Thank you Tehran Bureau!

Week 1:  Zahedan

Week 2:  Bam

Week 3:  Bicycling across Iran

Week 4:  Kurdistan Part I

Week 5:  Kurdistan Part II

Week 6:  Sufi Dervish Ceremony

Note:  written in haste- hence, typos grammatical errors etc-.  Forgive me.

I realize it’s been a while.  I’m no longer in Haiti, but have continued to keep track of our patients there & wanted to update you on a few.  Above is a story i never told you about til now.  When i was working at Project Medishare in early April the work shifted from taking care of earthquake related injuries to being the one and only hospital equipped to care for dire emergencies like the above case.  If the hospital was not there many would have died if life had gone on as “normal.”

The above child, let’s call him “Joe”- Joe and his sibling were outside (homeless due to quake) in one of Port au Prince’s many neighborhoods when an electric generator- which provided electricity to his neighborhood (installed by a private company)- suddenly burst into flames, falling from the sky- tragically landing on two small children: Joe and his sibling.  Needless to say they suffered the worst kind of burns.  When they were brought to Project Medishare they were put in the ICU.  That day i was given the new duty of training 4 new psychs at the hospital.  Many were asking very valid questions like- ‘how do you talk to people if you yourself have not experienced such tragedy’ (ie: natural disaster, death, losing a limb)?  I explained that most of us have not been through this & that it doesn’t really help to ”talk at” folks like we do at home- we are simply there for people as human beings (why i often argue that you do not need to be a psych but def do need to be a compassionate person).

I had been there long enough to witness how the Hatians console eachother- in some ways it was more sophisticated in how we handle death- they mourn and grieve, and don’t try to talk one another into being anything but devastated.  Enter:  Joe, his mom (pictured) “Rose”, and his sibling who very sadly passed on pretty much right away- rest in peace.

Rose and her extended family received the bad news and were under a large green mango tree in mourning- this involved loud crying, reaching up to the sky and asking God the same question many many times ”why”, and pretty much losing it- as any of us would.  One of the new psychs asked me- ”shoudn’t we sedate her.”  No.  We should let her mourn.

We sat under that mango tree for hours- sitting behind Rose, holding her, holding her hands, letting her hug us collapsing into tears.  As we did a doctor came out and let us know- the next child- Joe- would probably pass on within 24 hours and to get her ready for it.  Rose already sensed it.

We moved into the children’s tent where her child was, because she also needed to make big decisions- take the body on her own- for a funeral she cannot afford- or let us cremate the body.  I am happy that Rose had family there to support her.  She had already lost 2 other children in the quake (how anyone can believe in karma after knowing such stories is beyond me), so how she could handle any of this was truly miraculous.

I found a cot for in the children’s tent and laid Rose down, putting ice bags on her head- she began wailing asking God questions again, which built up to screaming.  I sat behind her like a mom would do her to her child (mind you she is 6 foot tall- and i am 5′5″) and did what i had seen Hatians doing to eachother in such a situation.  Eventually she was dead quiet- eyes wide opened, as if she herself had just died.  I do not doubt that parts of her had- time after time.

One of the volunteers who was American but had done Peace Corps in Haiti & is married to a Hatian man came over- i told her I was worried that we had taken over the children’s tent by bringing in an adult who could yell louder than any of the kids there.  All the families crowded around their sick youngsters- sometimes one whole family in one cot-  were looking at us- some of their kids just beyond consciousness. I thought, in America parents would be pissed that this *adult* was having a melt down in the *kids* tent keeping their sick children awake.  The volunteer, probably chuckling to herself at my naivate, told me- “no- they are used to this- and the way she mourns.  What they are staring as it is how you are dealing with her.  You are actually making a little statement right now & they are judging whether or not they can trust you- and these doctors- based on how you are helping (or not helping) her.”

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After a few hours, extended family made decisions about the child’s final arrangements, and they decided to leave for a few hours and change- they had already been there for about 24 hours, yet their clothes were still pressed and they were groomed meticulously.  Grace and poise among devastation.

I thought that little Joe was definitely on his way out, and that how were they going to ever have the option for funerals… So i dipped into a special reserve of $ that friends had given me before i went to Haiti- for situations just like this- found $80, crumpled them up into a tight wad, and forced it into Rose’s hand.  I did not realize that this small gesture would make them my die hard friends for life. Actually it probably wasn’t the $, it was probably that i happen to be there during one of the hardest times of her life.

_____

The good news is Joe was fighting for his life- fighting hard and he was making a comeback.  There would be no way that he could fully recover in Haiti so a hospital that specialized in burns- in Boston- said that they would take him, and his mother (required for a relative to be with them).  One of my friends, Lisa Anderson, worked night and day to get this med-evac to happen.  She fought against bureacracy, workers who had the connections to government officials and visas not showing up to work for days on end w/ no excuse, and impatient nurses and volunteers who mistook other people’s negligence for Lisa dragging her feet.  I observed as Lisa- a person normally cool as a cucumber- broke down into tears fightng to make this happen.

When the day came that the German EMT team was whisking away Joe and Rose to the United States there was another small but bizarre twist in the plot: Another volunteer appeared to be trying to take credit for the med evac (crazy, I know..).  She stuck a cam corder in Rose’s face- getting her jovial reaction, her praising god for what was happening, not leaving Rose’s side like all her “hard work” had finally paid off.  Because this volunteer was in everyone’s face, and Lisa is an understated, not looking for the spotlight sort of person- people started assuming that this was Lisa & that she was the person who put it all together!  I was miffed, but Lisa did not care- she was just so thrilled that this med evac was finally bloody happening and that this child had a good chance of living because of it.

I think Rose may have sensed this.  She came over and rubbed Lisa’s face with her hands- kissed her- thanked her, hugged her.  One of the hospital admins, who knew how hard Lisa had worked for this yelled “Lisa, you go with them to the airport” clearly gesturing at the real Lisa Anderson.  Everyone gathered round as the Germans lifted Joe into the ambulance- Everyone was relieved but no one more than Lisa & Joe’s family.

Lisa sent me the above photo from Boston a few weeks back- Joe is doing incredibly well.  And Rose as always looks happy & appreciative for the little victories amist a life full of insurmountable hardship.

For those of you who remember my stories of “Jean” from a while back- well, his real name is Luckner.. & here’s an update:

I was visiting Luckner and his wife at his bed when a skinny dude ambled by on crutches.  The PT assisting him said in passing, “did you know that this man was run over by that man?” pointing to Luckner, and smiling- (so it was not said in an accusatory way just an FYI/now they are both doing much better way).  She did not know that i sat with both Luckner and the younger guy (we’ll call him “Alex”) when they arrived to the ICU 6 weeks earlier.  A quick recap, Luckner was shot when someone tried to carjack him.   He immediately became quadripalegic & so lost contol of his car- ended up running over someone who was walking down the street- the man who now stood before us- Alex.

I wanted Alex to know how much heartache Luckner had about what happened.  I told him that Luckner cried when he found out that Alex had to have his leg amputated, and how uncomfortable it was when Alex’s family came to visit in the hospital- Alex’s bed 4 feet from Luckner’s.  I remember Alex’s family & how they stared at Luckner not knowing what to say… i had to explain that Luckner was not at fault & that it was an all around tragedy.  At the time Alex had lost so much blood & suffered so much trama that he was bloated beyond recognition… nurses said that he was likely not going to make it.  He was hooked up to so many machines- i do not even know what they all did.  As i sat with Luckner, he did not say anything about the fact that he would never be able to walk or move his arms or trunk again- he moved what one thing he could- his neck- to look over at ALex’s bed about 4 feet away.  Tears fell from his eyes.  It was absolutely heart breaking.   

I worked with Alex’s family- but they did not say much.  The next day when i checked in on Alex he was awake- still bloated and hooked up to all sorts of tubes- but he was actually using his phone to text.  I was told he had been texting all morning. 

To see this healthy man now standing in front of me- he looked nothing like he did when he was in his bed 6 weeks earlier,  I joked with Alex about his texting skills.   Alex smiled widely- the PT said that that was the 1st time that she saw Alex smile since she’s worked with him. 

After introductions, Alex sat in the chair next to Luckner and the two of them talked.  It was tear jerking- to me at least- i could not believe that they were reunited & that they were both alive.  Despite losing his leg Alex looked really good & healthy.  Alex was sweet with Luckner and they even developed a friendship after that where they visited about once a day. 

The sad news in the good news is soon after that Alex was ready to be discharged.. like most people, he had no place to go- but the streets.  we scrambled to find him a tarp or something to use for shelter.  Hardly anyone wants to be dischared and leave the hospital- because there is nothing out there for them- any of us would feel the same way in their situation.  Even when we see progress and have good news, people still not having even the most basic of basics is beyond sobering and unbelievable.

Above:  the big tent is a communcal sleeping area- the 3 other big tents not shown are the actual hospital.  The smaller tents house staff overflow, isolation for patients with highly infectious illnesses, and also the morgue.  My first rotation with project medishare I stayed under the big top tent: ”the city” as many of us called it- however when i went back again, it had gotten seriously cramped in there.  Much more cramped than this pic i took back in January:

the next 2 rotations i opted for smaller tents in the “burbs”  provided by Shelter Box- the first was their standard round thing- but the next time i opted for a more palacial “African style” tent that had more ventilation & gave an air of not Africa, but Arabia.. muy romantico. 

Shelter Box (SB) has given away tens of thousands of tents all over Haiti- they go in after disasters around the globe & provide very durable tents to those left homeless- thsi is a critical need.  Even at the hospital one of the biggest requests from patients is for a tarp or a tent- people have absolutely no where to go to & no place to call home.  It is truly beyond comprehension. 

I hate to admit, unlike most people i somehow found myself to have the Africa tent all to myself for 2 decadent nights after my Physical Therapist roomates left… I had learned at the hospital that among the death there is also life- so when i see it i need to embrace it.  Makes sense that the men, grapes, foot rubs, and wine then appeared to provide stress relief when i had the tent to myself (kidding of course..).  You really have to take it while you can otherwise you will go crazy…

Ok, Ok.. so we’re not supposed to have “favorites” but we all do… My favorite baby in the age 0-2 category *this* rotation (not 1st or 2nd- those awards are aready spoken for ; ) is this sweet little twin.  She was badly burned in a cooking accident, but still managed a jubilant disposition.  She loved to head-butt, dance, and pretend walk.   Here she is the only time i ever saw her get cranky:

I have to say, Babies in Haiti cry & trantrum alot less than their American counterparts… I think we can all guess why.

Here is her twin- also very cute…

One of the things I do in my “down time” at the hospital this rotation is “skin to skin” with the preemies.  While doing this, I bonded with a 1 week old orphan named “Emily” pictured here..

I love this little lady…. hard to fathom that she is parent-less…

Incredible to hold and cuddle such a tiny little girl… I hope that we find her a good parent & that she does not get lost in the shuffle of bureaucracy… time will tell..  I’ll keep you posted…

First it was Wyclef Jean & now they are attacking Sean Penn- why does the media love to attack celebrities who do charity work?  Is it simply that no good deed go unpunished?  I know, I know, some are simply opportunists- i get that, ie:  what’s her face- the blond- who went to Rwanda to soul search after she gained 5 lbs, etc-.  However Sean Penn & Wyclef have been putting their money where there mouth is for years- not just when it’s fashionable. 

While in PAP i met an evangelical minister from Texas- he started complaining to me:  “Why do the media attack Wyclef?  I saw him with my own eyes, picking up dead bodies!!”  Hey, great point mister.    He went on to say that he has not seen the Red Cross once.  And that it was starting to piss him off.  A conservative evangelical minister from Texas.

Sean Penn came to our camp to drop of a little girl with Hydrocephalus.  He was flying a specialized doc in with his own money to treat her.

Afterwards a group of about 10 of us gathered round him- not b/c of his movies, but becasue of his charity work & activism.  He looked tired and worn- it was clear that he had been working round the clock- for the past MONTH.  Sean gently and humbly told us of the work he and his group J/P HRO had been doing and how he just could not bring himself to leave after what he had seen- every single one of us knew exactly what he meant.  Like me, the man is driven by his heart right now- not dollar signs or fame.  So why must the press attack him?  Let’s even pretend for a moment that he was doing it for fame (which i do not believe he is) then in the grand scheme of things, does it really matter?  Should we continue to wait around for the Red Cross to finally DO something rather than let him?  I would not hold my breath.

THere is no shortage of NGOs in Port au Prince right now- the streets are clogged with SUVs inching along- all with various NGO banners accross them.  Oxfam, Doctors WIthout Borders, Catholic Charities, etc- they are all there… but one big group was surprisingly absent, from my view at least.  I gave them the benefit of the doubt but once again, on my second trip they were nowhere to be found.. and i was not the only one to feel that way.  Why does the media not attack Red Cross who gained the most money rather than the humanitarians who also happen to be celebrities?  A few days ago, Red Cross distributed 5000 tarps in Port au Prince- their “biggest distribution” yet.  Uh, that is sad sad sad.  Wyclef is picking up bodies with his bare hands & Sean Penn has built refugee camps- but the Red Cross: 5000 tarps.  Really? 

 I finally saw the Red Cross once- it was at a mental health meeting at the UN.  I spoke about what we were doing at the hospital- afterwards the Red Cross lady stopped me to ask “what do you think the needs of Haiti are?”  She went on to say that they are still assessing the situation.  I wanted to say:  “shouldn’t I be asking you the questions lady?” but i kept my cool & told her how horrible it was to discharge patients onto the street- how they all had no where to go- most without even a simple thing like tarp to protect them from the elements.  What we need are refugee camps- YESTERDAY and housing that can withstand the fast approaching rainy season & soon thereafter hurricane season.  I explained that i was not the expert.  I arranged a meeting for her with my boss, the head of the UM hospital- but she cancelled last minute and once again asked me on email to answer the same question that i had already verbally answered the day before.

(I wanted to say: read the writing on the wall, lady..)

If you wonder the same about the Red Cross, here is some advice from a friend who shares my frustration:

 
“We need your help…..please continue to work on your own endeavors to solve this problem, however please help us lean on the Red Cross.  Please call your local chapter and speak with the CEO.  Leave a message daily until he/she calls you back. 
http://www.redcross.org/where

Call DC HQ (don’t fall for the 800-get-info routine- they don’t know). Ask them for information regarding distribution of essential items in Haiti.  Tell them that you work with locals that are homeless, tell them that you discharge patients with newly amputated limbs to a street corner filled with rubble.  Tell them you want information to give to these people stating where they can collect a tent, tarp.  Demand an answer regarding supply distribution and fund distribution.  This should be public information.

The estimated population of Haiti is 9.7 million
http://www.google.com/publicdata?ds=wb-wdi&met=sp_pop_totl&idim=country:HTI&dl=en&hl=en&q=haiti+population
http://www.huffingtonpost.com/2010/01/13/haiti-population-graphic_n_422179.html

Below article states 2.2 billion raised
http://www.google.com/hostednews/ap/article/ALeqM5idZiVQhHcyG1gpBjzXaAmmk4_OtAD9E8PTRO0

My elementary math equation from # of people and $ raised, appears that everyone could have a tent….actually, everyone could have had a tent by now.

Google “red cross criticism” - call a local reporter in your area that has reported on this.
http://www.google.com/search?hl=en&client=safari&rls=en&ei=wYmVS77jCJG6swPFgpWmBw&sa=X&oi=spellfullpage&resnum=0&ct=result&cd=2&ved=0CAYQvwUoAQ&&q=red+cross+criticism+haiti&spell=1

Also, Starbucks is taking customer donations and matching them.  What do they do with combined donations?  Turn it over to the Red Cross.  Where is this money?  There are other major corporations that are doing the same.  Call them.”

I rarely leave the tent hospital- maybe to go to a clinic or to the UN, but this time a friend took a few of us for a drive through the center of town “just to see it.”  It was not different from what you see on TV, but to see the destruction 1st hand- after some time had passed- I could hardly imagine how anyone survived.   Yet somehow life carries on.  People sold fruit and rice out of bags at a “market”, and other industrious people were collecting metals from the rubble and cars that were destroyed in the quake.  On the road side CDs, phones, champagne (?), radios, watches, shoes, etc- were up for sale.  Rudimentary “tent cities” are everywhere- not sure how any of those can withstand even a light rain though, nevermind the rainy season.  Near the UN tourist trinkets and art work are sold- Saw that as early as 2 weeks after the quake.  At the recently re-opened airport necklace sellers are out in full force- giant smiles on their faces and jokes at hand.  

Yes, ladies & gentlemen i hear you- you are asking: what about the mens of PAP, this round?  Last time we were in awe of the dreamy Portuguese Bombeiros.  But as we know they left Haiti- all that is left is a shell of their old camp which is now used as a triage center for our hospital-

So eventually we all had to accept the reality- start to lather and wash our own hair- and sigh loudly as we eat canned fruit straight from a can- no rum drizzled atop by a muscular Adonis type.  the suffering!!!! Enter: the Argentine Army…

YEs, ladies- it’s true.  All a girl has to do is leave San Francisco to be treated like the goddess that we all are by handsome adorable sweet men from all sorts of different countries.  But how do these gorgeous Argentine soldiers stack up in comparison to the Bombeiros??

As you an see: they are cute- but the sheer number is quite low (3 vs 30) add to that they do not have the sweet berets that the Portuguese wear.  THey did come bearing their own Heineken- and yes it was cold, but no one spoon fed me or gave me a stylish flame resistant suit.

In the end they were a delicious diversion who tried their best- probably not smart to even attempt to compare them to 30 beret wearing elite force Bombeiros.  However I thoroughly enjoyed my time with the Argentines, and for a little while, received some extra special treatment.   A memory never to be forgotten… in the midst of despair there is still life!  Thank you for teaching me that.

Last week there was so much death- but if Haiti has taught us North Americans anything- it is that we are fully alive- and to live while we are here.  Being short handed at the camp many had to do things they never thought they would have to to accomodate death- bagging dead bodies, creating a respectful funeral, and tending to the tent morgue.  We have a different relationship with death in America.  Not saying that Hatians do not mourn, are not in deep grief etc- but they have had to deal with death much more than we have- or choose to.  Because of that they are more enlightened and wise than us, in my opinion.  In America we do anything to avoid death- cheat aging, etc-.  We enable denial of a very basic and unavoidable sapect of life.  Maybe instead we could simply embrace living more so that our days here are full and when it is time to go we do not regret and in fact we are tired and ready to go?

I have not had to deal with death hardly ever in my life.  Sure grandparents passed on, and some of my students have died at the hands of guns… but i have never sat with someone as they were dying… until now.  The other day i was completely shattered because my favorite patient ( i know- not supposed to have favorites but we all do!)- had a very bad prognosis.  I sat with him as he went into near septic chock- annoyed with the doctors and nurses wondering why they could not do something more.  I crossed the boundares- personalized it, and then went into denial.  the doctors told me- this is it, lady!  I am in Haiti to help the Hatians- not be a burden- so when i began to well up in tears i reprimanded myself:  hold it together girl.  I did a pretty good job of it until myself and 2 other counselors- 2 of religious faiths, sat with the patient’s family and said prayers with them.  One of the counselors kindly came to console me- it was the first time i could not hold back the tears.  I was embarrassed and felt the spoiled westerner- he is here for them- not me: I immediately directed him back to the dying patient’s family.  

Later that night that rabbi/chaplain/funeral director/psychologist/counselor- as he called himself- came to tell me a story to enlighten me a bit on death.  This was more the Hatian way- tell a story, say a prayer to understand the death- don’t try to talk someone to death- figuratively speaking- as we do in the States.  He told me a long story about so many bible characters whose names are too long for me to even begin to remember them.  WHat the story boiled down to was some bible character asked another:  “How many days have you lived?”  rather than “How old are you?”    He explained that all that matters is how many days you have truly lived.  A good friend of mine, Dr. Shea, was standing beside me at this point- she knows me from Iran… “Michelle you really have lived many days.”  WHat she doesn’t know about me is that there are so so so many days- where I like many others- am waiting around for something to better to happen- some other time to come.  The rabbi/chaplian/psych went on to say- “When you look into ___’s eyes- you can see that he has truly lived- many days.  God is in his eyes.”  He was right.  Before this story was even told to me, i felt like i had a direct pipeline to god/divinity/grace when i looked into this patient’s eyes.  I know it may sound strange, but i felt like he was trying to tell me something.  He knew something that i do not know- that most of us do not know.  Something that words can not explain or describe.  All we can do is be present with it and not understand it.