Feb 1

Woke up at 5 to film the sunset and then followed the docs on rounds. At one point they came to juanika the little girl singing in the video who lost half her foot. She's simply amazing and has this huge smile on her face all the time. They called in her parents and told them that they had three options to consider - to do a skin graft over the foot, to cut the leg midcalf, or to cut it above the knee. Each has it's pluses and minuses and not only did they take the time to explain the pros and cons but also what the larger societal implications will be regarding how her walk and appearance would be and whether or not people would know she was an amputee. That's what amazes me about these guys. Not only are they giving topnotch free healthcare to underprivelaged people but they are offering them choices just as they would be in any decent hospital in the states. They deserve no less than anyone else does.

Next up we went into Cange which is essentially one dirt street long with vendors and houses on either side. The docs found the parents of a girl in the hospital who had shattered her forearm and was ready to be discharged. They explained that they were doing a preliminary assesment to determine how best to get her home and continue her treatment. This is another amazing aspect of PIH. After a patient goes home a worker from the hospital will check in on them as long as is considered necessary in order to make sure that they are recovering well. n this case they were in Cange but in the case where they are farther out, PIH employs locals that have healthcare training to monitor recovery, help when necessary and phone in so that the patients progress can be tracked. We walked about a mile, up a steep incline to a little series of tin shacks where the girls mother and father showed the docs where she would be sleeping and they assesed how to get her there.

We then went back and they loaded her up in an ambulance and drove her to the base of the hill. Then, with great care, 4 guys took turns carrying her stretcher up this steep terrain and into the house. They set her down on the bed, made her comfortable and gave the mother and father a 20 minute summary of everything they needed to know and answered their questions. As we were leaving I asked when they'd be back and one of them told me someone would be by that afternoon. Can you imagine this happening in the states? And for every patient no less? Aftercare is considered no less important than the initial hospital stay and with houses with tin roofs and dirt floors it may even be more important.

The house itself was really interesting. Made from tin and wood that had been picked from other places using nails that were bent and rusted it consisted of very small rooms that I could barely stand in. That said it was clean, neat and obviously a great source of pride as they had painted it quite vibrantly, decorated it and had several ornate wood cuttings as trim. Very pretty.

We came back to the hospital and did a few interviews with one of the chief docs and a nurse who lost her sister and is now going to be caring for her 9 children. It's incredible how everyone is coping and I have seldom if ever seen the type of strength they have shown. Everyone here has lost someone, some their entire families and yet everyone is here working because they feel its the best way to help.

We also talked with a surgeon her from Philly who could not believe how amazing this place is. He pointed out that if American hospitals ran this way no one would have a single complaint. When i asked him about money he pointed out that the operating budget for the whole hospital is in the low single digit millions yet they treat as many people as some big city hospitals. Go figure. OUr director asked him if there was one case that was the toughest and he told us about an 8 year old who came in with a major head injury. The only way to save him was to open a burr hole and relieve the pressure but that he would need a nuerosurgeons care afterwards and they don't have one here. There was a hospital they contacted in Port Au Prince who could have helped but was not willing to do so. So it was decided that there was nothing to do for him and he died. 8 years old and his mother had just buried his father as well. The docs offered to the haitian staff to say they'd like to pay for his funeral as she had no money and they were told that she had opted to have him go to the morgue where the bodies "just disappear".

Several other tough stories today that I'd rather not go into. Terrible things have happened here but wonderful ones as well. It's an odd place.

This evening we met with the priest who started this place back in the 60s before he asked PIH to get involved. He explained that there was nothing here and he came when thousands of locals were displaced by the flooding of a valley for a power generating system. Of course they got no power from them. Anyway he described the begiinings and getting water up here. He mentioned that where there is water there is life and finished by saying in spite of it all he was happy because he had been given the ability to make others happy. How cool is that. Through all this, that's his feeling. My grandmother would have liked him very much because that was her philosophy as well.