Children’s Global Health: A return to Haiti

Michael Felber, RN, is a nurse at Children’s Hospital Boston. He spent two weeks as a medical volunteer in Haiti in March of 2010, in the aftermath of the earthquake that devastated the country. The following February he returned with a group of clinicians from the Global Surgery Program at Children’s, to work at a hospital founded by Partners In Health. While there he met a child who changed his understanding of the relationship between caregiver and patient. This is the second half of his story, for the first blog entry, click here.

Louveda's first day in Boston
It took two months to get Louveda to Boston. I communicated by phone and email with Sybill and David weekly. I was sure that it would eventually be possible to get her here, but I feared for her well being in the meantime. I work part-time at Shriners Burn Hospital, so I know of too many children who died waiting for their immigration paperwork to be processed.

 

I was working a night shift at Children’s Hospital Boston when Louveda finally arrived, accompanied by David. Jay, one of the nurses from the Children’s team, met her at the gate, brought her to the ambulance that would take her to Shriners Hospital. When I made my way to Shriners Hospital’s Acute Care Unit the next morning after my shift, I felt a wave of relief and gratitude when I saw her name on the board behind the nurse’s station.

She was frail but remarkably upbeat. It had been months since we had last seen each other, but she greeted me as if I had just stepped out for the afternoon, and told me she wanted to visit my house. She was clearly enjoying her new surroundings, but you could also sense her nervousness. She asked every new person she met if they were going to “take [her] skin.” She was still hugely protective of her wounds, and unsure of her new caregivers.

At Shriners Hospital
Louveda’s treatment at Shriners Hospital lasted six weeks. She had a difficult recovery. She was unable to walk or even stand independently. A feeding tube was used to supplement her diet. There was daily physical therapy and she was treated for emotional trauma. I tried to imagine what a day in the hospital was like from her perspective. She was physically healing, but there were more demands on her here than in Haiti: more caregivers, more treatment and a language barrier to deal with. Her stomach and legs were grafted with skin from her back.  As a result her burns soon felt better, but her back hurt. It could not have made much sense to her.

 

I visited her as often as I could, usually after working at Children’s. Sometimes I drove down from New Hampshire with my wife or one of my children, who quickly befriended her. On a few occasions I even worked a shift at Shriners as her nurse, although I preferred just spending time with her. Beverly Small, another nurse from the Children’s team who visited Haiti, visited her regularly as well. Partners In Health scheduled daily visits from their Boston staff, and from other Haitians living in Boston who could offer her a small sense of home. Just as she had done in Cange, Louveda formed bonds with all her new caregivers and quickly built a strong support network in Boston. She had a cell phone that she could use to call Anita, who was now living in a foster home next to the hospital in Cange. Somehow she figured out how to call my phone, and took to calling me to make sure I would visit her after work.

Loveda and David Bayne
I wondered how she would react to the strangeness of being in Boston, but she seemed to take it all in stride. Once Sybill and I brought her outside. She admired the high-rise apartment buildings all around us. Sybill tried to explain to her that people lived in each apartment, but she scoffed at that – the windows were too small! She missed Haitian food, and did not like eating alone. She always asked me to sit down when I visited her, and I made a point of eating with her when I visited. Some of the Haitian staff began bringing her home cooked meals. I brought mangoes from the market around the corner. She loved to laugh at me and tease me when I tried to speak Haitian to her. As she grew stronger and more mobile she became more interested in the clothes that people had brought her.

 

She loved trying on new outfits and having her hair braided. She learned to write the alphabet, her name and do simple arithmetic problems in Shriners’ school program. She was clearly proud of her accomplishments and loved to show off her new skills. In class she made a new friend, a 12-year-old girl from El Salvador, who like her was alone in Boston and being treated for burns. After a few days we started to hear each of them speaking a blend of Spanish and Haitian. She worried she was going to forget how to speak Haitian. I began to realize that all of the newness and wealth of Boston didn’t really change who she was, or what mattered to her. She liked making friends and meeting people. But she also missed Anita, and asked when she would be able to return to Haiti.

When it was time for her to go home my daughter and I drove her to the airport. While she waited at Shriners for her discharge she sang church songs from Haiti and danced. She gave us a running commentary of Boston as we drove. She laughed at the rowing teams on the Charles River, “Why do they have such small boats?” she laughed.

I knew I was going to miss Louveda, but goodbyes are part of nursing. You make a decision every time you exit a patient’s room when you decide they are well enough to be left, and now was that time with Louveda. She was better, and she wanted to go home. And somehow seeing her leave for home made the world seem a little more right.

Sybill takes Loveda to her flight home to Haiti
Louveda and Anita now live in a foster home near the hospital in Cange. In the fall both girls will attend school for the first time. Many people helped Louveda, keeping her safe and stable in Cange, and getting her to Boston. I am deeply appreciative to all of them, as well as her many caregivers and supporters in Boston.  And I am still amazed and inspired by her spirit and resilience. It’s my privilege to have been included in her journey.  Dr. Paul Farmer, one of the founders of Partners In Health, recently spoke about the idea of accompaniment as it pertains to his work. In it he says:

 

To accompany someone is to go somewhere with him or her, to break bread together, to be present on a journey with a beginning and an end. When you accompany someone you travel with them.

Helping in that context is a shared, collaborative experience. I think Louveda understood that from the beginning.

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