Mon retour

     I’m back in Haiti. My sabbatical is officially over but I am back to continue my projects. Pierre did not come back with me this trip. He spent three months with me in Haiti (see Pierre’s blog at: http://pierremaurellihaiti.blogspot.com/) and returned home on April 4. I went through my usual departure routine. Monday night I filled up the University of Florida suitcase with stuff for the lab and a few items for myself. Tuesday morning Pierre drove me through the predawn Beltway traffic down to Reagan National Airport for my 8:10 departure for Miami. I bought my coffee and a muffin for breakfast at the Dunkin Donuts in front of my gate. I downloaded a few documents on my laptop while waiting for my flight. After arriving in MIA, I had a few minutes to grab a quick sandwich at Nathan’s before heading for the gate for American Airlines flight 1665 to Port-au-Prince. Same flight, same gate, just departing an hour later than when I flew to Haiti in January. At the gate, I met a group of people from UF who were also on the 1665 from MIA to PAP. They were coming to Haiti for the dedication ceremony of the BSL3-Tuberculosis lab next to our lab that Meer and I had helped get commissioned. So Glenn (Director, UF-EPI) and his family, Mike (Chief, Division of Infectious Diseases and Global Medicine) and some people from his lab, and Tim and Evelyn (our mechanical engineers) were all flying down for the dedication.

     On the plane, I was seated next to a young woman from Minnesota who had been working at an orphanage north of PauP for almost a year. After exchanging some general remarks about what we were each doing in Haiti, the conversation turned to how projects are managed and how things get done in Haiti. Even though we both work at separate sites for different organizations and are doing different work, we had many shared experiences. Her complaints were eerily similar to my own. We had the same views on what works and what does not work in Haiti. Our conversation was almost identical to conversations I had in the lab with Pierre and Meer about the problems in C'ville. At times it was almost as if she was talking about C'ville. So the story is the same everywhere. Our problems are not unique.

     We had a fantastic conversation and the time went quickly. Soon American flight 1665 was on its final descent into PAP. This time we landed from the east. Though I have done this flight many times before, we usually land from the west, over the bay. I had no problems with immigration, baggage claim, or customs. I called Meer. He already tried to call me but my phone was still off. I walked out of the air-conditioned terminal building into the hot afternoon sun. Meer and Marsha were at the barrier to greet us. It was really great to see them and I gave each a big hug. We chatted while we waited for the UF folks to get their bags and exit the terminal.

     Since there were so many UF people going to C'ville, they sent the big white “Obama bus” (these white buses appeared in large numbers in Haiti shortly after Obama’s first election. A coincidence??). The Kia also came for us. We loaded the luggage into the Kia which then drove up to Caribbean Supermarket to pick up the food Marsha had purchased for the guesthouse and the dedication ceremony luncheon.

     The Obama bus pulled out into the lighter than usual afternoon traffic. As we drove through the marketplace, I noticed people on the bus were taking pictures through the windows. The people who had been to Haiti before explained the sights and sounds to the newcomers. I thought, that was me six months ago. Now I see it, but I don’t see it.

     Then we were at C’ville. The Obama bus dropped everyone off at the fish house, the guesthouse where many of the UF people were staying. Madsen and Justin were already there. We greeted each other. Justin remarked that he found the UF lab strangely empty without my laptop open on the desk in the malaria room. Meer and I headed for the lab and I greeted his lab team. We talked and then I brought my suitcase (empty of the lab stuff) back to the house. I tossed my passport on the bed and went to the dining hall for dinner and to see the rest of the C’ville family, Ken, Kirk, Dale, Raymond, Herold, Arthur, Danette, Christian, Khan, Roodly, Raoul and the interns. I'm back in C'ville. It is hot and it just started raining. It is the rainy season. It is really good to be back. I feel at home.

March 30, 2014 – The End of the Sabbatical, the Beginning of the Project

     I need a break. I am worn out, not so much physically (although I have lost about 10 pounds), but mentally. Worn down is maybe a better phrase to use. I just flew in from Port-au-Prince and I am sitting in the Miami airport on my way to a meeting in Chapel Hill, NC. My six-month sabbatical is officially over tomorrow. I spent six months in Haiti with a three-day break at Thanksgiving and two weeks at Christmas. This last trip I was in Haiti for almost three months. I need a break.

     When I look back at where I was, what I hoped to achieve, what I thought I could do during these six months, I am shocked at how naïve I was back in late September before I got on a plane for Port-au-Prince. I am so disappointed that I have not been able to do what I set out to do. I have not even begun my sexually transmitted infections surveillance study and I am on my way back to Bethesda. I thought I would have the study underway in Gressier by Christmas and then set up the laboratory and begin the second part of the study in Baradères. I did go to Baradères twice. Sister Denise is still waiting for me to set up the lab there. When Pierre and I went to Baradères earlier this month with a team from our church in Silver Spring, we visited Sister Denise. The first thing she asked me was when was I going to move to Baradères and build the lab (her second question was where is the construction engineer I introduced her to during our visit in November). They are waiting for me in Baradères. I need to go back.

     So I did not accomplish what I set out to do. I was naïve. Rule #1 for working in Haiti: adjust your expectations.

     I am looking at my last six months in Haiti through the prism of my high (naïve) expectations. So naturally I am terribly disappointed with what I did not accomplish. At the same time, I have become more critical and more cynical about projects in Haiti. Critical, because I know now the nuances of what it takes to get things done. Not to just start things but to actually get things done. Cynical, because I see how much money and resources (human and material) are wasted on good ideas that are not sustainable and wasted on just plain bad ideas. Cynical, because 99.9% of these projects I see are started with the best of intentions. Cynical, because so many opportunities are squandered due to lack of vision and will. Money is not always the problem. The absence of effective on-the-ground leadership, management, accountability and sustainability are the main problems that I have seen. These are hard problems that money alone cannot solve.

     But looking through that prism I fail to see all the wonderful things I experienced, what I learned and, more importantly, what I did accomplish. I wrote my first ever human subjects research protocol and got it through the Institutional Review Board process. I managed to do this without having access to the secure website through which all their business is transacted. My project was approved on March 28, three days before the end of my official sabbatical. I had all of the project documents translated into French and the Informed Consent Document and Questionnaire translated into Creole for the Haitian Bioethics Committee. My submission to the Haitian Ministry of Public Health and Population Bioethics Committee will be hand-carried and submitted tomorrow to their office in Port-au-Prince. I had lots of help with the translations. Isabelle, Pierre, Nancy, and Madsen all contributed. The Haitian Bioethics Committee meets in two weeks. Hopefully, they will approve the protocol. Then I will be able to begin my study. I arranged to get some of my equipment and supplies flown in on a Denton Program flight (see March 29, 2014 post) and I plan to bring in more of my materials that way in the future. I networked with a lot of people in lots of different areas. I have plenty of ideas for new projects.

     Here are some of the things I discovered about myself over the past six months:

I am patient, to a point, and then I become insistent. I nag. And I nag more insistently when there is no obvious reason for a delay.

I can beg. I can plead for donations, favors. There is no shame here. I am doing it for my cause. To help Haitians.

I have a low tolerance for incompetence. I have a very difficult time masking my distain for someone who is not doing their job. I hate to hear excuses about why something was not done, or was not done right. Fix it and don’t let it happen again. Take a little pride in your work and finish it! Maybe I am not as patient as I thought I was.

I am judgmental.

I am demanding. I am critical, maybe overly crucial, of people who are not performing up to their abilities. It upsets me to see energy and intellect wasted. And I have seen a lot of it wasted here.

I hate to see food being wasted. I really hate to see food being wasted. I really, really hate to see food being wasted.

I am not an outwardly religious person. But maybe, in my own way, I am as religious as the rest of the C’ville family and the mission teams that come to Haiti and stay in C’ville. Maybe not. Maybe “religious” is not the right word.

I can learn Creole. I just need to get out of the C’ville bubble more and speak Creole.

I miss my kids. It was really great having Pierre here working with me these past three months. He learned a lot and really grew (see his blog at http://pierremaurellihaiti.blogspot.com/). I miss Cecile and Odile. But they have their university lives and I do not need to be watching over them every day. But I miss them.

So how do I sum up all the positives of the past six months? I don’t know. I need some distance to see. I think I helped the UF lab in the area of management and in scientific matters. Meer and I are a great team. We started off so well but the last three months were really eaten up by a mountain of administrative and management issues that Meer had to deal with, principally the completion and commissioning of the BSL3 lab. It is good that Khan is finally here to take over the BSL3 lab and start the TB work. That will free up Meer to do what he is here to do: his science. I am anxious to get back to Haiti and actually work on some of the projects that Meer and I talked about three or more months ago.

I’m not done yet. I will be back. There is still so much more to do.