAT) and they said that instead of chile, we were now going to Haiti. So last night I booked and paid for my flight, and here I am, en route.

People keep asking me what I am going to be doing and the truth is that I have no idea. I know that the Canadian Medical Assidtance Teams has sent several rounds of groups in, so i think the acuity will be less severe. I know that the actor Sean Penn is financing a large field hospital that is seeing 380 patients a day and I will be going there on Monday. And I know that there is still no power in port au prince. But that is the extent if my knowledge. That is the purpose of this blog- to keep you all informed. Stay tuned, and thanks for reading!