Learning more about the Haitian culture

On Friday the 8th we received some bad news – Joel’s grandmother passed away. She lived a long life, but had been sick recently. Since Joel is one of the few men in his family with a steady job, the funeral responsibilities fell to him. Monday was the wake and the funeral yesterday. He asked me to go to the party after the wake, and I accepted his invitation.

Monday evening was the party Joel setup following his Grandmother’s wake. He was supposed to pick me up at 7:00pm, but got delayed until 9:30ish. I was tired and getting ready to head to bed. I figured he was busy and didn’t have time to get away and come pick me up. But, just before I called it a night, he pulled up on a motorcycle with Alix. I hopped on the back of Alix’s bike and we were off. The ride was quite bumpy and was made a bit more exciting when a goat jumped out from behind a fence in front of us. Alix is a good driver and handled the surprise well. After a few more minutes we were there safe and sound.

I was a bit surprised to see how many people were there at almost 10 o’clock. I would have to say there were at least one hundred people. The first stop we made was at Joel’s mother’s house. It was approximately 10’ by 20’, stone wall construction with concrete mortar. The roof was only partially finished. Maybe one third was complete and covered her bedroom. But, there was a 1 and ½ foot gap exposed over her room. So, when it rains, it rains in her room. She was very nice and invited me in. She kissed me on the cheek and offered me something to drink. It wasn’t long before two of Joel’s cousins came in to meet me, followed by two of his brothers. They were extremely friendly and spoke excellent English. I was happy to meet his family.

We walked around a bit and I tried to soak up as much as I could. There were so many different activities going on that it was hard to keep track. Some people were singing, some dancing. Others were playing cards or dominos. A few were cooking various types of food, while a couple of ladies were making coffee and tea in giant pots.

I found the domino game interesting. Not the game itself but the dynamic between the players. The game was being played on a makeshift table. One gentleman in particular would slam his domino on the table as if to say “take that!” All the dominos would bounce up in the air about 6” and land in a scattered mess. But, it was essentially a “nothing” move. I figured out that the real game had nothing to do with dominos. They didn’t even keep score. The real game was to identify how the other team was cheating. You see, the game was played in teams. The teammates sit across from each other. Everyone cheats. The trick is to figure out how they are cheating and call them on it. Once cheaters have been “found out”, they are kicked out of the game and replaced with the next team of cheaters. The guy who kept slamming his dominos was sending a signal to his teammate. The other team figured out what the signal meant and kicked them out.

While we were watching the game I started asking Joel some questions about his mothers’ house. I wanted to know why the roof wasn’t finished and how much it would cost for him to finish it. He told me what I already knew, which was that Haitians build their houses themselves. They build what they can, when they can afford it. I believe this is one of the reasons why there were so many buildings that failed in the earthquake. When you drive through a city like Port-au-Prince, you start to notice that when a building collapsed, one floor may have remained intact. For example, I saw a three story building in which the top floor crumbled into the second floor. The second floor remained largely in one piece, but the first floor crumbled underneath it. I think it demonstrates that when they build structures as they can afford them, some areas are made better or worse than others, and with better or worse materials. The cost of the materials that Joel will need to finish the house is exceptionally modest by US standards, $250. But in Haiti, that constitutes almost one quarter of the average income for an individual. What makes it more difficult in Joel’s case, is that he had to spend whatever money he had saved for his mother’s house, on his grandmother’s funeral. It was obvious that the roof issue weighed heavily on his mind. The rainy season is just a few weeks away and he doesn’t have the time or the money to complete the project before then.

It seemed as though I was shuffled off as quickly as I arrived. Alix received a series of phone calls from his wife before he finally said, “we have to go, my wife wants me home.” Without hesitation we all said goodnight and away we went. I think most of us married men knew that when the wife says it’s time to come home, it was time to come home!

Brahms returns!

Monday the 11th, was the day I had been waiting for, for a few weeks. Brahms came in! I have to admit that I was a bit nervous. I put a lot of pressure on myself and felt like there was a lot riding on this case since Brahms had never walked before the earthquake, and will never walk without the use of a prosthesis in his entire life. It is a concept that I have never experienced before and I found it difficult to express my emotions when I began his fitting. I can only say now, that it was one of the most “awe”some experiences of my life.I started the fitting with a very thin sheath, a minimal fabric barrier between his skin and the foam lining. It was loose, and I almost forgot what to do next. It was like I panicked and forgot all my training. When I snapped out of it, I went over to our supply shelf and picked out a couple of socks of various thicknesses. Using socks is a basic part of maintaining the fit of a prosthetic socket. I think that I put so much pressure on myself to make everything perfect, that I momentarily forgot the basics. When I fit the thinner of the two socks, I found that the socket fit well. What a relief!

Now it was time for Brahms to stand. I rolled up his suspension sleeve and his mom stood over him for support. I don’t know if he didn’t know what to do next, or if he just didn’t like everyone staring at him, but he didn’t move an inch. Then, one of the physical therapist had the idea to get out the soccer ball. And in an instant, Brahms took his first steps ever. He held on to mom’s hand, but when the ball got just a little too far for him to reach, he let go and took two steps all on his own and grabbed the ball. It was absolutely amazing to watch, and the smile on his mom’s face was worth every second of the angst I put myself through. She told me earlier that she just wanted her son to grow up and have a “normal” life, but she didn’t think it would be possible after his amputation. Today, we showed her that he will be able to do whatever he wants, he just has to want it enough. Sunday, that soccer ball would have been out of reach. Monday, we watched in awe as Brahms took his first steps of many, to reach his goal.

8-year-old Wanley

Week five brought a new group of practitioners, Dave and Ken, and a new special patient for me. This particular one was cast during my first group of practitioners. Her name is Wanley.

She was seen by Mike about 3 weeks ago. I remembered how shy she was, she wouldn’t even look at me when I said "hi". She just tucked her head or looked the other way. I learned that she was 8-years-old, but she had the outward appearance of a four or five-year-old.

Wanley’s shyness would soon be replaced by a giant smile and a young girl that liked to kick the soccer ball around. It was amazing to watch how fast she learned to walk and run with her prosthesis. But, it was even more amazing to watch her open up and become a fun loving little girl. By the end of her time with us it was hard for me to imagine that this girl, who would barely let go of my hand, would not even look at me a few weeks ago. I hope I get to see her again before I go.

R.I.P. Van Goat

Wednesday, April 6, 2011 was a sad day at Kay Hanger. Van Goat, our Haitian Hanger pet, died unexpectedly.

The day before, Max came down to the Klinik in the afternoon and asked for some money to take him to a local vet. He said it would only cost $5 so I gave it to him out of my personal money. I didn’t think anything of it, but when I got back to Kay Hanger at the end of the work day, I went around the side of the house to check on him. I noticed him leaning up against the tree, but my initial thought was that he got himself tangle up in his rope and couldn’t get loose. When I approached him, he tried to walk over to me. I saw that he wasn’t tangled up, but rather his legs were wobbly and he was using the tree for support. He could barely keep his balance and his eyes appeared to wonder. It was obvious that he knew I was there. His little tail wagged with excitement as it usually did, but I could tell he was sick and I didn’t want to get too close. As I walked away, I watched as he leaned back up against the tree.

When I woke up the next morning, I looked out my bathroom window and saw him lying away from his usual spot. He wasn’t moving and I knew he probably didn’t make it through the night. I walked outside and spoke to Max. He told me Van Goat died and he was clearly upset about it. Max took care of Van Goat and I imagine he thought of him as his own pet. I too thought of him as my adopted pet. I have three dogs at home, so it was nice to see a wagging tail again when I came home from the Klinik. It’s not the same here without him.

A first in my career

Week four ended with a first in my career. It was the first time I cast an infant for a prosthesis.

Brahms was just 6 months old when he was injured in the earthquake. I spoke with his mom and she told us his story. Brahms was lost in the earthquake and thought to be dead. His parents had given up looking for him in the rubble and knew it was unlikely that such a small child would have survived such a terrible ordeal. But, six days later, while searching for the remains of those who perished, Brahms would be pulled from the rubble. Unconscious and battered, he would spend the next three days in the hospital while the doctors tried to save his leg. However, the infection would not improve and his leg would have to be removed below the knee in order to save his life.

It did not dawn on me until a few days later, but I realized that the first steps that Brahms would ever take would be with a prosthesis I made for him at the Hanger Klinik. He is just shy of two years old now and I cannot wait to see how he does.

Another great week at Klinik Hanger

Since we had Sunday off for the election, I took the time to introduce Amir and Amy, our new clinicians, to our Klinik. I walked them through the process and when patients arrived on Monday, they were ready to go. A number of these patients were those who were casted the week before, including Richard and Derilus.

Richard is a young bilateral above-knee amputee that was injured in an electrical accident. Bilateral amputees are always challenging, but bilateral above-knee patients are particularly tough. He was cast by Michael and myself last Thursday and will soon be fit.

Derilus was fit by Amy. He was so anxious and full of energy that his first steps were better described as a jog instead of a walk. We knew this patient would be a go-getter because before he was fit with his prosthesis he could not sit still in his chair for 2 seconds. Every time I passed by he would point at his limb and ask if I was done yet. So when the time came, we fit him and cut him loose. After only 3 – 5 minutes of alignment adjustments, he started working on his dance moves. He was quite the entertainer. If he wasn’t dancing, he was jogging. If he wasn’t jogging, he was doing a back flip in the parallel bars. By the end of the first day, he was riding a bicycle up and down the walkway in front of the clinic. He did so well that we applied his cover the next day, and away he went.
Next week we are looking forward to getting Richard on two feet again and will be welcoming a new set of practitioners by week’s end. It’s always exciting to see what the new week will bring.

8-year-old Neika Love

One of the most memorable patients from the week is 8-year-old Neika Love. Neika suffered the loss of her left leg above-the-knee, as well as the loss of her father in the earthquake. Holly took a plaster hand cast of Neika and I modified the mold the next day. Typically, the patients are casted in Port-au-Prince and will make the trip to Deschapelles for their fitting and therapy. But on this particular day, since many patients made the trip out for casting, they will stay at HAS and be fitted early the following week.

Neika was one of those patients who would stay. By the time we were ready to fit her prosthesis, excuse me… “faux pie”, as she would put it, it was clear that her time waiting was not wasted. Typically, I walk the patients through the process of donning their socks and the socket, but Nieka had a different plan. She snatched the prosthesis away from me and quickly went through the routine she had seen repeated countless times by other patients over the last few days. She did everything correctly, brushed me aside, and was on her way. I had to chase her down just to make some minor alignment changes. Within the first five minutes she was walking up and down ramps, up and down stairs, and outside of the clinic along the gravel roads. She was so good that later in the day I caught her walking down the road playing with an mp3 player that one of our techs gave her to use. She was quite an amazing little girl.

We had fun playing with her over the next few days; we spent time painting behind the Klinik and writing our names on each others hands. I was sad to see her go, but even more sad that I didn’t get to say goodbye; she left while I was working in the lab. I know I may not see her again, but at the same time, I know she will be back. Just four days after receiving her faux pie, she would use it to begin the next phase of her life. As she grows, she will need to be refit with a new prosthesis, and it makes me happy to know that the work that has been done to establish this Klinik will allow it to be here in the future when she needs it. Best of luck, Neika.