Winning the Lottery (On Leaving Haiti)

I am sitting at the PAP airport now, leaving Haiti. Kevin told me that this would a trip of a lifetime; it was. To briefly recap, the week here was absolutely nuts. I began taking all the Pap smears and HPV tissue samples from the clinic home with me so that I would have enough time to get all of the samples labeled, entered, organized, packaged and sent. It’s interesting, because at the clinic here so much rests on human relationships in order to get things done. An example: The new medical students interning for the summer came down recently. One of them is helping us with the HPV study in HIV positive women. My role in this project consists of many things: enrolling patients in a study, performing vaginal exams and collecting samples, assisting OB/GYN guys during colposcopies, taking inventory on materials and making sure we have everything, organizing and labeling all samples, making sure samples get sent to Cornell, etc. It sounds like a normal busy clinic/lab set up, but it is extremely hard to get anything done if people don’t know and like you. For instance, we ran out of slides (we take vaginal swabs and send them over to the micro lab for analysis). I sent one of the interns to get more covers, but people just told her they didn’t have any, etc. They didn’t know her well enough yet. I went back for the same thing. I greeted them, they all know me and joke with me in Creole, and then I asked for the slides. There was some discussion and eventually a guy I know popped out of his office and told me he would help me. We eventually found a lab that lent us some. The new intern has actually done a great job of walking around and making her face “known” so that she can get materials, etc. as well. It’s hard to explain unless you go through it. It’s extremely frustrating, but that’s just how it works there. Everything is based on relationships.

In the last week we had a big push to rescreen women from last year for HPV/lesions/cancers, etc. So each day for the last 2 weeks that I was in clinic we were in the exam rooms collecting samples. Of course, this made for GREAT clinical training for me, and the OB docs I worked with are awesome. One would stay as long as I was willing to see patients. He would even take us home if we missed our ride. This doesn’t sound like a big deal, but driving up to where we live in PAP is not easy. I digress. I was also enrolling patients in a different study with MORE samples and more paper work were required (and much more time). It was a huge mess but we got so many patients seen; more importantly we collected samples on projects that could lead to better treatment for HIV/HPV patients in Haiti and worldwide.
I skipped the last weekend at the beach and a few other things to get these samples finished up. It was a pain, but it worked out really well.

Then, I had a day or two to pack. Of course I got really sick one of my last days at the clinic (last Thursday). I actually was discussing a procedure with one of my OB mentors while I was performing it, and suddenly felt like I would pass out and puke right there between her legs. I had had major gallbladder attacks that morning and had hoped they would go away. This was something else. I felt sick. I looked up at him with my hands still on the speculum and brush and calmly said “I need you to finish this one.” He looked at me like any good mentor would and said “No, you can do this, you’ve done this many times, if it’s still bleeding you know what to do.” I looked at him again and said “I feel very sick, I really need you to do this.” He immediately grabbed the instruments, gave me the chair, and finished the exam standing up. He was great. He went and got me a shot of anti-nausea stuff and injected me and then got me a coke in case my blood sugar was low. I then developed had chills and flu-like body-aches. The problem was that I had patients scheduled for me to collect samples from the rest of that day (Thursday) and Friday, my last day. I HAD to see the patients. I had to rest for 30 minutes then finished the patients. I went home that day, got in my underwear, and slept til the next morning, on and off.

By the way, it is over 100 degrees F most of the time in our house right now. This means several things: 1) This is REALLY hot, especially considering that our ceiling fans don’t do much. Turn your heat on to about 90 to 100 degrees F and try to walk around inside for a bit, it’s awful. 2) In this heat my computer only works for about 30 minutes at a time. I’m serious; it then overheats and gets really choppy/freezes up. 3) I have taken to filling the bathtub with cold water and immersing myself in it for relief and to get my core temp down. 4) It doesn’t really cool down that much at night. Besides the fact that this is weird, it sucks.
I couldn’t eat anything all Thursday. Friday I felt better and managed to eat around lunchtime. Seems I had a 24-hour flu.

I started packing Fri night, but my friends had thrown me a wonderful going away party. My Haitian friend from the streets came, along with one of our guards. And of course, all the ex-pats I like. One of my very good friends here actually created the company that makes Rara bags. You HAVE to check these out and order some for people you know! These are wallets, bags, etc made from trash off the streets. She actually employs Haitians to sew these things. It's really remarkable. Check them out:

http://klynnstudio.com/RARA.html

This is a great cause and a cool gift. You can order one of these and it goes to a project that employs Haitians and helps clean up Haiti/is good for the environment! Order something!! At any rate, she showed up with one of the wallets as a gift for me. Also, both OB doctors I work with came, and one of them brought a Vase for me as a gift. A social worker I work with brought me a Haitian Vase/Case as a gift earlier in the day at the clinic too. During the party, I was drinking beer and talking creole with my Haitian friend and the security guard, and the security guard was telling me how he never gets to do this. When I asked him "do what", he said he never has had a beer with people he works “for.” I thought this quite unusual. He said in Haiti he is just in a different class – we wouldn’t party together. Maybe I live in my own little world, but I was telling him that in the states everyone is allowed to party with everyone if they want. We had a great time. I was moved that everyone came.

On my last day of work a good friend of mine at the clinic brought me a necklace. It was touching for several reasons. For one, I talk to her every day; she is a wonderful woman. She is a peer-counselor at the clinic. I found out later that she “grew up” around the clinic; she was a victim of mother-child HIV transmission. And this girl is awesome. She comes in every day that I have time and we practive English together. On my last day she made me close my eyes and put the necklace around my neck. I love it and was very moved by the gesture.

Today I left. I drove through PAP for the last time for now, but I think I’ll be back. In customs in Miami I got the opposite treatment as Haiti. In Haiti white means rich, and you’re treated well, as if you have lots of money. Of course, I have long hair and a beard. At customs in Miami I got asked some questions about how long I’ve been out of the country and then sent through the “agriculture” checking scanners. I have no idea what this is, but later in the airport a man came up to me and was like “Man, I saw that, that’s crap. I used to have a big beard and I’d get crap like that all the time.” We then went on to speak about Haiti and what I was doing. He then asked me, “Ok, I’m sorry if this is ignorant, but how can you work with those patients? Aren’t you scared you’ll get HIV?” I explained that even if I spilled HIV blood on my arm (which happened more than once during exams) it would be extremely hard to get it. In fact, I could take a needle out of an HIV-infected arm and stick it in mine, and the rate of transmission is still less than 1%. I explained all this and he was like “oh wow, that’s crazy; when I was in San Francisco I would cross on the other side of the street if someone looked gay or sketchy.” I then joked, “Well, if you‘re sleeping with your patients, it’s a different story!”

Finally, in Miami (I am at the airport typing this now), I tried to hop on a flight tonight to ATL instead of sitting in the airport all night to take the morning flight. I was told in Haiti that there was a flight tonight that was empty that I should get on. When I tried, the lady simply told me that she couldn’t do it; it was a rule - she can’t put me on a flight for a different day even if there are openings. I was confused and tried to work her with a smile, etc. But she was having none of it. I then realized I wasn’t in Haiti, things aren’t so heavily based on interactions here…Well, perhaps I just contrasted this with what happened as I left the PAP airport in Haiti: I have 4 bags, so I had to recruit bag-help at the airport. The men took me through to “business class” check in (skipping the big line for regular people). I told them that I was not business class, they were like, no worries, we got it. An American Airlines rep asked me if I was business class..I just said no. These guys grabbed him and talked to him and he just nodded and let me stay. Then they quickly checked me in, no worries. So I obviously tipped these guys well. It was an interesting situation.

So now I am back, the journey is over, for now. I wish I had some end all, be all advice, some wise words from six short months of experiences. I don’t. In fact, all I have is a mind full of memories, good and bad, difficult and fun. I learned more than I thought I would, about people, about life, about me, about the world. I also made better friends than I ever imagined I could in such a short time – friends I will have for life, Haitian and American.

Perhaps you don’t agree with everything I say; and if you don’t, I hope you show me evidence for where I have erred. Rational dissent is always welcomed. If nothing else, I hope you became more informed and stay informed. Appreciate where you are, what you have. And even if you can’t go see for yourself what these places are like in the world, read about them, try to understand them. Try to understand that while Haiti may be “the most dangerous country to travel to” on someone’s list due to kidnappings and violence, it’s also home to millions of people that were born there and are simply trying to make a good life. They’re just like you, just not so lucky. One of our drivers is about my father’s age. He has a family, he works hard, he speaks creole clearly and slowly so the Americans can understand him, and he is funny too. If he could speak English or my father Creole, I can picture them talking for hours about things, about life, about the good, about the bad. What do they have in common? Maybe not so much, maybe a lot. My dad never has to spin his wheels and do a 180 in the car because he runs into an angry mob charging at him; then again, he also probably doesn’t get a new crop of young foreigners coming into his workplace all excited to change the world every few months. But they both love their families, they both like to laugh, and they both are kind and hard working.

If you were to travel somewhere like Haiti you would likely meet someone like this; someone that makes you realize that despite what frustrations you have, despite what people say, despite how “bad” or “dangerous” a place it is, the majority of people are good. Maybe some bother you for money; is it so wrong that they are trying to get money to eat or send their kid to school? Others will bother you about their religion because you don’t believe what they do; is this so different from how you treat people that have a different belief system than you? But most will try to help you when you’re down, will smile when you joke, will greet you when you pass them. They might not understand why you would risk coming to their country right now, but they appreciate it, because they know the ease of life from which you come. And they appreciate your understanding that a few violent people don’t make everyone that is born there “bad.”

So in closing, appreciate the US, love the US. But please understand that you were lucky, you won the lottery. They didn't. Have compassion for your fellow humans. They're just like you, just not with a winning lottery number. Perhaps one day we can all win the lottery.