This will be my final blog before I hit home. The last few days have been hectic with people wanting to say goodbye and the sudden realization that our time was at an end. On Sunday after church we spent the day at the Hotel Roi Christophe. We had breakfast there, watched the soccer on the large TV, went for a swim and generally lazed around. In the afternoon we stayed on to attend a party of an engaged couple Frantz and Cassandra who (as Robyn had been secretly told) were going to announce that they had been married recently. It started as an odd celebration. Everyone gathered in silence and waited over an hour for the couple to arrive. They slipped in unannounced – no music or anything. The sound system was not working initially, so there were more delays. Eventually they provided entertainment – a terrible rendition of Pachelbell's Canon on an electric violin with keyboard and guitar. The highlight however was when the groom’s all male choir got up to sing – fabulous harmonies with the groom as the lead singer. After much drawing out of the explanations for the celebration, the groom finally announced that he and his fiannce were married much to the shock and delight of their friends. The cake was cut and a huge meal was served but it had taken some time to get the party going.

The last 2 days at work were not very busy for me. Steve decided to return to duties on Monday although he still was not completely back to normal. By Tuesday, he was feeling distinctly unwell again. Blood tests had confirmed that his illness was Dengue fever and it would take a good month to get over. On Tuesday, he was presented with a number of gifts from the anaesthetic people, much to his embarrassment. I had a similar presentation at the end of my

final lecture on the retroperitoneum on Tuesday morning. The residents gave me a painting and a leather face mask. In the afternoon, one of the consultant surgeons, Dr Damas wanted to show Jean-Claude and me the ruins of the historic French fort Picolet. He took us in his car and we walked along the beach to the old fort built by the French in the late 1700s. There were many rusting old cannons lying around but the basic 2 tiered fortress was reasonably well preserved. It was part of a string of forts along this coast where Christopher Columbus first landed.

In the evening there were plans for people to visit to offer farewells. The surgical residents at the hospital had asked for a final meeting at a local hotel to review my visit and ask advice. It was heartening to see their gratitude for the little I had done and to hear of their concerns for the future. Frankly, I am overwhelmed by the magnitude of the problems they face. They are so keen to see changes made but where to start? What could I say? They desparately need some administrative structures in place in theatre to help them use the resources that they cannot get access to. They need simple things like sutures, dressings, instruments but the OR supplies are shut out to them through corruption and basically because no one really knows what they

do have. So they wander round with a small plastic bag of a few basic sutures and dressings they have begged and a foley catheter so they can do a catheterisation if needed. Patients have to buy their own IVs and bags of IV fluids. If they miss a drip, the patient has to send the relatives out to buy another IV cannula. These are the people who need the supplies but it is literally drip fed to them. I gave them all the sutures so kindly donated by Mercy Hospital Dunedin and they were so grateful. By sharing them around the residents, they will last a few weeks. They need books, or electronic media and opportunities to see other hospital systems but how can you afford that on $200 a month? I feel for these surgical residents who struggle against all odds to prop up a health service that is inadequate for the massive needs of the place.

The big question I have been asked by everyone as I leave is “When are you coming back?”. I feel that without the French language, I have made a limited impact, unlike Jean Claude who is already being highly respected and appreciated. Nevertheless, they have indicated that I have been helpful with the kind of teaching I have given. I have avoided the high tech discussions

that many American visitors have given as they do not have laparoscopes, CTs or any of the high tech gear, instead trying to pitch it at what they can do and that seems to have been appreciated. Will I be back? Not in June again if I can help it. They say December is cooler. But who knows what calling God has for any of us. If called to come back, I may have to. But in the meantime, I will look at various resources we can make available to these guys. My biggest encouragement in this land of voodoo infamy was to see a thriving Christian community, openly welcoming to strangers like me and very supportive of anything we can do to help their plight. To see such large congregations being fed from the Word of God so well was a great delight and my most enduring memory. Their physical health system my be overwhelming and in disarray but beneath that obvious surface, it was pleasing to see them spiritually more healthy than most

New Zealand communities. It reinforces what Paul said in 2 Cor.4:17 - “So we fix our eyes, not on what is seen, but on what is unseen. For what is seen is temporary but what is unseen is eternal.” And I think the Haitians have got it right, more so than most New Zealanders.

So home it is, and I cannot wait to enjoy cooler, even cold weather, a proper shower with plenty of hot water and the family around, especially Catherine. I ran out of video tape just as I crossed the border to Dominican Republic so there are 6 hours of tape to edit. That will keep me busy for a while.