Since I did a bad job blogging last time I went...

Tickets were purchased yesterday for a departure the day after tomorrow. And no, it's not for a funeral...

I'm going back to Haiti for a week as part of a team of Biomedical Engineers/Technicians to assess the equipment situation at 4+ hospitals and do as many fixes as we can sight-unseen. Well, sight-mostly-unseen except for some photos. It's incredibly exciting, intimidating, thrilling, and overwhelming. My approach at this point is to be as prepared as possible without sacrificing rest beforehand, do the most thorough job possible while we're there, and write a kick-butt report when we return. Hopefully it will be an impactful project, and not just some disaster-tourists out for a joyride.

In the past I've tried not to drop names of organizations in my blog, but I was told to on this trip... and it makes sense. The more publicity and awareness there is of our cause and related ones, the more we'll be able to affect change. So here it goes:

I'm traveling with Engineering World Health (EWH), based out of Durham, North Carolina. This is the same organization I traveled with in Tanzania. But no, this is not a 2 month stint involving swahili lessons. And since an English-Haitian Kreyol dictionary is not possible to find last minute (as I learned this afternoon), I'll be relying on my French and incredible non-verbal communication skills. Fortunately or unfortunately, my stomach usually lets people know when I'm hungry. I'm hoping that will work in the positive next week.

EWH is not initiating this project all alone. AmeriCares has asked us to partner in this (potentially) multi-phase project to improve the state of medical equipment in and around Port-au-Prince. They may be addressing other needs too, but I don't know about them. Do your own research.

Since this trip has been pieced together so last minute, you'll learn more details as we go. I'm really enjoying the challenge of getting to think through the whole process to make our work effective. This is in contrast to being a student with a set packing list, scheduled itinerary, and pre-established connections. Next week in Port-au-Prince all the preparation will have been things that our team has thought of, designed, and intentioned. It's exciting to use the knowledge I've been learning over the past year while compiling guidelines of how to donate medical equipment effectively. Now it's time for the practical exam.

To give you an idea of the preparations -

• Spent this morning distributing travel insurance cards I bought yesterday
• We compiled and refined a list of pertinent questions to ask the hospitals. For instance, we can get their wish list, which might include an ultrasound. But we've got to ask if they have a doctor trained to use it AND if there's even electricity to make the ultrasound turn on.
• Found a connection with a Clinical Engineer from the University of Arkansas who has been given donations by Siemens, Drager, and others... talked about how we could help him identify appropriate recipients.
• Looked for the non-existent English-Haitian Kreyol phrasebook (and the even more impossible medical phrase book)
• Bought silicone sealant to fix a leaky autoclave. Picked up WD-40 and superglue as impulse buys. I'm guessing they'll be useful.

But what am I talking about? I've got all day tomorrow and even Sunday morning to prepare! Ha... oh dear. Keep praying!



Photo: From my first visit to Haiti. This is the sign we put on a half-fixed autoclave. The next day I found it on my bag. "Dange: Pa touche wap mouri." "Danger, don't touch. You'll die."




Oh, and before I forget, the views expressed in this blog are solely the personal views of the author. Unless of course I'm quoting or misquoting someone else.

How to Feel Small

As I begin to write this, I can't decide if I continue writing somewhat negative posts because of the name of the blog (see the first post, May/June 2009) or because writing makes it better. Bear with me... hopefully there will be much more interesting and uplifting stories soon!

But for now, I'd like to divulge my secret to feeling very small and insignificant:

Take 1 bicycle and add 1 not too serious (but carrying lots of serious stuff!) rider. Add a once-sunny day turned gray and overcast. Then set the time to just before evening rush hour. Ride the little bicycle right down main street and start praying that no one hits it...

This wouldn't be such a big deal, if it weren't for the five-points intersection in the middle of downtown. And the intersection wouldn't be such a big deal if it weren't for the man in his massive sedan taking his time through the intersection. And the car wouldn't be such a big deal if it weren't signaling a left turn - which is exactly what I was doing while approaching from the other direction.




















The problem lies in the fact that this man had no intention of turning left and was rather upset when I started to turn in front of him. Wake up drivers! When a bicyclist is signaling a turn, it usually means we're going to take it. Leaving your arm hanging out without knowing it is a little bit more difficult than leaving your turn signal on accidentally.

So no, I didn't get hit. And no, there were no horns or screeching tires. But I was definitely frustrated, angry, and not just a little shaken. Perhaps a good spring present would be an air-horn for my bike...

And that is how to feel very, very small. Sometimes I enjoy the reminder of my insignificance in this world. Today was not one of those moments. I think I'm going to make some cookies.

Why we didn't all just go to Haiti

I think it's reasonable to say that many of us, when we hear of a crisis, would much rather do something tangible than sit around and weep, pray, or part with our money. And yet, praying and giving money are often some of the best things you can do. This article does a good job of explaining exactly why.

Interestingly enough, much of my work this last year has hinged around this kind of a problem - specifically with medical equipment. So often, wealthy nations or hospitals want to help "the poor starving children" and think that by donating items, they can really be of help. A common idea is that "something is better than nothing." In all reality, that couldn't be farther from the truth.

In disaster situations and even extreme poverty, the infrastructure isn't present to keep even human waste from getting into the water system, much less dispose of expired drugs, medical waste, and unusable food/clothing items. A rule of thumb we often repeat in guidelines for effective medical equipment donations is "if it's not acceptable in the donor country, it's not appropriate for the recipients."

Seems to me we just keep coming back to that simple 'do unto others...' advice.

Disaster do-gooders can actually hinder help
Uninvited volunteers, useless donations can cost money, time — and lives
By JoNel Aleccia
Health writer
updated 7:13 a.m. ET, Thurs., Jan. 21, 2010


No question, the two church-goers from New Jersey had the best intentions in the world when they arrived in Port-au-Prince this week to help victims of Haiti’s killer earthquake.

Trouble was, that was all they had in a land where food, water, shelter and transportation are at a desperate premium, said Laura Blank, a disaster communications manager on the ground for World Vision, a Christian humanitarian aid group with long ties to the country.

“They seemed very eager and very passionate about helping the people of Haiti, but they didn’t have a ride to get out of the airport,” said Blank, who had to direct the pair to assistance.

More than a week after a magnitude-7 earthquake devastated the country, disaster organizers say they’re seeing the first signs of a problem that can hinder even the most ambitious recovery efforts: good intentions gone wrong.

From volunteer medical teams who show up uninvited, to stateside donors who ship boxes of unusable household goods, misdirected compassion can actually tax scarce resources, costing time, money, energy — and lives, experts say.

“Everyone wants to be a hero. Everyone wants to help,” said Dr. Thomas Kirsch, co-director of the Johns Hopkins Center for Refugee and Disaster Response. “It’s not the way to do it.”

Even a medical crew from his own school — Kirsch declined to identify them — arrived in Haiti so ill-prepared they had to seek sustenance from non-governmental organizations.

“They had no bedding, supplies or food,” he said. “They ended up glomming onto some of the NGOs.”

Volunteers simply show up
What to do with well-meaning volunteers is not a new problem. In every disaster, large numbers of people simply show up to help. A handbook published by California disaster officials estimates organizers can count on 50,000 “convergent” volunteers after any severe earthquake. After the Sept. 11 terror attacks, more than 40,000 unsolicited volunteers arrived at Ground Zero in New York.

In the U.S. and around the world, aid organizations are walking a fine line, trying to encourage skilled professionals who can provide indispensable assistance — and waving off those who might not be up to the task. At the federal Center for International Disaster Information, a stern note warns the well-intentioned:

“Volunteers without prior disaster relief experience are generally not selected for relief assignments,” it reads. “Most offers of another body to drive trucks, set up tents, and feed children are not accepted.”

It’s an effort to help would-be Samaritans recognize the reality of the situation, said CIDI director Suzanne H. Brooks.

“It’s very romantic in the TV and movies,” she said. “They think it’s flying in for a weekend. They need to think of it in terms of months.”

Those best suited to help are probably already there, experts said. They’re trained crews who not only have experience working in disasters, but also in developing nations, Kirsch said. The best teams also have a command of Haitian Creole and French, if possible.

When teams arrive without those skills and without their own supplies, they drain resources that could better be used for actual victims, said Dr. Kristi L. Koenig, an emergency physician at the University of California, Irvine, who specializes in disaster response.

“Unless you’re part of a team before the disaster happens with a formal mission, you’re going to be part of the problem,” she said.

Even worse, certain volunteers have required emergency intervention themselves, Kirsch noted.

“Most people do quite well, but about 10 percent don't,” he said. “They end up totally freaking out and having to be evacuated.”

Winter coats and high-heeled shoes?
A different but equally pressing problem is the flood of ill-advised donations that aid agencies already are facing, organizers said. A handful of “Help Haiti” food and clothing drives across the country are inspiring cringes among some workers, said Diana Rothe-Smith, executive director of the National Voluntary Organizations Active in Disaster, a coalition of agencies.

“I would strongly recommend that no donation drives be conducted unless there’s an existing organization on the ground, in Haiti, that has asked for the help,” Rothe-Smith said. “It does pile up very quickly.”

Donations of old clothes, canned goods, water and outdated prescriptions are accumulating, said Brooks. While such items sound useful, they’re actually expensive to sort, to transport and to distribute, she said. Cast-off drugs can be dangerous.

Oftentimes, the household items donated are simply not useful to the disaster victims they’re intended to help.

“I guarantee you someone is going to send a winter coat or high-heeled shoes,” Brooks said.

In fact, after the tsunami in Indonesia in 2004, aid organizers in Sri Lanka were forced to deal with donations of stiletto shoes, expired cans of salmon, evening gowns and even thong panties, according to news reports. In Florida, a truckload of mink coats showed up during the 2004 hurricane season, Rothe-Smith said, a likely tax write-off for a retailer having trouble pushing furs.

The compassion behind some donations is understandable — and laudable, she added. People see dire images on television or in news reports and they want to help.

“It seems to make logical sense to go through your own cupboard and gather those items,” Rothe-Smith said.

The reality, however, is that inappropriate donations actually do more harm than good.

“If you buy a can of peas and it costs 59 cents, it’ll cost about $80 to get it where it needs to go,” Rothe-Smith said.

Mathematics of donation favor cash
Many agencies try to motivate donors with the mathematics of the situation. Jeff Nene, a spokesman for Convoy of Hope, a Springfield, Mo., agency that feeds 11,000 children a day in Haiti, urges cash donations that allow his group to buy in bulk from large suppliers and retailers.

“When people give $1, it translates into $7 in the field,” he said. “If they spend $5 for bottled water, that’s nice and it makes them feel good, but probably it costs us more than $5 to send it. If they give us $5, we can get $35 worth of water.”

That’s a sentiment echoed by virtually every aid agency.

“I would really say at this point, honestly, right now, money is the best thing to give,” Rothe-Smith said.

Donors can find vetted agencies helping in Haiti on sites such as Charity Navigator.

Still, trying to direct the flood of compassion can be tricky, Nene acknowledged.

“Some people get a little miffed by it. They think they’re trying to help and when you don’t receive it in that attitude and spirit, they get upset,” he said.

“You just have to tread lightly. You don’t want to crush people when they’re so willing to help.”
© 2010 msnbc.com Reprints
URL: http://www.msnbc.msn.com/id/34958965/ns/world_news-haiti_earthquake/

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Haiti: Pre-earthquake

In light of the catastrophe in Port-au-Prince, Haiti, I figure I should probably write a little bit about my experience there. Fortunately, the hospitals we were working with are farther inland and all their locations are still standing. This puts them in the position of providing care to many of the wounded. Having worked with the people at Partners in Health (PIH), I would highly recommend sending any support through them if you want to help with the disaster relief. PIH isn't just an outside aid organization, their whole strategy is to train and employ Haitian nationals, from the cleaning staff and community health workers all the way up to the doctors and nurses - and everyone in between.

While in Haiti, we worked with Youdy, their head biomedical technician. I was so impressed with his knowledge and desire for learning. Youdy has completed multiple courses in specific types of equipment, both in the US and via distance-learning. He is training at least 8 young men to work at the different site hospitals and as assistants for him. While we were in Haiti, Billy and I worked with Youdy to repair 3 tabletop sterilizers and help set up an x-ray machine. Once we arrived at home, we were also able to send back the parts for a 4th sterilizer which is likely in service now.

More to come later. For now, here are the pictures from my time there:

Zanmi Lasante Hospital in Haiti

Polka-dot Umbrella Day

A week after I intended to write this blogpost, I'm getting back to share just a few details of my new Durham home with you all. Today was a mixture of continuing to explore a new city: I found the MASSIVE Southpoint mall; and getting to know good friends even better: Jennifer and I had dinner with our neighbors and some friends, most of whom are new to the area.

For those who haven't heard the basics, I am living in a neighborhood called Lyon Park - in fact, we are two houses away from the Lyon Park Community Center. It's always a nice break to hear people picking up their kids from after school programs or see the teenagers walking home in the evenings. When I first moved here, there were those who said it was a dangerous neighborhood - and it isn't rich, that's for sure. But as for safety, I see this as my home. People are sitting on their front porches all hours of the day. I talk to the ladies on either side of me, both with lots of children in and out of their houses even though they are long past their own mothering years. There's construction going on up the street on a huge church with gorgeous stained glass windows, and you can hear people playing music late at night - just loud enough to know there's life.

Last weekend I had the opportunity to learn more about my neighborhood and the surrounding area. While searching for a place to buy stamps, I discovered that there was an entire shopping area and street I had managed to miss by driving and riding only on select routes. So I set out with my polka dotted umbrella to buy stamps and see what was there!

On my way, I walked past the community center, lots of rather old little houses, and a few recently renovated places -- mostly from Habitat for Humanity and Self Help, the organization that redid my house. The rain and gray brought out the rich greens in the yards, and even the kudzu covering everything in a few empty lots. One house was particularly striking - it was old, a little run down, and you could tell there wasn't a lot of money there. But there were a few women standing outside with umbrellas, saying goodbye to friends, and someone had taken the time to plan just a few brightly colored flowers in the yard.

Once I reached the main road, the business area wasn't anything like the pristine Southpoint mall. The local Food Lion (cheap local grocery chain) anchors an old plaza with some authentic Mexican restaurants and thrift shops. I ran into a young man at the gas station who made a little pass; the older gentleman who came behind him exchanged a knowing smile with me. On the outskirts of the area, a series of three houses hold a business called The Tuba Exchange.' Someone tell me why they need a house and three full sized garages for tubas? There's also a small shop called Pennies for Change - an adorable thrift shop with funds going to help victims of domestic abuse.

On my way home, I got to meet Ricardo - a man I've seen many days as I drive by - always studying English on his front porch. I stopped to say hi, and we immediately had a wonderful conversation. His wife stuck her head out the door just far enough to see who he was talking to, but she didn't seem to want to speak. Perhaps she wouldn't have been able... I told Ricardo I was interested in learning Spanish - he said that we could exchange language lessons, though I think he is better off learning from the local Catholic church where he said he gets classes. I hope he and his wife do well here. Perhaps I'll get to know them better.

All in all, this neighborhood especially, is beginning to feel like home. I've connected with a friend from high school and am continuing to get to know some great people in the area - students, staff, and a few people like me, who are still trying to figure out what life holds.

Comfort Food - Tanzanian Style

A little less than a month after our return from Tanzania, I'm now living in Durham, NC, where I just started working with Engineering World Health at Duke University. I live in a wonderful little green house just close enough to campus to ride my bike on winding roads up and down through the woods.

Perhaps my biggest worry with work was that I would be bored... but that doesn't seem to be the case at all! First day and I already have more than I could want of projects to work on. AND they're all projects I would enjoy working on. What more could you ask for? A salary, perhaps, but that's why I'm babysitting until my North Carolina EMT registration comes through. In the meantime, I'm working on being frugal... kind of a challenge.

That's why I looked up my favorite Tanzanian lunch food: Wali na maharage! (Plain ol' rice and beans). The best part is that once you get a big bag of rice and big bag of beans, you can eat for a long time on minimal budget. In the process of looking up how to cook this beautiful food, I found a website that a peace corps volunteer had put together of many traditional recipes I loved eating this summer! His directions and descriptions are quite amusing and seem to be pretty accurate, too.




Wali na Maharage

Enjoy! Now I just need to find a whole-foods type store to buy my rice and beans in bulk... A farmers market would be nice too, but I think my roommate knows where to direct me. Hmm... now I'm hungry. Mango time.

Favorite East African hit song!

Pii-pii, move out the way!

Basic story of the song - he is in traffic, wants to get home and see his baby because it's been a long time and he's tired of calling on the phone, etc.

We always loved hearing this one playing in cars, bars, homes, and even our own computers once we figured out how to download it. This is the video that was also playing on TVs constantly.