Motorcycles & Pickup Truck Obstetrics
It was great to get back to work today. Not only was it great to be back working, but it was nice to step back from the psychological support and back into more of a hands on medical role. I joined the Vermont team today at Operation Hope. This clinic is setup right across the street from Adventist Hospital. We are a part of the triaging system where we can treat those less serious more acute conditions and help filter the more serious cases into the hospital. The clinic used to be a large home that has been converted into a functioning medical facility since the earthquake. When the team found out I was an RN, they were ecstatic! They said, "Good, we'll have another person to see and treat patients!" Turns out we were about an hour out of town where services are more limited and there was only 1 doctor on site. So, myself another RN, and a new med school grad were asked to step into the role of primary care. It was great! It's just the way things go around here, you do what you can. Sometimes that means stepping out of what you're used to doing, but you do what you feel comfortable with, consult with your peers when need be, certainly don't do anything that could harm the patient, and know that if you don't step up, they may never get the care they need... or have to wait weeks or months to receive it.
I have some pretty incredible resources on my Ipod. They are easily accessible and convenient to use. It allows me to searching correct dosages, confirm diagnostic criteria, and review treatment options. I'm learning so much. Today, I ended up with one patient who I suspect had malaria, another patient that I got to tell she was pregnant, and another with a severe case of impetigo. I really enjoyed the autonomy today and the challenge of analyzing, synthesizing, and playing the role of investigator in sleuthing what might be wrong with each person's individual case. It was complete reassurance that the Family Nurse Practitioner courses that I'll return to next week are exactly what I'm supposed to be pursuing.
Again, today was a day in the field that really challenged my analytical skills as a nurse. I was on a team with one doctor, a PA, and myself who had to treat a line of hundreds of patients. We went up into the mountains to a village called Belot. I had heard from someone on the campus here that there was a resort in this town that they had converted into a relief center/clinic of sorts. I had ideas of this nice clean facility with a pool in the back, etc. When we finally arrived at the site, I realized my expectations were very far off. To start with, we had to take a special car to get to the site with about 12 of us stuffed in the back or a Land Rover. The roads were so treacherous, bumpy, pot holes, and a cliff that dropped a couple thousand feet to the side. We were so high that the clouds were rolling past us and through us in the road. Truly, it is beautiful up here. The mountains are green, the foliage is lush, and the air is clear. It's quite a shocking contrast to the scarred city below. When we finally arrived, we got to the top of this one mountain and up ahead we could see the site. Clouds rolling past, there was a small shelter constructed from bamboo and tarps. This was the "resort" I was so excited about. There was no running water, no electricity, and no toilet... not even an outhouse! At one point, myself and a couple of the girls had to pee so bad and all we could do is walk a few hundred yards away from the "clinic" to a bush along the side of the road and "pop a squat". People come walking by to see these three girls in scrubs taking a pee. Corrine and I are just laughing out heads off, and the best part is that none of the passerbys even batted an eye. This is what people do here, it is completely normal for them. As I continued back at the clinic in my more professional role, I was seeing a lot of cases of scabies. This continues to be a major problem here. As a side note, for people wanting to send supplies, the needs are constantly evolving. Right now, we are in need of permethean cream to treat scabies, any sort of vaginal creams, Diflucan, and adult/children vitamins. At the end of a tiring day, we packed everything up and took the cramped ride back down the mountain. We got back to camp with a good dinner prepared for us... you'd never guess... rice and beans! I've had so much rice and beans in the last 2+ months that it has probably ruined them for life. I'm so sick of rice and beans, but yet I am truly grateful that God is putting food in my stomach each day. I try to say a quick prayer before each meal just to thank him for blessing me with sustenance and energy to keep going. After dinner, I had a friend come over. We watched a movie on my ipod, and then got to bed.
I slept in this morning, and by sleeping in I mean that I woke up at 6am. After a cup of coffee and some bread, I started planning my day. A group of people here at Quiskeya are headed up to this remote place about 7 hours away in the mountains to provide care to groups of people who have yet to receive any. About a week ago, a group attempted to do some outreach there and on the way up the mountain had an accident. The truck carrying 7 medical professionals flipped, and rolled a couple thousand feet down the mountain. Everyone had to be airlifted to the hospital. Many were in critical condition, but latest I have heard, everyone is fine now. If I went with this new group, I wouldn't have been back until Tuesday, when I'm supposed to leave and that didn't sound like something I wanted to do. Besides, I really wanted to take a few days of wrapping up loose ends around here, dropping off some extra supplies, spending time with my newly forged friends here in Haiti, and having an adventure or two.
My friend Chantel and I decided to hang out for the day down with the guys living on the roof at CDTI. I took a nap in a hammock on the porch of the compound while I waited for her to arrive. Then, I had my first real Haitian cross-town transportation experience. We jumped on the back of a moving tap tap and about 15 other people piled in. You never really know where these "tap taps" are going either. If it's going in the direction your headed, then you just hop on until you need to go another direction. It only costs about 10 Gould, the equivalent of about a quarter. For those of you that don't know what a "tap tap" is, it's basically a pickup truck with benches lining the sides, a topper on it, and it stops for passengers when they tap on the side of back of the window... hence the "tap tap". All of these vehicles are decorated with bright colors and say something about Jesus or religion on them. It's a superstitious thing for many of the drivers. They don't feel their vehicle will be really protected until it's properly decorated and adorned with something reassuring their faith. Anyhow, after that long side note... we finally needed to go another direction so we hopped off and waited for a taxi. Now this was interesting! As we drove in the taxi, we continued to collect more passengers. This was a small little sedan that myself and 6 other sweaty Haitians piled into. Complete strangers are sitting on each other's laps and such. I kept looking out the window, just laughing at how this country and culture never ceases to amaze me.
Finally, we got to CDTI where we met up with the roof crew... Alan, Cory, and the Pauls. It was so great because I was able to finally meet Cory Gould. She is a nurse from New York and one of the biggest supporters of my organization. Before coming down, she made it possible for me to bring about 800 doses of antibiotics into the country. Once here, she was able to coordinate with folks back home so I could pickup a shipment at the airport of 2200 more doses. This amazing woman was finally in Haiti and we were on the same team!
We all just hung out at the hospital for a while, made some plans for the coming days, tried to organize some supplies in the back and so forth. This older lady we are friends with showed up and asked if we wanted to come over and hang out for a little bit. Chantal and I agreed and we arrived at the woman's cracked house. She was very lucky it did not collapse as major support columns are buckled in places. We sat on the porch drinking sparkling fruit punch and then we got a lengthy tour of the entire house. She took us through every room, pulled out picture after picture, told us stories about everything from a trophy to a candle. Even though I had nowhere else to be today, I started wanting to pull my hair out. The show and tell went on for at least a couple of hours. Then, she started talking French and Creole because I think she forgot that I only speak English. So, not only am I entirely bored out of my mind, but I have no idea what she is saying. I thought we were only going to be here for a quick stop by and now the sun was starting to set.
Suddenly, the woman's servant comes up from the basement and says dinner is ready. She had prepared a massive spread of food for us all. There's no electricity in the house, so they lit candles and we sat around eating beans and rice and other interesting side dishes. Just as we were finishing up, Victoria called from the place she was staying and wanted to come over. We went to pick her up and brought her back with us. We had already been here for about 5 hours now and I was so tired. As we sat there waiting for Victoria to finish eating, every time I thought we were going to get up and go, they would start talking about something else. I looked down at my watch and thought, we'd probably be there for another 45 minutes... 2 and a half hours later we were finally getting in car to ride back.
That entire I was sitting there at the table listening to everyone talk in a language I didn't understand, staring at the clock, and completely restless I had the worst anxiety attack I've had since I've been down here. I was sweating, my heart was racing, had a headache, and was entirely restless. I had to go take one of my anxiety pills because I thought I was going to lose it. The thing about the Haitian culture is that it is unbelievably slow. Nobody seems to be in any sort of a rush here ever. When it comes to completing a task, instead of going from A directly to B, they start at A, divert to D, then M, N, O, P and finally make their way to B for no logical reason. For instance, at the hospital you need a key to get into the back room. The man who holds the keys has to go to get a key to open a room upstairs, where there is a lockbox inside on the wall to get a key to go downstairs to open the back room. Every time he needs to get in there that's what he has to do. It's so frustrating because I'm all about efficiency, effectiveness, and momentum. Another thing that's interesting here is the lack of attention to body language. I've noticed that people here keep talking and focus on what is being said rather than how it is being said... or how it is being received. In the U.S., I'm pretty sure that just about anyone would have easily picked up on my restlessness and lack of enthusiasm in the conversation after about 15 minutes. They would have become self-conscious that they were being taken as boring or non-interesting and changed the subject or something. It's such an interesting place here.
Anyhow, Just as I'd think we were about to get up and leave, she would want to start telling us about her great grandmothers sailboat or where the silverware came from. There would be little pieces of English that I could pick out of the conversation, but the words were few. Finally, as we got into the car to leave, she said, "where are you going?" We told here were headed to our friend Dominique's house to stay the night. She said, "Why don't you just stay here?" Everyone else seemed happy with the idea, so I just went along. If I had known we were going to be staying here tonight, I would have gone upstairs and gone to bed much earlier.
From here on out things just got more bizarre for me. We did another tour of the house, the lady pulled out about 10 pairs of sheets for us, and then pulled out this cord that she had rigged into the neighbor's power source and turned on a light bulb in the hallway. She truly was so excited to have guests at here house. I think she is probably a really lonely woman. Next, she wanted us to have something to sleep in. She went into the closet and started pulling out silk "grandma" pajama dresses left and right. She gave us a whole pile of them with matching robes for us to wear. I thought to myself, "somebody already forced me into a skirt this week, there's no way in hell I'm putting on grandma pjs now." :-) There I was sitting on the bed and glanced up at the mirror on the dresser. I instantly reminded myself of my little sister. I looked just like her and had the same confused semi-amused look on my face that she would have had on hers. I suddenly really wished she was here with me to laugh about this situation with. I know we would have both really gotten a kick out of the whole thing. Over in the shower, we had to bathe out of a big bucket of cold water. That was interesting. The old lady then starts walking around in her underwear and bra and keeps walking into our room asking if we need anything else. The servant brings in water and glasses, and I decided I was done for the night. I was ready to check out of the Twilight Zone for the day.
Today, I am realizing how much my serenity level is wrecked. My focus here is pretty much gone. I'm ready to go home. I'm tired. I'm getting restless. I've checked out. And, I've got a pretty bad respiratory infection brewing. If I can just get through the next few days with helping a couple more people and having an adventure or two, I'll be fine. One nice thing today is that we started the morning with the servant bringing us hot coffee in bed. After we got up, I made this delicious oatmeal I brought down here with me for everybody, and the servant (by the way, that's what they call them here) brought me some special flower tea to help clear my lungs.
Once we were able to get the day started and get out of the house we walked our way down to CDTI to meet with the roof crew. The old lady we had given the tent to was no longer there on the sidewalk. Instead, the sidewalk was filled with rubble being cleared from the house nearby. I wonder where she went? The rubble from the professional school that completely collapsed is all gone now too. We walked through the new construction site and it was very refreshing to see things being built differently. Instead of using concrete and cinder blocks, they are rebuilding the school using wood. The joints are all reinforced and they are using a tin roofing. This is great to see because it appears they are using lessons from the past to help prevent further tragedy into the future.
When we finally got to CDTI we met up with the roof crew and hung out for a little bit. I don't know where the day has gone, it just flew by. I started myself on a course of Augmentin today from the massive pharmacy that just sits overflowing with medications that are not being used or moved. It's the same story with the rest of the hospital. There are thousands of pounds of supplies that are just sitting and not being used. It makes me sick.
Later on in the afternoon we headed down to the port. Along the way, I noticed something interesting. There are no real imports coming into the country right now. There are certainly no exports going out of the country. The only money coming in is really from the NGOs spending money on food and lodging, but other than that, the economy here is stagnant. What people are doing is attempting to create economy from the very thing that ruined the system. Locals have gone through the piles of debris and are reselling everything. It's become a rubble economy! Everyone has a niche. One guy sells pieces of wood torn from buildings, another sells steel railings, and down the way there's a guy selling broken furniture. They are even selling salvaged concrete blocks! Its nice to see how people are making the best out of the situation. They certainly are doing everything they can to survive right now.
I have been trying to get a sample of the sand that poured out of the massive fissures in the earth. As the plates rubbed together and cracked open, they spit up piles of ground up earth that was "digested" in the grinding. I'm going to use the sand to add texture to paint for a project I'm putting together when I return. While down along the coast, we came upon a fleet of old rickety wooden sailboats. They are all stacked with layer upon layer of charcoal being brought in from the town of Jeremie. It's about an 8 hour boat ride. We talked with a few of them and they agreed to take us along on their boats to the island for 50 Haitian dollars, that's just over $7 U.S. We'd camp out overnight and then take another sailboat back in the morning. We are considering the adventure, but it seems like I'd be cutting things too short with leaving on Tuesday. If we had a day of bad weather that delayed coming back, I'd miss my flight and really make a lot of people upset.
We continued down to the main sea port. It's very difficult to get into. I had to go speak to about 3 different security officers, sit down in the office with one and explain what we wanted to do, tell them about the sand, etc. Finally, they allowed us to enter the port with a security escort. It wasn't the first time I had been down there, but it was the first time the Pauls and Cory had seen the place. They were amazed at the damage and the extent of how the earth just shifted. I crawled down into one of the cracks and got my sample, everyone got their pictures, and we headed back to CDTI.
By the time we got back, the truck had a flat tire. The boys had to swap it with the spare and a few of us returned to the roof to just hang out. That night it rained as hard as it ever has here. I was sitting in the back of the pickup as they were driving Victoria, Chantal and I to our friend Dominique's house for the night. Boy, did we ever get soaked! We came inside the house to now power, soaking wet, and tried to navigate our way through the halls. Luckily, I had an MRE with me, so I was able to cook some food for us. It was the meatball and marinara packet, not bad... kinda like Chef Boyardee. Once you choke down the packaged wheat bread and cheese spread, you can convince yourself that you are actually full.
Falling asleep tonight was kind of difficult. There have been small earthquakes the last 2 nights in a row. You get kinda scared when you start expecting there to be a trend. What freaks me out about this place is that they lock the doors to get out with a set of keys that the servant sleeps with. So, if the house starts to shake and we need to get out, we are trapped. All of the windows have steel bars covering them. Victoria asked if she could sleep with the keys tonight and that left me feeling a little safer.
This morning, I woke up to make everyone some of that yummy oatmeal with cinnamon and brown sugar. Fortunately, we had power, but unfortunately, the microwave plug-in did not fit into the kitchen wall. We had to take the microwave and put it on a stool in one of the rooms. Even then, the buttons didn't work. The only way we could get things to cook was to plug it in, time it out for about a minute, it would shut off, and we'd have to replug it in and it would start the process over again. It was like the possessed microwave, but it ended up providing us with hot food in the end, so that's all that really mattered.
Finally, we were all ready to hit the road this morning and we headed down to CDTI to meet with the "roof crew". They are headed up to an orphanage in the mountains today to assess the facility's needs. On the way, they were going to drop me off at a friend’s house that was going to let me rent his motorcycle for a couple of days. Well, the driver never showed up. The truck the boys had wasn't going to make it up the treacherous part of the mountains they had to go to, so they had to cancel their plans. We all sat around saying, "Well, everything happens for a reason, there's probably a good reason things didn't work out."
Meanwhile, the owner of the motorcycle came with the bike and met me down near tent city. Chantal was with me, we hopped on the bike and a little nervous we sped off onto into the crazy Haitian traffic. We stopped by the Plaza hotel to grab some breakfast and ran into who, but Cory and the Pauls! I also ran into the girl who was on my original charter flight into Haiti more than 2 months ago. After breakfast, we went and sat by the pool for a little while we drank our coffee and checked out internet. Again I started thinking to myself, am I really in the middle of a disaster zone? We hopped back on the bike, I dropped Chantal off at her mom's house and I headed back to Quiskeya.
I was alone in one the Haitian streets now... alone on a motorcycle in the middle of one of the craziest places to drive! I was loving it! Everywhere I go on this bike, people stop and stare. First of all, most of the time I'm the only white person around in my vicinity at any given point of my day. Secondly, I'm a girl. Third, I'm on a motorcycle. The combination of being a caucasian girl on a motorcycle in the city just blows people's mind. Guys wink, kids shout "blanc, blanc", and I just keep moving head up, focused on the road, with the occasional smile. I'm feeling very comfortable here in the city now. It's probably a good thing that I'm going home soon because many would probably say I've gotten to feeling too comfortable. It's a long stretch from when I first got here. I wasn't familiar with the language, the culture, the city, the situation and I wouldn't even go outside the gate of the hospital alone to get a Sprite. Now, I feel pretty connected to the situation and people around me enough to fend for myself. Plus, I always have mace on hand.
Anyhow, let me get to the real guts of the day's events. So, I'm sitting here at Quiskeya planning for my day when I get this phone call. It was my friend Justin from the Kenscoff clinic up in the mountains. You may remember stories I've written about this group. It is the same people who encountered the strange voodoo ceremony in the middle of a woman giving labor on the roof. Well, Justin calls me and explained that they are in the middle of helping a woman in labor deliver her child. Meanwhile, another woman pregnant with twins was at the Farmount Baptist Mission hospital experiencing placenta previa. She needed to get to a hospital in PAP capable of providing her with a cesarean. They needed a medical team to get to her and transport her down the mountain. I got off the phone, called Cory and the Pauls and explained the situation. They were game right off the bat! We suddenly understood the reason things hadn't worked out earlier in the day, it's because God had bigger plans for us all.
They met me here and I led the crew on my motorcycle up the mountain to the hospital. Halfway, we stopped for a moment and I got a phone call from Justin that now we weren't just going to be transporting one woman to the hospital in labor, but two! Things just got even more exciting. Marilyn and her son had been working on the woman at another location. She had been in labor since yesterday. The woman had a bulging vein ready to rupture at any minute and the baby was pinned against the woman's pelvic bone which wasn't spreading. We zipped up the mountain and arrived at the mission's hospital. The father was waiting for us outside, crying and led me inside to his wife in the middle of having a contraction. We gathered their things and got her to the back of the truck.
I threw a line in the first lady and we got fluids running. Paul taped the IV fluids to back window of the pickup. Minutes later, our other pregnant lady arrived in the back of a car from higher up the mountain. We laid the two mothers side by side in the back of the pickup and Marilyn, Cory, and I sat at their feet. As we're riding down the windy, bumpy mountain roads the woman are contracting and trying to push. Marilyn and I are checking the woman's cervix as we fly down the road. I can feel the top of the baby's head and the bulging vein ready to rupture at any minute as we cruise down the mountain passing cars, whizzing along faster than we should. Meanwhile, Alan who was riding back behind us on my motorcycle wiped out on a puddle of water and got some pretty bad road rash. But for the most part, he and the bike are fine.
As we cruised down the road, it hit me. By complete coincidence, things had come full circle. The antibiotics that Cory had given me months ago to bring into the country had gone to Marilyn and the girls up at the Kenscoff clinic. Now, here we all were. Cory, Marilyn and myself... 3 women whose connections came full circle sitting in the back of a pickup helping 2 moms through labor! We are trying to get them to change positions, roll them on their side, Marilyn is talking with an OB specialist in the US who's telling us to put them on their hands and knees- yeah right! Not under these circumstances! We continue checking their cervix, taking their blood pressure, and I sang to them Bob Marley's famous, "Don't worry... about at thing... cause every little thing... is gonna be alright." The women smiled.
Finally, we arrived at Medishare, the Miami University hospital by the airport. We pulled up to the hospital, one of the only places in town suited to take cases like these, and we explained the situation. At first the hospital didn't want to take them because there were no OB docs available. We didn't care. There was a general surgeon available. These women needed a cesarean. And if they weren't going to take these patients, then they were going to die in the back of a pickup. Finally, the doctors agreed, brought the two women into the hospital and immediately gave the mom at risk for hemmhoraging and with the baby malpositioned an emergency cesarean. We stood there watching, changing out IV solutions for the team and praying everything would be alright. Before we knew it, out came the baby... first a bit quiet, then came the beautiful sound of the baby's first cry. The entire operating room erupted in applause and cheering. I cried a bit. It was such a wonderful thing to see this new baby girl come into the world. Meanwhile, mom number 2 was on another operating table getting an ultrasound and prepped for her cesarean. I ended up having to leave because it was going to be getting dark soon and if I didn't follow the Pauls and Cory out on the road, then I was going to be lost in the dark in Port au Prince on a motorcycle alone... not something I really wanted to do. We left the moms in the hands of Marilyn and her son, watched the sun set, bandaged up Alan from his little spill and set off knowing that we had a part in saving a handful of lives... some of those new faces in the world.
The next adventure... the motorcycle ride home. OMG! If I ever had any doubts that I can ride a bike, or that I have earned my motorcycle endorsement... let me tell you, driving in Haiti should earn you a lifetime permit to ride. It had gotten dark by the time we left the hospital, I had sunglasses on, and I have no idea where I am dark. All I'm doing is just following the roof crew's bumper through the packed streets. The traffic here is god awful! Cars going every which direction, trying to cross, pass, backup, turn around and all in one big cluster. A few times, I had cars pushing me from behind against my back tire. Another car came and the side of my bike got hungup on their front tire. People are honking, pedestrians are trying to weave through the cars, and the occasional goat or dog shows up. It's a mess. On top of the traffic, you have massive potholes in the road, places where the road is completely warped and bulging from the earthquake, rubble lining the streets, and then the rain. The sky opened up and it started pouring. There I am stuck in the middle traffic, pouring rain, a red bandana around my face trying to mask the smell of diesel, and a stethoscope still hanging around my neck from the previous adventure. The roads here get slick when they get wet too. Several of the cars were spinning out just trying to get up the hills. Although far from it, this whole thing felt like a video game. It was like a cross between Frogger, Xtreme Motocross, Super Mario Brothers, and some racing game. If I had only had video game music playing in the background, I would have thought I was in the middle of some virtual reality game. Anyhow, I kept praying to God that I'd be alright and that I wouldn't end up hurting anyone else. The last few miles, the roof crew went one direction and I had to go the other. I was so relieved when I finally passed into the gates at Quiskeya with both myself and the bike in one piece. What a long and crazy day it has been. After a cold shower and some beans and rice, I sit here typing and can hardly keep my eyes open anymore. I am exhausted.
I woke up this morning and headed to Church here on the campus. I didn't sleep well last night, so I only made it through about an hour of the service before I had to go crawl back into bed. I think I was just too wound up last night from the day's events. Once I woke up, I had lunch with one of our translators here named Desert and planned my day.
I decided I would make use of the last full day I had the motorcycle and go exploring all the things I had yet to see. I geared up, threw on my Ipod, hopped on my bike, and headed downtown. Of anywhere you could be in Haiti right now, it's the creepiest place you can spend time because it still looks like a complete war zone. On my way down Delmas (a major road through town) I had a scary experience. I was flying along at about 40 kph when a car ran a red light and then stopped right in the middle of the road to avoid hitting another motorcycle in the other direction. Meanwhile, I had to slam on my breaks and rapidly downshift to avoid broad siding him. It was like complete slow motion. The bike fishtailed left, then right, left, right, about 4 more times… every time I thought I was going down, it was like there was someone on the side of the bike that lifted me back up. I was sure I was going down and yet I didn't. Finally, I was stopped and the people on the sidewalk nearby were like 'whoa!' Some of the cars behind me passed me and gave me a big thumbs up. I looked over at the one guy standing next to me and said, 'hey, you believe in Jesus? I'm sure I do now!' He laughed.
With a grateful heart, I continued on my journey downtown. I stopped at the ice cream shop and downed a chocolate cone, walked over to the outskirts of tent city to talk to some folks about the conditions, and then lit up a Haitian menthol and smoked before hopping on my bike. I don't know what it is about third world countries, but I always end up having to smoke a menthol or two while I'm there. I think it's because I don't drink or do anything else and it leaves me feeling a little like a rebel.
I passed the palace, and as I got deeper downtown, one of my favorite places to be, things still appeared to be pretty messy. It's crazy down here. Fires continue to burn in the road as people dispose of their trash, one of the buildings had a fire burning inside, I had to weave through piles of rubble, navigate around and under downed power lines, and keep a sharp eye on the people around me. Meanwhile, I had my favorite song to listen to while in these parts, the theme song from the "28 Days Later" soundtrack and "It's a Mad Mad World." I passed by a group of Asian contractors who I stopped by and chatted with. They were so excited by the fact I was riding a bike around that they all had to each get a picture with me in front of the rubble on my motorcycle. It was so cute. I caught up later with some guys with the 82nd Airborne and chatted with them for a little bit! They said I was brave, gave me the thumbs up, and told me I could come down the the base and hang out with them all any time I wanted.
Eventually, I got tired of aimlessly driving and headed back to Quiskeya. I caught up on some journaling, met a friend later at the bakery Ipador, packed up some supplies that I'll be forwarding on to a pediatric hospital, ate dinner, and am laying in a hammock on the porch listening to the rain drench the city. I hope my friends and patients are dry tonight.