(This post summarizes our day yesterday, August 1, 2012.)

Today, we continued to explore the spectrum of prevention, treatment, and care found here in Haiti. This morning, we walked through the dirt roads of rural Hinche, passing donkeys loaded up and heading to market, ox-drawn carts, roadside food and drink stands, and friendly, waving neighbors, to St. Therese Hospital, the local health care facility run by the Haitian government.

Carrie Wortham, the In-Country Administrative Manager for Midwives for Haiti, and two translators from MFH, provided us a tour of the facility. We weaved throughout the green and white campus and quickly made mental notes of the vast differences between this place of care and the health care facilities we are accustomed to at home in the United States. We began our tour by visiting the maternity ward where midwives trained by MFH assist in delivery on average 85 births per month. We toured the pre-op and post-op wards, the pediatric unit, and saw the HIV and TB wards off in the distance in the back of the hospital. Both Partners in Health and Midwives for Haiti have a strong presence at the hospital, most notably paying the salaries of many of the health care providers employed there.

While Carrie took us anecdotally through the day to day workings of the hospital, we were shocked to hear that families of patients have to provide and maintain all linens, bed pans, and food and water for the patient; the hospital is there only to provide the direct care. Even after a woman gives birth, the family collects the soiled linens, etc. in a bucket and carries them as they make the trek home. Many times, a woman will walk or ride a moto the more than two hours home within a few hours after giving birth. Perhaps even more shocking, at times there are no surgical gloves to be found in the hospital. Midwives for Haiti stocks their own supply room for the maternity ward so that is not an issue, but the rest of the hospital is vulnerable to supply shortages. As we made the walk back to our guest house from the hospital, conversations brewed amongst us trying to make sense of what we had just seen.

Back at the guest house, we convened for a Creole lesson conducted by Pierre Kenel, who gives private lessons to our host, Carrie. The fellows were studious pupils, taking notes and practicing pronunciations amongst themselves. I have been most impressed by the commitment of our fellows to learn the local language.

After an afternoon rain shower cooled us off, we headed to the Azil, a malnutrition center for children that is run by nuns of Mother Theresa’s Missionaries for Charity. We arrived right at feeding time, and we helped bottle feed the youngest children a nutrient-rich formula. The children at the center usually stay from 3 weeks to 2 months for treatment, and their parents are required to visit them every Monday. Many arrive at the center with severe malnutrition, stomachs bloated with fluid and worms, and hair with a blondish red tint to it, signaling lack of nutrients. We saw a variety of cases, but the most jarring was the sight of a 3 month old baby that looked like she had just been born months premature. After the older children had had their afternoon snack of mangoes and milk, they joined us in a small classroom where we brought out educational coloring books. The books, designed by Virginia Beach local Jean Mackay Vinson, tell the story of a Haitian brother and sister while teaching proper hygiene and sanitation to prevent gastrointestinal parasites. The Azil is about to celebrate its 25^th year of operations here in Hinche, and it was incredible to witness a community center devoted to free care to treat the health of the youngest.

We concluded our day’s activities by visiting Maison Fortune orphanage, where we will spend a part of each of our remaining days in Hinche. Today’s visit was merely a meet-and-greet and while the boys played a competitive game of soccer, the girls visited the girls’ home to paint nails, sing and dance, and assist in practicing their English. More on the history and mission of Maison Fortune to come…

Stimulating conversations and sharing reflections on the past few days rounded out our evening.

Aneesh’s Highlight of the Day: Playing soccer at Maison Fortune.

Brian’s Highlight of the Day: How one game of soccer can be a uniting and hopeful force.

Bridget’s Highlight of the Day: Realizing that what seem the smallest details in medicine can be the most important (e.g. the availability of gloves in a hospital).

Elizabeth’s Highlight of the Day: Hearing the girls sing at Maison Fortune.

Stuart’s Highlight of the Day: Coloring with kids at the Azil.

Wyatt’s Highlight of the Day: Feeding a baby formula for the very first time in my life.