Two years in

       In a little over two weeks, I will be wrapping up my second year living in Haiti. Being me, I have feelings about this (having feelings is one of the things I'm best at doing). Two years ago when I was getting ready to embark on this adventure, I thought that if I could just check all the boxes, I could be prepared for what was coming. I think a part of me knew there was no way to really prepare for what was in store, but I tried. I read books on missions and development and what it means to do those things well. I listened to podcasts and sermons and prayed my little heart out.
       Then I got here, and it's been more than I could have dreamed. If you had told me at the end of October 2012 that in under two years, I would be running a clinic (with a staff!), I would have laughed you off. Yes, I dreamed of those things, but I didn't dare hope that my dreams could really happen. I didn't dare hope to find a mission with like minded people I could respect, work with, and when necessary submit to. I didn't dare hope that educational programs could be started. I definitely didn't dare hope that the first nurse we hired would be dedicated to learning every possible thing she could in order to better her professional practice.
       I was reflecting this morning on how deeply grateful I am for the last two years. They have been hard, enormously hard most days, but they have also been incredibly rich and beautiful. I have a group of coworkers I can laugh with. I have learned to make jokes in a second language. A huge chunk of my heart is now walking around with a couple of half-grown, moody teenage boys. I have been challenged, stretched and grown in a myriad of ways. My thinking on the kingdom of God and faith in general is more nuanced than before.
     As I start dreaming for year three, I am so incredibly grateful for the time I have spent here and cannot wait to see what 2015 holds. To all of you, who through prayer, finances, Skype calls and emails have made this thing happen, thank you for your support. As this communal culture continues to teach me, I couldn't do it without you!

Our new staff

The Doctors Lavaud, a married couple, split the work week between them as they hold down other positions as well. I appreciate their gentleness and patience in teaching patients.

Nurse Ruth consistently seeks out opportunities to learn new things in the clinic and jumps right in to help with any needed task.

 

Introducing our new MOHI clinic staff:

         Having a staff meant I got to spend some one on one time with this chickadee yesterday, convincing her to take her worm medicine. Yes that is a lollipop in my hand. Like Mary Poppins, I believe a spoonful of sugar helps the medicine go down.

      In unrelated housekeeping news, I fly to the States in a little under three weeks and will be there until early January. I'll be traipsing around Florida. Let me know if you want to get together!

Enough

     Last Sunday I listened to a sermon about how the Lord uses us in our weakness, how coming to the end of ourselves can be a redemptive thing when it allows the Lord to work in our lives. After listening to it, I basically thought to myself "well, that's nice" and filed it away for later.
      Later came faster than expected. In the space of a week I have gone from running the MOHI clinic on my own, to having a staff. Suddenly tasks are getting accomplished faster and I am having to learn to manage personalities in a culture that is not my own, in a language I still wrestle with. More than twice I have wondered when everyone was going to catch on that I am not enough for the task at hand. Not smart enough. Not strong enough. Not culturally sensitive enough. Not experienced enough. Not tall enough. Not enough.
    The thing is, all of those things are true. I am not enough for the task at hand, for the dreams that are being spun for the MOHI clinic. Left solely to my own knowledge and experience, I will make an utter mess of this thing that is so precious to me. Which I why I have been enormously grateful not to have been left to my own devices this week. There has been the grace of an international network of experienced health professionals to refer to for the program building. There have been people with more experience and insight into this culture than I have to talk me through laying a foundation of professionalism and respect for my new employees.
     More than anything, there has been the grace of me, on my knees before my God, begging for mercy as I negotiate these changes, begging for the grace to know how to proceed. Would you continue to join me in prayer for the MOHI clinic and the major and exciting changes we are making? Pray that we would work in unity for the good of our friends and neighbors, that we would learn to communicate and fit together well, that we would glorify the Lord in our thoughts and actions. Thank you.

Welcome Dokte!

     After a roller coaster week of decision making and interviews, I am terribly excited to report that we have hired a doctor for the MOHI clinic. Dr. Miche Lavaud was born in Haiti and educated in Haiti and the Dominican Republic as a physician and an ultrasoud technician. He has several years experience working in both countries in hospital settings and speaks Kreyol, English, French and Spanish.
    Part of the vision of the MOHI clinic involves working respectfully within existing health systems in Haiti. Among the assets that Dr. Lavaud brings to the table is several years experience working in Grand Goave's local hospital. Dr. Lavaud's experience and connections open doors for our clinic to expand our level of care and assist our patients in further fulfilling their healthcare needs. Today was his first day on the job and he is already setting up personal appointments with patients to help them get needed surgeries. Welcome to the team Dr. Lavaud!

Update from the clinic

       We spent this week dreaming for the MOHI clinic, weighing options and weighing next steps. We look forward to the days of a fully Haitian staffed clinic and strong community health programs and have been looking at how to implement those goals. In looking at our options, we have decided that next steps for the clinic include hiring a Haitian physician and nurse to work alongside us.
       There are several reasons we are excited about these next steps. For one thing, having Haitian staff helps affirm the dignity of the patients we serve. Haitian healthcare workers are already familiar with language and cultural nuances and needs, and can bring a depth of insight into patient care that would take me, as a foreigner, years to match. The other exciting point about increasing staff is that it frees me up to pursue building up our community heath programs. Having Haitian medical professionals gives me more time to pursue programs, and more resources to partner with as we work together to develop health related classes and try to develop a more community based role for the clinic.
          Hiring a staff takes money. I don't love asking for money on this blog (or really at all), but for this I will. We are developing a physician sponsorship program where people could donate monthly towards the cost of paying our doctor. If that is something you would be interested on, please contact me. Beyond that, will you continue to join me in prayer for the MOHI clinic in this decision making and transition time? Thank you!

Sometimes

      I have written before about how I am learning to lament this year, gaining practice in grief. Sometimes (most times) that grieving comes from being here. It comes from the patient who refused to be compliant on his TB medication and died, despite all our efforts at intervention and education. It comes from the woman who comes to the clinic with a massive breast mass and almost no treatment options. It comes from the daily hurts of systemic injustice. I counted the cost of this kind of grief when I came  to Haiti. I expected it. I prepared for it.
     It turns out there is another kind of grief, the grief of not being there. This grief crashes down when the people I love more than almost anything are wading through hurt and our contact is limited to Skype, Gmail or Facebook. Modern technology is an incredible grace in allowing me to remain connected with loved ones in the States, but it does not replace sitting on the couch and sharing the hurt with them. I am nothing if not a nurturer and I was not, am not prepared for the grief of not being present. This grief leaves my heart small and shivering, to borrow a phrase from one of my favorite novels. My closest friend is walking through heaps of pain this year and I hate, hate, hate being so far away. I would give almost anything to be able to sit with her in her tears tonight. Since I can't be there with her in person, will you join me in praying for her as she hurts?

Prayer Request

     I have had a cold this week, which has left my head floating somewhere above my neck, barely tethered. This makes stringing sentences together in English difficult. Let's not even talk about my Kreyol language skills the last few days.
     As I have mentioned before, we are looking into major changes for the MOHI clinic. Things have been absurdly busy in the clinic for months and we are in the process of trying to figure out what our next steps should look like. We are looking at how to wisely implement opportunities available to us in the best interest of our patients. Join with us in prayers for wisdom and guidance as we figure out what the next few months will look like? Thanks friends!

Oral Rehydration Corner

                Yesterday's clinic experience was a veritable parade of mamas making wonderful choices for their children.We had mamas bringing their kids in for follow up appointments (more a of a rarity than we would like), mamas advocating for their babies' needs and mamas working with us to help rehydrate their sick toddlers. I was fairly dancing by the time clinic ended, a rarity for Monday.

One of the things I see fairly often in the clinic is children under five years old with diarrhea, a major worldwide killer. We have implemented a set of protocols for treating these children that follow WHO recommendations. Part of these procedures involves keeping children with some dehydration in the clinic for a couple of hours, to orally rehydrate them, and assess whether they are stable to go home. This procedure gives us (hopefully) a four hour window with these children and their caretakers, a great opportunity to chat and teach. At least that's the theory. In practice it is difficult to convince caretakers to stay for the entire time and I am often left giving instructions for home care, a much less preferred option. We had a little girl in the clinic yesterday who fit the criteria for some dehydration and I asked her mama to stay with us for a bit, so we could give her daughter the fluids she needed. The mama, to my very great delight, agreed.

 In an effort to keep little ones from going stir crazy in the clinic, and to encourage the caretakers to stay for rehydration therapy, I keep some educational activities around for them. Yesterday I shared a coloring book and a book with the alphabet in it with the mom and her daughter. After explaining what I needed from the mom, as far as giving her daughter frequent sips of fluid, I left them to themselves to see my next patient. Within a few minutes, I heard the mom singing the ABCs with her daughter and her daughter trying to sing along. This continued off and on for the better part of an hour, interspersed with drink breaks, where the mom managed to turn getting the needed fluid to her child into a game that keep the little girl drinking plenty and often, exactly as we like it for dehydrated toddlers.. 

I'm not sure if I can express strongly enough how beautiful the whole thing was to watch. This mom who had been desperately worried about her daughter, singing and playing with her just a few minutes later.The little girl who came to the clinic droopy and left with a bounce in her step. Some of their friends who were in the clinic line, who celebrated with the mom over her daughter starting to look better. I was left marveling again at the beauty and strength in this incredible country.

School Nurse: Year Two

        As I mentioned in previous posts, school started back up at MOHI about a month ago, which meant I resumed my duties as school nurse. I have written before about some of what it looks like to act in this role, but things have changed a bit in how I relate to the kids as we start our second year together. Last year was a time of getting acquainted with one another. This year, we are working off of that foundation, which can be a lot of fun.
      Working off of that foundation means there's a first grader who stops on her way to lunch to fling her arms around my waist and proudly announce that she drinks lots of water. (I am forever telling the students that drinking more water will help heal near any ailment they come to me with.) It means there are twin preschoolers who jump up and hug me every time they see me. It means the teacher for our youngest preschool class brings a group by the clinic on a tour of the school, to introduce me and tell them they do not have to be afraid of seeing me
       It means welcoming teachers back, and rejoicing to see how they work with their students. It means birthday crowns in the preschool and singing and dancing in the yard when I arrive to start clinic. It means clinic consultations happen at a slightly higher volume because of the lectures going on in classrooms. It means a line of kids in the clinic in the afternoons, coloring and reading books and talking to me about what they see in the books. It means discussions on hand washing and trash disposal and tooth brushing. It means smiles and cheers and bustling activity. It means a continual influx of new reasons to fall in love with this country.