January 8, 2018 WE MADE IT!!! The 0500 meet up at the airport was certainly early, but everyone was able to get through the check-in process efficiently. We had some great American Airlines employees helping us check in our 30 bags filled with everything from medications and toilet paper to jock straps and toothbrushes. And miracle #1 was that we did not have to pay for our bags! We had a nice long layover in Ft. Lauderdale, which allowed for long walks through the terminal and lunch. It definitely felt good to stretch our legs! Once we arrived in Port-au-Prince, we made it through customs and were able to swat away everyone who attempted to “help” us with our bags. A few of us had to check our carry on bags all the way through which added some extra anxiety, but they all made it to Haiti! We had about a two-hour journey to the house. Fifteen of us made the trip standing on the back of a pick up truck! We were able to watch the sunset and test our balance as we navigated through the busy streets. I am confident that there are zero traffic laws in Haiti. All of our suitcases were piled in the back of a dump truck and all the men sat on top of them! A few people followed in a van. We safely arrived at Willem’s home! The power was off when we arrived at around 7:00pm so we unloaded the suitcases with the help of phone flashlights and headlamps. We had an amazing dinner with rice and peas, chicken, pasta salad, and some fresh veggies. After dinner, we had a team meeting to discuss our plan of action for the first day of clinic. We have a well-rounded team filled with doctors, nurse practitioners, NP and pharmacy students, nurses, and some other special talents. We were told that there were lots were already people lining up at the clinic this morning. People come from all over Haiti to be seen at our clinic, so many people will be spending the night on the ground outside to wait for us to arrive tomorrow. How crazy is that? Willem talked about about how impatient Americans are when our doctor is running late. We have magazines and TVs while we wait, whereas the people of Haiti would wait for days with nothing to do just to be able to be seen. We learned about the logistics of who will be at what station and what our roles are. The providers met and reviewed protocols, common ailments for our clinic, and tips for teamwork and smooth workflow. It will be a fast-paced morning to get the clinic open again! We are going to move extra efficiently to make sure as many people as possible are seen - we don’t want people having to sleep at the clinic two nights in a row. Sorry for the delayed email! More after clinic! Audrey and the Little
By Little Team

January 9, 2018 Day 1 at the clinic is complete!! It was a crazy day and we saw SO many different types of patients. 214 in total!! We think this may be a record. If it keeps up like this, we could see over 1,100 patients this week! We think we were able to see everyone who had arrived the day before, which was great. Coffee was made and people began gathering in the kitchen around 0630 this morning. Unfortunately, the roosters in the yard woke some of us up much earlier than that! The Haitian coffee is incredible and we certainly have lots of it. We had a breakfast of egg bake, bananas, and oatmeal. The morning was very rushed as people were packing their bags, making PB&Js for lunch, and trying to get out the door. The newcomers of the group quickly realized how exhausting the hike up to clinic is. It’s a beautiful journey but it is definitely not for the weak and feeble - everyone who attempted made it up safely! The near asthma attacks make for some great breaks to take in the view. We had nine stations at the clinic which made for a higher number of patients being able to be seen. The patients line up outside the clinic and are given their medical records to hold on to. Once they get into the clinic, their vitals are taken (height, weight, temperature, blood pressure, and heart rate) and they are told what station to go to. We have teams specializing in OB and women’s health, pediatrics, and adults. It was cool to see the teamwork amongst the providers when we had a complicated case or people needed to bounce ideas off of each other. We also saw some goats and a cow on the way home from clinic today! It’s so fun waving at the kids in the village and seeing all the homes. It gives us a good opportunity to practice some of our french creole greetings! Most of us were able to “shower” (more like dump water on various parts of your body) and change before dinner, which consisted of salad, sloppy joe’s, mac and cheese, kale/carrot/squash sauté. We had good conversations and were able to do a group debrief on how the day went and what we could change for tomorrow’s workflow. After dinner, a group counted TUMS while the providers and nurses discussed a few cases from the day. One project we are working on categorizing is all of our medications into level of safety during pregnancy. Everyone has SO much knowledge to share. More tomorrow!! Thank you for your patience with our Haitian WiFi! Audrey and the Little By Little Team

January 10, 2018 Day 2 of Clinic! Today was such a rewarding day at clinic. You could tell that everyone knew the flow of the day and we were all working so well together. A few people switched stations today but for the most part, most people stayed in their roles. We were able to streamline our intake/lab process and get more organized in the store room. All of the suitcases are unpacked, now they are focused on inventorying all the items up there. They are doing great work! Today we saw goiters, scabies, diabetes, obscure skin conditions, possible tuberculosis, and wounds. Our top complaints were hypertension, eye issues, acid reflux, and worms. We saw a total of 210 patients!! Our breakdown was 150 women, 60 men, 70 kids, 140 adults! Yesterday seemed to be lots of people with rendezvous slips (pieces of paper they received the last time they were at the clinic that tells them to come back on a certain day for follow up) for chronic illnesses, whereas today seemed to be more infectious disease. How fun! The providers had great communication and teamwork with the pharmacist which can help consolidate medication lists for patients. The people who work in the pharmacy are doing a phenomenal job keeping up with the amount of prescriptions we have. They are also so great about coming back into the clinic to clarify orders if need be. Julie McCrary also does such thorough education for our patients which is so, so important. Willem says that without education, you have nothing. If we hand our patients a bag full of medication but they don’t know what they are for or how to take them, the medication is essentially useless. The end of the day was slightly rushed because of a looming rain cloud. The Haitians started taking cover and putting jackets on so we knew the rain was legitimate. Luckily we made it home safely and the rain never came! You know you’re being too slow on the goat path when you get passed by men with giant baskets of carrots on their path. Also women in flip flops with babies on their hips. It’s a very hard blow to my self esteem. We were able to change, eat a wonderful dinner outside, and have our nightly rounds. What an amazing day in Haiti! More tomorrow, Audrey and the Little By Little Team

January 11, 2018 Day 3 of Clinic! Edit from yesterday’s email - the men were carrying baskets of carrots on their HEADS! I apologize for the typo! Everyone’s muscles were feeling pretty sore this morning after two days of hiking up the mountain. The shin splints, joint pain, and sore backs are abundant here in Haiti. The mornings seem to go a little smoother each day, as everyone knows what needs to be accomplished before we depart around 0730. We rush to eat during our “business breakfast” so we can get out the door on time. A rain cloud also contributed to the efficiency of the morning. A group of people chose to take the truck up and the rest of braved the potential storm. Again, the rain held out until the afternoon! It definitely dropped the temperature for our hike down the mountain. We had a very high level of acuity for today’s patients and everyone seemed to step up to the plate. Sue said the third day is usually the hardest but we met the day’s challenges head on. We are over the hump! Today we had 244 patients!!! 180 women, 64 men, 73 children, and 171 adults. Worms, hypertension, yeast infections, and acid reflux were the most popular complaints of the day. It’s hard to remember in Haiti that our most of patient’s don’t have access to any over-the-counter medications. We give out so many TUMS, Tylenol, and other common meds that we are so used to being able to pick up at a Walgreens or CVS. We had an amazing casserole made with ground beef and cornmeal for dinner tonight! We also put a bean soup on top which was fabulous. We had our nightly team meeting and are constantly communicating about how to keep improving aspects of the clinic. We are always improving! The providers then met to discuss interesting cases from the day. One of the most difficult things about working at this clinic is our lack of lab tests, x-ray, and MRI machines. Even without blood draws and imaging, Cameron is doing an incredible job in the lab. We are able to do pregnancy tests, swabs for bacterial vaginosis and yeast infections, blood glucose levels, and urine dipsticks. We also found a hemoglobin A1c machine but only have a few strips. We are truly forced to look at symptoms and make our best guess about a diagnosis based on the limited information we have. It’s definitely a challenge for those of us who are used to Western hospitals with all of these resources at our disposal. It is especially difficult when we can’t prescribe certain medications because they require close monitoring. Tomorrow is the anniversary of the Haiti earthquake so we are going to try and close the clinic an hour early so we can learn about and remember the day. A Little By Little team was serving the day the earthquake hit so we have first-hand accounts of what happened. It’s been quite a week! More tomorrow, friends! Audrey and the Little By Little Team

January 12, 2018 Hello!!! Today was our second to last day at clinic and the anniversary of the tragic and devastating earthquake that shook Haiti and killed over 250,000 people! We had our typical breakfast with a few special words from Willem....and then made our way up the mountain! Thankfully, the hike seems to get easier every time we do it. We still get passed by the locals, but we’ve definitely gained some endurance. Once we arrived at clinic, Willem gave us a tour of the school. It’s right next door to the clinic! They have students in preschool all the way through high school. We learned that 40-45 students graduate from this high school every year - some have graduated and became teachers at the school! They know the value of education and want to give back to their village. Before Willem’s school, barely anyone in Gramothe went to high school. Children walk 3-4 hours from all around the mountains to get to school. Willem has really instilled the importance of education into the people of Haiti. All of the children also get a meal at school because, “when you are hungry, you cannot learn.” We also learned about how difficult it was for the people in Gramothe (the village that the clinic, school, and church are in) to get clean water. The people knew about a spring at the top of the mountain, but they were afraid to go up there because of voodoo. Once Willem educated people about the realities of voodoo, they had a whole new source to get their water. Now, the people on the mountain have been able to produce many crops throughout the year: bananas, leeks, onions, tomatoes, and potatoes. Even though today’s clinic hours were shortened (due to our school tour and our earthquake remembrance), we still managed to see 239 patients!!! 164 women, 75 males, 68 kids, and 171 adults. Fun fact: Willem’s house sits at 3,190 feet of elevation. To get up to the clinic, it’s about 900 feet up! Our hike is roughly 4 miles for the day. For our entire week, that’s about 10,000 feet of climbing and 20 miles of hiking! (Thanks to Josh for doing the math!) Our day at clinic ended with a rainstorm...but we saw a DOUBLE RAINBOW! Someone yelled and we all stopped what we were doing to look out the window. The sunshine came out after the rain and the sky was crazy beautiful! What’s amazing is that a fog rolled in minutes later and completely covered the entire mountain. Definitely a special tribute to all who perished during the earthquake. A group of us decided to brave the storm and hike. We had rain coats, panchos, and garbage bags to shield us from the rain. The steep decline of the mountain plus the rain and mud made for quite a slippery trip. I fell more than once (don’t worry, most of your loved ones stayed upright). I must have looked so pathetic because this kind Haitian man who was walking UP the mountain turned around to hold my hand and guide me down for a few minutes. We all made a train and were side stepping down the mountain while trying to hold each other up. Luckily, the road has grooves carved into the sides which allows you to dig your foot in for a little stability. The whole ordeal only added an extra half an hour on to our trip, and everyone made it down the mountain alive - one way or another! Those who took the truck told me it was quite bumpy ride. When we all got back, we spent some special time reflecting on all the pain and suffering Haiti experienced during the earthquake January 12, 2010. We  heard Sue, Brian, Dawn, and Willem’s stories from the earthquake. We talked about how amazingly strong, faith-filled and resilient the people of Haiti are and how much progress the country has made since 2010. As Americans, we can return to our country and share the stories of our new friends back in Haiti - we are able to be advocates for this country and these people. During our evening pathology rounds, we discussed a confusing skin condition that puzzled even Sue! Lindsey also saw a child today who Sue had seen back in August. Over the summer, she was severely malnourished and was suffering from a zinc deficiency. When Lindsey saw her today, she had gained a significant amount of weight and Sue was able to see how much better the little girl looked! We also talked about a patient with heart failure and discussed the pros and cons of different medication courses. We’ve also had a number of difficult diabetic patients which are interesting to learn about. It’s been an amazing week so far - we can’t believe we only have one more day of clinic left. Thanks for following on our journey!!! Audrey and the Little By Little Team

January 13, 2018 Hello from the Haiti Team - and our last day of clinic!! Today, our morning started out as usual and actually seemed to be pretty leisurely! We all found ourselves drinking coffee on the balcony and enjoying the sunrise. We have been able to eat most of our breakfasts outside which has been a treat. Our hike up the mountain was still a little slippery. There was mud leftover from the rain yesterday so we contributed to watch our step. It’s hard when there are so many cute kids to wave at on our walk! Everyone was motivated that it was our last time hiking up to clinic! Our statistic from today was 226 patients! Over five days, our total for the week is 1,133 patients!! The best part of the week was learning that we saw every single patient who arrived at the clinic - we didn’t have to turn anyone away! Another team will be coming to the clinic in two weeks which is so rare. Typically, we have to write our rendezvous for months later to follow up on our patients. It’s especially great for the patients with new, high-risk medications to be able to come back so soon. It’s also helpful for our pregnant patients who are nearing delivery and those with wounds that need more consistent care. Mike N. also performed two minor procedures today! He had lots of “scrub nurses” to help. He removed an infected growth off of a nipple and “saved a child’s life” (direct quote by Mike) by draining a large abscess from a one-year-old’s head - it was caused by a rat bite! All of the providers keep talking about what an incredible group this has been. Everyone has so much knowledge to share and really showed that this week. Here’s another fun fact courtesy of Josh: the thing we distributed the most at the clinic is multivitamins with iron. For the week, we gave out a total of 24,625 multivitamins with iron. 3 multivitamins lined up is as long as an inch. Our total vitamin length is 684 feet which is almost 7 football fields!! That’s incredible! Think about that when you take your daily multivitamin tomorrow! After dinner we played the garbage game, something we’ve all been looking forward to this week! We all wrote down 10 famous names and put them in a bowl. They could be anyone - including cartoons and people on TV shows. We then divided into 6 teams. Someone from each team would see how many names they could get their team members to guess in 30 seconds. It’s called the garbage game because you throw the slips of paper on the floor. With 350 names, it ended up being a very long game. The team with Nancy, Wendy, Sara, Sherman, and myself won!!! Everyone’s competitive sides came out and we had a blast. The most popular options were Florence Nightingale, (the first nurse!) Bob Marley, and Tinkerbell. Tomorrow we will make our way up the mountain to church! It’s not in English so it should be an interesting time to people watch and visit with some of the patients we met this week! Everyone in the village wears their best clothes and there is a LOT of singing. More stories tomorrow! Audrey and the Little By Little Team January 14, 2018 Bonswa from Haiti! Something I forgot to add from yesterday’s email: it was crazy scrub day! We all picked out fun scrubs and we got to pick out tops for the men. Kim did a great job finding perfect options for them! Once we went to clinic, we had a fashion show complete with a runway, flashlights, and music. The people waiting for clinic got a kick out of it and it was a fun way start to the day! We got to sleep in a little this morning before breakfast around 8. We were all energized for our last full day in Haiti. Surprise! Yesterday was not our last hike up the mountain! 23 of us packed our change of clothes and braved the mountain. We walked up with many villagers in their dresses and suits. It’s so fun to do this hike because you always end up walking next to someone new. I’ve had such incredible and intimate conversations with many people in this group and that’s been one of the most rewarding parts of this week. Those of us who have been on this trip before agree that this has been a very special group. At church this morning, Mike N. sang the national anthem of Israel in Hebrew. The title means “the city of our soul” in Creole and “the hope” in Hebrew. He told us the song reflects the 2,000-year-old hope of returning to the land of Israel and restoring it as their free nation. It is based on a poem published in Jerusalem in 1886. This song was sung by the Jewish people on their way to the gas chambers at Auschwitz. So how did this song get to Haiti? The Jews left Germany fleeing Hitler and the lucky ones went to Israel. No country wanted to take in the Jews. The United States did not, but Haiti did. The people of Haiti saved many lives after the Holocaust. This song of suffering, pain, and hope is now sung in Creole. It is sung by Haitians to be closer to God and find strength in hard times. It is also one of the few national anthems in a minor key (which means it has a very sad tone). We also learned that Israel was the first county to respond with supplies in Haiti after the earthquake in 2010. We had taken collection at the beginning of church. After lots of singing and some sermons in Creole, Willem went around and asked for a second collection from the Haitian people. We were all very confused because the basket had already been passed around. People of all ages came to give what little they could. Many more people contributed the second time and we were all amazed. He called Mike back on stage and presented him with the money, explaining that God says if you bless the people of Israel, then you will be double blessed. We were all in shock and brought to tears by their generosity. It was truly incredible to share this morning with our Haitian friends. We then opened the clinic for a few last-minute patients, including our surgical patients from yesterday. We were able to change their dressings and give them pain meds. They will both be seen again by the next team in two weeks! This afternoon we all met with the vendors who set up their shops in the front lawn. They sell jewelry, paintings, wooden items, and metal art. We showered, started packing, and ate a meal around 3:00 outside on the porch. The weather was beautiful and we all enjoyed talking about life at home. We exchanged phone numbers, Instagram handles, and book suggestions. What a week this has been! We are all anxious to get to the airport tomorrow! We will keep you updated on our journey home!! Audrey and the Little By Little Team

January 15, 2018 Hello from Illinois (and California, Florida, Minnesota, and Pennsylvania)!!! This morning, we all woke up and began packing our suitcases. Since our checked baggage is now empty (because all the supplies were brought up to clinic), many of us were able to put our carry on (plus some extra Haitian goodies) into the empty suitcase to be checked. It made the trip home so much easier to not have another back to keep track of! The morning was spent fueling up on coffee, stripping sheets off of the beds, weighing suitcases, and making sure we hadn’t left anything behind. After breakfast, we loaded up the back of the pickup truck with all the suitcases. A few people stood in the back of the truck with the suitcases while the rest of us road in a car with Willem or the van. It seems like every hour is rush hour in Port-Au-Prince. It was hot and busy, but it was fun to see the city in daylight. Our group talked about the cholera outbreak in Haiti after the earthquake and Sue and Leslie’s project about getting chlorohexidine to keep infant’s umbilical cords from getting infected. We all got to the airport safely and were able to check our all our bags with no problem! The Port-Au-Prince airport has two security checkpoints and then you get to the lounge! We drank Diet Cokes, margaritas, Prestige (a Haitian beer), and Haitian rum! We had so much fun together and meeting other people at the airport. Karen even saw her internist from Illinois at bar at the Port Au Prince airport! How crazy! Besides our bumpy landing, it was a smooth ride to Miami! Most of us were able to sit together on the plane which is always fun. Our layover was the perfect amount of time and we all enjoyed exploring the airport. Many of us took over tables at the Island Bar and Grill! We got to eat ribs, burgers, coconut shrimp, and fish tacos! We found cupcakes to eat at the gate and FaceTimed with Jane and Sherman’s grandson, Joseph! We had to spit off from some non-O’Hare passengers when we started boarding our plane. It was hard saying goodbye to these friends we’ve come to love over the past week. How have we only been Haiti for a week? It’s amazing to think about how many lives we were able to impact in such a short period of time. The hardest part about doing this work in Haiti is that it feels like we have only put a drop in the ginormous bucket. There is SO much need in Haiti and it’s easy to get overwhelmed by the amount of poverty we saw on a daily basis. It seems so cliché to think “if I changed one life at the clinic, then it was worth it” - but it’s really true. We all walked away remembering certain patients that really made an impact on us. Whether it is the long time hypertension patient who hugged you when she learned that her blood pressure was normal, or the mother who watched carefully as we showed her how to change her child’s wound dressing. If we were able to provide these patients with Tylenol for their pain, sunglasses for their sensitive eyes, or a cure for their worms, then we have impacted their lives more than we will ever know. I will miss reading these nightly emails out loud to my roommates in room #2 as we lay in our bunk beds under mosquito nets, trying to fall asleep to the sound of barking dogs. Thank you to Sue and Brian Walsh, our fearless leaders. They have perfected this trip and have anticipated so many potential disasters. We will be forever thankful to you for including us on this life-changing journey. Little by little, the resilient people of Haiti are rebuilding this country - and we got to witness it! Also - a special shout out to Josh Howie and his personal hotspot. Without his WiFi, these emails would not have been possible!! Thank you for following along with us this week! We are missing our new friends in Haiti but are very happy to be home! Audrey and the Little By Little Team

10/22/17 Little By Little, Granmouthe Haiti
Dearest Family and Friends....I was blessed and privileged to be a part of this team. Words come to mind like passionate in care, fun, energetic and committed and willing to do whatever is necessary to assist our Haitian brothers and sisters. This week most patients had to sleep on the floor of the waiting room or outside awaiting care... the team before us had canceled so we were "behind the 8 ball" as they say from the get go....3 deep they stood as we approached the clinic and squeezed hands and said Bonjour.... prayerfully we made a difference... they said we did. We diagnosed 3 new type 1 diabetics...UGH, provided hospice care and refilled many hypertensive and diabetic meds and creamed many a child for scabies...God knows their needs and we are there to provide some relief and education. So I am lucky to be the pediatric component of this team ....so many cute, beautiful breastfed babies!!!!!!! Thanks to friends who knit blankets and sew pillowcase dresses and cute jackets for my children in need....I'm on the good end of the stick!! That being said I needed a boy to return for wound care and did not return. Pray that he comes to the next clinic in 3 weeks (isn't that cool... just 3 weeks between care!!!)  The following clinic isn't until January!!!  Please keep your thoughts and prayers rolling for our patients and their needs to be fulfilled!!

Tomorrow we will begin our journey home to you after a long, hard, amazing week of humanitarianism, stewardship, and friendship. Here a few observations, thoughts, and/or stories from this week.This has been one of the most amazing weeks I have ever had. We keep saying to each other that we will never be able to describe the things that we have seen, done, and experienced; while I believe this to be true, I hope that someday you will be able to feel what I have felt this week. I have been blessed to take part in the hands of God, doing his work, in his name. We were able to help over 1,000 patients in 5 days! I am proud and blessed to have had each and every single person with me on this journey, everyone playing an integral part. I will never forget this trip, this feeling, or my new Little By Little Family. Thanks be to God! <3 courtney="" p="">
What an incredible week, everyone came together, both the newbees and oldins, as an amazing team with one goal, to provide our Haitian friends with loving but professional care. It was so good to see old friends including Hatian friends and a delight to have the students and meet new friends. Each trip here both amazes and humbles me. Everyone has something to offer and there is so much wisdom abounding. God blessed us with great weather too so we could trek up and down the mountain safely. As I get ready to leave to go home I will always keep Haiti and my special friends here close to my heart. Laura D

It never ceases to amaze me that when you provide service to another, God blesses you in return.  He has blessed this team with the endurance and strength to trek up and down the mountain every day, providing service to hundreds of the most gracious people.  Our hearts return to the states full of love and gratitude. – Emily

I did not know what exactly to expect when I received the invitation for the trip but I truly believe that God knew that I needed this country in my life. There are not many words to describe what this trip has meant to me as it goes beyond anything I could have ever imagined.  I am returning home tomorrow full of love and a new appreciation for the little things I have taken for granted.   I cannot wait to come back. This group was truly amazing and I am so blessed that I got to be a part of it! -Renae

This my last night in Gramothe, Haiti and I can honestly say it has been an eye-opening experience. An experience I was original scared of: could I handle the physical demands that would be made on me, could I handle the many different emotions I will feel, could I handle being away from my family for a week as I have never been gone this long. What I have learned is that I am strong and I am surer no than I ever was before that I want to be a nurse and help others. I have learned so much here but I have so much still to learn. I am grateful I have chosen a career that will provide me with the opportunity to learn daily. The people of Haiti are unlike any people I have ever met. They are without so much but their lives are filled with a faith and love of life that it shines through them ever day! I am beyond humbled by this experience and I cannot wait to come back as a nurse, not a student and continue to improve my skills. Much thank and love to Little by Little and Mountain Top Ministries for providing me with this opportunity. – Katie Diakow

My trip to Gramothe, Haiti has been an incredible and faithfilled experience.  I am glad that I accepted the invitation to join the group and serve the people at Mountain Tops Ministries.   I feel that instead of us serving them they serve us by their smile, humility, love, patience, faith and gratitude.   Fr. Pierre Polycarpe~

What a wonderful week it has been – my 7th trip with Little by Little, and always leave feeling humbled and grateful for all we have, and for connections with new and old friends here in Haiti, all with a “servant’s heart”.    God Bless all of the team, Willem, and all of the people of the village of Gramothe.    Kris McHarg

Another great Haiti trip.  Amazing Haitians.  The young people on this trip also make me optimistic about the future of American medicine.  Everybody was great.  God bless all. Pat Murphy
This week has been a great experience. I am thankful for the opportunity to serve this wonderful Haitian community and for the privilege of working side by side with such kind hearted, genuine, service driven individuals. I will now return home with a greater appreciation of the Haitian culture, a warm heart knowing we helped many, and with a determination to get back here in the future to lend a hand. Thank you to Willem and the entire team for providing a wonderful and humbling service experience. It has been an honor to be here. -Justin Wiltse

Gannon asked me yesterday if I’d ever been to a third world country, and after thinking about it for a while, I realized that I hadn’t ever been immersed in one the way that we were this week.  I have learned so much from Haiti, its resilient people, and their way of life; but equally important to my experience has been the LBL team itself.  You all are truly an inspirational group, and it has been great to witness the passing of knowledge from exceptional current providers to the next generation of nursing and medicine.  Thank you to Willem and MTM for your support and guidance.  Without you, none of this would even be possible.  All of your constant displays of empathy and compassion will be a guiding light for the rest of my life, and I can’t wait to see where life takes all of you.  It has been a pleasure working with this crew, and hopefully I’ll see you all here in the (probably distant) future!-Matt McHarg

It is hard to put this incredible experience into words.  This is truly the opportunity of a lifetime! It has been a life-changing experience to have the privilege of providing care to the needy in a third world country.  The Haitian people are so kind and patient.  I feel that we have a lot to learn from them.   I am proud to say that we provided care for over 1000 patients this week!  However, there is much more work to do.  With an open heart and an open mind we can move mountains (and climb them!) Little By Little J  Thank you MTM for the best experience of my life!  I will never forget this amazing week! -Connie Kotecki

Thanks to the best Man Cave Crew EVER!!!!   Father Pierre, Gannon, Justin, Matt, and my old friend Murph made my life enjoyable!  Best of luck to all of you! -Lou Marohn

Grateful for the amazing week-the amazing team-for this country filled with people who are resilient-faith filled, and peaceful!  It is difficult to see how diabetes and hypertension have afflicted this population, and I am so happy we can provide needed care, but do wish we could do more!  However, so  Very Grateful to all that make what we can do a possibility!!!  Thank You for saying YES -to providing us the means to carry on this mission!! -Mary Maginot

Thank you!  This has been an amazing experience to serve others, especially those in great need.  We are called to love and serve the poor and vulnerable, and this has been a week of opportunity to do provide those services. Thank you, also, to everyone for providing this wonderful experience for our Rockford University Nursing students.  This will enrich their future practice for years to come.  I look forward to bringing other students in the future.  God bless you all,  Laura Monahan

Another wonderful week!  I feel privileged to have been allowed to participate with LBL.  It is always amazing to me how a group of strangers can come together with a common goal, and quickly form a cohesive team.  Thank you to Oct ’17 team.  Namaste, Anne Foster

So we are on our way home to you.  As team leader I thank our families and friends for your support as we ministered and attempted to heal our Haitian friends. We were able to care for 1036 patients and work toward sustainable care for our patients. MTM , Willem Charles, gave us excellent shelter and food to fuel our work. Our medical manager, Johanne, guided us through our patient load and kept us organized. This team was full of passion and spirit and smiles and hugs. I will miss them and look forward to working again with each of them. Again, thanks for sharing them with us this week.
Blessings on your day, Vanda Marsh Team Leader for this outstanding October LBL team!

 I have so much to say but I am going to do my best to exercise some brevity. First, I want to thank all of you so much for being so welcoming to our group of nursing students. I can only speak for myself but I think I can safely assume that we all feel so fortunate to be pulled into the fold with all you veterans. I am almost at a loss for words for the experience I had in Haiti. Traveling abroad is such an enriching experience and it is one of the few things that helps me realize how small I am in this world. This trip helped me re-center and realign my focus on the direction that I would like to take my career and more importantly the direction I want to take my life. This week was an affirmation that love has, more than any medicine, a healing power and I felt it from all of you. Thank you again for the opportunity to join you on your quest to spread love to even the darkest corners of this world. I will cherish my experiences with you all for the rest of my life and I hope to one day trudge up heart attack hill again to be greeted by the many waiting eyes of those in need. With love and appreciation, Gannon

On Mon, Jan 2, 2017 at 6:15 PM,

Bonswa from Haiti!

Our team landed safely in Port Au Prince this afternoon and had a very smooth exit from the airport. Everything was very well organized and all of our bags made it with us! The ride out of the capital was invigorating and we had to opportunity to see the sun set over the mountains of Haiti. We arrived at Mountain Top Ministries and were greeted with a fantastic meal. Everyone is just now getting settled in for the evening and preparing for our first day of clinic tomorrow. As the internet can be a bit unpredictable here, we'll try to send out an email update at the end of every day, but don't worry if you don't hear from us right away. Also, as mentioned, these emails are sent to one designated person for each volunteer as it takes quite a bit of time for the emails to go through (Just getting online now took about 15 minutes....ah, 90's dial-up nostalgia). Please forward these emails to any other family members or loved ones who also want to keep up with our adventures in Haiti (you were chosen as the responsible family member, who would be up for the task, you got this). For now, I think we're all looking forward to a restful night's sleep after today's travels, and likely already looking forward to our first Hatian bucket showers...

Until tomorrow,

The Little By Little Team (written by Tracey Lynn)

On Tue, Jan 3, 2017 at 5:36 PM,

Bonswa!

Our team successfully finished our first day of clinic! We saw quite a bit of patients (the tallies are still being totaled) and encountered a variety of interesting cases. Lots of us braved the walk to and from clinic, and encountered many friendly locals, who we were able to "Bonjou" and "Bonswa" along the way (we also encountered some goats, chickens, and a cow). We have just finished dinner, and many of us are experiencing our first Haitian bucket showers, which means that many of us are likely looking forward to our first shower upon arriving home. Everyone is settling into their roles in the clinic so well, and adapted to how the clinic is run very quickly. We'll spend this evening prepping for clinic tomorrow, reviewing interesting cases that we saw at clinic, and unwinding from the busy day. Hopefully the roosters will wait to start crowing until the morning.

Until tomorrow,

The Little By Little Team (written by Tracey Lynn)

On Wednesday, Jan 4, 2017 at 6:02 PM,

Bonswa Friends and Family!

Today was a very busy second day of clinic! We tallied up yesterday's patients and found that we saw 237 patients, and while we're still counting, we know that we saw over 230 patients today! That's almost 500 Haitian patients that we have impacted in just the last two days, and we still have three more clinic days to go! Another huge moment today was that Willem got a generator, and with the help of Brian Walsh and Alex Ogdon, we now have electricity in the clinic, and the providers are able to see their patients under the lights! It makes such a huge impact, especially for those who are not near windows and have been utilizing flashlights for exams and procedures. There's also a light in the pharmacy, which means that by the end of the day, the team in the pharmacy doesn't have to squint in the light to count pills. It's amazing the things you take for granted back home that become such a huge hurdle to obtain out here. Everyone here is doing so well. Many of us felt that the walk up the mountain to clinic was a little less taxing today, and hopefully will continue to get better every day. Quite a few of us have also continued to brave a "goat path" on our route home. It's always interesting to see us struggle a bit walking up, while Haitian women walk up and down the goat path with large buckets on their heads like they were simply walking down the street. We're also an amusing spectacle for the local children, who like to watch us from their windows and proudly say "hello" or "bonswa" as we pass by. We all just finished a fantastic dinner and will be sitting down shortly to go over the events of the day and plan for tomorrow.

Good night!

The Little By Little Team (written by Tracey Lynn)

On Thursday, Jan 5, 2017 at 6:22 PM,

Bonswa!

Phew! Another busy day in clinic today! We have now seen over 700 hundred patients in our time here in Haiti. We encountered many patients today with complex and unique issues and this team works amazingly together! There are so many levels of expertise among everyone here that we all seem to work like a well-oiled machine. For those who are on their first adventure in Haiti, they have learned their roles so quickly an are adapting so well to the way things work in the clinic. Our team members consist of providers, scribes, a very busy occupational therapist, a pharmacist (a two "on the fly" learning pharmacy techs), a nurse educator, a wound care team, a supply team and runners, scribes, and our two electricians (Brian and Al brought light to the church today). When the lights were reset today and we briefly went without overhead lights, I think all the providers were reminded how impactful having lights can be. We also met a few children from Gramothe today, who tried to learn all our names on the walk up to clinic, and were calling some of us by name on the way down (they mostly just remembered the name of the 6'5" man since he stands out in the crowd...). All of the locals are so friendly and great us with smiles every day. Those we wait hours (and in many cases, days) to see us in the clinic, are just happy to get even five minutes of our time and have their concerns heard. I'm sure I can speak for all of us when I say this week has been very rewarding, and we still have two more clinic days left. Everyone is still safe, happy, and well.

Orewva,

The Little by Little Team (written by Tracey Lynn)

On Friday, Jan 6, 2017 at 6:45 PM,

A Big Haitian Bonswa to you all!

This team is cranking! At the beginning of every clinic day the team gathers with all of the interpreters as a group and we sing a song and say a prayer, led by one of our amazing interpreters (also a dear friend aka Mouse for those of you who have been here before). Sue mentioned that we should get cranking today, and our dear friend finished the devotional by telling us, "Let's get cranky!" It was an amusing way to start the day. The interpreters have been so amazing this week. They help us to understand the culture here and connect us to our patients in a way we would never be able to do without them. They are kind, patient, and incredibly smart. They have been such a joy to work with this week. Today we saw over 300 patients in the clinic. That means that in 4 days, our team has helped over 1000 Haitians, touching (and in many cases, saving) so many lives means the world to this team. Brian, Al, and Tim have also been hard at work prepping the trade school that is in the process of being built. There is a school near the clinic that educates children through high school, but many don't have plans after school. This will allow for further education for so many Haitians, creating skills and jobs. Tim, our architect, has been able to use his expertise to help create the plans for the trade school. Ultimately, education is what will have the greatest impact on the future of Haiti. It's pretty amazing to be witness to the opportunities being created. Everyone has just finished dinner and is gathering for discussions about the day (and sharing of snacks and treats).

Last day of clinic tomorrow!

The Little by Little Team (written by Tracey Lynn)

On Saturday, Jan 2, 2017 at 6:15 PM,

Good Evening From a Very Productive Team,

We have officially completed our last day of clinic. During this week we have seen over 1,200 patients. Many of these patients had critical wounds and were seen earlier in the week. Their wounds were cleaned and they were given medication and brought back today to see how they are healing. Our wound team, Nancy and MaryAnne were incredibly busy today, caring for people with often limb and life-threatening wounds. Seeing over 1,200 patients also means that our pharmacy team, led by Lea and Julie, filled over 1,200 prescriptions this week! That wouldn't have been without the help of the stock room team, who were counting out pills as fast as they were being prescribed. There has been so much healing happening this week, and it's thanks to every single person on this team. This clinic is now quiet, the pharmacy is stocked, and it will wait for the next team of medical volunteers to open it's doors again. Tomorrow our group will join the local members of Gramothe at Sunday church and have a chance to see the school and trade school. In the meantime, we will continue to enjoy a relaxing evening of games and conversation. Tomorrow is our last day in Haiti!

Goodnight, The Little by Little Team (written by Tracey Lynn) 

    

On Sunday, Jan 8, 2017 at 5:57 PM,

Bonswaaaaa!

Today is our last day in Haiti! We joined the locals of Gramothe today for Sunday church, and it was such a great and energetic experience. Afterward, we were led through the mountain town and received a little tour, of the neighborhood up close. This allowed many of us to get a glimmer of what our patients experience on a daily basis (Tiny stone homes with 1-2 rooms, outdoor bathrooms and kitchens, and if you're lucky-a cistern). We also met the village midwife today, who has delivered more children than he can count, and walked us through his steps to delivering a baby on the mountain (or a cow). The Charles family, Willem, Beth, and David (Stephan is in the states this week) has made sure that we were safe and well fed throughout the week, and have been such gracious hosts. We have had a lot to celebrate this week, including the amount of people's lives we were able to impact, AND two birthdays! This afternoon has been about relaxing and enjoying each other's company before we all depart for home tomorrow. Beth is currently gearing us up to play the annual game, Garbage, and eat some birthday cupcakes. This week seems to have gone by so quickly, and there are many things we will all miss about Haiti and our experiences here, but I'm sure everyone is also eagerly looking forward to a real shower, and more importantly, talking to you all. Thank you all so much for lending your loved ones to this wonderful cause. I'm sure you'll be receiving calls and texts from them once we hit U.S. soil. Everyone sends their love!

Orevwa, The Little by Little Team (written by Tracey Lynn)

October 2016 (3 weeks after the hurricane)

Hi Friends,

What an amazing week so far. We have been able to enjoy great team work at the clinic, wonderful Haitian hospitality, beautiful weather, extra bumpy rides up and down the mountain, and even the Cub game (Thanks Laura). The "W" flag is flying.
Lea

Hiking up the mountain this am, we watched a beautiful young mother with her 1yr old baby, heading to the clinic on the back of a motorcycle.   The cycle died and she started walking across the river bed with us.   When  we got to the river she handed her baby across to us, but then with baby in arms she grabbed me when my footing slipped on the road up the mountain.   We finally all made it to the top and at 3:30 this afternoon they brought the baby to me for a visit.  They had been waiting outside for 7 hours and mom was still lovely and grateful.    The baby was treated for a bad case of scabies and they headed back down the mountain.....just another reminder of how easy life can be at home where we drive to a clinic for an appointment at a certain time and hope there isn't more than a 15 minute wait.    Patience is truly a virtue here.
Kris

This Chicago LBL team is hot with World Series fever! As the ONLY one on this team representing the Cleveland Indians amongst the bunch I am reassured by (Cleveland fans) Facebook posts that I'm not outnumbered. If only this could be a 7 game series so we could watch the last game on TV! Our team is working like a well-oiled machine and I truly appreciate the comradely amongst everyone.
Lisa

Only three of us in the storeroom this trip so a lot of pill counting and stocking of supplies for each of us. Shelley says she has counted "thousands of pills" and we've only been working since Tuesday!  All suitcases have been opened and materials put onto shelves--hopefully in right spots so we all can find them easily.  Joanne discovered the worlds largest cockroach this afternoon as she was folding some clothes.  We will start inventory tomorrow to make sure  LBL does not buy wrong supplies for next trip.  We all hope all of you at home know that we love and miss you as we continue doing what we feel is such important work for those receiving our care.
Lou

Well, today was "hump day", and I was happy when I woke up, anticipating another day, and even happier and more fulfilled when the day was over.  Every moment spent here gives you pause to reflect on so many things in our lives that we take for granted.  Working in the pharmacy, I am able to look up from time to time and watch the crowd of people outside the window , who are patiently waiting to be seen or pick up their medications.  Today there was a perfect example of patience demonstrated by one of our patients:   An elderly woman was seen sometime during the morning and brought her prescription to the window to be filled.  Four hours later, after watching people come and go, she finally said something to Willem about her medication.  Her script had blown out of the box and had just been found on the floor .  We all felt terrible, and apologized profusely to her.  She took it all in with a nod and a beautiful gracious smile!!! ( well, we also rewarded her with 1/2 of a homemade PB & J sandwich).
Debbie

This is my first mission trip and it has been amazing. I am awed by the care and compassion that the medical staff provides to the beautiful people of this country. I'm looking forward to the last 2 days of clinic.
Shelley

This too is my first medical mission; first time out of the country actually. Truthfully I did not know what to expect. Watching CNN and following the weather channel while hurricane Matthew came through, I was both nervous and excited to get here. I was completely speechless on our truck ride to the guest house. Never have I been so humbled and thankful. Clinic has been utterly amazing. The patience of the Haitian people is mind blowing. The climb up the mountain everyday is unlike anything I have EVER experienced but the Haitian people who make the trek day in and day out keep me going and striving for better. I am blessed to be here and very thankful for all my new friends!
Christina

This is my first trip to Haiti with this amazing team. I have volunteered with other organizations but never participated in an American based medical mission. I have to say the services provided here are truly amazing. The organization, time management, care and compassion observed show why this clinic has been operating as long as it has, as well as it has. The people of Haiti are one of a kind. They are beautiful inside and out. Despite whatever brings them into the clinic and no matter how long they have been waiting, they great you with a smile and leave with a sincere thank you. No one asks for more than they given, no handouts, no extras. Such a beautiful change from home where the sense of entitlement seems overpowering at times. The walk to and from clinic, delicious meals and new friends are all added bonuses to this experience. I am already looking forward to a return trip.
Meghan

     Our first day of clinic was busy as usual.  We worked hard to make sure every station was properly stock in order to start seeing patients as quickly as possible .   Once everything was up and running the process of unpacking the bags began. we sis not end until we left clinic at 4 pm. At the end of the day I always enjoy the walk home  to unwind with the staff.  .  I knew the roads were in bad shape and that we had a challenge ahead of us.   The walk down the hill was long and slow but gratefully not slick.  As we approached the riverbed I could hear the movement of streams of water on the rocks.  There were Haitians bathing and enjoying the moment.   We were quickly confronted with the idea that some how we had to get over a wide stream of water not wanting to get wet.  We attempted various areas but realized that it was inevitable the our wishes were not going to be granted.   Quickly I was reminded of how kind the Haitian people can be and how  gracious Gods timing can be in a time of struggle.  A group of young Haitian men saw us struggling.   One young man dropped what he was carrying and offered to help . Without even hesitating he threw a larger rock in the stream for us to step on and offered his hand in a loving way to help us cross without being harmed or slipping.  We were thrilled!  We thanked him and went on our merry way, thanking the dear lord for brining us home safely to the top of the other side of the mountain.
Joanne

I Have an interpreter that is brand new to this job. It has been a great learning experience and challenging for both of us but today we really synched. We have been so busy and well many of you know what happens when your a Family Practitioner in Haiti.....the visit is never really over until you hear "Infection Vaginal". So today when I thought just maybe, Ronaldine said wait she has an infection vaginal, I said "Your Killing Me Smalls" she wanted to know what that meant so I explained it. We both started laughing and now it's her favorite, she even made me write it down for her. It's what I love about Haiti even the littlest things are new and fun.
Laura

 This is my first mission trip.  Leaving Virginia, I was very nervous and worried about what challenges the week would bring.  When I landed in Ft.Lauderdale airport,  I was greeted by the team with hugs and a home made lunch. I called my family and said there was nothing to worry about.  This group has been so wonderful.  We begin our day in a prayer circle, then eat a beautiful breakfast overlooking the magnificent mountains of Haiti . We hike to the clinic chatting ,laughing and physically pulling each other up the mountain.  When we arrive at clinic we are all ready to work as a team and use our skills and passion to provide healthcare.   I am so blessed to be part of this team. Jen

I am so grateful to be here serving these amazing people!  I also was slipping down the slope and not knowing who was behind me felt a hand upon my back-stopping the slide propelling me forward- when balance was regained I turned to see a beautiful young mom and her baby who had prevented my decent.  I praise And thank God for all of you praying and supporting us as we try our best to stop all of these beautiful people from slipping down a slippery slope!  A simple smile, hug, vitamins and worm treatment may be all they need to  let them know we all care.  We are headed to day 4 of clinic now and pray to see the 200 people who were turned away yesterday-and pray we can get to those that travel to the clinic today.  Thank you for your continued prayers for this amazing team I am blessed to be a part of!
Mary

This is my first trip to Haiti but one of many mission trips. It has been an experience that will always be so SPECIAL to me.
Paula

I feel beyond blessed to be serving with this amazing team. Our hours of care feel busy but fulfilling as we enjoy the many smiles and hugs of our patients. For all of your love and support we say a huge and heartfelt thank you. Please continue your prayers. We have one more day of clinic and will likely see another 200 folks as we saw all those who had waited to see us yesterday and could not be seen. The days are shorter in October and the light is lost by 4-4:30p.  I have converted my translator to "CUBISM" This email has taken 24 hrs to finish. I will close it now. Blessings and hugs to each of you. 

Vanda

August 2016

August 2016 (Notes written as emails by Lynette Kerrane-Darragh)

Day 1: Hello to all - We have all safely arrived as a group to Haiti.  We had a smooth transition from the airport to MTM.  We had a warm welcome and a yummy meal followed by meetings that help us prepare for our new day tomorrow at the clinic. We have extremely limited internet connection. Please do not expect personal replies.  We will be sending a daily group email as internet connections allow. Looking forward to the new day.
Best - Little By Little August 2016 Team

Day 2: Good Evening! We completed our first day in our clinic and were able to take care of 124 patients.  The patients waited patiently outside in a line for their turns to be seen.  Everyone part of the team worked diligently to be sure that we were able to help as many people as possible.  Our stock room was refilled and it has been noted how nice it has been to have the extra help in the pharmacy this year.  The providers have been teaching as they help the patients and the students have been learning through these amazing experiences. The translators have been incredibly helpful so that we can communicate to the patients what needs to be done to address their individual needs. As the clinic closed today, we all made our way home rather it be walking on the road, driving in the atv or truck, or hiking down along the goat trail.  We all safely arrived back and missed the rain that was waiting to fall. Some of us enjoyed a few rain drops on the back porch that faces the mountain and enjoyed the beauty of the clouds that hung low in the background. We all said our nightly prayer together at dinner and enjoyed a wonderfully prepared dinner.  Dinner was followed by meetings both as a group and then in individual groups with the providers. Looking forward to a new day tomorrow in the hopes of seeing even more patients as we will have an earlier start now that the clinic has been stocked and we have the first day of clinic under our belts. As a reminder, communication is limited due to the wifi capabilities but we will do our best to continue to send daily emails.

Best - Little by Little August 2016 Team 

Day 3: Good Evening! Another new day in Haiti!!!  We gathered early this morning for a yummy breakfast of porridge, fresh bananas, and watermelon.  As usual, we had a business breakfast and we were all off and running to start Day 2 of clinic.  Positions were rotated throughout the group so that everyone could understand how the clinic is run more efficiently and to provide the students different learning opportunities from both the patients and the providers.  Today, we were able to see between 150 and 200 patients.  Our ability to tally numbers were compromised by a thunderstorm that rolled in quickly near closing time and we all had to hurry out of the clinic to be able to arrive home safely. Some team members made their way down and up the goat trail during the storm and felt the beauty of the rain fall. We gathered for dinner shortly after our return and followed up with our meetings as usual.  The room was filled with compliments and enthusiasm about the team member’s contributions to the clinic today.  The students reiterated how many learning experiences they were being gifted with by experiencing patient care first hand with their providers teaching along the way. 

Another successful day in Haiti - Little by Little August 2016 Team

Day 4: Good Evening - We began our day by waking up to the sounds of roosters. Freshly brewed coffee awaited us...a shared love by many.  We had our business breakfast meeting as usual and then off we went to Day 3 of clinic.  A long line of patients waited patiently to be seen lined up along the road.  Some of these patients travel quite a long ways and yet remain patient and appreciative of their ability to have a turn to be seen in the clinic.  It truly is remarkable how resilient these patients are.  Once again, members of the team switched around duties in the clinic which provides everyone an opportunity to both understand how different parts of the clinic work as well as have the opportunity to interact with different team members in different capacities. It turned out to be a beautiful and cool afternoon to return home both on foot or by vehicle.  Some members hiked back via the goat trail which is a little steeper but a shorter distance, while others took the hike back along the road that the vehicle travels along. As some of us returned to home, there was a pause to listen the sounds of singing children in the church.   Dinner was served shortly after and our nightly meeting was held. Patient stories were shared by both the providers as well as the students. We are proud to report that we were able to see and treat over 200 patients today. Everyone worked as quickly as they could, all the while trying to provide the best possible patient care.  Knowing how this team is needed by all of the people that travel so far for help, feeds the positive energy that runs through the clinic. The compassion expressed by all team members and the level of commitment to patient care was exemplary and it was acknowledged repeatedly by different team members during the team meeting. Truly a special team to be part of and another successful day in Haiti. Best - Little by Little August Haiti 2016 team

Day 5: Good Evening - We just finished up our general meeting where we recapped the events of the day.  We are happy to report that we saw 228 patients today.  The quote of the evening has been...."We were crankin'!"

We began our day with porridge along with fresh bananas and apricots.  It felt a bit warmer than the previous days on our walk to the clinic this a.m.  As usual, we were greeted by a long line of patients who patiently were waiting for our help.  As a team, along with our translators, we said a group prayer as usual and opened the clinic for the day. Once again, team members moved around in different spots.  Everyone moved as quickly as possible throughout the day.  We broke for lunch which consisted of rice and beans and returned back to the clinic quicker than usual as rain had begun to fall. The afternoons always fly by extra fast and we found ourselves once again working past 4pm to help as many patients as we possibly could.  On the way home, it began to lightly rain, but stopped shorty after it began.  The chitter-chatter amongst the members filled the walk home as members exchanged stories of their day. The smiles on the faces and the appreciation expressed in their body language were a testament to the dedication of these members to their patients. Upon our return, we were served an "American meal" that consisted of sloppy joes with other sides.  We had the chance to purchase coffee tonight as this region is known for their great tasting coffee beans. The members of this team continue to appreciate these experiences and are continuing to bond with one another.  It truly is an amazing experience to be part of this group. Little by Little August 2016 Team

Day 6: Good Evening - Hard to believe this was our last day of clinic. We began the day as usual with our business breakfast and our commute to the clinic by foot or vehicle.  The sun shined brightly.  Focus remained on providing the best possible patient care while meeting as many patients needs as possible. Everyone continued to work collectively.  At lunch time, the group gathered and shouted out our "We are crankin!" motivational theme.  Many laughs were shared and we all returned to the clinic to finish out our afternoon assisting the needs of the patients.  You could see the joy in the team members as they saw progress from their efforts in the returning patients.  Tremendous empathy was also shared as the challenges that many of the patients face are brought to life. At the end of the day, we shared a prayer and a delicious dinner. Members sat around after dinner and exchanged stories of the day.  The beauty of these stories is that they both reinforce the learning and teaching experiences which provide for growth. Tomorrow we will all gather for a mass spoken in mostly Creole.  The rest of the day’s activities have yet to be decided. We are happy to report that we were able as a group to treat every patient that made his or her way to the clinic. In total we were able to treat 948 patients. This is truly a blessing. Little By Little August 2016 team

January 2016 ~ Ten Years of Service

Dear friends,

Maybe you’ve started your day, week or month by remembering a special anniversary such as a birthday, wedding day, graduation, loss of a precious friend or family member. All are unique markers of time, accomplishment and love. The beginning of 2016 represented the 10^th anniversary of our first medical mission trip and our 30^th Little by Little team to serve in Gramothe, Haiti together with Mountain Top Ministries (MTM). In 2006, the departure of our first team to Haiti, consisting of 12 volunteers, was postponed several times from the beginning of January until mid-February because of political instability surrounding the presidential elections. During 2015, Little by Little brought together more than 140 medical professionals and various essential volunteers enabling 5 dynamic medical teams to serve with each other in Gramothe, Haiti.

January 12, 2016 was also the 6^th anniversary of the devastating earthquake our team experienced together in Haiti. Renewal and rebuilding have brought new life and expectancy back into Haiti. Vibrant paint splashes the finished buildings. Memorial parks have been carefully designed and created as tents and their shadows were replaced with tropical color and hope. Even though no one is yet used to the new traffic signals on the new roads, evidenced by drivers who continue to honk their way through the newly erected stop lights, I definitely sense Haiti’s rebirth.

Life in Haiti also seems to be falling back into routine. Of course people will always remember the tragic time of the earthquake, however, traumatic memories seem to be fading, just as the fresh pink, yellow and turquoise paint is becoming dusty and blotched with political graffiti. Garbage is starting to accumulate where rubble used to haunt the walkways. It is again an election cycle and the president who has been in office since before the earthquake has served his extended term.  

Returning to Haiti at the beginning of this year made me examine the way I am responding to the normalcy of my life here at home. I don’t want dust, garbage and political uncertainty to dim or damper my shine, empathy and respect for those around me.  Instead I want to remember, observe and strive to stay bright in my daily walk. We continue to serve in Haiti where our volunteers and resources will be of the most benefit. We maintain our core values of partnership, reciprocity, sustainability, transparency and universal healthcare for all. Thank you for joining us in 10 years of service together!  J sue

January 2015 ~ 5th anniversary of the devastating earthquake

We just returned from our January team’s medical mission to Haiti, where we provided much needed care to more than 1200 at the clinic at Mountain Top Ministries. January 12, 2015, was the fifth anniversary of the devastating earthquake in Haiti—so I would like to take this opportunity to share a few poignant facts. The earthquake was the first to strike this island nation in over 200 years. Haiti is approximately the size of Maryland with a population of about 10 million people. As the poorest country in the Western Hemisphere, Haiti had been considered a failed state for many years prior to the earthquake due to its lack of infrastructure, a stable government, or a viable economy. In addition to the destruction of personal homes, the international airport, seaport, roads, hospitals, schools and universities, municipalities, a prison, and the presidential palace all collapsed during the earthquake. It took more than 2 years for only half of the rubble from the earthquake to be removed. According to Haitian government officials the earthquake disaster killed more than 250,000 people and displaced 1.5 million, who lived in tent cities without clean water, sanitation, food sources, or jobs and were ravaged by crime. According to the International Organization for Migration an estimated 103,565 people still currently live in 172 temporary settlement camps scattered throughout Port-au-Prince today. After an absence of more than 200 years, the cholera outbreak that began at the end of summer in 2010 has killed almost 9,000 and sickened over 700,000 people (UN statistics). The disease surfaced in Haiti months after the powerful earthquake, spreading rapidly during the rainy season due to the lack of adequate sanitation and clean water sources. Now most cholera treatment centers have dissipated, an immunization campaign has started and I did not hear of any recent cases.

As we traveled from the newly rebuilt airport to the guest house and clinic we see new roads with drainage curbs, street and stop lights, new buildings including homes, churches, businesses and hotels, gas stations, truck yards, street vendors, beautiful Haitian art, refurbished parks and many people going from here to there. What we don’t see is rubble or garbage. What we still see are the remaining “temporary” camps, people in need of health care and jobs, the valiant struggle of the Haitian people, somber reflection but a resilient countenance on most, and a lump in my throat with hope in my heart.

Sue Walsh