Today we drove out to the PAP airport again to await the arrival of anther Denton flight. Last week’s flight had all of Meer’s cargo but none of mine (see July 23 post). Since the original load had been split, my cargo was supposed to be on this flight. Meer and I left C’ville in the Kia with Gesnier, a weekend driver for C’ville. An hour later as we turned onto the airport road, Meer pointed out the driver’s side window. The C-17 was in the air! It looked like it had just taken off. I quickly got on the phone with Ruben. Had we gotten the arrival time wrong. No, he assured me. The plane was just making a second approach. I was relieved but we were still stuck on the airport road for another 30 minutes before we finally broke through the lines of cars going to the terminal and the parking lot and we headed for gate #7. We pulled into the parking area alongside several of Kathy’s trucks and waited. I called Ruben to let him know we had made it. We waited. About 20 minutes later, the escort vehicle came and took us out alongside the runway to the unloading area. I remarked to Meer how security had changed since we came to the airport for the first Denton flight in March (see March 29 post). Back then our driver had to surrender his driver’s license for a vehicle pass. Before we could drive onto the tarmac, we stopped at a second checkpoint where our vehicle was inspected and we were wanded with a metal detector. Today, no vehicle pass, no second checkpoint; we just followed the escort vehicle onto the tarmac right up to the U.S. Air Force C-17 from Charleston, SC.
Meer and I got out of the Kia and started looking around. Most of the cargo had already been off-loaded. There did not seem to be much food this time but a lot of furniture and boxes of clothes, a washing machine, blankets, chairs and desks. But no GeneXpert and no test cartridges. We walked around several times. My cargo was not on this flight. We talked with Kathy. She did not know why my stuff had not made it on this flight. She does have stuff on two more Denton flights coming in later this week. By then I will be back in the U.S. I was hoping that I would be here when my equipment arrived. Now, after two flights in one week, I still don’t have my equipment. I was very disappointed.
We could not leave with an empty truck. Kathy asked us if we needed any desks or filing cabinets. Meer showed her a couple of nice four drawer filing cabinets we could use so we slide them into the Kia. Then someone found an incubator on one of the pallets. It did not belong to us. Kathy thought it might have arrived at her warehouse after she left for Haiti and they just shipped it without telling her. She asked Meer if he wanted it. Sure, he replied. So the old microbiological incubator went into the Kia. Maybe it works, maybe not. If it works, we’ll use it. If not, we’ll find someone to fix it.
Soon the C-17 was revving its engines to taxi away from the unloading area. The plane was facing us and the noise was deafening. The pilot made a tight pivot and pulled away. The heat from the engines was indistinguishable from the late afternoon Haitian summer heat. It was time for us to go also. We will stay in touch with Kathy and Ruben. When the next flight arrives, they will let us know and Meer will work out a way to pick up my cargo. We thanked Kathy and Ruben, climbed into the Kia, and left the unloading area and followed the escort vehicle back to gate #7. We headed back to the airport terminal where one of Meer’s friends was waiting to pick him up. Meer will celebrate the end of Ramadan with his friends in PauP. I walked to the arrivals area and waited for Danette and two students from Texas A&M who came in on the American Airlines flight which arrived while our C-17 was unloading. I found them and brought them to the Kia. We loaded their bags and headed back to C’ville.
I was hot, tired, sweaty, and dusty. I had spent the afternoon breathing diesel fumes while stuck in the PauP traffic (remember, the Kia is not air-conditioned so the windows were open) and aviation fuel fumes while waiting under the unrelenting sun in the parking area. I was disappointed that my cargo was not on this flight. Very disappointed. I hope my cargo will come on the flight next Saturday. If it does, we have another plan to pick it up. If not… I don’t want to think about that right now. Stay tuned.
Sunday, July 27, 2014
Saturday, July 26, 2014
Meer, Me, and the Mountain Loop
Meer and I have been taking early morning hikes up into the mountain. We get up a little after 6 am, get dressed and head out the door. Meer leads the way through the C’ville gate and along the road behind the C’ville school. We turn left up the road that leads to Haiti Health Ministries (HHM), one of the sites where my STI study will take place. We go past the site of another mission called Shepherd’s House. Their compound is very large and they have a soccer field. We continue up the road and then it begins a steep climb. It is rough and the going is slow. The road is rutted and there is nothing but rock and stone. There are generally a few people on the road and several moto taxis but otherwise it is quiet. The view from the ridge opens up on the plain that extends down to the coast and the Bay of Port-au-Prince. We walk along the ridgeline and then down the hill until we reach the main road that brings us past the Marechal soccer field and finally along the back of the C’ville school. All told, the loop is a brisk 45 minutes.
Saturday morning, I head out alone on Meer’s mountain trail loop. The end of Ramadan is approaching and Meer is still fasting. Meer worked late last night so he wants to sleep in this morning. It is about 8:15 am and the temperature is near 90F. The sun is up above the mountains to the east. I greet the guard at the gate and let myself out of the C’ville compound. As I walk along the road behind the C’ville school, the women at the food stand are already cooking the food that they will be selling during the day. I greet them and they greet me in return (they recognize me by now) and I walk along the road that is quickly filling with moto taxis. There are a lot of them this morning. I try to walk along the edge of the road to stay out of their way. Several young people are at the corner filling up buckets of water from a faucet that is hooked to the C’ville water system.
I turn left and walk up the road toward the HHM campus. HHM is closed now for two weeks for vacation. Everything is quiet there. Twice earlier in the week, I saw things on Meer’s mountain loop that I had never seen in Haiti. One morning near the HHM compound we saw a young blan woman walking a dog on a leash. I had never seen a dog on a leash here before. As if that wasn’t strange enough, the dog was a German shepherd. I don’t know how the poor puppy can stand the heat. The only other time I had seen a dog on a leash here was a drug-sniffing German shepherd at the PAP airport. At least that dog was working in an air-conditioned building. The second unusual thing we saw was a group of five Haitian teenager boys jogging down the mountain road. Yes, they were clearly runners in training.
Along the road there are goats and cows and a few people. I reach the ridgeline and turn right along the road. I look back over the coastal plain. There are fields under cultivation, pastures with cows and goats, and the two large mission compounds. As is true throughput Haiti, the mission compounds are fenced in communities. HHM is large and encircled with a cyclone fence. They had recently completed an expansion of their campus and moved out of the tents that had served as their clinic into very nice facilities with tiled floors, windows, lights, and a cool natural ventilating breeze circulating throughout.
Shepherd’s House Ministry is further up the mountains and partly built into it. A tall concrete block wall partially encloses the compound and obscures it from view from the road. From the ridge, the size of the compound is evident. I did not realize it was that large. A group of young men are playing soccer. I can also see a basketball backboard and hoop and what appeared to be either a gazebo or a moon bounce. A few solar panels dot the roofs. The large mission buildings are in contrast to the varied construction of the homes along the loop trail. Haitians live in homes made of concrete block, sheet metal, thatched vegetation, or tarps such as the popular sky blue tent material from Samaritans Purse. Such is Haiti, a country of contrasts.
The air is hot and the sun is beating down on the large, bare rocks that litter the road. Even though it had rained quite a bit last night, the road is mostly dry with only a few scattered puddles of water. In spite of the heat, I am wearing my jeans. They are my protection against mosquitoes. I had also sprayed my arms with Off Deep Woods for protection on my bare skin. I am wearing an Under Armour heat shirt but I am soon sweating right through it. I pass an old man walking along the road. He looks at me and says, “Ou mouye”. I nod. Yes, I am wet. “Fa cho,” (it’s hot), I reply. He laughs.
I continue my walk along the main road through Marechal heading back toward the C’ville school. I greet a pair of young girls who are walking in the opposite direction. They stop and ask me if I am Haitian. I laugh. “Non. Je suis americain. Mwen se amerikan", I reply. They giggle and walk on. Sometimes I think I’ve been down here too long.
 |
| Marechal |
Saturday morning, I head out alone on Meer’s mountain trail loop. The end of Ramadan is approaching and Meer is still fasting. Meer worked late last night so he wants to sleep in this morning. It is about 8:15 am and the temperature is near 90F. The sun is up above the mountains to the east. I greet the guard at the gate and let myself out of the C’ville compound. As I walk along the road behind the C’ville school, the women at the food stand are already cooking the food that they will be selling during the day. I greet them and they greet me in return (they recognize me by now) and I walk along the road that is quickly filling with moto taxis. There are a lot of them this morning. I try to walk along the edge of the road to stay out of their way. Several young people are at the corner filling up buckets of water from a faucet that is hooked to the C’ville water system.
 |
| Haiti Health Ministries |
Along the road there are goats and cows and a few people. I reach the ridgeline and turn right along the road. I look back over the coastal plain. There are fields under cultivation, pastures with cows and goats, and the two large mission compounds. As is true throughput Haiti, the mission compounds are fenced in communities. HHM is large and encircled with a cyclone fence. They had recently completed an expansion of their campus and moved out of the tents that had served as their clinic into very nice facilities with tiled floors, windows, lights, and a cool natural ventilating breeze circulating throughout.
 |
| Shepherd's House Ministry (foreground) and Haiti Health Ministries (background) |
The air is hot and the sun is beating down on the large, bare rocks that litter the road. Even though it had rained quite a bit last night, the road is mostly dry with only a few scattered puddles of water. In spite of the heat, I am wearing my jeans. They are my protection against mosquitoes. I had also sprayed my arms with Off Deep Woods for protection on my bare skin. I am wearing an Under Armour heat shirt but I am soon sweating right through it. I pass an old man walking along the road. He looks at me and says, “Ou mouye”. I nod. Yes, I am wet. “Fa cho,” (it’s hot), I reply. He laughs.
I continue my walk along the main road through Marechal heading back toward the C’ville school. I greet a pair of young girls who are walking in the opposite direction. They stop and ask me if I am Haitian. I laugh. “Non. Je suis americain. Mwen se amerikan", I reply. They giggle and walk on. Sometimes I think I’ve been down here too long.
Wednesday, July 23, 2014
A Plan B for Plan B – The Denton Flight Arrives
After the cancellation of the Denton flight on Saturday, we had to plan for a possible flight arriving on Sunday. Ruben, the military liaison from the Embassy, was going to contact us all on Sunday to let us know as soon as he heard when the flight would arrive. Meanwhile, Saturday night I explained our situation to Pastor Herold. We needed a truck and a driver again for Sunday. The Dodge was the only truck available. Herold called Juliome, a C’ville mechanic who also works as a weekend driver. Juliome would drive me to PauP in the Dodge where we would pick up Meer and then go to the airport and wait for the Denton flight again.
At 10:30 am Sunday, I received the email from Ruben. The flight was on and scheduled to arrive at 1:00 pm. Time to go. I called Juliome and Meer to let them know. In less than 10 minutes, Juliome was at the lab to pick me up. We headed out to the National Route #2 and drove to PauP. There was a lot less traffic than on Saturday and we made good time. We picked up Meer and went straight to the airport. We checked through the gate and Juliome backed the Dodge into a space next to the trucks from Lifeline Missions. As I stepped out of the Dodge, I heard the sound of military jet engines. I turned around in time to see our C-17 rolling slowly down the PAP runway to a stop. I checked my watch: 12:50 pm. The flight was exactly 24 hours late. I managed to pull out my cell phone and snap a few pictures as the C-17 turned and began to taxi down the runway to the unloading area.
We walked over and greeted Ruben who was getting ready to drive onto the runway area with the airport security escort. He gave Meer a great big hug and thanked him for the Indian food Meer had given him when we were here for the flight that was canceled on Saturday (see July 21 blog post). Then we all got back in our vehicles and waited for the escort vehicle to lead us onto the runway area. Soon we were driving on the tarmac and past a Delta Airlines and two American Airlines planes and then parked behind the C-17 that a forklift was busily unloading. We got out of the Dodge and looked around at the pallets that the forklift had already off-loaded. Soon we found two pallets with Meer’s petri dishes. Meer counted them: all 40 cases were there. I looked around, twice. My GeneXpert and test cartridges were not on this flight.
We began loading the petri dish boxes into the Dodge. They were all going to fit. Then Kathy started showing me stuff and asking if we could use them: a desk, filing cabinets, buckets. We took them all. At least we took what we could fit in the Dodge. I reminded Meer that we still had to pick up Nancy, the graduate student from UF, and her bags. Her flight was arriving in another 40 minutes. Ruben helped us tie down the load on the Dodge while the C-17 revved up its engines and taxied to the runway for takeoff. The C-17 was quickly in the air and on its way back to Charleston, SC. It was 2:15 pm. The entire unloading operation had taken less then 90 minutes.
We said good-bye to Ruben and Kathy. We’ll be back next week for the next Denton flight. Kathy has 85,000 pounds of rice and 42,500 pounds of beans in the system. Her group always brings several trucks and school buses that they fill up with all the food and stuff that Kathy brings into Haiti. We will come back with the Dodge again next Sunday. My stuff should easily fit in it.
At 10:30 am Sunday, I received the email from Ruben. The flight was on and scheduled to arrive at 1:00 pm. Time to go. I called Juliome and Meer to let them know. In less than 10 minutes, Juliome was at the lab to pick me up. We headed out to the National Route #2 and drove to PauP. There was a lot less traffic than on Saturday and we made good time. We picked up Meer and went straight to the airport. We checked through the gate and Juliome backed the Dodge into a space next to the trucks from Lifeline Missions. As I stepped out of the Dodge, I heard the sound of military jet engines. I turned around in time to see our C-17 rolling slowly down the PAP runway to a stop. I checked my watch: 12:50 pm. The flight was exactly 24 hours late. I managed to pull out my cell phone and snap a few pictures as the C-17 turned and began to taxi down the runway to the unloading area.
 |
| The C-17 Globemaster III from Charleston, SC |
 |
| Kathy, Ozmy, and Meer with Meer's petri dishes |
We began loading the petri dish boxes into the Dodge. They were all going to fit. Then Kathy started showing me stuff and asking if we could use them: a desk, filing cabinets, buckets. We took them all. At least we took what we could fit in the Dodge. I reminded Meer that we still had to pick up Nancy, the graduate student from UF, and her bags. Her flight was arriving in another 40 minutes. Ruben helped us tie down the load on the Dodge while the C-17 revved up its engines and taxied to the runway for takeoff. The C-17 was quickly in the air and on its way back to Charleston, SC. It was 2:15 pm. The entire unloading operation had taken less then 90 minutes.
 |
| Some of the pallets of humanitarian cargo from the Denton flight |
Monday, July 21, 2014
A Plan B for Plan B – and No Denton Flight
A rule. My Rule #2 for working in Haiti is: Have a plan B and a plan B for your plan B. Meer and I put the rule to the test this week. After a lapse of three months, we have more cargo coming in on a Denton flight. The last flight (our first) that we had was back in March (see blog entry March 29) and we have been anxious to get another shipment of material for the lab on another Denton flight. Meer ordered 40 cases of petri dishes and I purchased a GeneXpert plus several cases of test cartridges. All of these orders were shipped to the Operation Ukraine warehouse where Kathy Cadden included them in her load of humanitarian aid for shipment to Haiti. And then we waited. No flights came in April or May. One flight came in June but it did not have any of Kathy’s cargo. Meer and I waited impatiently for a date for our shipment.
A date. Early July, Kathy emailed me and said a flight was coming in on July 16. She would arrive in Haiti on July 16 to be there when the flight arrived. I emailed Meer, who was back in Haiti, and made my arrangements to return to Haiti in time for the shipment (and also to be present for training the personnel I planned to hire). Before I left, Kathy emailed me again to say that the flight was arriving on July 20, not July 16. I flew out on July 14 as planned and waited in C’ville for Kathy to call. A few days after my arrival, I received a call from Kathy. Good new, bad news. The good news is that there will be two Denton flights arriving this month – one on Saturday, July 19 and the other on Sunday, July 27. The bad news is that her cargo was split up and she does not know which flight our cargo will be on. We need to be at the airport Saturday with a truck in case our stuff is on that flight.
A truck. Meer and I talked about getting a driver and a truck to transport our supplies. No C’ville weekend drivers were available. So we had to call on Makendy to work on Saturday, his day off. We talked to Pastor Herold, the C’ville director about getting a truck. The large red flatbed Daihatsu will do nicely. Not available, it was leaving on Saturday morning to bring chickens up to Gonaives. I have no idea where the Kia is. The other pick up trucks are too small. Then there is the Dodge. Herold said we could use the Dodge. It is large but not large enough to carry 40 cases of petri dishes plus my instrument and supplies. We would have to rent a truck. Meer thought that maybe we could fill out the paperwork to rent a truck and wait until the flight arrived to sign the rental contract or cancel. I guess that may work. We needed a Plan B for Plan B. I called Kathy and explained our problem with the truck. She told me that her logistics guy knows how to get a truck on short notice and not to worry. He’ll take care of us. Meer and I left it at that. We decided to see what would happen next.
The Dodge. We piled into the Dodge at 10:15 am Saturday and Makendy headed for the PAP airport. Traffic was bad around Mariani (it usually is) and it took us about a hour and a half to get to the airport. We dropped off Amanda, a graduate student from Johns Hopkins who worked with Meer on a cholera project for the past couple of weeks. Then we drove to gate #7 and into the parking area to wait for the Denton flight. It was 11:45 am, one hour before the flight was scheduled to arrive. Kathy arrived with the trucks from Lifeline Mission shortly after 12 noon and Ruben arrived 15 minutes later. Meer had prepared some Indian food for Ruben and his fiancé (who was visiting this week). We originally had planned to have a big Indian dinner with Kathy and Ruben and his fiancé and one of Meer’s friends in Port-au-Prince but it is the middle of Ramadan and it would be too hard to set something up. So Meer made the meal and froze it for Ruben. We all stood around in the bright mid-day sun and talked about things: the situation in Ukraine, the state of orphanages in Haiti, sexual violence against women in Haiti and other countries (Ruben’s fiancé works in that field), Indian food, how Kathy manages to raise money for her organization and how she gets people to donate things. There was a constant breeze so we did not feel the July heat so much but it was better to stand in the shade.
12:45 pm. We all squinted up to the sky as Ruben pointed out an approaching aircraft. Then he shook his head. It’s not our C-17 transport. Even at this distance he could tell by how the wings were bent. Sure enough, the plane that landed was a Delta flight. We waited again. Then another aircraft began its final approach. Still not our C-17. This time it was an American Airlines 757. 1:45 pm and still no Denton flight. Meanwhile, another American Airlines 757 landed. At 2:00 pm, Ruben contacted flight control. Where is our flight? Bad news. The aircraft had taken off from Charleston, SC but encountered some mechanical problems and turned back. They were not sure how long it would take to fix the problem but they were hoping to get the flight out today. We all shook our heads as Ruben read the email. No way. It was too late. By the time the plane gets to PAP, unloads and gets turned around, it would be too late to take off. The PAP airport has no runway lights. All air traffic stops around 6 pm. We did not think there would be a flight today. But flight control told Ruben to stand by and they would do their best to get the flight out. At 2:45 pm. Ruben got the word. No flight today. They will let us know what time they plan to fly out tomorrow. We all got in our empty vehicles for the long return ride home. We’ll be back tomorrow, maybe?
3:00 pm. We drive up to Petionville and drop Meer off at his friend’s house. Meer will spend the night with them and we’ll come back Sunday to pick him up and meet the Denton flight, if it comes. Makendy and I get back in the Dodge and start down the mountain into PauP and the National Route #2 to drive back to C’ville. Traffic started to slow down and then stop just before Mariani, always a bottleneck. We managed to drive past the curtain of smoke that continually blows across the highway from the trash dump next to the road. And then traffic stopped completely. For almost two solid hours, we barely moved. All told it took us more than three hours to cover the 12 km from Mariani to C’ville. We finally pulled into C’ville at 7:15 pm over four hours after we left Petionville. A long day and we returned home empty-handed.
A date. Early July, Kathy emailed me and said a flight was coming in on July 16. She would arrive in Haiti on July 16 to be there when the flight arrived. I emailed Meer, who was back in Haiti, and made my arrangements to return to Haiti in time for the shipment (and also to be present for training the personnel I planned to hire). Before I left, Kathy emailed me again to say that the flight was arriving on July 20, not July 16. I flew out on July 14 as planned and waited in C’ville for Kathy to call. A few days after my arrival, I received a call from Kathy. Good new, bad news. The good news is that there will be two Denton flights arriving this month – one on Saturday, July 19 and the other on Sunday, July 27. The bad news is that her cargo was split up and she does not know which flight our cargo will be on. We need to be at the airport Saturday with a truck in case our stuff is on that flight.
A truck. Meer and I talked about getting a driver and a truck to transport our supplies. No C’ville weekend drivers were available. So we had to call on Makendy to work on Saturday, his day off. We talked to Pastor Herold, the C’ville director about getting a truck. The large red flatbed Daihatsu will do nicely. Not available, it was leaving on Saturday morning to bring chickens up to Gonaives. I have no idea where the Kia is. The other pick up trucks are too small. Then there is the Dodge. Herold said we could use the Dodge. It is large but not large enough to carry 40 cases of petri dishes plus my instrument and supplies. We would have to rent a truck. Meer thought that maybe we could fill out the paperwork to rent a truck and wait until the flight arrived to sign the rental contract or cancel. I guess that may work. We needed a Plan B for Plan B. I called Kathy and explained our problem with the truck. She told me that her logistics guy knows how to get a truck on short notice and not to worry. He’ll take care of us. Meer and I left it at that. We decided to see what would happen next.
The Dodge. We piled into the Dodge at 10:15 am Saturday and Makendy headed for the PAP airport. Traffic was bad around Mariani (it usually is) and it took us about a hour and a half to get to the airport. We dropped off Amanda, a graduate student from Johns Hopkins who worked with Meer on a cholera project for the past couple of weeks. Then we drove to gate #7 and into the parking area to wait for the Denton flight. It was 11:45 am, one hour before the flight was scheduled to arrive. Kathy arrived with the trucks from Lifeline Mission shortly after 12 noon and Ruben arrived 15 minutes later. Meer had prepared some Indian food for Ruben and his fiancé (who was visiting this week). We originally had planned to have a big Indian dinner with Kathy and Ruben and his fiancé and one of Meer’s friends in Port-au-Prince but it is the middle of Ramadan and it would be too hard to set something up. So Meer made the meal and froze it for Ruben. We all stood around in the bright mid-day sun and talked about things: the situation in Ukraine, the state of orphanages in Haiti, sexual violence against women in Haiti and other countries (Ruben’s fiancé works in that field), Indian food, how Kathy manages to raise money for her organization and how she gets people to donate things. There was a constant breeze so we did not feel the July heat so much but it was better to stand in the shade.
12:45 pm. We all squinted up to the sky as Ruben pointed out an approaching aircraft. Then he shook his head. It’s not our C-17 transport. Even at this distance he could tell by how the wings were bent. Sure enough, the plane that landed was a Delta flight. We waited again. Then another aircraft began its final approach. Still not our C-17. This time it was an American Airlines 757. 1:45 pm and still no Denton flight. Meanwhile, another American Airlines 757 landed. At 2:00 pm, Ruben contacted flight control. Where is our flight? Bad news. The aircraft had taken off from Charleston, SC but encountered some mechanical problems and turned back. They were not sure how long it would take to fix the problem but they were hoping to get the flight out today. We all shook our heads as Ruben read the email. No way. It was too late. By the time the plane gets to PAP, unloads and gets turned around, it would be too late to take off. The PAP airport has no runway lights. All air traffic stops around 6 pm. We did not think there would be a flight today. But flight control told Ruben to stand by and they would do their best to get the flight out. At 2:45 pm. Ruben got the word. No flight today. They will let us know what time they plan to fly out tomorrow. We all got in our empty vehicles for the long return ride home. We’ll be back tomorrow, maybe?
3:00 pm. We drive up to Petionville and drop Meer off at his friend’s house. Meer will spend the night with them and we’ll come back Sunday to pick him up and meet the Denton flight, if it comes. Makendy and I get back in the Dodge and start down the mountain into PauP and the National Route #2 to drive back to C’ville. Traffic started to slow down and then stop just before Mariani, always a bottleneck. We managed to drive past the curtain of smoke that continually blows across the highway from the trash dump next to the road. And then traffic stopped completely. For almost two solid hours, we barely moved. All told it took us more than three hours to cover the 12 km from Mariani to C’ville. We finally pulled into C’ville at 7:15 pm over four hours after we left Petionville. A long day and we returned home empty-handed.
Wednesday, July 16, 2014
Cholera, Chikungunya, and (Pay)checks
Meer tells me that the lab has been receiving fewer cases of severe diarrhea from the clinics. There are fewer cases of cholera also. The incidence of cholera seems to ebb and flow with the seasons, peaking in the rainy season. Now is the rainy reason in Haiti but, curiously, there is not a lot of rain. I arrived in Haiti two days ago and there hasn’t been any rain since my arrival. The last time it rained was a week ago. As we drove in from Port-au-Prince, I could see that the drainage ditches were dry and the rivers and streams had very little water flowing through them. Amanda, a graduate student from Johns Hopkins, went out with Meer yesterday to collect water samples and they told me that they saw the same thing: rivers and streams are drier than usual for a rainy season. Where is the rain? Maybe the unseasonable lack of rain is keeping the incidence of cholera down. Good for Haitians; not so good for Meer’s project.
One of my biggest concerns about returning to Haiti was the risk of getting Chikungunya. Before I left last month, I heard about many people I knew who had Chik or someone they knew had Chik. Sue told me that all of her kids at the C’ville orphanage had it. Ken, our former chief mechanic, got Chik just as he left Haiti. He was so sick on the flight home that he could hardly walk. I was a little worried. The epidemic is sweeping through Haiti and catching everyone. I’m wearing jeans despite the heat just to keep my legs covered and using Deet on my arms, neck, and face every day. And I’m careful to be sure my mosquito net is closed around my bed at night (against the mosquitoes that carry malaria; the mosquitoes with Chik and dengue are day biters). Today I read in Le Nouvelliste, the Haitian newspaper, that Dr Paul Adrien, Director of Epidemiology, Laboratory and Research at the Ministry of Public Health and the Population (and a collaborator on my STI surveillance project), confirmed that the number of Chik cases reported for the first week of July declined throughout the country. Maybe the efforts to eliminate mosquito breeding grounds are succeeding. Maybe the epidemic is burning out. Maybe the virus is evolving into a less virulent form and fewer victims feel sick enough to seek medical attention and, thus, are not counted. The cases are all classified by symptoms anyway since there are no diagnostic tests for the Chik virus. We just don’t know and the surveillance studies proposed by UF-EPI to study the epidemic may not be reviewed or funded before the epidemic dies out. Both the reduced cases of cholera and the declining cases of Chik fit a maxim of Amanda’s Ph.D. director, Dr. David Sacks. Basically he said that if you want to cure cholera (or insert your favorite infectious disease here), start a surveillance study. It is an exaggeration to be sure and more a reflection of our slow response to studying epidemics and how long it takes to set up these projects. However, I doubt that sexually transmitted infections will go away before my surveillance begins.
This afternoon, Meer and Amanda and I drove out to Petit-Goâve. Meer’s diarrheal disease surveillance project receives specimens from a hospital there: l’hôpital Notre-Dame de Petit-Goâve. I had been in contact with the administrative director of the Henri Gerard Degranges Foundation, which operates another clinic in Petit-Goâve. Earlier this year, a team from UCLA published a small study on STIs they carried out at the Degranges clinic last year. In addition to the STI work, I thought the clinic could be another possible source of diarrhea specimens for Meer’s project. I had planned to meet the director in March when she was in Haiti but our schedules never matched. I contacted her on my return to Haiti on Monday and asked if it was possible to visit the clinic since Meer planned to go to Petit-Goâve to visit Notre Dame Hospital. No problem. She gave me the clinic director’s cellphone number and I called him last night to set up the meeting.
This morning Makendy dropped off Khan at the airport for his return to Gainesville but traffic in Carrefour made his return to C’ville over an hour and a half later than we planned. We got on the road to Petit-Goâve and when the clinic director called to ask me where we were, I explained the reason for our delay and told him we would arrive about 3 pm. The clinic closes at 3 pm but he assured me that someone would be there to show us around. We arrived in Petit-Goâve shortly after 3 pm and were greeted by Mr. Georges, the accountant at Clinique de Henri Gerard Desgranges. I told him about the UF-EPI lab at C’ville and Meer’s project, avoiding the scientific details since I was talking to the accountant and not the medical staff. He seemed to understand what Meer was looking for in the collaboration (diarrhea stools) and then we talked numbers (he is an accountant, after all). How many patients do they see at the clinic per day? About 20-30, a lot less than a few weeks ago when they were seeing over 60 patients a day, mostly Chikungunya cases. How many cases of severe diarrhea? Not many at all. Any cholera cases? None. Is there a Cholera Treatment Center in Petit-Goâve? No, there was one but it closed down. So here, too, it sounded like cholera and Chik were on the decline. Then the surprise came from a chance remark. Do all the cases of severe cholera go to the Notre Dame Hospital? No, that hospital is closed. Stunned silence. I asked him again to be sure my French was not fooling me. Mr. Georges said that the Notre Dame Hospital in Petit-Goâve was closed. There was no money to pay the staff salaries so the 80 employees of the hospital went on strike last Tuesday. The employees are demanding 18 month back pay they claim that they have not received (see http://www.haitilibre.com/article-11561-haiti-sante-l-hopital-notre-dame-de-petit-goave-de-nouveau-paralyse-par-la-greve.html). I turned to Makendy. He shook his head; he didn’t know and Makendy said that he had picked up samples there last week. So maybe with the strike at the larger Notre Dame Hospital, the Clinique de Henri Gerard Desgranges will get the diarrhea patients and Meer can get his samples after all. It may be that our visit today was more fortuitous than any of us expected when we drove out to Petit-Goâve. It seems that I experience a lot of these chance events in Haiti. Maybe it happens more, maybe I just see the chances more readily here. In any case, I think our timing today may prove to be impeccable.
One of my biggest concerns about returning to Haiti was the risk of getting Chikungunya. Before I left last month, I heard about many people I knew who had Chik or someone they knew had Chik. Sue told me that all of her kids at the C’ville orphanage had it. Ken, our former chief mechanic, got Chik just as he left Haiti. He was so sick on the flight home that he could hardly walk. I was a little worried. The epidemic is sweeping through Haiti and catching everyone. I’m wearing jeans despite the heat just to keep my legs covered and using Deet on my arms, neck, and face every day. And I’m careful to be sure my mosquito net is closed around my bed at night (against the mosquitoes that carry malaria; the mosquitoes with Chik and dengue are day biters). Today I read in Le Nouvelliste, the Haitian newspaper, that Dr Paul Adrien, Director of Epidemiology, Laboratory and Research at the Ministry of Public Health and the Population (and a collaborator on my STI surveillance project), confirmed that the number of Chik cases reported for the first week of July declined throughout the country. Maybe the efforts to eliminate mosquito breeding grounds are succeeding. Maybe the epidemic is burning out. Maybe the virus is evolving into a less virulent form and fewer victims feel sick enough to seek medical attention and, thus, are not counted. The cases are all classified by symptoms anyway since there are no diagnostic tests for the Chik virus. We just don’t know and the surveillance studies proposed by UF-EPI to study the epidemic may not be reviewed or funded before the epidemic dies out. Both the reduced cases of cholera and the declining cases of Chik fit a maxim of Amanda’s Ph.D. director, Dr. David Sacks. Basically he said that if you want to cure cholera (or insert your favorite infectious disease here), start a surveillance study. It is an exaggeration to be sure and more a reflection of our slow response to studying epidemics and how long it takes to set up these projects. However, I doubt that sexually transmitted infections will go away before my surveillance begins.
This afternoon, Meer and Amanda and I drove out to Petit-Goâve. Meer’s diarrheal disease surveillance project receives specimens from a hospital there: l’hôpital Notre-Dame de Petit-Goâve. I had been in contact with the administrative director of the Henri Gerard Degranges Foundation, which operates another clinic in Petit-Goâve. Earlier this year, a team from UCLA published a small study on STIs they carried out at the Degranges clinic last year. In addition to the STI work, I thought the clinic could be another possible source of diarrhea specimens for Meer’s project. I had planned to meet the director in March when she was in Haiti but our schedules never matched. I contacted her on my return to Haiti on Monday and asked if it was possible to visit the clinic since Meer planned to go to Petit-Goâve to visit Notre Dame Hospital. No problem. She gave me the clinic director’s cellphone number and I called him last night to set up the meeting.
This morning Makendy dropped off Khan at the airport for his return to Gainesville but traffic in Carrefour made his return to C’ville over an hour and a half later than we planned. We got on the road to Petit-Goâve and when the clinic director called to ask me where we were, I explained the reason for our delay and told him we would arrive about 3 pm. The clinic closes at 3 pm but he assured me that someone would be there to show us around. We arrived in Petit-Goâve shortly after 3 pm and were greeted by Mr. Georges, the accountant at Clinique de Henri Gerard Desgranges. I told him about the UF-EPI lab at C’ville and Meer’s project, avoiding the scientific details since I was talking to the accountant and not the medical staff. He seemed to understand what Meer was looking for in the collaboration (diarrhea stools) and then we talked numbers (he is an accountant, after all). How many patients do they see at the clinic per day? About 20-30, a lot less than a few weeks ago when they were seeing over 60 patients a day, mostly Chikungunya cases. How many cases of severe diarrhea? Not many at all. Any cholera cases? None. Is there a Cholera Treatment Center in Petit-Goâve? No, there was one but it closed down. So here, too, it sounded like cholera and Chik were on the decline. Then the surprise came from a chance remark. Do all the cases of severe cholera go to the Notre Dame Hospital? No, that hospital is closed. Stunned silence. I asked him again to be sure my French was not fooling me. Mr. Georges said that the Notre Dame Hospital in Petit-Goâve was closed. There was no money to pay the staff salaries so the 80 employees of the hospital went on strike last Tuesday. The employees are demanding 18 month back pay they claim that they have not received (see http://www.haitilibre.com/article-11561-haiti-sante-l-hopital-notre-dame-de-petit-goave-de-nouveau-paralyse-par-la-greve.html). I turned to Makendy. He shook his head; he didn’t know and Makendy said that he had picked up samples there last week. So maybe with the strike at the larger Notre Dame Hospital, the Clinique de Henri Gerard Desgranges will get the diarrhea patients and Meer can get his samples after all. It may be that our visit today was more fortuitous than any of us expected when we drove out to Petit-Goâve. It seems that I experience a lot of these chance events in Haiti. Maybe it happens more, maybe I just see the chances more readily here. In any case, I think our timing today may prove to be impeccable.
Chik is Chic
May 6. I’m sitting on the porch of the priest’s house in Baradères while I type out my blog. There is a steady stream of people and animals on the road making their way to the Saturday morning market. Young men, women and children lead donkeys laden with bananas. They balance containers with dry goods on their heads as they walk. It is not yet 10 am and the day is sunny and hot.
After lunch, Father Jacques came to tell me that a girl came to the house with Chikungunya. Could he give her some acetaminophen? Sure. We brought dozens of large bottles of acetaminophen to Baradères for this reason. How much should she take? I told Father Jacques to check her age and read the label on the bottle. Twenty minutes later, a man greeted me on the porch. I didn’t recognize him though he seemed to know me. He said he was happy to see me again. We exchanged a few words, in Kreyol, and then I ran out of things I could say. He said good-bye but before he left the porch he turned and asked me if I could give him some acetaminophen. I told him to ask Father Jacques. Later this afternoon I translated for Cynthia as she spoke with the graduating students of the Philo class. The girl whom Father Jacques told me about earlier was there. She looked a little tired but clearly was able to move. From what I heard about the symptoms of Chik, the joint and muscle pain is so severe that it is incapacitating. Does she really have Chik?
There is no doubt that Chik is really here. The Ministry of Public Health and the Population (MSPP) declared its arrival earlier this month. Mille is in the mosquito room every day preparing his traps to take out. I asked him what he has found so far. Chik. Now all the Haitians believe Chik is here. The Haitians all think they have it, too, and they all want acetaminophen. Back in C’ville Pastor Raymond said that it is “chique” to have Chik. Everyone says they have it. And no one is really sure, not until we can start doing some surveillance testing for it.
June 14, 2014 – I spent the weekend in Baradères to attend the graduation ceremony for the “Philo” class of le College St. Jean Baptiste, the school that my church in Silver Spring supports. We again hear stories of people suffering from Chik in Baradères. The epidemic continues. After my return to C’ville from Baraderes, I learn that a good friend of mine who works at an orphanage near here came down with Chik. Matt is a big guy but Chik laid him out with fever and muscle pain so bad he could barely walk. Three days later, he was back in the dining hall looking and feeling much better. Chik is making the rounds. I’ve lost track of who has had it.
July 5, 2014 – I received an email from Sister Denise. One of the sisters in her community died of complications from Chikungunya. I had heard about many cases but no fatalities until now. Chik is not “chique”; it is for real. Sister Denise’s email went on to say that one of the candidates whom we had interviewed for the lab tech position in Baradères died. Malaria. Yes, I remind myself. These diseases are real and real people are dying.
After lunch, Father Jacques came to tell me that a girl came to the house with Chikungunya. Could he give her some acetaminophen? Sure. We brought dozens of large bottles of acetaminophen to Baradères for this reason. How much should she take? I told Father Jacques to check her age and read the label on the bottle. Twenty minutes later, a man greeted me on the porch. I didn’t recognize him though he seemed to know me. He said he was happy to see me again. We exchanged a few words, in Kreyol, and then I ran out of things I could say. He said good-bye but before he left the porch he turned and asked me if I could give him some acetaminophen. I told him to ask Father Jacques. Later this afternoon I translated for Cynthia as she spoke with the graduating students of the Philo class. The girl whom Father Jacques told me about earlier was there. She looked a little tired but clearly was able to move. From what I heard about the symptoms of Chik, the joint and muscle pain is so severe that it is incapacitating. Does she really have Chik?
There is no doubt that Chik is really here. The Ministry of Public Health and the Population (MSPP) declared its arrival earlier this month. Mille is in the mosquito room every day preparing his traps to take out. I asked him what he has found so far. Chik. Now all the Haitians believe Chik is here. The Haitians all think they have it, too, and they all want acetaminophen. Back in C’ville Pastor Raymond said that it is “chique” to have Chik. Everyone says they have it. And no one is really sure, not until we can start doing some surveillance testing for it.
June 14, 2014 – I spent the weekend in Baradères to attend the graduation ceremony for the “Philo” class of le College St. Jean Baptiste, the school that my church in Silver Spring supports. We again hear stories of people suffering from Chik in Baradères. The epidemic continues. After my return to C’ville from Baraderes, I learn that a good friend of mine who works at an orphanage near here came down with Chik. Matt is a big guy but Chik laid him out with fever and muscle pain so bad he could barely walk. Three days later, he was back in the dining hall looking and feeling much better. Chik is making the rounds. I’ve lost track of who has had it.
July 5, 2014 – I received an email from Sister Denise. One of the sisters in her community died of complications from Chikungunya. I had heard about many cases but no fatalities until now. Chik is not “chique”; it is for real. Sister Denise’s email went on to say that one of the candidates whom we had interviewed for the lab tech position in Baradères died. Malaria. Yes, I remind myself. These diseases are real and real people are dying.
Subscribe to:
Posts (Atom)