Ezekiel

Ezekiel

Ezekiel at the hosp

FAILURE IS AN OPTION

Anyone who goes to Haiti, or any 3rd world country, and says “Failure in not an option” is in for a rude surprise. And no one makes broad sweeping changes in the socio-economic landscape. Change takes time;

one child at a time, one family, one community. Tangible things are needed, food, education, housing, medical care, employment, but the only way forward is to change the mindset of a people who have been mostly illiterate and destitute for as long as they can remember.

EZEKIEL

Ezekiel’s mother died shortly after he was born. As a child, he was tormented by his father and suffered absolutely inhumane abuse too hideous to even relate. As the age of 7, he ran away to the streets. 

For 3 years, Morgan saw Ezekiel begging outside the local market. He was dirty and hungry, often sick, often violent but also very sweet. He told her he wanted to get off the streets, where he slept under a truck, and tried to stay alive any way he could, fists at the ready. He told Morgan he wanted to go to school. He wanted to be able to write his own name.

Morgan’s first impulse was to bring him to the LFBS Safe House, but she quickly learned that Ezekiel’s trauma was so great, he could not control himself, he stole from the other boys and attacked them physically.

It was clear that Ezekiel needed professional help, but psychiatric hospitals in Haiti are the stuff of nightmares and horror movies.

 

Frustration and Suffering in Haiti’s Mental Facilities

http://time.com/3802476/frustration-and-suffering-in-haitis-mental-facilities/

Phase I:   HOPE

Maranatha Mental Health Hospital, Guilleme, Haiti

Morgan located a psychiatric hospital near the Safe House, and with the support of The Timoun Foundation, she was able to get Ezekiel admitted for 3 months, at the staggering cost of $10,000.

However, Maranatha Hospital and Dr. Felix seemed to be Ezekiel’s only hope.

IN MORGAN’S OWN WORDS:

The morning of Thursday, November 7th, 2014, Ezekiel came to the Safe House bright and early. He knew it was the day we’d take him to the hospital. The day before, he’d wandered over to the Safe House – asking for food and a trip to the hospital. He’d had a fever, was completely covered in dirt, and said he’d been lying in once place for days, which is why he couldn’t make his way to us sooner.

Our Outreach worker brought him a set of clothes and medicated soap. Ezekiel bathed in a nearby river and carefully washed his plastic sandals. After giving him a warm meal, our Outreach worker took Ezekiel shopping for some church shoes and underwear. He came to us with a single pair of clothes: an oversized, dirt-covered grey shirt and a ripped pair of jean shorts that were just a bit too big.

After shopping, Ezekiel went to a studio to have his hair done. This costs less than $3 but is a special privilege this boy had never experienced such a luxury. We packed up a bag with drawing supplies, a little stuffed animal, a colorful book, a few other clothes, toothpaste and a toothbrush.

Ezekiel jumped off the motorcycle as we stopped in front of the brightly painted, flower-engulfed hospital. He grinned! “Thank you! Thank you manmi!” he said, hugging me.

The medical team was waiting to meet Ezekiel. Each month, the Mental Health Hospital receives 5 -6 interns from a local Medical University. These are students studying to become doctors of various specializations. In addition to this team of medical students, 3 nurses and 3 health agents are available to work with Ezekiel 24/7. The psychiatrist, Dr. Felix, is also working with him multiple times per day. Although Ezekiel has his own room in the facility, he always has at least 2-3 people with him.

The doctors showed us the dining area, and open space where Ezekiel could play, and then Ezekiel’s very own bedroom: not the roots of a tree, or the corner of a street, or an abandoned concrete patio – but his very own bedroom. He jumped up and held on to me in an excited hug. “Thank you! Thank you!”

Our payment contract will ensure that Ezekiel remained in the hospital until at least February 7th, 2015 (a 3 month period of intensive treatment and hospitalization). He is eating 3 times per day, living in a secure and comfortable area, and having qualified personal attention all of the time – all of which he has NEVER had in his life.

UPDATES ON EZEKIEL:

When Wilner and I arrived at the hospital, Ezekiel was playing dominos with one of the medical interns.

Dr. Felix told me that, despite some progress, Ezekiel had “begun to show them his character”. The child had taken pieces of metal from the windows in an attempt to ‘escape’. He’d claimed he would not stay, and told the doctors that he would “cry out and tell Morgan that you beat me”.

Ezekiel grew up without any parental figures. Therefore, it is a huge adjustment for him to accept a loving relationship. It is new for him. Dr. Felix has remarked that Ezekiel is extremely attached to “us” (me, Wilner, Safe House staff). He is eager to change and please us. However, Ezekiel is afraid of mutual love. If he accepts a loving relationship – staying in a situation where he is loved and with people he loves – this would mean he needs to change his ways. He would have to leave the streets, his ability to do whatever he wants, when he wants, to be involved in gambling and crime, etc… So, each time he becomes attached and close to having a situation of mutual love, Ezekiel becomes scared and runs away or strikes out.

So far, the hospital has not given Ezekiel any medication. Ezekiel calmed down after the doctors spoke to him. They warned him that if he became too angry to control himself, they would give him medication to help control himself.

Ezekiel is, despite being 15, an adult in his own mind, and due to the lifestyle he has been living as well as the level of experiences he’s endured. Ezekiel’s sleep patterns are currently abnormal as he is used to sleeping at 2am or 4am. Ezekiel explained to the doctors that a cook who sold hot meals in the streets used to give him left over food once she was done selling, at about 2am, and she would give him a place to sleep sometimes. He would also stay up to watch movies in the night at public televisions.

Ezekiel has spoken of his older brother, and misses him. However, for now, Wilner and I are the only ones who will visit him (twice per week). Ezekiel’s brother was extremely abusive to him, beating him and forcing him to work while taking Ezekiel’s belongings. Ezekiel loves him nonetheless. Dr. Felix hopes to help Ezekiel realize that he cannot change his brother, but he can change himself.

Wilner and I entered to visit Ezekiel. He was so beautiful and healthy! His skin was bright and clean; he smelled like flowers.

On a few pages of his drawing pad, indistinguishable but very deliberate lines and circles demonstrated Ezekiel’s attempt to write. He pulled out one drawing, of a flower and a heart filled with color. He’d written his name.

“This one’s for you!”

 

PHASE II: Shock and Disappointment

In February 2015, Ezekiel’s three month hospitalization in the Maranatha Mental Health Hospital came to an end. We saw a remarkable improvement in Ezekiel’s physical health, and some improvements to his mental health as well: he was able to communicate his emotions with words instead of violence, began to socialize with other children, and seemed much more stable. He also stated that he did not want to return to the streets, although he wanted to see his friends from the streets.

The director of local Social Services had accompanied me to a meeting with Dr. Felix to ask if he could work with Ezekiel for an additional 3 months at a more reasonable price, something he had promised at the time of Ezekiel’s admission. Dr. Felix refused to change the price and asked for another $12 000 USD. He also seemed reluctant to provide information about Ezekiel’s care and did not provide us with a plan for his discharge from the hospital, as he’d said he would.

We were also concerned by the amount of medication he had been giving Ezekiel without informing us. Ezekiel had been sedated for much of his time in the hospital.

Also, we were concerned that Ezekiel had not yet been integrated into a school system, as Dr. Felix had told us he would do in January. Due to our limited resources and the desire to have a long-term plan for Ezekiel’s social reintegration, we did not want to continue having Ezekiel in the Maranatha Mental Health Hospital.

The director of Social Services offered the support of his agents, a psychologist from Terre des Hommes, and social workers in visiting Ezekiel to ensure his success in the foster home.

LFBS staff had a brainstorming meeting to see if any of our workers knew a family that could care for Ezekiel. Remy, our security guard, had a cousin who was willing to take him in – and their family seemed perfect! Lesly was the father of a 3 year old. He lived with his wife in a rural community about 1.5 hours from our safe house. He lived on the mountainside with many goats, a garden, a carpentry shop in his yard, and not many neighbours. His wife was a stay-at-home mom. It seemed to be the perfect family!

PHASE III – Hope Springs Eternal

Ezekiel was soon calling the 3 year old child his little brother, and Lesly was teaching him to make carve useful items out of wood.

During his time at the foster family’s home, LFBS staff visited Ezekiel at least two or three times per week. Our outreach worker, Fedner, is a school teacher so he began tutoring Ezekiel to prepare him for school. Each time our staff visited him, they did a meeting with Ezekiel and the foster family to ensure there was as much communication as possible. We supported the family with food – as Ezekiel now has a VERY healthy appetite!

We purchased church clothing and shoes for Ezekiel, and his foster family took him with them to church each Sunday. Each Friday, our staff took Ezekiel for a visit in the safe house and also to stop by the Social Services office to see a psychologist. We then returned him to his foster family each Friday evening.

We continued providing medication to Ezekiel during his time with the foster family, which we were given by Dr. Felix. Morgan contacted the psychology team at the University Hospital of Mirebalais (HUM), which is run by Partners in Health and is one of the top medical facilities in the country. The psychology team had seen Ezekiel several times but had difficulty creating an outreach program for him, as he had not been living with any stability. Morgan notified them about Ezekiel’s medication and they informed her that it was a lot of medication even for an adult to be taking!

In March 2015, Morgan received emergency calls from Ezekiel’s foster family on two occasions. Ezekiel had some violent outbursts. On one case, he attacked the family’s 3 year old child for no recognizable reason. In the second event, he took a large stick and threatened to kill the foster mother. The family said that they could no longer keep Ezekiel.

PHASE IV:                  Down but not Out 

Desperate for an option, I contacted the HUM hospital in Mirebalais once again. The hospital was eager and willing to work with Ezekiel, yet they do not have any inpatient program for mental health patients (only outpatient).

And then a miracle happened: HUM hospital in Mirebalais said that they would receive Ezekiel and try to work with him! This was a remarkable exception since they do not hospitalize mental health patients in this hospital – and seemed to be his last chance.

We took Ezekiel to Mirebalais. The psychology team assured Ezekiel that they would not beat him. At first, Ezekiel did not believe them and was afraid he would be physically abused. However, he soon came to understand that their methods were incredibly gentle and understanding. Morgan was blown away by the professionalism and genuine care the psychology team at HUM had for Ezekiel. They soon became attached to his bright personality as well!

Ezekiel was hospitalized in the pediatric ward. This became an issue, however, since his aggression is primarily aimed towards other children. The moment Ezekiel was not supervised by an adult, he attempted to attack other (ill) children in the pediatric ward. So LFBS hired two adults to supervise Ezekiel: one for days and one for nights. We purchased cooked meals for Ezekiel 3 times per day, as he did not like the hospital food. We also sent our outreach workers, when we could, all the way from Les Cayes to spend 5 days at a time with Ezekiel. Our staff did drawings with Ezekiel and he also saw the psychology team.

Although the psychology team was providing their time and affectionate care to Ezekiel, his living conditions still lacked the structure necessary to truly apply a treatment plan for him. Ezekiel requires a very structured environment in which his behaviors can easily be observed and in which he lives in a lot of consistency.

Unfortunately, in May 2015, Ezekiel was caught stealing some very expensive cameras and telephones in the hospital. Please understand that in his past, stealing has been a way of survival for Ezekiel – and no one has had second thoughts before stealing from him. So, this behavior is like an addiction for Ezekiel. Regardless, HUM hospital was no longer able to keep Ezekiel.

PHASE V:       Hope Fades

Our options at this point were very limited. We were unable to place Ezekiel in the Safe House, as we do not have adequate supervision to give him one on one attention and he would therefore present a risk to the other children. The foster family was not willing to receive Ezekiel again. Morgan has not been able to find a facility qualified and able to receive Ezekiel. The only choice we had was to reunite Ezekiel with his family: and the only family member who was willing to receive him was his brother.

Ezekiel is close with his older brother, and very attached to him, yet his brother has been known to abuse him physically. Ezekiel’s older brother has recently had a child of his own, yet he agreed to accept and care for Ezekiel.

We told Ezekiel and his brother we would visit them every Friday and support them with food. A few weeks later, Ezekiel complained that his brother was hitting him. LFBS staff have been having regular meeting with Ezekiel and his brother to try and reduce the physical abuse and mediate their concerns. We continued to support Ezekiel with food while he lived with his brother… but did not really see any other options for this child.

PHASE VI:           Back on the streets

Eventually, Ezekiel ended up back on the streets. It broke my heart to see him, dirty and begging once again, outside the market. He still wants to get off the streets and go to school, but his trauma is so deep, it would take more resources and money than LFBS, Haiti, or the numerous people who helped us can provide.

Perhaps one day another option will appear, but for now I have to accept defeat.

Am I heartbroken? Yes.

Would I do it again? Yes.

Every single time.

 

Ezekiel’s 3-months were up, and the director of social services accompanied me to meet with Dr. Felix to talk about options for Ezekiel’s transition. When we were discussing his admission I brought up his transition out – as requested by the board – and he’d told me that we could re evaluate the costs of keeping him in the hospital after 3 months because it would likely be reduced significantly and be closer to $1500 USD monthly or something like that.

Well.

Dr. Felix pretended (really badly, wrinkling his face up and everything) that he’d never said that. He said that it will be more work than what they’ve already done, that he could do the same price but not less. Then eventually said the lowest he could go would be $3000 USD monthly. The social services director was in awe and said it’s obvious that the only reason he’s asking so much money is because I’m white.

He’s also telling me now that Ezekiel is on bipolar meds every day – which he NEVER told me; previously I asked if Ezekiel was on medication aside from calming injections for occasional rages (which happened about 5 times over 3 months) and he said no. He said it costs at least $13 USD per day for medication…

Also, Dr. Felix had offered to do special training for our staff about how to work with kids like Ezekiel (in the safe house). When we worked out the contract for Ezekiel’s 3 month hospitalization, he said that the training would be included in that fee. WELL he just tried to tell me that since the 3 months noted in the contract for Ezekiel’s stay are up, and we hadn’t organized ourselves for the training during that time…. he has no obligation to do it anymore!!!!

Anyway, I really don’t think we should have him stay in the hospital anymore as we need to start working towards a long term solution. And he has made a lot of progress. SO I need to find a family that can take him, and we will support him in the family’s home and visit him very regularly:

Have IBESR (social services) agent who he knows visit him weekly – which they have already agreed to.

Have a psychologist from Terre des Hommes work with him regularly – which will be free and which the director of social services already offered to arrange.

Have occasional soccer dates/ church visits/ etc. with our safe house boys, with supervision, maybe weekly.

And continue to have him do psychology sessions (Outreach) with Dr. Felix at the mental health hospital, perhaps every 2 weeks, as that is a safe place for him and he needs the stability/ familiarity.

 

Ezekiel
Ezekiel & Morgan 2
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