Cholera Carols

I am staying for a few nights near Limbe (an hour-ish from Cap Haitien). Last night I worked at the cholera treatment unit here. Today my coordinator and I met with Doctors without Borders to discuss possibilities for collaboration in Bayeux a village an hour from here. I also facilitated communication between my Haitian and Dominican colleagues to get a shipment of cholera supplies on Sunday, communicated with future volunteers about airport closures and flight cancellations due to the roadblocks and demonstrations that started today. And then, when I thought that after supper remained only sleep (after getting 2 hours in the past 36), I found out that we would be gathering with some of the volunteers that have come to work with the cholera patients.

It was lovely. We sang Christmas carols, read the story of Jesus' love for Mary and Martha and his weeping with them in their sorrow just before the resurrection of Lazarus. We heard from a sermon that addressed why Jesus weeps and where he is in moments of death and suffering. As we sang the carols, we kept on finding ones that were about cholera. I'm not kidding! Now, maybe if you haven't been working many dark, tiring nights battling death and dehydration, you won't see the songs in the same way. But here are a few verses:

O Come, O Come Emmanuel

O come, thou Dayspring, come and cheer

Our spirits by thine advent here;

disperse the gloomy clouds of night,

And death's dark shadows put to flight.

Joy to the World

No more let sins and sorrows grow

Nor thorns infest the ground.

He comes to make his blessings flow

Far as the curse is found.

(Cholera would be the "thorns" that are literally infesting the ground and seeping into the drinking water.)

Okay, there were more but my brain is no longer functioning. Good night!

Cholera Update

Hi, everyone! Our internet has been nearly non-existent recently, and when we've had it it's been slower than the slowest dial-up you can remember. But suddenly today it is running beautifully! Um, when we've had electricity, that is—I think it's gone off five times today.

Thank you all so much for your prayers for little Odlin. I stayed in touch with one of the nurses from Hinche by phone, and I'm happy to say that he continued to slowly get healthier and finally went home! When I think of what he looked like the day he came in, and indeed even the next few days, I am just amazed.

Every day there are more patients in more communities sick with cholera. There is no sign of this stopping for the next few months, if not longer. There is also a lot of misunderstanding about cholera. It's not uncommon to hear people say they would rather get HIV than cholera. In the past weeks our work has been to:

• Coordinate shipments of IV solution and other supplies to combat cholera.
• Prepare for a Training of Trainers in Port-au-Prince, specifically designed for people who have children's ministries. We were supposed to go to Port-au-Prince on Sunday, but have postponed the training due to continued violence in the city.
• Follow up with the Community Health Evangelists (CHEs) who continue to teach their neighbors from house to house. I've mentioned before the lessons they teach for physical health: what is cholera and how is it spread, how to wash their hands with a simple system using a plastic jug, string, and a stick (most people don't have running water), how to make oral rehydration solution at home, and the importance of using latrines.
• The CHEs have also helped people develop frameworks to process things emotionally and spiritually. Cholera is yet another disaster being faced this year, by people who suffered greatly from the January earthquake and now also violence surrounding national elections. I have heard many people, even young children, say that Haiti is cursed, and cursed by God. What a terrible burden to live under! Our lesson entitled "God and Cholera" leads people to God's Word to learn about God's character and God's heart for us.

On the last day of the feast, the great day, Jesus stood up and cried out, "If anyone thirsts, let him come to me and drink. Whoever believes in me, as the Scripture has said, “Out of his heart will flow rivers of living water." Jesus (recorded in John 7: 37 -38)

And when Jesus speaks in Kreyol, you hear it like this: Dènye jou fèt la, se li ki te pi enpòtan. Jou sa a, Jezi kanpe devan foul moun yo, li di yo byen fò: Si yon moun swaf dlo, li mèt vin jwenn mwen, li mèt vin bwè. Moun ki mete konfyans yo nan mwen, y'ap wè gwo kouran dlo k'ap bay lavi koule soti nan kè yo, jan sa ekri nan Liv la.

Cholera in the North

Evelyne, me, Solencia, and Mme Grimard (some of my colleagues)

From a note I wrote to my coordinator on Wednesday, November 17 :

Last night I went to the Cap Haitien gymnasium where I was given a tour of the cholera treatment center by the director for Doctors without Borders (MSF) for northern Haiti. MSF has been here for a week and are now seeing only a quarter of the deaths in Cap Haitien compared to the previous week. So much of this has to do with the importance of understanding how easily treatable this disease is, if only patients are hydrated quickly! The MSF director told me that the hospital wasn’t quite where they would like it yet, but they were pleased with the improvements. From my perspective it is so much better than the nightmare I lived through in Hinche.

As soon as the roadblocks clear they will be bringing tents to set up outside the gym to enable them to expand to over 400 cholera beds. They are now coordinating all cholera treatment in Cap Haitien, although they do work with the health ministry. They have also been working in Limbe, the other area where we would like to send volunteers. They only knew about the two hospitals there, not the 60-bed (and rising) center at Seminaire Limbe, five km from Limbe. That is where Dr. Steve has been working tirelessly and with few staff. MSF plans to return to Limbe (again, as soon as the roadblocks clear). They are coming back to the hotel now so I’m going to see how soon they think they can get through. Dr. Steve only has enough IV fluid for the next 24 hours.

Since we don’t usually work with short-term medical volunteers, I’m glad that MSF has accepted to take them under their wing here on the ground – we will just need to coordinate flights, airport pickups, meals, and housing, which will be part of my job the next few weeks.
MSF has also offered to train our community health workers on “bucket chlorine.” This means that a person will be stationed at each community water source (if there are too many some will be closed). The worker will have a concentrated chlorine solution and will put a specified amount in each bucket of water collected. In other countries this has reduced the cholera outbreaks to two or three days. However, due to the already widespread nature of Haiti’s epidemic (now in every region of the country) we will likely need people to do this work for a month or two.

Brief return to Port-au-Prince

Cholera Treatment Center tents in Hinche

Saturday, November 13:
I arrived in Port-au-Prince yesterday after spending the last seven days and nights working in Hinche with patients who had cholera. This morning the J/P HRO group loaned me a computer so I have been able to catch up on some of your responses. Thank you so much for your prayers and notes of encouragement!

It can be so challenging be aware of God's presence when one is physically, emotionally, and mentally exhausted. I thank God for your prayers, and praise God that in the last few days I was really able to gain a better perspective in the midst of the horror. Too tired to focus in prayer, I listened to a song with the following lyrics, "I will lift my eyes to the maker of the mountains I can't climb...'cause you are and you were and you will be forever...you fashioned the earth and you hold it together." How true! God is always moving everywhere to bring life and healing and hope.

Thank you for your prayers for Odlin. He was not on his cot when I arrived to the tent hospital the following day, and everyone assumed that he was dead. What joy to find out the next day that he had been transferred to the neighboring "real" hospital and that they were treating him for typhoid fever. We had already been giving him the antibiotics that treat that terrible disease. I was able to visit him yesterday and he looked somewhat better, although he is very weak and still has diarrhea. There was no family by his side, although I heard that his mother had been around some days earlier. Please continue your prayers that he would not be alone, that he would be assured of God's presence and that he would be completely healed.

Before leaving tonight for my "home" in Cap Haitien I will be visiting the site where we will be holding a Community Health Evangelism (CHE) training in December here in Port-au-Prince and working out logistics.. My computer is still not working due to viruses, but my brother-in-law has sent several CDs and SD cards of material to help it to work again and then to de-bug it and our office computers. Until I get his package and, Lord willing, am able to resurrect my
computer, I may not have much access to the internet.

I will be in Limbe all next week, a town 20 km (one hour and a half) from Cap Haitien. Our team will be training people to be trainers in new villages using the holistic CHE tools. Our volunteer trainers continue to go to village after village teaching cholera prevention. Cholera is spreading quickly in Limbe and in Cap Haitien and many other places in northern Haiti. There are not enough supplies or medical personnel. We have one more shipment of supplies arriving
from the Dominican Republic tomorrow. For the next few weeks I will be facilitating communication between those who want to come short-term (particularly nurses) and the areas of need. I also hope to be able to help get experienced groups such as Doctors without
Borders to the remote areas we work in.

In the name of the one who has defeated death and the grave,
Liz

Cholera Treatment Center, Hinche

Church building in Hinche used for cholera patients

Monday, November 8

Hello! I'm writing from Hinche, a small city a few hours north of Port-au-Prince. (If you click on the map at the top right and zoom in a bit, you'll see it in the center of the country just north of Mirebalais: Arrondissement de Hinche.) Cholera hit this town six days ago, and a cholera treatment area was set up next to the local hospital by using several tents and a small church. Since I am working with the J/P HRO team these two weeks, they sent me here with a group of volunteers on Friday. We plan to stay till Wednesday when another team will replace us.

Cholera has not been seen in Haiti in at least 50 years, and it can take some time even under the best of circumstances to set up a good system. This site is run by the Ministry of Health in partnership with Partners in Health (PIH). Doctors Without Borders arrived yesterday to provide technical support—they are building special cholera beds and have laid down gravel, which are critical steps. Cholera leads to profuse diarrhea, and it has been incredibly difficult to keep patients, floors, and cots clean. We have also been having heavy rains with the passing of the hurricane, and the tents we work in were very muddy before the gravel.

I'm working with a great group. We're currently sitting around not talking about work for the first time! We've realized that we've been working from late afternoon to mid-morning every night and while not at work have been strategizing. We know this isn't sustainable.

We've established good relationships with the medical director, Ministry of Health, and the Haitian and Cuban physicians who work here. We've had significant challenges working well with the national nurses, and we've been told that this is perhaps due to the government hiring and retention system, although we're also aware that we are from a different culture and are outsiders. Please pray for wisdom and good working relationships. Constant vigilance is needed with IV fluids and oral rehydration since the main cause of death with cholera is dehydration. We have a great team of cleaners who recently received excellent training and are applying it with vigilance. Their efforts have wonderfully changed our work environment.

This is a very challenging environment. We work at night with little light. We do not have all of the supplies we need; the supplies we do have don't stay stocked, and it can be difficult access supplies even when they are here. Patients have died, although thankfully not in our areas on our shifts. Whenever a patient does die the family members wail, which adds to the emotionally-charged atmosphere. There are many patients who are children, and since this site is currently not allowing family members to come in as caregivers, the children are alone.

In addition to praying for the patients, families, and staff, please pray for the efforts of community health workers in prevention of this terrible disease. Our Community Health Evangelism (CHE) volunteers have now gone to 100 villages, teaching prevention methods (hand washing, latrine usage, cleaning drinking water, etc.). However, in the areas in the north where they are starting to see cholera they do not have enough medical personnel. We don't have any CHE programs where I am now, but PIH has been training and sending out their community health workers.

Thank you for your many notes of encouragement and particularly for your prayers. I haven't had access to e-mail since arriving in Hinche, but was able just now to briefly read what you've written. People have asked about donations, and for CHE work they can go to LifeWind International (www.lifewind.org) to the Haiti Disaster Fund (code D921).

In God's mercy,

Liz

Working inside the "church."

P.S. Please pray for Odlin, a little boy I've been caring for since yesterday morning. He arrived malnourished and severely dehydrated, and it was very difficult to get a good access for fluids. We struggled again yesterday afternoon and evening, needing to place another access for fluids (in his shin bone).

Obviously we care for all of our patients, but this little boy has really touched my heart. When he's able, he talks, calls out, "Oh, God!" or "Stop, it hurts!" He also frequently reaches his arms around my neck.

Please pray for this child of God.

Arrival in Port-au-Prince

Breaking down the tents at the J/P HRO refugee camp hospital. (All pictures from J/P.)

I arrived back "home" in Cap Haitien on November 13. It's now been over a month since my computer and all of its drives were disabled due to viruses. That problem combined with inconstant electricity and internet access has interrupted my blogging. I will post here some e-mails that I sent during that time.

Wednesday, November 3
Hello! As many of you have heard, there is a tropical storm/hurricane approaching Haiti. It looks like the rain should start at about 1 pm tomorrow followed by hurricane weather on Thursday evening or else on Friday morning.

I'm still in Port-au-Prince working with the J/P HRO. The plan here is to continue dismantling the tent hospital and store everything by tomorrow noon. We will attend emergencies and deliveries only. As soon as the rain starts, we'll come back to our base which is a large
house. We have stored all the tents we were sleeping in (on the grounds), and we'll start sleeping inside tonight. As soon as the rough weather stops (on the sixth?) we will go back to the refugee
camp and set up to start attending patients as quickly as possible.

In the morning I was the "designated doc at the camp for emergencies." I only saw a few pregnant women, but the title sounds good. In the afternoon I perfected my taping skills at the house we were staying at!

This is a very well-organized group, and I am privileged to be a part of it. Please pray for the people in the refugee camp. Evacuation routes are still being planned, and they are worried about landslides. Please continue to pray for our Community Health Evangelism (CHE)
teams up north. I heard today that the cholera cases continue to increase in Cap Haitien and Limbe. We praise God that yet another shipment of IV solution, chlorine, and oral rehydration salts were able to come in from the Dominican Republic, albeit with some
difficulty crossing the border.

We are anticipating not having power soon, so I will probably not be communicating via e-mail until well after the storm is over. We are anticipating a lot of injuries in the camp due to the weather conditions, and so we wil likely be very busy for days.

After my night shift was over this morning, I attended the meeting of the (mostly Haitian) medical staff. As their portion of the meeting started they sang "Count Your Blessings," then one woman prayed, followed by all reciting Psalm 23. May God truly shepherd this land
and the people He loves so much.

Training in La Gonave

Here's the group of new trainers! This photo was taken at the end of the Training of Trainers 1 in La Gonave.

This trainer is presenting his groups ideas on how to obtain information from the communities in which they serve. Instead of formal (and often inaccurate) surveys, the groups suggest spending time forming relationships, talking with village elders and children, and using their five senses in observation.

In groups of two the trainers practice sharing about God's plan for us to live abundantly.

In between classes we use songs and dances to keep ourselves awake and keep the training fun. In Nicaragua I had learned one with lots of movements about planting and harvesting corn. While in Bolivia the group we trained invented a version using yucca (which has about twice as many steps!). Both corn and yucca are big crops here. So with Kreyol translation in hand, here I am leading the group in the life cycle of yucca! Haha! They had to show me the "real"movements since of course they know much more about yucca than I do.

We use a lot of sketches, too. Above you see trainers acting out the story of the paralytic and his four friends going to Jesus. We use this story to talk about key concepts in development: finding and using local resources, perseverance, love, and hope.

Here are my co-facilitators and our host: Enoch, Erigeur, Enick (our host), Lucson, and Sully (Enick's colleague). In this picture we're on a hill on the island and you can see the sea and the mountains of "mainland" Haiti in the background.

Food!

Spaghetti (with ketchup and mayonnaise, oil, bits of fried chicken), the breakfast of champions.

Another day's breakfast, corn mush. My colleague said, "Mmm, I can taste the dried fish."

Fruit! These are really yummy! You bite off the outside, then suck the fruit off of the pit.

Here's the inside.

Since we were on an island, we ate a lot of fish. See my Facebook for the delights of the fish head.

Mmm! This is truly the best! "Custard apple" in English, kashiman is super-yummy, especially after a several-hour hike in the heat. While we were hiking, a friend was picking dozens of them for us to enjoy.

Travel to La Gonave

Lucson and Eriguer, two of my fellow training facilitators, enjoy yucca as our ferry is about to leave the port.

Steps to get to a training on La Gonave Island:

02:30 am Wake up since a truck has stopped outside with loudly-miked religious music (voudou). It stays there for about 20 minutes.

3:30 am I lift the heavy iron bar off from the outside gate of my lodgings (more Jane Austen) to let my co-facilitators in to pick up our training supplies.

3:40 am Wake up porter to lock the gate behind me. Leave hotel via pre-arranged taxi to the center of Cap Haitien.

3:45 am Taxi stops to pick up another few people along the way, so we are seven adults and one child in the car.

3:46 am The child sees me (it's dark) and says, "Blan!" (foreigner) I greet her with, "Bon jou." She doesn't respond, and her mother says, "She said 'Bon jou,' how to you respond? Come on, she said 'Bon jou.'" The girl looks at her mother and inquires, "In English?"

4:00 am Find our beautifully decorated (formerly yellow) school bus that is en route to Port-au-Prince. Using the light of our cell phones we find our assigned seats (three to a seat). While waiting, we can buy plantain chips, cell phone credit, water, etc.

5:00 am The bus roars out of town. At the top of a mountain someone calls for a bathroom break, so a bunch of people get off the bus (and go to the side of the bus). Um, this is why women tend to still travel in skirts even though in the past few years pants have become more acceptable. Since we're at a market, it's also a great opportunity to buy bananas, yucca, and peanuts from the vendors who come up to the windows.

10:30 am We yell at the driver to stop as we approach our destination, a port town. We yell again, until he finally stops. We get off and walk back to the port.

Enoch (the other facilitator) and me as we leave the "mainland."

11:00 am The ferry leaves. A man in a suit takes out a (miked!) megaphone and starts yelling at us that we need to accept Jesus today or we will die. He then gets into highly controversial doctrinal issues, all at a really high volume. People respond, argue back, etc. What I like best about all this is that the evangelist really resembles Chris Rock.


12:30 pm Arrive at La Gonave island. We can't reach our contacts by phone so we eventually decide to pay someone to take us in the back of his pickup truck to town.

3:00 pm Start the training for 16 participants who represent about eight different organizations!

Bayeux Clinic

A few days ago I went to the Bayeux Clinic. This formerly self-sufficient clinic sustained damage in the January earthquake, as well as other damage from initially poor construction. They have received donations for reconstruction, including from my sending church, Epic Christian. Above you can see that they are already moving ahead. A contractor from a church in the neighboring Dominican Republic has made several trips to the site to advise them and work with the construction workers.

Here is a picture of what will be the new storage facility for the pharmacy, on top of the laboratory. The old storage facility was too damaged to be saved.

I hope to go out here every week or two to assist the (very capable!) nurse auxiliaries. My medical knowledge is sure to come back rapidly with the wide variety of cases they have there. On our way back to Cap Haitien we took a woman with severe pre-eclampsia to the "big city" hospital.

Above is the Cap Haitien office of Medical Ambassadors Haiti in action: Evelyn, Anias, Enoch, and Lucson. I'm here when I'm not traveling -- it's on the same site as my lodgings, which is awfully handy!

Next week I'll be at a Training of Trainers 1 we're facilitating for an organization on the island of La Gonave. If you look at this map you'll see both Cap Haitien and La Gonave -- it's the big island in between the two "arms" of Haiti. If you zoom in you can even see Bayeux, on the north coast (written "Bayeau, " it's on the coast west of Cap Haitien). This should be a great opportunity for more language learning!

Leaving

My sister (seen here on Skype on my computer) has been a huge help in preparing electronically for my move.

I arrived in Arizona today for a couple of days to meet with my pastor and be prayed over by my church before leaving for Haiti. My host so kindly said, “Welcome home – well, I don’t know if you consider this home, but we think of it as your home.” Buenos Aires feels like home. Lots of cities in the US feel like home. But today, unsure if I’m returning to Argentina, that’s where my heart turns.

I was listening to “I Can Only Imagine” when I started writing this note (and started crying). That song, seen in a Hebrews 11:16 light, is sort of about homecoming. Now “Be Thou My Vision” is on as I unpack, so many of my things reminding me of my friends in different places. But the prayer of this song is that God would give us true vision. It reminds me of church last Sunday, when we sang (in Spanish, of course), “Precious Jesus, my redeemer, beloved Lord, you are everything to me, I will worship you every day of my life.” I was crying then, too, since I was declaring those truths with my words. Declaring that God is faithful, and worthy of being followed, even though that means leaving people that I really love, yet again. Leaving a city and a country where I feel at home, where I have loved ones, where I know how to get around and where to get what I need, and am able (most of the time, anyway!) to get potable water out of the sink.

Nicole and Tim, my fabulous hosts in Arizona! Here they are on "make your own pizza" night, yum!

On the positive side, over the past few years I have realized that my heart is capable of more love than I ever thought possible. Six dear friends came to see me off at the airport. I miss them already.

My three buddies in Arizona. I was honored to get to borrow the Superman cape during my stay!

Peru -- food!

This post is about FOOD! There is lots to say about Peruvian food, from 2500 varieties of potatoes to omnipresent Chinese restaurants. Here are a few pictures:

This is a really large amount of food!!!! Audra (in pink) and I shared -- with lots of leftovers --the pachamanca you see in front of her, but it really is for one person. In addition to three kinds of meat (no guinea pig, although it was served there) there were several kinds of potatoes, fava beans, and a sweet corn mush inside the corn husk wrappings. The drink you see is "purple chincha," and there was also a "fermented yellow chincha" at the other end of the table.


A Peruvian potato dish: served at a local restaurant with a Veggie Tales tablecloth!

Ceviche: raw fish "cured" with lemon/lime juice.

This is a rough and tough tri-vehicle (tee-hee!) seen on the streets of Huancayo on our way to a restaurant.

I don't remember the name of this fruit, but it's really strange-looking inside! It tasted yummy, though -- one eats the gray seeds and the gelatinous goo surrounding them.

Peru -- training!

Marco (a Peruvian colleague) and I facilitated a Training of Trainers 1 (TOT1) in Huancayo, Peru, for two different mission organizations.

We split up into small groups frequently. Above one mission organization is discussing future plans.
Here's another way of working with small groups: the group above is trying to put in chronological order the steps to implementing Community Health Evangelism (CHE).

Above is a skit: we frequently do a river-crossing drama to illustrate the differences between relief, betterment, and development. In this part of the skit Paul has "hurt" his back carrying Rocio to the island in the middle of the river (relief), so he has no choice but to teach Karen how to cross (betterment going towards development). Then he leaves, and Karen teaches Rocio how to finish crossing the river (multiplication).

And here is a view of the mountains we crossed going from Lima (Pacific coast) to the high valley where Huancayo is located. I've read different estimates, but it appears we got up to nearly 16,000 feet (5000 m). Huancayo is just under 11,000 feet (3300 m).

Future Plans

I've spent the past few weeks preparing for two big events:

1) Training of Trainers 1 in Huancayo, Peru! Two mission organizations have requested Community Health Evangelism (CHE) training there. A Peruvian missionary, who is already using CHE in another part of the country, will facilitate this five-day training with me at the end of August.

2) Move to my temporary assignment in Haiti! In mid-September I will arrive in Cap Haitian, the second-largest city in Haiti. This northern city is also the headquarters for Medical Ambassadors Haiti, and the four Haitian facilitators who are the core of this team have invited me to work alongside them for six months. I'll spend the first few months learning the language and accompanying the team to trainings and site visits, while I also take advantage of my English skills and work on project proposals and continuing relationships they've begun with other non-governmental organizations (NGOs).

Some of the people with whom I'll be working. The woman in the yellow t-shirt is Mme. Grimard, one of the four facilitators with Medical Ambassadors Haiti.

I'm to travel to Port-au-Prince monthly. There were two CHE programs there before the earthquake which are still trying to recover. There are also lots of pastors and NGOs who are looking for ways to move from relief to development and we want to be available to work with anyone who is interested in using the CHE tools.

Since so many of the Haiti CHE programs are involved with local clinics, one way that I will be able to help is with my medical skills, both in consulting and working alongside the nurse auxiliaries. Please pray for me about this: I haven't practiced medicine for three years and although I saw a few malaria cases in the States I have mostly only read about tropical medicine -- 13 years ago in the first year of medical school!

This is a great hand-washing system that we teach: there is a stick this man is stepping on which tips the bottle so that a small stream of water comes out. Soap is hanging next to the bottle, protected from rain by a plastic cup. This particular "tipitap" is right next to the latrine at the Bayeux clinic.

On the road again

We had meetings in Baradero on Friday and Saturday and I asked them to sing the national anthem since their national holiday was celebrated that week!

And above is a fun picture of everyone getting supper ready.


I had all day yesterday in the Dominican Republic and got to accompany Bibiana, my supervisor. We left Santiago at 6:15 am and went to Santo Domingo to say "hi" to the Compassion International staff. Following that we had a meeting with a Dominican pastor whose denomination wants to help in Haiti. Above you see part of our afternoon meeting with the CHE committee in Cambitas, Dominican Republic, along with a group of Canadian youth.

Yay! I met Flor in 2008 at the Nicaraguan internship, and Paula last March. What a joy to see these beautiful women again! They both work with CHE here in the Dominican Republic.

Trip to Haiti

I went to Haiti last month to accompany my coordinator: we visited several different CHE villages and also held a refresher course for CHE trainers from 35 different communities. If you've ever been to Haiti, you know that traveling there is a challenge. We noticed a flat tire on our arrival to Terre Blanche, a village that has started using CHE. Our driver put on the spare while we met with the trainers. Shortly after leaving the village, we got another flat! The driver hailed a passing motorcyclist and took the two tires to "nearby" Gonaives.

We waited by a river in the shade: below you see Madame Grimard (facilitator with Medical Ambassadors Haiti), me, and Bibiana (my coordinator) as I served Argentine mates to the three of us.


Some of the kids who'd been playing in the river came to see us. Renee, a Canadian from Partners International who'd come with us, took some great pictures which they loved to look at. Later (we were there for hours), Madame Grimard played games with the kids.

Two days later we stopped at the town of Ennery on our way to a training in Gonaives. After visiting several CHE homes (where Madame Grimard verified that all latrines had covers in place!) we met with the CHE trainers and several CHE workers. Walking back to the vehicle we met the husband of a CHE worker who had significant pain. Bibiana mentioned that I am an osteopathic physician, so I got to do some hands-on work!

We spent the next few days in Gonaives with 45 trainers from 35 different villages. Below is a photo taken during the morning's study on Philippians.

I facilitated two lessons: the first one taught a game that they can use to identify skills in the community, the second about growth monitoring of children (lots of kids are malnourished).

In the picture above you can see both the "problem tree" and the "solution tree" that we teach the trainers to teach their committees. The problem dealt with above is the lack of immunized children in the communities.


A bus drove many of us back to Cap Haitian, and there was a lot of hymn-singing along the way, which was lovely. However, since the "road" is mountainous, with lots of twists and turns, there was also some vomiting (not so great)! Again, traveling there may not always be smooth, but appears to never be boring!