Au revoir

Thursday 22 July

Tuesday and Wednesday went by in a flash - Tuesday literally, as we felt the side effects of the largish tropical storm I mentioned which was heading west along the north coast of the Dominican Republic (the other side of the mountains). There was a chance that it might veer south and turn into a tropical depression which is the forerunner to a hurricane, and at the base there was some hasty refreshing of the disaster plan. We had heavy rain and some wind on Tuesday evening / night but were relieved to find the sun out in the morning - the storm had headed further north west and is now headed directly towards the oil slick in the Gulf. My flight to Miami this afternoon took a big diversion and spent some time flying towards the UK before going round the top and back to Miami. The heavy rain left a real mess and we saw, walking through the mud and puddles to the hospital, the misery that is a flooded shelter with the family's clothes and few belongings laid out to dry. I can't imagine what will happen when the hurricane season really gets under way - just hope they'll be spared this year.

Anyway, back to the hospital. On Monday morning we picked up walkie talkies from the doctors' guest house and started work just before 8. The queue for triage was already quite long and the benches outside the ER (A&E) full . Registration, triage and the parmacy are in separate tents outside the hospital ward tent (when I visited triage last week in the evening we disturbed 2 goats using the lower shelves as beds and several chickens, one with chicks, in the roof supports - still can't work out how the chicks got there). The operating theatre is empty this week as there is no surgeon here - last week a volunteer orthopaedic consultant apparently had a busy case list dealing mainly with earthquake injury complications. There is only one patient in intensive care - a good thing I guess - while the pre-natal clinic has a long queue of pregnant ladies. (By the way, the photos on this page are from a professional photographer and / or me with the staff's permission).

I spent the morning in the supply room trying to learn where things are. In earlier weeks HODR volunteers had built shelving and sorted and labelled most of the supplies - before that things were just piled in boxes and it must have been a nightmare trying to find anything. Supplies are very patchy. The general position is that there are big stocks of fairly useless things and hardly anything that is really needed. Apart from drugs, most of which are not in stock, the biggest demand is for paediatric rehydration, and the stock we had for that was about to run out. Most medical and non-medical supplies are brought in their luggage by the rotating doctors and nurses who volunteer through a small US charity, Worldwide Village. There is little possibility of obtaining supplies in Haiti through any other source. We have now arranged for the non-medical wish list to be available to incoming HODR volunteers as well so hopefully there will be an additional trickle of supplies.

In the afternoon I swapped with Pat and worked as a runner in the busy ER. There were 3 doctors, 3 nurses and 2 translators working non stop with 10 examination beds. The runner's job is to fetch and carry for the medical team and replenish what is used form the supply room or pharmacy, if it's available of course. As time goes on though, you get more involved with the cases and try to help with dressings, record keeping and so on. Most of Monday's patients were babies and young children. The most common diagnoses were dehydration, malnutrition and "failure to thrive", scabies, abscesses and infected wounds. The volume of cases (80 - 150 a day in ER) means that the medical team does not have the luxury of more than a few minutes for diagnosis and decisions on treatment for each one. This is clearly uncomfortable for Jason, the senior doctor, who is used to having time for closer involvement. As the HODR volunteer nurse Christina has been here for 9 weeks (and the hospital doctors and nurses generally rotate every 1 or 2 weeks) and has seen many typical cases, she is often relied on to help move things along.

I returned to the ER again on Tuesday and Wednesday, each day getting more involved with the patients and their families. There were a few more adult patients: several accident injuries, one TB case, a nasty burn, one earthquake injury presenting for the first time (the patient said "well it was the earthquake" meaning he survived and didn't see himself as deserving attention.

But mostly children. Two patients were babies who appeared to be a few days old but in fact were several months old - one 6 months weighing just 8 lbs. This baby girl was brought in by her grandmother who could no longer look after her. The two of them were the only survivors of a family of 14. The baby will stay in the maternity ward until she starts to thrive and will probably then be transferred to an orphanage. Many orphanage children have been left by relatives (including mothers) who belive that the child will have a better chance there. It's hard to describe the emotional impact of seeing so many children and parents in distress. Many of the mothers are suffering from post traumatic stress sydrome and desperately need psychiatric support - there are no therapists in Leogane at the moment.

I ended the day holding and trying to comfort one or two, and then bumped into Christina who had just returned from an orphanage where some of the HODR volunteers work. Of the 36 children there that she and a doctor examined, 30 were sick, all with conjuctivitis and scabies, others with a variety of problems. Christina is always smiling and laughing but she was clearly upset and told me she hadn't talked through what she has seen in that time with anyone else. We shared a crying session before we went back to the base.

My last evening required a compulsory short farewell speech at the nightly meeting. Unusually the noise of the regular evening rain shower didn't drown it out, and I ended up sharing mango juices with friends from the past 3 weeks.

Saying goodbye on Thursday morning just as the teams were getting ready to leave for their projects was difficult, and heading out of Leogane while looking forward to getting home was a bittersweet experience. There is so much more to do there. I hope I get a chance to go back.

Please call me if you want to know more - there's loads!

THE END

First day at MASH

Managed to get on the lunchtime dishwashing team then raced to the job board to grab a hospital runner spot for today, tomorrow and Wednesday.

This is the washing up process for 100+ people. There is no hot water so there is a "safe" sequence: First wash in detergent plus bleach, then rinse in strongish bleach, then finally dip in a mild bleach solution, and leave everything in racks to air dry. Surpisingly seems to work but the cooking pans take a bit if work. Lunch w/up takes about an hour and evening a bit longer usually.





So off to the hospital this morning with Pat, the other runner, Christina, a volunteer here who is an almost qualified nurse, and Caitlin, another volunteer who is training as a pharmacist. Pat is 68 and, with the recent departure of Bob (71) and the HODR founder David Campbell (68), Pat is now the honorary head of the Old Geezer Club.


The dirt road leading from the main (dirt) road is lined with temporary shelters. Christina has been here for 9 weeks so is well know in the community living in them, and we get a great welcome, especially from the kids...as you can see:























and after picking up some walkie talkie sets from the doctors' guest house, we head to the hospital tents (after hours picture).








More later - thunderstorm approaching so have to unplug everything!

Roof almost finished - the evidence

First, a puzzle: what's unusual about this picture?



















So, almost finished - hot enough to fry several eggs


















Yep, this is Chris, the man with the titanium leg.

Cat on a hot tin roof

Friday 16 July

The country community around the school seems lucky to have a really caring and popular young pastor (Evangelical of some sort) who lives with his wife and family in 2 rooms each about 10 foot square. We also store our generator, cement and nails in there. His wife cooks our lunch every day. HODR supplies the rice and beans, and they supply everything else - it's always been delicious - and there's enough for the local young men and a couple of older ones - all unemployed - who supplement our team, and embarrass us with the speed they learn and their stamina. Francois, an older man, is a carpenter and as skilled as the 3 we have in the team, but he also saw me sweeping up the inside yesterday and quickly grabbed another brush and joined me. The bulk of the community live in tents and other shelters. Some of the older children go to the main road and on to Leogane to school in the morning while the younger ones seem to help with the smallholdings. In the afternoon most of them are watching us and playing around. We play football with them as we're waiting to be picked up.




This week so far we have put on and fixed the roof trusses. fitted wooden louvre windows (no glass) and ventilation panels, run wire mesh around to take a cement render, packed underneath the frame with concrete and then started putting the corrugated tin on the roof. The concrete packing was my main job for a couple of days and was needed because the slab was 5 inches lower at one end. There are no laser levellers and the foundation team had to use short spirit levels and a water level, or at least that's their excuse.

The concrete has to be hand mixed with poor quality sand that has to be sifted first, and goes off very quickly in the heat. Can't remember if I said, but contrary to expectations, it seems even hotter in the country. It may be that the vegetation traps the heat and raises the humidity. Yesterday 10 of us got through 15 gallons of water.

Yesterday and today we have been fitting the tin roof - now I understand the Tennessee Williams title. It's thinner and lighter than corrugated iron andhas a shiny finish to reflect the sun. I've been trained as a tin monkey, climbing around the trusses nailing down the sheets. My partner today was a young New Yorker, Angie, who is an actor and also writes children's books and has offered to show Janet and me around when we get to NY in September. We should finish the roof tomorrow so that a new team can start the rendering. Although that is still to be done, and the doors fitted and the furniture installed(built at base), it still feels as if we will be leaving a finished job tomorrow.

Last night I managed to fit in my hospital orientation visit so that, if I offer to do the dishes quickly enough on Monday morning, I can sign up as a hospital runner for my last 3 days. Remember MASH? Well the hospital is 2 side by side H shaped tents with a central corridor and each leg is a ward or supply store. There are A&E, maternity, medical, intensive care wards and an operating room, in use when there is a surgical team resident which is not all the time. More on this next time, but understandably no photos.

Less than a week left so off for an ice cream now.

Back to "The Pines"

Thursday 15 July

By doing the washing up on Saturday I was able to jump the queue to join the school building team on Monday and arriving on site has brought back memories of building the bungalows in Fareham in the late 70s. We could certainly do with the tools, equipment and materials we had then.

We leave early (load at 6.30) and stay all day, returning at about 3.30. This is the 3rd school so far. And while I remember - for those of you who gave me cash to bring here - I've put it all towards school no. 4 as a rich American has been matching all the money donated for school build, so altogether we've added around $1000 which just about completes the $20000 needed for the materials for each one. Most of the cost is timber and cement. Over the years, Haiti has been almost completely de-forested to make charcoal for cooking so all timber has to be imported. the other effect is that much of the soil in the foothills has been washed away leaving large scars of bare rock.

This school site is in the countryside outside Leogane, about a mile down an unpaved track (fun after the almost daily heavy afternoon showers. It feels a long way out of town. No traffic, healthier(ish) animals including some turkeys, a mix of largish fields of maize and tiny smallholdings.

More on the school build next time - thanks for watching this space!

More on wildlife

More on rubble

http://www.nytimes.com/2010/07/08/opinion/08desroches.html?ref=opinion

Sunday 11 July

With a final push we finished the kindergarten rubble clearance yesterday morning. As we ran out of tipping space, we were wheelbarrowing the last rubble across the main road. Sounds dangerous, but there was always one of us watching the traffic. Drivers always hit the horn hard whenever they see any activity in front of them and most traffic is slowish. The fastest cars are the 4wds, many of them owned by the UN and other agencies.

As we finished, Jackson and his wife and 3 sons (just his eldest here)arrived with 2 cakes and a long speech - it was emotional for everyone and we all felt quite sad as we set of back for lunch. We tried to explain to him that we take much more away from Haiti and the Haitian people than we give, but for him the thought that people are prepared to travel across the world to clear his rubble is just too huge. I'd like to see whether it would be possible to set up some sort of link between the kindergarten and one of our local junior schools.


Just for the afternoon I signed on for yet more rubble, this time at a residential site more in the countryside. For some reason, I'd expected there to be less damage in the country but actually it's just the same. I don't know whether it would have been more or less terrifying to have been out of the town when the earthquake hit. I would guess that any rescue work would have been much slower.

A treat last night. There were several people leaving and they clubbed together to buy all of us (125) an ice cream at the bar next door which has a rare American ice cream machine. Vanilla or pineapple heaven, especially with a little cane sugar rum over the top.

There is a constant turnover here as people sign up for anything from a week to several months. "Long termers" are virtually staff as they preserve the institutional memory for the project and usually take the lead on projects. Found out about another interesting one yesterday: two volunteers returned from 5 days on the coast north of Port au Prince being taught by a Canadian couple to build domestic water filters. These are simple and made with concrete moulds and then filled with gravel and sand layers, and can effectively filter the worst contaminated water at about 5 gallons an hour with help from microbes which (apparently) join in the fun a day or two after the process is started. The 2 volunteers brought back some sets of moulds and the plan is to start building the filters here. The cost is almost all labour so, with volunteers doing the work, these will be very cheap to produce. The objective is eventually to hand over the whole operation to a local organisation to carry on.

I talked to David Campbell yesterday about HODR's history and about the theoretical difference between disaster response and development. The growing demand from volunteers means that he (and the HODR board) see HODR doing elements of both in its unique style, and Haiti is beginning to provide the test bed for this. He is a very easy person to talk to and personifies the characteristics of most of the staff and volunteers here too. He looks younger than his 68 yrs - quite an achievement to set this up at 63.

Well our day off is disappearing fast. The remaining 3 wrinklies (we lost 1 leaver this morning) repaired some bikes and spent an hour riding slowly and carefully around town. There was a hope that the bar would have a TV set up for Spain v Holland but unfortunately (or fortunately by the sound of it) that didn't happened so I'm writing this instead. Next up, a read and a nap I think.....
Part of the work supporting the operation of the mayor's office - fairly basic stuff as you can see, but valuable and (now) highly valued.

Friday 9 July

Kindergarten site still not quite finished, but we definitely expect to wrap it up tomorrow - some other teams think we have been swinging in hammocks all day, drinking iced beer and so on. I wish!



We had more wildlife visitors today: another tarantula popped out of a hollow concrete block, a small snake arrived and left, and so did a puppy from next door and a handsome cockerel.

The schools coordinator for HODR has been trying to facilitate a frame tent building for the kindergarten from another NGO. Meanwhile the owners, Jackson and Nicole are so pleased and grateful for the runbble clearance. He paid $US600 to have an area about 15' x 10' cleared by a private contractor before he heard about HODR - probably best part of a year's income for them -and the was quoted $US20,000 to clear the slab. There is no way they would have been able to find that sort of money. Their gratitude and the children make us want to make sure we live it ready for their new building, however temporary.

Jackson and his neighbours have been very friendly and, having watched us clear the site, one neighbour has realised how much can be done with a few tools and some manual labour and has now started on their own home. Although mostly very friendly to us, Haitians can be quite volatile to each other. Arguments are held at the top of their voices and look as if they about to erupt into violence. the local community tends to gather round and join in the shouting too

The timber frame for the school I mentioned before was completed back at the base here in a temperature measured at 115 degrees in the sun, and has now been shipped to the school site, courtesy of the UN and some of their Sri Lankan soldiers. The outer walls were erected today and the roof goes on tomorrow. May sign up for this next week.

The nightly meetings here, which everybody attends, review the day's work and give team leaders the opportunity to sell the benefits of their projects for tomorrow. "All day fun", shade, food / drink presents from the local community, "loads of sledging" are popular selling points.

I continue to be very impressed by the people here: staff, long term volunteers (many here since February / March) and short termers too. Energy, intelligence, common sense and a huge sense of care for the Haitian people and their situation. You can see how closely they relate to the local Haitian volunteers as they work with them.

HODR's founder, David Campbell, arrived here last night on his 6th visit. I can see, from the little I've seen of him so far, the same characteristics that the volunteers have. It would be good to get some time to talk to him at some stage.

Wednesday 7 July

Hey guys, I've been here a week already, awesome. The groundhog day routine of eat, work, drink, eat drink, work, eat, drink, shower, read, fall asleep.... means the time flies by although as you can see I'm picking up the local lingo.

Sunday gave me a bit of a chance to venture out of the compound to see more of Leogane, partly to avoid the enthusiastic Independence Day celebrations by the US contingent: "Star Spangled Banner at 7am, American "sports" all day, pig roasted in a pit (skipped that, but the potato salad was good) followed by a lively evening until the generator shut down (10pm every night).

The damage to houses, public buildings, roads, drainage etc still astounds me. The only public space, a small park in the centre has been ruined by emergency activity and one of HODR starting projects is to facilitate a clean up and replanting exercise. Most people are still living in temporary accommodation - tents, lean-tos, corrugated iron shacks, some still in the road. Those houses that are still safe to occupy have damage which leaves them vulnerable to the frequent heavy downpours.

But life goes on. It's always surprising to see schoolchildren and young women beautifully dressed in bright and clean clothes in poorer countries, but particularly here. I don't know how their mothers manage that. There are lots of small roadside businesses - clothes, food, tarpaulin "cinemas" (a DVD player and TV with a few chairs) and a popular lottery. And as always there are people making real money out of the situation. Anyone with a JCB is making a mint.

Every day I seem to hear about some new projects going on. There are 2 demonstration composting toilets on site and the Haitians are being shown how to build them and the benefits. There is also an English engineer volunteer who is training locals in assessing the state of houses and giving the owners advice on what to do next.

Monday to today I have stayed on the kindergarten project which we should finish tomorrow. This morning's team of 12 represented 8 different countries: US, Ireland, England, Israel, Haiti, Slovenia, Oz and NZ. Jack, our grizzled Vietnam vet ex- courtroom lawyer and regular leader had to miss this morning. He was bitten by a spider in his tent on Monday night and had a growing blister on his hand by the end of yesterday. They cut it off in the local hospital and he was back this afternoon. Moral: forget the tent option, take a top bunk (see above).



More tomorrow, internet access permitting. Frequent thunderstorms knock it out from time to time. Any questions? I'll be testing you when I get back.

Sunday 4 July

Arrived here Thursday. From the air Haiti looks the idyllic island in the sun, like the Bahamas and Cuba as we flew over them. But as you get lower you can begin to see the enormous clusters of tents and shelters, and as the plane prepares to land the scale of the destruction and chaos in Port au Prince is staggering.

Getting out of the airport has similarities with Bombay 15 years ago!. Fortunately we're not working in PAP, but in Leogane about 20 miles away. The "shuttle" from the airport takes 2 hours to cover that. Leogane is (was) a town with a population the size of Swindon - 30,000 people died in the quake so it's now a bit smaller. 80% of the buildings have either collapsed or are totally unsafe. It's hard to imagine what it must have been like here immediately afterwards. 6 months on it's hard at first to see that there's much recovery in progress, although most people seem to have shelter of some sort. Just hope the hurricane season passes Haiti by this year.

The HODR base is a bit like a PGL camp complete with the smell but without the PGL refinements. Most of the 125 people here are strapping 20-30 year olds with a smattering of less strapping middle aged people of all sizes and a few of us wrinklies - the current oldest member is 71. 100 or so are volunteers with a few paid HODR staff and also some local non-resident volunteers. As well as the majority Americans, so far I've met some "awesome" people from Canada, Tazzy, Phillipines, Vietnam, Ireland (father and daughter), Scotland (father and son), 2 people from Oxford and one from Blandford.

Friday was straight into work. There is an impressive range of projects in progress but most of us are on "rubble", which generally means demolishing a collapsed building back to the original slab. The project I signed up to is a kindergarten which is trying to cope with 60 3 to 5 year olds in an area smaller than our garage and covered with a tarpaulin. Friday was the hardest days work I've ever done in my life, shovelling, pushing wheelbarrows, sledging concrete and cutting out reinforcing bar. But seeing the children there every time you stop keeps you going. I'm going to stick with this project until we finish it sometimes next week, then try something else.

Some of the other projects are:

- foundations and timber frame building for school no. 4
- digging trenches for a clean water supply (all clean water comes in by tanker or in bottles)
- teaching teachers how to deal with disasters and fallout (e.g spotting children's trauma symptoms)
- mapping the town (there were no good maps even before the quake) and marking where the 200 schools in the area were or should be. Then contacting the schools to try to find out what state they are and what is needed
- working with the hospital as runners, admin support, etc
- driving 2 bulldozers to help shift the rubble ( I fancy having a go at that)
- teaching English to the local volunteers and mentoring them so that they can apply for jobs
- organising after school clubs and play
- helping the mayor's office create some civic order and system

and more.

The amount of work reported at the end of day meeting is very impressive.