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February 21, 2010 Hi everyone, You could probably all guess this, but the last few weeks have been basically non-stop work (there was one day where I only put in 8 hours – I considered that a day off). I had, not surprisingly, plans to work on a given project today but they fell through. I’m thus taking the opportunity to finally go running and swimming, do some gardening, clean my house up, update myself on the Winter Olympics (where my Plan A for February 2010 had me right now) and write some communications. The details and reflections from the last few weeks are too numerous and too weighted to convey. At some point in the future I’ll talk more about it; this point will likely come after all the cards have been laid, the game has lost its emotional charge and the players no longer have any stakes. The gist is this, however; rehabilitation in Haiti has half-emerged from its somnolent state into one of parallel spastic activity and inertia. The combination of these two is mind-blowing; actors race so quickly to be the first to do such-and-such an activity that they devote no time into understanding the ground on which they are walking. At the same time other important, but more challenging or lower profile activities, are left untouched to grind along at their snail’s pace. In the intervening time between the present and that future where all of this will be trivia and not daily reality, I’d rather devote my half day off here to process and express more personal and less controversial subjects. In this spirit of raw and direct expression I can now confirm to you that Port-au-Prince has been physically and psychologically ravaged. Although I have always found the place grotesque on a superficial level (remaining fascinating in a more profound way), this reaction is pale in comparison to its current state. Traveling through the city is a tour of collapsed buildings and tent cities with multiple thousands of people. Interestingly, not every one of those tent dwellers has lost his or her home: although Tuesday will mark the 6 week anniversary of the main earthquake much of Port-au-Prince refuses to sleep indoors out of fear of the built environment closing in around them. The manifestations of this situation were most apparent when I spent a few days at the Healing Hands for Haiti Foundation. Shortly after arrival I was shown the grounds by long-time friends and colleagues Gail Buck and Lisa Bagley. We started with the collapsed 5 storey apartment building where 2 international tenants perished. According to Gail, one of these survived the quake and was alive under the rubble and able to communicate through the fallen blocks and cement. Removing a fallen cement structure without heavy equipment is a taxing and dangerous process and took several days to get to her. By this time the communication had stopped and the workers aimed merely to retrieve her body. We continued on to the neighbouring apartment block with long oblique cracks in its walls and then onto the clinic/administration building, now leaning at a precarious angle. From there we went by another collapsed house where the keepsakes of a family had spilled revealingly down to the terrace below. We crossed by the pool which was now void of water and instead filled with debris and passed my favourite balcony, a cement platform that protruded from the terrace on a stone wall that made it feel like the stern of a ship. The latter had since detached from the terrace and hanging on an angle. Continuing down the property we visited the tent where Healing Hands was conducting a medical clinical for people in the area. Fortunately, as the clinic building did not collapse it was possible to remove much of the equipment. This was moved into the tent, although this time the focus was not rehabilitation but rather acute primary care. At the clinic I saw the staff that I knew well from my time in Port-au-Prince. I think talking to them is the toughest thing I have done since arrival here. Although I was relieved to see them it was earth shattering for them to describe the processes that caused them to lose husbands, wives, children and parents. Although that was now 2 weeks ago I still shudder when reflecting upon those moments. Against all odds the guesthouse survived the event and has been determined safe. There I saw the staff that I knew the best, all healthy but unwilling to return inside. They now cook outside using charcoal, away from threatening ceilings and spaces that must seem to be hopelessly confining to the psyche of the Portauprincien. Having no homes to return to, the staff slept at the guesthouse, as a group in a line of mattresses, in an area with only a corrugated tin roof and margins delineated by hanging sheets. As I should have expected, I actually began this message yesterday (in the end I never got that half day off and the schedule didn't allow for swimming or Vancouver 2010 updates) and am now scrambling to complete it among other obligations. Our activities have ramped up here substantially with a new prosthetics (artificial limbs) clinic opening tomorrow and the American staff en route right now. This past week I have had the support of additional physiotherapists that were necessary for me to make it through this week with my head held high. Another will come tomorrow – a bit of time will be needed to get her re-oriented, but she’s been to Hopital Albert Schweitzer many times and will hit the ground at a jog that will quickly reach sprinting-pace. In other news, I have been closely involved with national planning for rehabilitation and was thus back and forth to Port-au-Prince 3 days this week. I was able to procure a tent and will travel with it next time to ensure that I have accommodation in the city as I’m not a fan of spending 5 hours/day in a car and would rather stay over and sleep on the ground then continue with the return trips. Thinking about the future, I will likely stay at HAS (Deschapelles) for a while yet. I’m hoping to get a half week or so trip into Canada soon to regroup, move my things around and better brace myself for longer term involvement. With the intense activity happening I can’t see a natural window opening up, making me think that I’ll have to simply identify the time and accept the consequences of an absence. I will try to inform you when that will occur but suspect that I’ll only know a few days prior. Contrary to my promise, I have yet to figure out a better, quicker way to communicate regular updates. I would appreciate any help on the subject…really taking a half hour and learning how to use Twitter would probably work, but yet that 30 minutes has never materialized. On a similar note, we are moving towards hiring a long-term, rehab professional colleague to help out with the work I’m doing but need to work out some basic principles first. Since many of you receiving this message happen to know me through global health PT involvement you can consider this as an invitation to get in touch if you’re interested. That’s it for now. Shaun Cleaver |
Haiti (New!)
