Sunday, August 15, 2010

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.

Friday, August 13, 2010

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 .

Thursday, August 12, 2010

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.

Wednesday, August 11, 2010

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!

Tuesday, August 10, 2010

Posted by PicasaWhat 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!

Monday, August 9, 2010

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!