Thanksgiving 2013

     I would like to tell you about my Thanksgiving in Haiti in Christianville. But I can’t. I wasn’t here. After a long GoogleChat with my daughter, Cecile, last Saturday night, I decided to go home to Silver Spring for Thanksgiving. I was not planning on going home until December 19 for the Christmas holidays. I had told my kids many times not to worry about me being far away because Haiti is so close to the U.S. and it is relatively easy to go back and forth. People do it all the time. Why not me? So I went on line and booked my flight for Wednesday with a return to Haiti on Saturday morning. A two day holiday with my kids. I told no one back home except my lab manager (I asked him to prepare a box of supplies that I could take back to Haiti with me) and my son (to pick me up at the airport). I asked Pierre not to tell Cecile and Odile and to make it a surprise. Of course, Cecile may have been a little suspicious when Pierre told her that he bought a 12 pound turkey for Thanksgiving dinner for the three of them. But she did not push the question of the size of the turkey any further.

     Wednesday morning, Makendy drove me to the airport. Traffic was light and it took us just an hour. I had taken one of the UF suitcases for my checked bag and slid in a couple of items. The suitcase was mostly empty. The reason for taking it was to fill it up for the trip back. That is the exception to Haiti rule #4: Nothing leaves Haiti, except empty suitcases to be filled and brought back. The temperature was 90F in PAP when I left and it was 29F and snowing lightly in Washington when I arrived. Door to door, it took 12 hours, including a three hour layover in Miami. Haiti is close and in the same time zone as DC and New York so there is no jet lag.

     Pierre picked me up at Washington National and drove me back home. We walked into the house, Pierre said, “Hi girls” and I said, “Hi girls”. “Papa?” was the response from the girls in the family room. Odile and Cecile were incredulous. Yes, it’s me. I was home for Thanksgiving.

     November 28, 2013, was not just Thanksgiving Day for us this year. It was also a day of remembrance. The day marked three years since my wife, Bernadette (Bedou), died of lung cancer in 2010.

Gate of Heaven Cemetery, November 28, 2013

Every November 28 since Bedou’s death, I was either with the two girls (Pierre was away at school at Penn State) or with just Odile (Cecile was away at the University of Virginia and Pierre was still at Penn State). This year all three kids would be together for the first time on this anniversary. I had to be there with them. And I was. We drove out to the cemetery together on Thursday morning. The air was cold and crisp, the sky was blue and the sun was bright. The weather was very much like the day of Bedou’s funeral. We stood there each of us with our own thoughts. And I said a few words. I said how proud their Maman would have been to see where each of our kids is today. How well they did in school, how they have grown and matured. Bedou’s death was such a terrible loss for us all. Yet the kids pulled themselves together and moved forward, exactly as Bedou would have wanted them to do. I am so proud of Pierre, Cecile and Odile and I love them so much. And I miss Bedou. We drove back home and everyone helped out with Thanksgiving dinner. I was so looking forward to some green vegetables and meat that was not chicken. We had a great meal.

Thanksgiving table, November 28, 2013

Odile, Pierre, and Cecile, November 29, 2013

     Saturday morning 2:45, my alarm goes off and I am up and out of bed. I need to finish packing my stuff for my return flight to Haiti. Cecile is still up. I say goodbye to her and then she goes to bed. I had already said goodbye to Odile who is sleeping over at a friend’s house. Pierre is up and getting dressed. He will drive me to the airport. It is much like back in October when I left to come down to Haiti. Except this time it was a different airport, the weather was colder, and I had no clothes in my luggage. The items in my suitcase and backpack consisted almost entirely of material for the lab and food items for our house (some spices, 10 lbs of basmati rice for Meer, and Gala apples; apples are really expensive in Haiti). I wasn’t leaving to begin an adventure. I was going back home. My flight from Washington National to Miami departed on time at 6:00 am. American Airlines flight 1665 from Miami to Port-au-Prince was also on time. I got off the plane at 12:10 pm. I told you Haiti is not far.

     After clearing customs, I pulled out my Haitian cell phone. I already had three missed calls from Meer. I need to re-learn my cell phone ring tone. Meer came out to the airport with John, a weekend driver, to pick me up. John met me in baggage claim. It was 29F in Silver Spring when I left. It was 90F in Port-au-Prince when I got my bag and we walked out into the midday heat. I breathed in the hot air. I felt at ease among the crush of arriving passengers as I navigated the phalanx of men asking if I needed a taxi and made my way toward the parking lot. I found Meer, we loaded my bags into the Everest, and headed to the Visa Lodge for lunch. This restaurant is the same one I had lunch at on arriving in PAP back in October. It was the subject of an earlier blog post (see 10-03-2013 post). After having lived in Haiti for six weeks now, my attitude is changed from those first impressions of shock and disbelief. There clearly is a class divide in Haiti between the rich and the poor. And there is a middle class and people who have money to spend have places to spend the money. I even heard a report on All Things Considered last week about the number of luxury hotels being built in Port-au-Prince. There is a big push to develop the tourism industry here. So I can’t criticize people for living well and eating well. I asked John, our driver, if he had eaten at the Visa Lounge before. Yes, he said, last year. The buffet was good.

Buffet table at the Visa Lodge

Salad bar, spinach, fries, lasagna, rice and gravy, and a type of fish beignet. Maryland was playing North Carolina State on the flat screen TV behind us as we ate. Yes, this, too, is Haiti. John and Meer each had seconds. I declined. I lost ten pounds since coming here in October, but I’m not starving and I feel great. I eat what I need (the menu is not too varied) and that’s it. Keep it simple. I did, however, have a brownie for dessert at the Visa Lounge (in case you were wondering, they do take Visa; by the way, when you use a credit card here, you are always asked to show a photo ID; a U.S driver’s license is acceptable).

     John pulled the Everest into its parking space next to the lab. We got out and brought the luggage into the lab to unload the lab supplies then brought it back to the house for the rest of our stuff. I saw Dale and Ingram and Solomon and Georgie. Everyone asked about my trip and Thanksgiving. I’m back with my C’ville family and working in UF-EPI Haiti Lab 1-Gressier. The adventure continues.

We Drive to Baradères, Part II – Yes Rasta and a Cold Prestige

     Petit Trou de Nippes. The road was slab concrete through the town and at the edge of the town was the end of the road. The pavement dropped off onto an unfinished road, clearly under construction. Driving on packed dirt and gravel pavement was not so bad. V&F Engineering is building the road to Baradères from Petit Trou de Nippes. We passed lots of construction equipment and dump trucks (not camion Mack but Isuzu) and drove over a couple of brand new bridges. There were sections of road that were being carved out of the hillside by these construction machines. It was real road building, not fixing up existing roads. It looked encouraging. Maybe there will be a road to Baradères someday soon. Then the construction work disappeared and the road got narrower and rougher until there was no road to speak of, only a trail leading off into the wilderness. And Lamothe kept driving.

     No one was talking. The animated chatter from earlier this morning had ceased.

Broke-down charcoal truck

We held on as best we could as the truck bounced along the impossibly bad road. We drove across four streams. The road was a never-ending series of ruts and mud and rocky outcroppings. It was barely wide enough for a single vehicle so we were fortunate that there was no traffic coming in the opposite direction. That observation also leads one to think that maybe the road is a dead end. But we were not alone. Up ahead we could see a truck. A broke-down charcoal truck was blocking the single lane trail. The truck had a flat tire. Lamothe stopped the Nissan, we all got out and Lamothe walked over to talk to the workers who were changing the tire. They pointed out a path on a small ridge just above the road that another truck was taking to get around their disabled truck. Lamothe got back in and drove the Nissan up and around the truck. We walked down the road, greeted the Haitians working on the truck and joined Lamothe and the Nissan. The broke-down truck had an unusual name. It was not the typical Christian religious name or phrase praising the Lord. The sign over the truck simply said “Yes Rasta” – the phrase spoken by true Rastafari when greeting each other.

Lamothe and Madsen taking
pictures on the road

     The road was brutal but the views were breath taking. One by one, the beauty of the countryside seduced the team. Lamothe and I had been up in this part of Haiti before but not the others. They were astounded. It was green, lush, and sweeping. The sky was a clear, sharp blue and the mountains were painted in green. On a wide part of the road where they was a spectacular panoramic view of the mountains and valleys, Lamothe stopped the truck so that we could take pictures. The air was quiet; there was not a sound except for the occasional carrion bird screeching overhead. There were no other vehicles, no blaring horns. A young man walked down the road past us and we greeted him. I took pictures of the landscape and then turned around to find that there was a small house up on the ridge above the road. So people lived way out here. But there is no cell phone coverage. We were in a dead zone. That is one reason that some people are reluctant to take this route to Baradères. Better not break down (like Yes Rasta) or have an accident out here.

View from the road to Baradères

A house on the ridge above the road

The road narrows

The road along the mountain ridge

Close to the edge

     Sr. Denise was right. It was four-wheel drive time. Several times I thought we would get stuck in the mud on the road. The ruts were so deep I was afraid Lamothe would not be able to pull the Nissan through, but he did. Each time the mud got deep, Lamothe got us out. Then the road got dry, dusty, rocky. We had been driving along the ridgeline but now it was time to drive over the mountains. The road got really narrow and steep. With all the loose rocks, I was worried that we may lose traction and slide sideways. Lamothe kept the Nissan on the road. It was close. There was not much clearance on either side of the road. Slowly we climbed and then we reached the top of the mountain and there was the Bay of Baradères in the distance.

The Bay of Baradères

     We started downhill. The road was still very winding but a bit clearer. I breathed a sign of relief. I recognized the area now. It was Pede, St. Anne, one of the chapels (satellites of the main church in Baradères). I had been here in February. This part of the road had been cleared and leveled by women. They had been taught how to operate the construction equipment and they did the work. However, the road did not look like any more progress had been made since I was here 10 months ago.

     We were very close to Baradères now. Soon there were houses and the small bridge across the Baradères River. We crossed over and felt the smooth concrete pavement under the tires of the Nissan. The road from the church square almost to Fr. Jacques’ house had been improved and was now a slab of concrete pavement as in the other villages we had driven through earlier.

     Lamothe pulled the Nissan into the front yard of Fr. Jacques’ house and we all got out and stretched. Jacques came down to greet us. He had cold Prestige and water waiting for us. It was exactly 12 noon. We had made it, and on time!

We Drive to Baradères, Part I – Two Haitians, Two Browns, and Two Blans

     I awoke at 4:00 am on Wednesday morning. I had one more hour to sleep. We were driving up to Baradères today to inspect the site for the forward lab, to meet with Fr. Jacques (the pastor of St. Pierre de Baradères Church) and Sr. Denise (the administrator of the Baradères Hospital), and to interview candidates for lab techs. I had been planning the trip for a month. I recruited the people I needed for the trip and picked a time when everyone would be available. Now all the pieces were in place. I had a schedule of what we would do in the 24 h we would spend in Baradères. I had our vehicle and a driver (Makendy). The team was ready. We were to leave at 5:45 am.

Madsen and Meer

     The Science Crew – Madsen, Meer, and myself comprised the science crew. You already know Meer. Dr. Madsen flew in from the University of Florida, Gainesville on Tuesday afternoon. Madsen is a Haitian physician who in on the faculty at the UF-EPI. He helped set up UF-EPI Haiti Lab 1-Gressier and made the connections with the local clinics and hospitals for the diarrheal disease study. I needed
Madsen to talk with Sr. Denise and explain in more detail our plans for the sexually transmitted infections and diarrheal disease studies as well as UF’s long-term plans for the lab we will build in Baradères at Sr. Denise’s hospital (the “hospital” is really a clinic; it has one full-time doctor and only three beds). On a previous visit, Madsen and I had a long discussion about a sustained and expanded presence of UF-EPI in Haiti. That was when I started numbering the UF-EPI labs. Gressier is the first. Baradères will be the second. We hope there will be others in the years to come.

Solomon, Tony, Dale, Madsen, and Lamothe

     The Construction Crew – Solomon and Dale work for Christianville. Solomon is the construction boss. He is currently supervising construction of three buildings in C’ville and he has built many other structures in PAP. Solomon is an expert on foam core construction. I wanted Solomon to come along for two reasons: to inspect the lab site and to determine how additional usable space could be made on the adjacent roof area; and to introduce Fr. Jacques and Sr. Denise to the concept of foam core building construction. Watch this YouTube video that explains the concept (http://www.youtube.com/watch?v=YD5kqiDE53w). It is a remarkable technology that produces buildings that are highly wind and earthquake resistant (hurricane winds and earthquakes up to 9.5 on the Richter scale). It is also cheaper and faster than conventional concrete block construction which is very common in Haiti. I wanted Solomon to show Fr. Jacques and Sr. Denise what it was possible to do, especially in Baradères, with foam core modular panels. I asked Dale to come along because Dale is C’ville’s inside guy. He does the plumbing and fixtures. I needed Dale to measure the room that would become the lab and get me plans and a budget for how that empty room could be converted into a working microbiology lab.

     The Bonus – I asked my friend Lamothe Lormier to come along with us. Lamothe, who is Haitian, is the in-country liaison for Gift of Water (see post and GOW web site). Lamothe was already planning to visit Baradères to do some refresher training of the Water Technicians there and to deliver 50,000 Aquatabs for the Gift of Water units my church had distributed in the community last year. It would be a good opportunity to introduce Lamothe to Madsen and combine two tasks into one trip.

     The Truck – A Ford rented from Hertz. But that would change.

     The day before we left, I got a call from Sr. Denise. She wanted to confirm that we would have lunch with her when we arrived. More importantly, she warned me that the road from Cavaillon to Baradères was blocked and that we needed to take the road from Petit Trou de Nippes instead. I had never taken that road. It does not even appear on GoogleMaps. I asked Sr. Denise if that road was OK. She said yes. But be sure you have a four-wheel drive vehicle. It’s Haiti. Be flexible.

     Wednesday, 5:25 am, my cell phone is ringing. Damn, I slept later than I had wanted. I answered the phone. It was Lamothe. He was here already. I quickly washed up, grabbed my backpack, made sure Meer was awake, and walked over to the guesthouse where Lamothe was waiting. We talked while we waited for the rest of the team. At 5:37 am, I got a call from Fr. Jacques. He, too, warned me not to take the road from Cavaillon. The residents there were protesting something and had blocked the road. I mentioned this to Lamothe and asked if he was familiar with the road from Petit Trou de Nippes. Of course, he was. Lamothe has been everywhere in Haiti. In fact, Lamothe planned to take that route so that we could stop at the hospital in Petit Riverie de Nippes (more on that later). Lamothe offered to drive us in his truck to Baradères. He had a four-wheel drive Nissan Patrol, the best vehicle for the road.

Lamothe's Nissan Patrol

Lamothe at the wheel

We discussed this idea with Madsen who had rented a truck the day before in Port-au-Prince. It was decided. Makendy would take the rental truck back to PAP and return it. Lamothe was our driver, the Nissan was our truck. The last piece of the puzzle was in place.

     Dale and Solomon arrived. We loaded up Lamothe’s truck with our backpacks and climbed aboard: two Haitians (Madsen and Lamothe); two browns (Meer [Bangladeshi] and Solomon [Indian]) and two blans (me and Dale). We left at 6:25 am, about 45 minutes later than I had wanted, but it’s Haiti. We pulled out of C’ville and I knew we were in for a wild ride.

     The short road from C’ville to the main highway is unpaved, rocky, and rutted. Lamothe took it faster than any of our drivers. Lamothe pulled onto National Route 2, the coastal highway, and we were flying. Conversation in the Nissan was animated: Meer in the front seat talking with Lamothe. Me and Madsen and Dale in the second row, and Solomon napping on the bench seat in the third row cargo area. We passed Léogâne, Grand Goâve, and Petit Goâve and reached the outskirts of Miragoâne about 8:00 am. Route 2 turned south into the mountains but we continued along the coast on Departmentale 21. Miragoâne is the capital of the Nippes Department even though it is located at the extreme eastern edge of the department. Departmentale 21 took us around Miragoâne, the old port city. As we climbed up a hill and rounded a turn, the beauty of the Miragoâne Bay suddenly lay before us. And there was Reynolds Terminal.

Reynolds Terminal, Miragoâne

For about 20 years, Reynolds Aluminum operated a bauxite mine
and a port on the western shore of Miragoâne Bay a few miles outside of Miragoâne. Reynolds abandoned the operation in the 1980s during the “Baby Doc” Duvalier regime and left everything there. The terminal is the only operating port in Miragoâne, the docks in the city being blocked by sunken vessels. Meer and I had often discussed the possibility of shipping lab equipment and supplies into Reynolds instead of having everything come through Port-au-Prince. Customs is a nightmare in PAP. It takes months and costs lots of money to get things out of customs. The Reynolds Terminal looked like an attractive option. It is close (only about a 90 minute drive from Gressier) and the customs facility is small. The terminal accepts less than container size loads since big ships cannot come in. But Makendy bought a used Toyota Camry in the U.S. and had it shipped into Reynolds. He got it from customs in 10 days.

     Lamothe kept driving. The road ran right along the coast and the view in the early morning was beautiful. We passed Bezin, Charlier, and Madian where, the road ran practically on the beach. It was about 9:00 am and we were just outside Petite Rivière de Nippes. Lamothe turned left off the road and began climbing a steep, unpaved, rocky road that led to Klinik Vizitasyon (Visitation Clinic). The hospital is run by Visitation Hospital Foundation from Nashville, TN (http://www.visitationhospital.org/). Lamothe explained to us that Gift of Water had distributed 1500 units in Petite Rivière and had worked closely with the clinic. Gift of Water also stored their material in a warehouse on the clinic grounds and this was where Lamothe wanted to pick up the Aquatabs for Baradères. Lamothe also wanted to introduce us to Dr. Jean Francois who runs the clinic. We met Jean Francois in his house next to the clinic. Madsen and Jean Francois chatted in Kreyol and it started to become clear to me that they knew each other somehow. I interrupted and asked (in poor Kreyol) if they had already met. Yep. It turns out that they both attended medical school in PAP but a few years apart. Jean Francois recognized Madsen because he was in the same class as Madsen’s younger brother. Small world, again. It was like alumni weekend as Madsen and Jean Francois chatted about old times, former classmates, and teachers. Then Madsen explained what we were doing in Gressier and asked me to describe our plans for Baradères. Jean Francois was very excited. We will definitely work with him. We invited him to come visit Haiti Lab 1-Gressier the next time he drives to PAP. It was a very pleasant meeting and another very useful contact to add to my network. We picked up the Aquatabs for Baradères, piled back into the Nissan Patrol and headed back to the Departmentale 21. It was 9:45 am. I wanted to arrive in Baradères by noon. I was starting to wonder if we would make it by then.

The "road" ahead

     We drove through Petit Rivière de Nippes. On the right side of the road almost on the beach was a beautiful white edifice, St. Anthony of Padua Church. It was brilliant in the morning sunlight. We crossed Grande Rivière de Nippes. We drove through Anse-a-Veau. Then we pulled into Petit Trou de Nippes. Up to this point, the road was paved and we had made good time. But we still had the worst part of the road ahead of us.

Goats, Anyone?

Doe ready for insemination

     Last week, Char Farin and her colleague Bill Knox, came down from Raleigh, NC with a box of dry ice and a bunch of “straws” filled with goat semen. Char is a reproductive physiologist and professor at North Carolina State. She and Bill came to Christianville to artificially inseminate the goats. A few weeks ago, Eric (see 10-28-13 post) had come down from NC to inject the does with hormones to synchronize them for the breeding. Now the does were ready and Char and Bill were here with the tools for artificial insemination. They are breeding crosses of Nubian and Boer. The cross is for fast growth, tolerance to hot weather climate, and carcass quality. The plan is to breed a good goat for meat in Haiti. It’s genetics!

Char inseminates a doe

     I wanted to see how artificial insemination was done so I wandered down to the goat pen in back of the guesthouse one Saturday morning and found Char and Bill already at work. Bill had a Dunkin Donuts thermos full of hot water and all the instruments they needed laid out on a table in the space between two pens. A doe is brought in from one pen, a “straw” is taken from the box of dry ice, warmed, and connected to a pediatric catheter. They inseminate the doe and move the doe to the opposite pen. Then the next doe is brought in and the process is repeated. It takes about 10 minutes per doe. Char and Bill are good at artificial insemination of goats. They even teach a short course in it at NC State: Goat Artificial Insemination & Breeding Management Short Course. (http://www.cals.ncsu.edu/ncsugoatAI/CourseInfo2.html). It is a three-day course and is next offered in August 2014. Register now!

Char inseminates a doe

Bill prepares a "straw"

     After they finished inseminating the does, Char asked Meer if she could use a microscope in the lab to check her goat semen. They looked fine she told us. Char always packs a few extras, so before leaving she asked, “Do you guys want a few straws of goat semen?” Eh, no.




     With so many goats in Haiti, why is there no goat milk or cheese? Char had a simple answer: refrigeration. A dairy “industry” larger than a single household requires refrigeration. And refrigeration requires electricity. So there are lots of goats in Haiti but no fromage de chevre.

Bill inseminates a doe

The PA Team

     A mission team from central Pennsylvania left this morning. They arrived in Christianville last Saturday. They were a terrific group of people: seven women (four nurses) and two men (pastors). The people in the mission teams are volunteers. They take off from work (or school), they pay their own way to Haiti, and they pay for their meals, lodging and transportation while at Christianville. Don’t let the term “mission” mislead you. These folks are not here to preach or convert. They come here to help Haitians.

     Sunday, the day after their arrival, we all got on the C’ville school bus and drove to Grand Goâve for an afternoon at the beach. It was a beautiful day: hot sun, warm, calm sea, and a cold Prestige. One of the PA team waded out into the water to bring us our beers (I knew then that this was a great team). So I had a Prestige while relaxing in the water at the beach. I think somebody took a picture but I did not have my smartphone with me to get one myself. This was the beach where I ate the lambi that did me in for three days (see 11-11-13 post).

     The PA team started work at the clinic on Monday. That evening the nurses told us that a patient died at the clinic that afternoon. The patient had an abscess and went into cardiac arrest at the clinic. So what do you do when a patient “codes”? You are a well-trained nurse who instantly swings into action to stabilize the patient until the code team with the “crash cart” arrives. But you are in a clinic in Haiti. You are the code team. The crash cart at the clinic was ill equipped. The ambu bag, the self-reinflating bag used during resuscitation, was dirty and moldy. And the patient was also HIV positive. Despite their best efforts, the patient could not be revived. The death was particularly hard on one of the younger nurses. She was upset that the kinds of things she would instinctively have done to try and save this patient she could not do, some of the material was just not available. It’s only their first day at the clinic and the PA team was getting their first personal experience with the frustrations of working in Haiti.

     The PA team was a really fun group. They were friendly and joked and laughed (loudly) all the time. So they pulled together, supported each other and went back to work the next morning with energy and joy. All week long they worked at the clinic, played with the children at the orphanage, tutored children, and distributed rice and other items that they bought. At meals we talked about what we did during the day, and shared stories about family, Philly, and PA. It was a pleasure talking with them. We were becoming family. The ladies made chicken salad one day for lunch and shared it with us. Teams sometimes bring in “goodies” that they share with the C’ville folks. So one afternoon I had some pretzel sticks dipped in Trader Joes chocolate. In Haiti! They also brought in several boxes of Pringles (Meer’s favorite), a box of Cheerios (Raymond’s favorite), and boxes of cake mix. It’s funny how you forget about these everyday food items when you are down here and so they become special treats. Thursday night, we all got back on the C‘ville school bus and drove to the Ocean Grille for dinner. My appetite was back so I enjoyed the meal. Almost everyone, including myself, ordered the charcoal grilled red snapper (but Georgie ordered lambi; he just can’t get enough). It was a fun night out and a welcome break from the dining hall menu.

     So this morning at breakfast, I found the PA team in the dining hall with all their bags packed and ready to leave. Some of the orphanage kids came to say goodbye. Pictures were taken, email addresses were exchanged, and there were hugs all around. The PA team boarded the C’ville school bus and headed into PAP for their flight back to the U.S. All was quiet at C'ville this afternoon.

     Another mission team came in this evening.

It’s Haiti v10 – Two Guys, Two Saws, and a Concrete Post

     Remember I told you that the concrete post right next to the emergency exit from the BSL-3 lab needed to be removed? (see October 6, 2013 post “Back to Work? - Did We Ever Stop?”). One Friday morning, two guys with two saws started work on the concrete post. They chipped away the concrete to get to the steel reinforcing bars and then started sawing away the bars. By midmorning, the post was down and a guy with a pick set to breaking up the stump of concrete remaining in the ground. They started pouring concrete (by hand) for the sidewalk after lunch and that was done by dinnertime. Things like this small project could sometimes take months to get done here. But with the right word to the right person at the right time, things get done. Of course, back home the job would have used one guy with a mechanical saw (and protective goggles) to cut through the concrete and the post and it would have been down in less than 15 minutes. But two guys with two saws managed to do the same thing in less than two hours.
It’s Haiti.

Cutting down a concrete post

Cutting down a concrete post

Breaking up the post stump

Building the sidewalk

Oral Rehydration Solution Saves Lives

     But it does not taste so good.

     I have mentioned oral rehydration solution (ORS) as an important treatment for diarrheal diseases, particularly cholera. When we visited Diony’s neighborhood after we learned of his uncle’s death from diarrhea, I gave Diony my box of Pedialyte. He gave them to his family and explained how to use them and what the treatment was for (see 10-31-13 post). A week later Diony told me how his cousin used the Pedialyte and was “cured”. “A miracle”, they said. No, I explained to Diony. Be sure to tell them that Pedialyte is ORS. It is not a cure for cholera or any other diarrheal disease. It replaces the fluid and salts that the sick patient loses from the diarrhea. It treats the symptoms, but does not cure the illness. But the patient usually gets better, as did Diony’s cousin.

Diony, Benoit and Dr. Taina explaining the dangers of
diarrhea and the importance of ORS treatment
to a meeting of the Christianville school PTA

     The British medical journal, The Lancet, described ORS as "potentially the most important medical advance of this (20th) century." ORS contains glucose and that is the key to helping your body absorb the salts that are in ORS. Common sports drinks use the same principle as ORS to replace lost fluids and electrolytes when you sweat. But sports drinks have more sugar and less sodium. The extra sweetness makes the sports drink more palatable. ORS is saltier and less sweet than sports drinks. I know. I am drinking some ORS right now and it does not taste like your standard sports drink. It is saltier and not sweet at all. 

     So why am I drinking ORS? We went to the beach at Grand Goâve yesterday afternoon. We had some beers and fruit drinks and someone ordered lambi (conche) with plantains. I love lambi. So I ate some. That was the source of my problem today. I will spare you the details but this morning after I woke up I just felt tired and weak. I ate some breakfast and worked in the lab. I still felt tired. I had a little rice for lunch and went back to the house to take a nap. I slept for about an hour. I got up and still felt tired and sweaty. I had a bout of diarrhea and felt really weak after that. I laid down again for a while to get my strength back. I walked over to the lab. I saw Meer and another person who had shared the lambi with us yesterday. When I asked how they felt, that’s when they admitted that they both had diarrhea last night or today (I guess it’s not just Haitians who are shy about admitting they have diarrhea). Meer sent someone to the clinic for some ORS packets. I made a liter and here I am drinking my ORS. And I feel a whole lot better. I am not eating any more lambi at that beach again. That was a rookie mistake.

ORS packets from Hind Pharma

My Day

     Now that I have been here over a month, I thought it might be a good time to talk about my daily routine. There isn’t really a routine but some things are fairy consistent. I wake up about 6 am. The sun is already up and there is movement on the road outside the house. Workers and vehicles arrive for the day’s work. The chickens are making a lot of noise. You get used to it. Did I mention the smells yet? Christianville is a working farm. In addition to the chickens, there is a herd of goats here. The herd moves between pastures next to the lab to down back of the guesthouse. Some mornings I hear the goats, too. Some mornings I’m not sure if what I smell is the chickens or the goats, or both. It doesn’t matter. You get used to that, too.

Sunrise

     I take a shower. I’ve gotten used to taking cold showers. After I shower, I do some pushups, some stretching, some yoga. Some mornings I get up earlier and go for a run. I have not done that too much lately. The road is too rocky and the circuit is basically a boring path back and forth. I take my doxycycline (anti-malaria), hang my bath towel on the line in the yard to dry and walk over to the dining hall for breakfast. We drink coffee while we wait for breakfast to be ready at 7:15 am. Everyone who is present joins hands and someone volunteers to say a prayer. That person gets to be first in line to eat.  There is a long table with the food. We pass along both sides of the table to serve ourselves. Later I will do another post on the meals (with photos) at Christianville. People wander in and serve themselves. We talk about our plans for the day. If there is a mission group present, we’ll talk with them, ask where they are from, what they are doing in Haiti, just get to know them a bit and make them feel welcome. Mission groups come and go. They stay at the guesthouse (also known as the Fish House or Hotel West Virginia) for a week or 10 days. There may be five people or 15 people. As we finish eating, everyone helps collect the dishes and bring them into the kitchen where the ladies wash the dishes.

     After breakfast, Meer and I head over to the lab. The lab techs come in about 8 am. Meer checks to see which clinics called in and where he needs to send Makendy to pick up samples. We get specimens from Léogâne, Petit Goâve, Grand Goâve, and Jacmel. I don’t do anything with the samples. The Haitian techs do all the work. I turn on my laptop and check my email. I pull up the list of emails for which I am awaiting a response. If it is taking too long, I’ll send out another email. I check with Meer to see if we going to meet anyone today. Some days Meer and I drive out to meet people. We drive out to introduce ourselves to the staff at the clinics that we work with. We want to establish a personal relationship with our partners. Sometimes we will drive out to meet someone new to establish a partnership, to learn what they are doing, to explain to them what we are doing, to see if there are ways we can work together. Basically we are getting the word out to the community that the UF-EPI Haiti Lab 1 is here and explaining what we do. It really does help to cultivate that personal connection.  

     Back in the lab, I work at my laptop. I write protocols for our surveillance projects. I review research progress from people in my lab in Bethesda. I write proposals for funding. I write emails to collaborators. I write to my colleagues in Florida and in Haiti. I send out requests to meet with different people and organizations in Haiti as I try to build up my network. I also spend a lot of time setting up projects, developing ideas of things to do. It is crazy and fun!!! Meer and I just toss around ideas of what a microbiology laboratory can do in Haiti. What about parasites? I didn’t think I’d get into parasites but now I’m learning about schistosomiasis and reading up on it. I spent most of the day one Saturday writing a pilot protocol to test for schistosomiasis. I'm not a parasitologist so I need to bring in some people I know at USU and the University of Georgia as collaborators. Why not food studies? Meer and I talked about looking for Campylobacter and Salmonella in chickens. They raise lots of chickens and produce lots of eggs in Christianville.  Maybe we should look and see if the chickens are colonized with Campylobacter or Salmonella. But how do you get cloacal swabs from a chicken? I don’t know but I know a guy who knows chickens – my Ph.D. mentor, Roy Curtiss III. So I sent Roy an email and he told me how (there is a YouTube video). 

     There is so much that can be done here. The limiting factors are personnel (getting the right people to work on the project), material (it's not easy to get equipment and supplies into Haiti), and money. At times I almost feel like I’m back in Bethesda writing grants. I spend a lot of time sending out emails begging companies for donations or reduced pricing for material and supplies. We are doing things on a shoestring and the work here really needs a much larger investment. But I love it down here. We're going to get a lot of good stuff done.

     Lunch is at 12:00 noon. Same routine as at breakfast. On my way to lunch I go into our yard to fold up my bath towel and bring it back into the house. After lunch, it’s back to the lab. Sometimes during the day, one of my kids will jump in on Google Chat and we exchange messages for a while. I really enjoy that. It keeps me connected with them and what they are doing. We also Skype. That is great (except when the Internet connection is poor and keeps dropping the call). But I still miss them.

     Dinner is at 5:30 pm. After dinner, I grab a flashlight from the house and head back to the lab and continue working on my laptop. It usually rains. We are in the last month of the rainy season. I work until about 10:00 pm and then pack up the laptop, say goodnight to Meer (he works until after midnight) and walk back home in the dark. The nights have gotten noticeably cooler this week. I brush my teeth and rinse with bottled water from our Gift of Water household water treatment system. I have not used the tap water since I got here. I have not been using the bed net. I think we have our mosquito problem under control since Meer and I spent a whole day taping around all of the window screens with duct tape and did a thorough house cleaning. I am sleeping a lot better.

     Time for bed. 

     Bonne nuit, les enfants. Dormez bien.

Sunset

Post Script to Two Kids (goats), Two Kids (humans), and Two Shots (10-26-13 post)

     About 10 days after the incident, someone came from Port to pick up the dog’s head. Yesterday (Nov. 9) we learned that the dog was rabid. Another wild dog from our area who had bitten someone also tested positive for rabies. It was suggested that the guards be told to shoot any stray dogs that they find on the Christianville grounds.

     I’m not worried about tarantulas, or malaria, or cholera. I can take precautions to avoid them. I worry about rabies and I am more aware now of stray dogs. I stay away.

Camion Mack

     Sometimes I think Haiti is a little boy’s playground. It is full of trucks and construction equipment. Back hoes, front-end loaders, graders, and cement mixers. But most of all, there are the dump trucks. Everywhere you go there are dump trucks. Things are constantly being built up or torn down and the dump trucks are there. Dump trucks rumble down the roads day and night carrying rocks and dirt from one location to another. In many places that’s what Haiti is, rock and dirt. So it seems like the trucks are just re-arranging the island.

Camion Mack

     I asked Makendy how to say dump truck in Kreyol. “Camion Mack”, he said. How true! At least 90% of the dump trucks in Haiti are Mack. I have seen a handful of Ford and International Harvester dump trucks but the big dog in Haiti is Mack. They are all here, new and old (well mostly old). It seems like all the Mack dump trucks ever built have come here to finish out their useful days. And that probably lasts for years.

     The camion Mack is the king of the road. It is not the biggest dump truck but the Mack makes the most noise. Its air horn is the loudest. And like dump trucks back in the U.S., many camion Mack sport names. However, unlike the ones in the U.S., these names are more likely to be “Dieu tout puissant” or “L’Eternal”.

     The camion Mack goes anywhere. I awoke the other morning to the sound of a (yet another) diesel engine powered truck lumbering past the window of my bedroom. It was a camion Mack coming down the narrow road into Christianville. Solomon had ordered two truckloads of fill for the foundation of the UF house being built next to the lab. This Mack was bringing in the first load. So like a little kid, I ran out to watch the truck back up and empty its load. When I was a kid, Mack Trucks were the quintessential American truck. Now the iconic Mack Truck is part of Volvo Group (after first being bought out by Renault which then sold Mack Truck to Volvo). It’s so good to see so many camion Mack still working and hauling their loads in Haiti. I love it!

Camion Mack at work

It’s Haiti v9 – What is a Haitian Dollar?

     The official currency of Haiti is the Haitian Gourde. It is exchanged at about 43 gourdes to the U.S. dollar. So when you see prices here in gourdes, you do a quick mental calculation to get it into dollars by dividing the price by 43 (or 40 to make it easier). We were at the market looking to buy some mangos. The women asked for 50 gourdes for a stack of six mangos. OK, that’s about $1.25 for the six, not bad. A lot better than the 110 gourdes we paid in the grocery store for just three apples. So I’m starting to figure it out. Then I walk into a store where the prices are listed in dollars. Not U.S. dollars, but Haitian dollars. So how do I pay in Haitian dollars? I can’t. There is no such currency. The Haitian dollar does not exist as a currency. It exists only as a manner of expressing a value. Now you need to multiply the Haitian dollars by five to convert the price to gourdes to pay in gourdes. Then you can divide by 43 to get the price in U.S. dollars. And most places will accept U.S. dollars, but not Haitian dollars. Because they don’t exist.
It’s Haiti.

Not a Haitian dollar but a 250 gourdes note (worth about $6 US)

Window Shopping for a Freezer in PAP

     I woke up at 5 am today. A very large truck pulled into Christianville and rumbled noisily right past our house (right past my bedroom window). The truck was filled with chickens, about 570 of them. Pastor Raymond had ordered them to give to a group of people. When I spoke to him later he was upset because things did not go as planned (it’s Haiti). Some people did not show up or they did not come in time. There were fewer chickens than he thought and about a dozen chickens had died in transport. They sat in a pile by the tree. The ones that were alive certainly made enough noise to keep me awake after I was awoken by the arrival of the truck.

     I showered, ate breakfast (pancakes and corn flakes) and by 7:30, Meer and I climbed into the Ford Everest with Makendy at the wheel to drive into PAP. The radio had one of Makendy’s favorite radio stations on: Alleluia FM 98.9. All inspirational music, all kinds, in English and Kreyol. Traffic was heavy and barely moving. Makendy turned off the main highway and down a side street. Soon we were in a narrow alley that ran parallel to the highway. We drove past ramshackle houses, stores, drainage ditches filled with trash, and people watching us drive past. We soon joined the highway again. Traffic and the way people drive in Haiti still amaze me. Makendy does things that one would not ever think of doing back in the U.S. I don’t mean to say he is a bad driver. He is a great driver. It’s just that it takes a lot of nerve and street savvy to navigate the traffic in Haiti. And Makendy is equally adept at weaving through the traffic of PAP as he is in handling the off-road unpaved trails we frequently take.

     We were going into Port to shop for a freezer for the lab. But first we had to stop at the DHL office to check on a package of donated rapid test kits we were expecting. The nice DHL lady checked the tracking number. The package should be in tomorrow. She then called the airport office and asked them to have the package sent to the office in town where we were. Then she gave us her card and told us to call in the morning to be sure the package is in the office before sending Makendy out to pick it up. Great service. Better than my first experience with the FedEx office (they checked the tracking number, the package isn’t here; wait, it is here; let me get it; wait, wait…).

     Back in the Everest, we drove off to visit several stores to look for an ultra-cold freezer for the lab. Something at -30C or -40C would be good but a -20C would probably be all we could find. We were going to the large appliance/hardware dealers in PAP and I doubted that we would find a specialty ultra-cold freezer. A quick calculation by Meer determined that a -20C freezer was a -6F freezer. Only one freezer showed a temperature range. It got down to -6F, so we assumed all the others did the same. After the first store I figured out that the Haitians call a freezer, “freezer” not “congélateur” as in French. And frost-free is “no-frost”. I love this language.

     The stores we visited included a grim looking warehouse near Cité Soleil, a very bad neighborhood of PAP. On our way there we passed a former Texaco gas station where a tent city had replaced the gas pump islands under the large black canopy. This store had a “showroom” with three or four freezers that looked like they fell off the back of the truck. There were four guys with shotguns at the entrance to the parking lot and a guy with a shotgun on the loading dock where customers picked up their purchases. At the other end of the spectrum was a store in a tidy industrial park across the street from the U.S. Embassy (yes, I finally saw the U.S. Embassy in Haiti). The store was air-conditioned and sold furniture and appliances. We checked out the freezers and I took some notes. There were a few models that looked like they might be okay. On our way out, we passed through the furniture section. It had everything for the living room, dining room, and kitchen. I saw a very nice, black leather easy chair for $3200.  If the chair was there, it is because there are buyers. For me it was yet another jarring shock of seeing pockets of prosperity surrounded by vast zones of poverty. We will come back tomorrow to buy the freezer. I should check and see how much a nice leather sofa costs. 11-05-13: We went back to the store today to get a price quote on the freezer. On the way out, I took a look at the prices for the leather sofas. I saw one for $6750 and another for $9590. I'm sure someone will buy it.

It’s Haiti v8 – What Time is it?

     This weekend Haiti returned to Standard Time just like the U.S. What is the point of Daylight Savings Time here? Because of Haiti’s proximity to the equator, there is little change in daylight hours with the changing of the seasons. So why does Haiti switch back and forth between Daylight Savings Time and Eastern Standard Time? It doesn’t always. It depends on the government in power. Previous governments did not make the time change. When Michel Martelly took office two years ago, he decided it would be a good idea to make the time change to stay in sync with the East coast of the U.S., to remain on the same time as Miami, Washington, DC and New York. So now it gets dark here at 5 pm, and dinner in the dining hall is still at 6 pm. So we walk over there in the dark from the lab. And now the roosters and chickens start making noise at 5 am instead of 6 am.
It’s Haiti.

Boulangerie Eva – The Best Fast Food Around

      Eva is the best fast food around. Eva is also a boulangerie, a bakery. Great bread, pastries, and cookies. You will find Eva on the National Route 2 that runs from Port-au-Prince west along the coast past Gressier, through Léogâne, on past Grand-Goâve, Petit-Goâve, and Miragoane before turning south into and over the mountains down to the south coast. Eva is on the outskirts of Léogâne. As you drive west from PAP, look for Eva on the left just at the point where you turn off the National 2 to go into Léogâne proper.  Everyone stops at Eva to eat. They have sandwiches and cold drinks, cakes, cookies, and bread. Eva is popular. There are even street vendors in and around Léogâne who sell Eva’s bread. And there are stores in Léogâne that sell Eva’s bread.

     Since the Christianville dining hall was closed yesterday, Meer and I had to find something to eat. So when Makendy got back from Petit-Goâve, we got into the Ford Everest and headed over to Eva for lunch. I ordered a sandwich jambon fromage and Meer ordered a cheeseburger (he’s so American sometimes). We also got a couple of “paté” which is a puff pastry with ground meat filling (une pâte feuilletée renfermant de la viande). And a bag of cookies for dessert. My sandwich cost 100 gourdes. The cheeseburger was 115 gourdes. The exchange rate is about 43 gourdes to the dollar, it comes out to about $2.30 for my sandwich and $2.60 for Meer’s cheeseburger.

Boulangerie Eva, Léogâne

     Meer likes Eva because you can see the kitchen staff preparing your food. And they wear plastic gloves like back home. The food is good although my sandwich would probably make my French friends grimace. Le sandwich jambon fromage contained ham and cheese, as advertised, but it also had onions, tomatoes, and a little green pepper tossed in. There was also a splash of ketchup. In fact, the seasonings looked a lot like what was in Meer’s cheeseburger.

     As we ate, I asked Makendy who Eva is. He did not know so he went to the counter and asked. When he came back he told me that Eva is a “notaire”. There is no close equivalent in the U.S. but the notaire in Haiti functions like a notaire in France. Notaires handle property purchases and sales and they validate contracts and agreements. They also estimate property values. So it is close to what a realtor does in the U.S. but more. Not quite a lawyer but more than a realtor. Anyway, Eva owns the whole lot, the boulangerie, the small grocery store next to it, the gas station, and the Western Union office on the edge of the lot. No guns are allowed in Eva and there are no guys with shotguns standing in the doorway. However, like most stores around here, Eva does not accept credit cards. So bring your gourdes or U.S. dollars.