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Nursing in Haiti - a week like no other

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Nursing Times’ resident Haiti-based nurse Fi Stephenson on a moving week in the the earthquake-hit country

So, another week or so has passed… and very different to others I must say!

We (Haiti Hospital Appeal team) were invited to the dedication service of four-year-old twins in a local church on the other side of Cap Haitian. This in itself was unusual as children are not usually officially named until they reach the age of five, due to the one in five death rate of children under five here in Haiti.

Jack was a healthy boy who accompanied his sister, Jill, to the Children’s Home, where she was cared for on a weekly boarder basis to provide respite relief to their family as she had a lot of special needs.

We had all clubbed together to pay for the celebration. We arrived at 6am at their hut, which was perched half way up a very steep hill. Totally inaccessible by any vehicle. We walked up a very steep, narrow, slippery track to get there, passing close to a deep red Voodoo Temple with flags at each corner. We were greeted at the top and carried the children down to the church in a proud ceremonious line.

How anyone did not slip I do not know! For their mother to do this every day with her other five children is incredible – I cannot believe there have been no broken bones (yet).

Electricity in the air

The view over Cap Haitian and the sea was breathtaking and would be worth a fortune in any other country. The little local church was simply decorated and full of people. The local choir was fabulously harmonious and could uplift any hymn I am sure.

We sat near the front and had a great view of the proceedings. The twins were very well behaved and looked gorgeous dressed in white. Everyone was dressed in their Sunday best, and all the other local children were squeaky clean and very well mannered! Looking around the church I noticed that every single electrical point was being used. This was the mobile phone electrical charging point for the village as it was the only building with electricity.

After the service we retraced our steps and sat in their hut, eating rice and beans and chicken legs and sharing a coke and sprite, oh and some strange local alcoholic creamy something (tasted quite nice actually and was very strong!). It initially felt uncomfortable to be eating their food but it was their custom to entertain their chosen guests; and we were them.

One thing that I will always remember though were the children, who insisted on sitting next to me; big wide eyes, smiling and giggling, practising their English, and asking for food and drink. I had divided the chicken flesh up and was going to give the dog the chicken bone but one of the girls pointed at it and asked for it. I gave it to her thinking she was going to get rid of it.

She ate the whole thing; bones, gristle, everything. To think that we worry about chicken bones getting stuck in throats of dogs. I guess the bone marrow was a good way of getting nutrients.

Back at the Children’s Home, where I live, we have a lovely group of children aged between 6 months and 11 years. They all have special needs (apart from Jack) and attend daily or for set days and nights per week to help their local families. Most of the children have suffered birth trauma – over 75% of deliveries are at home with no one in attendance.

Song and laughter

As you can imagine the maternal and infant mortality rate is very high. The local Haitian staff  have been trained to care for them by Reninca, an English teacher (married to Carwyn who set up the Haiti Hospital Appeal) and some UK physiotherapists. The home is full of song and laughter, as well as the inevitable crying of a child wanting something.

It is a busy and happy place. One of the children, David, was at a hospital, having been evacuated from Port Au Prince. His parents had left the day before I met him. His mother was 17 years old and seven months pregnant. His father was 19 years old. David was 18 months old and had gross hydrocephalus. Something you would see in an old, old medical text book; His poor head was so big, if it was not supported at all times, he would break his neck.

The head nurse spoke to me asking if I knew of anyone who might know of an orphanage in the area. To cut a long story short, he came to the children’s home. At one point it was hoped he would be a candidate for a shunt but it became clear that he was for palliative care. It was lovely to see him change and start gurgling and kicking his legs, having lain so still and quiet in a cordoned off area of the paediatric ward. (The nurses had had to do this as he had become a spectacle and something for other children and parents to stare at and ridicule). He had lots of attention and settled in well.

Reninca and Carwyn kept in close contact with his parents, who had returned to Port Au Prince and it became obvious that they really missed him and had not wanted to give him up - but had felt compelled to because of the next baby being due. The best thing for David and his family was to be together so a special helicopter was organised to fly him and Reninca down to meet up with his family. The reunion was an emotional one. Who better for a child to be with than his family?They knew his time was limited but his young parents wanted to give him the love that he deserved. He is still alive and on medication. His prognosis is very poor but he is where he belongs.

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