Friday, March 12, 2010

The last days in Haiti and the D.R.

At the request of Uncle Scott, one of my loyal readers who said he read the blog every night at bed to the annoyance of his wife Tammy, I will finish up the Haiti blog. Thanks for reading, guys. Definitely adds to the experience to share it.

Sunday was a nice day off. The Mennonites move a little slower on the day of rest. Except for Jedidiah, who was picking up the puppies, carrying them across the yard and putting them in a cooler. Talk about a toddler from hell. Kidding. Cute kid.

Jason and I went to church. I promised the pastor I'd go (it's kinda what the guy does for a living) and didn't want to let him down, especially after everything he had done for us. Plus, I like experiencing church in other countries. We get there late, of course. Whatever this service was it had started at 0700. We rolled in at 9. Good morning, God. Not sure how to say that in Creole. Bonjour, mon Dieu? Everybody was in pews outside, and we snuck into the back and stood. The pastor spotted us, and showed us to 2 nice chairs...IN THE FRONT OF THE CHURCH FACING THE CONGREGATION. Great, I was screwed if I feel asleep during this one. And there was no leaving after Communion, either. We ended up staying for 2 hours before calling it quits. Who knows when that stuff was going to end. Lots of singing and clapping and praising the lord in Creole. Reminded me of a baptist service, although I've never been to one. The main sermon wasn't delivered by the pastor, not sure why. But they guy that did it had everybody laughing the whole time. And he liked to yell. Lots of heads nodding in agreement. I think I uderstood "Dieu" and "Jesui;" got my fill for Sunday. The pastor gave me one of those little Gideon Bibles in French. Sweet. Especially since I didn't have to steal that one I found in the back of the church. I tried to sing in Creole; and I thought nothing was worse than my speaking in Creole. I was wrong. Church was good, then we split. I did do some clapping.

Then Jane, the medical director and ein furher of the operation, came to pick us up to go back to Port-Au-Prince. We said au revoir to the Mennonites. Did I tell the beard story yet? By this time it's been a couple weeks since I'd shaved. So there are plenty of long hairs on my face. One Mennonite told me that when they get married, they grow a beard. I remember this guy earlier asking me if I was married. And I think he did it not because he wanted to know my relationship status, but because he wanted to know if that shit on my face was a beard. I told him no, and I think that made sense to him. Anyways, they were a kind bunch of round men with glasses that really looked the same. Arrividerci, boys. I handed over the keys, sign and papers to Noah and we were headed back to the capital.

It was nice to get back to better accomodations; the tent was fine, but the dripping water over my head led me to twice weekly showering, and let's just say I was "due" for more than an underwear change. That was an amazing shower. I definitely stole someone's shampoo.

This is hilarious. One dude, Louie, was a physician's assistant from KC. Big guy, he had sleep apnea, and needs to sleep with a breathing machine (CPAP) at night. Well, he didn't bring it with him to Haiti, and without it at night, he was exhausted during the day. We're talking sleeping all day. The dude came to Haiti and slept for 16 hours a day. He was in bed when I got there--snoring like a rhino--and last awake in the morning. Deadly volume. Lucky me, I secured the cot underneath the loud AC, which drown his snoring out. But not so lucky for the 8 others in the room. One other dude was snoring in sync with him, which was kinda cute, although Lou would occassionally stop breathing for 30 seconds at a time. Amazing that brain, living without oxygen and all. So another guy got everybody ear plugs. Anyways, Jane decides that Heart to Heart "needs" Lou to go to Leogane...hope the Mennonites get some rest the next couple days! Ha, suckers!

Monday morning, Jason and I joined the gang in the church clinic near ground zero in Port-au-Prince. We were a "mobile clinic." Literally, we had a bag of meds that we put together, and got in a truck and parked it at an intersection about 5 blocks from the church clinic. When we got out, people just lined up. Kinda wild. We were able to snag an empty tent nearby, and bam, just like that we had a clinic. We saw 67 patients that day. Mostly the same stuff: GERD, headache, backpain, vaginitis, UTI, colds, lots of high blood pressure, several like 260/140, out of control.

One guy came in with 2 weeks of this big swelling on his neck, by his adam's apple. It was soft and squishy. "What the hell is this" I thought to myself. I wanted to biopsy it, which will do a lot of good here since there are no microscopes or pathology. So I sent him to the main clinic and I think they popped it. I dunno. I wanted to cut it off myself but had no scalpel or lidocaine.

Another lady came in with a week of swelling in her right knee. No infection, just fluid after banging it up. She wanted it drained, so I cleaned her skin with alcohol and put a needle in there. We pulled off about 60 MLs of fluid, and the crowd was mesmerized. It was like magic, and of course, afterwards she was flexing it, demonstrating the miracle. Terrible medicine, hardly a sterile environment, although I doubt it will get infected. Most likely it will just fill back up in the next couple days, but maybe it won't, and at least it gave her some relief.

Our translator was Mark. He was cool, grew up in Haiti, spent 10 years in Miami, then got deported. He had less of an accent, and we got along. He liked me because I "didn't give a fuck." Initially, I was a little offended by this. I certainly considered myself someone who gave a fuck. But he meant I didn't let things get to me. Keep the compliments up, Mark, and we are going to get along just fine. For lunch, everybody else brought powerbars and ate like mice. No good for Lorenz. I rolled with Mark down the street and did a cardinal NO NO in the Third World--like a fat kid at a candy story, I gobbled some street food. Mark was nervous, he said I was going to make a scene since most of these people have never seen a white person, let alone someone who eats their slop with them. "It's like seeing Jesus." Flattered he compared me to Christ and liking him even more now, I told him too bad, I was hungry and cheap and let's eat. We ate a rice and beans plate, with chicken. And a generic Coke. It was ok, and filled my belly good. I definitely devoloped the shits for the first time since El Salvador (I pride myself on having rock solid guts), so bad in fact that I broke down and took Cipro. For a day or so, the toilet was my happy place. It was worth the Jesus comparison, but probably not the food. Damn street chicken. The locals definitely stared.

The afternoon mobile clinic was not good. No bon. It seemed like the morning people had told their neighbors what to say in order to get tylenol from us. Everybody had the same complaints--back pain, vaginitis. I was beginning to get skeptical and tired. We ran out of heartburn/GERD medicine, there was none at the other clinic either. So I was giving people with heartburn tylenol and gas-x, as if saying, "Here's something that doesn't work." Doesn't make you feel good as a doctor when somebody comes to you in pain and you send them away knowing what you gave won't do much. I was getting frustrated.

Near the end of clinic, one case really got to me. This 12 year old girl had a week of fevers, especially in the evening. No other complaint--no cough, no urine problem, no pain. I think she had malaria. Finally! Someone who was actually sick and had a treatable disease. While it's kinda sick to get excited about illness, this is what I came to do--actually help people. Now, the medicine to treat malaria in Haiti is choloroquine as there's not significant resistance, as opposed to Tanzania where resistance makes chloroquin ineffective. Not too expensive, takes maybe 6 pills to treat someone, and we had plenty at the other clinic. Well, of-fucking-course, we had none. Neither did the other clinic in Port-au-Prince. I was pissed. After seeing 66 patients that were not sick, we get one who is actually ill, and I can't do a damned thing. "Hi, you have malaria. Here's a medicine that works maybe 50% of the time if you're lucky. Good luck." Call me a doctor? Fuck that. So frustrating. Not like I could send her somewhere else or refer her. Nobody has these meds. Her body will likely clear it on its own, but people die of malaria all the time. AND IT'S TREATABLE. I hate that. At that point, I was like, "Why am I here? So I can put some band-aids on people and feel good about myself?" Worthless. Really felt like I was not doing much.

At that point, I was fried. Done seeing these people work me for tylenol. Street value for tylenol? Really? Only in Haiti. Done seeing backpain. Done seeing patients who trust you as a doctor and treating them with shit that just doesn't work. Get me out of here, I'm done.

Don't get me wrong, Heart to Heart as an organization has an excellent setup. Tons of meds, well organized and staffed, translators, patients, etc. It's very well run. But it ain't perfect. The needs are unending, there is no system, so you can't call it broken. And it had just overwhelmed me.

That night, I got the chance to skype with my best friend since 5th grade, Ben. He's a 2nd year law student at USF in San Fran, and wants to be an international human rights lawyer. If you an "international" to any job, by the way, it sounds more sexy and James Bondish. International Bartender. International accountant. International doctor is no different. Anyways, we've dreamed of saving the world together, and he's thinking about doing law work in Haiti in the summer. We got to chat about things--the UN, international aid, US foreign policy to Haiti, the history, etc. Lots of interesting issues. He was organizing a guest lecture from Haiti by yours truly. A little Q&A on the ground with Dr Lorenz. LIVE FROM HAITI. I was excited and definitely thought I was cool and important. Too bad the internet connection went down and only 3 people showed up (Ben + 2 others). Looks like my widespread fame for international do-gooding will have to wait for another day. But it was good to talk to him.

That was it. We left Tuesday. Instead of a drag-yourself-from-the-bumper-bus-ride for 8 hours, we took a 1 hour UN charter flight from PAP to Santo Domingo, Dominican Republic. That was sweet. Total rock star on that one. Heart to Heart, at Jane's insistence really, hooked that up. Then we crashed at the adult channel hotel (don't judge) and had a nice evening in store: it was Jason's birthday. The girls, Jane and Jeana, did girly stuff like massages. Jason and I hit the beach! We rented 2 ghetto wave runners for half hour, had some shrimp and beer. Ok, I had a coke. I got along well with our Dominican driver, and was feeling pretty good about my Spanish-speaking with him until the bill came. Funny how communication seems to be lacking when it comes to money. Guess I missed the "It's $35 each way to and from the beach, pal." That night, we went treated Jason to dinner at a restaurant overlooking the ocean. Very nice. I meet my old friend, El Presidente, and had a good time. Turns out there is tequila in the D.R. as well. Who knew? Facebook documents the results a little too well. I believe Jason called it "the best birthday ever." Not sure, as my English was probably poor by that point, too.

On the way out, I bought 4 Cuban cigars, and lit one up back at the hotel. I offered to share it with the hotel owner, and he in turn pulled out his top shelf rum. "Imperial," a Dominican rum he claimed was the world's best. I'm not a big hard alcohol drinker, but it did warm the gullet and was quite smooth. He generously gave me 2 shots, got me drunk, and started a conversation about US politics. Initially, we were having a good conversation. He asked me about health care in the US, and knew more about Obama's plan that I did. Ignorant American. My Spanish gets better when I'm tipsy (or at least, my awareness of how bad it is goes away), so we were hummin'--one of these great things about traveling and learning languages. You can really connect; doors to the culture and people open that aren't there if you are pure boring American gringo. In Paraguay, I loved sitting on the porch with Armando and his wife and talk about things we knew nothing about--like politics. Anyway, then he turned the clock back to 1492 as if he knew Columbus and started telling me the entire history between Haiti and the D.R. By this time, the rum was wearing off, and Lorenz was trapped in a history lecture. Merde! Oh, I listened to it alright. The prized French colony for wood and sugar cane. A slave country's freedom from imperial France, France's crippling taxes, wars, etc. WHERE'S MY RUM! He cut me off, and then the conversation got painful. I should have faked passing out, but I lasted to the end like a polite little American, and then went off to blissful sleep.

And like that, my adventure was over. Stay tuned for further big picture reflections to follow...

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