We had an early start this morning in an attempt to stretch out our last full day in this incredible country.  Uncle Marion, our host’s uncle, led us on an herbal walk.  At age 81, he is quite the character and can identify the “miracle” plants that cure anything from kidney stones or prostate cancer to upset stomach or worms.  Two of the students ordered and received special teas for their respective ailments – we have our fingers crossed for them! 

Today, we walked much of Jeremie as we made final trips to many of the sites of our week’s work.  We spent our morning huffing and puffing up the mountainous terrain to the Missionaries of Charity where we did health education to about 40 children.  Jessa, the germ, wowed the children as she danced around to explain where germs live and how washing hands, covering for coughs, and brushing teeth will help keep germs away.  A giant soap, giant toothbrush, and a giant hand whisked the big germ away.  This health lesson was quite the spectacle, but as the Sisters do not allow photos to be taken inside the compound, our descriptions will have to suffice. Just imagine Jessa with Groucho Marx glasses and a hot pink feather boa – wouldn’t you be afraid of “germs” too??  Teaching through song reiterated the message and the children enjoyed playing decorating ‘healthy teeth’ with stickers and crayons.

Afterwards, we crossed the breezeway to the men’s side of Missionaries of Charity.  These men live at the complex for hospice care.  Patients include both the old and the young -- from diabetic amputees to cachectic and frail victims of unknown maladies. We spent our time massaging their sore muscles and tired bodies. Often, it felt as though we were simply rubbing their bare bones. As we made our way down the rows of metal beds, the men began to line up for their massage. Those who are well enough to sit outside came in and lay down, awaiting their turn with the nursing students. It was an act of the most basic nursing care and reminded us of the sheer power of human touch. The men showed their appreciation through their smiles, their relaxation, and the light in their eyes.

 

Making our way across the street to the women’s hospice care center, our patients were no less grateful. The women had heard that we were at the Missionaries of Charity compound before our arrival, and the ones who are able waited for on the porch benches. What started out as hand massages for the women turned into full body rubs, as each directed our attention to other weary body parts that needed massaging – feet, temples, backs, and even bellies. When they had finished with their massages, the women went inside for a craft activity. We had brought along colorful plastic beads, and giggles filled the room as the women made bracelets for themselves and for their bedridden fellow patients. To have something extraneous, something out of the ordinary, and something of beauty – this was extraordinary for them. Once again, the power of touch and individual attention proved amazing.

 

Working at the Missionaries of Charity was the perfect way to end our week in Haiti. Providing holistic, basic care was exactly what the patients – and we – needed. There’s a lot to be said for medical advances, for expensive drugs and technology. But in an area like Jeremie, where much medical care as we know it just isn’t available, a return to basic, low-technology nursing proved quite effective. The activity was intensely moving for both patient and student nurse. If the experience alone wasn’t enough, the Mother Superior at the Missionaries of Charity of Jeremie gave each of us a medal to express her gratitude. They are small medals of Blessed Mother Teresa of Calcutta, which have been touched to her tomb in Italy, making them very special for believers. “Blessed” is the first step to sainthood in the Catholic Church.

 

After our last meal at Place Charmont (a very un-Haitian dish of pizza, complete with ketchup sauce), we went out on the town with our translators, FanFan and Moondi. Even our fearless instructor Beth, who had been laid up since Thursday after a “spectacular” fall down the rained-on steps of the dining area, trekked down the mountain in the dark to “Oasis,” where we enjoyed a few last (cold!) Prestige beers and danced in the dark bamboo-curtained club.

 

Early the next morning, we loaded up our bags and headed back out of town. Our luggage was much easier to manage this time, as much of what we had brought was donations to leave in Haiti. Arriving at the airport, we waited for about an hour for our puddle-jumper plane to come, and then we took off from the dirt runway and were gone. The plane ride allowed us a few last spectacular views of Jeremie’s beautiful landscape -- an incredible end to an incredible week. Though our trip was short, it made quite an impression on all of us. We learned so much about public health nursing, about cultural competency, about humility and humanism.  Even after returning to Baltimore and resuming our usual activities, a part of all of us remains in Jeremie.

Waking up this morning at the top of the hill overlooking Jeremie the skies were dark and it was quieter than usual, even less humid, even a little chilly? Running up the mountain, the roads, so filled with pot holes that the pot holes have pot holes that the ruts are roads unto themselves and the footpaths wind their way through the road. The roads were strangely clear today, everyone preparing for impending rain. After our breakfast among the flowers and trees at the top of the mountain we pile into the old school land rover and head down the mountain for whatever adventures Haiti brings today. We get dropped off at the Center of Hope, a maternal waiting home and treatment center for children with Kwashiorkors (a malnutrition disease when children don’t get enough protein). The maternal mortality statistics in Haiti are staggering (1 in 17 women) so the Center of Hope is one more way to try to help bring these statistics down. At the Center of Hope after a tour and orientation to the center we split into two groups – half of us going to the pediatric health education and vaccination area and half of us working with the amazing nurses (and one doctor) who were doing post partum and some pre natal visits. Though the nurses we were working with are “only” LPNs, they do some amazing work assessing diagnosing and educating the patients. I think all of us are struck here by the possibilities of the nursing role that we have seen. The nurses in the health education and vaccination center were equally adept in their work riling up the crowd of over 50 women and their children who show up for education according to age for nutrition and baby care. We all feel pretty confident in our abilities at administering vitamin A, oral polio and DPT to squirming babies under the tutelage of the Haitian nurses. We also had the unique experience of meeting some doctors from Cuba who are part of the Cuban government’s outreach to other countries. They are in Haiti, as they are in other countries around the world, giving medical care, aiding health institutions and training local doctors. The Cuban doctor who spoke with us was amazingly humble in her expression of her work and her desire, the goal of the entire outreach effort, to work in a culturally appropriate way that would aid Haitians to be able to meet their own health needs without outside assistance. Humility was in fact the theme of the day – after getting stuck in a phenomenal rain storm that only lasted for a bit, we went to visit Eve Rose. As we arrived at her house we tromped up the steps to be met by little children, many many little children, who kissed our hands and wished us Bon Soir. Eve Rose runs, far beyond an orphanage, a home for children, a spot of grace. She has 75 children of all ages who are clean and healthy orphans, those who no one else wanted, but Eve Rose’s heart envelopes them all and the sense of pervading calm and kindness is profound. We played with the children, we toured their home; we held them, took pictures of them and then in a surreal moment that can only happen in Haiti, only in Jeremie, the children assembled their band of discarded instruments and played. From what was discarded something beautiful emerged and in the shining faces of the children playing and the littler ones clapping, it was hard to believe that this was not a family … somehow of 75. After clapping and cheering we felt obliged to return some bit of entertainment and led the troop back down to their courtyard playground of cinders. We sang our new favorite health song (Bon Sante – Good Health – sung to the tune of Father Abraham with crazy actions … it’s a long story). Every single face broke into a smile as we danced together and sang together, taking turns one American song for one Haitian a cultural exchange, a human exchange transcending our lack of Creole. The culminating moment was when the children sang an American hymn about lifting up the name of the Lord – the spirituality that Eve Rose professes evident in the way the children help each other little paired with big and vocalized in both Creole English to not a dry eye in the humble courtyard. Humbled we could only say thank you and after hugs and kisses and pictures and writing down the words to songs we knew to add to the impressive repertoire the kids already know. Humbled we are seeing in Haiti immense need tempered by immense kindness – from the malnourished child who offers us a seat, to the nurses who wade to meet us in the middle of the linguistic divide, to the people who open their homes and hearts to us, to the Cuban doctors who are giving free service to a people not their own, to our host who has made this her life’s work, to Eve Rose whose family numbers over 400 orphaned children finding a home in hers and grows with child she plucks from the street and each heart that is touched by her family. Humbled, every one of us would be happy to not get back on the plane on Saturday for at least few more days in Haiti to offer whatever help we might be able to offer, and yet humbled to know that it wouldn’t be enough, but that it would be accepted as if it were.