Kriye

I don’t always sleep well when I’m in Haiti.  I don’t say that to complain, but as a mere statement of fact.  The beds are not luxurious, but they are a thousand times better than what most of the Haitians we are serving sleep on.  It is difficult to control the temperature; the city can smother you with heat and humidity while the thin mountain air can leave you chilled.  As I’m older I feel more aches and pains, which seem to be magnified with poor quality sleep.  And then there are the noises.  


Typical noises in Haiti can be Kampa music from a distant discotheque (Club Affeksyon is one of the best named ones I’ve visited).  The bar could be empty, but that won’t stop the owner from dropping dope beats through the aux cord ALL NIGHT LONG.  If it isn’t the beats, then sometimes it’s the ‘baaaas’.  I laugh at the customs form when re-entering the states as is asks if you’ve been on a farm or handling livestock.  Have you been to Haiti?  Anywhere but the city is agriculture and livestock.  Roosters, goats, pigs and dogs all like to make their presence known at all hours of the night.  Sunrise be damned.


On the morning of 9/17, though, there was different sound… a ‘kriye’.  We had had some deliveries the day prior, but none of the newborns had been noisy up to that point.  There were two pediatric patients in the hospital.  But, again, they had not made much noise in the days up to this point.  


I couldn’t sleep.  It was LOUD.  And it had been going on for over an hour straight.  So, I got up. 

She was outside the hospital… sitting in a chair… and she couldn’t have been older than nine months.  Her hair was in braids.  She had a dress on.  I looked around and there were several adults using the outdoor water supply to wash off their feet as they changed their clothes.  It was, maybe, four in the morning… maybe.  #EverythingBeforeSunriseIsFourAM I picked her up and I think the sheer shock of my whiteness plucking her off the metal folding chair stole her voice.  She stared.  I bounced.  Silence.  Perfect.


Her mother finished cleaning up and came and grabbed her.  About that time, she started crying again, but I at least satisfied in my mind the source of the screams.  I was up for good at that point, so I went into the post-partum suite to check on the moms and babies we had delivered.  When I passed back through the lobby of the clinic, I saw the little girl, her mom and her brother laying down on the bench to hold their spots for the day’s clinic appointments.   


I don’t personally see as many patients in the clinic as I used to.  I mostly go to observe clinic flow, provide resource support, trouble shoot and offer an occasional “this is how we would approach x/y/z in America”.  On this day I was observing in clinic when the mom brought her young boy and girl in to see Dr. Leo. Once again, my pale skin must’ve scared the little girl, or she was tired, or she was cold, or she was hungry because she immediately started screaming… no…crying – scryming?!?  I tried to hold her, but that was unsuccessful.  John, however, is the child whisperer and was able to bounce her around the clinic enough to keep her content.  


She wasn’t the patient.  Her brother was.  His body was skin and bones and his face looked beleaguered.  He was, himself, a child, but you could tell that he carried so much responsibility at his young age.  The little girl looked nine months.  She was fifteen months.  The mom’s concern was that the young boy had been coughing for over two months.  He was timid and often parroted what his mom said when Dr. Leo would ask a question.  Suddenly, Leo recognized the mother.  He confirms her name and turns to me, “we diagnosed her with TB last April.”  Yes, Tuberculosis.


She had gone to “the city” as a 16 year old.  According to Dr. Leo, she met a man and got pregnant.  As is all too common a tale, the man left her without concern for the well-being of his child or the child’s mother.  She moved back to Gran Bwa this past March.  She lives with her mom and tries to work as a seller in whatever market she can create an opportunity.   Even in better economic times, there are not a lot of opportunities in rural Haiti.    


I can’t say that I’ve seen a high volume of TB patients during my time in Haiti.  It isn’t the easiest thing to test for, so I may have started the work-up on some patients with breathing/coughing complaints that would eventually lead to a TB diagnosis.  However, we have a 20 year old mom of two with a known TB diagnosis.  The older child is here for a cough lasting two months and looks emaciated.  The 15-month-old has powerful lungs but is clinically malnourished.  Everyone needs treatment and fortunately there is a State sponsored clinic in the area with a TB program.  Yay! 

Jocelyne had been in treatment since her diagnosis in April.  One might think the system would take care to ensure close contacts did not contract this deadly bacterium, but alas here we are.  All we need do now is send our young man down to the clinic on a TB day to undergo sputum testing and enroll in the treatment program.  And fortunately, September 17^th was a TB day!  We tell the mom to hurry, pack a quick sack with a little food for the trip, and grab a moto to take her to the clinic building.


This would’ve been too easy.  The protests, or #Manifestations, had started in Port au Prince and somehow had found their way up our peaceful mountain. Crowds flooded the city streets to burn tires and generally disrupt commerce.  Not with plans of violence, this time, but to cause a scene and be heard.  The same was true in the mountains.  Young men, and possibly women, set up “road blocks” along the one road that went up and down the mountain.  Jocelyne was stuck.  She couldn’t reach the clinic to get her son started on his life saving medication.  She returned to the clinic and they had to wait.


This is one of many “road blocks” this poor, young family is going to have to deal with just to treat this disease.  I mentioned earlier that when I found them originally, they were cleaning up in the water supply outside the clinic.  They had hiked several hours in the mud just to get to our clinic.  They had brought a change of clothes to ensure that they were clean and dressed well to see the doctor.  If I’m sick, you can bet that I’m rolling up to my doctor’s office wearing sweatpants and bags under my eyes.  

Several days go by and finally the mountain road opens.  They were stuck at our clinic the whole time.  I have difficulty with the clinic being treated like a soup kitchen, but in this situation even Scrooge would show compassion.  Charity is, to me, a very delicate and difficult act in Haiti.  With nearly every trip I have people offer to personally give me cash so that I can deliver “whatever they [Haitians] need.”  I always go into a trip not knowing what I will encounter.  Where will the money be best used?  This time, it was clear.  I spoke briefly with our Haitian social worker - who had already recorded as much information about this family as he could - and I told him that I had money to support this young mother and her two children.  I felt that we should buoy them as they tried to fight through poverty to treat tuberculosis.  The clinic will always do what is necessary to take care of patients, but I wanted Jean Louis to not have to worry about the funds coming from somewhere else.  



Their story isn’t finished.  Unfortunately, it is one lasting several months with frequent long trips to refill their anti-TB medication.  It is one lasting several years to fight through the cycle of poverty to have a sustainable income.  But I do think we offered this family a new chance at life.  For those that gave this trip, thank you.  Jocelyne and her young family have an opportunity to pursue life they would not have had without your gifts.  I cannot thank you enough.