Update on the Maternal Mortality Project

We've done 30 interviews in 7 days of field work! On one hand, I am SO EXCITED that the surveys and data are coming in so quickly, but on the other hand, I am devastated by the real-life implications of this. In just seven days, with little to no strategy, we were able to find 30 people who knew a mother, sister, daughter, cousin, or friend who died from complications related to childbirth. I knew from my preliminary research that Haiti's Maternal Morality Rate (MMR, for short) was 630 deaths /100,000 births (more facts on Haiti's healthcare here), which is astronomically high compared to the US's MMR of 13.3 deaths/ 100,000 births, according to the World Health Organization. However, I didn't expect to literally stumble upon so many people who had lost a loved one. Here's a document from UNICEF on the causes of maternal morality, if you care to read more: www.unicef.org/health/files/PreventingmaternaldeathsQandA.doc. What's the percentage of maternal deaths that occur in "developed "(I hate that term, but that's what UNICEF uses) countries? 1 percent. 99 percent occur in "undeveloped" states. 

Sagar and our translator, Valery, doing an interview in a tent city near our hospital. Notice how the siding is donated by Samaritan's Purse, an International Relief organization that identifies itself as being Evangelical. The siding on the next house was donated by USAID ("From the American People" it reads in bold letters), and the next one was from the Red Cross Society of China. I think I am beginning to understand why Haiti is called "A Republic of NGO's."  

Around Town

I thought I would post some pictures of things around Leogane. (Keep in mind that this city was the epicenter of the 7.0 earthquake that occurred on January 12, 2010. Around 90 percent of buildings fell, and the estimated number of deaths ranges from 40,00-100,000, depending on your source.  Quick background on Haiti's earthquake)

This mural was painted to commemorate some Duke students who stayed in this building one summer! "Haitians say that you can tell they are smart because they are wearing glasses," said Missy, the in-site coordinator for FHM.

At the "port" of Leogane. "I sailed my ship to safety... until I sank it." The water is so hot, it's almost unbearable to swim! 

(This picture was taken through the van window, so it looks like there are icicles hanging from the roof. I assure you that there is NO ICE in Haiti). This is a hotel (with rooms at a pricey rate of $65/night!)  that was just opened by our friend Fritz, an avid entrepreneur who built the place after the earthquake to give "Haitians something to hope for." He also built a "green" house (clarification: it's "green" because it is painted green-duh!- and not because it is eco-friendly) We watched the Mavs beat the Heat on a flat screen in the lobby! (So glad I got to see this, live!)

This is the Nursing School of Leogane! I wish I had a panoramic setting on my camera, so that I could capture the huge tent city that lies beyond the gates surrounding the school. Many of the nurses who work in l'Hopital Sainte Croix (where I live) were educated here. (I took this picture for my mom, who is a professor at the University of San Diego's Nursing School! Go Mom! And nurses!) 

This is a tribute to my friends who go to school at the University of Notre Dame! ND has a partnership with the Bill and Melinda Gates foundation (who also fund Duke Engage!) to treat and eradicate neglected tropical diseases, like Lymphatic Filariasis, in Haiti. This is the guest house where the people from ND stay when they come....pretty swanky, if I do say so! Read more about ND's efforts in Haiti here: http://haiti.nd.edu/

Some things are universal

Yesterday, I met a thirteen year-old girl named Linda in one of the tent cities. Although she can speak very little English, and I speak even less Creole, we somehow figured out that we were destined to be friends. I love her sassiness! 

Linda taught me that some things are universal. The list (so far) includes

1. A friendly smile

2. fist-bumping

3. high fives

4. laughing (at or with someone)

5. Shakira's "Waka Waka" dance

6. Justin Bieber. Seriously, the kid is painted on tap-taps next to Jesus! And I sang "Baby" in English with three Haitian kids today.

Other popular American artists include: Lil Wayne, Kanye West, Michael Jackson, Rihanna, Rick Ross, Akon, and Jason Derulo.

Typical Linda. She was probably making fun of me when this picture was taken.

Today we went back to the tent city and ran into Linda again! Yesterday I asked her why she wasn't at school, and she told me that she was "taking a day off." When I teased her about skipping two days in a row, she told me that she didn't have enough money to go to school. I felt foolish for joking about it, and chastised myself for assuming that she was lazy. She also told me that her dad is in Port-au-Prince and that he won't pay for her to go to school. She has five brothers and sisters as well.  I still have SO MUCH to learn about life in Haiti.

BABIES at the compound! A Haitian woman was educating her peers on healthy habits, pregnancy myths and facts, and how to avoid cholera. Yay public health!

Big and little brother 

INSANITY!

Mama Bear Nicole (our family tree will be explained in a later post) enjoys doing a DVD workout program called Shaun T's INSANITY workout when she is not training for ultra marathons (her personal insanity will also be explained in a later post-- just kidding! We love you, Nicole!) We've done Insanity almost every day since we got here, and I have to say, we are going to be looking fantastic when we leave Haiti! It's like doing the most intense workout in a bikram yoga studio, considering the hospital does not have air conditioning, and we are, after all, in Haiti, where it is hot.

My personal workout studio! From Target: A yoga mat, jump rope, and Jumpstretch bands! 

First Weekend in Leogane!

The weekend brought many new things for us to explore, including some nearby restaurants, a talent show, Clowns Without Borders (whose mission is to leave "No Child Without a Smile"), a 2-hour church service (that's on the short side, apparently), and goat for dinner tonight! 

Friday night a few of us went across the street to"Masaje" and danced in the rain! Sagar taught us some Bhangra, Nadine and Sedlin showed off their traditional Haitian dance skills, Lisa and Steph demonstrated the basics of salsa, and Annie and I danced in the way that white girls do: like fools!Despite my apparent lack of dance skills, I had a ton of fun blowing off some steam, dancing until the club closed and laughing until my sides hurt. When I knocked on Nicole's door to tell her that we were home, she responded with, "Are you sweating? Or is it raining?" I hadn't even noticed that I was dripping wet. "Uhh... a little bit of both...we were dancing the entire time... outside." This indicates two things: it was a great night, and I have completely abandoned the cause of keeping up my appearance. (See pictures for further evidence). 

On Saturday we woke up early and went into the field. We got lucky and ran into a Haitian midwife (Miss Tiot), who had many fascinating stories about the hundreds of babies she has delivered since she was fifteen! We told her that we are having trouble finding people who know someone who has died shortly after childbirth (we know you are out there...come out, come out, wherever you are!), she advised us to make an announcement over the radio station. We found the address of the station and set out to find it, but once we got there, we saw that the building had been ruined during the earthquake. About to turn around, a woman pointed us to a "Chinese Red Cross"  tent that was almost hidden behind the remains of the building. Unfortunately, the price they quoted for us was too expensive. I guess we will have to rely on old fashioned word-of-mouth to inform the population that we are looking for people to interview!

Saturday night, we met a group of people from All Hands Volunteers, an NGO that specifically works in areas that have been affected by natural disasters, at a restaurant called Joe's. They put on a talent show, and Nadine, Lisa, and Elisabeth managed to whip together an impromptu (yet perfectly harmonized) version of "Amazing Grace!" Mama Nicole was so proud, she said we can keep our privileges to leave the hospital (aka "the nest" or "the compound" and even "home" by now). 

We went to a two-hour church service at 7AM this morning (doesn't that count for extra Holy Points?).  Although the service was in Creole, and they sang the same song at least 4 times (I recognized the tune, if not the words), I still enjoyed seeing Haitians in their Sunday best (even the kids were dressed to kill) and was again stunned by the open-mindedness of my peers. Not all of us are Christian, few of us speak Creole, and none of us enjoy getting up early, yet all of us passed on a rare chance to sleep in (and breakfast!) in favor of exposing ourselves to something incredibly unfamiliar and exciting. Duke Engage Haiti really does attract amazing people!

After church, we went over to "Mon P'tit Village" to watch some Haitian kids show off their newly-learned karate skills! We got a kick out of "Clowns Without Borders" (seriously, it exists: http://clownswithoutborders.org/), who were also a part of the show. Once we got back to HSC, we ate dinner, which included goat, rice and beans, some veggies, and yellow cake for dessert!

Our (Lisa, Steph, Annie, Erin) room! Our white hospital beds in a line remind me of "Madeline." The only thing that we have that she didn't is white mosquito nets! 

My favorite picture that I have taken so far! Steph was overwhelmed by the kids at the school, who wanted to see their faces on her camera!  

Maternal Mortality Survey

So, what exactly am I doing in Haiti? I am doing research for Family Health Ministries, a Chapel-Hill based non-profit that is run by Dr. David and Kathy Walmer. Lisa, Sedlin, Sagar, and chose to work on the maternal mortality project, while the rest of the Duke Engage crew is working on the Post-Traumatic Stress Disorder project.

My Duke Enagage family! Front row, left to right: Sedlin Mirtil, Lisa Grossman, Stephani Zakutanksky, Nadine Michel. Back row, left to right: Dr. Nicole Tinfo (research coordinator for FHM), Sagar Mehta, Annie McDonough, Jenn Denike, me, and Elisabeth Michel!

Second graders at a school we visited! They sang us songs in French and Creole. 

We are using the WHO Verbal Autopsy Survey to conduct our interviews. Each survey take about 45-60 minutes. We ask the questions in Creole, record the answers, then transcribe AND translate the surveys into English. We have a lot of work to do!

First Impressions of Haiti

So now that you know what my home for the next eight weeks looks like, you should also see where most Haitians in Leogane live:

Tent City, near HSC 

I was surprised by the number of tent cities that exist, given that it has been almost 18 months since the earthquake, but Missy (the in-country manager for FHM) told us that we should be surprised by how few tent cities there are, given the damage done by the earthquake. When we drive through Leogane with her, she points out open fields or mud pits that used to be covered in tents. 

The Guest House!

We are living in the Hospital Sainte Croix Guest House, which was the surgery unit before the earthquake. They turned the 2nd floor into a guest house during the reconstruction phase. There is a kitchen/dining room; a "lounge;" the manager's office; a few rooms for the doctors; a room for Lisa, Stephani, Annie, and me; a room for Sedlin and Sagar; a room for Jenn, Nadine, and Elisabeth; and a room for Nicole and her suite-mate, Carly. I am perfectly content with the guest house's amenities: internet, fans/one air conditioned room, great food, showers, water, and a great location! 

The guest house manager's name is David Page. He practiced law in Scottsdale, AZ for 35 years and is spending a total of 3 months in Haiti. He is a fascinating man, with plenty of stories and advice about Haiti to share! I'm trying to appreciate the time we have with him, since he is leaving on June 30 to go home for his daughter's wedding. 

When I asked him what brought him to Haiti, he told me that he did some service work here twenty years ago through his church, and that "You'll find that Haiti has a way of pulling on your heartstrings." I am beginning to understand what David is talking about, and admire him for giving up a season of golfing in Scottsdale for a hot summer in Haiti!