So I'm back. And it's been kind of a rough trip. Or an eventful one, to say the least.

On my last night on the island I passed by the Mission center on the Dominican side of the border with Dr. Dave, with whom I had been working in the Haiti clinic. It was late at night, and we were expecting everyone to be in bed. Instead we found almost all of the doctors, nurses and students awake and gathered in the central patio. It turned out that on that same day, a nurse at the Mission had been killed in an accident. She was riding in the back of a pickup truck up a steep mountain road, and the truck lost its traction and flipped over. She died instantly and several other people were injured. It was her first time in the country, and she had been there for six days. She was twenty-seven years old.

Because of the accident, the whole future of the Mission is now in question. It's unlikely that the university that organizes the Mission will continue to allow students to come down to the Dominican Republic. And the doctors and nurses who do come, if any, will not be allowed to travel to the more remote towns and villages on the mission circuit. Because I'm a free agent, this wouldn't prevent me from working in Haiti, but if the Mission shuts down or decreases its scope, it would cut off the Tilory clinic's main source of medicine and supplies, not to mention doctors and nurses for me to bring there.

But there was also some good news. We had a good couple of days at the Tilory Clinic in Haiti. We were able to help quite a few people, including some very sick babies, although there was one who was so far gone by the time he was brought to us that he's almost certainly died by now. He was barely two weeks old. A neighbor brought him in because apparently the mother was mentally ill and unable to take care of him. He was severely malnourished and barely had enough flesh on his bones to inject antibiotics into. Clemencia will follow up on his case now that the gringos have gone home, but Dr. Dave didn't have much hope that he would survive.

But wait, I was going to talk about the good news. The good news is this: A couple of years ago, a Christian organization called World Vision built a small health center in Tilory. Nothing very fancy, but certainly a lot better than anything we have at the Tilory clinic. The problem was that after it was built, there was no one to work there and no medicine or equipment inside. So the facility has been sitting unused all this time with its doors locked, gathering dust.

The good news, then, is that the Cuban government has just sent a doctor to Tilory to open up the World Vision health center. Cuba requires all its doctors to do two years of this type of foreign service after they graduate. The health center is still a work in progress, but thanks to this doctor's efforts, there is now a small staff on the grounds, including a pair of nurses who work for the Haitian Ministry of Health.

Even better news is that Zanmi Lasante (Partners In Health), an NGO based in Boston that has been doing amazing work in Haiti's Central Plateau region, as well as in places like Peru and Rwanda, has become interested in Tilory since Clemencia, Dr. Dave and I visited their hospital last year, and they have begun sending medicine to the new health center. They are also making plans to build their own facility in Tilory, which would provide affordable, quality health care to anyone in the region who requested it. This is exactly what we've been hoping for, and it would be an incredible change for the community.