Little Girl Friends

I must admit I was pretty distracted on our village tour the first day by the following of little girls who accumulated as we went.  I think it started because I was trying to practice my Creole and asked one of the girls who was eyeing me as I was walking past her family’s hut what her name was.  (She was also darling and reminded me of a friend I have in Iowa City, Leara.)  Her name was Islan, and although I’m normally terrible with names, that one stuck.  I said “Au Revoir Islan” as I was walking away, and I think that was the spark that ignited our fast friendship.  She started walking with me, then a few of her friends follow suite; and soon they all started helping me learn Creole by pointing at things we’d pass and trying to teach me the word.  Some words were easy, like sheep is ‘mouton,’ and cow is ‘bef.’ The best for them though was teaching me the harder words, as they really got a kick out of my mispronunciations—sometimes giving them giggling fits that lasted minutes.  They also really enjoyed touching and commenting on my hair (if I’d known more Creole I would have told them something like “oh, girls, this ain’t nothing compared to my little sister’s locks”).  I really fell in love with them though when they started holding my hands as we walked (especially grabbing my hand to stabilize me whenever the road was steep or especially rocky.)  At some points on the walk, Islan (14), and her 13 year old best friend would be on either side of me holding both my hands; and then Manize, the most precious 7 year old I’ve ever seen, would just hold onto the back of my shirt, or even put her little hand on my hip as we walked, I guess so she could be physically linked into our little group too.  Towards the end of our walk Manize told me she loved me (in Creole of course, but luckily one of the other village kids that joined the group knew enough English to translate).  Amazingly I knew an appropriate-ish response in Creole: ‘Eh ou mem tu’ I said, meaning something like ‘and you also.’  Islan and co. were definitely the highlight of my first day in Haiti. 

Days One & Two

It’s hard to even start typing this blog because I already have done so much in the past two days that I feel like I’ve been here a week at least.  I think a bullet point list of activities will cover it best right now:

Day 1

• Arrive in Port au Prince Airport at 8:10 am yesterday, breeze through customs, and get into a tap tap with Chris, and Elain (I cannot be held accountable for spellings of any names in this or any future blogs) who is one of Chris’ good Haitian friends.
• Visit Elain’s family to see their new house, his adorable wife and young children.  The 3 year old has had a rash for a while and Elain wanted Chris to take a look at it.

• Head to the home of some of Chris’s American friends who live here doing medical work (and raise their 8 children, 4 biological, 4 adopted), to pick up some medical supplies from a storage unit they let CHI use.
• Pick up Rigan on the way, a former employee of CHI who is still very interested in working on Community Health Worker programs in different communities.  His English is incredible.

• Arrive at the house (they had two beautiful mastiffs) and spend the next hour or two sorting through medicines to bring back to Mission Matana.
• Take the tap tap back through Port-au-Prince up to Arcahaie and arrive at Mission Matana.

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• Meet Liz and Abbey, the two other Americans who will be here the whole time I am. More on them later.
• Go walking for several hours around the nearby villages for a full tour of the latrines which are still being constructed; the river, canal system, and dam; the decrepit road which needs major work to be functional for vehicles; and crop irrigation system.
• Best part of the walk for me was the little girlfriends I made—I think they deserve their own post though—soon to follow.
• Home to dinner at the mission (lots of great stories of the happenings from the last month told to us by Liz and Abbey), then a skype conference call with a fellow CHI’er, and then to bed.  (Oh, I did end up having to pack back up and switch rooms with Chris around 9 pm because we discovered my door did not lock.  Well it locked, but the door frame could very easily be pulled off the wall, definitely not leaving the room secure.)

Day 2

• First moto ride (of my life).  As nervous as I was, it was not only super fun, but I felt pretty safe.  And, as weird as it sounds, sitting between Santho, (my translator, creole teacher, and good friend after today) and the moto driver, not holding on to anything (and yes, sorry parents, no helmet) I felt really secure.  I also heard that moto drivers are extra careful when they are transporting “blan,” and I definitely experienced this to be true today.
• The trip was so I could go into town to exchange money, buy a phone sim card, and get some internet card minutes—and also get over the hurdle of my nervousness to leave the mission without Chris or the girls.  Santho and I were fairly successful on these errands, and I am just so glad to have gotten to know him, had him with me, and very excited that he will be my translator and companion doing the water surveys in the coming weeks.
• Next, Chris, the girls, Santho, and I went into the village to visit with Peterson, who is now going to be running the Gadyen Dlo program.  He was awesome.  And, he drove us around in his tap tap the rest of the day.
• We went into Debak to visit a hospital to make connections there for Abbey and the next time there is a CHI clinic team down here.
• Then, onto the coast road, Route 1, and went to Kaliko, the resort. We went there so Chris could introduce us to the manager, a Canadian former Olympic wrestler, who invited us to stop by anytime during our stay.  We also wanted to talk to him about real estate around Arcahaie because we’ve come to the conclusion that getting CHI it’s own “office” type of space may be slightly more productive to our projects and causes than always staying at the Mission.  We’ll see what happens and I’ll explain more about this at some point.
• Next, we head home, after stopping by a former clinic patient on our way.  Most memorable for me was meeting the patient’s brother, who was a 50 something year old Haitian who had lived in the US for 25 years.  He ended up telling us about his 19 children, “some with white women, some with black, some in Haiti, some in Florida, some in Minnesota.”  Oh, and that he’d be into the clinic next month for his hernia.
• Then home for more beans and rice, and a nice early night so we can get up early to see off Chris L

It’s the Journey

The most stressful part of most trips for me seems to be the preparation (i.e. making travel arrangements, organizing my life enough to leave it for a period of time, arranging care for my animals, packing, etc.).  And, I think that is why I got sick this weekend.  Although, I do think the exposure to germs I got sitting in a hospital waiting room on Friday—to get my rabies titers checked (to see if I have immunity following the vaccinations I received last year before India), definitely didn’t help my stressed out immune system.  Anyway, I’m happy to report that right now, my main lingering symptoms are nasal drainage and sinus pressure. 

               One of my favorite concepts I learned about in undergrad (in communication studies) was about how our society’s dominating focus on the “destination” results in the loss of some of the most important life experiences, because we aren’t able to actually be mentally present enough in the moment to have them.  Well, for some strange reason, I think traveling in my state of mental fatigue due to my cold actually forced me to focus on the journey more than the destination.  I was so sick and medicated, all I could do was focus on the exact moment I was in—and it was unexpectantly enjoyable.

               Despite the fact our flight out of Cedar Rapids, Iowa was delayed 2 hours, and resulted in us missing our flight in Chicago (we were so close to making it we literally watched the plane back away from the terminal); and, then not getting into our hotel in Ft. Lauderdale until 11:45 pm (we had to get up at 3:30 am for our flight to Port-Au-Prince); I actually was in a state of calm elation, that has only recently died down a bit.

               The final leg of our journey this morning, literally a trip into a completely different world, started when we were boarding our flight to Port-Au-Prince.  I’ve never seen such blatant racial profiling, or any full-fledged person and belonging searches for that matter going on IN THE GATE.  (Not at the gate, I mean in the little tunnel bridge you walk down that connects you to the plane.)  Not that the situation in P-A-P was much better… Though, I think there is no need for me to go into greater detail than saying that I have never gotten through customs with such speed or ease.

This is one of the beautiful views from the plane as we begin our decent into P-A-P airport.

               As I write this post I am sitting in my room of the next 5 weeks.  Behind me, up into the mountains, I hear a few dogs barking intermittently and the comforting songs of insects; much like the sounds you might hear on a summer night in the Iowa country side.  However, to my immediate left, I hear as clearly as if there were no wall separating us at all, the non-stop singing and chanting of the other ‘Mission Matana’ residents.  It’s 11 pm, and I’m just starting to realize how completely my life has transformed in the past 19 hours I’ve been awake.

               I have much more I need to write, but need my sleep much more.  The picture I’ll leave you with is the view from my bedroom door right before I walked down to dinner tonight.  You have to look at the picture as a whole, a bit down the hill and at the horizon line, but that’s the ocean, and Anse-a-Galets (the island in cove).  I can’t wait for tomorrow—and for this incredible journey to continue…

My Practicum in Haiti

For my Masters of Public Health practicum project, I will be traveling to Arcahaie, Haiti, to help evaluate an in-home water treatment system.  The system is called Gadyen Dlo, literally meaning "Water Guardian" in Haitian Creole. I will be leaving in a little over one week, and flying down with my project preceptor, Dr. Chris Buresh, MD, MPH, FAAP, FAAEM, FACEP, Associate Professor of Emergency Medicine at the University. 

 

Haiti is located on the western third of the island of Hispaniola, and is well known for its historical legacies of inequality, corrupt governmental regimes, and extreme levels of poverty. 

Yet, the widespread lack of clean water is one of its most significant obstacles.  According to the WHO/UNICEF Joint Monitoring Program, only half of Haitians in rural areas have access to improved drinking water. Lack of access to safe water results in many negative health outcomes, the most serious of which are waterborne diarrheal diseases, including cholera.  In Haiti (as well as many other developing countries), these diseases are the leading cause of death among children.  After the earthquake in 2010, the cholera epidemic (brought over by aid workers), caused more than 7,000 deaths.

 (This shows the number of people affected by unsafe water globally, and the number of children around the world who die from waterborne diarrheal diseases per day.)

The Gadyen Dlo program was recently implemented in Arcahaie, and is a chlorine based treatment and safe storage system which is manufactured, distributed, and managed locally by Haitians. 

The Community Health Initiative (CHI) Iowa chapter started the project in Arcahaie, and is the organization I am partnering with for my practicum.  CHI Iowa has a long history of partnering with local communities in Haiti to address the biological, social, and environmental causes of disease. They are primarily known around campus for offering University of Iowa medical students the opportunity to work in rural clinics in Haiti for 1-week sessions.

For my project, I will be visiting 250 households that have been using the Gadyen Dlo system since October.  I will conduct interviews with residents in homes who use the system and Gadyen Dlo employees, conduct focus groups with community women, and test water quality in homes and at the community sources.  

I am extremely excited and a bit nervous for this experience.  I do know without a doubt that this will be a life changing, educational adventure, where I will truly be ‘practicing public health’ in the real world.  I will try to blog whenever I can, at least posting some pictures if I don’t have time to write much.  I welcome any questions, comments, or advice on my project or traveling to Haiti.  You can email me at: Joanna-krajewski@uiowa.edu if you prefer not to post a comment.

Finally, as I am trying to learn as much Haitian Creole as possible over the next few weeks, I’ll end with one of the most popular Haitian sayings, which describes pretty accurately this past week as I prepare for my practicum:

Deye mon gen mon.  Beyond mountains, more mountains.

Water Poverty Video - IRRAD

Tourist Traps and Tour Guides

As I mentioned in an earlier post, having light skin attracts a lot of attention in India. Unfortunately, the extra attention also makes you an easier target for people looking to take advantage of tourists. Of course it didn’t help that nearly all the buses and vans we were driven around in had “TOURIST” written across the top (as pictured above).

Our first night in Jaipur, we were all very excited to have dinner at a cultural festival/theater that was supposed to teach us about the new state we’d just entered: Rajasthan (literally meaning ‘land of kings’ or ‘land of colors,’ depending on who you talk to). This is the largest state in India and also is the farthest northwestern area of the country, bordering Pakistan. While we were given traditional Hindi bindis and blessings as we walked through the gates of this “festival,” it quickly became apparent that we were going to be experiencing something closer to a circus than learning a historically or culturally accurate account of Rajasthani people.

There were camel and elephant rides, horse carriages, tightrope walkers, puppet shows, snake charmers, dancers, monkeys on leashes, people walking on stilts, and acrobats—just to name a few of the “attractions.” Having seen the newly released film “Water for Elephants” I was particularly sensitive to how sad the lone elephant giving rides appeared, when I saw it up close. I was actually looking at his face particularly closely because my younger sister, who is in Vet School at Iowa State and is going to visit an elephant sanctuary in South Africa on a study abroad program in May, warned me about male elephants becoming aggressive when “in Musth.” Apparently, you can tell if they are entering this hormonal craze by a dark streak of sweat that frames their face/jaw area. Luckily for the people taking elephant rides and the elephant handlers, this elephant didn’t appear to be in Musth, at least by my diagnosis.

At one point, a group of us came out from walking through an underground tunnel/cave walkway that passed by a huge (and roaring) dinosaur statue—to find what looked like aboriginal tribesmen holding wooden sticks and dancing crazily around a bonfire. Upon seeing us, they rushed over and handed us their sticks, and indicated that by holding a stick you had to join in on the dancing. While there’s no doubt this was fun for a few minutes, the moment was somewhat ruined when we stopped dancing and tried to hand back our sticks, and were immediately met with stern faces and outstretched palms demanding monetary donations.

The dinner we were served that evening was the most bland and tasteless meal we had the entire three weeks, which definitely added to our disappointment. We were later told that it was because they are cooking for tourists, whom they expect cannot handle traditional Indian spices. But, perhaps the worst part of this ‘fake India’ (or, “India Disney” as most of our group started referring to it) was that our tour guide that evening had told our professor that the experience was already covered in the tour fee for that day, however, upon our return toGurgoan—our professor received a several hundred dollar bill for our group that night.

You live and you learn—and it’s no different in India.

The Girls

In an attempt to keep my post trip depression at bay, I’ll continue on with my favorite things from India list. One of the most incredible aspects of this trip that I never expected was the friendships that were formed by many of us in the group. It’s always a little worrisome to go on a group trip not knowing many people, but my worries were quickly assuaged within the first few days of our journey because we really did have many amazing individuals. If I had time to go through and give a short bio on everyone, I would, but I want to at least recognize my project group members—also the women with whom I was closest throughout the past three weeks—and whom I hope to continue friendships with long, long after our journey.

Meagan, my fellow MPH CBH department cohort member and classmate, travel companion, and dear friend before this trip—I could not have done it, or had such a glowing experience—without her. She went to Illinois State University for her undergrad in Health Education. She is both wise beyond her years and one of the most caring and thoughtful people I’ve ever known. This picture is of us on a bridge overlooking the great Ganga.

Kim is a graduate student in engineering, but comes from a liberal arts background. She is an incredible woman with the most beautiful children; two young teens from Cambodia, a 7- year old from Haiti, and an infant, Gracie. Listening to her stories of other travel experiences (like the trips to get her children), and discussing innovative research papers on subjects like ‘The Water Poverty Index’ (among many others), I could not have been happier to have to opportunity to spend time with and befriend this amazing woman. I know that Meagan and I will continue to work with her in the future. The picture of Kim standing in the middle of me and 4 other girls, in her beautiful orange/gold salwar kameez was specifically taken to show off her new clothes her very stylish daughter Sophie (13).

Meredith was on this course as her last requirement of her undergraduate degree at Iowa. Her degree is in Political Science but the purposes of this course were specifically for her Sustainability certificate. She was such an asset to our team in so many ways, but her interest and passion for learning about the tribal governance issues was much needed. Meagan and I said many times that we never want to travel without her in our lives again, as she is such an advocate and strong voice to have on your side ensuring that no advantage would be taken of us as first timers to India.

Kristina is an undergraduate in Environmental Engineering, and was instrumental to have in our group for the actual process of water testing. One of the pictures shows her (on the far right) and Meredith next to her actually taking samples from some of the villagers we interviewed. She is an avid photographer, whom I went to for advice on my own camera, but also whom I saw many people in our group trying to watch and imitate—as we knew that if she was standing snapping away from a certain angel—it had to be a good shot! She unfortunately got sick with a version of what Meagan and I had on the last days of our trip, and as a precautionary measure, Meredith, Meagan, and I got to experience the Indian hospital system the last night in Delhi, when we took her to be checked out.

Nandita was the second professor on our trip, she has her PhD in Civil and Environmental engineering, from Purdue. She is from Calcutta originally, and it was fascinating hearing her perspective on our journey through northern India, as compared with her youth traveling more in the south. Nandita is such a strong, smart, and delightful person, and our trip was such a glowing and positive experience in large part thanks to her. She (along with Kim) was an integral part of this course for Meagan and I, always advocating for our public health perspective and stressing the need for an integrated approach to the hydrologic problems most of our group was primarily concerned with.