Coming Home

All my interviews are done. My final presentation is complete. My bags are packed. Today I fly from Jeremie to Port au Prince and from Port au Prince to JFK. What a great summer, I have learned so much here! I have a feeling this won't be my last trip to Haiti…

Tropical Storm Emily….or not

Don't worry, I stayed dry. We expected 10 to 20 inches of rain, but we didn't get a drop! We did, however get a really crazy looking sunset.

Week in Terre Rouge

So I just got back from spending four days in a village called Terre Rouge which is just outside of Moron Haiti. Emily and I spent 4 days living with a HHF health agent and her family. We got to go on many home visits with her and see mother's, father's and children's health group meetings. It was an adventure to stay in a place with no electricity or plumbing or cell phone service on the brink of a tropical storm!

            On the second day we were there we were summoned to the home of a woman in labor. The matwon (traditional birth attendant) told us that she had been in labor for four days. The mother was lying on a bed in a two room hut made of banana leaves. She was still fully dressed, but when she lifted her skirt we could see the umbilical cord lying between her legs. I don't know much about birth, I knew this wasn't good. The health agent was able to round up men from the village to carry the woman down the mountain in a "stretcher" and Emily and I phone Jeremie to have an ambulance sent for her. Unfortunately, before the ambulance could reach her, she delivered a lifeless baby boy. The mother survived and is doing well. Although it was an awful experience for the family of the baby, I now fully appreciate the struggle women face to reach adequate obstetrical care. Haiti has a lot of accommodations to be made before infant and maternal mortality rates can be reduced. This is an experience I won't soon forget.

Trip to Bonbon

            I had a pretty quiet week, as I tried to finish up my interviews at the Center of Hope in Jeremie. Only 6 more until I reach my goal of 130 interviews! Yesterday I got to see another new city in Haiti. I went to the beach in Bonbon with Emily (American HHF volunteer), Pierre and Clifford (Haitian HHF volunteers). I drove with Pierre on his moto which took about 35 minutes from Jeremie. Even though I am a little scared of riding around on motos, they really are the best way to see the country. The picture above is of a place where a river meets the road between Bonbon and Jeremie. People come there to wash their motos, their clothes and themselves! It was wonderful to have a day relaxing on yet another gorgeous Haitian beach before I head up to live in the mountains for four days. That will be an adventure for sure!

Last Interview in the Mountains

Today I finished my last interviews in the villages. The rest of the time I am here I will be interviewing at the Center of Hope (maternal waiting home) in Jeremie. I am sad to be done going on the health posts because they are a lot of fun, but it will be nice not to spend so much time in the car getting to them. Even though my interviews are done, my time in the villages is not. Next week Emily and I will be spending 2 nights at the home of a health agent in Moron, Haiti. We will see all of her patients with her as well as live with her family. The home in the picture above is actually the one that we will be staying in. I think that will be a really great experience. I will keep my fingers crossed that one of the women I interviewed will go into labor while I am there!

Beach Weekend

This past weekend I spent at the beach in Port Salut with Emily (nurse/HHF volunteer) and Michelle (works for Caris Foundation/my housemate). Port Salut is on the southern coast of Haiti. It took us 5 hours to get there over winding roads. Most of the way the road was only wide enough for one car. On the way we drove through Les Cayes which is the 4^th largest city in Haiti. We were so excited to see paved roads and a traffic light that we actually stopped to take pictures.

Once we were at the beach we were really spoiled with American style food and air conditioning. The beach was gorgeous with clear blue water, white sand and mountains in the distance. We ate at one really nice hotel that had a swimming pool and a flat screen TV which seemed so out of place in a country like Haiti. It felt kind of wrong to be indulging in good food and sunbathing while there was so much suffering around us, but I have to admit it was nice to have a few days off!

Voodoo Lesson

Today I spent the morning interviewing Marion, the uncle of my summer host, and a local Voodoo expert. Marion has been studying Voodoo his entire life, but also understands my Western perspective since her studied mathematics in US and other places abroad. It was nice to interview someone in English! He is 84 and although he had a stroke last year, he is doing well (mostly sustains himself on Ensure and the local beer, Prestige).

            He spent a lot of time explaining the differences between good Voodoo and bad Voodoo (he only practices good Voodoo of course, but knows about both kinds). All in all it seems extremely complicated. For example, if I had an enemy that was pregnant and I wanted her to die or lose the baby I would go to a Voodoo priestess (only a female will do). She then has to mix poisons, preferably into a food, and then trick a close friend or family member to feed my enemy the poison. However, if my enemy catches wind that I am trying to harm her, all she needs to do is find a Voodoo priestess with a more powerful spirit than the one I hired. If the baby is born healthy I will know that my priestess lost to a more powerful priestess.  

He also told me that Voodoo services are extremely expensive; 700 to 1,000 gourde (between $17 and $25 US) is the going rate to have an enemy killed. This is interesting because many women say they can't afford to come in for prenatal care which costs only 50 gourdes ($1.50 US), but I guess people find the money when they really need it. I definitely learned a lot from Marion, and before I left he asked me to recommend his services to the pregnant women I interview if they are in need of good Voodoo!

Rural Post

So I just got back from a trip to the village of Joudant. It is about an hour and a half from Jeremie. The drive there was beautiful, which was good because the speedometer never went over 20 mph. Out one side of the car you could see the ocean (it was so clear, I half expected to see Cuba) and out the other side of the car you saw mountains. From all of these drives out to rural health posts I can definitely say that the Haitian proverb "beyond mountains there are mountains" is true!

 

The post today was set up in a cockfighting arena, which basically is just a few rows of circular bleachers set up in the middle of the forest. After I finished talking to some of the women who were there for prenatal care I got to help with some of the medical care. I took blood pressures on everyone waiting and then I gave children polio and DPT vaccines. I felt bad because we only had adult size needles for infants and toddlers, but these kids took it like champs. They cried a lot less than American kids do!

Local Flavor

This has been a very fun week! I got to do some more sightseeing with Denise, a nursing professor from Uconn. She is thinking about bringing students here next spring. We went to the outdoor market (see above picture) in Jeremie which was insanely crowded, but a lot of fun. They sell everything there from live chickens to ginger to raw meat to nail polish. They also sell used clothing from the US by the pound. Bette showed us around and helped me bargain for some baking soda and sugar so I could make cookies for our 4^th of July celebration.

 

Another fun thing we did was go to church on Sunday. Even though I had no idea what they were saying the entire time, being at church made me feel at home. The priest of this parish owns an orphanage in Jeremie and all of his children sit around the alter. One little girl, maybe 6 or 7 years old, feel asleep during his homily. When the priest saw her sleeping he pulled her up on the alter and made her kneel there for the remainder of mass! He may have been a strict priest, but he did make a point of shaking every single persons hand in that church twice before we left. I have made a few more trips to villages this week; I will write another post about them soon!

Ethnographer

Things in Haiti are going well! I really enjoy talking to women and hearing the stories of their pregnancies and births. It is just amazing to me how strong these women are. Most of them deliver at home with a traditional birth attendant.  Honestly, that seems like a better option than delivering at the hospital which is rather unsanitary and expensive. One woman this week told me that she gave birth to her last child completely unassisted and then flagged down a neighbor to come over to cut the umbilical cord! I can't even imagine what that was like. I am hearing a lot about voodoo. Many people believe that enemies can use their negative thoughts to "tie a baby in the womb" and thus cause a difficult labor. The necessity for some C sections is blamed on the negative thoughts of enemies.

 

The photo above is of women staying at the Center of Hope maternal waiting home. I will not be interviewing them for my study, but they see me around a lot and we have become friendly with each other. I took this picture at about 11:30 am when everyone got tired right before lunch. They prefer to nap on the floor of the porch rather than in their beds because the floor is cool. You would certainly never see women with high risk pregnancies sleeping on the floor in the US!

Village church in Lassise, Haiti

This was the site of a rural health post last Friday.

Adjusting to life in Jeremie

Hello Everyone! I have been very busy over the last couple days. I have started to have some preliminary conversations with pregnant women about their experiences with prenatal care. I think I am going to focus on how the social issues surrounding pregnancy affect when a women first comes in for prenatal care. I have gotten to go out on some more rural health posts in the mountains. The days that we go out are long. We leave early and the posts are extremely busy. Even at the smaller posts there are at least 100 people waiting for us when we arrive. Everyone is always exhausted on the way home.  The drives to get out the posts are usually at least an hour long, but they feel longer because the roads are so bad. Although I can't complain, the views are spectacular! Some of these villages seem a million miles from civilization it is hard to believe that HHF has been able to set up a health care system there.

 

Anyways I am having a wonderful time in Jeremie. I am starting to find my own way around the city on foot. People here are generally pretty friendly and I feel safe walking around. Jeremie is full of hills so walking is also kind of a workout for me. I am adjusting well to the heat; it is great to never get cold! Another thing I like about Haiti is that there is toilet paper in every public place I have been. Seriously, if Haiti has toilet paper everywhere then Paris has no excuse!

Tour of Jeremie

So after our afternoon on the beach David offered to take me for a tour of Jeremie on his moto. I was kind of scared after my spring semester critical care elective (we saw a lot of motorcycle traumas), but I figured there was no better way to see the city. David has been here since October and knows his way around the city really well. He let me wear his helmet, which was appreciated. I was the only person on the road with a helmet! He took me through some of the poorer neighborhoods which reminded me a lot of the some of the poorer places I saw in Africa. Most of the houses were one room with broken down tin roofs. We also went to "the point" which is a piece of land that jets out into the ocean which has the remains of an old French fort complete with cannons. I also saw the city center which has a plaza and a big cathedral. Attached is a picture of Jeremie from on top of one of its many hills.

Beach Day

So today is Corpus Christi (a Catholic Holiday that celebrates the Eucharist), which meant that I had the day off from work! I went to the beach with some American HHF volunteers and a Haitian HHF staff member (Emily is a nurse from PA, David is a premed student from RI and Clifford is an English/Creole translator from Jeremie).  The beach was absolutely beautiful! The water was water was calm and warm, but the sand was so hot we had to sprint from out towels to the water. There was an old sunken ship that we swam out to and jumped off of. There was also a cave that we swam into and climbed up the walls. Not many Haitians know how to swim, but there were people there wadding and floating on blocks of wood. Apparently Haitian people don't really like this beach because they believe that there are evil spirits in the cave. Luckily, we were informed that it was safe for us to go into the cave because evil spirits think white people taste too bitter!

Dental chair outside at the rural health post

How would you like to have your teeth pulled here?

Rural Health Post

Yesterday I went to a rural health post in Moron County which is about an hour and a half drive from Jeremie. I piled into the back of an SUV with 8 nurses from HHF (all men). Luckily one of them spoke English and was able to introduce me to everyone. Another SUV full of American doctors, nurses and dentists met us at the health post. Haitian nurses handled prenatal and postnatal care visits while the Americans saw all the other patients. The dental chairs were set up outside in the gravel. I weighed and took the blood pressure of all of women who came for prenatal care. There must have been over 100 of them which really surprised me since we were in such a rural area. They all crowded around the 2 chairs that were set up next to the scale and shoved each other out of the way to be the next one to get her blood pressure taken. Every time I pumped up that cuff I felt 100 pairs of eyes on me! Most of them had extremely low blood pressure (like 90/60). I wonder if that is related to malnutrition. I really needed a pediatric cuff to get accurate BPs on many of them because their arms were so thin. A few of the younger women were far enough along in their pregnancy to be showing, but weighed less than 90 pounds. I have no idea how they had enough body fat to ovulate in the first place!

            Today I officially began my research. The daughter of Bette (my summer host) has offered to be my translator for the summer which is great! Michelle, who is 17, grew up speaking Creole and English and also was in need of a summer job, so she is perfect! Judy (my professor from UCONN), Michelle and I interviewed 3 women this morning after they had a post-natal care visit. For my research I will be talking with women who come in for prenatal care, but since this was just for practice it was fun to talk to women with their adorable newborns! I am starting to get an idea of the factors that play into women coming in for prenatal at the Center of Hope. One woman today told us she could not come in for prenatal care to early because then everyone would know she was pregnant (the women all have to line up and wait together) and she was concerned about others sending evil spirits to harm the baby. I am sure I will get a bunch more interesting responses to my questions; I can't wait to do more. On the way home from work today a truck was broken down in the middle of street, blocking traffic in both directions. We had to leave the car and walk the rest of the way, a true Haiti experience!

Check out the view

This is the view from the inn where I am staying. Not what you typically think of Haiti looking like.

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Kristen Pepin
kjpepin@gmail.com

Made it to Jeremie!

Yesterday I arrived in Jeremie and I have already seen so much! We took a very small and rather unstable looking plane out to Jeremie. Even though it was kind of scary the views were absolutely beautiful. When I arrived Bette (HHF public health director/my host for the summer) took us on a drive through downtown Jeremie (see picture). The inn were I am living is like a resort. My room is very simple, but the views are gorgeous since it is up on top of a mountain overlooking Jeremie and the Caribbean sea. This week, while Judy is here, I am having all of my meals with Bette and her family, but next week I will start having my meals with the rest of the hotel guests.

 

Today I went to a Haitian Health Foundation (HHF) health fair in a local village. It took about an hour to drive there. The roads in Haiti are so terrible the car never gets out of 1^st gear! The health fair consisted on the entire village gathering in the church to watch skits. Men, women and children all sang and danced about the importance of breastfeeding. I couldn't believe there were preschoolers singing about colostrum! At the end they invited me to get up and dance with them which was so much fun! I felt like I was able to make a connection with these people even though I was unable to speak their language. The kids all loved to have their photos taken which was very cute. After the fair we went back to the health agent's home where they served us fried plantains, sweet potatoes, rice and beans. Haitian food is much better than Chinese food!! I also met some student volunteers today that are about my age, so hopefully I will get to hang out with them more in the coming weeks.  Tomorrow I will start preparing for my research!

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Kristen Pepin
kjpepin@gmail.com

Port Au Prince

I know everyone was worried, but I made it through my 16 hours in Port Au Prince without any trouble. We spent all of our time at our hotel which was full of other foreigners. During the drive to and from the airport I was able to see a fair amount of earthquake damage. There were huge slabs of broken concrete all over. We also passed several "tent cities" where people who lost their homes in the earthquake are living. The tents cities are huge and each tent is literally inches from its neighbor.  Our hotel was neat and clean, but unfortunately next to a very loud night club. That was a bit annoying, but it is good to know that with everything these people have gone through they still like to drink and dance with their friends. Now off to Jeremie!

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Kristen Pepin
kjpepin@gmail.com

I'm off!!

Hi Everyone! Welcome to my Haiti blog! I am flying from JFK to Port Au Prince on Friday morning and will make it to my final destination, in Jeremie, on Saturday. I will let you know how it goes!