Monday, March 5, 2012

Anal Atresia: Cashed

Physically.  Mentally.  And Emotionally.  Cashed.  The term hasn't quite made it to Haiti.  In fact, I'm not so sure that this use of cashed has spread much further than my Southern Illinois routes.  But when something is done, or empty, we say it is cashed.  And that's how I feel.

Last Friday seemed successful.  On Thursday we were told that the paper was lost and that we'd have to restart the process.  We did.  We went to Arcahaie and had to pay $20 to get them to make a new birth certificate.  Pretty sure that was extortion, but when you're pressed against a hard time line there really isn't much negotiating.  However, this time they did what we asked them.  They actually gave us the copy so that we could deliver it to our next step.  The constant promises of "the paper is coming" or "we just sent it to the next place" were in fact all lies.  I'm assuming they were lies.  I can't verify that anyone knew where the copies of paper were last week.  So, we started over on Friday.  With the hand-written birth certificate in hand, John and I made for Port-au-Prince where we went to the Public Archives.  There, we walked up, handed over the sheet of paper, and waited till they brought it back out with a little slip saying they "verified" it.  Really important step apparently.

So that was it, we were told.  That was what was needed to move forward towards procuring a passport.  And I was happy to head into the weekend with some positive news.  It all seemed so easy when they just let us take care of transport...  Oh, what could have been.

Last night I passed out at 8pm.  I had went on a three hour hike up the mountains and then moto-ed back to the compound.  Then I went to English Club and basically gave a lecture about health and medicine.  It was a long, exhausting, but also rejuvenating day.

I woke up at 2 am feeling awful.  My stomach wasn't rejuvenated and for some reason I picked the last week to catch some sort of cold.  #NotHelpful.  My sleep was shot.  My breathing was labored.  My stomach was, well I'll spare you the details.  Let's just say I wasn't feeling good when 6 am rolled around.

The troops were rallied.  Water bottles were filled.  The wallet was replenished.  I was off to secure the passport.

We hopped on the truck.  I opted to stand because no matter what position you're in on those things you're going to be uncomfortable.  At least this way I wouldn't be bouncing my tailbone on a hard plank.  The ride was jerky.  Swerving left to right with sudden stops and starts.  Pretty standard.  Not great when you feel like crap.  Speaking of crap.  The other day I was on a moto when the driver pointed out a woman on another moto and said, "She has cholera."  How did he know, you ask?  I wasn't paying attention, but he said you can tell because she was laying down on the back of the moto.  Makes a lot of sense.  With cholera you don't have a lot of bowel control, so you want to put yourself in the best position possible to prevent leakage.  Therefore, you lay down on the back of the moto.  Wonder what the sensitivity and specificity of that observation is?  

As if the poop stories weren't enough.  My luck just wasn't great today.  The tap tap was packed full.  A woman in a yellow dress came a stood next to me.  She didn't last long.  She certainly looked uncomfortable.  She sat down and it became more evident; this woman was sick with something.  A man behind me opened up some sort of cooler and she splashed the water on her face.  With every bump or twist of the truck she would grab my ankle for support.  And then the gates opened up.  I glanced down and see her vomiting all over the floor, into her hands, and then into her coat.  Like I said, she looked sick.  I certainly couldn't diagnose her with anything other than diaphoresis, emesis, and pregnancy.  Her traveling companions kept offering her water to splash on her face.  The emesis didn't seem to stop. 

It did.  The girl sitting behind her was nice enough to not complain when the woman laid back against her legs.  We were almost to PAP.  I checked her pulse.  Quick, but not scary quick.  When we got off I made sure they were on their way to the hospital.  I bought 6 things of ice water to pack with them and sent them on their way.  I had other fish to fry and the family was tending to her.

We left by moto to the Ministry of Justice.  The motos are ten times more expensive in PAP than everywhere else.  I would guess that is because they know we aren't familiar with the layout of the community.  We don't know how far everything is away from each other.  It seems like they won't even start their engines for anything less than twenty dollars Haitian.  I'm tired of arguing at this point.  I know I'm getting ripped off, but it's exhausting to argue for a fair price.  

En route we encounter a police road block.  Just a few policemen with really big guns.  They were checking papers from the drivers and giving people pat downs.  Now, I speak a little Creole at this point.  But I sure wasn't going to let them think that I understood a lick.  He started asking about my papers.  "M pa konprann."  I didn't have my passport and I don't know why he would need it.  The questions kept coming.  I really don't think he believed me when I said I didn't speak Creole.  And for good reason I guess.  He came close and put his hand on my shoulder.  He walked around to the back of the bike and told me to "descendre."  That much I do know, so I started getting off.  Before I could even start to truly worry what was going to happen, he started laughing, said something about me understanding Creole, and let us go on our ways.  Crisis averted.

We arrived at the Ministry of Justice.  As always, the guards at the gate start asking John a bunch of questions.  They inquire about me.  They inquire about the mom.  And they inquire about what kind of "malade" the baby has.  It doesn't help that the baby doesn't look sick.  She looks very peaceful and the mom doesn't seem to be at all concerned about the image she portrays when she breastfeeds her child in the waiting rooms.  Maybe you'd want to hide that.  Maybe we don't want them thinking that the baby has no problem eating.  If the baby has no problem eating, then why wouldn't they assume that they baby can actually poop okay?  And often times they do.  IMO they shouldn't even be told what's going on, but this is Haiti and judging by my abundance of photos there is no HIPAA here.  

And now it starts getting frustrating.  My understanding of the process from here forward was that I would need to pay the Ministry of Justice for some sort of authorization and then take that paper to the Ministry of Immigration where they would complete a passport for the child.  Piece of cake.  Nothing in Haiti, or on this journey, has been a piece of cake. 

We needed more paper.  They told us we had to go to get a notary to "authorize" the travel.  No amount of questioning could ever get them or my translator - never truly know who is to blame in these situations - to articulate what this paper was or why I needed it.  Just that, "we have to do it." So John got directions, sort of, and we were off.  By directions I mean he was told a name to tell the moto drivers.  In case you haven't figured this out yet by my writing, I hate dealing with less than a full deck of cards.  And throughout this entire journey we've been playing with a deck that was a little "light."  Maybe smaller than a euchre deck.  

We wandered around.  If I pushed him to then he would ask for directions.  But a natural problem solver he is not.  

The office is not well labeled.  There is a small print of the official's name on the window, but other than that no identifying marks can be found.  We enter.  Mom is quiet, like always.  She finds a place to sit and tends to her baby.  John goes to work trying to figure out what paper we need and how much it's going to cost.  "Twa mille Gourdes."  I was dumbfounded.  I didn't know what this paper was.  I didn't know where else we could get it.  And I definitely didn't know how much it should cost.  Although, I would wager a bet that it shouldn't cost 3000 Gourdes.  

Over the course of our visit in the notary's office I was asked to hand over my passport, give them my address, give them the address where the baby will be taken in the U.S. just to name a few.  I tried to have some language put into the document that would place medical decision making into the hands of Dr. Buresh and his wife.  No one could translate between English and French including my translator.  So we have English mixed in with the French of this "very official" paper.

It cost $500 Gourdes.  Discount for some reason.  But we were told that we would have to come back and get more papers before we took the child out of the country.  Whatever it takes.  We hop on a pair of motos and head back to the Ministry of Justice.

Before we even get through the front gate, the security guards start telling us we need another piece of paper.  Now, these men do not know where we've been.  They do not know what papers we have.  And they shouldn't really bother themselves to know what we're trying to do.  But they do, and they have, and they were right.  We did need to go somewhere else to get yet another paper that I had not been told about until I was already trying to move on to the next step.  Remember what I said about operating with less than half a deck of cards?

It's walking distance from the Ministry.  After John gets us lost again by walking in the complete opposite direction as they told us, we finally get on the right path.  Before we even get to the front door a couple well dressed gentleman standing outside flag us down.  John explains the situation.  One of them says for 500 Gourdes he will get the paper we need.  Again, "What paper are we getting?  Why do we need it?  Where else can we get it?"  John is clueless.  He doesn't answer any of my questions.  I'm tired of pulling teeth.  I hand over the money.  He disappears inside the building. 

Twenty minutes later he emerges with a sheet of paper.  I guess it's what we need.  At the bottom it has a "cost."  "9.5 Gds."  Great.  Really glad I paid so much extra for that.  We get a copy made of each document before heading back to the Ministry of Justice.  We make it past the guards this time back to the original office.  She said something about us having the other paper and all I could think was, "Oh, very good you went and got the paper that I knew you would need but thought it more fun not to tell you to get it before coming back here."  She and another lady signed our papers and sent us on our way.  And as opposed to going to the Ministry of Immigration like I thought we would be, they sent us back to our second stop where the guys were still hanging out front.  We had to purchase a "temp passport."  

I breezed past them this time.  I wanted to see the process inside.  One followed us and even showed us the way.  It was a long line.  I was smart enough to ask the lady at the previous office how much this temp passport would cost.  "320 Haitian Dollars."  That's about $40 U.S.  I asked the man who walked us back to the line.  "They cost about 320 Haitian, so if you give me 400 I can go have it made for you."  Honesty.  I was impressed.  I agreed and got out the money.  He took it, a couple of our papers, and headed towards the front of the line.  I saw him pass by an older gentleman and hand off the money with a few quiet words in his ear.  He came back and got the mom and placed her at the front of the line.  It's that easy.  

We had it.  The man asked for a small tip since he got none of the extra money.  I handed over a couple bucks.  We finally had everything in hand that we would need to get the passport.  Another moto ride brought us to the Ministry of Immigration.  

The building is poorly labeled.  In fact, we had to walk around the back and through a gate to get where we were supposed to go.  We stop and talk to a security guard sitting behind a desk.  John volunteers our papers for further direction.  He pauses at our ID cards.  "You're going to need a NIF number."  "She has a NIF number."  "She needs a better one."  Again, I ask why, how, how long, when and where.  The answers I get are, "It'll make it easier.  There is a man nearby."  Turns out there was a guy right behind us who said for the low low price of 1000 Gourdes he could make it for us.  I counter with $20 US (just over half).  He accepts.  He takes our papers and my $20 and heads off.  I send John to fetch our food as it was nearly 2 pm and we hadn't eaten other than the protein bars I had given to each of them.

The gentelman returns with a piece of paper with the same NIF number on it as the photo ID's I had made and this paper didn't have a photo on it.  He said we'd need to attach one.  I didn't feel like messing with it, so we went on into the building.

We didn't get questioned about the IDs once.  In the first office they directed us upstairs.  In the second office they said that we were too late for today and we'd need to come back tomorrow.  They stop at 1pm.  I toyed with the $40 U.S. in my pocket looking for the right person to try and encourage to help us make this happen today.  We convinced this office to direct us to the office where they handle the passports.  The door is open.  The guard lets us pass.  A half dozen people are still sitting in the waiting room.  John speaks up, surprisingly, to talk with the receptionist.  She states that we are too late.  I implore her to let us speak to the director in charge.  She asks.  He comes out.  He's a very tall, young man who greets me in English.  He examines our papers and confirms that we have all the necessary documents.  No reference to the photo ID cards.  But he still tells us to come back tomorrow.

I'm awkward.  I've never actually bribed someone before. But I wanted to do it without everyone else seeing it.  So I palmed a couple twenties in my hand and just asked the man, "Are you sure there isn't anything else we can do to make this happen today?"  All the while my eyes keep glancing down towards my hand.  He probably thought I had a nervous tic.  He didn't see it or he wasn't impressed.  We're going back tomorrow.

Another long day has passed.  I still feel sick as I type and I hope that I wake up feeling much better tomorrow.  We have to make yet another trip to Port-au-Prince to get the passport.  After that it will be the visa.  The way our progress has been thus far I do not hold great confidence in my getting this done before I leave this Friday.  But I do know that John and I will continue to move forward and that she will get her surgery.

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