November 6, 2009

This morning was a busy one as we packed our bags for the week to follow and got ready to leave with Tour Haiti for Jacmel. After breakfast of fruit and toast Jolyane and I headed up to the clinic at 7 because we were told they would open the store room for us. We needed to gather up a few items for ile a vache and in our hectic clinic schedule did not think of it until last night. When we got to the clinic there was no one around. As we were about to leave we heard a noise so went back in, asked around but no one had a key. So we went back to the guest house and I helped Karen arrange our hockey bags for what was needed at ile a vache. Cyril arrived and we loaded the van, Jolyane and I decided to head back up to the clinic to see if they had arrived. No luck, but Jack was there and says he is feeling better after his motor accident, he laughed when he either recognized me or because I used kreyol "Koumon ou ye?" Again, as we were leaving, the storehouse clerk arrived so we scrounged around up there…it is really hurting, we had a hard time to find even simple things like a quad cane. We did not get much checked off our list so that is disappointing. I wish I had been better prepared on what we would need.
We set off for Jacmel and had a beautiful ride over the Chaine de la Selle mountains. Cyril announced when we were going up the steepest section and it was in this area that we had to pull over to allow a gas truck to squeeze past a tap tap that was stopped on a big turn and all the people were on the side of the road. We didn’t think much of it, but then as we passed the taptap we see that it is literally on top of a small car that it crashed into on the turn, and it appears that it was at fault because it was on the wrong side of the road. There was a girl crying and bleeding but it did not appear that anyone was killed. We did not stop because it was decided we would not be much help and we were running behind for pazapa.
At pazapa Marika led Jolyane and I to a room full of small children and said they were all new to her and needed programs designed for the year. Marika figured we would do one or 2 of the kids in the room. Jolyane did not feel comfortable doing a peds assessment, so we teamed up, she took notes and translated and I asked all the questions and made the treatment plan. We made it through 4 kids and when Karen came to get us saying it was time to go. Jolyane and I could not believe it because it really did not feel like we had been there that long! Time really flew. I literally had sweat dropping off me though, it was that hot in there. That and a few of my tests involved physical activity :P
We saw a young boy, who had autism quality symptoms, but fairly good eye contact. We also recommended he see Nath, about his ankles and Karen for his swallowing difficulties so a true team approach on our first kid. Karen thinks he likely had microcephaly. He was a sensory seeker for sure, vestibular, tactile and perhaps a little auditory but the mouth noises could have been an oral tactile thing. He calmed with activity and compression. I recommended a sensory diet and trying a weighted vest and taught them how to make one.
Then we saw a young girl, who absolutely broke my heart! She was found at 2mos. Lying in a field covered in ants. She had welts and lumps and bumps all over her face, her ears were swollen, her gums deformed, her nose sunken in, a malshaped chest and inflamed and contracted joints…she even had an ulnar claw. She is now 2, so quite some time since the ants…we were told it had been worse than this. She had difficulty breathing and her heart was absolutely racing! She calmed in my arms and I recommended she be seen by a MD for pain and distress. I also recommended gentle gentle slow ranging, and to dress her very cautiously and demonstrated.
Then we saw another young girl, she is 15 mos and likely has mild CP. Very bright alert cute girl who will sometimes drag her R foot and will not use her R hand though it is strong enough for her to hold my finger and pull herself up to standing with it! She has not began to speak many words as of yet, so I recommended they begin model prompts and singing things like tete appaule; also games that encourage bilateral hand use or more forced choice to use the R hand.
Lastly we saw a young boy, he was 13mos and very hypotonic, especially the neck muscles. The pazapa lady thought he was blind, but his mother assured us he could see…and after some attempts he did indeed track me all the way past midline but it was a struggle to have him really focus on you and you had to move slowly. He only tracked with his eyes, no head movement. We sat him up in a bumbo just to see what happened, we had to support his neck of course, but he seemed to look at more things. We are going to try and get a wheelchair together for him for proper seating for when the next team goes.
After pazapa we checked into our hotel, Cyvadier, and it turned out Jolyane and I got our own rooms. We had a welcome drink of rhum punch and then drove along the coast for supper on the beach. We took a quick swim before taking our seats right on the edge of the beach. I had red snapper and it was really good! I was hesitant at first because it was the whole fish, big teeth and all. But I braved up and dug in…I really enjoyed the seasoning and spices and how they BBQed it…and I did a good job of de-boning it! It was a little pique! After supper we went back in the water, and made a little friend of a Haitian dog. We were wary when it came running over to us, but it was just like any puppy…it wanted to play! I think it was so cute! It even guarded our bags while we swam. And would walk with us down the beach. I bought a lantern on the beach made out of a fruit casing that apparently does not taste good, they only use it for jars or bowls, Carabasse. I think it will be pretty, I remember seeing them in Petionville at a café. We had a tailgate party and had some rhum punch and then went back to the hotel where we changed and sat on the patio having drinks and appetizers (accra with piklis) and then supper (amazing fried chicken and frites and salad) and then talking late into the night about many things, like Haitian politics, kidnappings, tours, relationships. The hotel owner Christophe, who is german Haitian (haitian mother) joined us for drinks and provided 2 rounds of shots (a type of moonshine that is lethal). Cyril says he has a surprise for us for tomorrow, we are taking a rache pwel to the waterfall…we tried guessing but he will not tell us what that is!