An Emotional and Unsatisfying Ending...

I guess one could make the argument that I shouldn't be posting this here in such a public forum. But I think with carefully chosen language I can say what needs to be said in a diplomatic enough way so as to tell what is an important story without offending anyone.

As those of you who have been following our travels here in Haiti during the cholera outbreak know... we have been escorting a team of experts from the ICDDR,B (a team from Bangladesh with years of cholera expertise). They arrived on November 15th and their commitment was that they would stay till the 7th of December. They would remain supported by our Project HOPE team of staff and volunteers in terms of lodging, meals, security and transportation throughout their entire stay. Their role was to assess the cholera situation on a number of country wide levels, perform training where needed and collect cholera sample for culture and sensitivity.

The trip was going very well even though our travels had been somewhat hampered by the election events and political unrest and the occasional riot due to the cholera epidemic. The team was making a huge impact with their training and expertise at every site they visited to include 5 major cholera treatments centers and hospitals. Their lab personnel had been accommodated at the national lab in Port Au Prince and were getting their necessary work done. All of the team's needs were being met and they seemed satisfied with their work and the outcomes of it. We all believed they were making an impact and were pleased.

Having been invited here by the Haitian Medical Association (AMH) one of the members of the AMH asked the ICDDR,B team to attend and help sponsor a conference for the AMH and other partnering organizations to review the team's findings and recommendations re the cholera epidemic... a much needed wrap up to the work they had done here. Without such a wrap up to bring closure to their visit and review there findings it negates one of the very purposes of them being here.

That said... the Project HOPE side of the team had started to hear rumblings that the team wanted to redeploy home early because of concerns about safety surrounding the Haitian elections... but the date of this important conference was in a state of flux due to the availability of an appropriate venue and having to work around election events. Without going into the minute details it became clear that the team was not only going to redeploy early but they were all going to leave without leaving appropriate representation from their team to present at the conference. Initially the team seemed unwilling or unable to articulate why this was. They were presented with a heartfelt and impassioned in person plea from a representative of the AMH but to no avail. They were unwilling to budge from their stance due in large part to their leader who seemed to lead by dictatorship and not democracy. I know if the individual members of the team, whom I liked very much, had felt like they had a voice there would have been more than one team member that would have stayed.

Each of these individuals is well thought of in their field, were well thought of as people and experts by the Project HOPE team and worked hard for Haiti while here. But to leave such a mission so prematurely without the appropriate closure having been asked by the AMH and others to stay I believe is an injustice. The leader of this team in my personal opinion, and it is only that, had his own agenda from the start and in the end didn't speak for the entire team.

Having worked this hard by their sides on behalf of helping Haiti navigate through this cholera crisis, their first ever, it is heart wrenching for this to be the end result. It was a slap in the face to the team that worked so hard to support them, it was a slap in the face to the AMH and to Haiti, and it was a slap in the face to Project HOPE. For an organization whose mission it is to help in times of cholera epidemics in the most austere environments world wide it was quite shocking to have them leave so abruptly without any well founded grounds to do so... shocking indeed...

Thanksgiving Guilt...

You can't spend much time in Haiti without feeling guilty for the things you are privileged enough to have in your own culture that aren't readily available here in Haiti. Most of all in this situation clean water and access to safe food sources that don't cause disease or illness. Being here in Haiti on Thanksgiving is all the more poignant  when everywhere you look there is need, there is suffering, there is poverty. On an American holiday where the emphasis is gratitude I cannot tell you how exponentially more grateful I am for everything I have in my life at home. Remind me never to complain about the strange taste of the water in DC, or the smallness of the living space Frederick and I share, or the "challenges" I face in my life. I don't know nor have I ever known the challenges the average Haitian suffers through on a daily basis. These pictures represent some of those challenges. On the top left is a Catholic brother we met on the cholera ward in Milot. He helps run a home for disabled orphans 10 of whom were admitted with cholera that day and one of whom died. He does his work in this austere environment happy, lacking resources and without complaint. There is truly a lesson there!

As political tension rises before the elections here Sunday and the cholera epidemic keeps a steady pace it is an interesting time to be here in Haiti. Thank you to all of my family and friends for supporting us being here. We love you all!

Love in a Time of Cholera

OK – I know it’s hokey but I couldn’t resist… I used it… G. G. Marquez would probably not be pleased but it really does apply here. There are many great privileges to working here in Haiti during the cholera outbreak most notably the capacity to feel like you are helping make strides towards even some minor improvement is wonderful… but an added benefit for me is being a witness to my husband Frederick at work. We are a great team and our skills complement each other well but Frederick is a master organizer and motivator and to watch him in action is inspiring. It inspires me to be better at my craft. I learn from him every day as he reaches out and makes contacts in this harsh and austere environment. At his hands we have reached more than 450 local staff for training on cholera diagnosis and treatment and when you consider how many people each of those people will be able to reach out to and impart the same information the impact is exponentially greater. We have done hands on training with doctors and nurses due to his planning and have been a witness to lives being saved directly because of these interventions. He is a wonderful, smart, hard working humanitarian and I am so lucky to be able to share my life and work with him! Truly love in a time of cholera…

Can You Blame Them for Being Scared

When you hear reports of family members and members of the community dropping off patients outside of health clinics or hospitals like this little guy and left to die for fear of contracting cholera your immediate reaction is judgement. How could they do that? Why would they do that? But as I reflect over these last several days I have softened a lot. The people of Haiti are truly scared. They have never had cholera before and have never had reason to know about how it is transmitted or how it is treated. They have never had any reason to know that it is easy to diagnose and treat if the proper treatment is started immediately. All they see is their loved ones and community members perishing rapidly before their eyes. They have never had any reason to know that you can only get cholera from contaminated food or water and so it is natural to assume all kinds of things about how you can get this treatable but deadly disease. The ICDDR,B team we are here with is hoping against hope that a little education about diagnosis, treatment and prevention will go a long way towards alleviating some of these fears.

With the presidential election approaching next weekend and tension mounting in Cap Haitien and Port Au Prince about who is potentially "responsible" for the cholera outbreak it is a tense and tenuous time for Haiti. One that I fear will get worse before it gets better. But the people of Haiti are strong and have withstood a lot over the last year and years previous so I can only hope they will come out on the other side of this disaster stronger for it.

ICDDR,B Saving Lives

After two full days of training in the Southern city of Jacmel the ICDDR,B team and Project HOPE volunteers moved West to the coastal town of Les Cayes. Their assistance was requested by Dr. Mbassi of the International Medical Corps (IMC). Although reports from Port Au Prince did not include Les Cayes on the map of cholera outbreaks the team found a very different scenario upon arrival bringing to light one of the greatest challenges of this cholera epidemic, under reporting. In a country that lacks the appropriate communications infrastructure for the reporting of morbidity and mortality statistics the true number of deaths due to cholera as well as the number sick or hospitalized is difficult to estimate.

The ICDDR,B and Project HOPE team spent the day in Les Cayes training doctors and nurses at the Hopital Immaculaee Conception Des Cayes (HIC Cayes) bringing their three day total of training sessions to a total of 11 classes and more than 150 participants. They have reached a wide audience thus far training people not only from local hospitals and clinics but from organizations that range from Save the Children and International Medical Corps in country staff to United Nations peace keepers and UN physicians.

After completing the training session at the hospital the team spent the day in the cholera ward led by Chief Medical Officer Dr. Jean Baptiste Glardimy to assess further training needs and treatment gaps, do hands on training with local staff and assess the patient care area for appropriate handling of cholera patients. The conditions the team found were startling to say the least. According to the medical director for the hospital, Dr. Marie-Josette Calixte, supplies and basic resources are in short supply creating unnecessary challenges for staff. Supplies such as Ringers Lactate, the primary intravenous fluid used to rehydrate the most severe cholera patients, Clorox and chorine used to disinfect patient care areas and drinking water, and the oral rehydration solution used to rehydrate all cholera patients are difficult to come by due to supply issues out of the capital Port Au Prince. An additional challenge is the lack of local staff able or willing to work in the cholera patient care areas. Throughout the day Dr. Glardimy was the only medical officer servicing all the hospitalized cholera patients and there was one ward nurse assigned to the area.

When the team first arrived on the cholera ward there was a cholera patient who had died and was wrapped in a sheet on the floor of the ward waiting to be taken to the morgue. In addition, there was severely ill young woman with an IV that was not infusing who according to the ICDDR,B staff was within minutes of dying had nothing been done. A severely ill cholera patient can die within hours if they don’t seek and receive the right treatment. The team was able to start a new IV and after 3 liters of IV fluids the young woman was able to sit up and start sipping on oral rehydration solution.

Later that afternoon as the team continued treating cholera patients a young woman rushed into the ward with a 3 year old Haitian boy wrapped in a blanket. She was the child’s neighbor and while watching him had witnessed his rapid decline so she rushed him to the hospital. When the boy was placed on the cholera cot for rapid assessment he was unresponsive to stimuli and his eyes were sunken in from dehydration. Within minutes the team had placed an IV in the young boy and were infusing the first of the life saving Ringers Lactate solution. By the end of their shift there at the hospital the team witnessed the little boy sitting up and laughing and sipping on oral rehydration solution. This only further reinforces how easy to diagnose and treat cholera disease is and how rapidly a patient at the brink of death from dehydration can make a turn around. With the proper resources and staffing hospitals and cholera treatment centers like Hopital Immaculee Conception Des Cayes can save every life that walks through their doors.

Fear, Confusion and Suspicion...

This lovely slide was given to me by one of our Bangladesh team members. Hard to believe this microscopic little bugger can kill someone who is untreated in a matter of hours.

Two days into our mission and things have gotten interesting... When the team from Bangladesh landed Monday to lend us their expertise our original plan was to head north to one of the hardest hit areas in Haiti. Cap Haitien is a city on the Northern coast of Haiti that has the highest death rate of any region currently at 7.5% with more than 1,500 hospitalized and 119 deaths thus far. However this plan was foiled by the outbreak of violence and protests in Cap Haitien. Ground traffic was halted by road blockades and commercial and private airline traffic canceled flights in and out of the city. The residents there are angry because they believe that the outbreak of cholera can be blamed on a Nepalese contingent of the UN that has an installation there. Cap Haitiens claim the Nepalese UN peace keepers dumped untreated sewage into the water supply there. The UN denies this claim. Lack of understanding of spread and transmission of cholera impair the capacity of Haiti to appropriately treat those most severely affected by the disease leading to the high death rates. There are reports of families and even physicians and nurses not wanting to touch cholera patients for fear of transmission delaying or even preventing life saving treatment.

Catching a break...

Okay, so it's high time Haiti caught a break. Earthquake, hurricane Tomas and now a cholera epidemic... The latest from CNN says the death toll has risen to more than 900. I feel very fortunate to be able to join my husband Frederick there to help out. He is there trying to coordinate the efforts of a team from the International Center for Diarrheal Disease Research from Bangladesh (ICDDR,B). Hopefully with their expertise along with the help of USAID and the CDC the Haitian people can get some much needed hope and relief.

Update on Jonny D!

So those of you who have heard anything about my time in Haiti you all know what an impact our little patient Jonny D had on all of us. Thanks to my photojournalist friend who sent me this link (I have attached to his name above) I have finally gotten the most recent update on his status. It is an inspirational read for sure. I had known that he was adopted by a family in Texas but this article brings even better news about his condition. As Haiti struggles with even more trauma with the recent cholera outbreak - it's hard not to think back on all the folks we met there and how they might be struggling through... Hold a good though for Haiti once again!

Full Circle

Frederick and I recently had the honor of participating in the Project HOPE Spring black tie gala at the National Building Museum. The thrill for me was having the privilege of seeing one of my little patients again from my time in Haiti. I had done a post here on the blog about Dave while in Haiti - he was an inspiration then and continues to be. He is a double amputee and suffered severe facial fractures. He and his father were honored guests at the gala and in this photo were brought on stage after his inspiring story had been told. Dave and his father are currently living in Boston where Dave is getting much needed plastic surgery to reconstruct his face. He will eventually be fitted with prosthetics and will be given the appropriate therapy to go along with this new way of life. His smile still lights up a room and at 8 his positive attitude is truly something to emulate. The generosity and caring of the Mass General medical community in Boston will offer Dave the opportunities he needs to succeed after having lost so much. Please keep Dave and his father in your thoughts as they embark on this epic journey towards recovery. To continue following Dave's story and others like it or to donate or volunteer please visit Project HOPE's website for more information.

And by the way, I never need an excuse to dress up an enjoy and evening out with my honey!

Reunion With Jonny D!!

So I have good news and I have bad news. The good news is we found Jonny D (or John Doe as he was originally referred to on the ship). The bad news is they changed his name.... again! Now they are calling him Job. If he wasn't confused about what his name was before he sure is now. But at least it starts with a J and quite honestly as long as Jonny (Job) is getting the love affection and attention he wants and needs I don't think he much cares what he is called. So we spent the better part of a day tracking Jonny down having had some loose idea of where he was and had been discharged to from the ship. He is at the facilities run by the Mission of Hope Haiti (ironic that they too have "hope" in the title). They are an NGO that has been in country since 1998 and do a variety of different things. They are a faith based organization so there is a church ministry there. But more impressive is they have a hospital that has a 24 hour ER, dental services, surgical services and patient wards for peds and adults. They also have a clinic that is open 5 days per week and sees about 60 patients per day. In addition they have a school that educates about 1300 students from surrounding areas.

As we arrived I couldn't decide whether or not I thought that Jonny would recognize me but felt that since he had encountered so many people during his time on the ship he probably wouldn't and that was fine. The road out to Titanyen was long and dusty. You trek through some of the busiest parts of Port au Prince especially during rush hour which is when we departed. Titanyen we had been told had become sort of an off limits area for folks because since it is out and away from the main part of Port au Prince they have been using it for mass burial sites. As we made our way out route one you could see all the tent cities and IDP camps that had formed along the way. What suffering... and the smell along the road was the smell of the indignity the Haitian people have had to endure these last several weeks.

As the sun was setting and dusk was upon us we arrived at the Mission of Hope for Haiti and it only took a brief explanation of why we were there and who we were there to see before peoples faces lit up knowing exactly who we were talking about. He was being housed in a school room with other medically fragile patients because he was awaiting surgery the next day to clean the wound on his eye.

As we entered the room we were greeted by several "mammas" (Haitian women that were looking after the children). Jonny came right over to us but not because he recognized me but because he saw a new pair of arms to hold him for a while. We visited with the mammas and were sure to get the exact address for their location so that we might be able to arrange for follow up care perhaps even in the states for Jonny.

It was nice to see him there... a circular moment really when so many were discharged and you will never have the benefit of knowing what happened to them or where they ended up. I hope to keep tabs on him and see that he gets treatment but who knows what lies ahead for sweet little Jonny D/ John Doe/ Job... I hope good things!

It's All in Their Faces...

We were able to take our site survey north of Cap Haitien to the town of Milot where the Hospital of the Sacred Heart resides. It has been there since 1986 and is sponsored and supported by the CRUDEM foundation (Center for Rural Development in Milot) and was originally started by the Brothers of the Sacred Heart in Montreal Canada. There we were able to assess the site for potential use for volunteer opportunities. We were able to see some donations made through Project HOPE by Seimens, Philips and Dyn Global on the ground and being utilized and more importantly we were able to visit with some wonderful Haitian patients. Post earthquake Sacred Heart took what was a 64 bed hospital and added a tent city of sort to treat an additional 290 post earthquake patients.

But what struck me the most - throughout all the struggles and challenges and medical ailments you could see the positivity and joy in the faces of so many of the patients - especially the young ones. This is what will stay with me as this mission and site survey draws to a close in the coming days.

Five Languages and One Headache

After a long days work doing site surveys and sitreps in the town of Cap Haitien is was time to have a nice leisurely dinner at our hotel overlooking the water. Cap Haitien is a bustling place that's hard to navigate without a huge degree of patience. Our Haitian driver Eric has been great to us and took us on what should have been an 81 mile drive as the crow flies but took us five hours because of road conditions and got us there safely. We invited him to join us for dinner. This was a site... None of us spoke Creole except Eric our driver. Frederick and the owner spoke French. Frederick speaks German and mixes it with his French whenever he forgets which language he is speaking. Eric also knows a fare amount of Spanish as do I... and of course there is English. So five languages and one headache later we were finally able to order and enjoy a nice meal before retiring to bed to get up and do it all over again!

Beautiful Colorful Haiti

Grounded

On Friday February 26th the last four remaining HOPE volunteers debarked the Comfort to go ashore. There we were met by Project HOPE employee Matt Peterson (a great guy) and were taken to a hotel in the center of Port au Prince (PAP) where we linked up with Frederick. There we had lunch, swapped stories, and got a quick intro to what lay ahead of us. After lunch we proceeded in two cars to Deschapelles north west of PAP where the Albert Schweitzer hospital is.

There we met with the director of the hospital Ian Rawson. We were able to get a tour of their impressive facility and have dinner with the group before turning in for the night. Ian's mother Gwen Mellon and his stepfather Larry Mellon opened the Albert Schweitzer hospital in 1956. They were inspired to open the hospital by a Life magazine article they have read in 1947 about Albert Schweitzer's work in Africa. The hospital usually carries a maximum census of 80 patients but post earthquake they received 800 injured and sick patients that were cared for by a staff of approximately 75. Since the earthquake they have succeeded in opening a prosthetics lab and physical therapy training center for all of the amputee victims of the earthquake.

They will likely become a referral center for patients in need of prosthetics because of their success in getting this PT and prosthetics training center up and running so quickly. All of the people we met from PT's to prosthetics people to physicians and ward nurses are all so committed to the suffering in Haiti both pre and post earthquake. What a wonderful group of people. After our tour of the hospital and a meal with the group we settled in for the night.

We were able to sleep in the main house that belonged to the Mellon's and was designed by one of Frank Lloyd Wright's students and is a beautiful but subtle property in keeping with the landscape of the Haitian countryside.

The following day three of the Project HOPE volunteers (Sunder, Rosemary and Anne) were put to work in their respective specialties. They will remain there for the duration of most of the week supporting the post earthquake medical relief efforts there at Albert Schweitzer Hospital. Matt Peterson, Frederick and I will move on from Deschapelles to head to Cap Haitien to do a site survey to identify potential sites for future on the ground HOPE volunteer opportunities.

Good Carma

I am quite sure that this phrase in reference to Carma Erickson-Hurt has been overused because it's so true. I just seemed appropriate here so I couldn't help it. You know those people you meet in life that you are immediately drawn to... their energy, their light, their interaction with the world... well she is one of them! I had the pleasure of first meeting Carma when she was still in the Navy back in 2005. We worked on a project together at the TNI hospital in Band Aceh Indonesia post tsunami where we were helping the Indonesian military set up a pediatric ward for the first time. She is a great leader, a great clinician and has a firm but joyous way about her. I am so thrilled to have reconnected with her and hope this will be a long lasting friendship and professional partnership. She is just someone you want to emulate and I am proud to know her! Go Carma...

Change in Mission

As I have said in previous posts this mission has taken on many different shapes as it has progressed. That's part of the adventure - always needing to be ready and willing for what comes. With the patient census aboard the Comfort rapidly dropping and the Haitian government wanting to start taking over more of the medical responsibility in collaboration with the on the ground international NGO's it started to look like as the census here dropped - it would not be added to. With that in mind those of us aboard were left to wonder and wait to see what would happen and how our medical expertise would be utilized - or if we would be sent home. This uncertainty as you can imagine was met with varying degrees of angst but for the most part everyone was understanding and flexible. Those that decided to part ways with the collaborative efforts of the Navy and Project HOPE did so on their own and with the well wishes of everyone aboard. I wish each of them good health and safety as they join the mission of Paul Farmer (my personal hero) on land at the Partners in Health Hospital. The remainder of the HOPE volunteers aboard left today to redeploy back to their homes. Four of us remain aboard and are due to leave in the morning to take a boat ashore to meet a two person on the ground Project HOPE team to continue our work ashore. The mission there will be two fold. First, a site survey/ assessment needs to be done to identify sites for future on the ground work, program sites, and capacity building projects for Project HOPE. Second, three of the four remaining volunteers will be joining the efforts of the Albert Schweitzer Hospital in Haiti. As many of you know my fiance Frederick heads up these humanitarian missions and collaborations along with his employee Matt so I have the great fortune of joining him in Haiti as he heads this team on the ground. Wish us luck as we navigate new territory. I don't know what internet access will be like but will try to post again.

And He Smiles Anyway

We have another little boy that the peds team has been treating who could teach us all a lesson about staying positive in the face of adversity. He is 8 years old and due to traumatic earthquake related injuires is a double amputee. He lost the majority of one arm and a leg below the knee. The other foot is also injured. In addition he suffered severe facial fractures that took the majority of the structure of his nose. The surgical team has done amazing things to help him. Skin grafts, tending to both stumps, harvesting tissue from his forehead to recreate a nose. And all the while what does he do? Does he cry? Rarely... Does he complain? Not often... Does he misbehave with his father by his side? Never... Instead he adapts, he smiles, he charms, he rolls around in his new little wheelchair using his one stump more adeptly than I could my fully functioning arm to whiz around the unit. He races in his wheelchair with the corpsmen who have grown to love him. He marvels at the pinwheel that turns around and around as he spins the wheels of his wheelchair. He marvels at the ship as you take him top side to see his country from a vantage point he has never seen. As if the loss of these body parts and functions weren't enough he and his father have suffered incredible losses... family, home, the security of knowing what's next in life. This attitude of his has clearly been taught to him by his has father who is steadfast by his side. And this will not go without reward. He is so compelling and so charming and so much in need of complicated and long term services he will be going with his father to the Shriners hospital in Boston to get this much needed care. I have learned a lesson from this little eight year old without him ever having spoken a word to me. In times of adversity and struggle there is hope...

So Long John Doe

John Doe (or Jonny D as he became known) was here when I got here. No one knew upon receiving him what his name was or how old he was. They just knew that he needed help. He was brought to the attention of the Comfort medical team members by a local orphanage. Jonny had been dropped at their door only a few days earlier but post earthquake. He was clearly malnourished, wasn't speaking in a meaningful way, and clearly had some sort of growth or abnormality of the eye.

When the wonderful Creole speaking Red Cross volunteer translators tried to get out of him what his name was he spoke only one word and that was the Creole word for shit. Therefore he was known from then on as John Doe. Turns out Jonny has a rare skin condition that causes him to be unable to tolerate being in the sun. The growth/ abnormality of the eye was actually cancer of the eye. The eye was removed and the skin over it was reconstructed. The dental folks that came to see if they could determine his age said they thought based on his teeth he was about 10 even though when he was being dressed he was being put into a toddler 3 sized clothing! His behavior was primitive at best giving strong evidence that he had been fending for himself or had been abandoned. Slowly but surely as he bonded with staff he made enormous strides. He was initially refusing to eat and then learned he liked hot dogs very much. He would refuse to be touched or handled and eventually didn't want to be put down. We were unable to redirect his behavior and soon found that with a lot of patience and coaching he could be redirected. As he became more medically stable we were able to have two respresentatives from the orphanage come out to see him and evaluate him. The staff's concern was that since the earthquake had created so many more orphans the orphanages would be too overwhelmed to be able to take on Jonny given the one to one attention he is clearly going to need. With much trepidation and our best wishes Jonny D was released to his knew home. Many of the Red Cross volunteers who themselves have relatives in Haiti will check in on him now and again. As well as some of the staff here. One can only hope Jonny D is headed to a better life filled with love, compassion and the companionship he so desperately needs and craves...

To Amputate or Not to Amputate

The stories of hope and courage here are plenty as you can imagine. Listening to the stories of those that were here on the ground right after the earthquake hit or shortly thereafter will stop you in your tracks. Aid workers and medical personnel that were a witness to the initial onslaught of acute traumatic injuiries I am sure will not soon forget this experience. Some of our Navy medical counterparts that have been to active combat have said what they saw here in terms of trauma and injuries in the initial aftermath surpasses what they saw in combat. The number of aputations both on ground and on board will bestow upon Haiti a new generation of folks in need of prosthetics. In the early days when the Comfort was docked in site of the port Haitians were nervous about coming aboard because they viewed it as the ship where you came and lost your limbs. One surgeon talking to a group of us about some of the early surgical procedures became teary eyed telling us that he would have people roll into the OR suite to have their limb aputated (or face certain death from infection and or gangrene) and they would beg via their translator to be left alone to die rather than face being sent back to Haiti without an arm or a leg. In Haiti, life is harsh, people work hard to survive and resources are limited. The availability of prosthetics is not a sure thing especially for little ones that will grow and change and require many different prosthetics throughout their lives. This new generation of amputees in Haiti will need some special care and services from the international aid community. To have lost so much - mothers, fathers, sisters, brothers, friends, houses, churches, schools - and in addition a part of yourself so vital to your survival in an austere environment such as Haiti is almost too much to ask...

Heart Breaking Moment... A Brother's Request

Pediatrics is my specialty so that's where they have me working. As you care for these little ones you cerainly get to know them, their stories and you quickly grow attached. They make every attempt to have an escort for each patient on board preferably a family member. In this situation it isn't always possible because a patient or child is displaced or separated from their families. Or there just aren't any family left due to the devastation of the earthquake. One of my little patients (I say little because he is although he is 14) has his older brother with him. His brother is so loving and gentle and is concerned about the other 7 or so siblings that were left behind. They lost both of their parents in the earthquake. So many donations have been received on board from a variety of different sources that we are able to send each patient and escort home with a box of clothes, socks, some shoes, toys and the like. My patient's brother had received his box and you could see them both sorting through it. They will be discharged soon to a hospital on shore for the 14 year old to receive much needed follow on care and rehab. The brother will likely then be able to reconnect with his other siblings. The moment of all moments came though when after surveying what they had received in their donations box the brother in a very shy way pulled one of the nurses aside and asked if we had any tents on board he could have - when he and his brother leave the on shore treatment facility they will have no home, no shelter, no parents. And to think I dare complain even internally about my shoebox sized condo I share with my fiance. I will certianly think twice before whining about my small accommodations when these folks are working to rebuild a life for themselves from nothing.

Unnecessary Gratitude

Little Emmanuel became known as the mayor of the unit. Standing only a couple of feet tall he had the presence of a 6 foot tall charismatic man. He would wave at all the patients and staff as he made his rounds of the unit each day and when you would wave back he would often decide he would trump you by waving with both hands. He liked to snack on cereal and the like and if you came near him while eating he would try to feed you too and often wouldn't take no for an answer. Emmanuel like many other children suffered severe facial fractures and injuries that will require long term reconstruction. His mother like many mothers on the unit became like a den mother of sorts looking in on those children that weren't fortunate enough to have a family member or escort with them. The time came for Emmanuel and his mother to be discharged to an on shore facility for his follow on care. The mother became very emotional upon leaving and in Creole wrote a letter to the staff that was then translated into English.

In it she wrote, "I say thanks to God for all the good things he has done. Thanks to everyone on this ship for their help and their kindness to the sick. Thanks also for their patience from the doctors, nurses, corpsmen and everyone that has been around to show love, support and concerns. Shall God bless everyone of you and give you protection as He will bless Haiti and the people of Haiti."

The letter goes on for another page or so. I thought I was going to have to be peeled off the ground after reading it was so heart felt. But the truth is I am the one that feels grateful. Grateful to have been a witness to such courage and grace in the face of adversity and suffering. Grateful to all the Haitians that helped make our jobs a little easier by helping with the unaccompanied minors. Grateful for the experience and lessons embedded in it...

Earthquake.... Again?

Poor Haiti... they just can't catch a break... Yesterday in the wee hours of the morning yet another earthquake hit Haiti measuring 5.0 on the Richter Scale. I am still not sure in terms of the geology folks how far out from the original earthquake you have to be for something to be considered an after shock. Apparently it was felt here on the ship although I will admit that I slept right through it. Reports from the ground are that some of the make shift hospitals had to move all of their patients outside. When will the suffereing end? And then to think these poor folks are prepping for the rainy season here in Haiti just boggles the mind.... ugh...

Rumors Are Plenty

This mission is a really interesting sociology experiment. I feel a little like I am back in junior high on this mission... Who is going to sit with who at meal time... Who is pulling their work load... Which in the group is most annoying (usually a clear winner in every group). Who complains the most (or the least which is my preference). The rumor mill is churning even as we sleep. It's like we all when confined to a space together as adults regress a little bit to the awkward social behaviors of pre teens. And that rumor mill extends itself to all facets of the mission including how and when the mission will change and or end. At the beginning of the day the mission is moving to the left or being shortened. By the end of the day it's being moved to the right and being extended. One hour all NGO's aboard are leaving at the same time... the next hour there are several more options that have arisen. All in all as I have said before this is the nature of this kind of work and a large degree of flexibility is the only way to survive along with an iron clad will to resist being bothered by rumors that may or may not be true. It's a great group of folks out here both the Navy and the Project HOPE side all with the same intentions of helping the people of Haiti. Frustrations are high for some feeling as though we could have done more and while that's true the capacity building and long term efforts of Project HOPE and other NGO's like them will remain here in Haiti for the forseeable future. Hopefully those of us that felt slightly unfulfilled about the work we did here can come back and give again to the people of Haiti. That's not at all to say the we didn't contribute in many meaningful ways to some very needy and sick Haitians and we should all as a group take that away with us. I feel honored to have worked with each and every one of my colleagues here... and the mission continues on...

Much Needed Fuel

So today we are out to sea about 150 miles off the coast getting refueled. We left the coast of Haiti at about 3 pm yesterday and sailed throughout the night. This morning at about 6 am we came along side another ship about the same size called the Leroy Grumman. Some of you remember this from your days on the Mercy. The two ships sail side by side at about 13 knots (don't ask me how fast that is in people speak cause I don't know!). They are able to connect fuel lines between the two ships. The whole process takes about 6 hours. They are just now finishing and then we will set sail to head back to the coast of Haiti. We kept the patients that were on board when we left Haiti with us and surgeries continued while we were out to sea. The fate of the mission is still unclear but it's a great group of folks on board. For the most part everyone is very positive and flexible and realizes that nothing is certian out here. It's a privilege to be able to participate regardless of how the mission requirements change.

Triumphs and Challenges

So this has taken me a while to get up and running. Email access is iffy at best. I am borrowing a friend's Blackberry (yay Ellen!) cuz mine isn't working properly. We are doing some great things here and seeing some needy folks just not in the volume we had all hoped. One of the many challenges of a mission like this. I wish I could upload some photos but that would take the better part of a day! Love to all more when I can!

New Friends

Every time I do humanitarian work I am struck by the amazing people I meet along the way. This mission is no exception. Without a doubt this is a great group of folks all committed to the same thing and that is helping the people of Haiti. It is a pleasure to have met and worked with them all! Can't wait to stay in touch.

Kamp Krusty

We made the long trek from the airport to a make shift port the Navy had constructed called Terminal Verreaux (or Kamp Krusty) as someone had affectionately named it. We drove through some of the hardest hit areas of Port au Prince on the way. It was heart breaking to see the conditions people were being forced to live in. At Kamp Krusty we boarded smaller boats to be ferried out to the Comfort. Spirits were high at this point because folks were anxious to get aboard and start helping.

The ride out was wet but fun. As you approach the Comfort you are immediately overwhelmed by its size. I remember thinking that about the Mercy but we had an aerial view that time having been flown by helo...

T minus less than 12 hours...

So for those of you that know the history... this is a watershed moment for me reuniting with a field mission related to Project HOPE. My last sojourn with Project HOPE in SE Asia post tsunami brought many blessings and challenges. I was fortunate enough to meet the love of my life and fiance/ future husband there in Singapore while at the same time contracting an illness that brought me to my knees and had me reevaluating the very course of my life and career. Here I am again embarking on a mission on the sister ship to the USNS Mercy that I was so fortunate to ride some 5 years ago... the USNS Comfort will now be my home for the next few weeks as a member of Project HOPE going about the business of trying to assist another vulnerable population ravaged by natural disaster. Wish me luck... Due to be up at o'dark thirty!

A quick trip to Walmart for some tropical footwear

Who knew you could get a nice pair of flip flops at Walmart for under $3. Remind me to never take for granted access to comfortable and versatile footwear. We received another request from the field prior to departure that patients were being discharged without something to put on their feet!

Much Needed Snacks and Supplies....

So the first thought that ran through my head as I packed to get ready to go was what item or items could I take to the pediatric patients of Haiti beyond the obvious needs for food, clothing, shelter, medical care, potable water etc. and I thought - CANDY!

My next thought was what realistically, after having talked to some of the providers already there, could I take beyond candy that would make a difference and that I could carry. In comes the help and loving support of my dear sweet mother who single handedly (but with the help and support of my father) brought to me a box of supplies for the most vulnerable of Haitians to include: onesies, T-shirts, socks, pacifiers, receiving blankets, clothing, pajamas and cartoon videos to watch while convalescing... My sincere gratitude goes out to them both. I will enjoy distributing these items with my colleagues!