Anal Atresia: Hope

Hope isn't a disease, nor a number as far as I know, but it's the best term to discuss the near-conclusion to our story.  I emerged from the Ministry of Immigration on Tuesday with Bedica's passport in hand (notice the name change from how I had previously - Begika -  spelled it as this will be important to our story).  My final posting or contact with the outside world was a photo I was able to upload to facebook showing her passport.  That would be the last instant that we had power inside the compound for quite some time.  No power.  No internet.  #AsPrimitiveAsCanBe #IsMerryAnnSingle?  The lack of power/internet I believe was ultimately my undoing.

The steps I needed to complete before securing the VISA were muddy to say the least.  I knew I should secure a better "letter" from a Haitian physician as the one I was currently rocking was a google.translate job that I bs'ed one day by writing in cursive.  It had certainly worked up until this point, but I wanted to be as legit as possible when approaching the embassy.  I also needed to fill out the online application for the VISA.  And not only did I have to fill out this 10 page application that asked such gems of questions as, "have you ever been involved in any attempts to engage in human trafficking?" and "Have you ever enlisted child soldiers?"  But I also had to have the mom physically click the submit button.  No idea why.  And I have no idea how they expect anyone from Haiti to jump through these hoops.  The questions are absurd and not contextually appropriate.  What is her address?  Let me think, the stick and tin lean-to off the road leading from Carrefou Poy?  The only number is the one spray-painted by the post-earthquake inspection team that gave it the okay.

Okay, I'm venting.  But it is kind of a ridiculous questionnaire.  Again, I had to have the mom to click the submit button.  This is also impossible to do without power.  And for those of you wondering why I hadn't worked on this earlier it's because the second page of questions request the passport number. So, handcuffed until last Tuesday.  And then powerless.

The last things I needed were various documents from the U.S. including a letter from the medical team that would take care of her, notes from the host family stating that they will provide for her, and then some sort of confirmation from CHI that we wouldn't be expecting Haiti to pay for anything or using tax dollars.  Dr. Buresh had sent me most of this stuff the previous week.  For those of you waiting for the foreshadowing to come back, this is the time.  The previous week when we had all been operating under the understanding that the little girl's name was "Begika Emilise."  That's how my interpreter had spelled it to me during the first interview.  The parents had nodded when I showed it to them.  But when I finally took the time to look at the birth certificate and then the passport, to the people of Haiti her name was not "Begika" but "Bedica".


I was torn.  My phone batter was nearly dead.  It had few minutes.  I had no internet.  Do I find a way to get in touch with Dr. Buresh to get him to change the papers?  Or do I use the remaining charge on my computer to see if I can change the baby's name?  I opted for the latter.  You'd be surprised what you can do with a screen "snipping tool", Paint, and Microsoft Word.  After about an hour I had some fresh new documents with the baby's correct name and legit looking signatures and letterhead.  So that was settled, but I still had no way to print them and now my computer was about dead.

I cast that aside and took mama and baby to another clinic by my translator's house.  The local physician with whom we've established strong ties repeatedly rejected his ability to write a letter in support of our cause.  I do now know why.  He is a recent graduate of their medical school in Haiti, so perhaps he felt that he didn't have enough seniority.  It clearly states "A letter from a Haitian physician...".  It doesn't need to be the Grand Chief of Pediatric Butt Surgery.  But I certainly can't force the issue.

The other clinic is very nice.  Small, but appropriate.  John says they usually work from 6 am till 6 pm.  They had one physician there, a general medicine physician, but they also claimed to provide Ob/Gyn and Peds consultations.  Granted, there aren't residencies that I'm aware of in Haiti, so it's basically a person saying they specialized in a field.  The general med physician saw our patient.  He agreed with my assessment.  But once again I found a physician who did not want to write the letter.  I still can't understand why.  He punted to the clinic's "Medical Director" perhaps because he was an older, more respected physician.  Only problem, the medical director wasn't in yet.  We would have to return.

And we did.  We came back and sat down in the waiting room.  It was filled.  However, I think that most of the people were there because the tv was playing the Barcelona soccer game.  Cheers would erupt when Messi would score his goal and the doctors would come sprinting out of the exam rooms to catch the replay.  I guess I can say I'm no better as I was watching the Cardinals playoff games while I was doing ER shifts #12in12.

Finally he took us back.  He sat down behind his desk and asked what we needed.  I explained the situation.  "We need a letter from a Haitian doctor describing the baby's condition.  We need their declaration that she is healthy enough to travel to the U.S., but that she needs to rather urgently to get the surgery performed because it cannot be performed in Haiti."  The word "cannot" is used rather loosely.  The surgery can be performed.  Heck, I can "do" it.  But if you want the kid to have a good outcome, heck, if you want the child to survive, you need to take her to the U.S.  We tried Zanmi Lasante.  We tried the Italians or Spaniards that have the hospital in PAP.  We were told that the General Hospital was trying to achieve 100% mortality rates for this procedure.  So all of our local options were drying up quicker than a goat hide in the Arcahaie sun.  We needed a letter, and since I was leaving in two days, I needed it stat.

"Come back tomorrow so the pediatrician can see her."  "I DON'T NEED A LETTER FROM THE PEDIATRICIAN.  A FOUR-YEAR-OLD GIRL CAN MAKE THIS DIAGNOSIS."  I explained to him in a much more watered-down tone that he couldn't understand anyways.  The other doctor had already seen her.  All I need is a letter.  He discussed with the other physician...  "We'll get it to you first thing tomorrow morning."

FML.  So much of this journey has been spent walking away from an office at the end of the day with the 'promise' of having what I need be there "first thing tomorrow morning."  It hasn't been the case yet, and on Thursday (today) it would keep its hitting streak alive.  I had yet to find that single person who was a problem solver.  A person who would look at a pile of nails in their path, and instead of turning around (like I'm convinced most Haitians would) he/she would lay a tarp over it, or build a bridge, or make wooden shoes.  I don't know what, but they would do something.  Everyone seems very content to just sit back and let everything happen.

I went home.  Still no power.  Maybe there would be some tomorrow.  People were coming to fix the generator at some point #HaitiTime.  I was left with my thoughts.  At this point my thoughts are pretty sparse, so I fell asleep at approximately 9pm #GoodOrBad #BrainDrain.  Unfortunately, Mike was sick and probably could have used an IV.  Apparently I'm a bad roommate and slept through all of his cries for help #StillAlive  #BackInTheUs#BackInTheUS#BackInTheUSofA.

The next morning John was supposed to pick up the letter at the clinic and then grab the mama and baby on the way to the compound.  Both are on his way.  I call him at 8am.  It doesn't ring.  I call him at 9am.  No answer.  He calls back.  "I'm still waiting for them at the clinic."  So much for them working from 6am till 6pm.  He finally gets the paper and calls to ask what he should do.  "Like I said ten times before, bring the paper and the patient to the compound."  Why, you might ask.  Well, late in the morning the people finally came to work on the generator.  It fired up about 10am.  I went to work on the application.

Ten pages, at least.  I finished just before John arrived with the mama and baby.  "John, can you tell her to push the submit button?"  He stutters.  She doesn't move.  I take her hand, put it on the left mouse key and say, "Presse."  You better believe I bloggie'ed the crap out of that action.  I wasn't going to let them tell me she didn't submit the application.  I loaded everything onto my flash drive and we took off as quick as we could.  Mike said his goodbyes and came with since he was heading to the airport.

We left the compound at 1130.  Boarded a bus/tap tap at about 12 and stood waiting in City Soleil for about half an hour for my go-to driver to come pick us up.  Mike's flight was at 5, so he opted not to make the trip to the embassy.  We drop him off at the airport and the guys in red shirts pounce on his luggage.  We arrive at the embassy at around 2pm.  The sign says they operate until 3:30pm.  I know heading into this visit that I do not have an appointment, which you are supposed to take the time to schedule for a non-immigrant visa.  I did not have that luxury.  You are also supposed to print out the application confirmation.  I had it on my flash drive, but did not have available printing #NoKinkos.

I talk to the Haitians guarding the front and explain the situation.  She guides me back to the more formal security gate.  Fortunately the workers I talk to are bilingual as John had went with the driver to find food for everyone.  I carefully explain the situation and hand over the doctor's letter.  He reads it, and he clearly cannot understand it all, but it obviously strikes a cord with him.  He realizes the serious nature of the child's condition.  I mean, as soon as you hear that someone doesn't have a butthole, you probably freak out #WhatWouldYouDoWithNoButthole?  He starts making phone calls.  Dial tone.  Answering machine.  Endless ringing.  No voices.  He re-iterates that I'm supposed to schedule an appointment.  I re-iterate that I was only able to submit the application this morning and my flight leaves at 0930 tomorrow morning.  Again, he realizes my relatively desperate position.

The phones still go unanswered.  I decide to try my one and only trump card that I have access to, my hosts.  I call Mahalia who readily offers up a personal friend of hers that works in the Embassy.    The clock clicks past 2:30.  I walk to the other end of the building along the outside wall.  He meets me outside the gate.  We exchange pleasantries and then he starts up with, "You need to schedule an appointment."  #BeenThroughThis.  "I can't."  He says there is no way around this, you have to schedule the appointment and then email the lady to request an urgent meeting.  "You mean I can't call her?  I can't show up and try to speak with her face to face instead of dancing around the internet?"  Is it just me or is that kind of ridiculous?  That would be like going to the police station to file a complaint and them saying, "I'm sorry we only handle that business by phone."  WTF.  I'm trying to eliminate a few steps in the process here.  I only need enough of her time and energy as it takes to pick up a rubber stamp and place it down on this little girl's passport.  Or hell, if she's pissed off she can slam it like it's Wile E. Coyote's head under the mallet.  I don't care.  Just stamp the damn passport.

He couldn't help.  I thank him for his kindness of coming to see me and quickly brush past him.  I had limited time and I had to try something else #WhoYaGonnaCall.  Unfortunately there were no ghosts to be had nor do I have Bill Murray on speed dial #HowAwesomeWouldThatBe.  So I called the next best thing, my mom.  "Mom, are you by a computer?"  She's actually in a car dealership where they have a public computer #WhatADeal.  I have her log into my email and send a message to the PAP embassy.  Subject: Medical Visa Bedica Ermilus.  Content: Need appointment today. Medical emergency.  Signed -Me.  Dramatic?  I think not.  Then, she is able to find my submission confirmation and in the email are links to follow that eventually lead to a scheduling page.  I tell her to schedule one for the first available.  It's Monday, March 12th.  Whatever.  Get it on the books.  #ThanksLoveYaMommy.

I run back to the other entrance with the scheduling confirmation scribbled on my hand.  It's about 3:15 at this point.  Keep in mind that I walk when I talk, so I had actually crossed the street at one point, entered into a bank, got frisked and wanded by a security guard, contemplated bribing a bank teller to print off everything off my flash drive, but then walked out dejected before having even tried to speak Creole all in the midst of having my mom pull off the epic Toyota Showroom Scheduling Spectacular.

I rush past the first security guards praying I don't get tasered in the back.  I enter the main security doors and tell the very helpful guard that I have a appointment code now and have sent the lady an email.  He gets a look of absolute "Oh shit."  The person that you have to talk to...just left.

Foxtrot.  Uniform.  Charlie.  Kilo.  He tried.  To his credit, he tried.  Hell, he might've got himself in trouble by trying so hard.  And I certainly hope that wasn't the case.  From the look on his face he felt like a failure too.  I felt bad for him.  But I also felt bad for Bedica and Carole (the mom).  Not because this would have been the might success for them, that will come with the surgery, but I have been pushing and pulling them back and forth across Haiti for nearly two weeks and I fell one step short of securing the child's trip to the U.S.

It won't be difficult to complete the process.  It will just take somebody to bring the baby with them to the embassy with the paperwork that we have assembled and with a pre-arranged appointment (piece of excrement) to get the rubber stamp go-ahead.  Then the 'Blan' Knight can come down and whisk Bedica away to the land of germ theory and post-operative nursing care where she can safely have her surgery performed with expectations of a great outcome.  And honestly, I've had so much of this kid's shit on me that the surgeon better do a damn good job so that never has to happen to anybody else #BabyPoopIsNotTheNewAxeBodyFragrance.

I will leave Haiti tomorrow morning, bright and early.  A week ago I was nearly in tears with all the struggles I was facing in trying to power through this process #TearDuctsSurgicallyRemoved.  But now, I can leave with the comfort of knowing that I did what I could and she is way closer than Vegas odds-makers would have placed her.  I didn't know what my chances of success were when Chris told me to focus on this.  In rereading the emails we received from others who have been involved in Haiti, they said that they usually take 7-10 days to get everything lined up.  Some steps can take up to a couple months.  The quickest they've been able to do it is 5 days, but that was before many of the regulations were in place and it was a medical emergency.  I've used up the last two weeks of my trip trying to make this happen.  I've dealt with public transportation, a well-intentioned but under-equipped translator, extortion, bribery, a lost birth certificate, 2 hour lunch breaks, week-long karnival celebrations, work days ending at 1:30 pm, and my own frustrations and limitations and still managed to come to the front gates of the final goal.  My grail.  My El Dorado.  But unlike the explorers of the past, I have faith that my quest will come to fruition and Bedica will get her surgery.