Thursday 2/26

Judging by the increasing number of people on the roof this morning, I think a lot of team members have given up on sleeping in here. All of our mornings begin with coffee and tea, which is usually served on the rooftop, weather permitting. Breakfast is served at 7:00am, and Pastor Osamee or Pastor Dellamy will usually have a morning devotional at 7:30, before the clinic opens. Religion is extremely important in this country, with the  top three being Christianity (in various denominations such as Methodist, etc...), voodoo, and Catholicism. Haitian Catholicism is a combination of Catholic and voodoo beliefs. At 8am, all of the school children meet in the school courtyard for the raising of the flag, then they march, single file into their classrooms. The school uniform for Terre Blanche is a blue checkered blouse or shirt, and dark pants or skirt. It is remarkable how meticulous the students look, the Haitians take great pride in their appearance and the uniforms look spotless in the morning, although the clothes are washed in shallow river nearby. 

HFH has started some incredible community health, agriculture, and feeding programs in Terre Blanche, which are now run by the locals. I learned about these programs on my last visit, but I was so overwhelmed by the number of patients needing sonograms, that I usually worked through my lunch break, and after clinic closing, and did not see many of them in action. I am determined to be a little kinder to myself on this trip, and I also feel there is great value in seeing the School Lunch Program and Ti Foyer first hand...and I took photos, of course. :) 

When Joe and Linda's church first became involved with Terre Blanche, they started a school lunch program that fed about 65 students. This ensured that the children who came to school would have, at least, one good meal a day. This program has expanded greatly, is now run by a group of local women, and feeds over 1,000 students a day. Initially, many of the children were sent to school for the sake of the meal. Thanks to the expansion of the school, and a community health program, the children are a lot healthier now and seek a better education. The women cook large pots of rice and beans, setting out plates of food on picnic tables, in the school kitchen area. When a group is finished eating, they quickly wash the plates and set up for the next group. Lunch starts at 10:30am, and the youngest children eat first. The children must first wash their hands, they rush into the lunch room, eat, then are quickly filed out. It's a bit like herding cats! They are not allowed to dawdle, since the program must feed all of the children, and typically ends around 1 pm. 

The Ti Foyer is an incredible program, that was initiated by HFH, and is also now run by the local women. Many years ago, HFH noticed that, although poverty affected the entire community, there were some children who were not medically malnourished, while others were. After much research, it was found that, even though everyone had access to much of the same food options, some of the women cooked and fed their families differently than the others. The women with healthier children formed a committee, received training, and began to teach the other mothers in the community better hygiene, nutrition, and cooking schools. The women who host the Ti Foyer are given a small stipend, which is used for supplies, and they usually take great pride being the host. The women are encouraged to work together and support one another, creating a much stronger community. Madame Meeshoo was hosting today, so I ran over there on my lunch break to take pictures. She had finished the cooking class and the group of mothers were gathered under her covered eating area, feeding their chubby, healthy babies, 

Tonight, instead of a didactic lecture, all of the care providers had the opportunity to talk about a case. Krista, a social worker, ran this meeting, and the point was to talk about a difficult case/patient that really moved you, and how you felt about it...sad, frustrated, helpless. As I mentioned before, people in the medical profession often have to manage their emotions much differently than the lay person. This becomes a lot more complicated when you consider the fact that we often see conditions that could have been prevented, or would not have been a terminal diagnosis, in a country with more resources. This time, there were 3 translators, including Celestin (my translator). Celestin and I had been talking about the importance of not only having a translator, but having one who understands the medical terminology, and the importance of getting the communication correct. It's easy for us to forget that when we have to communicate bad news to the patient, so do they, which is very difficult for them. It is also an important part of their culture to always have something positive to say, to always give the patient a sense of hope. Hope is the cornerstone of this culture. Unfortunately, I missed most of the discussion, because I was assisting with a surgery, but I was able to hear the translators share their stories. Celestin is the kind of translator we all fight over, I was incredibly lucky to have him for the entire week on my last visit, and I have had him all but one day this week. Justifiably, this has been frustrating for some of the other providers. We have a number of truly excellent translators, but some of them are young, with little or no knowledge of medical terminology, and a lack of understanding of the importance of translating correctly. 

We decided to cancel the debriefing this evening, in order to grade some of the quizzes given out at the medical conference, then most of us headed to the roof. As with my last trip, this group is filled with wonderful people, and I would love another week just to get to know them better. I love hearing about their families and lives back in the states, their perspective about what we are doing here, and their plans for coming back. Most of us all plan on coming back. The generator is off, and our solar power is limited, so I'm signing off for the evening. Bon Nwit!