Sunday, February 11, 2018

After the Visit: Reflections by Rebecca, Part I


The following was written by Madame Rebecca, who visited CAP February 2017 and November 2017 for a total of seven school days. An educator from NH, Mdm. Rebecca wrote these pages of reflection after her return to the U.S.

Part I
Christian Academy of Petit Goave, Haiti
Mission Statement 
Christian Academy of Petit Goave seeks the Lord's guidance to educate impoverished children in Biblical knowledge, life skills, and relationship building to create a rich school environment, supportive families, and unified community.

Physical features of the building:
  The National Road which connects Port-au-Prince with the western portion of the island passes in front of the building.  There is just enough space to pull in the vehicle from the house to park close to the metal gate manned by the hired guard.  (Unlike many places in Haiti, he is not armed with an automatic weapon.  Tall cement walls, topped with barbed wire and broken glass encircle the building.  The gate opens onto a small dirt floored courtyard, littered with building materials on the side.  There is just enough space for the six classes to line up side by side facing the building.  An exterior staircase ascends to a portion of the second story which is rented by a training clinic for nurses.  The children gather in the courtyard and wait for the teachers to be ready to sing and pledge to the flag and begin the day.
As they step over the high threshold, children proceed into the concrete building to their classrooms.  A bench sits along the left wall and it is here that children gather for triage, or if they have been pulled out of line for disciplinary action.  Along the left side of the corridor are four rooms.  The first two, grade one and kindergarten have been painted and contained louvered cement block windows.  Banana trees grow right up to the building and block most of the light.  The building has no electricity.  First graders have desks and benches which seat three to four students each, and kindergarten has long tables and individual low chairs.  Each room has a chalkboard, a bookshelf, a small table on which rests the water supply, and a table and chair for the teacher.  Each room has two doorways, with no doors.  The second two rooms are for grade three and recreation and were not painted until this January.    The recreation/assembly room is empty except for one small bench. 
On the right side are two rooms for the three and four year olds.  Each has a plywood door which can close.  The furniture is the same as for kindergarten.  The rooms are smaller, but brighter because of the natural light.  In the three year old room there is a basket with a few toys.  A small office, with a private toilet for staff, has a door which locks.  Records, medical supplies, and extra consumable supplies are in this room.  It is used for medical treatment, and discipline.  Following down to the end of the dark corridor is a two stall bathroom for students.  Outside is a table with room temperature water for hand washing, and strong soap.  There is no way to dry hands.  A large barrel of water sits at the bottom of the indoor staircase.  Jonas, the day custodian periodically uses the bucket from under the hand washing station to force flush the toilets, then refills the washing bucket.
Going up the cement stairs, which turn once, you ascend to the portion of the second floor which the school also rents.  Here is a small kitchen, with a counter for the two tubs of water for washing and rinsing the tin plates and spoons.  A table is for the pots of rice and beans which are cooked at the house and then transported to the school to begin serving at 10:00 am.  Earlier in the morning Jonas prepares peanut butter crackers and takes a plate to each class for a snack.  Another large barrel is used for filling the wash basins.  Detergent goes in the wash water and bleach is added to the rinse water.
The second grade classroom is located on this floor and though the furnishings are the same as first and second grade, this room receives more light and in addition to paint on the walls, they have also been stenciled in a bright design.  One small locked room contains shelves of donated books and some resources for teaching which are not yet in use.
Everything is constructed from concrete and there is nothing to absorb the sound.  Only the three and four year old classrooms have doors.  The Haitian style of teaching is rote repetition in loud voices.  The noise is relentless and inescapable.  The room used for recreation allows each class to come in for some physical activity while they practice academics and English.  Here is the only time the children get to run around (a dark concrete room), and the noise level is commensurate.  Additionally is the constant noise from the flow of traffic and pedestrians outside the gate.
There is only natural illumination, and recently a couple of rechargeable battery operated lanterns for the darkest rooms (kindergarten and third) to augment the limited light.  The property next door is owned by someone else so the landlord cannot cut down the vegetation blocking the light.  The green chalkboards are almost impossible to read from the back of the classroom.  The children write with pencil on tiny lined notebooks that absorb the humidity, and even the graphite is hard to decipher.  Obviously, there are no technological devices of any kind.
If you stand in the hall you may be fortunate enough to catch a breeze coming from the courtyard, but there is no ventilation anywhere else.  Even in November, it is hot and humid.  Many bodies in small spaces raise the temperature.  Here is one reason to be thankful for the concrete.  School begins at 8:30 a.m.  Three, four, and five year olds are dismissed at one and the older students at two.  By the afternoon everyone is wilting in the heat.
As the day progresses the stench from the bathrooms (two toilets for 145 students) becomes unbearable.  It is necessary to hold your breath when you go up the stairs.  By 9:30 the floor is soaked with water from hand washing and force flushing. The children and staff walk through it all day, adding mud to the concrete floors.  A night custodian comes daily to clean.
Many schools in Haiti are simple roofed structures with open wall, which is why school is cancelled nearly every time it rains.  Nicer, expensive private schools have more amenities.  Most schools require uniforms and books, which parents must pay for. 

Health:
Children receive peanut butter crackers in the morning and fortified rice and beans (Manna packs from Feed My Starving Children) for lunch.  (Extra nutrients have been added, and occasionally the person cooking adds a few canned vegetables.)  Children and are given oral vitamins with iron daily.  Children and staff are given worm medicine every six months.  Some children do eat something at home before they come, many do not.  Some bring pre-packaged snacks from the vendors which line the streets, most do not.
In each classroom is a double bucket with lid.  Water is poured into the top bucket which contains a charcoal filter.  Water flows into the bottom bucket with a spigot for filling water bottles.  Each child has been given a water bottle, but a supply of pre-used juice bottles is kept in the office when they need a replacement.  The children are encouraged to drink water frequently, as their supply at home may not be as sanitary and it is a hot climate where much body fluid is lost through perspiration.
The vast majority of the children come to school scrubbed clean.  They wear their uniforms Monday through Thursday, and are allowed to wear other clothing on Friday.  The uniforms may or may not get washed during the week.  The school ensures that children are provided with clean socks and shoes if they do not have them.  In a culture where almost everything is outside of one’s control, they take pride in their personal appearance.  (I was astonished to see little girls coming on Friday in spotless frilly dresses. (Lye soap and sunshine is the key.)  Of course some children come disheveled, and uncared for, but the majority is more than presentable.
In the morning when the children enter school, any who are sick wait on the bench to be summoned to the office.  This may involve a teaspoon of cold medicine, a dose of acetaminophen, cream for head fungus or ring worm, or wound care.  Serious illnesses are taken by the director to the local hospital, where you pay up front before any treatment is given.
When I visited in February, many children were suffering from grippe(cold symptoms).  I was given a bottle of cold medicine and a handful of metal spoons.  Depending on the age and weight of the child I dispensed liquid accordingly.  When finished each child took the used spoon to the kitchen to be washed in bleach water.  During the November trip I was much busier with medical concerns.  Many of the little boys suffer from head fungus.  They wear their hair very short, or completely shaved.  The boys line up and with one gloved hand for all of them, ointment is applied to each spot.  One child had a severe case and was taken to the hospital.  Infection was discovered and he was given an antibiotic.  Unfortunately he took it at home on an empty stomach the next day and vomited it all over the floor of the office at school.  (The good thing about it was that the office is the only room with a tile floor which makes cleaning much easier.)  The several cases of ring worm were treated with the same topical ointment.
On different days I had little girls coming to school with very high temperatures.  (102 and 103)  These I treated with acetaminophen, and sent back to class.  One girl, who was too ill to return to her studies, stayed in the office, lying on the hard wooden bench.  I sponged her down with water, and she eventually went to the hospital because we learned from her mother, who is on staff, that she had not been eating.
Any child taken to the hospital is tested for parasites (requiring a stool sample), anemia (because they have virtually no iron in their diet) and are given vitamin C.  After those things are checked, they look at the symptoms.  The child with the fever and the boy with the severe head fungus were both found to have intestinal parasites, though everyone was dosed with worm medicine in October.  The little girl who had not been eating was prescribed vitamin C and an appetite stimulant.  None of the three students were anemic enough to warrant attention.
Wound care is another ongoing task.  The normal bumps and bruises of children are virtually ignored in Haiti; they are simply not serious enough to deserve notice.  More serious wounds from cuts, scrapes, or burns are tended to.  (Because most of the children live in hazardous environments, and because many of them travel to school on motos, (motorcycles with long seats that carry a driver and up to five students) and because everyone cooks over charcoal fires, wounds are common.  One boy had a partially healed burn on his leg which I washed, treated and bandaged.  The wound had begun to close without getting rid of the inner infection, it had not been stitched and the scar will be significant.  He was taken to the hospital and the director was at first told that he would receive a surgical procedure.  Though the wound should have been opened and drained, it was just washed and covered with a single band-aid.  His treatment at school was better.  This child barely flinched while I was treating his leg; many children in Haiti have learned to tolerate pain because so little medical attention is available.  Another boy, however, reacted as most seven year olds would.  His wound had scabbed over and then was scraped off.  I cleaned and bandaged it, while he cried, but the second day it was full of green pus.  He was afraid to have me treat it again, but the director chided him for his understandable reaction.  The children have to learn to be tough!  Fortunately on my last day there, the leg was looking better.
I visited a local pharmacy while there.  It is a typical, tiny store.  You step in and immediately in front of you is a long counter, glassed in, with a window to pass things through.  On display behind glass is over the counter remedies, and the pharmacist hands everything from the inventory in the back.  I don’t know what happens if the medicine is not in stock.  One day we went to fill prescriptions for a sick baby we had visited.  The mother had taken the baby to the hospital where it was evaluated, but the family did not have money to pay for medicine.  The doctor wanted it treated with acetaminophen for fever.  The house and the school have a donated quantity of this, but not the infant dose, so we purchased this.  The hospital recommended pedialyte for the dehydration and diarrhea, but this electrolyte isn’t available in the town.  It can be purchased in Port-au-Prince, but it is very expensive.  We bought Gatorade to give to the baby.  We did fill a prescription for an antibiotic.

Mdm Rebecca with one of the triplets

Recording height and weight of four year old students

Another family we visited has one month old triplets!  The previous week the family asked for assistance because the babies were losing weight.  Through connections the director was able to procure cases of free formula to supplement the mother’s breast milk.  Another connection in a close town will be providing care and supplemental food and nutrition for the mother and the babies every other week.  The director will pick them up and transport them.
Students at the school each have enrollment information, a copy of their birth certificate, and any medical history available.  Copies of height and weight growth curves are also in their files.  While at the school, my husband and I weighed and measured each child and I recorded and plotted this in their chart.  The three year olds did not know what to make of the process, and needed lots of help and encouragement to complete these ‘scary’ requirements.  Most of the rest of the children have experienced this before and I was happy to see that only gains had been made.  One little six year old who has a history of severe malnutrition, has now made it onto the curve!  This was a reason to rejoice.  Tracking height and weight are not common in Haitian schools.  Hearing and vision checks are unknown.
As previously noted, there are two toilets to service 145 students.  Many of the children have never used a toilet before entering school, and need to be taught how.  There are two stalls, and a privacy wall, but no doors.  Toilet paper is kept in the office, and children must stop by and help themselves to a few sheets when needed.  Afterward they wash from the room temperature water and use the round, rough soap.  Hands are air dried or wiped on their uniform.  The office toilet paper is also used for runny noses.  Extra rolls are locked in the supply cabinet in the office.  To my knowledge there is only one student who is not ‘potty trained’.  She is not yet two years old who is there because her mother is a teacher.  Despite the lack of sanitation facilities in the home, or perhaps because of this, children seem to learn to take care of this bodily function very early.
Tin plates and spoons are used and washed and reused several times to service all the children for lunch.  All children are required to take a small serving of rice and beans, even if they have brought something from home.  Some children request a large portion, because they are very hungry and may not eat again until the next day.  Weekends, and other days off from school are very chancy.  There are no government services to help.  Extended families and neighbors care for each other as best they can.  In extreme cases, families go to visit the Pastor’s house to request food, or express other needs.
Each class spends a half an hour in ‘recreation’ moving around, and practicing academics in the one open room in the school.  This is another unknown for Haiti.  Children sit or stand in silence and follow the directions of the adult, or they are disciplined.  Continuance discipline problems result in permanent expulsion.  Though the school doesn’t have any place for children to run around or play outside, they know that physical activity is important, and under the influence of the American staff, have worked this into their day.  The guard doubles as physical education teacher for the three year olds, (also known as herding cats).  A young university student comes four days a week to do recreation for the other grades.  The day he doesn’t come, the guard covers all the classes.
Recreation is held in the unfinished concrete room.  This room is also used for assemblies.  It is a small, dark, echoing space, and falls result in bumps and scrapes, but this is a small price to pay for the opportunity to act like children!  The school is grateful for this space and utilizes it to capacity.

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