So the morning began with a 7:30am church service. All of a sudden, Nathan is called out immediately, and Paige follows suit. We wouldn't find out until after church, that a new born baby had just arrived unresponsive from one of the tent cities. An anesthetist from one of the tent cities an hour and fifteen minutes away went to check on this little soul, who was born at 36 weeks. The baby had no pulse, and was not breathing. Upon arrival, CPR was performed, and Paige intubated the child, as the local anesthetist was unsuccessful. Unfortunately, the baby did not survive. This death added to the weeks' toll...it is without que
stion gut-wrenching, that I say there were four deaths at the
hospital during our stay. Sometimes, even when you do what you can, and you leave it all out on the field, you end up with heartache. This is again one of those times. On a more positive note, we've been following the poor lady with the pelvic and acetabular fracture (and did we mention she also has a left femur fracture that needs to be fixed) closely and day by day her hemoglobin is slowly inching upwards, she's making more urine (those beans are working again!), and her blood pressure is holding steady. She actually might pull through. Once Paige breaks the news about the poor newobrn to all of us, we look that much more forward to visiting all of the children at the orphanage that Frantz's parents run. The six of us, as well as Sarah Carignan from Boston, and guided by Frantz, Claudy, and Roosevelt, the Adventiste translators who've become our friends, gather our backpacks and a few other donated goods we have, and head out into the sweltering heat. Along 
the way, heaps of trash, piles of rubble, and homeless Haitians line the streets. This is nothing new. Ten months after the quake, little has changed. We noticed more of the streets are getting
stion gut-wrenching, that I say there were four deaths at the
hospital during our stay. Sometimes, even when you do what you can, and you leave it all out on the field, you end up with heartache. This is again one of those times. On a more positive note, we've been following the poor lady with the pelvic and acetabular fracture (and did we mention she also has a left femur fracture that needs to be fixed) closely and day by day her hemoglobin is slowly inching upwards, she's making more urine (those beans are working again!), and her blood pressure is holding steady. She actually might pull through. Once Paige breaks the news about the poor newobrn to all of us, we look that much more forward to visiting all of the children at the orphanage that Frantz's parents run. The six of us, as well as Sarah Carignan from Boston, and guided by Frantz, Claudy, and Roosevelt, the Adventiste translators who've become our friends, gather our backpacks and a few other donated goods we have, and head out into the sweltering heat. Along 
the way, heaps of trash, piles of rubble, and homeless Haitians line the streets. This is nothing new. Ten months after the quake, little has changed. We noticed more of the streets are getting
cleaned; we actually saw more than one garbage truck, and some people were sweeping the sidewalks. Although a lot of aid groups are pulling out (for example, MSF Holland and the German Red Cross) because the disaster phase of the earthquake is over, other advancements have been made, like Wycleaf Jean's group clearing rubble, and money to the government for cleanup. So despite things still looking pretty desolate to the casual observer, there are some unglamorous but important changes being made. We are all looking forward to visiting the orphanage that Frantz's mother runs here in Carrefour. Upon arriving at the orphanage it hit me; the sight of 45 children, huddled together under a tarp. In an area smlller than most apartments, these children e
at, sleep, play, and live with remnants of sheet metal and tarps held up by tree branches. Their carpet is dirt and rubble. A faint, hauntingly familiar odor hovers in the air, in the background of your awareness, making you wonder where you've smelt that before, and then you realize it's stale urine. They had one toy that everyone shared...one toy. It's difficult to write this, as my memory is instantly haunted. The
y have so little; we already saw children with some of Cole (my 4-year-old son)'s flip-flops and clothes on... the same one's I'd brought when I came down with Pat back in July. You can see these flip-flops in the photo... Amidst all of this...they never stopped smiling. We all spent time singing and playing games with them...looking into their sweet innocent eyes, and wishing we could take all of them back with us...but we know we can't (eve though Tom's bag could probably hide a few
inside it - sorry, couldn't help adding that in - Pat.). These kids range in age from 2 to 16. Among them is Jean Junior, or just Junior, whom everyone at Adventiste knows well and has been a constant source of joy to all at the hospital, with his charm, energy, and infectious smile. He's right there near the front, in red, his smile a mile wide as he dances and sings to all the songs that the kids sing at the orphanage. You'd never know his father had just passed away on a Wednesday morning in July, the last time we were here. (He passed away due to an AIDS-related opportunistic infection.) Among the games we play is Detective. It goes somehin like this ... one kid, the detective, leaves the room. The kids pick a leader who beats out a rhythm using his or her arms and/or legs ... as he or she changes the rhythm, everyone else follows suit. This can be hand clapping, fist pumping, or my favorite, the chest pounding. The detective comes back in and has to guess who the leader is. The whole time, the rhythm is punctuated by collective chants of "Changez movement!" to the beat ("Change movement!"). It's catchy, fun, and makes you forget you're surrounded by the smell of urine and the filth of the street. The kids, especially Junior, seem to love anything that involves them getting to jump around and sing, and frankly so do we. 
Beth, Sarah, Paige and Tom do a great job of whooping it up as leaders of Changez movement. Tom in particular brings down the house. Something about the sight of large bald bandana-covedred dome and his big blue eyes really captivate the kids. Looking at the roomful of adorable face makes you want to bring them all home with you ... Unfortunately, as big as Tom's bag is, I'm not sure how many of them we could sneak home in it! As it is, the odds are not good. Junior is the only one I know of of the whole lot of them who's been adopted. As it came time to leave, we became rejuvenated with some awesome Haitian hip-hop music. Frantz is kind of a mover and shaker and stops the tap-tap every so often to jump off at this kiosk or that to get another CD for Beth so that by the end of the trip she's amassed quite the collection of Haitian hip-hop, pop, and
at, sleep, play, and live with remnants of sheet metal and tarps held up by tree branches. Their carpet is dirt and rubble. A faint, hauntingly familiar odor hovers in the air, in the background of your awareness, making you wonder where you've smelt that before, and then you realize it's stale urine. They had one toy that everyone shared...one toy. It's difficult to write this, as my memory is instantly haunted. The
y have so little; we already saw children with some of Cole (my 4-year-old son)'s flip-flops and clothes on... the same one's I'd brought when I came down with Pat back in July. You can see these flip-flops in the photo... Amidst all of this...they never stopped smiling. We all spent time singing and playing games with them...looking into their sweet innocent eyes, and wishing we could take all of them back with us...but we know we can't (eve though Tom's bag could probably hide a few
inside it - sorry, couldn't help adding that in - Pat.). These kids range in age from 2 to 16. Among them is Jean Junior, or just Junior, whom everyone at Adventiste knows well and has been a constant source of joy to all at the hospital, with his charm, energy, and infectious smile. He's right there near the front, in red, his smile a mile wide as he dances and sings to all the songs that the kids sing at the orphanage. You'd never know his father had just passed away on a Wednesday morning in July, the last time we were here. (He passed away due to an AIDS-related opportunistic infection.) Among the games we play is Detective. It goes somehin like this ... one kid, the detective, leaves the room. The kids pick a leader who beats out a rhythm using his or her arms and/or legs ... as he or she changes the rhythm, everyone else follows suit. This can be hand clapping, fist pumping, or my favorite, the chest pounding. The detective comes back in and has to guess who the leader is. The whole time, the rhythm is punctuated by collective chants of "Changez movement!" to the beat ("Change movement!"). It's catchy, fun, and makes you forget you're surrounded by the smell of urine and the filth of the street. The kids, especially Junior, seem to love anything that involves them getting to jump around and sing, and frankly so do we. 
Beth, Sarah, Paige and Tom do a great job of whooping it up as leaders of Changez movement. Tom in particular brings down the house. Something about the sight of large bald bandana-covedred dome and his big blue eyes really captivate the kids. Looking at the roomful of adorable face makes you want to bring them all home with you ... Unfortunately, as big as Tom's bag is, I'm not sure how many of them we could sneak home in it! As it is, the odds are not good. Junior is the only one I know of of the whole lot of them who's been adopted. As it came time to leave, we became rejuvenated with some awesome Haitian hip-hop music. Frantz is kind of a mover and shaker and stops the tap-tap every so often to jump off at this kiosk or that to get another CD for Beth so that by the end of the trip she's amassed quite the collection of Haitian hip-hop, pop, and boy-band stuff. This is what we needed, despite these conditions, we found joy in the day, just like these amazing people we're her
e to help. You see, if you didn't know what had happened last January, and had never seen the filth, the tents,the unemployed, the homeless...you'd be awestruck at the outlook these people have. A strong faith, and a big smile gets these Haitians through each day...take a minute, and it's easy to see. As Beth and Sarah groove with Francesca (Frantz's niece) in the back of the tap-tap, we head back to the hospital to gather our gear. We need to decompess some, have a little bit of relaxation, reflect on what we've done, sweat a little more, and have a cold one...for Andrea this would mean an ice cold Mountain Dew. We leave Pat at the hospital to do the hand off to the incoming orthopedic team, Andrea to complete the census, and the rest of us load the gear (why is my bag the heaviest?) and bring it to the hotel.
..
e to help. You see, if you didn't know what had happened last January, and had never seen the filth, the tents,the unemployed, the homeless...you'd be awestruck at the outlook these people have. A strong faith, and a big smile gets these Haitians through each day...take a minute, and it's easy to see. As Beth and Sarah groove with Francesca (Frantz's niece) in the back of the tap-tap, we head back to the hospital to gather our gear. We need to decompess some, have a little bit of relaxation, reflect on what we've done, sweat a little more, and have a cold one...for Andrea this would mean an ice cold Mountain Dew. We leave Pat at the hospital to do the hand off to the incoming orthopedic team, Andrea to complete the census, and the rest of us load the gear (why is my bag the heaviest?) and bring it to the hotel.
..As Tom and the rest of the crew bring all of our stuff to the Auberge du Quebec (we've decided to take a break there for our last night before heading home tomorrow morning), Andrea and I go over the census with the new team from Dallas. Unfortunately, despite the week's worth of work (including three consecutive 20+ hour days), we've still left them with 7 patients in-house who still need surgery and at least that many who are out there in Carrefour with instructions to return to clinic to meet the new team on Monday who also need surgery. Fortunately, this group includes three orthopods, their own jet, and a lot of equipment. The funny thing is, no matter how hard you work, and how much you bring (and all six of us truly felt that we gave it our all and left it all out there on the field), there's always going to be that feeling of regret, that you could have done more, seen more patients, operated longer at night, stayed longer ... I suppose it's a natural feeling when you're in a country of 9 million million people, surrounded by so much need. One of the HCMC residents had asked me after our last trip, did I get the feeling that it was just spitting into a bucket and didn't I get the feeling that there's no way you could do enough? Well of course you can't do enough for everyone. Out of a country of 9 million people, did it really matter that we saw x many patients in clinic and did x many surgeries? The more appropos question to ask would be, for the people we did operate on, how much did it matter to them? And did helping them out make your trip, the preparations, your time, and the lack of sleep worthwhile? I think if you look at it that way, the answer is clearly yes. For the 44 kids at the orphanage who didn't get adopted, the weekly groups of doctors visiting them may not have made much of a difference. Junior is one kid whom if you asked him, I bet 100% he'd say yes as well.
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