Dr. Herby leads a practice session



This was my final day in Haiti. We trained an excellent group of Friends today and had just the right number so that they could work comprehensively in small groups with their facilitators. We were in a horrific camp in Port au Prince. We were first directed to a tent that was full of garbage and had no seating and started looking around for another place. The Camp manager directed us to the basement of the old city theatre that sat in the middle of the camp. The earthquake had split it down the middle, and it still looked like it was in a somewhat precarious position. The basement area looked safer than the patio area, but it had a stench and such a thick layer of dust and grime that the nurses and Steve all started having allergic reactions - itching and respiratory. The Friends didn't seem to be bothered at all, probably used to it more being camp residents. We powered our way through the didactic part and then did the practices out on the patio amongst rubble and rebars and a huge crumbling column over us. We went back and forth trying to choose our poison. The Friends were remarkably enthralled by the work. At first they talked about just needing more cash to give to their older people so they would have food, but they finally agreed that they had something incredibly important to give them in helping them stabilize themselves from trauma upon trauma. They were receptive and hungry to do their own work and grateful that we were there for their own care. They made a good first pass on the skills and want more training soon. One woman was struggling with heart palpitations, agitation, and anxiety that were re-activated by her fear of Hurricane Tomas last week. In the trauma work, I helped her focus on the sensations in her body when she remembered a day in May when a clean water source finally arrived at the camp she had just migrated to--specifically, sensations of the cool water running through her when she could finally drink, and feeling the water on her hands as she was able to wash her clothes and her dishes. Working with this resource helped her neutralize the activation of fear that a tree would crush her tent in hurricane winds, and her body settled to a calmer, more balanced state.. Help coming is the only hope for these most vulnerable people.
The HelpAge model here in Haiti has been such a palpable lifeline for older people here who have lost everything in the earthquake- their homes, their livelihood, sometimes their spouse or a child. And now they are in IDP camps often with no family around or a grandchild or two that is solely in their care, a leaky tent, noise and violence everywhere. And what I heard from the Friends over and over was that older people in the camps rely on HelpAge being there , for help getting clean water, for intermittent cash for food, for microcredit grants to start a small business back, for respite out of the oppression in the camps on monthly field trips out to the beach or mountains, for education about what to do to prevent cholera and what to do if they get cholera symptoms. The Friends visit their each of their 20 plus older people beneficiaries often twice a day, assisting with personal care when needed, giving them the latest information about security and health issues, and being a support. Now almost 100 of the 200 Friends have been trained in a trauma model which promotes psychological resiliency and they have more to give themselves and their people. And the Friends have a means of usefulness and livelihood as they themselves are getting back on their feet with the part time salary HelpAge pays them. They get to be a healing asset for their country. This HelpAge structure made it possible for many people to be reached. I am amazed and inspired to see what American dollars from AARP and HelpAge International can buy. It is quite stunning.
So off to bed and to catch an early plane out in the morning, very tired after a long couple of weeks, but so honored and privileged to be a part of all this.

Juliette, my interpreter, was the best ever
Sunday with the nurses


Just finished a good day with the nurses for them to do personal work. They are a tight supportive group to each other now and it has been good to watch their bonds develop. They are pleased with themselves and their new abilities. Today's work was laced with courageous vulnerability, a lot of girl talk, mutual commiseration about fat tummies and how to get rid of them, joking with each other , and playing with Mary Lourde's 8 month old baby , Prince, all of us taking turns with him on our laps. It was a sweet time.
Yesterday's training with more Friends in a camp was a less than stellar day. We were tired, but this group of Friends seemed more spaced out that other groups, and some never really caught on very well at all. That was less than encouraging to me, but it was a good learning tool for the team to see that there can be such variety in the groups that we teach, and concomitantly variety in our results and satisfaction. The one thing that always goes over in every group is the participants leading singing, dancing, sharing of jokes,poems or stories. They also love how it feels to them when a resource settles their bodies. They like knowing about ways of connecting and communicating with their older people, and they always like learning that the reactions that they and others are having in the camps are normal reactions in response to extreme events. When they practice teaching about how trauma affects our bodies, they are very proud of themselves. What continues to be very spotty is their learning the skills themselves. It was discouraging to me not to have made it work better today. I have the disease of all the care providers here- if we don't feel like we made enough of an impact, there is no payoff.
Here is the cholera update: rapidly rising 12,000 cases. Anyone with diarrhea needs to get oral rehydration salts immediately. Since there are no labs in Haiti, it is treated as cholera by clinical symptoms only. If it doesn't work in an hour, they have to get IV fluids and tetracycline. If they are not treated immediately, they can die in 6 hours. Getting people to a hospital is a serious challenge with the traffic here which can take an hour to go 5 miles. If they cannot get better sanitation in the camps, people will continue to be drinking water with fecal contamination, and it will continue to rage out of control. They are distributing chlorine tablets that people can purify water with. I wonder if they will get the US military in here to help with setting up IV's. I don't think there are near enough nurses, nursing students, or doctors here to take care of it. I am living here at the house with all the supplies and a doc, and our water is clean. One tragic thing that happened a few days ago is that a political candidate got on the radio and warned people not to touch anyone with cholera. A man died when people were afraid to take him for treatment. They are trying to counteract this with public service announcements telling people it can only be transmitted through contaminated water. There is a very aggressive tent to tent campaign working to do hygiene and intervention teaching . This country really isn't going to get anywhere without proper sanitation though. Dumpsters and the streets are strewn with garbage. This is a very mountainous country. A good rain or a mudslide washes fecal material into the creeks and rivers. It is not pretty.

Fiona doing a demonstration

Fiona, one of the nurses teaching



One of the Friends asked me today,what I thought of Haiti. I told him that although I find the infrastructure horrific , I love the people. Though people are people and of course there are many differences, this is what I love. Haitian people really look to connect. They are incredibly friendly and usually look at me in the eye, interested to check me out, with an expectant invitation that seems to say to me- "just try a little and I'll be there right with you " And that's the thing- such a little bit goes such a long way here. I feel respect without being deferential. I hear a melodic voice that is rich in its fluidity that draws me to it.( It's also great fun how forgiving they are about my French and pathetic attempts at Kreyol). I see a light-heartedness in the midst of devastation, a curiosity that is compelling. The community is very open with each other and with me. I see much purposefulness among the HelpAge national community that has an earnestness laced with a smile. All the HelpAge staff looks out for me everywhere I go, not in a "she's an American and we have to be careful with her" way, but more like " you have come a long way and we appreciate that you want to be here with us".
A big learning for me today was that because we were late coming from one training to another (about 1 and 1/2 hrs), many of the Friends left so we ended up training just 8 . Felt like I had died and gone to heaven. Even though we were in a dirty, dark, kind of smelly shed-like structure in a rough camp, there was no loud generator going like yesterday. Training 8 instead of 27 is a cake walk. The Friends, 7 older men and a women were really touching to me in their attentiveness , very willing to talk about their own difficulties as part of the practice, and seemed genuinely moved about feeling more balanced having experienced the work. Research has come out that it may be less about what therapeutic modality is being used, and more about the quality of presence of the practitioner. Each person on the team has that down, and I think that at least matches skills as the healing element . The nurses took another leap in their teaching the skills, and we left feeling very accomplished. It moves me to watch more and more Haitians become trained to help their own people . And as they do, their pride and hope is palpable. That's where the healing has to come from- not from internationals. The only business we have here is to train.

Steeve, our psychosocial coordinator and Mary Lourdes, one of the nurses with me
Juna, one of the nurses teaching at the camp in Delmas

Somelia, one of the nurses, teaching

Teaching the Friends about the resilient nervous system by waving a sheet





Steeve supervising a practice session
Training in the tent at Croix des Bouquets


We just ended our second day of training in the camps for the "Friends"- camp residents (many older people beneficiaries themselves). The training yesterday at Delmas was really hot and crowded in a pretty small tent for 38 of us, but it went great. The camps are pretty grim places- hot, crowded, dirty, tense on the verge of cholera and constant hunger. Our tent however was extremely spirited with lots of singing and dancing led by everyone- facilitators and trainees at different times, creating lots of energy intermingled with painful stories and earnest learning. My trainees from the previous 3 day training all jumped into the water with quite a bit of success. Many of the Friends at Delmas were educated, some teachers, who picked it up pretty quickly. Others were slower but started to get it after practice sessions. The stories in the practice sessions where Friends all got a chance to be the "patient", were crushing, filled with so much loss, horror and devastation. But so many were able to identify resources that allowed them to make a shift from heaviness, palpitations, muscle tension, bodily pain to a calmer, lighter balanced nervous system place. They were incredibly appreciative,and began inroads to learning the Trauma Resiliency skills of tracking, grounding and resourcing based on Somatic Experiencing principles. I cannot imagine any other therapeutic modality that would be more appropriate for Haitians in the camps. They carry so much of their emotional lives in their bodies, true to Scaer's work that the body does bear the burden of trauma. The facilitators are getting excited seeing this work in the camps. We all were very quiet on the ride home, pleased, exhausted, and sobered.
Today's camp at Croix des Bouquets was a totally different story. The camp was the last thing you will ever see resembling a Cross of Flowers. It was very rough, this time no USAID nice tents like Delmas, but only makeshift tarps of any which kind of material held together by duct tape. It is next to a polluted river filled with garbage and I saw no clean water source. Don't know about the latrines there either, even if there are any. I continue to be amazed that in an 8 hour day out I never feel the urge to pee. It doesn't even cross my mind. I guess when you know your only option is the Haitian squat, it leaves your possibility sphere.
The Friends in this camp were mostly illiterate and much slower to get the concepts. We were in a much bigger tent this time, which was lots better in terms of air moving through, but there was the loudest generator going the whole time we had to practically yell. The whole training just felt more chaotic to me. And certainly I chuckle to myself thinking about our American standards of what a training venue should look like, and what the educational credentials of those trained should look like. After this, I think doing a training like this in a screeching NYC subway station would feel like a conference room in the Ritz Carlton next to this. The nurses made a quantum leap in their teaching skills today, which was encouraging to me. But the Friends had a much harder time grasping the skills. They were convinced the way to help their older people was to tell them to forget about their painful thoughts and pray to Jesus. It took a lot to try to convince them that while it would be great if we could just forget about our painful thoughts, but it just isn't that easy. When we could get them to think of a specific time that they remembered really feeling the presence of Jesus being with them, and notice what happened in their bodies when they thought about it, then we could use their faith as a resource to re-stabilize their nervous system. So far, my experience with most of the Haitian camp residents is that their faith has been strengthened since the earthquake, deeply believing that God has and will bring them through this, as well as their lifetime of adversity.
All that said, the Friends were quite attentive , joyful in their singing, and very engaging and appreciative. Pretty amazing.
Cholera on the rise. Ndaro says Haiti is in for cholera for years. Deaths up to 700. No fruits and vegetables for me this trip.

Practice sessions


Handing out certificates



The third and final day of this training is over and I am so pleased. The trainees have done so much courageous vulnerable personal work in the role plays, that now several of them are ready to train others in the camps, which we begin tomorrow. After a really tough day of long practice sessions that were extremely intense emotionally, we ended the day with graduation, all singing "Lean on Me" together led by Juliette, my fabulous interpreter, with her gorgeous strong voice. Everyone was very proud of their certificates with cameras going off every which way with their holding up their certificates beaming with me standing next to them, The group really bonded, and true to form, one of the nurses came up to get her certificate while talking on her cell phone. I finally figured out today that they were not only on the phone or texting about work stuff, so I at least put the kabash on the phones while we were in practice sessions.
I am so lucky to get to participate in this healing community and am so touched by these men and women who want to help heal themselves and their country. The life force is so strong in the midst of this chaotically dysfunctional country. We have had such a good time today singing loud together in between each practice session with a number of different trainees each taking a turn leading us. It was such a fun break. This was a very good day.

Steve and a few trainees pushing our truck to give it a running start to take us all back home at the end of the day


I just finished the second day of this first three day training and feel like I am running a marathon in a minefield. Many of the participants are talented and willing, but many have been so traumatized since the earthquake that I am having to negotiate how to work with them appropriately for their own self care, and teach them how to be trainers themselves of other care providers. Several men claim Jan. 12 as a day in their life that they feel good about themselves because they had the courage and fortitude to help people get out of their houses and help the injured. Those that barely made it out themselves and lost family members and couldn't help anyone because they were so debilitated themselves, feel tremendous shame, guilt and loss. That said, these men and women are all heroes to me the way most of them can laugh and sing and dance and connect with each other . And they are so wonderful to me- so appreciative, warm, supportive, inquisitive, real and willing to be vulnerable. Practice sessions have been good today but way behind because there is so much personal work that needs to be done for the nurses to move forward. It is happening, but slow, so I have to figure out how to spin something tomorrow that gets us there so that they have all done one and practice teaching one. This is hard work trying to figure out at night how to make each day work after the challenges of the previous one. We lost an hour and a half today because of transportation issues ( a day in the life of Haiti). That doesn't rattle me at all, given that keeping the trains running on time has never been my strong suit. Luckily they have a logistics person that is taking care of all that, but cars invariably break down and get stuck in crazy traffic. Everyone has to be transported from all over the Port au Prince and Carrefour areas, so it is a total crap shoot when everyone will actually be there. And then there is the matter of the cell phones which have to stay on because all of them are in leadership positions in the camps and there is a cholera epidemic going on. Every person with diarrhea has to be evaluated immediately, re-hydrated and referred fast if they have cholera. The cell phones are having to be responded to all the time, so it feels like I am teaching in a 3 ring circus. I am the only one that is not mainlining with my blackberry. But I have to look at the other side that these people and their bosses feel like this is important enough to field everything else to be able to do this. That is pretty awesome. I hope maybe we can make a dent.

Lunch at Fabbius' restaurant, a reunion for Fabbius, Ndaro and me.


Street market scene, dumpsters are piled up at the end of the day and often not emptied.



Trainees getting a ride home.


A few of our training group at Censhop.



I started my part of the psychosocial training yesterday at the Censhop Hospital. I have 16 participants, Steve, the HelpAge Psychosocial coordinator, 4 HelpAge nurses, 2 HelpAge public health docs, 2 program people from HelpAge, a HelpAge community agent from the camps, the medical director of the Censhop Hospital, and 7 other healthcare providers from other NGO's. They are a wonderful group who are eager to learn and seem pretty engaged. They are practicing skills in small groups in breakout sessions that they can use in the hospitals and camps with people who have PTSD and depression. As a whole group we are having lively and touching dialogues about how to do the work with the particular challenges that older people face in the camps, and how to apply these skills to themselves, all whom are Haitians who have personally been through the earthquake here and are still dealing with their own losses of home and family members, and traumatic stress. My interpreter is top notch and is familiar with the material I am teaching and is also helpful with the small breakout groups. We have 2 more days together to do the "watch one, do one, teach one model", so by the end of tomorrow they have to have learned all the skills themselves, so we can be practicing their teaching the skills Tuesday. Starting Wed. a team of us will go to a different camp each day to teach the skills to a group of 30 "Friends", who are camp residents that HelpAge is paying a small part time wage to be health "carers" . The Friends have about 20 older people in their camp that they look in on each day to provide assistance. I am hoping that we can train 150 Friends before I go this time. I know from the time I spent in the camps in August that we will run in to many Friends that are really challenged themselves not only from the loss and trauma from the earthquake, but every day living in the difficult conditions in the camps , often not knowing where their next meal is coming from for themselves or the older people they are supposed to be helping.
Today Sunday has been a really good day off for me. I went to see my friend Mike, who has been here in Haiti running a big USAID program which has been helping Haitian farmers change to and multiply crops to export. He lives outside of Petionville high up on a hill that looks out all over Port au Prince and the ocean- a breathtaking and awesome site to see so many clumps of camps. This afternoon, Ndaro and I were invited by Fabbius, our Haitian driver and interpreter from when I was here in August, to his restaurant for lunch. It was a warm and engaging reunion, a great stew, and lively discussion about Haitian politics, Tanzanian Christianity and voudu. We went the "back way" to avoid traffic and had quite an adventure with Claude our driver, who had to make many attempts to get up the muddy rocky dirt roads, winding around hairpin turns with huge deep holes , through little rivers strewn with garbage. Carly (my daughter who shirks over my driving) would have gone crazy. I am now back at the house safe and sound, happy to have had two really fun times with friends, and ready to review for my training tomorrow.

A quick note to say it is the end of a long day that started out extremely tense not knowing how the hurricane would go. We spent all morning being hurricane trackers. Much relief to see it clip Haiti and move on north. It did mean that I can begin my part of the training tomorrow, which we are all really pleased about.
This afternoon our team met to figure out how to jam the lost one and a half training days into the remaining ones. Although there is much less flooding than feared in the camps, the cholera epidemic is spreading with over 6000 cases and over 400 deaths. The massive push is the water and sanitation problem in the camps and getting polluted water chlorinated. I have complete access to clean water and only eat known cooked food, so I am fine.

I am back in Haiti as of yesterday. Admittedly, I felt some nervous before getting on the trail of planes yesterday from NC, but felt totally fine as we came within sight of a partly cloudy Haiti . I had been following Tomas carefully and knew it was several days behind me, but was still relieved to have arrived here without event.
It was a joyful arrival back at the HelpAge house with a raucous welcome from all the HelpAge staffers I knew from August. It is such a great group of people who are not only so committed to collaborating with Haitians to help improve their lives, but to supporting each other in a place that just keeps on keeping on with it's challenges. Gordy was in great spirits too, pleased that his first part of the psychosocial training had been going well, and very positive about continuing to plan together for the rest of it. Ndaro, the public health doc director from Tanzania, is really pumped about getting the integrated psychosocial program going in 75 of the camps and is full of ideas and support.
Today was to be Gordy's 3rd out of 4 training days for Haitian nurses, psychologists and community agent leaders. It was a great group and very energetic. We got a call at 2pm this afternoon that we had to shut it down , anticipating the hurricane coming in tonight or tomorrow. People needed to be given time to get to the grocery store and get home to be out of harm's way. We have all been glued to online weather reports which now look like Tomas has been down-graded to a tropical storm and seems to be heading right through the corridor in between Jamaica and Haiti, likely clipping Haiti with rains, and lower than 25 mph winds. Thank God. The government was announcing to the over 1 million people in the camps to evacuate to families and friends. Problem is that the camp residents are there because there are no family or friends with available housing. There are a few churches and public areas that can offer very temporary shelter. This storm definitely needs to stay away. Enough. In addition, most all of the NGO's have spent all of the funds and resources in their pipelines, so there is so little for another disaster!
The cholera update is that it is also slowed down, but not contained. HelpAge is doing a ton of education for cholera prevention in the camps. If this storm does create massive flooding, cholera will really ramp up. Some neighborhood residents in Haiti boycotted an additional cholera hospital being put up because they were afraid. Fear keeps people from learning what the facts are so much of the time.
My part of the training is going to have to include a bunch of material that Gordy was going to cover, but that is fairly workable. Hoping the storm will be past to continue the formal training Saturday. I am perfectly safe and comfortable. It's the people in the camps that need not to get hit again.

Gordy and I have been holed up for two days this weekend at the staff house writing our needs assessment report and now at 6:45 Sunday night I am finally coming up for air. As is always the case for me in writing reports, grants or proposals, the fight is not about plowing through the job , it's my fight with the computer. I lost 3 hours of work I know I saved on a flash drive, spent two hours trying to recover it, and another two hours re-creating it. Gordy has the same problem with the computer so I am very relieved it's almost done.

Yesterday did have a little break when we went to one of our Haitian partners ngo's to watch them do clown practice. Kids that were walking around aimlessly on the streets were recruited to learn how to be clown actors who go all over doing public service messages about hygeine and psychosocial issues. They go into the camps as well now and we are going to try to do an intergenerational project with kids and older people and the clowns. What would be really great is to train some of the older people to be clowns. They have nothing to do and it would give them a way to contribute.

We present our report to the HelpAge staff tomorrow morning and after that to ngo's. Then it's off to the airport and home through an overnight in Miami. My head was spinning with so many possibilities I couldn't sleep much at all last night, and unfortunately I still am not sleepy. Everyone here that I have run into at the ngo's just works all the time. I think it is too hard not to. You look at all the devastation around you and you just want to help. Another reason is that working a lot helps. It is a distraction in a place that is so unsafe you can't go anywhere without a driver and a translator and they are only available for work. There are some nice restaurants that we have gone to a few nights- our whole team- but is always tinged by a huge camp right next to it and the disparity is pretty hard to swallow. I was hoping to get together with Mike, Marilyn's friend one more time tonight, but no driver for either of us and Mike has clearly instructed his staff that it is absolutely unsafe for anyone to drive alone on the Rue des Freres that is right next to us that allows access anywhere. It has been weird to get absolutely no exercise for this long as it is unsafe to go out on the street even in our gated neighborhood. We have an armed guard right outside the house 24-7, so I feel really safe at the house. This weekend 3 of us have been on the computer the whole time. Lance , the logistics officer is working on his computer at the table as Gordy and I do just working away. Ndaro, our Health director from Tanzania is an Adventist, so he didnt work on Saturday. It was nice to see but I know he misses his wife and young daughters so far away. We talked for quite a while last night. He has great wishes for what he wants to accomplish as a public health doc here in Haiti. I am glad to see that he allows his religion to make him stop one day a week. It would be so easy to run yourself into the ground here. The need is like a sinkhole that takes you with it and the only way to survive the force of it is to fight back with work. Nobody here at the house drinks either, which is good- you could get into trouble if that was your comfort. I think many here are on a spiritual mission which drives us with a level of energy that is quite something. It is strangely not emotional. It will be hard and odd to leave tomorrow, and I am sure I will be back.

Several of us had dinner with a really good friend of Marilyn's, Mike, who has been in Haiti for the last 2 years working on a big USAID project assisting over 10,000 farmers change over into growong more profitable crops for export. Mike says Haiti is referred to as the Republic of NGO's. I had read that over 10,000 ngos were in Haiti after the earthquake and Mike says at least 9500 were probably here before due to the extreme poverty and years of ineffective government not providing an infastructure. Though certainly the number of ngos here reflects worldwide humanitarian concern and response, there certainly lies the possibility of dollars wasted by unnecessary duplication of administrations and undermining capacity building for Haitians.

To that end, our day was much more satisfying than yesterday. We met with a fabulous Haitian physician trained both in general practice and psychology who heads a small organization, CARPA that has been providing a kind of integrated care (combined medical and psychological care) to older people in Haiti for 10 years in clinics all over and in mobile health units in the camps. So many Haitians carry their trauma and suffering in their bodies. and he treats his patients wholisticaly. It sounds like he has developed his own morphing of somatic experiencing, by tracking emotions in the body and doing relaxation. Because so many international ngo's are finishing up their their initial emergency phase funding, it is leaving many of their Haitian partner agencies potentially without funding to continue their work. I don't know what will happen with this one (it actually hasn't been known to Helpage before now) , but it holds promise and I hope they won't be left high and dry. Helpage is looking at partnering with an ngo that supports them that would also help with livlihood issues, which would be great.

We also had an encouraging meeting with University d'Etat d'Haiti faculty in the psychology and social work departments that demonstrate interest in having their students participate in psychosocial efforts in the camps. They have been putting together a project that hasn't quite materialized, and there are great seeds for collaboration. We also met with the project manager of the Mental Health and Psychosocial Services working group cluster to help our Steve,our Helpage Haitian psychosocial coordinator get hooked in with the coordination efforts there.

Lastly we met with the head of the IFRC (International Red Cross and Red Crescent) Psychosocial Dept.. They are forming a consortium of the 8 big country red cross orgs that are all in Haiti doing their own thing to put them all UNDER a new hired Haitian director who will be with the Haitian Red Cross over the IFRC . This is important stuff moving the work from the direction of international ngo's running Haiti ,to Haiti running Haiti with international ngo partners. A long way to go but there is momentum. Very impressive to me.

Tonight our team went out to dinner together to celebrate the end of an incredibly intense week. We have become quite a little band- the five guys and me. We have started to poke fun at each other and we are getting to know each other as people and support each other as we try to make our way through the morass of this country of such suffering, need, confusion,heat, danger, desperation and spirit. Everyone is so comitted to what they do, it blows me away. I feel so privileged to be a miniscule part of this .

This was a very different day as our job this next two days is to visit partner Haitian and international ngo's to see who is available here to provide psychosocial services to the older people Helpage serves in the camps. It was a trying day being driven for hours through Carrefour, a teeming , insanely crowded urban area, the likes of which I imagine in India. The ghetto there has been there since the 90's we are told. I thought the camps were difficult until I saw this- horrific congestion, filth, tiny cardboard boxes for shacks stacked one next to the other, not a tree in sight and the sides of the road filled with people selling their wares- sodas , pure sugar drinks, candy, purses, cell phones, phone cards, chargers (people may be going hungry, but many have cell phones), old clothes, plantains and mangoes. We would drive for hours through bumper to bumper traffic and then not be able to find the place we were supposed to go, or find that the person we were supposed to meet was called out on an emergency. This is Haiti. One Haitian ngo was actually pretty organized and has been a strong and valuable partner to Helpage. The other one was much less developed. We finally found them in a hole in the wall, which looked like they were trying to look as professional as possible for our visit. In talking with them though they seem to be very connected to the older people in the camps and motivated to offer them group activities as they have this last 7 months. They worked with Helpage to take the older people out of the camps on a day trip to the beach. I had heard someone talk about this as "psychosocial lite" and at first wasn't that impressed by it, but now talking with folks down here see that this is the first time most have ever had a vacation away from their very severe congested living circumstances, and it is a very big deal. No wonder a lady in the camp yesterday said she felt she had been treated like a queen.

The way most people get around in Haiti is by these colorful buses that Iwant to call jitneys. If I can get my camera to load onto my blog, I'll get some pictures up. The buses are pick up trucks with canopies and no rear gate. People just jump onto them from the back even as they are moving along (which is easy since traffic is always bumper to bumper). They are always crammed with people and easily have 10 more people than there is room for. They are brightly painted and have all kinds of names painted on the back of the top of the truck like "Merci bon dieu". I read that and thought they were thankful to their good God who gets them through their suffering- now I wonder if they are asking God to get them through the ride alive. Other names of the buses: Pere eternale, Fils aime, Merci Jesus, Don de Dieu, Le Main Divine, Christ capable, Grace de Dieu, La roche (rock), , Dieu d'amour. There are tiny shacks that sell their own lotteries called Onge Dieu (angel of God) 3 for 2. Steve says everyone buys these lottery tickets hoping to win. Other names of businesses: God Bless. Us Depot, and Jesus Roi Boutique. A very long day today and would have wished to be at the camps more. However the work to find other Haitians who might want to receive some training to do this work is a big part of our task to empower them help themselves.

Today driving -to the camp at Lilavois was a journey about one and a half hours away bumping along the most ripped apart road I have ever traveled. They must have the most expensive tires made on the Helpage car to have gotton through without a flat. Fabius is a skilled and wild driver - nothing fazes him. Steve and I sit in the back and Steve just closes his eyes I think trying not to hurl while Gordy sits up front and expounds on needs assessment methodology. I am fascinated at everything along the road- hundreds of people selling all kinds of strange looking stuff that Fabius assures me that people buy. When we get to the camp, we meet the Camp President Mr. Edser. He is Haitian but had been living in the U.S. for 12 years in NY and Miami until the earthquake hit and he wanted to come back immediately to help his people. His family owned some land so he started a camp here where 3000 people live, about 30 perecent of them older people. He literally went out on the streets and collected people to come there, gathering together support from ngo's for tents, food and medical care. The camp residents love him and he is such a loving caring guy- blew me away.

I should take a minute to talk about Helpage. It is a London-based ngo that has been around for 25 years offering humanitarian assistance to older people in poverty in 74 developing countries around the globe. They do quite a bit of disaster preparedness and disaster relief, and were here in Haiti doing that for the last several years. My good friend Marilyn Grist was consulting to them as they were wanting to start Helpage in the U.S. a few years ago. Helpage and Marilyn fell in love with each other in the process and Marilyn became their first US exec director about a year ago. When the Haiti earthquake hit, I called Marilyn and said "I want to go!" After what seemed like a long process of developing a proposal to assist with psychosocial needs for older people in Haiti, I am here! The way Helpage is structured in the camps in Haiti is that there is a lead "focal person" who the older people get registered with for services and who supervises several "friends" whom each have a dozen or so older people that they are in contact with every day. The friends are usually wonderful who are in the camps themselves struggling with their own suffering, but are also helping .a group of older people in a very caring way. There are always tons of logistical nightmares trying to get food, functional tents, medical care and comfort measures to the people, but by and large the older people see Helpage as really in there for them.

We are finding that each camp has its own personality and culture. Lilevois was full of suffering and triumph. We listened first to the friends talk about how painful it is for them not to be able to give the older people the things they need- they cry when they see them hungry or so hot they cannot bear the midday heat. Then we had our group with the older people- it started with about 30 under shady trees and grew to about 100. I asked them to tell us about what it had been like for them since the earthquake being in the camps, and what we got were about 25 people getting up one at a time emphatically telling us their earthquake story. Each story was full of horror of what it was like for them as they felt their house shaking, many grabbing children , falling and getting up as they were running out of the house, having hurt parts of their body, some watching their children crushed, their husband die, and still thanking God for sparing their lives, giving them Mr. Etzy and the camp. In my Somatic Experiencing training we are taught to make sure people feel their resources as they tell their stories in order not to re-traumatize themselves. These people did so easily, always going back to Jesus or Dieu being there to help them get out, get a baby out, to give them life then, and now. After each story, all 100 sitting under the trees( and of course us too) would clap loudly. It was just incredible. The other side of the triumph was feeling pain all over their bodies, still trembling and shaking, hearts beating fast. We all did a little grounding exercise feeling the calm in their chests now feeling safe and alive. So much trauma is locked in the body- blindness after the quake with no head injury, weakness in the legs, dizziness, confusion. There is so much work to be done!

The emotional stuff is there, but many people in the camps are still going to be hungry and many older people talked about needing money to start a small business so they could support themselves to get food. Small business usually means selling things on the street- its what they did before and know how to do.

The second camp today was much different- much more depression, discouragement about getting help, and anger. The camps are like a family- if there is a good strong parent, the camp is strong and the culture hopeful . This camp was filled with garbage even though there were receptacles for it. Lots more lethargy here and many legitimate complaints about hunger and again many medical problems. Paul Farmer's ngo Partners in Health is here in Mobile Health units 5 days a week, yet many don,t feel attended to. Lots of

despair about having no way to take care of themselves. The small business development has to be a huge priority. Anyone out there know who is trying to tackle this?

Heavy rain a blessing late this afternoon to cool things off!

What a very long and full day in two of the camps. We set out at 7am through crazy traffic driving through rubble bouncing around on trecharous roads that would give Carly a heart attack . The first one was in Port au Prince and was so amazingly crowded and hot. We interviewed about 30 older people who told us their stories of what their lives have been like since the earthquake living in the camps. So much loss and yet so much spirit. This lady was telling me about losing her son, her home, her dry cleaning business, now with no means of a livlihood. But she says God helps her, and her community helps her. She is often hungry, without food for a whole day. And she was so grateful for our being there to hear her story . We stayed in this tent for almost three hours talking to people- everyone so open, willing to tell about their pain and what gets them through such hardship.. For almost everyone, they raise their hand up to the sky- "Dieu". I got a first hand experience of what it is like for them in the tents- suffocatingly hot- all of us dripping sweat for hours and noone wanting to leave.

We drove another hour again bouncing through rubble bumper to bumper now with many more people trying to sell stuff on the sides of the streets- mostly second hand Salvation Army clothes and shoes, cheap new cell phones and chargers, rotton looking produce. These are the small businesses that many of the older people were talking about that they wished they could start to begin to make a living for themselves again. The second camp population was about 29,000 , but because it was on the edge of the city it was a little more spred out. The tent that hosted our gathering was bigger with a higher ceiling and we could breathe a little better than the first camp. Again, each person was eager to tell their story. Many people still shake in their bodies and have a general malaise of generally feeling bad since the earthquake. Camp living is especially hard for these older people who struggle with not feeling safe due to theft, feeling alone in the world having lost their families, and still now 8 months out go hungry many days. They are hoping the food and safety issues will be addressed and that they could have a designated place to congregate to talk together and tell stories to the children and other adults.

Got back to the staff house around 6:30 to wrap up what we learned today. I did my interviews with the new young Helpage psychosocial coordinator Steve- a really kind and smart Haitian man . He was my interpreter and co-leader of the groups and we have bonded well. Gordy is working with another interpreter doing interviews with camp staff and other groups. Between the 4 of us we are learning lots. It is hard to stay on the emotional stuff in the face of so much basic need for food, health care, housing and money, but folks do want to talk about the sadness and frustration and how they are getting through. I think it has been perhaps some good that they have been asked to name what inside them and outside of them that gets them through such tremendous hardship. Naming these resources and tracking the feelings in their bodies is the beginning of healing trauma work. It is hard to hold back from trying to do treatment interventions, but this is the time to do the assessment . The need and destruction would totally overwhelm me if I did not see so much beauty and strength and ability to connect in these people. Out to two more camps tomorrow!

Arrived in Port au Prince without a glitch this morning flying in with Gordy Dodge, the veteran disaster psychologist that I am doing the needs assessment with . The Port au Prince airport is barely put together in a torn apart hangar with incomplete outer walls. It is hot- a very humid 100 degrees with of course no air conditioning. The HelpAge driver Fabius drove us through PAP on one (the only one) very pot-holed road, teeming with people on either side slightly trying to sell rotton looking street food and paintings done on cloth, little kids coming up to the car asking for money, many others hanging out looking very lethargic. It was pretty grim. We drove for about an hour in a ton of traffic passing lots of rubble interspersed with three or four new building sites and the rest tiny small store shanties, most of which were not open for business.

.The shocker was arriving in Bellville where the Helpage staff house and office are located. It is like a wealthy development that didn't get touched by the earthquake. The houses are stucco and have white tile floors. They are not fancy and are still very hot, but compared to all else here are totally palatial. We are right next to Petionville where Sean Penn works with a tented city of 55,000 people sitting on an old golf course. There are 2 Haitian ladies here at the staff house that make lunch for the staff during the week. Everyone is on their own for food the rest of the time. The lunch was good- some kind of mushroom ragu rice and homemade pizza.The staff is friendly- a finance woman from France, a program coordinator from Germany and the health coordinator who we are working with, Ndaro is from Tanzania. Ndaro has just been here a month and is awesome. We met with him and Steve, the new Haitian psychosocial coordinator hired last week, and our 2 drivers/translators, Herby and Fabius. Everyone is so respectful and commited to empowering local nationals to help themselves. We spent hours talking philosophy about empowerment of people who are dealing with poverty and disaster. We reviewed our plan of the week which is to visit as many as 6 of the tented cities, or camps, that Helpage is working in to listen to the experiences of camp mangement, health care providers and older person beneficiaries and begin to put together a training plan. So it all really begins tomorrow. I have my DEET, mosquito netting , local cell phone and wonderful Helpage staff companions here really commited to making this experience safe and hopefully productive. Just feel like I have to put my head down ask for blessing and forge ahead!