Beginning the Taper

If anyone has ever trained for a marathon, ironman, or other endurance event, then you know that towards the end of your training it's important to make the workouts easier or less frequent. It's what is known as "the taper" as you get closer to the actual race. Now that I sadly have only 2 weeks left here in Les Cayes, I had a very important discussion with Baby Joseph's mother. Dr. Cleonas and I explained to her that I will be leaving in 2 weeks. And while I very much love her son and am willing to continue to help with his feedings and diapers and cuddle with him on my work breaks at the hospital, it is important for us to keep reality in sight. It is important to remember that in 2 weeks she will be the sole caretaker of Baby Joseph. She can't realistically afford the disposable diapers that I have been bringing for him. I won't be there to remind her to wash his bottles, and actually use soap when she does so (or just do it myself). I can't be there to find anti fungal meds when she gives him dirty bottles. And for the fecal-to-oral infections she might have given him when putting her fingers by his mouth after changing his dirty diapers, without washing hands in between - Dr. Robin and her zinc to stop the diarrhea that ensues, will no longer be a call away via my cell phone.

And so with 2 weeks to go in Les Cayes, the education sessions have begun. I am getting Baby Joseph reusable diapers, thanks to a generous baby package donation from Carol from Harvest Field. Next week Baby Joseph's mom and I will go over how to properly wash and reuse these. I will explain to her the importance of using soap when washing diapers and explain how to wash her hands after changes. Carol is bringing me a baby bottle cleaner as well. How-to-wash-things-with-soap 101 class continues. I will show her some of the tricks I have been using to get Baby Joseph to feed even when he's fussy. And re-emphasize the importance of trying to get as much milk in him as possible (the vomiting from coughing so hard with pertussis the other week has made her think if he drinks more than a little bit he will vomit). We will talk about how rusty safety pins (not-closed) for securing cloth diapers is a no no.

While all of this seems simple to those of us who grew up in the states, I think we need to step back and remember to take off our judgement caps. We need to remember that someone, at some point, taught us how to wash our hands (and use soap). Taught us how rusty metal probably shouldn't be poked through our skin. That certain water needs to be boiled in order to be clean. And even though Baby Joseph's mom is older than a kindergartner, I think it's important to not over look the basics. It's important to remember that teaching her how to wash her hands with really cheap soap, is a lot easier than her having to come back to the hospital with Baby Joseph for an easily prevented infection. And while washing soiled, reusable diapers will not be the highlight of my last week here, it's much more sustainable and cheaper than the easy disposable ones.

While I am sad to finally have to come back to the reality of leaving Baby Joseph in a couple of weeks, I am trying to remember what is best long-term. He can't grow up and be all the things I want him to and go to school and accomplish amazing things, if I don't equip his mom now on how to prevent him from getting life-threatening bacterial infections after I leave. I think it was very easy for me to tell others how important it is to teach Haitians how to help themselves instead of giving handouts or doing the work for them. But I think it's much harder practicing what I have been preaching. I think that's because at the core of being human, if we're honest with ourselves, we want to feel needed. That's why handouts feel good short-term, even if they're bad long-term. It's why sometimes we go above and beyond for certain patients even when we shouldn't. It's probably why a part of my pride loves the field of medicine.

I used to say how much of a pain in the butt it was to take my nightly moto rides to give him his bottles and oral anti-fungal med. But now that I've made myself stop, I miss those nights getting to pace around the pediatric unit until he fell asleep. I miss the pride that came with knowing I was the only one who was able to get a bottle in him, while he was screaming, and then get him to fall asleep peacefully. But now it's time to hand over the reigns and let his real mom start taking the credit. I hope that tapering off being needed will make the transition easier for Baby Joseph's mom and for me... But if I am being honest with myself, race day will still be a shock when it arrives.

Baby Joseph showing me he is getting stronger and more independent. He rolled over by himself on Friday... But then of course got mad when he couldn't figure out how to roll back over!

The best part about making myself take time off from Baby Joseph care - I got to spend the day at the beach and touring Dr. Robin's clinic in Port Salut. Both are very impressive!

And of course, no day in Port Salut would be complete without visiting our new friend, Walter. A Swiss chef who makes some of the best (and fanciest) seafood dishes I have ever had. And all at a reasonable price! He buys all of his ingredients from locals. So if you'd like to help your stomach and the people/ economy of Port Salut, come visit Walter the next time you are in Haiti :)