Thanks

Each night we arrive at "The Plaza" an oasis in Tent city with palm trees around a pool and 12$ bottles of wine. Outside tonight I can here gun shots and yelling as we sit around and chat. Demonstrations have started. It has rained for four days and the people of Haiti are upset that they are living in tents. All this Aid money and no aid. God I wish I could just stay and help and help. It is sad here.
The people here are so appreciative. They wave at me when I come in and my translator pulled me aside today and said quietly and sincerely "everybody loves you here" (I don't know why). My patient told the media rep that I saved his life and we got our picture taken together to send to the sponser of IMC. Things like that feel so good. I'm so far far away from patients who complain about their dinner tray, from being so damn sweet to crazy mean crack addicts, from all the bullshit that comes with my job at home. All day long people say "thank you" to me... and I'm just doing my job.

Je Fait Mal

I'm lazing by the pool today... seriously. But I have been working my hard-exhausted by the end of the day. At this point I could stay here for a long time and be happy. I like it here. The people, the voodoo, the weather... and it's beautiful. They need help. By 8am even my knees are sweating and I prefer this to Boston weather. Who'da thought. I move bed to bed all day long hanging meds, placing IVs, saying "c'est bon", and pantamiming just about everything. This is what I've learned in Creol. The whole ward watches me work. It no longer makes me nervous. We do have 2 vents- powered by a generator when the power goes out, and one big oxygen tank in the center of the room with tubing running out to the different beds. Two days ago we finished making charts for everyone- it's as organized as can be ;) Eyeballing a versed drip..- god part of me really likes being far away from nursing that's based around preventing lawsuits. I feel like we are helpful here and it feels good. I joke with the translators. I document what is important. I take care of people. It is simple.

Haiti- Day 4

Working Triage on nights:

My translator is 19 yo- he never sits up and translates half of what I say. There is constant banging on the door and yelling outside. In order to get into this ER, you must look the most dead. So I go outside from time-t0-time to determine who is faking it, and who is critically ill- then I point and say "this one, then this one, then that one". Last night I had a man who was stabbed, a woman whose face was bitten by another woman, a 8 yo girl that was raped, a 4 yo who had been hit in the head with a rock, .... and on and on. People carrying lifeless bodies to have them then sit up and say "my stomach hurts".. "where?" ... and then they sweep their hand over their whole body.

Bienvenue Haiti

I went in without expectation and was once again surprised..haha.

Haiti

The roads are paved but rubble and tent cities line the "streets". This will be short because I am exhausted...but we see the same things here as Africa. God I wish I could elaborate more but I've been working hard on no sleep. It's hot- dripping sweat hot- just the way I like it :). And the people are kind and look after their family members in a way that warms your heart. The medical care they receive is awful- in a way that will break your heart. And the culture is fun and happy... but there isn't a whole lot of smiling here unless you are the one to smile first. Such a polite culture- they'd never leave you hanging. So anyway... the conditions report: I live in the ballroom of a hotel on a mattress beneath a web of strings holding up mosquito nets. I eat soooo well- seriously. Fresh vegetables... yeah MREs for lunch but who cares... dinner is amazing. And per ususal- jerks don't do forgien aid- the people are awesome. At the end of the day I jump in the pool. To summarize: I work hard, I sleep hard, I rest hard- life is good.

Zanzibar and Leaving Africa

Getting out to Zanzibar is nothing short of the usual adventure. I miss the last ferry by 10min due to the bus breaking down, spend the night in a seedy hotel, and then take the morning ferry to Zanzibar. Here, I am planning to have a reunion with my friends from Britian.

Zanzibar is ruled by Tanzania but operates like it's own seperate city. It has a mayor and its own government. For hundreds of years Mulims and Christains have been living door to door without dispute. This is a great source of pride. I can see why they are able to live so peacefully. Zanzibar is instant happiness. It's hot don't get me wrong. I am dripping sweat. But, since the slave trade ended, spices and fish are their main source of income. It's a perfect marraige of things. There are parties on the beach every night and there is no electricity on the island, which is a major source of agrivation for tourists hoping for a cold beer. But for me, I am used to warm beer and I like candle light. Generators run the music at night and we have an amazing time.

I write in my journal on the last day:

On my last day, Africa is already calling me back. In a bus crammed with 20 people, I am watching the sun set through the palms..white sand, and blue/green water. The woman next to me is muslim, wrapped head to toe in floral. She is trying to speak to my in Swahili: "Jasmine.... rice" she says, referring to my name. I can only make out one or two words but smile kindly as her baby carresses my arm. Football has just let out and kids with kleets are crowding on. Trucks full of teenagers shouting and dancing are driving by. I have left all my dear friends from England- we met in Jinja, bumped into each other here and there. "It's rubbish that you're leaving" ...a confession from Tom. Maybe I will hold up to the promise I have made time and time again in Africa and return for longer. I cried with I left Nikki- the two of us shared just about everything between girls. We navigated East Africa together, fumbles and all. Two strangers.

Zanzibar:

Imagine paradise in a sweat room. This is Zanzibar. Black bodies, fishing from dug-out canoes in green water and white sand. I jumped into the water in the middle of a school of dolphins, I sat on pristine beaches, swam with sea turtles, snorkled world class reefs twice, sailed twice, toured old slave trade sites, visited a spice plantation, and danced at night with rastas and masai. Oh Africa, I'm going to miss the people here...the beautiful, optimistic, pole-pole-ness of it all.

After I leave Nikki, I arrive in Stonetown in the dark. A local boy walks with me to the ferry terminal. Talking makes the pitch black alleys of Stonetown less frightening. I'm impressed with myself. I remember the way. I get on the overnight ferry to the mainland, a 10 hour journey. Because I'm white, I get a couch, and I am too grateful to feel guilty. Foam mattresses cover every inch of the floor. People have brought food and bedding for the journey. I curl up on my backpack and fall asleep. I wake up when I am nearly falling off the couch with the rocking. Babies are rolling back and forth and, because they are African, also still asleep. The plaques on the walls are swinging at 45 degree angles, and I'm feeling pannicked. All the doors are locked, there are no life jackets, no window that could open. I accept my fate and go back to sleep. "Salaam alaikum sister, Jambo, Jambo" I have arrived in heaven and it is African, Islamic African. I wasn't expecting this. No, but I have arrived for my last few hours in Africa. ...So sad.

I rearrange my bags 6 times before they let me get on the plane. They give me 10lbs for free. Africa ;) I thought they could do better but in the end did the best they could to help me. 10lbs and most everything I wanted. I left a bribe, a suitcase, and clothes for the girls...who immediatley started trying things on. You live and learn... and in the end it always works out.

Goodbye Kampala, Hello Safari

In the last few days in Kampala I slowly pack my things and say goodbye to some really great people. I leave with a list of phone numbers and a phone full of well wishes. I board the plane which I have a 1 in 10 chance of surviving on (according to statistics of planes in Africa). The flight is short and smooth and I write in my journal: From the plane window I can see the cooking fires so far away in the darkness. True to Africa, they have let me buy the ticket an hour before departure, waived the excess baggage fee, and departed 3 hours late. I arrive in Nairobi at night and spring the money for a taxi and nice hotel. In the morning I take a shuttle 6 hours south to Arusha, Tanzania. Visa fee- $100. Arusha is where I will be leaving for safari.

I spend the afternoon walking around, bargaining down safari prices, comparing companies, and making some friends. The next day I take the bus to Moshi to see Kilamajaro and it is immense, rising out of the flatness, and dissapearing into a cloud. Apparently, only 1 in 10 actually summit according to a guide I am talking to. Who knows- maybe I am misunderstanding.

Safari departs in the afternoon and in the morning I am driving through the Ngorongoro Crater Reserve. I drive for 3 days standing on the back seat of a landrover and watching the Serengeti and the Ngorongoro Crater sprawl out in front of me. I listen to my IPOD as we drive. I keep my shirt over my head to spare me from the African sun. I spend my evenings with the guides, drinking warm beer, and talking about absolutely nothing. The animals are incredible. I drink my coffee amoungst elephants and gazelles. I see zebras and wildabeast like schools of fish. It's a fitting analogy because the Serengeti feels like the ocean: vast, flat, rippeling in the breeze. I see a leopard and cub sleeping in a tree, the illusive black rhino, and sit in a pride of lions. Elephants, girraffes, antalopes, .... only 10 feet away. It's beautiful.

Burns Unit at Mulago Hospital

I found a picture of the halls of Mulago hospital. Here family members are lined up with their suitcases. They basically live at Mulago. They bring straw mats to sit on, buckets to wash the clothes in and for their family members to go to the bathroom in and throw up in, thermoses... etc.


BURNS UNIT

I had heard rumors of a burn unit at Mulago. There was, there wasnt..... Finally I stumbled upon the very well established burns unit of Mulago hospital. The ICU required and entire changing of clothing and shoes to protect patients from outside bacteria. I wore a hair net and Burn unit cover all. This is the same as I would at MGH. I had once read a book on the history of burn care and basically it hasn't really advanced since the turn of the last century. For this reason, I found the practice of burn care at Mulago very similar to MGH. My day started with washing the patience and soaking the tub in alcohol between. We would wash and hold down screaming children and then bring them to the dressing room where we would hold down screaming children once again. They don't give pain medication unless the case is severe (which there were some very very severe cases so I don't know what it really takes to be considered severe). "It causes addiction" said one nurse. So dressing changes are done without any analgesia. It took 3 people to hold down one nine year old boy. He was fighting us, begging us, losing his mind. So the nurse smacked him in the face. I'm not trying to say these nurses aren't compassionate but the approach is different. Some of the kids were so tough, just taking the pain. Some were so tired of the dressing changes and begging for us to stop. Here the dressings are changed every 2-3 days as opposed to every day like what I'm used to in the States. And the wounds really do look good. I didn't even see any that were infected. I did see one man with exposed bone and no dressing but he was headed for surgery to fix it. In the ICU there were 2 patients: one 45% burn and one 70% burn. In the back room I found a heating lamp, an oxygen tank, a ventilator from 1920, and a couple other machines they must use when the big burns first arrive. "They usually don't make it" the nurse told me. But obviously some did. 70% is a big burn to be able to manage. They get all their supplies donated. They use cardboard from boxes for splints to prevent contractures. They use silver cream and iodine which is very inexpensive. I was impressed by how well managed the burns were, aside from lack of pain medication. It was definatley one of the nicer units at Mulago.