Thursday, May 24, 2012

Notes From Leogane Part NO. 24 : Matthieu


       
May 18, 2012 is a national holiday in Haiti – Flag Day. No school and light work schedules. Flags were attached to buses, tap taps and motos all over Leogane. At breakfast I said “Bon drapo jou” to Jeannine, thinking I was wishing her a “Happy Flag Day.” She corrected me. “Dave pale, ‘ Bon fet drapo jodia.’ “  Jeannine’s on the spot Kreyol lesson came in handy about an hour later.

MATTHIEU
Friday last was the final mobile clinic day for the medical group that returned to the United States the next day.  I went to this clinic because it was held in Matthieu.  The first time I met Mario, last April 2011, he already was telling me about the beauty of his village.  He was so “spot on” – an expression I need to teach him. He after all has tried to teach me some Kreyol slang – though it is difficult for me to remember.

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I hopped into the back of the pick-up truck driven by Mr. Guey.  One of the two team doctors was in the front passenger seat. (Photo 0851)
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The pick-up was carrying equipment and supplies for the mobile clinic.  The rest of the medical team and four translators squeezed into the Land Rover driven by Jean Claude.  That’s Jean Claude in the red BoSox baseball hat in Photo 0853, talking to the Rector after we arrived at the Episcopal Church in Matthieu, where the clinic was held.

When I go to a mobile clinic location for the first time, I ride outside in the pick-up bed so I can take in the new surroundings. There was much to see last Friday. The trip to Matthieu took about twenty minutes; first about 4 miles north on the paved Leogane bypass road and National Route #2 highway, followed by about 2 ½ miles on a narrow dirt road. On the dirt road, we passed several sugar cane fields. Early stage corn stalks were scattered on both sides of the road. There was one field that looked like it soon would be home to small banana plants. Cattle and goats were grazing.


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(Photo 0850 was taken from the back of the pick-up.  Photos 0878 through 0882 were taken during my walk back to Leogane.) Of course, as in any village in Haiti, chickens roamed free, because it was not their time. Lucky are those that lay eggs.

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While I never saw it, during my walk out of the village I think I heard water flowing in the river that Mario later said was on the other side of a field that bordered the dirt road.  The river feeds the irrigation canals that line both sides of the road. (Photo 0882)


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A number of people were patiently waiting for the medical team when we arrived.  (Photo 0852)  After an opening prayer (0858), the clinic 
opened.  Patients first met with the lead translator, Peter, who conducted an interview to obtain information for the intake form.  Next, blood pressure, pulse and other vitals were taken by members of the team. Often, vitals are taken by non-medical team members who have received a tutorial from the nurse and doctor members of the team.  This group was fortunate to have a former lab technician serving in that role. For some, a drop of blood was taken for a malaria test or other screening done at the mobile clinic.

Patients then were seen by one of the two medical professionals. Last week’s team doctors were a pediatric physician and an OB/GYN specialist. At each stage of the clinic, a translator assisted the visiting medical team. About 140 patients were seen last Friday.

Among the patients were two infants. One was a twin who was suffering seizures. She was immediately rushed to Hopital Sainte Croix with her mother carrying her on a moto, and then was sent to Port-au-Prince for an MRI not available in Leogane. The other infant had a temperature of 104. She was brought back to Hopital Sainte Croix and was released four days later. Mario later told me the hospital bill was around 1,400 Gourdes ($35 USD). As I mentioned in a previous Note, Hopital Sainte Croix is a low income hospital that is essential to the delivery of medical care in Leogane Communale.
     
Many of the mobile clinic patients receive a prescription from the mobile clinic doctor and then go to the last stop in their visit – the pharmacy. Before they come to Leogane, many of the medical teams request that Mario be a member of the translators group so he can work the mobile pharmacy each day. As a patient arrives at the mobile pharmacy site, the American pharmacist reads the prescription from the doctor and hopefully finds the necessary medication among the drugs the team brought to Haiti. Then the pharmacist confers with Mario to go over the instructions he needs to give to the patient.

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Having watched him in action at several mobile clinics, I think Mario is so effective at making sure the pills, ointments, inhalers, etc. are used properly because he brings into play a combination of Marcus Welby (and definitely not House), your favorite uncle, and the wisest 50 year old in your neighborhood. After Mario talks to you, while looking over his reading glasses and waging a finger at the medicine bottle, I can’t imagine you would forget that the two pills you need to take each day cannot be swallowed at the same time, but rather one must be taken in the morning, the other in the evening.  That’s Mario and the pharmacist in Photo 0876, and Mario with the first patient of the day in Photo 0877.

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THE NEW “GREEN” SCHOOL
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The Rector of the Episcopal church and school in Matthieu was gracious enough to show me around the new school that opened September 2011.  Its construction was financed principally by Lutheran churches in Finland and Canada. For that reason, the Rector explained, one wing of the school was painted a light green for Finland, the center wing red for Canada (which also is one of the two Haitian flag colors) and the last blue for Haiti.  (Photos 0870, 0871 and 0872)  In the main courtyard a biogas system has been installed (0874), which provides methane gas used for fuel in the separate cook building and cafeteria of the new school.

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While the Episcopal church in Matthieu was severely damaged by the earthquake, so that now  church services are held outside in the pews shown in photos 0852 and 0858, some of the rooms in the school still are used for classes. (Photos 0863, 0864 and 0875).  As I was walking through the classrooms, I stumbled across an English grammar lesson that caught my attention.  (Photo 0854)  Peering at the blackboard, I learned a thing or two about the proper uses of “since,” “for,” and “also.”  A French lesson was on the blackboard in the next room. (0857)

THE WALK BACK     
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I’ve been to a number of mobile clinics, so I left the Matthieu clinic site one hour after our arrival. Mario talked to me enough before I left to know a liked his village – a lot.

It was a holiday, so why not walk back to the hospital in Leogane City Center. It only took me 90 minutes.  It was a trip that was easily divided into two parts. First was the walk out of Matthieu to National Route #2.  It is a major highway that starts in Port-au-Prince and ends in Les Cayes. Les Cayes is on the sea, on the Caribbean side, more than 75 miles west and south of Leogane.

On the walk out of Matthieu, I remembered Jeannine’s lesson. I think I surprised a few villagers when I said – I think in decent nasal Kreyol – “Bon fet drapo jodia.” There were smiles here and there, and sometimes “Bonjou” in response. The walk was peaceful. To see a quiet, lush, working farming community not too far from the hustle and bustle of National Route #2 was rejuvenating. In most cases, I met friendly people in Matthieu.

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Thirty-five minutes or so after I left the mobile clinic, I heard a siren in the distance and knew I soon would reach the main highway. I have little to say in this Note about National Route #2 that is not captured in the attached photos – 0883, 0892, 0895 and 0900 - other than to say that it is of course an important part of the infrastructure that brings people to market, connects Port-au-Prince to the western regions, and allows important products to reach rural areas from distribution centers in larger cities.

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To those of us who live in the United States, this comment must seem rather trite and simplistic.Of course highways are important. But when talking about Haiti, I know its infrastructure is nowhere near being on par with Maricopa County, Arizona.  Roads, public power, and sewer systems in Port-au-Prince do not come anywhere near the dependability of some of the poorer metropolitan areas in the U.S.  There is nothing here that approaches the U.S. Interstate Highway system. Without question, drastic infrastructure improvement is essential to meaningful progress in Haiti.

As I walked down that dirt road last Friday though, I also knew that I haven’t seen many places like the village I visited last week. I was enriched by coming to Matthieu. Thank you Mario for pestering me to finally make the visit.

I hope this Note finds you and your loved ones in good health and spirits.

Peace,
David

24 May 2012


  


Monday, May 14, 2012

Notes From Leogane Part II--No. 23: Manje and "I thought the Packers Won Super Bowl XLV"


                                                                         
Dear Family and Friends:

In two weeks I return to Arizona with Jeanne, after she visits Leogane for ten days and we take a day trip to Jacmel. Already, I’m thinking about which manje I’ll no longer be eating in salamanje a nan Hopital Sainte Croix (“HSC”) Guesthouse, and what I won’t be buying from a street vendor. I won’t, however, have to wait until this coming October, when I’m back for another month as the guesthouse manager, before having another piece of toast with manba pike. I’m bringing two jars home with me.

I often tell guests that we have the best restaurant in Leogane, though I’ve heard that Ocean Grill - at the junction for the bypass road to Leogane City Center and the highway to Jacmel – is a good place for grilled fish. In my humble opinion, there is great food (tre bon manje) at the guesthouse, and that’s because of Jeannine and her assistants; Yvette, Geralda and Lozina. All four are working for most of this month, while three different groups from the States are here over a three week period.

Bobby Cruse also eats here. He is the construction manager for the U.S. architect, Jimmy Hite, who designed a number of construction projects for the Episcopal Diocese of Haiti. Bobby is monitoring the completion of the HSC renovations and new construction at the Episcopal Nursing School, which is less than two miles away in the Belval neighborhood of Leogane Communale. He’s been living at the guesthouse since February, and may stay another six months. Every six weeks or so, Bobby returns to North Carolina for a two week visit with his wife and children. He will be Dr. L’s new guesthouse BFF when I leave, at least until Missy takes him, the cat, home with her to North Carolina in August.

While Jeannine is the “head cook,” she does much more than run kwizin nan.  She is the glue that holds the guesthouse together. Often upon their return, veteran guests seek out Jeannine to of course get a preview of the week’s menu but, more importantly, to see their friend.  Jeannine not only takes great pride in having the best place in town to eat, she makes sure  guesthouse managers like me don’t mess things up too much. That’s Jeannine in the kitchen this past Wednesday morning.  Photo 0757)

Jeannine
When mobile clinic teams and other guests stay here, meals are served in salamanje a on a set schedule; manje maten at 7:00 a.m., manje midi at Noon, and manje aswe at 6:00 p.m.

Because there is not a “the” before some of the nouns in paragraphs above, you may be wondering whether there are some typos in this Note, or I should say more mistakes than the usual number I overlook before I hit “Send.”  The Kreyol words “la”, “nan” and “a” can, at times,  mean “the” and usually they follow the noun.  For example, “the dining room” is “salamanje a” and “the kitchen” is “kwizin nan.” 
I’m sure by now you’re keyed into the fact that “manje” can be either the verb “eat” or the noun “food”.  You wouldn’t necessarily pick up on “fe manje” being the verb form for “to cook” or “cooking, “ as in “Mwen ap fe manje manje aswe” – “I’m cooking dinner.”  “Mwen ap manje manje maten” is what I usually say on the phone to let someone know “I’m eating breakfast,” but this coming October I should be saying “M’ap manje manje maten,”  after mastering the contraction of  “Mwen ap” to “M’ap.”  “Mwen” is “I”, “me”, “my” or “mine.” 

Some of My Favorite Foods                                                             
My two stints at the HSC Guesthouse have given me 4 ½ months to enjoy great home style cooking.  Almost nothing comes from a can or jar; except for such things as bottles of hot sauce and catsup, coffee creamer, grape jelly, and the soy sauce I bought a few weeks ago at the new “Original Market” to sometimes put on white rice/diri blan.  No frozen foods used here.

At one or two meals every day, a pitcher of fresh juice is served. It could be cherry juic /ji seriz, watermelon juice/ji melon dlo, mango juice/ji mango, lime juice/ji sitwon vet, or  pineapple juice/ji anana. At last Thursday’s lunch/manje midi, I tried fresh soursop juic/ji kowosol  for the first time, but not the last. I would liken its taste to a combination of 2/3 fresh coconut juice and 1/3 fresh lime juice. For two days last week, Watson acted as a translator for the group staying here. He thinks soursop juice tastes better when one part milk is added to three parts juice.
   
There is too much variety in the meals served here for me to cover a full week’s menu, but I can describe some of my favorites. For main dishes, it’s a tie between turkey/kodenn chunks in spicy red sauce and a pumpkin or squash based Haitian soup, soup joumou. A number of guests would vote otherwise were I to ask for their favorites, but they’re not here right now. I will concede, however, that many guesthouse veterans request that Jeannine serve her “three cheese meat lasagna” sometime during the week, which she did this past Tuesday.

One reason I like the turkey chunks is that the spicy red sauce somehow makes them taste like beef, but they’re healthier. Here the turkey simmers in one version of Haitian Ti Malice sauce. (Haitian folklore figure Ti Malice, and also Bouki, were introduced to you in Note 21.)  Sos Ti Malice is spicy, but not too much so. In fact, I wish the version we ate had more kick to it, but most visitors prefer it toned-down.

One of the many folk stories that attempt to explain the origin of Ti Malice sauce is:
“Two men, Ti Malice and Bouki, are good friends. Ti Malice has meat for lunch every day and Bouki just so happens to show up at Ti Malice’s house every day around lunch time. Haitians, being good natured, offer whatever they are eating to their guests. So Bouki winds up sharing Ti Malice’s meat every day. One day, Ti Malice decides to trick Bouki and prepares a very hot sauce for the meat, hoping to deter Bouki from coming back at lunch time to eat his food. Bouki tastes the meat with the hot sauce on it and runs all over town shouting to everyone, ‘Come taste the sauce Ti Malice made for me’, and that’s how Sauce Ti Malice got its name.”  (Source - Taste Haiti)

The spicy red sauce prepared here often includes onions and carrot slices with thin jalapeno pepper shavings.  It’s the bomb.  It is almost magical the way it transforms the taste of the poultry.  At least here, turkey chunks in spicy red sauce is almost always served with rice / diri; sometimes white rice, sometimes brown rice with a few brown conga beans added.    

At the HSC Guesthouse, Haitian Pumpkin or Squash Soup is most often served for lunch / manje midi.   Last Friday, Jeannine made my day by serving soup joumou for the send-off lunch for the group leaving for Port-au-Prince that afternoon.  (Friday’s bowl of soup joumou, after several servings, and other dishes, are shown in Photos 0797 and 0799.)

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One of the many recipes I found online is:       

 Haitian Pumpkin Soup - Soup Joumou (pronounced joo-moo)

Submitted by: MADANPAS

This savory soup is served in all Haitian households on the Haitian New Years Day national  holiday in commemoration of Independence day. It was on January first, 1804, that Haiti became the world's first independent black republic by defeating the French.

Minutes to Prepare: 30
Minutes to Cook: 150
Number of Servings: 10

Ingredients
Beef marinate made by crushing 4 garlic cloves, 1 teaspoon thyme 1/4 teaspoon pepper, shallot and 2 sliced scallions and 2 teaspoons of salt
1-pound piece of beef stew meat
10 cups water (add more later if necessary to make soup less thick)
1 whole scotch bonnet pepper with stem
2 pounds pumpkin (or winter squash / butternut), peeled and chopped (2 packages frozen squash will also do)
2 carrots peeled and sliced
2 stalks celery sliced lengthwise and cut into pieces
5 parsley sprigs
1 large onion cubed
2 medium turnips peeled and cubed
2 medium potatoes peeled and cubed
1 pound cabbage sliced fine and chopped
1/4 pound vermicelli or other thin pasta, broken into shorter lengths
2 limes juiced
1/4 can tomato paste (for browning meat)
1/2 cup or 1 can tomato sauce
1 low sodium beef bouillon cube (if you'd like more flavor)

 Directions
1.In a medium pot, cook pumpkin over medium heat in 6 cups water for 30 minutes. Puree pumpkin in the water. While pumpkin is cooking, clean meat with lime, rinse with hot water and drain. Marinate meat with meat rub. Rub the meat with the spice paste-scallions, onion, thyme, garlic, shallot, green pepper, salt and black pepper ground together. (For an enhanced flavor, you can in advance marinate the meat from 1 hour up to one day.)
2. In stockpot, add the meat with the oil and tomato paste and brown by adding small amounts of water to caramelize the meat. Cook covered over medium heat for 20 minutes. Add 3 cups water and pureed pumpkin and bring to a boil.
3. Add the cabbage, carrots, celery, onion, turnips, tomato sauce, potato and parsley to the soup, bring to a boil, then reduce heat and simmer for 1 hour with a whole scotch bonnet on top. (The whole scotch bonnet is for flavoring not to make the soup "hot". Remember to find and remove the pepper as you stir the soup and remove it before it bursts)
6. Add the spaghetti broken in to short pieces and cook until soft and tender.
7. Taste and add a minimal amount of salt, black pepper or hot pepper to taste.
8. Turn off the heat, cover the pot, and let sit until ready to serve.

Makes 10 1-cup servings.


Fair Warning for All Members of St. Anthony on the Desert
I plan on trying to prepare soup joumou for one of next year’s Wednesday Lenten Meals in the Parish Hall.   

At the HSC Guesthouse, soup joumou usually is made vegetarian style, with beef or chicken pieces on the side to be added as desired to your bowl. As on last Friday, sometimes goat pieces are served with the soup. Small pieces of toast are served for dipping in the soup.

For my favorite side dishes, nothing comes close to pikliz, a spicy cole slaw type salad made with thinly sliced cabbage and carrots, and jalapeno chili shavings. After this mix is marinated in vinegar, it is left to dry somewhat, sometimes in the refrigerator. No mustard, mayonnaise or Miracle Whip is used, so it’s light and has a kick, enough so that some guests give it a try only once in a while. Others are devotees like me. More conservative gourmets prefer lettuce and tomatoes, or tomatoes, cucumbers and water crest, or a few variations of combinations of cooked celery, cabbage, carrots, turnips and/or turnips that are cooled in the refrigerator before the meal. I could eat pikliz just about every day. I do eat mango everyday. Papaya/ papay is served two or three times a week.

I can’t imagine finding a store back home with mango that comes anywhere near the taste of what you get in Haiti, at least when mango is in season; which is right now. Early last July tough, I did give it a try.The next time you go to a market that is known for its produce, check out the price for just one mango.This week, Jeannine paid 50 gourdes ($1.25 USD) for six mango.That is less than the price for one mango in the U.S.  But then again, in Leogane, when I bought six large plastic bottles of Clorox in early May, 2011 for the clean-up of one of the hospital’s operating rooms, after the invasion of muddy flood waters through three entry points, each bottle cost $6.50 USD.

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Third place on my list of main dishes is any of the chicken/poul dishes served in a variety of sauces. It’s rare that we have anything other than chicken legs for a poul meal. It boils down to cost. As in the U.S., chicken legs are one of the least expensive cuts of chicken that Jeannine can buy, whether she’s in Leogane or Port-au-Prince. Because we pretty much only eat legs for our chicken dishes, we sometimes tell Jeannine that “there must be a lot of live chicken breasts hopping from the main market down Rue La Croix to the hospital.”

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To give you a flavor for the dinners served when teams are visiting from the U.S., Photos 0779 and 0781 are of last Wednesday night’s meal. Photos 0789, 0791, 0793, 0794 (pikliz) and 0795 are of last Thursday’s dinner with a nice presentment of the pwason head and tail. It’s no accident that there were more dishes served on Thursday night, the last night this group was in town. 

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The staff traditionally serves the biggest dinner spread on the last night of a group’s stay at the guesthouse, which for most mobile clinic teams is Friday night.

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Lunches are more modest. Last Thursday’s manje midi was pigs in a blanket, bread / pen for manba, mango and soursop juice. At breakfast, I usually eat 3-4 chunks of pineapple or mango and a piece of bread with peanut butter/manba.  Jeannine sells her manba pike for $5 U.S. a jar.The pike comes from the jalapeno bits Jeannine adds to the scratch peanut butter. Jeannine’s manba pike has a following in Leogane beyond HSC guests. 
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Two weeks ago, two American nurses dropped by around 11 a.m. on Tuesday to order five jars to be picked up the next day, even though they were staying in Belval for the week.

It was a real treat for me to watch the “all hands on deck” operation that went into high gear right after Tuesday’s lunch. Typanol and Madame Bellevue were taking the skins off the raw, shelled peanuts 
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Jeannine bought not too far from the hospital.  Geralda and Yvette chipped in to grind the whole peanuts into almost a peanut powder.  Jeannine of course was the master mixer the next morning.  She handled the “butter consistency phase” and added the required measure of the jalapeno kicker.  Jeannine of course shared part of the profits with her co-workers from the five jar order.

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Needless to say, I’m amazed that last year I returned to Arizona almost 30 lbs. lighter after working for three months in the best restaurant in Leogane.  I’m not experiencing anywhere near the same “per week” belt tightening this time around.  Dang!

The meals are more Spartan for me and Bobby when a team is not spending the week with us.  If it’s just the two of us, there is only one cook working with Jeannine that week. (Jeannine is a full-time salaried employee of the hospital, as are Typanol and Madame Bellevue. The kitchen assistants are paid only when they work in the kitchen during an assigned week.)

Bobby and I try to use the “off-weeks” to let the kitchen staff catch-up on their sleep. When  teams are here, the kitchen is busy from 5:45 a.m. until as late as 7:30 p.m. When it’s just the two of us, a few hard boiled eggs and mango chucks are left in the refrigerator at night for the next morning’s breakfast. Around 7 a.m. I’ll pop a few slices of bread in the toaster and knock on Bobby’s door and say “manje maten fini” or sometimes “breakfast is ready.” My contribution of pressing down two toaster buttons is payback for Bobby, the early riser, plugging in the coffee pot around 4:45 a.m.

For lunch, Bobby and I might have some pineapple chucks and either fresh egg salad or fish salad sandwiches, though we spread it on one slice of bread at a time. I almost called it “tuna salad,” but it’s not.  It’s made from the left over fish from a dinner earlier in the week. Another common lunch would be spaghetti, usually with tomato sauce, but there are times when no sauce is served, so we are left with a choice between catsup and hot sauce. There also may be fresh pineapple or mango chucks. A typical dinner for the two of us would have chicken legs, fish chunks or goat pieces in a sauce, with rice and some type of salad.

When Bobby was in North Carolina in April for three weeks, there were no groups here for two of those weeks. I skipped breakfast, just had a banana for lunch, and had a 2-3 dish dinner with small portions. I may have lost a few pounds then.

The mobile clinic teams are served a robust dinner because they are rather hungry after a 7:30 a.m.–6 p.m. day in the field. At times, a larger medical/dental group could see as many as 140 patients in a day. Their sack lunch is a P & J sandwich and fig. We don’t serve figs with the sack lunch. “Fig” is Kreyol for “banana,” while “bannann” is Kreyol for “plantain,” a very popular banana sibling or cousin in Haiti.
You may be looking at some of the dinner photos and wondering how a smaller group of 6–8,  plus me and Bobby, could eat all that food. While some of the larger groups will devour every morsel, others leave leftovers. But, nothing is wasted.

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Sometimes, when they have worked late, the kitchen staff may take food home with them. Other times, when there is less remaining, it may be left in the refrigerator and offered to Typanol and/or Madame Bellevue in the morning. Otherwise, Typanol pretty much eats boiled breadfruit for breakfast every day.   Or, we might offer some late dinner to the night security guard in the hospital lobby or the night shift maintenance/
operations worker. I’ve been told that from time to time, when Bob and Robin have been the guesthouse managers for three months before me, Robin has taken food across the street to Madame Carmen, who is in her 80s.  (Photo 0758)

Bones are rarely thrown away. They may find their way to someone’s soup pot if there is some meat left on the bone, or otherwise they may be given to someone’s animal. This is not a country where many people are inclined to pile too much food on to their plate to begin their meal, to then throw an unconsumed fist full of food down the drain. When too many people go to bed hungry each night, it’s difficult for needless waste of food to get a foot hold here.

Cheap Rice, Super Bowl XLV and Unintended Consequences of Well Intended Acts
On Saturday market day, you’ll see 25, 50 and 100 pound bags of rice being transported around Leogane and Port-au-Prince on tap taps, motos or one of the large man-powered wooden carts.Most often the rice will have been produced in the U.S.A., in such states as Arkansas and Louisiana. This reflects a dramatic decrease in Haiti’s production of rice for its own citizens over the past 25-30 years.

As reported in one publication, “[u]p until the 1980s, Haitian rice farmers produced the great majority of the rice consumed in Haiti. This situation, which changed rapidly in the mid-1980s, intensified dramatically in the mid-1990s. During this period, total rice consumption increased  in response to population growth which was to be expected. Also during this period, the percentage of rice imports consumed increased and overshot domestically produced rice in the mid-1990s. U.S. rice imports, which are called ‘Miami rice’ (because rice, like most U.S. exports to Haiti are shipped from the major port in Miami, Florida), now make up the majority of all rice consumption in Haiti.”

As reported after the January 12, 2010 earthquake, former President Bill Clinton acknowledged that his administration did not anticipate the adverse consequences that would accompany the lowering of Haitian rice import tariffs to promote lower prices. As reported in March 2010:
“PORT-AU-PRINCE, Haiti.  – The earthquake not only smashed markets, collapsed warehouses and left more than 2.5 million without enough to eat.  It may also have shaken up the way the developing world gets food. Decades of inexpensive imports – especially rice from the U.S. – punctuated with abundant aid in various crises have destroyed local agriculture and left impoverished countries such as Haiti unable to feed themselves.

While those policies have been criticized for years in aid worker circles, world leaders focused on fixing Haiti are admitting for the first time that loosening trade barriers has only exacerbated hunger in Haiti and elsewhere. They’re led by former U.S. President Bill Clinton – now U.N. envoy to Haiti – who publicly apologized this month for championing policies that destroyed Haiti’s rice production. Clinton in the mid-1990s encouraged the impoverished country to dramatically cut tariffs on imported U.S. rice.

‘It may have been good for some of my farmers in Arkansas, but it has not worked. It was a mistake,’ Clinton told the Senate Foreign Relations Committee on March 10. ‘I had to live everyday with the consequences of the loss of capacity to produce a rice crop in Haiti to feed those people because of what I did; nobody else.’

Clinton and former President George H. W. Bush, who are spearheading U.S. fundraising for Haiti, arrive Monday in Port-au-Prince.  Then comes a key donors’ conference on March 31 at the United Nations in New York. Those opportunities present the country with its best chance in decades to build long-term food production, and could provide a model for other developing countries struggling to feed themselves.
‘A combination of food aid, but also cheap imports have . . . resulted in a lack of investment in Haitian farming, and that has to be reversed,” U.S. humanitarian chief John Holmes told The Associated Press. ‘That’s a global phenomenon, but Haiti’s a prime example. I think this is where we should start.’ “
(End of article)

We all know that after the January 12, 2010 earthquake thousands of doctors, nurses and other medical professionals came to Haiti from many parts of the world to provide critically needed trauma care to hundreds of thousands of patients, many of whom suffered single or multiple limb amputations. Many charitable organizations rushed temporary shelters to areas near the Quake’s epicenter, which was equidistant between Leogane and Port-au-Prince. Massive supplies of food and water were needed.  
At the same time this essential humanitarian effort was arriving in Haiti in early 2010, I’m sure well-meaning church, service clubs and school organizations were collecting clothing. Much of these donations were needed on an interim basis; perhaps for example disposable diapers for infants living in tent cities where there were few, if any, clothes washing stations. But, on a long-term basis, used clothing sent to Haiti can undermine local garment micro-businesses so important to lifting women out of abject poverty. The following article provides some insight into this complex issue.

Haiti Doesn't Need Your Old T-Shirt

The West can (and should) stop dumping its hand-me-downs on the developing world.

BY CHARLES KENNY | NOVEMBER 2011

 The Green Bay Packers this year beat the Pittsburgh Steelers to win Super Bowl XLV in Arlington, Texas. In parts of the developing world, however, an alternate reality exists: "Pittsburgh Steelers: Super Bowl XLV Champions" appears emblazoned on T-shirts from Nicaragua to Zambia. The shirt wearers, of course, are not an international cadre of Steelers die-hards, but recipients of the many thousands of excess shirts the National Football League produced to anticipate the post-game merchandising frenzy. Each year, the NFL donates the losing team's shirts to the charity World Vision, which then ships them off to developing countries to be handed out for free.

Everyone wins, right? The NFL offloads 100,000 shirts (and hats and sweatshirts) that can't be sold -- and takes the donation as a tax break. World Vision gets clothes to distribute at no cost. And some Nicaraguans and Zambians get a free shirt. What's not to like?

Quite a lot, as it happens -- so much so that there's even a Twitter hashtag, #SWEDOW, for "Stuff We Don't Want," to track such developed-world offloading, whether it's knit teddy bears for kids in refugee camps, handmade puppets for orphans, yoga mats for Haiti, or dresses made out of pillowcases for African children. The blog Tales from the Hood, run by an anonymous aid worker, even set up a SWEDOW prize, won by Knickers 4 Africa, a (thankfully now defunct) British NGO set up a couple of years ago to send panties south of the Sahara.

Here's the trouble with dumping stuff we don't want on people in need: What they need is rarely the stuff we don't want. And even when they do need that kind of stuff, there are much better ways for them to get it than for a Western NGO to gather donations at a suburban warehouse, and send everything off to Africa or South America, and then try to distribute it to remote areas. World Vision, for example, spends 58 cents per shirt on shipping, warehousing, and distributing them, according to data reported by the blog Aid Watch -- well within the range of what a secondhand shirt costs in a developing country. Bringing in shirts from outside also hurts the local economy: Garth Frazer of the University of Toronto estimates that increased used-clothing imports accounted for about half of the decline in apparel industry employment in Africa between 1981 and 2000. Want to really help a Zambian? Give him a shirt made in Zambia.

Bottom line: Donations of cash are nearly always more effective. Even if there are good reasons to give stuff rather than money, in most cases the stuff can be bought locally. Economist Amartya Sen, for example, has conclusively shown that people rarely die of starvation or malnutrition because of a lack of food in the neighborhood or the country. Rather, it is because they can't afford to buy the food that's available. Yet, as Connie Veillette of the Center for Global Development reports, shipping U.S. food abroad in response to humanitarian disasters is so cumbersome it takes four to six months to get there after the crisis begins. Buying food locally, the U.S. Government Accountability Office has found, would be 25 percent cheaper and considerably faster, too.

In some cases, if there really is a local shortage and the goods really are needed urgently, the short-term good done by clothing or food aid may well outweigh any long-term costs in terms of local development. But if people donate SWEDOW, they may be less likely to give much-needed cash. A study by Aradhna Krishna of the University of Michigan, for example, suggests that charitable giving may be lower among consumers who buy cause-related products because they feel they've already done their part.

Philanthrocapitalism may be chic: The company Toms Shoes has met with considerable commercial success selling cheap footwear with the added hook that for each pair you buy, the company gives a pair to a kid in the developing world (it's sold more than a million pairs to date). But what if consumers are buying Toms instead of donating to charity, as some surely are? Much better to stop giving them the stuff we don't want -- and start giving them the money they do. (End of Charles Kenny article)

I apologize if I seem too harsh here. There is no question that many people living outside Haiti  have good intentions that we all commend, when they have become part of a charitable effort that nonetheless has unintended adverse consequences for the very people the good works are supposed to help.

Indeed, many, many people have traveled to Haiti, before and after the Quake, to provide essential charitable medical infrastructure not yet made available through the Haitian government. Mobile clinic teams that come to Leogane and other locations throughout Haiti provide somewhat of a medical “safety net” so to speak, though admittedly at times it is irregular and filled with holes. Partners-in-Health is a primary medical provider for Haitians in the Central Plateau region.

The Kenny article uses a pejorative phrase – the “dumping of used clothing” – when discussing a few examples of how good intentions can at times lead to unintended adverse consequences.  I have first-hand experience with such “dumping”.

0103
In early May 2011, muddy floods waters invaded Hopital Sainte Croix, requiring a three day clean-up to get the operating rooms, and the rest of the hospital, fully back into action. (Photos 0103 and 0107 show some of the muddy floor conditions. These early May 2011 photos were taken before I properly set my camera’s embedded photo date.)

0107
Next to the two operating rooms was “Salon C”, which at that time was being used for storage.  Over the next week, I was involved in deciding which of eighty or so boxes in this storage area needed to be disposed of because they were contaminated, and which ones could be moved to a storage depot on the guesthouse floor. I started this project, with four hospital workers, thinking that it was too bad we probably would have to dispose of at least half of the boxes with important medical supplies, because they had absorbed muddy water that at one time was 2-3 inches deep in Salon C.

My concerns soon vanished, when I discovered that of the eighty or so boxes, more than fifty contained surgical scrubs – tops and bottoms – that were Size XXXXL. Over the course of the next two months while I still was at the hospital, we only used three or four of the XXXXL boxes, and then only for clean-up rags or to place against a door to hold back casual water from heavy rainfall.

The Kenny article advocates monetary donations as one of the most effective ways to support  organizations and people in developing countries. I agree. Jeanne and I are members of St. Anthony on the Desert Episcopal Church in Scottsdale. Earlier this year, in addition to providing funds to a school in Leogane and an orphanage in Port-au-Prince, the Vestry made a four year commitment to provide a full scholarship for a nursing student at the Episcopal Nursing College in Leogane. It currently is the only four-year nursing school in Haiti. Individual parishioners at St. Anthony also are providing scholarship support to other students at the Leogane nursing school.

Nursing college graduates have positions of respected standing in Haitian society. They will play an important role among those Haitians motivated, in the future, to assume a greater role in the delivery much need preventative and therapeutic medical care in their own country.

I hope this note finds you and your loved ones in good health and spirits.

Peace,
David
14 May 2012  
   

Sunday, May 6, 2012

Note No. 22K


Unfortunately, the video of my favorite part of the service - at the end - with clapping hands, "Alleluias and Mesis" to God is too long for an attachment. 

Note 22I



This is part of communion.


Madame Carmen was the last to receive communion today. She was the fourth of four elderly parishioners Pere Kerwin gave communion to at their seats. I think it is a close call which of these women is the oldest member of Legliz Episcopale Paroisse Sainte Croix. After the service, Madame Carmen was ferried home on a moto, which was waiting for her abut 10 yards from where she was sitting right next to the opening at the left front of the church.   

Note 22H


Before the Consecration

Note 22G


The Doxology of the Episcopal Church (and other denominations) has the same melody and pace in any language.