Timoun III: Here, the children teach me. . .

Not to be shy to throw words out in a language I don't speak so I can get a new person's attention.

That most people sense what you are searching for, who you like, and when you are genuine, but only children will chatter that truth into your ears because "mind your own business" doesn't count if your smile is wide enough to make everyone's business your business and if it is more fun not to "mind" anything

That if you open your eyes wide enough to see the whole world but only look into one set of eyes, slide a your tiny hand lightly into theirs, and let your shoulders dance you will get a hug.

That it completely normal to be reenacting a motorcycle accident one minute--violently flinging your body, whirling in circles and screaming "Whizz," "Pzz" and "WAP" noises--and doze off in the grass the next.

That if I want something, ask for it. If the answer is, "No" shrug and smile.

That a hand in mine is security.

That if a tiny face thinks something is funny enough to giggle over then it is.

That the body warmth of a Mamie's arm knot is the best commodity.

That if I trip on my own dignity, get mud all over my legs, scrape my elbow on plant spines, rip running shorts on tree bark, skin my knees on gravel and blow snot into toilet paper, I won't die.

That I can see a boat fly over a bridge, a worm swallow a goat whole, an airplane rain ripe bananas, a flower turn into a butterfly, and a spider roar like a lion.

That I can mix mango juice with salty beef stew in my mouth, just to see how it tastes, then announce to everyone, "It was gross but I swallowed it because Sara said I can't spit food into my juice."

That at 6:30pm while I am sitting at the table, holding a fork over a plate of rice, beans and fish, there are five billion things I can talk about, look at, and point to that have nothing to do eating.

That at 7:20pm when I my grownup friends say I will have to eat alone if I don't finish my food soon, I can shovel the entire plate into my mouth in 10 minutes.

That the best place to hide is behind a Papa's leg.

That the prettiest view of Haiti is from a seat on top of someone else's shoulders.

That people are born knowing how to dance but they forget how because they learn to get nervous instead.

That the best person to emulate is the most ridiculous one.

That if you tell someone what they are good at, they will do it better.

That a Blan with blue eyes must have more toys than anyone in the world.

That it is terrifying when someone in scrubs with a stethoscope hanging from his neck wraps my bent arm in plaster because he could be trying to turn me into the Egyptian mummy I learned about at school.

To smile; to ask questions about the answers to questions I just asked; to talk till my breath runs out, put my hands on my knees, drop my head, gasp some breaths and then talk some more; to fight for the attention of grownups as if my livelihood depended on it.

Pictures

Malformed Miscarriage

Yesterday, I looked at the line between fetus and tumor,
the point at which two definitions of life argue over
jurisdiction. A membranous mass poked out of the
pink mouth between her two thighs. The only sign
of what she claimed 31 weeks of stomach stretching
had produced was her cringe when a latex wrapped
palm pressed against formless rock inside her womb.
Oxytocin injected through a silver needle into her leg
muscle swam through her blood and squeezed her uterus.
She whimpered—the dilute whine of futile contractions.
The nurse walked out—“There is no rush, it will come.”
She moaned and something lumpy plopped out of her
and onto the floor. She crocked her resistant head up
to see what her womb had abandoned. It was maroon
and gray, a blob of membrane, opaque and unremarkable,
attached to withered placenta flesh. I shined my flashlight
down and saw two feet, together smaller than my palm,
pressed against the amnion. There was no face, but there
was hair. For the sake of the tiny toes and contorted legs,
I scooped it up in my off-white gloves that separated
human life from the stench of death and rotten blood
and laid it down in a blue plastic tray. The Mama knew
how it happened—a voodoo curse,a zombie snatched
her baby’s face, sucked it cold,and replaced it with death’s skin.

5 Favorite Creole Expressions

1.“Ko pa fè, estomak pa mon, tèt pa kalbas”
Melissa, I think this is what you have tried to tell me again and again. You tried to say it when I sucked up my stomach pain—a stomach ulcer in formation—to prove to my body that I am stronger. You tried to say this when I wanted to scream at my knee for failing me three weeks before 26.2 miles in Nashville. If I could have listened, maybe you would have said it when I collapsed into dream fog on our favorite couch instead of finishing our conversation. Here is the translation: “Body is not iron, the stomach isn’t a mountain, the head is not a kalbas (a fruit that is as hard as a rock).”

2."Se yon 6 ki di yon 9, 'Poukisa ou krochi konsa?”
This one explains itself: “It’s a 6 who asks a 9, ‘Why are you flipped over like that?”

3."Si absèa pa nan dèyè ou, ou ap di pwese"(If the abscess isn’t in your ass, you will say, ‘press it.)
My senior year in high school, shadowing in the ER in Omaha, I helped a physician’s assistant pierce a large abscess, that seemed to me to be a lime-sized zit near a woman's anal orifice. We pressed it till all the smelly yellow slime ozzed out, and stuffed it with gauze soaked with betadine. The woman screamed in pain.
Last Sunday night, a 22-year old woman who sliced the bottom of her big toe open along it’s crease made me sweat frustration when she kicked each time I pinched forceps to pick pebbles out of the area around her exposed toe bone. I stepped back and sighed.
I had already told her, “If I don’t take these out, it may not heal and you can get an infection."
I was preparing to tell her again, more firmly when the obvious slapped my forehead. She was speaking the language of shooting pain: “I’m going to die!” “It’s too much!” “Make it stop!” And I was trying to feed her logic. It’s like giving milk powder to a dehydrated tongue and scratchy throat.
If the pebbles aren’t in your toe, you will say, “Hold still.”

4."Tet chaje" (Head Loaded)
Here is the feeling: I’m sitting at the pharmacy desk, surrounded by papers listing medications I don’t know in handwriting I can’t decode. The dates are wrong, but I should be able to figure out which order in the computer the receipts correspond to by comparing items purchased—except that 15 of the 20 items on each order overlap, so even if I could read them, I have to compare each medication name. Then I need to enter the amount purchased, convert gallons to ounces, one is one-hundred twenty eight. Except, does it say 5 or 4? Or is that a 2? Oh and Givanson is bouncing in my lap, usually a welcome distraction, but he bumps my arm so I type “111111111111” instead of “128” And Charlie, the accountant, just walked in, “Hey Sara, did we sell 3 Dextrose Serums yesterday?” Did I mention that the desk is a mess, a Christian show about purity in the household is blaring from the pharmacy lady’s radio, and the cashier is tapping her foot waiting for me to count out 60 Comprimés of 325mg Aspirin?
That is “tet chaje”

5.“Two prese pa fe jou ouvri”
Too much pressing time, doesn’t force the day open.

Kaka Bef

It is 7am on Saturday morning. I leave the hospital with 4 boys, ages 6, 13, 15, and 17, the hospital director, Shawn, a Haitian physician, Ruth, and the hospital administrator, Sandra to climb Limbe's Mon De Tet (Two-Headed Mountain).
I start up the mountain with the older boys, happy to keep their excited pace. Givanson, the 6-year old, would hurry up the mountain with us, except it he has a tendency to skip around, ignoring danger, so the Shawn holds his back pack and walks him up slowly.
Soon, we are ahead of the rest of the group and I am transpiring through my clothes. Every once in a while, we stop for a little bit and make sure we could still see them behind us. Finally, we reach the top of the mountain. We sit in the grass and rocks and wait for the rest of the group. In 30 minutes, we start to hear Givanson's voice. He is singing about something as he scurries up the mountain in front of Shawn.
When he gets to us, he runs up to me, and grabs my hand. "Sara," he says, "Nou se de kabrit." (We are two goats) I turn to Shawn for an explanation. He says, "I told Givanson he is a little goat (ti kabrit) and you are a big goat (gran kabrit) because you both run fast and you both scamper up mountains happily."
Givanson loves this.
I start to feel bad that I left Shawn to guide Givanson up the entire mountain, so I say, "Givanson, m'ap desann mon ak ou" (Givanson, I will go down the mountain with you.)
Shawn smiles. "Are you sure?"
I nod and we start down. I realize, contrary to what the rest of our group thinks, descending the mountain is much harder than climbing it. It seems steeper on the way down, I struggle to maintain my footing, as my arm starts twitching from the weight of Givanson's body as he skips around, hanging on my right hand. Givanson and I start sliding on the pebbles splattered over the path down the mountain. I hold on to any tree branches, or tall grass I can find to slow our descent
"Givanson," I say, "Si ou komanse tombe, chita konsa" (If you start to fall, just sit back like this) as I put my palms behind my hips, and sit on the rocks to show him. He nods, but I don't think he is paying attention.
He starts singing as he continues to skip, "Sara se yon kabrit, mwen se yon kabrit, nou se de kabrit" (Sara is a goat, I am a goat, we are two goats.) He likes his song so much that he starts giggling. Soon, he is telling a story about two goats on a mountain in creole, but he is talking too quickly and interjecting too many "click", "swoosh", "vroom" and "plap" sounds for me to understand the plot.
The mountain gets steeper, and my heart rate climbs because I don't see any grass (which is much easier to climb down than shifty pebbles) and I see ravines on either side of Givanson and me. Givanson is singing again, enjoying the immunity from worry of a child who does not yet have images of danger stored in his brain.
Suddenly,for no aparant reason, Givanson jumps. He jerks me and I loose my footing, letting go of his hand so he doesn't fall with me. I am falling down the mountain, sliding on my legs and bottom, scratching my skin on rocks, trying to grab onto anything that could slow my plummet. Givanson is running after me, saying, "Sara ou ap tombe" (you are falling).
Finally, I grab a bush with my left hand, and stop seated. I feel nothing for a few seconds and then every part of my body sings it's pain to me in chorus. Givanson slides up behind me and stops, grabbing the same bush that I am holding. He stares down at me with a serious expression for a few seconds, then he starts giggling--the spitty giggle of a happy child. Suppressing his laugh, he tells me, "Sara, ou te tombe nan kaka bef!" (Sara you have fallen in cow poo!) Then he resumes his laughter, letting his head fall back as his knees weaken with the weight of hilarity.
I look down. For a second, I want to cry, but Givanson's splutter of laughter prevents any tears from forming. I start laughing too. Soon, I can't breath. .
When we get home, I shower and go to dinner. Givanson is sitting, stuffing fried plantain into his mouth. When I sit down across from him, he smiles at me and sings, "Sara te tombe nan kaka bef" in a quiet voice. Then, he looks to gauge my reaction. I feel my cheeks twinge pink, and I smile.
He takes my smile as permission to announce to the entire table, "Sara te tombe nan kaka bef jodia!" (Sara fell into cow poo today). Everyone looks at me. I smile and shrug. I can't tell whether people are laughing at me or at the joy with which Givanson made his announcement.
Soon, he finishes his food, and he jumps up to share the news with the other table. Then, he scampers into the kitchen and sings to the ladies who cooked our dinner, "Sara te tombe, sara te tombe, nan kaka bef." He can hardly breath, he is laughing so hard. The more he shares the news, the more interesting his presentation becomes. By the end of the night, he has a song, a dance, and a clumsy reenactment for his performance. I would be embarrassed, but the situation is miles beyond embarrassment.

"Beautiful white, permit me take a photo?"

I'm sitting with Givanson wrapped in a towel in my lap, trying to warm him enough to stop the shivers that started when we stepped out of the clear, blue saltwater ripples. I look up and see a Haitian man standing in front of me, watching. I must have been rubbing Givanson's arms for a while before I saw him.
He motions to his silver cannon camera and says, "Beautiful white, permit me take a photo?"
This question grabs my brain. Suddenly, I recognize that everything is strange in this moment. I'm sitting on a beach chair (the first one I have seen since I have been in Haiti), under touristy palm trees, in shorts and a sports bra (because I didn't bring a swimsuit), sharing expensive beach shade with wealthy Haitians from the Cap and American tourists (compliments of Sandra, the hospital administrator), and a Haitian man wants to take my picture.
I can't say, "No." Haitians of all ages have been more than gracious in letting me flash light into their faces.
I say, "Wi ou ka fe foto." (Yes you can take a picture) He clicks and shows me.
"Ou pale Kreol?" (You speak creole?)
"Ou m'kapab." (Yes, I can)
He asks me if I am a missionary. I respond that I am a medical volunteer in the Limbe hospital. He asks me where my Haitian child is from. In creole, I say, "He is not mine, I'm watching him for the day, but he lives at the hospital."
"Patsyon?" (Patient) he asks. I say, "No, an orphan."
He nods and says, "Do you love Haitians? I can see you do." I am a bit confused by the intent of his question. Hoping our conversation isn't headed in the direction of another marriage proposal, which would boost my total for the week to 5, I say, "I love Haiti."
He asks, "Are you adopting him?" I tell him no and I explain that he has a foster mother.
A Haitian woman comes up to him and says in creole, "It is almost 3, we need to leave." She looks at me and Givanson for a few seconds. I smile and then she smiles back.
I ask the man if he will also take a picture with my camera before he leaves. I am curious to see what he wanted to capture. He takes a picture and asks, "Could I have the pleasure of your name?"
"Sara," I say.
"Sara, eske m'ka fe foto ak ou?" (Sara, can I take a picture with you?)
"Wi" (yes)
I stand, he hands his camera to his companion and she clicks. That makes two pictures of me in a stranger's album.

Timoun Part II: Running

There are 7 boys playing soccer outside the pharmacy window in the grass that spreads in front of the hospital. Before the lawnmower stopped cutting and started shrieking this morning, a gardener was able to trim some of the scratchy green tufts, leaving moist grass juice and patches of buzzed green. The boys are barefoot dribbling their new prize, a lively round replacement for their exhausted "boule" that burst at the seams when they tried to pump air into it so it would respond to kicks.
Claudelle runs into the pharmacy, bringing with him a gust of outdoors to add to his breathless smile.
"Sara, Eske ou vle chute boule ak nou?" (Sara would you like to play soccer with us?) I look down at the white, oval shaped medicine I am counting into bags. Yes, I want to jump into their excited running, passing, and blocking, to be done counting 70 sets of 60 325mg fever fighters into tiny Ziploc bags. But I can't abandon the pharmacy, lines of patients, and stacks of prescriptions till 5pm. "M'ap vini pita" (Ill come later,) I told him. He left.
I look down at the pills. I have lost count, 55 sounds right, but maybe it is 54 or 45. Instead of recounting, I let my eyes loose focus till the discrete entities on the aquamarine tray become a white blur. Then I stop looking out of my eyes and I jump into the back of the white truck I was in last Saturday.
Givanson, a 6-year old generator capable of powering a large city for several days, hoped up on the bumper, straddled the door to the truck bed, and then lifted his other leg over and plopped into my lap. We were going to see the new mountain road in construction in the city nearby.
I felt him bounce up and down in my lap as the wheels popped in and out of the series of holes the village calls a road. I locked my arms around him, shivering at the thought of this tiny bundle of bounce falling. Soon, we were circling the outside of the mountain, griping the edge as we climbed. I looked out the side of the truck and gulped--the only ground next to the tire's edge was miles down, where rock crumbles that had fallen where no longer within my eyes' reach. We followed the road till we reached a large yellow caterpillar that was blocking the road. Our driver stopped the truck and we got out to walk. I stuck out--a white girl in black shorts and SLU tee-shirt. A woman balancing a basket of mangoes on her head turned and stared as I passed her. Farther up the mountain, a little boy hanging on to his mother's hand stopped, stared and said, "Blan" in a matter of fact tone.
One small girl gnawing on sugar cane pointed at me and said, "Ou gade kon administra" (You look like the UN).
When we reached the highest point, the end of the road, Claudelle whispered something in Creole to Shawn, the hospital director.
Shawn replied, "M' pa kone, demand li ou-sel." (I don't know, ask her yourself).
Smiling shyly, Claudelle walked closer to me and asked, "Ou voule fe kous kouri?" (You want to race?)
My legs started tingling before I had the chance to express my excitement "Wi mwen vle kouri ak ou anpil!" (Yes, I really want to run with you) I said.
Because I had been waking up every morning at 6am to run, and because the children didn't leave for school till 7am, I had earned the title, "Blan ki kouri kouri kouri" (White who runs runs runs). Later, Shawn told me that Claudelle had been talking for a week now about racing me. I had no idea.
We started out--me, Claudelle, Shawn, Givanson,and 2 other boys. After about half a mile of running down the mountain, Givanseon quit.
Two minutes after that, the hospital director told me, panting, "I'm done, it's all yours." Soon, Claudelle and I were the only two racing. We rushed down the mountain over rocks and past people carrying objects on their heads holding children in their arms. I felt like water must feel when it pours over the edge of an abyss to splash below--my body was surging forward and I was just along for the ride. I soon realized that people on the road were pointing and laughing. "Gade blan la!" It wasn't mockery--it was surprise.
One woman stopped, put down her basket, clapped her hands together, and said, "Kouri kouri kouri!" with a broad smile stretched from cheek to cheek.
Soon, we could see the truck in front of us and we both started sprinting to finish. Claudelle's hands touched the back of the truck before mine and he collapsed, leaning his body's weight on the truck rim as he panted for air. I got my water bottle out of the back, pated his back in congratulations, and handed it to him. He smiled but didn't say anything as he gulped water. When he handed my bottle back to me, I poured water into my mouth, letting some spill down my neck.

The week after the race, I found out from the other boys that Claudelle told the story of how he narrowly beat the American marathon runner several times at school that week.
Imagining the eager story teller with his dramatic motions, I smile.
Ever since that Saturday, Claudelle and I have been running buddies. Most mornings, I walk out of my room to run and Claudelle is standing outside waiting for me wearing his honest smile. We run together. He tells me about school and corrects my creole. He also likes to cheer us on, repeating little phrases over and over with each breath, "Sara ka kouri, Claudelle ka kouri." (Sara can run, Claudelle can run).
I return to the room and the paracetamol tablets, to guide 60 pills across the tray with a tongue depressor and pour them into a small ziploc bag.

Medicine in Haiti Part II: "Smarter than Doc"

Our star patient, the hospital celebrity who had apparently managed to exhaust an entire asthma inhaler in one day, came back for a follow up.
She originally came to the hospital because she was in an accident and fractured both her left leg (fibula) and her right forearm (radius). The physician only prescribed her the inhaler because he noticed she had asthma while he was treating her injuries.
She entered the room with her two daughters. I thought people in casts know it is a bad idea to use or put weight on the healing bone--bad assumption. She limped in holding her cane with her right hand, the one in a full cast, walking on the plaster that surrounded her left foot.
Dr. Felix said, "Please sit" and her daughters each put a hand under her armpits to help her into the wooden chair that, when in the room, makes it impossible for four people to stand without touching shoulders.
Out of instinct, I set her cane on the left side of the chair, hoping that would lead her to hold it with her left hand when she got up, supporting the side of her body in need of support--the side of her broken leg.
The doctor looked at her chart, "That's odd...nurse didn't take her blood pressure."
He looked up, "Did you check in with Miss Diga outside?"
"Yes doc," said the wide-eyed sister who interrupted our consultation with a pregnant teenager a few weeks ago.
I looked at the three of them. The 80-year old woman with her soft concentrated expression--the result of a toothless closed mouth--breathing with the focused labor of an asthmatic exhale. The wide-eyed shorter daughter who had not moved her body or gaze from her position directly across from the doctor staring at him with eyeball protrusions. The third member of their party was different from her sister. She was obviously in charge of the situation. Her dominant stance, her sharp eye pokes cycling between me, the doctor, and her mother, her broad shoulders, and the fact that she stood 6 inches taller than her sister told me her role.
Dr. Felix's voice interrupted my analysis, "She didn't take your blood pressure?"
"No doc."
Dr. Felix called out, "Miss Diga, could you please come here?"
He set the chart down on the exam table to wait. The few seconds of pause must have been too slow for the daughter in command because she pulled the curtain open, popped her head out of the room, and said, "Miss Diga. Come here." If someone would have asked me to assign television set volume numbers to their voices at the time, Dr. Felix's would have been at 18 and the daughter's at 32.
After calling the nurse, she guided her sister out of the room, saying "This room is to small for you to stay when the nurse comes in." I laughed into Dr. Felix's eyes.
Looking at the patient, holding her broken arm above her lap with her leg cast stretched out in front of her, I thought about her transportation to the hospital. Most likely, they crowded into a twelve-seat bus with 25 other passengers. I imagined this elderly woman walking on her broken lag, pushing against a cane with her broken arm, leaning on one of her two daughters with the other. She had to walk the block from the bus drop-off to the waiting room. I cringed, 'I really hope she took a bus.'
The nurse wrote the blood pressure numbers down, unvelcroed the cuff, and stepped out.
Dr. Felix asked the older sister who had reentered with her sister before the nurse stepped out "How is the second inhaler working for you?" His eyes twinkled from an internal chuckle.
"Didn't get it," she said.
My eyebrows jumped. I thought I had my fill of surprises from them. "So you haven't had an inhaler for her for several weeks?" He asked.
The shorter sister--to whom Dr. Felix had directed the question said nothing. The larger sister said, "We still have the first one. It's almost gone though."
Dr. Felix asked, "So how many inhalers have you filled prescriptions for?"
"One."
"I prescribed you two. You said the other one was gone."
The older sister raised her index finger, "Yes Doc. I sent her to get another one from you because I knew we would need it once the first one ran out."
"But you never bought it?" I asked.
"And you told me you used all of the first one even though you hadn't?"
The shorter sister smiled--the way you smile when you pull off a successful bluff in a game of poker.
Dr. Felix examined the patient and started writing on a prescription paper. "I'm going to prescribe you some calcium so your bones can repair better. Take one every morning with breakfast."
The two daughters nodded and the dominant one said, "I never bought the second inhaler and I lost the paper for it, so add that to the prescription too."
Dr. Felix looked at me, shrugged and scribbled it down on the paper.
Two refill prescriptions later, this 80-year old woman is still on her first inhaler.
"Before you go," Dr. Felix said, "Tell me how you use the inhaler."
"2-3 pushes whenever she breaths badly" said the smaller daughter, smiling.
Dr. Felix told her, "Hold that with your other arm," as she reached across her chair with her right arm for the cane.

Thinking Into My Keyboard

I looked at you and I realized complacency is not an option for me. I used to think constant reaching was the problem; that it is important to be content right where you are so you never burn out.
But I see that it isn't the reaching that creates stress, burnout, and an inability to see the present through the hazy fog of an imagined future; It is the expectation that accomplishing the one goal will be self-actualization. It is "Once I get there, I will be done."
I will never be done. There will be something else to stretch my arms toward, something new to build brick by brick. But I can love the preparation, enjoy the sweat-drops and the heavy lifting. If I live challenge, I will not be lethargic, nostalgic, or disillusioned.
The moments of glory are not me. Success is dessert--short lived pleasure. Too much sugar spoils teeth. Easy successes--the result of setting goals that are lower than what you are--create an illusion of invincibility.
Habits are the components of character and personality. I am the key turning in the ignition, the sweat, the push, the hanging on, the lifting.

I Don't Want To Leave

(This is a journal entry from last Thursday morning)
I got back from my morning run, looked at the calendar and cringed. It’s June 3rd. I have to go home in 2 months. I don’t even want to think about leaving this hospital carrying three bags, pungent images, and a tear monsoon.
Two weeks ago, in the moist heat of the afternoon, Florita, a retired nurse from California who continues to channel her energy in medical missions, wiped drips off her glistening forehead and asked me, “Gee, do you really think you can make it till August?”
I smiled because that was not even a question in my mind. There is no “making it” in my schema of this summer. My mind reads, “I only have until August. I can’t let any bit of this experience slip between my fingers.”
I realized Florita sees me through her discomfort sunglasses. It hurts her to break inside over the orphans, to shower 2-3 times daily and still stand in her own sweat, to be away from her California kitchen with its rainbow array of home grown vegetables.
And all of that is here, but that is not what I am seeing in Ayiti. Yes there is sweat, there is a cloud of wet around me when I sit, stand, clean, sleep, eat, play and work. I am surrounded by pain and poverty. I see protruding rib cages, distended stomachs, and despondent eyes. I see the quivering chest of sickness, the thick maroon blood ooze, the arm reach of desperate loneliness. But, I do not see those things because I am in Ayiti. I see hunger, fear, despondence, and pain because I am a human being living in a world that maintains misery for other human beings.
The things that sting me here in Haiti will sting me while I memorize names and pathways at my desk in my air-conditioned bedroom in St. Louis. Distance may create an illusion of separation from human pain, but if I put my contacts in, I will see it in the mirror, in the sloppy letters I scribble on pages like these, on my way to and from rooms with chairs, desks, and a lecturing professor. I realize I don’t want to leave Ayiti because it is tangible human pain. Not only can I see and feel it, I can hug, feed, clean, and hold it. I will never be done with Ayiti, never be safe from the “inconvenience” of reality for human beings who reflect my character and values to me. I don’t want to be safe or far from Haiti.
I know I have to leave eventually. I have a 8.5 by 11 plane ticket sitting in the drawer under my nose to remind me, but I know that piece of paper with a return date that makes my stomach sink is not my last flight itinerary with “Haiti” written on it.
There is a feeling when you try a puzzle piece in a spot and it slides in snuggly and that is what being in Ayiti has been for me. My life’s contours are complimentary to my position here. I didn’t have to cut off bits of me just to fit or tape pieces of cardboard on to fill in my empty spaces.
I am here and for now, I will leave my ticket and suitcases in the drawer, away from my visual field and my first thoughts. I don’t have to leave—not yet.

Ti Moun Part I

I have never been so easily identifiable by my skin color before. For the children in Limbé, Haiti, I am a female and my name is “Blan” (White).
The first time I left the hospital grounds to hike up Limbé’s large hill with the surgery team visiting at the time, the village sort of splattered in my face when I stepped outside the gate. Chickens running along the side of the road caught my attention for a second until a truck carrying too many people for its overworked wheels, whizzed by, close enough to raise my arm hair, disrupting dust and rocks in the pothole scattered road. Next, my eyes stuck on a woman trotting down the street with a huge basket full of mangos resting on her head.
Once I had acclimated to the city’s bustle and filth, I felt a small presence around me—little brown eyes were staring at my face, my hair, my green Keen’s, my white shirt, and my black shorts. Breathless, open-eyed silence.
A tiny barefoot girl in a soiled pink dress broke the silence with her bird chirp voice, squealing, “Blan!” (White)
There were a few seconds of silence after but it was my turn to end those. I spread the smile that little girl inspired in me as wide as my lips would allow and said, “Bonswa tifi.” (Hello little girl)
She giggled and ran over, grabbed my hand, turned it around in hers to examine the skin, and then skipped her tiny dusty body closer to me. The other children followed.
“Blan, Blan!” They yelled, “Fe Foto,” (Take a picture!) “Ba mwen mange-a,” (Give me food)“Bam’ jouet!” (Give me toys!) They also demonstrated the influence of western culture by saying the only English phrases they knew, “It me babay one mo tie!” “I luff you babay!” “Touch ma body”
I felt like I was taking a 1st grade classroom on a fieldtrip and they had decided to bring all their younger siblings along. A little boy whose head barely reached above my knee was trotting along taking big steps with his baby sister on his back.
One by one, I tried to learn the children’s names as they crowded around holding my hands and my clothing. I said, “Rele mwen Sara.” (My name is Sara). One of the boys giggled, “Sara Blan!” (White Sara) and that became my name for the rest of the hike.

(Ti Moun literally translates to "Little People," but it means children.)

Some Pictures

The city of Cap Haitian (taken from my seat on top of 5 110pound bags of rice in the bed of the hospital truck)





Children walking in front of me in Limbe



Me in the OR.

Anecdote to the Personal Anguish of a Student

I used to cry, back when I felt entitled to save,
but the more still irises I saw and quiet chests I felt,
the more I realized the uselessness of me raining
salt water and whimpers. I found other ways to
purge myself of “I didn’t know enough, didn’t
do enough.” Now, I whisper, “I’m sorry.” to God and
pick up another stack of papers filled with names,
D.O.Bs, systolic over diastolic numbers, and chief
complaints. Instead of draining tears, I surge forward.
I say, “I couldn’t help you, but I will help them.”
And that ridiculous faith (that healing hands can
counteract the infinite forms a death threat assumes)
is enough to slow the lub-dub of this physician’s heart.

The Death of a Stranger

You were 17 years old, 98 pounds.
My fist on the bone between
your breasts, you huffed with each
push, merely an illusion of life— it
was the sweat from my shoulders
pumping blood through your body.

When Dr. Felix closed your eyelids,
I cried. Not because I will miss you
(I never got to find out how to make
you giggle or what little you had envisioned
for an older you) but because you should
not have died before you had the chance
to create life in your womb, to feel the frenzy
of your body amplified in another.

You came for us to help you, to make the
pain in your stomach, the dizziness, the
confusion go away. We took your pressure,
100/50, blood sugar, 70, asked questions
your Mom answered because your brain
acted like it was stuffed with cotton,
and sent you to drip blood into lab tubes.

I’m not asking God, “Why”— I know. Fifteen
minutes after your Mother shrieked at the
silence of your still body we saw your
Widal test—320. Typhoid attacked,
medicine and your heart failed you.

Diabetes in Limbe, Haiti

You are a Haitian with type-1 diabetes.
What is wrong with you?
Your body destroyed your pancreas beta cells that produce insulin to clear toxic sugar out of your blood so it can be stored safely. Your body ate the cells that keep what you eat from poisoning you.

How does this affect you?
You cannot make any insulin. Sugar is good—for energy, but just like water you can have too much of it. You need water to clean, to drink, but if you don’t have a way to get rid of the water you use, it will destroy things. If you wash your clothes in a tub of water, but cannot dry them out, they will grow mold. If you cannot eliminate the water you drink—if your kidney can’t get rid of gallons of H20, your body will be too dilute, too watery for your cells and they will drink till they burst.
If you can’t take sugar out of your blood, you get sick. You become dehydrated, you have trouble breathing, your stomach hurts and you might vomit. If enough sugar builds up, your body will try to fight the buildup, but the fight is dangerous breakdown of sugars that releases acid in your body. If your body pH drops too low, you will die.
Sugar poisons your eyes. Too much of it will make you go blind. In the same way that sugar turns clear water to thick, cloudy syrup. Sugar can cloud your vision--make rain trickles, and velvet moss on tree bark invisible to you.
Sugar can break your kidneys down so they no longer filter.
With enough time, sugar can take away your sensation. The nerves that fire at you when you stub your toe or warn you when bacteria eats away at your skin, break down.

How do you fight this?
If you are a Diabetic living in Limbe, you wake up every morning and urinate in a cup. You then take the cup and walk a few miles to the HBS diabetic clinic. You get there at 8:45 and wait for the nurse. You cannot eat until you see her. She should be there at 9am, but she is always late.
Maybe today, she gets there at 10:45. Your stomach grinds as it pushes air bubbles farther down into your intestines. You stand in line. When it is your turn, you use a dropper to put 5 drops from your cup of yellow into a test tube. Then you add 5 drops of a blue chemical and hold the tube over a flame. You watch the tube. If it turns from blue to yellow or orange, you show the nurse. She looks up from her desk across the room and scribbles down an amount of insulin she will give you. Then you put the dropper into a dish full of cleaning solution and pour your urine into a plastic bucket that used to hold dry detergent right outside the door.
You wait.
Once everyone has turned five drops of urine blue, orange, or yellow, the nurse calls you to a window—one by one. She draws up insulin--just humalog or humalog mixed with cloudy white solution called NPH. She hands you the syringe. You try to find fat in between your leathery skin and the bones that give it angles and inject. You give her the syringe and leave.
It is 11:50 and finally you can have your first meal of the day. There is no insulin later in the day. If your sugar levels get too high and you want to vomit, you have to get through it till tomorrow. If the insulin was too much—if it sucked away the sugar you need for energy, you will try to find some candy. You will repeat this every morning for your entire life. It is your only way to fight sugar poisoning—to sustain the ability to think, breath, feel, and see. Testing strips--the ability to know your blood sugar is a luxury life will not afford you. You would not believe it if I told you that American children have little machines that beep at them when their blood sugar is getting too high or too low. You are lucky to have survived to be diagnosed--diabetes kills many young people before they have the chance to figure out why they feel dizzy and nauseated so often.
Your mornings belong to your disease. This is how you survive as a diabetic person in Limbe.