We ventured out into Jacmel a couple times since we arrived on Monday. Today we had quite a time bumping into people and being hustled through the busy market-place to find Justin a pick-ax for working the garden. After we finally found and bought one, he proudly strutted through the streets with the pick-ax slung over his shoulder—dodging motos and piles of this or that, the guy carrying raw meat on his head, etc. While the streets of Jacmel are not as bad as I’d expected from what you hear on the news, it’s definitely representative of all my intense travel experiences in Mexico and Peru rolled into one, with the street markets being much busier and more aggressive, and generally more action. I will say however, that there are fewer stray dogs here than I’ve seen elsewhere. Yesterday we went to the beach, which was lovely, except kids kept asking us for money and we didn’t feel like we could abandon our stuff to get in the water, so we just looked out at the pristine water and the green hills in the distance.
The clinic is a little oasis amidst the chaos of the streets. Our bedroom faces the street and there’s basically never a moment of silence. People yelling to eachother in the streets, cars and motos honking, music from houses and store fronts, animals, etc. Inside the little clinic compound is a house with an outdoor kitchen, dining area and bathroom which is shared by us, the administrator, the other midwife and the various people working during the day—a cook, a cleaner, midwife apprentices, and translators. The shower is just a huge closed in tiled area with a spigot with cold water. You could literally walk a cow in there from the street to shower it if you so desired (not sure that’s been a desire however), so on nights when I’m not up at the clinic, Justin and I have adopted the custom of team showering .
The “dome” as it’s called, is the clinic structure on the hill above the house area. It’s generally way too hot to be inside, so we do prenatal and postnatal exams outside in a shaded area and go in only if we have to do a vaginal exam. During labor, the women mostly walk around outside. When they get too tired or feel ready to push, they find one of the rooms sectioned off by sheets inside the dome. It’s really a nice set-up. It’s of course very low-tech, which has been wonderful: paper charting (and very minimally), fetosope instead of electronic equipment (though dopplers are available if need be), and mostly herbal medicine (though again pharmaceutical stuff is available as well). I’ve caught 2 baby boys already and I’m on for tonight with another lady walking around in labor.
Justin is getting used to the pronunciation of his name in Haitian creole, something like Jeau-ste, while my name is pretty easy: Ra-shelle. We’ve been trying to learn the language, but the pronunciation is damn difficult. One thing I’ve mastered however, is how to say chocolate. They make this dynamite hot chocolate for breakfast detanzantan (“from time to time”) and I had to learn how to ask for it. It’s made with Haitian chocolate, cinnamon, grated coconut, and love, I can only imagine. Yum. The food is pretty basic, but quite good. We’ve been eating meat since we left the states, and lunch every day consists of chicken stewed with carrots and onions, rice and beans, and boiled plantains. For breakfast, it’s usually oranges or papaya and boiled or scrambled eggs, and for dinner: leftovers or snacks. I was shocked to find that peanut butter is a popular snack food here, as I have never encountered it on any sort of popular scale outside the US. I like to eat it on cassava bread/crackers. They also eat a lot of fried plantains, fried meat or fish, and some boiled veggies.
Some of the challenges include: no testing in the whole city for Chlamydia nor Gonorrhea, lack of medical supplies, iffy electrical and water supplies (it goes off and on), mosquitoes and malaria, people’s unawareness of germ theory nor the idea of not throwing trash in the garden space or really anywhere and everywhere, no running water inside the clinic (though there is a sink outside), trash and rocks everywhere and lack of functional tools, which makes starting a garden difficult, and a tent camp right next to the clinic, so not being able to hang out laundry or plant food up there because it invariably disappears. There are many positives though. There are already almond, papaya, and banana trees growing. The outcomes at the clinic are very good and working at the clinic is much less complicated than the hospital with all the headaches of “covering your ass” in respect to hyper-charting and doing unnecessary interventions which cause more harm than good “just in case.” And presumably because of all the aid workers here—we often see UN or USAID trucks in the streets--you can get a surprising amount of American products—chocolate bars, natural body products, beer, etc, though with a hefty price tag.
That’s it for now! bon nwit!
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