Boudon

Big Red 1 broke down. That was the first hang up. We thought we were going to get an early start this morning, but while waiting at the mission gate, the Honda 2 seater ATV, the one that Dr. Sorg, Abby, Johnny, Wilner and Hebron were in just decided to stop running.

We actually didn't find out until we were about a mile up the road following Rob Baker with Chelsea and Darla and he pulled over to let us know that he needed to turn back to sign a check for something. We waited up the road a little ways, but when Dr. Sorg never met us in Big Red AND we never saw Rob again, we grew concerned and turned back at the suggestion of Tee, my co-pilot.

Dr. Sorg was standing at the gate smiling with Abby and our translators when we arrived. They just resolved to pile into the pickup and leave Big Red 1 behind. We followed in Big Red 2 while wearing surgical masks and glasses to protect us from the increasingly unbearable exhaust fumes and dust.

I saw something on the way up that I've never seen in Haiti before. Road construction crews paving the single lane winding mountain highway.

Well, that's not exactly accurate, there are no official lanes in this part of Haiti and apparently only one speed limit sign (which said 50 km/hr, an impossibly dangerous speed on these roads). The road construction is a very good sign, it means that there might be an improvement in infrastructure coming to the heavily populated and developed areas of Haiti.

That's not where we were headed though. We were on our way to the previously unreached section of the Southwestern mountains called Boudon. What the area lacked in infrastructure, it made up in beauty. Beautiful scenery, beautiful weather and beautiful personalities.

We saw 80 patients today, with many of the same complaints and lots of hypertension, even with one particularly sweet 19 year old mother. Darla, an NP with several years of experience in remote medicine from the North Pole to Eastern Europe and the 10-40 window, had a small dilemma at one point involving this 19 y/o mom and whether to give her captopril or HCTZ or both for her hypertension, which was extreme for her age.

Due to tridiculously high sodium intake of the rural Haitians, hypertension is an epidemic affecting nearly everyone, it seems. I dropped a message on Twitter and Facebook hoping for a quick answer as to the efficacy and possible adverse reactions of Captopril. I got a lot of responses (Thanks for those of you who cared so much that you took the time to ask people and do the research on that! I love you guys). The most surprising was an anonymous email from a physician from the American Academy of Paediatric Physicians who sent me a link to cited research findings (after the fact, but no less helpful). Captopril has not only been shown to not be harmful to breast fed babies, but intact showed that we probably UNDER-dosed the mom while trying to error on the side of caution. If we see her tomorrow we might remedy that.

If you are interested, I would be happy to send you the research on it.

So Darla and I discussed it for a minute and decided that we were primarily concerned with long term renal function and that captopril would fit the be in our risk v. benefit analysis. Luckily. As it turns out we were correct, if not overly cautious.

That little village with no road, no electricity, no plumbing, running water, sewage or any other modern convenience was filled with the 150 most wonderful people I've ever met. They were primarily agragarian growing onions and cabbage on the steep mountain sides over-looking the cloudy bay of Haiti and Port-au-Prince.

The homes were little more than corrugated metal nailed to shaved tree trunks embedded in the ground. On the roofs, like a patch work quilt, clothes were laid out to dry and doors remained opened, if there was a door at all, while chickens roamed freely. Giant pigs basked in the equatorial sun and mother cats nursed their kittens in the middle of busy walkways, entirely un-intimidated by all the people walking around them.

I took pictures of everyone, because everyone wanted to know what they looked like on a digital camera. The video camera was a big hit too, if not too overwhelming for some of the other older folks who knew no more of technology that the single battery operated transistor radio situated like a shrine next to a woman who appeared to be the gentle and revered matriarch of the village.
They were so blissfully impoverished. They seemed to really want for nothing, except for the two things we came to offer them. Medicine and the good news about what Christ did for us on the cross.

Not long after we arrived, we were sort of ambushed by a loud, carismatic and sweaty group of a couple men with anachronistic bullhorns and a single file line of women in all white chanting and singing at the top of their lungs. They marched all over the tiny village stopping each time they saw a "blanc" person congregating with a Haitian and would scream/sing something in Creole as if we were 100 yards away. After they finished they'd shout "Hallelujah" about 4 or 5 times then break up and shake our hands the return to formation and go accost someone else.

We were stopped dead in our tracks as Benjamin and I were sitting with this very old woman who didn't know what year she was born, trying to discern her medical history. When conversation became impossible, I pulled out my video camera and recorded the spectacle laughing at the silliness of it all. To be honest. I just thought that they were voodoo practitioners but Rob Baker told me that they were Catholics (probably Catholic mystics, a common combination of Catholicism and voodoo) that had come from another village and that they were probably visiting because they had heard that we were here. I'm not sure what their intention was but throughout the day, we saw at least 3 other similar groups traverse the switch backs of the mountains coming toward us (probably from other remote villages in the area), but we had no more visits.

A Haitian Baptist Pastor came to hang out with us while we moved the patients through the clinic and seeing their medical needs, grinning from ear to ear. Recently this village and a few surrounding villages have been getting visits from the native Haitian Pastors who walk for miles up the steep muddy mountain sides with nothing but a Bible to tell them about Jesus. Today 11 people chose to follow Christ and several more showed an intense interest in hearing the gospel. What a moving experience to see so many break from the years of tradition of voodoo-catholicism and seek a relationship with Christ!

The clinic day ended unlike any other. With the expert talents of Chelsea, a young full-time missionary new to BHM, a rousing game of Canar, Canar, Swa (Duck, duck, goose) was intiated and played for the very first time by some 20+ kids followed by sing-a-longs, Simon Says (which is really hard to play if you don't speak the language) and some soccer.

One of the most impressive things I saw was kids playing soccer in a dirt field with golf ball chunks of rock through BAREFOOT! Haitian kids are way tough!

The drive down through the mud and rock was a blast until about 15 minutes from Fermathe when we hit pavement again and, again, sucked exhaust fumes from a large taptap (taxi/bus/pick-up truck).

All was well after we got back and hung out with Patty Baker, Rob's wife, who walked around the campus with us for a bit and informed us of much of the history of this marvellous mission.

Our night ended like any other with dinner, fellowship and prayer and... Of course, counting pills and preparing the formulary for another day in the field.
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