Jan 31

We began the day at 5 am by watching an incredible sunrise over the hills of Cange. The hillsides are beautiful but barren as is most of Haiti. Over the years Haiti has been deforested to the point that only 1.5 percent of the original trees are left. People have been clearing trees to plant food and create charcoal to sell for such a long time that not much is left. It's sad as this is largely due to poverty and with the trees has gone much of the topsoil so the cycle continues to get worse. If you want to see something alarming google "Haiti Dominican republic border deforestation" and take a look. It's quite startling. The dm protects it's trees as a natural resource and there side is quite verdant. Haiti with poverty and governmental problems had no protections in place and is brown. Amazing.

We followed the docs on grand rounds. There are people everywhere but that said everyone is being treated well. The pih philosophy is to not turn anyone away and no one is charged. What's more amazing is that almost all of the staff is Haitian with a handful of American docs here because there are so many patients and they are just slammed. The patients range with problems all over the map and sadly many amputees. The peds ward is the toughest yet all the kids smile and wave as do the parents. It's horrible to think what some of their lives will be like when they leave here. Life is hard enough with four limbs here.

We followed a few of the docs after rounds and watched them adjust a few casts and reset a young boy's leg. The care they give is completely wonderful and it's great to watch them hug and play with the kids even though there is a language barrier.

We also sat in on a beautiful church service run in one of the clinics because the church is being used for the wounded. It was quite moving and beautiful and odd to hear a sermon in Creole where I recognized the word Israel so much.

We then gowned up and headed into the two ERs to watch a biopsy and a broken arm. It was pretty wild. I asked the surgeon about the biopsy and he told me that there was some debate as to whether or not to do it. If they find he has cancer there is very little that can be done so some of the docs questioned whether knowing was a good thing. Hard to say.

The broken arm was interesting as when they started they noticed healed gun shot wounds and when they opened his arm realized this was an old wound and the guy probably hadn't been able to use his arm for years. He came in saying it happened in the quake. This is happening a lot since people see the opportunity for good health care. The irony is that pih would have helped him when it happened.

We finished the day doing some interviews with the staff including an imaging tech who lost her husband and son. Everyone here has lost someone and some even their entire families yet they are here working to make people better. It's humbling to witness.

The pih facility here in cange is sort of like the citadel. A huge compound with the hospital a school a nutrition center a church and a host of other services. They started by trying to treat tb and HIV and then realized that treatment was no good if they didn't have water, shelter and food. So they started working on clean water and nutrition as well as home fixing/building. Then they moved into nutrition as well. It's really incredible. And when you think that everyone who walks through the door gets whatever they need for free- surgery, aftercare, hospital care, medicines- sounds sort of cool doesn't it? And this is Haiti. I think the greatest thing that I've heard since I've been here has been talking with Konji, one of the pih crew. He summed up their philosophy like this. Pih is not necessarily about saving lives, although that is what we aim to do here. Pih is about assuring dignity and letting everyone know that regardless of who they are or where they are from, the utmost possible was done to give them the best care possible because that is the right of every human being. These guys rock.