After noticing that a rather large number of patients have been getting blood transfusions lately, I wandered down to the lab and asked the manager, Salah, if there was a need for blood here. He replyed in the affirmative, citing a need for type-O in particular. (I am O+.) I was working at the time, but promised to come back after my shift to donate.

During my shift, I tried to encourage my collegues to donate as well. Unfortunatly, Palestinians seem to be as lame as Americans when faced with the idea of voluntarily going under the needle, and I didn't get any takers. However, at least the excuses where different. Rather then citing a colorful recent sexual history, most stated that they could not donate during Ramadan, that thier hemoglobin was too low, or that women couldn't donate.

I actually didn't think that I would be able to donate myself, as my hemoglobin is generally through the floor and I have been joing the rest of the hospital in the Ramadan fast. But I guess that a diet of yellow rice and chicken is high in iron, because I was actually in the double-unit bracket (although I only gave one.)

I did warn them about recent travel to Haiti (which is a rule-out for America because of the risk of malaria) but that was not a problem. Which basically drove home my insistance that although I am happy to help treat the people here, if I need any real medical care I am heading over to the Israeli side faster then you can say "gesundheit".

JessicaI have been in touch with a young lady named Jessica who has spent the last few weeks in Gaza, and I was happy when she gave me a call, saying that she and another volunteer, Emmett, were in town and were hoping for a visit. They were involved in an Art Exchange in Gaza, where they worked with art projects with the kids there, and exchanged the art with other kids in the states.

Unfortunatly, I had to work that night. I did manage to sneak away-- I wanted to smoke shesha with them, and smoking during the day on Ramadan was not allowed. I had suggested to then that they visit the night market, but we found out that was closed. I was shocked-- 2AM shopping was half the fun of Ramadan while I was in Yemen. However, the Israelis did not allow shops to be open at such a later hour. So with only about 8 hours that one can eat, Palestinians can still only shop during less then half of those. (Another blow to the economy.)

Jessica had actually been in Palestine about a year ago and knew more about Hebron then I did. Emmett had not been, so the next morning we had breakfast in my room and then headed out. (As it was Ramadan, I had snagged some food during my overnight shift to store in my room, where we ate away from the eyes of fasting Muslims.) We walked to the old city, where we were approached by what I call an "impromtu tour guide". Seeing that we were on the way to the Cave of Ibraham, he told us that it was closed, but that he would show us around.

People come to Hebron for two reasons-- to see the Cave of Ibraham, and to see the occupation. As most visitors to the Cave are Jewish and therefore stay in the settlements, any westerners that can be found in the old city can generally safely be assumed to be examining the effects of the occupatiuon, as we were. Our tour guide, Ibrahim, was well aware of this and basically started to give us the tour without asking. It's hard to say "no" to someone whose schpeal basically starts with "come and see what terrible things have happened to our city." To say "no" sounds like "I don't care".

Ibraham was a great guide. His "specialty" seemed to center around the different art and graffitti that can be found around the settlements, as can be seen here. The most shocking, of course, was a door that proclaimed "Gas The Arabs JDL" (JDL stands for "Jewish Defence League".) which made me both angry and highly confused.

Shada Street

Palestinains on the left, Isrealis on the rightThe roads that are around and in the settlements are often segrgated,with some roads allowed for Palestinians to walk on, and others restricted. (There are also areas where Israelis are not allowed to go.) There is even one street, Shada street, where a divider through the center of the road seperates the area that Palestinians are allowed to walk from the areas where Israelis are allowed to walk. (Only the Israeli side allows cars, in general Palestinians are not allowed to drive in the Israeli-controlled areas of "H2".)

Our tour ended with a walk through a beautiful Arab Graveyard and a stop at a subterrian lake which Abraham and Sarah supposidly washed at at one time. Washing in it yourself was supposed to be good luck, so I headed down. The stagnent water was rancid, smelly, and buggy so I quickly dabbed myself with the green water while Jessica snapped a quick picture. Afterwards, I felt much dirtier then before.

In retrospect, ew.Ibrahim concluded his tour at this point, and Jessica talked us into heading to the "Synagogue part" of the Cave of Ibrahim. After the shooting in 1994, the cave was seperated into two parts. My tour book informed me that I was not allowed into the Jewish half, but Jessica told me that would be assumed to be Jewish and allowed in. Turns out that she was right. We walked right in to an area that was crowded and stuffed with people and books. Jewish tourists mingled amoung the people praying as we examined the Cenotaphs from the Jewish side. It was too busy for me, so after seeing everything we decided to check Ibrahim's claim that the mosque was closed. (It wasn't, the little twerp.)

The mosque side has a totally different feel. The first thing that we noticed was the hostility of the soldiers as we endered, which contrasted strongly with the welcoming smiles that we got walking into the other side. One of the soliders asked Jessica if she had "anything sharp, like a knife". (I did not point out that had she been carring a knife for the purposes of harming someone she was not likely to verbally own up to it.)

Damn it, this doesn't look like Mt. DoomWhen it is not Ramdan, many people will come simply to sit in the cool shade and drink water (as often the mosque is the only place where drinking water can be found.) The only think that I don't like about it is that women are forced to cover in incredibly hot denim capes that Jessica said made us look like hobbits from Lord of the Rings. We took a seat by a fan and were approached by a kid asking for money. I offered to take a picture of him instead. He counted by asking if he could take my picture, and I handed over my camera. As a result of this action, my camera was returned about a half hour later with about 5 lovely pictures (and 45 blurry ones) documenting the mosque and it's visitors from every concievable angle. Palestinian children are easily amused. He did take some good pictures, especially pictures that I would have never taken, such as the following pictures of people praying:

There is nothing that bridges a language gap like a phrase book.Jessica and Emmett left that day for a small area outside of Bethlaham. They were going to be staying with a woman who is dealing with an entroaching settlement that is slowly taking over Palestinian farmland. At night, fences will appear that grab farmland and are protected by the IDF. My hat is off to her, I can barely stomach the "Gas The Arabs" sign.



If you have money to blow, we could use

a few new incubatorsI have been working in the NICU, and during Ramadan most of my shifts have been night shift. This is because people prefer to be home during "Iftar", the meal where the fast is broken.

For me, one of the best parts is getting fed at 3AM. Normally, I would either have to wake up to get food at this time, squirrel some food away, or just go hungry.

On my first night, I was a little surprised when I found out that during the 16 hour shift, it was expected that each staff member would go take a nap for a few hours. It was hard for me to imagine this happening in America. I was also put off by the fact that my presence was needed to assure that there was adequte staffing while one was napping.

This little one is hoping that her

next leap will be the leap home.

Seriously, it's a 360-degree ultaviolet device

for jaundice.I had some friends visiting, so I took my "nap" early to go smoke some sheesha with them. I came back and the other staff took thier turns a little later. At one point, a sleepy staff member came out and told me a bit about himself. It turns out that he had two jobs-- one here, and one in Ramallah. Ramallah is about a 3 hour round trip. I asked, surprised, how many hours he worked in a week. He told me 40. I nodded, thinking that this was normal, until he told me that he had an additional 35 hours at the hospital that we were at. Turns out that he is working two full time jobs.

I found out the reason for this when I asked if he had kids. It turns out that he and his wife are not able to have kids, so the extra money that he is raising has gone to two unsuccessful in-vitro fertilization attempts. They are trying for a third. Having kids is vital to family life here in Palestine. (As there are no retirement homes here, it is also vital for a comfortable old age.)

Needless to say, I was a little more willing to work nights if it meant giving people a few hours to sleep when they were working double shifts. (Espeically since this hospital hasn't been able to pay anyone in three months.)

Swag from tonight. Books are pure gold.TIPH stands for "Temporary International Presence In Hebron". They are not very temporary, having been here since 1994 when a Israeli settler doctor went on a rampage in a mosque and killed 29 men and boys while they prayed. (Such a thing has never happened since, so I told them that they are obviously having a positive impact.)

They are stationed in a hotel that a former guidebook decribed as a "beacon of luxary in Hebron" (or something like that) before TIPH took it over. Today, TIPH's main attraction for me is thier full nightly buffet bar (including a salad bar), library, and large number of internationals that constantly staff thier office.

Oh yes, and they are one of the few places in the city, it turns out, where one can buy booze. So I had a good night.

I think that this clip from "American Dad" sums it up best:

Feeding a donkeySo I got invited by a "friend" to take dinner at his house. This was one of the rash of invites that I got while I was sick, and I finally decided that it was just easier to say yes. Since I was being picked up in a car, fed, and then was promiced to be taken home that night, I figured "why not?" I was getting a little tired of the hospital food, especially the yellow rice and dry chicken that they serve every bloody day.

Now, I love eating at the houses of Palestinian friends, but I wish that I didn't need a hostage negtiator to get out and back home. Because Palestinians really don't have a concept of "alone time", most people are pretty concerned that I am bored or lonely spending so much time on my own, and are pretty horrified at the thought of my sleeping away from my family. So, an invite generally comes with a request for me to sleep over. Explaining that I sleep better in my own room is generally a waste of time, so I have to come pre-loaded with excuses for getting back that night (generally a sceduled phone call to the states.)

So in this visit, I was pretty pleased when my male host offered to drive me home almost as soon as the last bite of food was down my throat. Not that I wasn't ready to go. I had been in his villiage for almost 6 hours. First, we went to his parents house. None of his family spoke very much English, which was expected, but what wasn't expected was that he decided to take off shortly after we arrived. He went to visit a friend and left me with his mother, brother, and two sisters, where I attempted to smalltalk in Arabic for a half hour. I am not fond of small-talk in English, so I was pretty relieved when he finally came back with his father. I was ready to strangle him when he left again ten minutes after that for another half hour.

Finally, we went to his house where his lovely wife was making food. We hung around with a few people outside, I fed the donkey, and finally sat down to eat after about two hours of me nodding politely as his family. I nearly burst out into simultanous tears and laughter when I saw the food-- yellow rice and chicken. My host told me that this was traditional food for visitors, which is probably why it is served at the hospital daily. But since he also eats at the hospital (and therefore knows what I eat) I did want to ask him just what the hell he was thinking. Instead I smiled and enjoyed the food, complimenting his wife after every bite.

After dinner I was gifted with some old jewelry which I tried to refuse. I wondered if such trinkets are actually worn, or if they are just continously regifted to others, because that is what I will be doing with them. I kissed the wife and thanked her again for dinner as she cleaned up and my host shuffled us out the door.

I discovered later why he was in such a hurry to leave. As soon as his house was out of view, he asked me if I would like to have an affair. I replyed in the negative, attempting to "save face" by saying that I had someone back at home. Mr. Charming pointed out that I had been here a month already and that he didn't think that I would be wise to wait much longer for relations. He asked me if I was a virgin. I told him that I didn't wish to discuss it and then pointed out various contellations to him.

Rural Palestine would be a lovely place for an

elicit affair, were I so inclined, which I wasn't.The strange thing was that he brought this up three more times. I reminded him that he had a wife. He told me that she would not know. I got pretty upset at this point, although I am sure that he was not the first man to take a potential mistress to his house, have his wife cook and clean for her, then expect a quickie in the car while I was still digested her cooking. The third time he brought up a possible affair, I decided "to hell with saving face" and lectured him sternly about makin assumptions about non-Muslim women, the sanctity of marriage, and my choice and right to say "no" regardless of what he assumed about my sexual past.

Needless to say, I think that it is going to be a while before I accept any more invites.

I've been sick again (this time tonsilitis, which I am prone too) and my illness has been causing a few cultural snafus. Just like the local belief that a stomachache apparently needs to be treated with food, a sore throat (and other respirtory illnesses) need to be treated with a journey out of the city and into the country.

So, when news hit the hospital that I was sick, a "rash" of invitations came rushing in, each to a villiage more distant then the last. Although it's rude to refuse an invitation to another's home in this culture, I tend to put my foot down when I am not feeling well and just want to rest. Unfortunatly, the invitations do not appear to be voluntary, and I have taken to hiding in my room to avoid them. The first one I thought that I would be able to perry with an excuse, but the lady said that if I came to her house I would be better. I laughed at her joke, then realized that she was serious. At that time I had a slight fever and I was an hour from the end of my shift and an hour from bed. Unlike milky food which can be hidden in the trash, I have had a harder time trying to convince people that I just don't want to travel or meet a ton of people when I have a fever.

For me, it seems unreasonable to make any type of demands on someone that doesn't feel well, and I am trying not to feel frustrated that people will not just accept my "no thank you, I don't feel well, perhaps another time" and drop it. I am trying to imagine my own reaction if I found out that someone was continuing to smoke during a nasty chest infection-- I would not take a "no thank you" to my advice to stop smoking if I really cared about the person, no matter how polite. I think that people here feel the same way about getting me some fresh air. But, after working for eight hours, I really just want to rest and spending another four hours trying to stumble through a conversation with my weak Arabic is just not an option.

I have been transferred to the NICU, where I have been for the last few days. The plus sides is that I don't have to try to talk to scared parents that don't understand my English. The con side is is that I am working with men who don't really know how to react to a woman like me, but I think that we will all learn. People of opposite genders are not friends here, unless they are also family.

I was talking to some NGO workers the other day, and I learned about the problem in Hebron that involves water.

You have probably heard at one point or another that the water is not divided equally amoung the groups here. There are basically two governments, the Israeli government and the Palestinian Authority (PA), which is below the Israeli government. The Israeli government decides who gets the water and how it is devided up amoung the people, and the PA who rations out the water that the Israeli government decides that they get.

Needless to say, there isn't a water problem that I know of in the settlements. The area of the city outside the settlements is another matter, however. Most of the Palestinians have water tanks that are on their roof. The PA gives each house 2, and richer families will buy more. The water is rationed to different areas during the month. When it is your month, you fill up your tanks and that is all the water that you get for a few weeks. This means that water usage that it not considered "vital" will have to wait. Some couples will even have to forgo sexual activity as they are unable to properly wash afterwards to pray. (I also heard that during the Intifada, bored Israeli soldiers guarding the settlements would shoot at the water tanks to rupture them, and leave the families without water.)

This is obviously not an issue here at the hospital, where we are able to have all the water that we need. But after learning this, I have taken steps to conserve.

Beleive it or not, the hospital isn't all

dying children and crazy staff.

There are good days, too. The day before I got sick, we admitted a little guy with Down's Syndrome who was having respiratory problems. I had not been able to determine what exactly was wrong with him, but he had obvious cardiac surgery, acidosis (probably respiratory), and was gray. I guessed that he was about less then a year-- age was hard to judge because of developmental delays. We did the same respiratory resuscitation efforts that we had done on Farah the day before and he was admitted to our pediatric ICU.

He wasn't doing very well when I came into today, with bruises on his body from what looked like DIC. I found out that he had been coded during the night. He was on a respirator and a heart monitor that was showing periods of apnea. I think that the heart monitor may have also been a defibrillator that was keeping him alive, but I wasn't able to find out. I worked in another area for about an hour, then when I went in to see how he was doing I saw that he had died. He was wrapped in a sheet that was taped closed, and someone had written something (probably a prayer) in green. I am not sure why the child died, or if he would have died had he been in the States. Down Syndrome kids tend to have pretty significant cardiac problems, so it was probably related to that and may or may not have been fixable.

About an hour later, the family started to congregate. I didn't take much notice of the men, but a young woman came in and sat in a different set of chairs and started to cry. Everyone was busy with rounds at this time. Now, the problem with working with families that have lost someone is that death rituals differ greatly, including among different areas and classes. So although my first instinct was to take this women in to see her son, I wasn't sure if that was appropriate.

I did know that, regardless of culture, it wasn't appropriate in any situation for this women to have to quietly sob while people were laughing at the nursing station five feet from her. I tried to get someone to take her someplace private (I didn't want to lead her away without telling her where she was going, and I didn't have the words to explain) and they started to take her into Farah's room (the young baby I've been caring for). Knowing that the last thing that women needed to see was another women holding a living baby, I intercepted the her and took the bewildered women into the nursing break room. I gave her some tissues and a glass of water and then demanded that she be allowed to see her son.

Finally, two nurses took her into the PICU and unwrapped her son for her to see and touch. She cried,touched his face, and asked that he be covered up. The family wrapped up the youngster in a blanket and took him away.

Been sick for the last 24 hours with some sort of stomach virus that has been going around. I think that I am finally over the worst of it. The staff here have been really great about taking care of me, although mostly they come into my room to try to talk me into eating food that I can not digest. One of the doctors thought that I had meningitis and wanted to give me a spinal tap, I managed to talk him out of it. (They draw spinal fluid in this place with the same frequency that most people draw blood tests.) I am going to head out in a bit and try to find a store that sells ramen. Instant ramen is a pretty universal food, I am hoping. I keep trying to explain to the housekeepers that I would rather be punched repeatedly in the stomach then try to digest the oil-laden hummus, flatbread, and yogurt that they keep bringing me.

My one (and only) patient, Farah, went down a few days ago to have a gasto tube placed as tube feedings unfortunatly seem to be a part of her permenent future. While she was down there, I got to wondering what would happen if a patient coded while on the unit. I had not been shown a crash cart, paddles, or anything like that. And I came pretty close to finding out. About an hour later, one of the nurses got a call to pick her up. I was behind the nursing station when the doors opened and Nabila called out that we needed O2. I wasn't able to figure out what happened exactly, but Farah was grey as stone and her mother was in tears. We took her into the room and I used a nasal cannula that was there to give her O2 until someone brought a vent. We got an O2 monitor at her and she was running at 76% O2 (normal is 95-100). We manged to get to O2 stats up, but she kept on stopping breathing on me and I had to shake her awake. It took 20 minutes to get her color back, and I insisted that the doctor be called when the poor little girl wouldn't stop gasping for breath. Normally, I would have called arapid responce the second that she had gotten off the elevator, and reamed surgery for sending what obviously was an unstable patient on an elevator without supplimental O2. On that note, I don't think that I have seen any portable O2 anywhere in the hospital.

Anyway, she is doing a lot better now.

Nabila, my preceptor, hasn't been paid in

three months, yet here she is diligently

showing how we get a flushAs Friday is a Muslim holiday, Thursdays are basically Fridays here in Hebron. As a result, there is a fireworks show going on at some big place about 200 yards outside my window. They shoot off about 20 or so every hour. It was cool at first, nows it's starting to get annoying.

Life at the hospital goes on. I found out today that no one here has been paid for a month. One of the nurses told me that since there is no money for the Ramadan feast (Ramadan is in August) she is planning on eating her children for the Iftar, or breaking of the fast. I think that the joke might have lost something in the translation. (There go the damn fireworks again.)

My patient, Salah, whose name is actually Farah (Salah is the mother) is still here. The doctors said a week ago that Farah could go home as soon as her parents buy a home suction machine. I am starting to wonder if the parents know that. I have tried to get the other girls to ask the mother if she has questions about this request, but the baby is still here. Not that I mind, I enjoy taking care of her. (That is us in the picture.)

Me and FarahBut I am really worried about her. I think that I mentioned that her mother and father are older, which is probably why she has so many congenital defects. She was also an IVF baby. Her mother is the second wife of her husband, which is often a role where the women has to try a little harder to prove her worth. The father rarely visits and seemed uninterested in the child. (In fact, when the father is here, it seems like there are two babies to care for.) What worries me the most is that there is very limited interaction between the mother and the baby. With the baby being likely developmentally delayed (I suspect Down's Syndrome), deaf, and mute from the trach, she will need much more stimulation then most babies to help her mind grow. But she is never held or talked to, which is only going to make her disabilities worse. She will cry, but it is completely silent, so she can't even ask for attention. Oh yes, and she is a girl, not a boy.

Farah and her mother, SalahThe mother left for Behtlaham for the night again, and one of the nurses on the night staff threw a hissy fit. Not only was she yelling and carring on in front of the other patients and parents, but I wanted to laugh at her because there were only 6 patients for three nurses. I was like, are you kidding me? If any of my old 5A colleges are reading this, you are probably laughing as well, as we would have 6 patients to a nurse. Sure, Farah needs feeding and suctioning, but all the other patients are cared for by thier parents. I offered to come back and care for her, but they wouldn't let me.

And there go the fireworks again...

Unrelated note, what is up

with this picutre?For my first day off, I took a walk into the old city of Hebron. Hebron is unique in that it is the only area in Israel and the occupied territories to have a settlement in a major city. Hebron is divided into two areas, H1 (under Palestinian control) and H2 (the Israeli settlement.)

Guard tower at the separation

between H1 and H2As a Red Cross/Red Cresent volunteer, I have made it a goal not to become involved in the politics of the situation. Although I have my own beliefs, I am not here as a protestor to to serve some agenda, at least I am trying not to. It is hard when everyone wants to talk to me about politics, or you walk around in Hebron.

I am willing to consider arguements about Israel's right to be here and it's founding, etc etc, but do firmly beleve that the settlements are wrong. Supported and populated mostly by the most extremist populations, it is generally believed that they serve simply to increase the land holdings of areas that are not under Palestinian control. They are akin to people moving into the “Green Zone” of Iraq, and are not only agaist international law, they are against Israeli law as well. They are tolerated in this country for the same reason that the US tolerates things like Abu Ghraib and Gitmo-- it is thought that they are necessary.

Hebron old city market, with the covered to catch garbage.

Can you imagine living here?A lock to a shop soldered shutIn the case of the settlements in Hebron, they have causes the old city and it's holy site – Ibrahimi Mosque-- to become heavily fortified by Israeli solders. Lonely Planet states that there are 4000 soldiers to protect the 500 settlers (no, that isn't a typo, in fact I just looked itup again to be sure.) After eeing the rooftop lookout points and walking through three checkpoints to get to the mosque, I did not find this hard to believe. The settlement houses are across a small alley from the Palestinian houses, and the Palestinians have had to put webbing over the roads as the settlers will throw trash out the window. In one house that I visited, my host said that he had to keep his windows closed and locked lest his neighbors from across the way toss rocks and Maltov cocktails into his home. (I did not believe him about the Maltov cocktail part until he showed me a area that had been bombed by such a concoction.) He also showed me that many shops were forcefully closed and their doors welded shut to prevent the re-opening of the shops. The shops were too close to the settlements (often, they were in the first floor of the building) and so they were taken away. Resisters were arrested.

The old cityHebron's recent history includes a massacure in the Ibrahimi Mosque, were a settler (who happened to be a doctor) walked in and killed 29 men and boys while they prayed, injuring another 200. This is most of the reason for the security to get into the Mosque. After walking through two remote controlled locked doors and being searched by two guards, I could start to feel the irritation. My irritation reached its peak at the last Israeli solder who searched me. She was blonde with an American accent, and when she asked me: “Where are you from?” I couldn't help but answer “America. And you?” She gave me a dirty look and let me pass. So much for not getting involved politically.

Praying at the tomb of Abraham



The mosque about 100 meters from my

window that is the bane of my exsistance.Well, I am starting to fall into the swing of things here. I really wasn't sure if this was going to work, but it's been about a week and I am starting to feel slightly helpful. I am able to occasionally sleep though a call to prayer although one of these damn minarets are right outside my window. (For some reason, the loudspeakers even manage to work when the power is out.)

My time here so far has been highly frustrating with moments of light. A few people treat me like I am a bit of a moron. Other times there are situations where I just want to cringe. For example, I saw a few nurses busy over a medical calculation. They had their cell-phone calculators out, and I wandered over to see what math problem was so completed that it requered three nurses. As I moved over, I hear that they decided to give five pills. I looked at the order, and saw that 0.25 mg of aspirin were ordered, and the pills were 0.1 mg each. It was such an easy problem that I quickly doupted my own answer, but I stopped them and insisted that only 2.5 pills were needed. They did not believe me, but fortunatly a doctor took my side.

The nurses trying to figure out how to setup the respirator.

(To thier credit, I couldn't figure it out either.)I am actually a bit annoyed with the nursing staff this evening. I have had just one patient for the last week, the little girl Salah with the trach tube. It's good that I took her-- her mother had to go home for an evening, and I was able to spend alol my time with her, suctioning, feeding, and holding her. Her mother is still afraid to hold her, but little by little I have encouraged her to hold the little girl. I also found that that a stay in the hospital is 200 sheckels (about $70) a night, not including money for medications. This is a lot of money here. So when the mother asked again for permission to leave for the night and go home again, I was horrified when the nurses said no, there would be no one to feed or suction the little girl. Isn't that what the staff are there for? I agreed to stay with the girl while the mother went home (I would just be hanging in my room anyway) but by this time the mother sensed that she was causing trouble and decided to stay. What are nurses here for, it not to do care like this? I have taught the mother to suction, feed, and give medications to the child, no one else has provided this education. Too bad we do not have a shared language, but when I ask for teaching to be done I am either told that the teaching was already done, or my instructions to the next shift are ignored.

Unfortunatly, when I see things like this happening, there isn't much I can do to stop it. I tried to intervene when I saw that a simple blood draw was being done in the radial artery on the wrist. (Generally, this is done on the vein in the crook of the arm, which is lower pressure, less dangerous, and much less painful.) The nurses told me that it had to be done this way. I went back to the nurses station and the sounds of that kid screaming made my stomach hurt. But I don't know how to request that the protocol change without sounding bossy or ungrateful. There is already a lot of resentment here towards internationals that think that they know better.

A little cutie with pneumonia who was the first

not to cry at the sight of me. In fact, she wants

me to visit her at home.In short, the most dissapointing thing that I have found is that I was not brought here to help, but rather to learn. Most people assume that I am a student. Although of course learning is part of the reason that I came, it was mostly to fill in some sort of gap that doesn't exsist. Most departments are overstaffed in an attempt to create jobs. Unemployment is high. Honestly, it would be a better use of my resources to go back home and raise money for the hospital then to actually work here. But I am here, and I think that I can make a difference, even if it is just to one little baby girl that needs a little extra love.

I am continuing to work with Salah, the little girl that I spoke about yesterday with the congenital defects. She is still needed almost constant suctioning. Today the doctor ordered that we try and perform feedings with the bottle, but she will almost immediatly start to choke, and she doesn't try top suck (probably because she has never successfully fed from the bottle or nipple.)

Her mother is an older lady (40+) who is having a very hard time dealing with her daughter's medical needs. I noticed that she has had no visitors, which is rare in Palestinian cultute. I learned today that she is actually from Bethlaham, so she is a long way from home. She also doesn't have any other kids. She is trying to be positive about her daughter, but when little Salah vomitted everything that ws given her, the mother broke down and stated to cry. If the child survives, then this women's next few years is going to be spent caring for a child that can not even eat. The mother has been very good about doing the suctioning and feedings herself, but today I had to take over when she was threatening a nervous breakdown. Even if I could speak English, there would be no words of comfort that I would be able to give her.

She must have been looking forward to having a child very much. Of course, there is no guarentee that any child will be born healthy, but I am sure that she was not expecting to suddently take care of a child that is so ill. I tried to get her to leave this afternoon, even for a few hours. She left overnight a few days ago, and returned in much better spirits, but the mother didn't want to leave. The child will be discharged soon, and hopefully will some day be able to have surgery to correct some of her defects. But I worry that the baby will die much before that.

We also got a terrible case of meningococcal meningitis. I was horrified to see that he was not put on droplet isolation, but they did have contact isolation (of sorts). He was covered with sores due to a very high PTT that was probably caused by DIC.

Nursing StationWell, I have completed day 2 and 3 of my hospital work. Today was very slow, we didn't have any admissions. I am starting to remember what I found most frustrating about working overseas, and that is the slow pace of life. Honestly, the workload of the entire unit could be done by one nurse from the hospital that I used to work at. The parents do most of the care, leaving the nurses to just administer medications. There were four nurses today, including myself. That means that there is about only one patient per nurse. Much of the day is spent talking and eating. There is a special concern over my eating habits to the staff, and the kitchen will often call the floor to tell me to come eat.

Intake/med room/1 of 2 sinksThere are a lot of areas that I think that I could help improve, but it would be difficult and rude of me to make suggestions. I have been careful to practice my own way of doing things as I do not want to offend. Wearing gloves is one example-- although I have been told that I can do this, I have also been told that it is "not necessary" when I don gloves, and after getting my glove caught on some tape the head nurse suggested that I not wear them. For a woman working with a head nurse "suggestions" are not considered to be very optional, although gloves are one area that I will not give on. Another area is the practice of introducing normal saline into the trach prior to suction-- I just can not justify adding water into the trach of an infant that can not cough. Two children had noticeably sunken fontanels, one of which I pointed out to the doctor, who stated that the baby was not dehydrated. Another problem that I ran into was during charting. I charted the normal physical assessment which included lung sounds, skin color, etc and was told that it was too much. The other nurses notes (thankfully, they chart in English, although I think that this is a bad idea since no one there really can speak English) simply contain the work done and retractions. I also noted that the nurses would chart different values then the ones noted. When I counted the respirations of an infant as 107, the nurse charted it as 72 (later changed to 75) because 102 was "too high". This makes me uncomfortable, and it is hard to request changes when I am so new there.

SalahI did get my own patient today. Little Salah is a little girl who was born with severe congenital defects. You can see in the picture that she has a trach, 6 fingers on her right hand, and deformed ear canals. The doctor attributed her deformation to her father, who he described as "an old man". (The father walked in a few seconds after he said this, and appeared to be around 60.) I have not been able to find out more about her condition, but I think that even in America there would be little that could be done for her. She requires almost constant suction, feeding through her NG tube, and is on an antiepeleptic drug phenobarbitol. She is going to stay until her mother "psychologically accepts her condition" and has learned to care for her. I think that this will happen soon. The mother would not allow me to touch her or play with her two nights ago, but today the mother picked her up and cooed to her and was able to perform feeding and suction. At the end of shift, I was told to give report. Sif, the head nurse, was there for report and I assumed that he would translate. I said that the infant was stable, was not needing suction as often, but that the mother needed to understand the importance of checking residue prior to feeding. The new nurse taking over nodded. I asked Sif if the night nurse understood and he said yes. (The new nurse didn't know enough English to even ask my name, so I found that doubtful.)

An empty patient roomI am learning a lot. I inserted my first NG tube, although I wish that it had not been on a baby of a month old. All patients get an IV, and scalp IV's are not inserted by the doctor, so I am terrified when I will first do this. One woman that I helped is obviously a new mother (she looks almost exactly like "Rogue" from XMen) and I was horrified to find, when removing the diaper, that the baby has stool so firmly caked to her bottom that it took five minutes to scrub off. I checked the diaper almost once an hour after that. It didn't help that the hospital only carries diapers for 6kg babies (there isn't a baby more then 4 kg on the unit) and no wet wipes. The paper towels fall apart like tissue paper when wet. I have taken to using gauze to wipe bottoms. I told the nurse that the new mother should be educated about the importance of keeping the bottom clean, and the head nurse told me to educate her myself. I pointed out the obvious-- I didn't have the language skills to share this. He asked another nurse to do the education, but the nurse said that the mother had already received the learning.

There are only two sinks on the floor with liquid soap and paper towels, so I carry a bottle of Purelmeds (both vitamins) as we didn't have any. At the same time, there is only one book on the unit on pediatric drug dosing. What I wouldn't give for my maternal and child textbook! When the head nurse found me looking up my meds in the book, I think that he got offended as if I didn't trust what he was giving. I explained that I was researching for my own learning, and I was told to just ask if I had questions. Very different then what I was used to, where nurses are expected to look up every dose prior to administration.

We'll see how this goes...

No pictures, I am afraid, I forgot to bring my camera. I should have some tomarrow.

I am hoping that this is just first day jitters, but I am actually not sure if this is going to work, but I am certainly going to try. The language barrier is a real problem. All the people that work are Palestinians and have only a very basic skill of English. I think that they thought that my Arabic was better, but if they are willing to give it a go, so am I.

I am working on the Pediatric ward, and my preceptor probably has the best English there. The kids that were there involved a few babies with hyperbilirubin, a baby with terrible congenital defects, and a few older kids with chronic health problems (respiratory). The first problem that I noticed was that gloves are not used, even when working with blood. During the first IV start that I saw, the nurse pulled out a glove and I was shocked when it was used as a tournaquit rather then as protection. I am going to talk to the medical director about this tomarrow, and I haven't decided what I am going to do about it-- espeically since gloves are probably not used because the hospital can not afford them. I might just have to buy my own supply, but I would wonder how it would look if I was the only one using them. I am not sure what I am going to do about this. The hygentics in the hospital are not too good, with surfaces not being wiped properly even after they are stained with blood products. I saw a baby laid on the same surface that had been used for a lumbar puncture only a few minutes prior without the paper being changed. As it was my first day, I decided to just watch and not say anything.

The worst part was that I couldn't answer the questions of the parents or even explain what I was doing when I went in to take vitals. At one point, a mother went to the door and motioned to me. I told my preceptor, who was charting, that help was needed and she told me to go in myself. I did, but obviously couldn't understand what she needed. I mean, how awful is it to have a sick kid, and a nurse who can't talk to you to boot? Communication and teaching is such a vital part of nursing, and this is why I am not sure if I will be successful here. Even asking a simple question like "do you want some tea?" is rewarded with a barrage of Arabic rather then a yes or a no. I am not very good at learning languages in the first place, and I don't think that I can raise to a level where I can be a helpful worker. But, as I said, I will try.

There was rounds in the morning, and for some reason they would switch to English when the doctors would announce what his plans were for the child. At one point he pointed at a premature (29 week) newborn and asked everyone what we should be concerned with regarding the eyes. No one there knew, and he was very pleased when I finally said that we should watch for retinopathy of prematurity, so maybe I will be able to help after all.

We will see tomorrow, maybe it will go better.

Well, I finally made it to the hospital. I am in my new room listening to call to prayer. My room faces west and I am able to watch the stunning sunsets over the city of Hebron. The strangest thing is that it feels like I never really left.

Yesterday, after a very brief argument over the day of the week in a Tel Aviv bus station, I discovered that it was actually Friday, not Thursday. This meant that the offices of the Red Crescent would be closed, and I would not be able to travel that day. This was actually pretty good news, as it meant that I would have a day in Jerusalem, although I was eager to start my work. At the bus station, I met a guy from Holland, Jaap, who was coming in to volunteer as well. It turned out that he was not only going to Damascus Gate, but he was also planning on staying at the Palm, which was the same place that I was last time.

We actually met due to the extreme rudeness of the Israeli citizenry that I have encountered here. We had been waiting for about 30 minutes in the searing heat for a bus to come. When it finally did, Japp helped me to load our luggage onto the bus while the rest of the people got on. When he started to get on the bus, the driver told us that there was no more room. We had to grab our bags from the bus, which drove away almost the second that our bags hit the pavement. Although this behavior was what I may have expected in America, I was used to the hospitality of the countries that I had been in and was pretty shocked. But it did give me a traveling companion, and we spent the day in Jerusalem together, visiting the tomb of Jesus and watching Shabbat at the Western Wall.

Ack, I am so tired. Will write more later. But here is a picture of the Seperation Wall for your viewing pleasure.

Made it in!!!

I didn't think that I would. I got into the airport having made a few friends on the plane and was chatting with them in an attempt to look casual as I approached the passport station. I had read somewhere that whistling people appear to be less worrisome, so I whistled a silent toon and tried to look tired but excited.

When I approached the customs person, I think that my first mistake was answering a little too pat. On the plane, I talked to a few Israelis who all expressed a good deal of shock when finding out that I was planning on asking for a three month visa. I was told by all of them that there really wasn't enough here to have a three day stay. I also found out that there really isn't an age limit for working on a Kabutz. So when they asked what I would do here, I said that I wanted to start in Jerusalem and move outward to see everything, and maybe volunteer in a Kabutz if there was time. She nodded, hit a few more keys, then asked me to go to the office "for security reasons".

When I went to the office, there were a few people of obvious Arab decent there (the women where wearing scarves) and no other white people. I waited patiently, trying very hard to stay calm. I felt a little better when another white woman was shown in. She was irate, swearing under her breath. I folded my hands and tried to look polite, feeling a little better. I felt a lot worse when she was was told a few minutes later that she was free to go.

All the people I was waiting with (and a few new people) were cleared and I started to feel screwed. An hour later, I finally noticed that one of the security men were looking at my passport. My stomach sank when he started to key my name into a computer. I basically gave up hope when he picked up the phone and told the listener my name.

I was called in a few minutes later, and the minute I stepped in a second man who looked like a policeman walked in behind me. Great, I thought, they are going to arrest and deport me on the spot. The computer guy asked me if this was my first time in Israel. Knowing that he knew the answer anyway, I said that it wasn't. He asked what I had done during my last trip, and before I could answer the two men started talking. I wished that I knew Hebrew. Mr. Computer then asked me about money, and asked to see my credit cards. I handed them over, with a glimmer of hope. He dashed that when he then asked me if there were any "problems" during my last trip.

In a move that probably allowed my entrance, I told him flatly that yes, there were problems, I was arrested and deported during that last trip. Hegding my bets that his computer didn't have any details about my arrest, I said (very somewhat truthfully) that I was following "a guy I met" from Denmark. I said that I stayed with a group of international women, and that I was arrested "for being in the wrong place". I said that it was stupid. I also told him that I was planning on volunteering during my stay. I told him that I was in contact with the Red Crescent and was also hoping to work with the Israeli version of the Red Cross, and perhaps a Kabutz. I said that I was a nurse.

He then asked me many times if I knew anyone here. He asked if I was still in contact with the women or the man that I was "following". I laughed a little and said no, I didn't even remember their names, I think it was Gustov or something. I talked with a few others later who had been held, and questions about people that we knew in the area were a common theme. Finally, I was asked to wait somewhere else. I assumed that they were holding me so that they could get the right people to escort me out of the country.

My hopes dashed was actually a bit of a relief, as was the coke machine that was in the new place I was waiting. I got a coke and watched some football on TV while I waited my fate. After about another hour, a women said my name, handed me my passport, and said that I could go.

"Uh, where?" She pointed to customs. I opened my passport and saw a three month stamp. It was a beautiful moment.

Well, the preparations are going slowly, and it turns out that the electronic preperations are much more of a big deal. As I heard from a friend today who is going to Gaza:

On my way out of Tel Aviv, they went through every scrap of paper I had, including a notebook for directions to various places. They also scoured my bag for residues, found teargas (I was at a [protest, details deleted] and the IDF [Israeli Defense Force] teargassed us), and had me escorted onto the plane by a heavily-armed, uniformed soldier. The airport security (IDF) have been highly trained to evaluate people and how nervous they are. They rank you on your way out of Ben Gurion based on your security threat level and I was a 5 (out of 6). I'm afraid of ever trying to fly back in.

I had a friend who arrived last summer and had her laptop searched. They demanded a password to her email and found that she emailed all of her pro-Palestine information to another email address, then demanded the password to that. She got in after a seven hour interrogation and strip search.

NEEDLESS TO SAY, a lot of the horror stories are true. BUT there are a lot of ways to save yourself some grief:

- Carry NOTHING about your work, or anything political AT ALL.

- Have Jewish Israeli contacts who know you are coming and will be able to confirm you will be seeing them if called.

- Have a clear itinerary. Make a couple hostel reservations or have your contacts be ready to reaffirm the same itinerary details.

- They will be suspicious of a one-way ticket. Have an explanation for your trip. Maybe you plan to fly home through Egypt?

- Clean your laptop. Remove every Arab-sounding name from your phone and email contacts. Disable Facebook. Try to erase any kind of political past you may have online.

- Dress nicely on the plane. My travel companion was pulled off of the plane immediately for questioning because she couldn't be bothered to look decent, and they automatically assumed she was an activist (dingdingding).

- Make a friend on the flight. Chat with them as you leave the plane. It makes a big difference to be shooting the breeze with a nice Jewish lady. :)

So, part of my preperations include removing myself from the internet. You may be thinking "well then, dumbass, maybe you should not be writing about them in your blog!" Don't worry, this blog, Facebook, and everything else is going to be going away in a few days.

Anyone who wants to help can let me know if they find me on the internet, and where they found me. (Don't worry about FB or this blog, because they will be gone.)

Also, please don't email me anything pertaining to my trip for a few days. The last thing I need is an email stating "How's Palestine?" for the IDF to find when I get off the plane.

I am going to be bringing everything back up a few days after I get it. See you then!

It’s Memorial Day, and I have been seeing a lot of the following drivel on Facebook: A normal person has 1,000 wishes. A Soldier only has one, to come home safe. I know 97% of you won't post this as your status, but the 3% that do are my friends. In honor of someone that died, a wounded warrior, or who is fighting (or has fought) for your freedom, please re-post in their honor. Memorial day Weekend! God Bless all those serving now..!!!! Well, uh, no, I am not going to repost, of course, and that might mean that I am not one of those lucky 3% that get to be your friend for a few keystrokes. (Kind of slutty, don’t you think?) But I am one of the 0.09% that actually DID something to help make the lives of vets a little more bearable. You can join me, and here's how:

1. Call your local VA to volunteer or donate, even just stopping by to chat with a vet. As part of my job, I have to call hospitals all over the place. When you call a VA, the first thing that the recording says is “Thank you for calling the VA. If you are having thoughts of harming yourself, please call the Suicide Prevention Hotline at …” followed by the local number. (FYI, the national number is 1-800-273-TALK (8255) and they have a special page for vets.) That’s right, enough vets are calling the VA because of suicidal thoughts that they had to stick a message on their recording. That’s f’ed, people, and a FB status isn’t going to make these people feel better.

2. Call or write your congressman and ask them to vote against activities that cause violence in the region of your choice. No, I am not just talking about Iraq, I am pretty much talking everywhere. I suggest that you ask for the School of the Americas to be closed, which is a training camp for Latin American dictators and basically teaches one how to throw a coup and then trash the country afterwards. One such graduate was Michel Francois, who threw the coup in Haiti that removed Jean-Bertrand Aristide and caused the death and torture of more than 5,000. How will writing your congressman help? Well, the School of the Americas in in Georgia. That’s Georgia, USA.

3. Give money. Pick a charity of your choice and sned 'em $$. Too busy for that? Then send a text message "DAV" to 90999 and you will donate $5 to disabled vets. Or give a dollar or your lunch to a homeless guy, who is probably a vet. (If I was a vet standing on a street corner, I would personally want to deck every idiot who thinks that some FB status is going to get me fed that day.)

“Be the change you want to see in the world.” I am sure that when Mahatma Gandhi said that, he was hoping that it would be more then the FB status of a bunch of spoiled westerners.

You can make it so.

Well, my next move has been decided, and that move is Palestine. It was between that and Haiti, actually. Funny story. You see, one fine day I woke up and found the following in my email inbox:

Thank you for contacting the Palestine Red crescent Society. Being a nurse, we would like to have you volunteering at the Hebron branch Hospital. I have already contacted them, they need you for at least 8 months. Is that suitable for you? They will provide you with accommodation and meals.

This was sort of a shock since I barely remembered applying. I sort of took a rapid-fire approach when I got back to Haiti and realized how much I wanted to work overseas. My preferences where Haiti, Palestine, and Nepal. Most of the places that I applied to wanted me to basically write a disertation before they would even consdier rejecting my application. So to be accepted outright was sort of a rush and terrifing at the same time. Give a girl some warning, will ya?

You might also have noticed the definite lack of information that the email gives. I actually really had to beg to wean more information out, but it looks like I would be staying at a hospital in Hebron. In fact, I think that I am going to be doing something like this: http://www.ms.dk/sw187323.asp

So, my next question was how to get there. Like a moron, I assumed that I would get a working visa, etc. What I found out was:

We prefer that you get one way ticket or an open ticket that you may change later according to the situation over here. You will get the ticket to the Airport, that you are coming for Tourism to Jerus'm and so. After 3 months here, volunteers actually go to Jordan, stay there for a couple days and then come back through the same bridge an get visa on borders for new 3 months.. so we may only have for 6 months instead of 8, unless we figure out a way for you to stay here more.

As Lando said, "This deal is getting worse all the time." Uh, you want me to lie at the airport and you can't guarantee eight months? Of course, I felt like an idiot to think that the Red Crescent was going to get me a visa. The Palestinian Red Crescent (PRC) has about as much authority to hand out visas as I do (perhaps even slightly less!) So I figured, well, this is the International Committee of the Red Cross (ICRC), right? Perhaps I can appeal to the Israeli version of the Red Cross (MDA), to let me in, citing the impartiality that the Red Cross inflicts on it's members. (They aren't called that, but I am using that name so that this post doesn't pop up on too many search engines.)

Now this is interesting. Turns out that there was a huge debate and the ICRC wouldn't let them in. While I was researching this debate, I figured that the ICRC did this because the MDA was stopping PRC ambulances and accusing them of hiding terrorists. I found out that in fact, the dely of letting Israel in was actually due to a squabble over what symbol they would use. MDA wanted to use a Red Star, the ICRC demanded that they use one of the three designs that they already had. I mean, what the hell?

It was around this time that I heard back from an organization in Haiti. This post is getting long, so I will wrap it up to say that I did not get the Haiti job, and I have since chalked it up to God or fate or whatever telling me that I need to go to oPT, where I am probably more needed. I felt like a bit of an ass anyway for choosing Haiti over them simply because Haiti was more convenient.

 Third goal: this kid is counting on meWell, it's been about a week since I have been back, and I have found although it's nice to be able to take showers with running water (although I am still feelign guilty over the waste) I miss being overseas a lot more then I thought that I would. 

I did a presentation at work (which was really more of a slide show) to show them the type of work that I have done, and unlike the other countries I have been to, I would really like to try and fufil what Peace Corps calls "The Third Goal". Peace Corps has three goals: to help the people that you visit, to teach the people that you visit about America, and then to bring whatever you have learned about this country back to America.

I think that Haiti has learned all they really want to know about our grand country, thank you very much, so the second goal wasn't really a priority to me, but the third goal is. It's also probably the most challenging, as it's nearly impossible to not learn about a country and teach them about yourself when you are in the borders (well, maybe for some Americans) but when you get back it's really easy to forget what happened and just concentrate on enjoying different types of foods again. On second thought, maybe Haiti's better off without me. Speaking of which, I could really go for some Eithopean. I had sushi the other night. Yum. (See how easy it is to get distracted?)

Anywhoo, my PP presentation was a step in that direction. I mean, aside from the fact that it's one of the poorest countries in the world, has been overrun by coups and recent natural disasters, what do people really know about Haiti? What do they really know about US policy there? Or even about voodoo? Why should be care about Haiti when there are so many other places that also deserve attention? And what the hell is up with the School of the Americas that is still running for some very odd reason?

Yes, all good questions. I'll leave it to Paul Farmer to answer them, most of which he does in his great book, The Uses of Haiti.

Meanwhile, I am looking for more work down there. Or in Palestine. Or maybe Nepal. Or Burma. OK, so I suck at Third Goal. I know I don't want to go back to Samoa is all.

Goodbye Haiti, I will miss you!What I have learned:1. ALWAYS study the language. Learn “it won't hurt” “sit here” at the very least.2. You never have enough clean clothes3. You always have more electronics then you need

Things I will look forward to athome:

1. Secularity2. A REAL shower3. Flat surfaces

Things I will miss:Everything.

Another satisfied customerThis is my last blog entry from Haiti,but there is still so much to say. We had the last day of clinic,and we mostly had schoolchildren and older people. Mary Kay, whensigning the contract for the iStat, agreed that all 300 cartrigesneeded to be used to show that the machine was really needed inHaiti. The problem was that we had to struggle to get that number,especially since the tests would take about three minutes to read. Since we had about 75 tests still to run today, I was really runningwith those stupid tests.

So to run a test, I had to pierce thepatient's skin with a lancet and squeeze the hand to get the blood. I needed a ton of blood as the cartridges needed quite a lot. As aresult, I had to squeeze the hell out of those Haitian hands (many ofwhich were badly callused, and my hand is very achy from 5 days ofsqueezing, or as I liked to put it: “My hand is as sore as a NYC hooker!” (Take a sec, you'll get it.)

Andrew, Amanda, Mary Kay, Kristen, Judi, Norma, Glenn, Chelsea

Maia, Kimberly, Naomi, Linda, Lynn, Margie, Kelly, me, Suzette, Julia, Julie, SherryI think that another thing that this trip has done is really recharge my desire to get out and join a medical team. I am going to really work harder towards this goal. I loved the people that I worked with, they were such a great mixture of people with varing talents and humor. As well as Haiti, I will miss them terribly. I hope that we are able to keep in touch, perhaps even have a party later.

I have learned so much from the people of Haiti and my teammates, and I hope to come back soon. I hope that I have helped to make Haiti a better place in even a small way, helped to make someone's life a little brighter, and helped give Haiti a butterfly's breeze push to a better future.

Thank you Haiti, I will miss you.

Mary Kay had promised had promised Rachel, who ran alocal orphanage associated with MTM, that we would test all the kidsfor anemia. This news was not well received my me as I hate testingkids for anemia, as they scream and fight and don't bleed well. Plusyou have to stick them in the heel, rather then the finger, and oftenthey are able to give a well-aimed kick to the face.

Mimose seeing Suzette at the airport in HaitiIn Haiti, you are considered an orphanif you have lost one parent. Many single parent households will puttheir kids up for adoption if they can't take care of them. One girlin my group, Suzette, was actually adopted by her mother Kelly (alsoin the group) when she was nine, she went to live with Kelly at 12. Her birth mother met us at the airport and stayed with us for a fewdays. We have often wondered what Suzette is thinking as we see herwith her biological mother. Kelly, her adoptive mother, is obviouslywho she thinks of as her real mother. Suzette does not seem to holdany anger towards any party for her situation, but seems like a welladjusted young lady with two mothers. She was adopted when she wasnine, but didn't get to live with her current other until three yearslater.Suzette and Mimose

Rachel told us a bit about adoption while we were driving up, stating that the mothers can come and visit thier kids while the kids were in the orphanage, and many often do. This can be very hard for thier kids, and sometimes the mothers will change their minds. Single fathers generally balk at the idea of a closed adoption (which all are by default) while mothers tend to view adoption as an act of compassion towards kids and feel that they would have a better life. Rachel's kids are generally gone in about 18 months, which is a very short time here.

Attacked on the couch (Judi, Kristen, and myself)We pulled up to the house and saw a kid, standing in the driveway staring at us. I got my supplies out of the car adn started to walk towards the house when two more kids came running out. The first kid ran to me and threw his arms around my legs and squuezed for a second, looking up at me with angelic eyes before moving on to Kristen. The next few kids did the same, and soon we were surrounded by enegetic and outgoing todlers who had obviously never heard of stranger anxiety. After we got into house, Krisin sat on the couch and three kids hopped into her lap. I saw next to her and was similarly tackled. I wondered if Rachel had trained the kids to act this way to help encourage perspective parents to take them home. Whatever she was doing, it was working as almost all the kids already had homes.

Me comforting a munchkinWork time. I got out the kits and started on the kids and almost immediatly became very unpopular. The caretakers would hold the kids while I poked them. One of things that I noticed was that the caretakers, like the translators, were very disengaged. (You can sort of see what I mean in the picture.) I wondered if this was because it was the end of the day. The kids were pretty interested, however. They gathered around and watched with interest as I poked thier compatriots then screamed like banshees when it was thier turn. I needed to scream myself (for help) periodically as they started to crawl onto me as they fought for attention.

Drawing bloodMany of the kids, sadly, were anemic. Rachel feeds the kids well, lots of greens, meat, and milk, but almost half had low hemoglobins. We left them with some children's vitamins and instructions to give iron with juice, and not give milk within an hour of getting the vitamins (milk prevents the absorption of iron, while vitamin C enhances it.) This isn't easy when you have 15 kids that you are caring for (most meds are given with meals) but I know that Rachel will try. With so many kids, she was able to keep them very straight. She knew the background and active illnesses of every kid.

Orphanages like Rachel's, that focus on adopting out kids, are only one type. There are others that focus on keeping kids in Haiti and trying to help them become productive members of society. What Haiti doesn't want is for mothers to receive funds from overseas to support their kids, since this would encourage parents not to work. But there are a lot of kids that need homes and food, and no real solution.

My roommates made me buy chocolate

(Julie, me, Mary Kay, Lynn in back,

Kristen and Norma in front)It turns out that that I didn't have towalk all the way over to church, it came to me as the music flowedover the valley into the guesthouse.

Although I had been worried that Sundaywould be a fairly dull day (the clinic is closed that day) it turnedout to be a pretty interesting one. During our morning prayers,Beth (who runs the guesthouse) announced that she would be heading togrocery store in a little bit. I immediately volunteered toaccompany her on this normally mundane task. We bundled into herfour-wheel drive and headed out. The grocery story brought backmemories of Samoa, where I saw packets of cookies and other foodsthat I had not seen since I left there, leaving me to wonder if alldeveloping counties shop at the same store. The people in the groupthat could not fit in the car asked me to pick up some chocolate,after much debate Judi and I found some Peperidge farm cookies thatappeared to be the best bang for the buck. We exchanged some moneyand added them to our possessions. We made another stop for ice,driving past the mansion of the former president Rene Preval. Bethtold us that since she doesn't have a freezer, she buys ice every daywhen she takes the kids to school. Judi and I also examined themeat, which was grey and suspicious looking. One pack was labeled“dog meat” and Judi wondered out loud if dogs where the intendedrecipient or the contents of the package. (It turns out that dogsare not eaten here, however cats are!)

There were rumours in the guesthousethat Willham was going to take us someplace after church. PerhapsPort-au-Prince! He was at a religious conference, and his return wasperpetually imminent. Shrotly after returning from the store, Bethasked me to come with her, and bring my iStat! mary Kay (thepediatrician) and Norma (a NP) were also summoned. As I gathered upmy supplies (it takes an amazing amount of crap to check a few dropsof blood) I learned that a pastors wife had been found fainted in adiabetic coma, and we were need to come check her out.

What we found when we got there,however, was a very different story. She didn't have diabetes (theperson who lived in the house just thought that she had) and had notactually fainted. she was, however, pretty sick with a fever. Herblood levels were fine, so we advised acetaminophen and rest.

Willham had returned by the time thatwe got back, so we, as they say here, had to “hurry up and wait”. We gathered up water and food and other supplies, wondering where wewere heading to. By the time that we got in the car, we were toldthat we were heading to a place called “lookout point”. Sodesperate were some of the people in the group that they didn't outwhere we were going until after we got into the car and were on ourway.

You can barely see the waterfront at Port-au-PrinceThe trip up was quite lovely. Most ofit was on a “real road” (such a road in the states would havecaused worldwide riots) and we enjoyed the breeze and the change ofscenery. “Lookout point” was exactly what it sounded, what wedidn't realize that was it was looking out on Port-au-Prince. Ireally wish that we could have gotten decent pictures of the awesomeview that we witnessed. We saw the presidential palace, the airport,the ports. I couldn't help but think of the line from Star Wars:“That's funny, the damage doesn't look as bad from out here!” Wealso noticed that for such a big city, there should be a lot ofhi-rises and major buildings, but there were only two builds thatrose above the others. Most were only two or three stories.

After we had our fill of the view, wewent to try to barter for some of the stuff that they were selling. There were a few other trucks of white people, they were all withNGO's or churches. As far as I can tell, Haiti has no tourists rightnow, so the souvenirs sellers were a touch desperate. I had alreadybough a few things, so I wasn't very interested until I saw apainting that I really liked. The guy wanted $40 for it, I told himthat I only had $20. All part of the game, apparently. Beth hadtold us to pick a price that was half to a third of that offered. Thesellers were very good at looking offended at our bids, but I wastold that it was all part of the game. However, when I pulled out mymoney, I found that I only had $15 left. He took the money anddemanded $5 more. I told him that it wasn't a matter of me holdingout, but that I really didn't have any more. He demanded $4, then$3, then $2. I put down the painting and tried to get my money back,but he refused to both surrender the cash or stop asking for more. Finally, I took the paining and walked away. He pocketed the money,but followed us to the truck loudly proclaiming that I was rippinghim off. All part of the game.People sold art at the viewpointStuff on sale

But the most interesting part of theevening was when we got back and I was told, once again, to grab myiStat. I actually have to run, so I will write about this later.

The front of the line waiting to get into the clinic

Back of the line. Willham is walking up.With church today, it's hard to believe that we only have one more day of clinic here. I could easily stay for at least another week before I start to wish to come home, and it feels like we could stay for a month before we actually start to help the population of 2000 here. (The population in Haiti is 9 million. With about 20 people in hour group, it's easy to see how Haiti's resources have been completely overwealmed for health care alone.)

When we open, the line for people puts the Star Wars episode 1 lines to shame. Often, the people will start waiting the night before to get into the clinic. Siblings bring siblings, mothers nurse in line, they wait in the sun. All to see a health care provider for five minutes and get a few pills. Some people have aches, stomach problems (gastroreflux from worms, generally) and others have things that are much more serious. We ask people to come back the next day to wait in line, some can, some can't. We see as many people as we can and still turn away people at the end of the day. It makes me never want to leave.

(Sidenote: I have decided not to go to church. I have already sat through many church services in other languages and I really did not want to go to this one. When we found out that the truck was not available, and would have to walk there and back in dresses and nice shoes, That did me in. Sorry.)

I was back in the lab today, but I did see a few people that came in for pretty serious stuff. We had one kid that was seen who needed stitches in his scalp. Julie, the pathologist, sewed him up and gave him some antibiotics. He had fallen while traveling up some stairs. (In the picture you can see that the boys have a school uniform with a plaid design on the shirt, the girls wear blue skirts and suspenders, looking sort of like "The Wiz" version of Dorothy. I hate school uniforms It is a plot to confuses the hell out of exapts. Anyone who has been overseas and had to deal with them knows what I mean.)

We also had a little one who had an "extra finger". I don't have a picture of the before picture, but here are the after ones. Although mary Kay (the pediatritian) said that it was indeed an extra finger, it looked more like a skin tag. She just got some sterile scissors and cut the thing off.

After the surgery

The waiting room. Linda, the trip leader, is in the backOnce the people get into the clinic, they are "triaged" with their weight, pulse and blood pressure taken. If they are pregnant, have hypertension, or are a kid they are triaged to the lab. Otherwise, they see a doctor. It's kind of crazy trying to explain to people where and how they should sit and we try really hard to not have any confused patients wander out after they have gotten their lab work and see that they are done. We are also able to give them eye exams and have a full pharmacy. For such a small clinic and a smaller number of workers, we do a good job. There are 23 of us. Four are providers, four are nurses, and the rest are non-medical personnel. (Some of them have medical backgrounds, such as working in a medical office.)

PharmacyThe eye examination room

One of the volunteers, Glen, is a speech pathologist with a specialty in stuttering. It turns out that one of the interpreters, JM, has as stutter. It's hard to tell, as the pauses when he is speaking English and generally attributed to his grasp of the language. Glen has been working with him during lunch breaks, teaching him a few techniques that he can use to treat this. It really is a miracle that of all the people in Haiti, there happened to be a person with a stutter and a speech pathologist in the same place. So Glen feels like he also has a special place here in Haiti.

On the way home, we ran into one of the familes that we helped, and we were able to get them a ride home. Kristen had started to walk and decided to stop one of our trucks when the rain started, and that truck stopped to pick up the family. They handed over the baby for her to hold, and as she said, she was in heaven.

Hopefully today we will go to Port-au-Price to look around, then we will have one more day at the clinic.

Opening the clinic

Rather then going on and on about theperils of travelling to and fro from the clinic, I thought that Iwould spend a moment discussing the real reason that I came toHaiti-- to provide health care for the Haitians.

A lot of people (myself included)assumed that I came to Haiti to provide earthquake relief, but intruth most of the most effective programs have been working in Haitifor years before the earthquake hit, Mountain Top Ministriesincluded. The village that I work in, Granmothe, was actually notdirectly affected by the earthquake. There was an influx of peoplecoming out of Port-au-Prince after the majority of the city wasdevastated which has overwhelmed what little resources that there arehere.

This little one had a burn on her lipMost of my time was spent in the labarea, which is a tiny little space, separated by a cubicle wall thathouses the scabies treatment area and a shelf that blocks view intoone of the treatment rooms where patients are seen by one of theproviders. This assembly-line setup has meant that I don't reallycome into contact with the individual stories or illnesses. But Igot pulled from the lab for a few hours and was able to help one ofthe nurse practitioners, Kristen, as she helped patients.

My job with Kristin was to keep trackof the patients she saw, write out prescriptions on a pad, mark thediagnosis on a list, and gather the supplies that she needed. Thiswas the first time that I was actually being a nurse, and I loved it!

The first patient that we saw hadcomplaints of stomach problems and gas. Kristen laid the patientdown and felt her tummy, then asked me to do the same. In the books,a patient with worms had what was described as “a doughy stomach”and I had been worried that I would not be able to recognise this. Ishouldn't have worried, the woman's stomach felt exactly like a hugebowl of bread dough. This was incredibly common in Haiti. Fortunately, it was easily treated with a dose of Albendazole. Wormswould also cause gas, as they would bloat the host. We have nearlyevery patient Albendazole, as nearly every patient.Glaucoma (right eye)The next patient that we saw was alittle 10 year old with a terrible looking eye. We called for aconsult with Mary Kay, the pediatrician. We quickly diagnosed him ashaving glaucoma. This exciting moment of seeing this rare oculardisease was quickly tempered when we realized that we had notreatment. Without the correct eyedrops, the young boy would one daygo blind.

Cataracts, conjunctitisThe next two people that we saw alsohad eye issues. One lady had nasty cataracts and conjunctivitis(pink eye). She was easily treated with amoxicilian eye drops. Inlooking for these eyedrops, we also found some eardrops for anotherpatient that we had seen with a nasty ear infection. Antibiotics arereally a wonderful thing, and they are perfect for our purposes, aswe would not see the patient again. However, I was worried aboutcompliance. The people who worked in the pharmacy hardly had time tocount off the pills and tell them how to take them, much less provideteaching on the importance of taking all the pills and not sharingthem. Paul Farmer has done a lot of work with TB (which requires6-12 months of treatment with a nasty antibiotic) to preventresistance. With every pill that we handed out, I worried about whatwould happen if that particular bug became resistant, but other thennot handing out the pill there was no other solution.

I helped Kristen to a pap smear (topictures of that!) She needed me to hold up an otoscope so that shehad a little light to see what she was doing. She and I had to leanover between the woman's legs, as I shined the pathetic flashlightinto the speculum so that she could visualize the cervix.

elephantiasisNear lunch we sawa woman whose leg was swollen with elephantiasis. I was back in thelab by the time that I met her, and didn't even notice that her rightleg was double the size of her left until I got her on the table. She was also hypertensive. The clinic was closing, but I snuck herin to see Norma, the other nurse practitioner after getting her labs. In addition to the massive swelling of her legs, she also had apulsing right carotid artery that could be felt easily onpalpitation. Her right leg was swollen as well with pitting edema,but that was easy to miss with has massive other leg. Her right legwas probably edemous as well, but the elephantiasis hid that. Shesaddest bit, like the boy, was that the condition with treatable andpreventable, but because she hadn't sought medical attention prior,her leg will always be terribly deformed.

Scabies

In addition to these, we saw a fewpeople and kids with scabies. For the adults, we treated with apill, ivermectin, which is not approved in the US but works wellnonetheless. For very young kids, We had to use the scabies cream. This involved taking them to the “scabies treatment area”, takingoff their clothes, rubbing them with permethrin cream, thenredressing them with new clothes. I worry about the effectiveness ofthis treatment, as they should really be re-treated a week later whenthe scabies eggs that are under their skin hatch, but we have no wayof seeing them again. This makes the babies scream

Kristen and JM with the glaucoma eyedrops

The Glaucoma boy had a happy story. While sitting on the floor to breastfeed, our trip leader, Linda,noticed a bunch of eye drops that were under a shelf. She got themout and saw that they were glaucoma drops. We asked around andmanaged to find out the address of the boy that had Glaucoma and wereable to send a 4x4 with the drops to him. We passed along severalbottles. Although this will probably only postpone the inevitable(blindness) it was still good that we could get him some treatment. Even if blindness is only postponed for a week, I tried to think ofall the things that he would see during that week that he would haveotherwise missed. As Kristen said, we can only do what we can do.

A few little munchkins we met on the wayAfter the harrowing experience of riding home in the pickup during a thunderstorm, I decided to join the walkers and trek back. Unfortunately, it was not raining this afternoon, and the sun was doing all it could to try and convince me that a walk was a bad idea. the only positive thing about walking was that Haiti is on "island time" and walking in the sun seemed a better idea that waiting around in the van for Willem. (There is a third option, which would be waiting in the shade in view of the truck, but that option seems only to have come to native Haitians.

My little 12.5 megapixal camera can NOT do justice to the landscape of this place, and I doupt that I have the poetry that would also be needed to describe it. Mountain Top Ministries is located in a section of massive hill-like mountains. I say "hill like" because they are rounded and covered with vegetation, but have the height and slope that is normally associated with a mountain. The villagers will plant their crops on the side, with the plants growing at acute angles to the land. Sadly, this is one of the reasons that the county has such a poor growth rate per acre, as this method of planting causes massive erosion. In addition, much of the trees were cleared for plantations and for charcoal, so thier supportive roots also are not present to help keep the soil in place.

The road heading out of the clinic. So my commute to work is three parts. First, we travel almost at a 45 degree angle downhill with the riders in teh back holding white-knuckled to the truck. Then, there is a light respite as we travel over a massive dray river bed covered in large white rocks. Finally, we travel uphill again at a hear 45 degree angle (the Haitians are not one for switchbacks.) It's not a trip for the lighthearted or the weak-stomached. In addition, the "road" is actually mostly mud and rocks. Oh yes, and there is often a massive drop to one side. And the road is one lane with tons of blind spots. Good times. Some of the people in my group cross themselves before they leave, and trust me, they are not just being cute.

The little bracelet girlSo I walked. We met up with a few kids who joined our group. One was a little school girl who enjoyed tossing her bracelet down the path. It would bound, bound, bounce until it hit a curb and she would run and grab it and start again. she listed to our chattering in English with great interest, saying "oui" and "no" when she felt it was appropriate. This part of the road was fairly well maintained, with the middle pretty much cracked out but the sides still more or less intact. There were huge ruts in the side so that there was something to grab onto, the road is that steep!We came across a few other travelers

Unlike myself, most people are not able

to choose if they walk or not!

Chicken wire "bricks" with rocks inside make up a wallEventually, the road gave way to a rocky path near the bottom near the dry river bed. The "road" was washed away when the waters came, and no one was been able to rebuilt them. One of the groups that came with MTM actually rebuilt the road, which was hard to believe since the rock path was barely transverseable-- made me wonder what it looked like before!! In addition, the group build a wall by making boxes of chicken wire, then loading them full of rocks and making large "bricks" that they would use to keep the waters back. These were still intact.Other volunteers chose to ride insteadA pathetic Haitian excuse for a road

The dry river bedAfter making it down the mountain that the clinic is on, we trek along a wide dry river bed. I guess during the rainy season, the river will fill up. The rainy season is from May and goes on through the summer. It's good that the season is in the summer, because if the river bed is transformed into an actual river, the children that go to school at the ministry can not cross it to get to school and back. There is no bridge. When the water comes in, people are stuck. As an American, it is nearly impossible for me to understand how life can be so ruled by the weather, when of course in most of the world the weather is a way of life!She loves shoes, boys and chocolate

All in all, the trip is about three miles although it feels like more, especially the last mile heading up hill in those slippery paths. There are not many houses on the ministry side of the "river", but on the guesthouse side we start to see a lot more houses. Some of them are nice houses, others are not so nice. A lot of them are just concrete bricks that make up a room, with no electricity or running water. Many times, the water is brought from a public well on the heads of female children of the household, and all the laundry and bathing is done from this.

Mountain Top Ministries at dusk,

as seen from the guest house

(although it should be called

"Halfway up the Mountain Ministries")Finally, we get to the guesthouse! Time for a soda, a cold bucket shower, and a rest. While resting, I realized that the ministry could be seen from the back of the guest house while sipping cold Sprite on the porch. I noticed that you could see the ministry from the porch. I suggested that it might be easier to install a skybridge, like the one at OHSU, where we can just ump in a little carriage (preferably air-conditioned) and travel over in comfortable seats over a wire. Beth, who runs MTM with her husband, said that this was a good idea and she would be happy to have it built as soon as I raised the funds needed.

While driving in the back of a pickup under a metal cage going uphill along a cliff on a mud path in a thunderstorm:

Sherry: It's all part of the Haitian experience!Me: What, dying?

Another long day in the clinic. We saw about 500 patients today, I did blood sticks on about a quarter of them. I have been so busy that I haven't even seen the rest of the clinic (a large room, divided by curtains, that is about the size of a very small gas station convenience store) and I didn't notice that the weather outside was turning bad. Anyone that has been in the tropics knows that the weather can be very bipolar.

The lab girls: Me, Ady (translator), Judy, the Other Kim

I am lucky as my station is right by the window with the breeze blowing in, but I was so busy that I couldn't spare a glance outside. I had to do sticks on all pregnant women, kids between 6 months and 3 years, and people who have hypertension that are on meds. A lot of people, but I would see more if it meant that I didn't have to see any babies. These little guys are the worse because they are just too small to really give the amounts of blood that the machine needs to be able to do a proper reading. They are also pretty dehydrated. They also start screaming the second that the little needle pierces their skin, and that's the real problem. I try to get the people that are standing around watching the spectacle to help out by holding them down, but they generally don't hold hard enough, and they also get bored and wander off or start to play with the baby. Meanwhile, the baby will smear what little blood has come out all over the place with their screaming. I have been trying to get the moms to breastfeed in order to keep them quiet, but that only helps a little.

Anyway, while working on baby #5, the head of Mountaintop Ministries, Wilhem came running into the clinic and said that we had to get done. I looked out the window as he was telling us that a thunderstorm was coming to see that he was right. I finished up the draw that I was working on and started to clean up. One of the nurse practitioners, Norma, stopped by and said that she absolutely needed am H&H and one last baby. Wilhem was yelling that if we were going to leave, we had to leave now. By this time, the clinic was empty except for me, my lab assistant Janet, the family and Norma. I guess that the family had been waiting for several hours to be seen, and Norma needed an H&H to make a crucial decision in her treatment. Fortunately, I was able to get blood on the kid (a one year old) pretty quickly and we threw it into the machine. We cleaned up the lab, watching the storm blow in from the neighboring valley and threaten ours as the machine ran through it's agonizingly slow three minute cycle. The test came back, negative, and we grabbed the iStat and ran out of the clinic to the waiting pickup.

We jumped in, watching as the clouds invaded our valley and everything turned to gray. I asked Lynda, the trip leader, if maybe we shouldn't stay at the clinic and wait the storm out. I told her that this would give us a chance to clean the place up, maybe come up with a few new protocols, but she wanted to head home. Since her infant baby was riding in the front, I felt that she wouldn't have said that we should head out.

I had never seen anything like that fog coming in. It was a black thunderstorm, and we were right in the middle of it. It wasn't the rain that worried me, however. It was the journey home. You see, both the guesthouse where I am staying and the church are on the near tops of large hill-like mountains. The roads go almost straight up the mountain, with few switchbacks that we are used to int he states. As a result, it often feels like we are travelling at a 45 degree angle, and it's harder to say whether it is more terrifying to go uphill or downhill. Plus, there is often a step drop on one side of the road. So the reason that I was offering to sleep on the concrete floor of the clinic rather then brave the drive home was that the roads were of that really slick mud and rock that sends even the most sure-footed person on their ass. Oh, and did I mention that the driver had to stick his head out the window just to see the outline of the road?

Obviously this story has a happy ending. We got home okay and I was soaking wet from the rain.

Tomorrow I am going to switch stations and work with one of the NP. This is going to be great as I will see patients and learn about their conditions and assist in their care. I am sad to be giving up the lab, but I am also very excited to know that I am going to learn about their health problems and learn more about patient care in a developing country, as this is really what I want to learn long term.

Finally, a touching story. When I was trying to get blood from a Haitian, I commented that "Haitians don't bleed." My translator smiled at me and said "That's because they've bled enough."

Still can't upload pictures.

Just got back from my first day at theclinic. We saw about more then 100 people, which I am told isactually not that many. Julie, the pathologist told me that it wasbecause word travelled and people were scared of us. And by “us”she really meant me due to the screaming coming from the clinic.

The day started when we were woke uparound 7AM. I found a set of scrubs and got them on, and wentdownstairs to run the controls on the iStat and eat breakfast. Weloaded the massive amount of medications and supplies into the backof a truck and then headed up down the hill. Mountain topMinistries is located on a hill, and the clinic is on an other hill. The “roads” (very much deserving of quotes) were just a littlemore narrow then the truck, and I swear that they ran about 45degrees to the road. We went down the mountain, across a dry riverbed, and then up the other side where we unloaded the bags and headedinto the clinic.

We had three stations at the clinic,plus the pharmacy and the lab. Two nurse practitioners, apathologist, and a pediatrician saw patients and diagnosed. I drewblood and fed it into the iStat, and the pharmacy obviously handedout pills. To get the blood, I had to prick the patient's finger anddraw the blood into a lancet. I think that I would have preferreddoing simple venipunctures, but we don't have the equipment that weneed for that. Although the finger pricks might hurt less, they tooka lot longer, and the patient saw a lot more blood.

The babies were the worse, because Ineeded to perform heel sticks, and they just refused to bleed. Thechild would scream and kick, and the stress would causevasoconstriction, which would in turn halt the bleeding. After thefirst three or so patients, I finally got it figured out and was ableto do my job.

I didn't know why most of the patients were being seen. There were a lot of young women that were pregnantthat came in for well-woman visits, and we tested them for problemswith glucose and anemia. A bunch of people with hypertension. A fewkids with scabies which were covered head to toe in spacial cream(the adults got a pill). Yes, a lot of screaming. We also did a lotof urinalysis and pregnancy tests.

Right now we are sitting around thetable at home looking at “People Magazine”. Justin Bieber, hotor not?

No pictures, because I can't quite get the internet in the guesthouse to keep it together enough to actually write and publish a post.  (But the pictures are pretty cool.)

Haiti is hot.  I had forgotten what hot really was.  After getting off the plane, I went from being happy to be someplace warm to feeling happy to actually be hot for a change to wishing that the Haiti airport was air-conditioned in the space of about a minute.  About five minutes later I was sweating like I was back in Samoa.

Haiti is one of the most densely populated places that I have ever seen, with the smallest airport that I have also ever seen.  Someone had fixed it since the earthquake (probably so that aid could get in) and made a nice little walkway.  There was a band playing for us as we moved down the  walkway into the main terminal.  Throughout our trip, we would pick up various people from various places that were in our group, and this was honestly the first time that I saw us all together.  Most of the people that were on the plane were Haitian or of Haitian decent, and all the white people that I talked to was there with an NGO.  We gathered in the main terminal (which was slightly smaller then the woman's bathroom at LAX) and tried to figure o Tut how to fill our our customs forms that had been written in French and Creole.  I think that this was one of the first places were English was not an option.  I wondered why this was, since there was such a strong (and highly dysfunctional) relationship between the US and Haiti.

From there, it was a pretty long walk from the terminal to the truck, even with our bags (50lb each x 2) on carts.  Some guys that were identically dressed swooped in to take the carts, I found out (too late) that they didn't work for the airport.  I tried to get rid of mine, and handed him a dollar.  He said "Give me five dollars" and refused to take it.  It turns out that "give me five dollars" is a common catcall for Americans here, there was a kid that called to me from the other side of the gate "Hey, sister!"  When I looked, he requested this distinct dollar amount.  Fortunately, but this point, the guy who is in charge of Mountain Top Ministries, Willhelm, told us not to pay and the haggle was over, although I was out my dollar.  I didn't feel to mad about it, I was temped to give more to the kid at the fence.  But I also know that such handouts are not helpful in the long run.

We left Port-au-Prince in a huge traffic jam.  I was in the back of a pickup truck, and I am not going to describe driving in a third world traffic jam except to say that if you've even been in a third-world traffic jam, you know exactly what I am talking about. It's not for the lighthearted, and the danger was compounded by the fact that we were climbing up mountain roads along cliff sides.  I had been nervous about my stomach-- I don't do well on windy roads, but after just a few minutes I forgot about my stomach and would have taken the chance just to get the car to move and generate some breeze.  I was wearing a hat, my face was burned just a few minutes later anyway.

The area that we are staying was not directly affected by the earthquake, but a lot of people fled Port-au-Prince and came back to these villiages, so they are going to be the people that we are helping as this area isn't well set up for medical help.  Our first job, after lunch, was to sort the bags.  We had a ton of bags to sort, and Linda had packed them in a way where the necessary supplies we spread out rather then in one bag.  As the bags were lost or pilfered, this made for a extensive re-sorting process.  We scattered all our pills on the table and made then into little 30-day packets.  We bundled them into baggies and slipped in a little piece of paper saying what the pills were and how they were to be taken.  We are thinking that we sorted 30,000 pills as we went through about 1000 bags.  It wasn't a bad job, very zen.

Tomarrow, we will go to the clinic.  I will be drawing blood for the iStat.  Tonight, I took my first bucket bath since leaving Thailand and loved every bloody second of it.  The ambian is start to really kick in, and as much as I would like to write in my soon-to-be-forgotten ambien high, I think that I will turn in.  Talk to y'all tomorrow!

Took a break from Haiti preperations for a hike in Forest Park. Forest Park is known for being the largest forest reserve within city limits in the country. (Not be be outdone,  they also have the smallest park in the country as well, but this one isn't a very good hiking spot.

 Hailstone! Can you see the harp in the window? In typical Portland style, the day was clear and sunny when I left, started to rain while I was on the road, overcast when I got to the parking lot, and started to hail about fifteen minutes into the hike. The hailstones were a good few centemeters in diameter, unfortunatly we were not able to get a good picture of one before it melted.Pitcock Mansion I was hiking with a new friend, Casey, who is also studying wildlife and has most of his labs in places like this. He was able to point out most of the different plants that we saw, let me know which ones are edible and which ones will sting (and demonstrated thier stinging properties over my protests). He also pointed out the types of birds that we saw, although having only seen a robin, his skills in that areas were not quite as impressive.

A mysterious stone structure

A doorway becons..

Me in the mysterious stone structure

Casey investigating the moss

The view of Portland from the top

One of my teamembers posted a link to our list that featured the photography of Jeremy Cowart, who is truly very talented and has captured the Haitian people in a truly unique and touching way. I highly recommend that you check out his photography work in Haiti.

T minus 7 days until Haiti!! If you (like me) can't wait to see my blog from Haiti, check out this link. It's from a guy that went to Haiti and worked with Mountain Top Ministries in the Gramothe Villiage. He seemed to have a pretty good time.

http://hiking-cyclingchristian.net/vacations/2008-Haiti/2008-Haiti.htm

Also, I learned that the villiage I am going to be is someplace between Petionville and Kenscoff, but Google Maps does not have it. So, the best that I can reckon is that I am going to be someplace in the little red circle that I made:

Or, someplace on the little squiggly blue line that can be seen here.

Connie, Mary Kay, and JulieOn Thursday I went to the office of the pediatrician who is going to be going with me to Haiti. She wanted to make sure that I knew how to use the "iStat". Not developed by Apple, this nifty little device is going to enable us to check the blood of our Haitian patients.

It comes with cartridges that you put a little blood on. Slide the cartridge into the device, and it will tell you the blood chemistry, Hbg and Hct. This is normally a test that you would have to send down to the lab. I learned that the lab in Haiti will not electricity. That means, in addition to not having power to run devices, we also don't have any refrigerator in the lab.

Me showing off my awesome blood collection technique

This means that we can't spin down blood and store it, so this device is pretty handy. So why isn't it used in all labs, or at doctor's offices? Because the device is very expensive, and the little cartridges cost more per pop then I fork over for a co-pay.

We really wouldn't have the funds to have anything like this in Haiti, but the company that developed them decided to donate the device and 300 cartridges. This comes to several thousand dollars (they have to give back the machine, but still.) The amount of generosity that I have seen while preparing for this tip has been pretty incredible.

Figuring out the iStat

(Note: it needs you to configure it to require a barcode.)And hard to use! To get the blood, I had to use a little glass tube (similar to a swizzle stick) to get the blood without any bubbles. Fortunatatly, Julie, the pathologist was more then willing to be a guinea pig as I demonstrated my ability to suck blood. She proved to be in good health. There was another person who worked in the lab, Connie, who knew all about getting blood, and she helped us out. She said that she would like to go, hopefully she will be on the next trip. (So might I!)

We are also taking a bunch of urine sticks, that technology has been power-free for quite some time. I was the guinea pig for that test (no pictures of that, I am afraid!) I am happy to say that from a urinary standpoint, my health is quite good.

T minus 10 days!

I think that we are good for peanut butter donations for Haiti.

On getting the Flintstones Vitamins, I started singing the Flintstones vitamin song ("We' re the Flintstones Kids/Ten million strong, and gr-o-owing") and none of my coworkers knew what the hell I was talking about. I'm old.

Well, here it is. Andante from Brandenburg Concerto No. 4 in G major, performed on 4/6/2011 at Classical Revolution PDX. It's good that I can record this as I am able to hear that I really need to work on pitch, although the other flute isn't much better, which tells me that a) I am coming along well when copared to a more professional student and b) we didn't tune well and c) the recording equiptment didn't have the best sound. (This ws a cell phone video that Kazu took, which is why it is so bloody dark!)

We actually performed this without a rehersal (which would have been very helpful) and down a flute. That violinist stepped in at the last minute. Finally, Kristin (the player on the right of me) pointed out that the peice was actually more difficult due to the numerous long tones, and suggested that a piece with shorter tones would be easier, as we don't have to sync up the pitch so much.

My flute teacher tells me that I need to keep my fingers down, and this picture illistrates her point well...

Still, it was a lot of fun and I can't wait to perform again!

A few weeks ago, I sent out an email asking people for supplies for Haiti. I put out a box and a bit of hope. When I came into work today, I was pleased to see that someone had added a few items. There was a big thing of paper towels, wipes, band-aids and Tylenol. (I felt like a moron when I was asked why we could donate Tylenol and not aspirin. When I told this to the meeting, half the group yelled out that it was because of Reye's Syndrome. Duh.)

Honestly, I wasn't really expecting much of anything. I wanted people to just bring junk from home. So I was pretty surprised when Kevin (my hiring manager) and Barbara Crow, the CEO of the Lions Eye Bank (where I work) told me that they wanted me to speak at the monthly staff meeting about my upcoming trip. (This is where I made the Reye's snafu.)

I got up and talked at the meeting about my upcoming trip. I told the group about how I was going to be travelling down to provide medical aide as a nurse, and that any donations -- either money or goods -- would be very welcome. I explained that due to the disasters that followed Haiti (namely New Zealand and Japan) donations for Haiti have dropped while the need in Haiti is still very great.

At this same meeting, we had had a lady who represented our benefits provider walk us though a few things, and she had sat politely sat through our meeting. When I told the group how Haiti still needed lots of help (perhaps more help then Japan and New Zealand needed, as they are first-world counties) she stood up, identified herself as Hatian, and asked to speak. With tears in her eyes and her voice cracking, she spoke passionatly about her family who were living in tents. She told us about how she didn't know if her family was even alive for three weeks. She provided rememberances of an elder member of her family who had died from lack of medical care. She told us how the entire country was still covered in rubble. And she thanked me for remembering Haiti, and asked the group to do the same. It was a very powerful moment.

I found out later that one of the people in the office (Janet) wrote the following:

I’d like to suggest that coincidence is more a matter of the good work we do and the good energy we all put out, rather than a random occurrence. I don’t think that anyone else had the good fortune of seeing all of the pieces that went into the phenomenal occurrence at our staff meeting last night... Kevin... suggesting that the Eye Bank get behind Kim in her assistance of the Haitian people. Barbara forwarding Kevin’s suggestion. Kim giving us an opportunity to help others through her mission.

Is it a coincidence our first benefits rep wasn’t a ‘fit’ and that our new benefits person happens to be Haitian? Is it a coincidence that we happened to have our benefits person speak with us the evening that Kim shared about her trip to Haiti? I don’t know. What will happen as a result of all of these ‘coincidences’? I don’t know. I do know that I have experienced special things happen when thoughtful people put strong thought and energy into producing something good, whether they are directing that energy together consciously or not. For me, this is definitely one of those experiences and I thought it was worth mentioning; as we all contribute in our own way. It’s something to think about.”

And when I walked into the office today, I found that someone had placed a box-- with a ton of goods in it, in the front room where we greet visitors. As you can see, someone put a great deal of work into the box, and I was nearly moved to tears.



“Be the change you want to see in the world.”

-Mahatma Gandi

I got an email from one of the doctors who is part of the medical team a few days ago:

Hi Kim,

I am a pediatrician and the medical director of our Haiti mission team.

I am so glad you are coming along. My last team only had one nurse and it was really tough. This time we have 4 maybe even 5, so much better.

Margie and Lynn have told me that they would like to work in the pharmacy. Margie said you like hands on jobs best. I would like to find out what you want to do as we are going to try to prepare a little to make things a little smoother. You can trade off later in the week but initally getting set up it's nice to have one person in charge of a station.

I will need a nurse to do the check in. It means taking a lot of weights and blood pressures, and other vitals as you see fit, like temps. You would have 2 helpers.

The other station is the lab. We are going to have a little machine to check hgb/hcts and lytes/glucose with. Also lots of urine dips and preg tests. This person would also likely oversee the scabies treatments. Again 2 helpers along side.

Let me know what you think. I still need to ask Betty also what she wants to do.

Looking forward to a wonderful experience.I wrote back with:

Actually, the lab station sounds the most interesting, but honestly I really want to be where ever I am most helpful! I don't think that I would have any problem with either of these jobs, although I do not know French.She answered with:

Thanks for getting back to me so quick. I talked with Bettie today and she is very happy to do the BP check in station, so you are set to be the lab RN. She lives up in Shelton so it would be hard to do the training on the i-stat machine anyways. I should be getting the machine in the mail on April 12th, and so sometime after that you and our pathologist, Julie Kingery will need to get together and figure out how to use it. I want to make sure we have all the right supplies and controls and all that. It's good to practice reading Urine dipstixs too before you go. No worries on the language. We will have Creole translators and they are very versed on telling people to pee in cups!! :) You can read about the i-stat on line at Abbot.com.

(This post is more for local people, although you non-locals are welcome to help out.) I am in the process of gathering supplies to take to Haiti. As I mentioned, my team leader is going to commandeer my checked luggage and most of my carry on for supplies that the Haitian people need. All of my trip fees are for buying supplies, but it doesn't cover everything that is needed. Therefore, if you are able to help out with supplies, let me know.

If you do want to donation, things can be either used or new. If you have these lying around the house, great, if you want to pick up a generic bottle of acetaminophen (generic Tylenol) the next time you are at the store, even better! All items will go directly to the Haitian people that we work with in the clinic, as well as an orphanage that is also associated with my group.

Here is a list of supplies that we still need:

nr Clinic: washclothes (for hygiene packs) bags of all sizes (large trash, small trash, baggie, snack, etc) clorox wipes non-latex gloves peanut butter batteries- all sizes adult multi vitamins with and w/o iron (UNOPENED) children's multi vitamins with and w/o iron (no gummy, they melt, also UNOPENED) Tylenol (generic or regular, UNOPENED) paper towels

For MTM orphanage: combs & brushes for black hair skin lotion hair cream-with a tar or sulfur base if possible, these tend to repel scabbies deodorant/antiperspirant bath towels kitchen towels/bar rags work best & are less expensive, can be bleached underclothes & socks pj type clothing misc. clothing in good condition, modest (boys sizes 7-12, girls sizes 7-16) accessories are always welcome-belts, purses, ties, hair foo foos, etc.

As I said, you can just give these things to me (either at work or at home) or if you are feeling really ambitious you could mail me the things if you live far away (although it would probably just be either to send me a check and a list of what you want me to buy.)

OK, the first thing is an earthquake update. I was listening to this guy on the radio who was talking about earthquakes and tsunamis on the west coast. His interviewer asked him about tsunami warning systems, and how people would know if there is a wave coming after an earthquake.

His answer: if the ground shakes, that IS your warning. If an earthquake stikes the west coast, a tsunami WILL follow. South coast has about 10 minutes until the wave hits, north coast has a little more time, about 20 minutes. He suggested that you get about 80 feet up, more if possible. If you don't know what 80 feet looks like, then right after a earthquake is not the time to find out.

The second is an update on my trip to Haiti. This lady that I am going with is insanely organized. She is bringing food. She brings supplies. Scrubs are already there. There are books and a computer there. She even has toothbrushes. "What should I bring?" I asked her. "Nothing, really", she admitted. Of course, she is claiming my entire checked bag quota (and part of my carry-on bag) for medical supplies going there, and I will have to stuff my nothing into whatever is left. I have my ticket and so this is looking like a go.

The third thing is that I MAY be playing flute at the Waypost on 4/6 at 7:30pm. I will probably be playing as a part of Classical Revolution PDX. I am hoping that I will be playing Bach's Andante from Brandenburg Concerto No. 4 in G major with three other flutes, which will sound near but not quite like this:

(Yes, there is a lot of uncertainty in this announcement. But if you get there and I don't play, then you are probably better off.)

Could you imagine the president of a major company in America personally apologising to those that were affected by his company?

This picture is from http://www.msnbc.msn.com/id/42144324. The caption reads:

Norio Tsuzumi, vice president of Tokyo Electric Power Co. (Tepco), left, apologizes to evacuees at an evacuation center in Tamura, Fukushima prefecture, March 22. Public sentiment is such that Fukushima's governor Yuhei Sato rejected a meeting offered by the president of Tepco, the utility that runs the Fukushima nuclear plant. "Considering the anxiety, anger and exasperation being felt by people in Fukushima, there is just no way for me to accept their apology," said Gov. Sato on national broadcaster NHK.If this were America, not only would the mayor take the companies apology (and probably his campaign finance contributions), the company and the mayor would probably band together to place all the blame on the opposite political party.

Please consider Donating to Japan. They are doing all they can to try to help themselves, but this disaster is too big for anyone to handle alone.

So, my housemate found a video of some geologist that is claiming that due to a perfect storms of tides and full moons and equinoxes (equini?) the "big one" is going to hit this Saturday. As the picture shows, I ran right out to the store, and I feel pretty prepared:

In all seriousness, if there is a big one, check here: Safe And Well. I will put myself on the site, if anyone cares.

Here is the video. Imminent earthquake? Decide for yourself. Before you panic, keep in mind that this is Fox News that we are talking about:

I attened a "Brown Bag" at the Old Church in Portland. As the name implies, the Old Church is the oldest church building in Portland. However, the name is misleading as it is actually no longer a church. It is not a nonprofit that houses weddings, concerts, and other gatherings. It is a beautiful place, and they will hold free noontime Wenesday concerts that I love to attend. This week, we heard David Rothman, who presented us with many lovely Chopin pieces. A list of their concerts can be found here.

They announced that the concert was going to be taped, and requested that we remain silent between movements, only clapping when the piece was completely finished. I wondered why live concerts were taped like this, rather then just taping in a controlled environment. I guessed that it probably had something to do with the energy of the player or something like that.

A few minutes into the concert, a few people came in. The newcomers were obviously a group of people who were developmentally disabled, with two escorts. They had to come in through the handicapped door due to the fact that one of them was in a wheelchair, and that door was at the front of the room, so everyone was staring at them. I glanced at the microphones, and thought to myself that this wasn't going to go well.

About five minuets after they showed up, one of the members gave a long, loud moan. Everyone's head spun around at the sound, mine included. The person who had made the noise was smiling and clapping his hands siliently in joy at the music, and the room glowered at him. I smiled, but I saw that a lot of people were troubled and a few were angry.

The pianist was one of them. After the song, he asked if there was a noise. One of the audience members pointed out the group and said that it was them. There was an uncomfortable silence, then one of the escorts led the noisemaker away.

I felt so terrible for him. Although I understood that the tape of the concert was probably ruined (at least for that song) I wondered if the audience and the pianist realized just how vital it was for the young man who was kicked out to attend a concert like this. If it was so important to get a good tape, then they should have made this clear prior to the concert to make sure that people who were not able to listen silently would not show up. Maybe the man who left didn't understood why he was leaving, or maybe he did and was sad, hurt, or even humiliated. I wouldn't be surprised if the small part of the concert gave him just as much joy as the rest of the people listening, perhaps even more. The disabled are marginalized, removed from societal, and rarely able to attend an event like that. It was wrong for him to leave.

I was driving to work the other day when I saw a guy holding a sign asking for money standing by the road.

Now that isn't a strange thing in Portland. At almost every busy corner, stoplight and stop sign, there are homeless people holding signs.

What was odd about this guy is that he was standing at the end of a freeway on-ramp. You know, the part where you have just accelerated to the speed of the expressway and you are getting ready to merge. He was standing right where the expressway meets the ramp.

He was holding a sign that stated "VETERAN, ANYTHING HELPS, GOD BLESS".

And as I zoomed by him at 50 mph I couldn't help but think, "Well, that explains why we haven't left Iraq yet."

I can't believe the pictures that are coming out of Japan. It's like the entire area was the set for some lame Micheal Bay movie. The most dramatic pictures that I have found are here.

Please consider donating aid if you can. I, of course, recommend the Red Cross, and you can donate directly to Japan here.

I will be travelling to Haiti this April!

I will be in Haiti from April 25th through May 3rd. I am very excited about this opportunity! This will be the first medical trip that I will be making as a nurse, I am going to be using some of the money that my father left me to fund the trip. I would like to think that he would be proud of what I am doing.

He might be less pleased (or at best indifferent) that I will be travelling with a Christan organization. I will be going primarily to provide medical assistance and less to "to help spread the good news of Jesus Christ", as they present as part of their mission statement on their website.

In addition, I have added a personal goal of not getting arrested in this particular country.

Stay tuned!

Although it's a day late from Halloween, I wanted to repost this awsome re-hash of the classic game (on which this website is based) "The Oregon Trail". Instead of battling natural forces, you are battling zombies to get to my new hometown of Portland, OR. It's a blast.

You can play the game here.

There is really no better way to spend your All-Saints Day.

Last Friday I exposed my 11-year-old housemate to what is essentially the whole of my childhood- Watership Down. My sister and I had a game, we would name a line in the movie and the other would have to give the next line. The loser either couldn't name the next line, or named the wrong line. (The script, by the way, can be found here.) That should give you an idea of how many times we watched that movie. A lot. And yes, on a few occasions we did manange to recite the entire movie from memory, a feat that I am sure I could repeat today. Oh yes, and the lines also included the heavily-accended cockney spoken by the human characters at the start of the movie and during the farmhouse scene.

I was glad to share this experience with my current foster family, as well as fill them in on any lines that they missed (and explain the Warren of the Shining Wire, which I don't think that the movie did a few good job of covering, we can't all be perfect.) While watching this movie for an interation that I am sure went into the triple digits, I was struck by how lovely the score was, one aspect of the movie that I had never really highlighted as one of it's charms. Anyway, I got to thinking how nice it would be to be able to do a sort of medley on the flute.

Anyway, a quick search of "Watership Down Score" showed that no such was avaiable. No score is for sale. The soundtrack is also out of print and very pricey. I figured that I could pick it out myself, but I have a lousy ear and plus I wanted to have the option of piano accompiament. Anyway, just when I was about to give up, I found someone who shared the thing. I got a copy, and I will start to work on a flute solo transpostion straightaway, but first I thought that I would share it here:

Download a version of the Watership Down score.

It's not the actual score, I think that someone had my idea of putting together a medly, but they did it with a full orchestra. Anyway, if you, like so many others, have been searching, enjoy! And please leave a comment about the book, movie, or the score, as both are truly amazing. (The TV show sucked however.) If you haven't heard of this and would like to check it out, then use one of the links below as I get money from Amazon when people buy off my site.

And remember: "What is, is what must be."

Sometimes I can't beleive how smart Google is.

I was applying for a job, and I wrote in the email cover letter "Please find my resume attached" but forgot to attach my resume, as I often do.

When I hitsend, Google threw up an error box that was like "Uh, do you want to attach something?"

I'm telling you, someone should write an app that can tell when you are romantic with someone by looking for keywords...

Then when you type too slowly or make too many mistakes, an error box will pop up and say "You appear drunk. Are you sure you want to send this?"