Day 3: in Hinche – each day gets more amazing and enlightening than the previous one. This was the third and final day of training for the midwives on the CommCare application. As in day 2 we reviewed the basics, ran through several scenarios with the tablets and discussed a few questions the midwives had from the previous day. We have been taping the sessions with the GoPro camera that Will McGuire loaned us, and plan to share the videos with the MFH folks so they can review and learn from them. We also thought there may be some learnings for us within the videos as well.
The women have been more and more engaged each day. It’s apparent that a few feel much more comfortable with the tablets than others, but that is as we expected. We’re sure that with time they will all feel more comfortable. Brittany, Jess and I are very excited to see the midwives in action with the tablets – tomorrow at the Mobile Clinic!
We rested briefly, then ate a lunch of hominy (mashed, warm corn, but not as granular as grits) and beans, and a type of Haitian ratatouille that was really, really good. Steve Eads said he remembers it being a little spicier, and it is one of his favorite dishes that the cooks here make.
After lunch Steve, Nadene, Emanuel (one of the MFH Haitian employees and translators) and I went into Hinche to order clothes. Nadene and Steve were chatting about this the night before and I wanted to check it out. The next graduation for midwifes is coming up on September 18th, and their new clothes will be for that event. Both Steve and Nadene have a few items made every time they come. It’s another great chance to support the local economy, and the clothes are unbelievably well tailored. We took two motos into Hinche to the market area. As I got off the moto I had to listen to Steve rib me about “not falling into any holes while I was walking around.”
We went to see the tailor first to tell him what we wanted. His seamsters work outside in the shade in front of the store with the same manual pedal machines I’d seen the day before at Azil. Nadene had brought two blouses with her that she wanted the tailor to mimic. They have very nice European fabric at this store. For the four of us (two men’s shirts, slacks, and four women’s blouses) the cost of the fabric was $31.00 U.S. We went back to the tailor to be measured which took about ten minutes. Cost to have all of the items made (to be completed on 9/7/16) was $25.00 U.S., or $56.00 total for fabric and tailoring.
We walked through the market back to where the motos would meet us (Alfredo and Nord; I prefer riding with Alfredo because he’s better at missing the potholes). On the way we picked up a few more avocados, onions, garlic, hot peppers, and a citrus fruit that looks like a lime, but isn’t a lime. I wanted to make guacamole. We found the motos and traveled back to the house to rinse the road dust off!
We all chilled out a bit; Steve and I made the guacamole and I decided to go to town for some sort of chips for the guacamole. Stephanie called a moto for me… Alfredo! He took me to Ebenezer’s Market in Hinche (about a seven minute dusty ride) where I got 15 snack-sized bags of nacho cheese Doritos (no large bags, and not the “hint of lime Tostitos” that Steve requested), Creamas (a slightly alcoholic creamer like Bailey’s for coffee), and five La Benedicta (that’s all they had or I would have gotten more!) La Benedicta is a hard cider that is quite good. Back to the house where we munched out on guac and chips. Thank goodness because all there was for dinner was mashed potatoes and goat meat that was a little tough (jerky?). Seems like the cook was in a hurry tonight.
Day 4: It’s hard to believe we’ll be heading back to PaP (Port-au-Prince) in two days! This morning was our trial run at the mobile clinic. Ten people piled into a small pickup (most in the back) along with two portable clinic beds and two suitcases full of meds and other equipment headed for Bassim Zim, one of the large clinics this morning. We arrived about 8:30 and immediately 10-12 women appeared in line. We had four midwives with us, Brittany, Jessie, me, Dr. Steve Eads, and two MFH male workers. We unloaded the truck and the midwives set up the clinic inside a small cinderblock building that is also a school. There are cutouts for windows, but it was a little like a sauna in the building.
The first part of the visit is still manual and not done on the tablet, so Jessie and I helped count various vitamins and meds into small Ziploc bags. They send all of the patients home with some basics like iron, prenatal vitamins, and Acetaminophen and Tums. They provide other meds on an as needed basis (like high blood pressure medication). Steve said they never used to provide the Acetaminophen and Tums, but what they realized is that the women say they have the symptoms to get those items because they know they’ll need it later. As a result the midwives spend a lot of time attempting to diagnose issues that aren’t really present. Dr. Eads (a retired OBGYN) performed an ultrasound on about six or seven of the 20 women that came to the clinic (~20 is the average number for this clinic). They record head circumference, abdomen circumference, and length of the tibia bone and can determine age of the fetus from this information. What they don’t disclose is the baby’s gender. Steve said if they do that, all of the women want ultrasounds.
Jessie, Steve and I spent most of the time sitting in the back of the pickup when we weren’t helping out or checking on Brittany. It was so God-awful hot in that building. They do bring a huge bottle of water for the women, but it’s still hot. Anyway, back at the truck – we drew a group of young, curious boys. Steve had been ignoring them, but I made the mistake of chatting with them. The phrases they seemed to know were “Gimme a dolla” or “Gemme ten dolla” or “Gimme my phone.” I gave them almonds and we used Will McGuire’s English to Creole/Creole to English dictionary to have a short summer school lesson. When Philamene, (a midwife) came out at the end, she gave them all a look and said something to them; they all moved quickly away.
We packed up about 1:00 p.m. and were back at the house by 1:30. Brittany took a couple pages of notes on changes she’d like to make to the process, very few changes to the app, and the midwives took turns using the tablet. Brittany said that whenever one of them read a question incorrectly or answered incorrectly, another midwife would correct them, so they were all helping to make sure everyone understood both the questions and the process. It was a very successful first day of the roll-out all in all.
The other exciting thing that was going on, that is also the reason that Steve and Nadene were here in Hinche, is that they are accepting applications for the next school session. Last year they had 117 applicants and this year they had 212. They hold application sessions at the hospital in Hinche (~1 mile from the house). It’s a long process. The applicants must come with their diplomas and other documentation and take a test. Only 30 applicants will be accepted for the new class. The group at the hospital returned to the house about 2:00 p.m.
We all rested for the afternoon. I walked up to the mountain (I think it’s the one in the picture of Carrie in our lobby) and watched the sun set. It’s quite beautiful and peaceful there, and there were two women praying there while I was there. One of the artisan vendors who camp out once a week followed me on my walk so that I’d look at her items. I did buy a few things from her; I’d love to get a couple of paintings while I’m here. Some of the Haitian art is quite striking and is indicative of the Haitian’s African roots.
Dinner tonight was pretty good (hopefully a trend!) – Paté, pronounced just like the French paté, like an empanada with vegetables and meat inside. Something interesting, lunch is always left out as an option for dinner (food here is always covered with large plastic baskets and dish towels over the baskets to protect from flies or bugs). We often sit around the table at or after dinner and have lively, interesting discussions about Haitian, American or world topics.
We weren’t sure if we’d be able to go to the Carrie Wortham Birth Center in Cabestor while we were in Haiti. MFH has two vehicles, a Land Cruiser and a Jeep. We learned when we arrived in PaP that the Land Cruiser (that they picked us up in) was only operating in three gears, 1st, 2nd and 5th. So, Ronel took it back to PaP on Monday to have it fixed. Joanne was able to secure another vehicle today for our trip to the Birth Center. We will leave early in the morning and come back late tomorrow. We are super excited to have the chance to go.
That’s all for now. Orevwa!