Port Salut

I don't want to give anyone the wrong impression, that I am spending all of my time at the hospital. This weekend, my girlfriends and I headed to the beach at Port Salut with Wilfrid (my wonderful driver). We were able to do this because I'm lucky enough to have a car.

Because Haiti is both an island and poor, there are very few cars in the country. This means even if you can afford one, there may not be a car available to buy. My organization spent months waiting for my rental car, a 2010 Ford truck. It's one of the few cars in Jeremie, and newer than most.

The drive takes about five hours or more on rough roads through the mountains and past Les Cayes (a town big enough to have a stoplight. We were shocked by this).

Port Salut has what is reputed to be one of the best beaches for a holiday. Pictured above is Jonathan. He was sitting in the water and doing small backwards flips into the waves. I complemented him on his gymnastics and he proceeded to fish about 20 tiny clams out of the sand for me.

After our day on the public beach, we headed to dinner at Dan's Creek, a hotel that is startlingly like a resort you might find anywhere else.

An Ordinary Day

My main responsibility here in the Grand Anse is to make sure that three hospitals in the region are testing children for HIV when they are four weeks old, and again when they stop breastfeeding. Any child who tests positive and is under the age of two years can automatically receive free antiretroviral treatment – as long as they have someone who can be trusted to bring them for monthly appointments and give them their medication regularly. Irregular use of ARV treatment would be dangerous for the child’s health as well as a waste of funds.

In the case of one orphan, the person responsible for his treatment is me. It surprised me that we were going so far to make sure each child gets treated. But Samuel lives with a charitable mission, and the hospital did not think the nuns would be able to bring him regularly. So Friday, I went to take Samuel to the pediatrician.

Samuel goes to the public hospital in Jeremie, a place where “it doesn’t seem possible anyone could get better there.” Rickety, rusting beds are jammed together in the pediatric ward, files are kept in gigantic paper registries, confidentiality is questionable. Folding chairs are spray painted on the back “PEPFAR” – gifts from the U.S. government.

Despite the fact that the physical appearance of the hospital is depressing, I really enjoy being there. Many of the staff are sharp, competent, and warm, which is a miracle. In particular, the health agents (you can identify them because they wear kelly green pants or skirts), are very cheerful when I arrive and shout hello to me across the waiting room. The social worker is particularly insightful, and he is very invested in the well being of the patients. And the pediatricians.

The pediatricians fascinate me: two very pretty, very professional young women. In this drab setting they seem glamorous. One of them entered the room with a red flower neatly arranged in her hair. The new pediatrician was wearing a low cut red floral dress with a black ruffled shirt unbuttoned over it. They speak to me in French and to their patients in Creole. (Except once when Dr. Saint Fleur said softly, in English: “Michelle. You are very quiet!”)

Like everywhere in the world, people wait patiently for the doctors to appear. There are just fewer of them here. They sweep in, do their job, and exit.

“Bonjour Michelle.” Dr. Narcisse Nadege greets me. “Is his infection any better?” Samuel has a bad ear infection, and she uses cotton to swab goo out of his ear with a worried expression. In the middle of Samuel’s appointment, her mobile phone rings. She speaks in fast Creole. “Did you put him on oxygen?” she asks. When she hangs up, she pauses. “Michelle, excuse me. I will be back in ten minutes.”

I bounce Samuel on my knee but he always keeps the same serious expression on his face, as if he knows what’s going on.

Ten minutes later, Dr. Nadege returns. “Is everything ok?” I ask. She shakes her head.

The child had died. “It’s sad.” she says to me.

I watch her calmly continue her work. I realize that there is nothing unusual about this day for her. I can’t imagine what it’s like to be her.

A Haitian Orphanage

There are three orphans who live at the hospital. By “live,” I mean that they have tiny cribs in the corner of the pediatric ward, and I assume they get some kind of food. One of them is a six year old girl who sleeps in a crib that is barely long enough for her body.

I don’t know how long they have been there. They are wards of the city. My NGO identified an orphanage near Port-au-Prince that would accept them if we can get permission from the city of Jeremie to release them.

I was asking for help from the hospital social worker when I suddenly realized that my concept of “orphanage” was not the Haitian concept. To me, an orphanage should be a place that tries to find families that will adopt its wards.

“Fedy, we would like to move the orphans to an orphanage, near Port-au-Prince.” I explained in French.

“Ahh!” he smiled gently. “A place where they would be able to give the children better attention, more care?” he asked happily.

I shook my head. A place where they might get to live in a home with a family, I explained to him. My head was a mess of creole and French, so I tried to remember the word in English: “ADOPTION.”

Adoption does not exist here. There are not enough parents for children. “So, in the United States, a woman can choose to adopt a child instead of having her own child?” Fedy asked me. Exactly. It wasn’t until that moment that I understood why those three children were just living in the hospital. No one liked it. No one believed it was good for them. The pediatricians wanted to help the children. But people do not adopt other children here -- my idea of an orphanage didn't exist.

In Haiti, Fedy explained to me, many children are said to be “without fathers.” I've met numerous women have children from different boyfriends. Abandonment of their children is widespread, commonplace. To the extent that parliament is trying to pass a “responsible father” law.

“What are they going to DO!” I asked Fedy. “Make them pay a fine??” I raised my eyebrows at him. “It’s in parliament, they are still working on the law.” He reassured me. “Mmm, Fedy, and who is going to go find these fathers and enforce it?”

We’ll see what happens, if this law gets written and passed.

Anyway, before the hospital will write me a letter allowing me to leave with the three orphans, I need permission from the UN military. I have been waiting for someone from the UN to arrive at the hospital so I can get the kids released.

“Michelle, MINUSTAH.... they are never going to show up. You have to go to the office of the UN Military. To get permission.”

“And I just walk into the UN office and ask who is responsible for these kids? Who do I ask for?”

Fedy shook his head at me. “Just go.”

Trying to find someone from the UN who will admit to having any responsibility for these children is going to be a nightmare. I am going to be shuffled from desk to desk, until I am unable to continue speaking French. I just know it.