Thursday, February 24, 2011

Trembleman Dete (Earthquake)

And so the earth's crust migrated again, violently shifting tectonic plate against plate.

This time, epicentered around the historically rich city of Christchurch, New Zealand and its coastal neighbor, Lyttelton. Amongst the city's many charms and wonders, it is known to me and many I care about as the historical jumping off spot to Antarctica. Another island of beautiful people, close to my heart.

At the time the plates migrated, I was sitting in the sweltering warmth of my clinic in Haiti, literally in the dark. Our electricity had gone out, again, for the umteenth time this week -- of course, timed perfectly to coincide with the stab of an IV needle into the arm of a young sickle cell patient, moaning and writhing in pain on the bed in front of me.

"Seriously?" I muttered to myself, as my eyes adjusted from the fluorescent light to the dark shadows, and I paused mid-stab to let my pupils widen and adjust to the sudden change in lighting. I palpated his vein with my finger, and attempted to blindly finish the IV placement by feel in the semi-darkness of the clinic.

As I felt for his vein... unbeknownst to me, across the world, on another island, on another sea, another hand in another dark place palpated the vein of another patient. A patient crushed by a fallen building. Trapped under tons of cement. Requiring emergency amputation to free him from the chaos of twisted cement and steel.

Trembleman dete. Earthquake.

That evening, as I ran past the grave of the Archbishop of Haiti and his two assistants -- killed last year in the earthquake collapse of Haiti's once grand, stained glass encrusted Cathedral....unbeknownst to me, on another island, in another sea, others worked in horror, digging bodies from the wreckage of another city's historic Cathedral.

As darkness fell in Haiti -- with still no electricity -- tired rescue workers in Christchurch, New Zealand -- still with no electricity -- continued searching for survivors in toppled buildings. As displaced persons in Haiti wandered about their tent cities, displaced persons in Christchurch wandered to tents in city parks, seeking shelter.

Mid-morning the next day, our electricity was momentarily returned. As the lights returned in the clinic, I took the opportunity to check my e-mail.

I scanned one message from home: "I'm so sorry about the earthquake in Christchurch. You must be so worried about your friends."

My heart skipped a beat.

"Earthquake?" I whispered to myself. "What earthquake?"

Perhaps I am not the normal earthquake-goer. Perhaps no one in Haiti is. You say the world "earthquake" to me, and images click through my mind like an old black-and-white 18mm film -- of fallen and tipping monolithic buildings, amputees, mangled flesh, tent cities, fields of refugees, screaming and crying patients all tangled together in a flash of memory.

"What earthquake?" I murmured again, as I quickly attempted to scan the internet on my telephone. The clinic went dark again. No electricity. No internet. No information.

My interpreter walked into my curtained exam room with another patient. At that moment, I had a hard time caring about her six month history of a headache. I forced my mind back to Haiti. Barely.

At the end of the day, electricity once again restored, I again accessed the internet. Facebook. Friends' postings: "Many dead here in Christchurch." "Cathedral destroyed in the square." "Buildings toppled." "We are lucky to be alive." "I slept on the ground in the park last night..." "I helped pull people from rubble." "We are okay." "I am okay..." "Has anyone seen Catherine..." "Has anyone heard from Joe..." "R U there?" "R U ok?"

No. Not again.

I scanned news reports. 100 dead, maybe more. 300 missing.

Stoically, mathematically, my mind did a calculation. 100 dead. Versus an estimated 310,000 dead in Haiti's earthquake 1 year ago. My mind does not minimize Christchurch's horrific loss and pain. Their 100, possibly 300, is devastating. Absolutely devastating. Instead, my brain is merely momentarily overwhelmed, by the magnitude of pain that comes from multiplying such devastation by a factor of three thousand.

After Christchurch's earthquake last fall, I spoke to a friend who lives in New Zealand. Their government advised its citizens that another severe earthquake was ultimately anticipated, and told people to take precautions. Of course, the problem with earthquakes is that the timing of the next "big one" is completely unpredictable. As tectonic plates get hung up when sliding against each other, the next big pop could be tomorrow...or one hundred years from now. Or, possibly never. Nothing, geologically, it seems, is dependably predictable in human time. A similar next "big one" is predicted for Haiti. Could this nation survive such a thing? Will it be tomorrow? Or long past time when it will matter to you... or me?

I stare at images of Christchurch. They are too sickly familiar. Flattened buildings, sprawling cinderblocks, dust covered people in civilian clothes digging through rubble. The gestalt of earthquake devastation, it seems, is cross cultural. As is the heroic and selfless human response.

There are some differences in the photos. In Christchurch, on day two, unstable structures are already surrounded by chain link fencing warning of dangers beyond. I have never seen such a thing here in Haiti. Good idea, I think, a bit cynically. I imagine, in Christchurch, one will not likely see a shopkeeper opening up a stall beneath a leaning wall of rubble. Nor will they see a tent, then a family, or three, settle permanently on the top of the rubble pile, with semi-naked children running about the apex of the pile, laughing and flying home-made kites. I imagine that deconstruction of buildings will take place with large gasoline-powered machines...not a single shirtless sweating man swinging a sledgehammer.

I pray that one year from now, my friends in Christchurch will not still be walking past the walls of their once glorious Cathedral, still crumbled untouched on the ground, as if it fell down yesterday. That they will not walk, day after day, past hollowed out shells of to peer inside to see the pink and green wallpapers of a better day. I pray that they will quickly recover, rebuild, and move beyond this horrible day. And, honestly, I know.

I know they can...and will... efficiently make things right.

My first reaction, upon digesting the news of this newest catastrophe, was an admittedly infantile and useless rant consisting of a few unsavory verbs, including one beginning with the letter F. And a questioning of the purpose of all things floating and tectonic.

But then, I realized... These same random crashing and floating plates of earth are the forces that created my beloved Alaskan and Himalayan and Antarctic, and, yes, New Zealand mountains. And, ultimately, the beautiful friendships that I have created there. The same random grindings that shook the earth in Christchurch this week are those that brought me to Haiti last year, and opened my heart and eyes to these people and this land.

And somehow, when the earth shook Christchurch this week, so too did it shake me. And I was reunited, instantaneously, with my beautiful friends of New Zealand and Antarctica.

So, to my New Zealand and Antarctic family: when I am threatened with your loss, I am reminded intensely of what you have meant to me and how you have shaped me. Be safe. And strong. And resilient. Be generous. And kind. And humour-laden. And, okay, sometimes inappropriate and cynical. That's cool, too. Be bold. And loving. And resourceful. Possibly intrepid. And, yes, because I know you can, be just a touch heroic and inspirational.

This is just one more upheaval in the crazy crust that creates the folds of our lives.

Things, from this moment, will get better.

This I know.

They will get better.

Peace and love to you all.

Sunday, February 13, 2011

Santo 19

I'm walking down Santo 19, the two mile dusty, sun-scorched dirt road connecting our clinic to one of the main roads in Croix des Bouquets. A walk through a microcosm of Haiti.

I pass an outdoor basketball court with rigged up hoops and nets. Dark skinned, well-muscled-if-slim, shirtless, glisteningly sweaty young men play a game of pickup ball under the blazing sun. Their moves are slick and strong, reminiscent of boys from inner city Baltimore I used to pass walking home from Hopkins. Bystanders, instead of clinging to chain link fences, stand in high grass, speckled with street dogs and the occasional goat. Players and spectators carry the same toughness of those inner city boys. They watch me pass, claiming their territory with sideways, less-than-friendly glances, intimidating in the universal body language of young men of neighborhoods across the world. One boy points and laughs at me. I pretend not to see him. I look ahead blankly and keep walking.

Beneath my feet, I look down and spy the dusty, flattened form of a shaggy brown teddy bear. I wonder about his story. Does a child long and cry for him somewhere? Did he fall from the window of a passing car? The act of a sinister sibling, perhaps? Or the tragic result of a sudden slip of small fingers, jarred out of a grip on the bumpy road? Was he carried away from a house by a family dog? Or, was he just discarded by his owner, his purpose in his child's life fulfilled?

The lady selling bottles of Haitian rum watches me pass. I do not imbibe, so no sale for her today. The glass flasks of amber liquid are 40 Goud each, or one American dollar. This is the average daily wage of a Haitian. I wonder how many flasks she sells in a day. This is how she feeds her family...on the profit of street sales of alcohol, brewed from the sugar cane indigenous to this land. A drink with a history as long as that of the Haitian people...a drink of the pirates who once wandered and plundered these Caribbean islands.

I walk on. I pass 2 baby goats. I wonder ... do they know about the stew? I cannot meet their eyes.

There is a large black cow, tied to a frayed rope, which itself is tied to... nothing. Escaped? Did it gnaw itself free, in an attempt to graze where the grass is greener...on the other side? The end of the rope is dragging in the middle of the street as the cow grazes next to a sign proclaiming "Merci Jesus". Is this somehow an ironic physical embodiment of the cow's thoughts? The grass here is pretty lusciously green. Appears tasty. If I were the cow, that's probably what I'd be thinking.

Two slim young women pass and smile. "Good morning," one says shyly in English. I apparently appear pale enough to speak English. They argue amongst themselves as they pass me. Her friend turns around, laughing, and corrects, "Good afternoon!" I smile. "Bon swa," I respond.

I look down. There is the skeleton of a dead puppy crushed in the road. This is hideous....far worse than the teddy bear. Ribs protrude from the dessicated, dusty hide. For a moment, I wonder if the puppy and teddy bear could have belonged to the same child. Now that would be a rather unfair turn of flattening events. I hope not.

The road is lined with high, new concrete-block and stuccoed walls. New since the earthquake, which shook down nearly every wall in the city. The walls are topped with broken glass bottles cemented into place to prevent (or at least lacerate) attempted over-the-wall intruders. Some wealthier walls support threatening curls of razorwire, ironically entangled with pink flowers of surrounding trees and, for added measure, thick spider webs. Yes, I suppose if the razor wire is not sufficient, putting your hand through a thick nest of spiders might be a wall climbing deterrent. It would certainly effectively deter me.

An old man pedals by on a bicycle, a young girl of about five in a pretty green dress balancing on his handlebars. She waves happily at me as she passes, a gigantic smile illuminating a face framed with braids tipped with little green bows. Her spirit erases the bad karma of the teddy bear, the puppy and the hostile teenage glares. A smile illuminates the old man's eyes as he pedals by. He is obviously acutely aware of the preciousness of his cargo.

I wander on, through the giant divets and potholes in dirt road, destined to rip the undercarriage out of even the most sturdy of vehicles that attempts to negotiate the scene. I pass the leaning, still-crumbling form of a building...a former clinic....that was heaved askew by the earthquake last January. More than one year later, it still teeters threateningly towards the road, partially held up by the metal fence which surrounds it. Red spray painted letters on the fence declare the obvious...the building is condemned. Is there a plan to remove it? Or will it sit there, in memoriam, for infinity?

A yellow motorcycle speeds down the road, directly towards me, as I edge to the side of the road. The driver and his passenger yell intimidatingly as they pass, the passenger reaching out, grabbing at me. I leap away at the last minute. They speed past, laughing, shouting something unintelligible, the passenger making arm gestures at me. I glare at them angrily as they speed away, infuriated. In my mind, I rewind the movie projector that plays this scene and I play it again. Except, this time, in the new and improved imaginary scene, I have a long broomstick in my hand, and just as they pass and scream and grab at me, I thrust the stick between the spokes of their front tire, causing the motorcycle to flip end over end into the air, and, in slow motion, catapult its passengers into the trickling stream of water/sewage on the side of the road. I stop the scene there, as they soak satisfyingly face down in the dirty stream, and before they can pull themselves slowly out to chase me down and pummel me for the audacity of my imagination.

I walk on cautiously, now hypervigilant as I am passed by a string of other motos. They pay me no mind.

A woman sways past, gracefully balancing a 5 gallon bucket of water on her head. She is walking away from a water pump on the corner, installed after the earthquake by the the Army Corps of Engineers. A blessing of clean water for this community, especially in this era of cholera. Even in a non-era of cholera...a blessing Children no older than 8 or 10 years old gather at this pump, also heaving large buckets of water onto their heads. 8 pounds per gallon times 5 gallons equals 40 pounds of water. Carried by mere children. The potential consequences of this pump are broad reaching. By limiting the distance women and children walk to retrieve water for their families, we know that this community will have a better chance to instead educate its children. And women will have more time to pursue income generating activities to better support their families.

Girls in blue and black plaid school uniforms pass. They are the lucky few in this neighborhood who have access to this case, from the Catholic school that sits on the compound that also houses our clinic. I am told that there are no public schools in Haiti. That children can only receive an education if they can somehow find a free private school, or if their family is wealthy enough to afford to pay. I'm not sure how to confirm this piece of information. But, if this is true....

Oh, do you expect to pull your people out of poverty without providing the poor with an education? Can't you see? How many young minds will never reach their potential for this nation-- as engineers, doctors, teachers, politicians, writers, artists, etc. -- because they were never given the opportunity to go to school?

I am acutely grateful, in this moment, for my years of education. Some of which were, ironically, spent wearing identical plaid pleated uniforms, ankle socks and black leather shoes. Huh. Never thought I'd be grateful for that.

I wander past the school. Classes are just getting out. Excited young voices spill over the wall as children anticipate their walk home for the evening.

I retrace my steps, wandering back towards the compound which houses our clinic.

Tomorrow morning, 250 people will walk this dusty road, slowly lining up outside the clinic gates. Some will wait up to 8 hours to see a doctor. Or a dentist. Or a nurse. Some will bring their babies to get immunizations. Others to get medica mamba, a peanut butter based protein supplement for malnourished babies. Some will be dying of cholera. Some with malaria. Others with myriad other concerns. Some seeking physical therapy, from injuries sustained in the earthquake, or other traumas. Some with immunization-preventable diseases. Some will see the first medical provider they have ever seen in their entire lives....even those who are living, amazingly, into their seventh decade.

At the free clinic, at the end of the long, dusty, rutted path of Santo 19.

Tuesday, February 8, 2011

Getting my Goat

I am so immature.

I stare down into the bowl of brown meaty chunks floating in a greenish brown watery chum, littered with specks of this and that, surrounded by a slick of swirling oil. I have a sudden flashback to the Louisiana gulf coast, and the BP oil spill catastrophe. The meat bobs like so many slimy, contaminated pelicans in a sea of sticky black crude.

Stew. Oh, no. Please...not stew. No no no. Not stew.

I stand in the dinner line and tap one of the brown floating blobs with the ladle and watch it momentarily sink, then bob resiliently back up to the surface. A strange, stringy, brownish floating leathery substance.


This appears to be Estelle. The goat. Last seen tied by a short rope to an overturned toilet out in a distant corner of our compound. Looking a little different now...her brown fur coat, elongated pupils, little goat smile....all stripped away. Literally Oh, Estelle. Mwen regret sa. You have become a stew.

It's not that I'm a picky eater, with stringent criteria for meals such as flavor and nutrition. I eat my own cooking, for heaven's sake. And it is a rare day when my culinary efforts contain both items simultaneously. I learned long ago to be grateful for any food that is put in front of me. So, though I have never been a fan of most meat, and turn pink and wheeze at the thought of certain shellfish, I will rarely push away a meal that has been prepared for me. At least outwardly. Inwardly, however, there is sometimes a whole lot of resistance going on.

There was that great dish "slaninia" when I lived in the former Soviet Union. That's raw pig fat, with skin and, yes, coarse spiky hair still attached. A favorite of the locals, especially fresh from the slaughter. (Sometime, let me tell you the story of a disease called neurocystercercosis... from a 10-plus foot tape worm acquired from eating raw pork. But that's another story for another day.)
Ah, yes...nothing like the sound of a screaming pig as it is slaughtered deftly in a neighbor's yard, hanging from its hind legs from a tree. As it exsanguinates into a bucket from its recent machete slice to the carotids, there is also -- unfortunately -- nothing quite like the sound of a thoughtful, neighbor, generously hacking off a slab of warm fatty flesh and skin, and calling out to you over the fence, "Friend...friend....would you like some slanina?"

I can't say that I ever "liked some slanina".
Thanks, "friend".

But, would I blankly turn my lips upward into a pseudosmile of pseudothanks, force my hand into extension, take the proffered still-warm, hairy, rubbery pig fat between my index finger and thumb, slowly lift it towards my reticently parting lips and shove it deftly at my clenched teeth until they reluctantly parted, then chewed wide eyed with an "mmmmmm...." sound that, depending on one's interpretation, could equal either pleasure or a suppressed whimper?
Yes. Yes I would.

The dance of cultural culinary acceptance.

When I lived in an Alaskan native village, did I similarly extend my hand to the generously proffered dish of raw seaweed, raw sea snails, and some sort of pea-sized raw fish eggs collected in honor of the coming of spring? Did I pseudosmile as I chewed, each fish egg popping like a small eyeball in my mouth, squirting out a gelatinous sharp fishy ooze, that simultaneously caused sweat to pop similarly from the pores of my brow, a reflexive gag in my posterior pharynx and sharp tears to sting the corners of my widely held, unblinking eyes as I whimpered internally?
Yes. Yes, I did.

And, when my friend -- a native Alaskan -- grinned knowingly as she watched me slowly chew and pop with a watery-wide-eyed "mmmmm", pseudosavoring the fishy slime, then quietly reached over and wordlessly scraped the remainder of the mix into her own bowl....did she become one of my heroes for life?
Yes. Yes she did.

Like the Native Alaskans and Native Americans that I have known, I am an omnivore sometimes out of necessity. But, as a not-avid meat- and living- creature eater, I acknowledge the sacrifice of the creature that gave its life for mine. So, I will quietly eat what is lain before me...and be grateful for its generosity.

Or, so I try to tell my so-called-noble self.

This intellectual challenge to the pallate is far more acute when one spends the day staring at malnourished children. Ten pound 2-year-olds. Young teenagers no taller than a first grader. Mothers who grab at my arm and say, "Dokte...I cannot feed my children. They are starving. Can you please help me? Can you give me food?" Orange haired Haitian children...with scaling skin, bulging bellies, protruding ribs...evidence of protein malnutrition. Marasmus Kwashiorkor. Starvation.

I am lucky to be eating. Even luckier to have protein. I am so overtly well fed. Overlyfed. More than fortunate. What a hypocrite I am, I think, as I balk at the proteinacous floating bits before me. Hungry sunken child eyes and flaccid skin and bony ribs flash behind my eyelids. Selfish hypocrite.

And so, I take a deep breath and face the bobbing oil-slickaceous goat stew.

Thank you, Estelle, the goat, for the days tied without dignity to the toilet, fattening yourself up for this day. That can't have been an inspiring life for you. Thank you cooks, who raised, slaughtered, skinned and slaved to prepare this stew for me today. Because you are honoring me, as a volunteer in your clinic, and a guest in your land, with this gift of meat. Because you take the time to caringly cook for me. In a land where so many go hungry every night.

Thank you for this food today. And for the contrast of my lot in life...with those that I meet every make me realize how fortunate and comfortable I truly am.

Don't let me forget that.

And, well, in a flash of extreme immaturity, here's a shout out to Louisiana Hot Sauce.
You are the ambassador of the international food ingestion challenge. The peacekeeper. The great leveler of the experimental pallate. Creating peace, understanding and culinary tolerance wherever you set your beautiful red-orange glass-bottled self.
Glad to have made your acquaintance here in Haiti.
You singlehandedly retrieved the shards of my wavering idealism.
While effectively suppressing my overlyzealous goat-induced gag reflex.

Today, you -- in your uniquely firey, spicy, distractingly vivacious nature -- are my hero.

Perhaps, starting today, I will endeavor to be more like you.