Haiti 2014 – Where Everything and Nothing Has Changed

Posted in: Medical Mission Trips, Mombin Crochu, Haiti
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I have been traveling to Haiti at least once a year for 16 years.  I go as a member of a medical team led by my sister, Dr. Sylvia Campbell, and we return to the rural mountain village of Mombin Crochu year after year.  My sister is a General Surgeon and in addition to her career as a physician, she founded Village Partners International, a non-profit organization that seeks to provide resources for Haiti and Uganda, so those who are in need can become more self sustaining.  Using my first-hand journal accounts, I hope to take you on a visual and emotional journey to a place and a people I hold very dear to my heart. 

Port Au Prince, July 2010: One thing about Haiti is that, in-between the poverty, pain and suffering that these people endure, there are moments of indescribable beauty.  A glance through the open doorway to the steep mountain hillsides shouldering cloud puffs, a meeting of eyes- dark pools as deep and innocent as memory, a bare-limbed tree lit with a hundred white egrets, brown skin glistening in a spring-fed bath, the turquoise, magenta, ivory and every shade of green that color the landscape outside of Port Au Prince.  Inside Port Au Prince, it is true sensory overload.  Tap-taps, automobiles, trucks and an occasional tank weave in and out of wavy lines all heading in somewhat the same direction.  No two tap-taps are painted the same, and it seems the more outlandish and riotous the colors and suggestions, the better.  I saw Jesus and a naked woman painted on the same tap-tap.  Serpents, rap singers, scripture and skulls.  Meanwhile, there is a whole other traffic jam going on by foot. Vendors squat at any available square foot of space selling everything from papayas to brooms. People parade by with their wares riding on their heads. Little plastic bags of water, fried plantains, all kinds of pills sold individually wrapped, like candy, live chickens held upside down by their feet, used shoes, including high heels and fake flowers wrapped in plastic to keep off the dust. Fifty pound bags of donated rice bearing the US flag are being illegally sold by the cupfuls.  “Who’s gonna stop them?” my friend said.

It has been 4 years since “the deadliest earthquake in the history of the Western Hemisphere” struck Haiti.  My sister arrived on a FEMA plane the day after the quake, when unsettling tremors still cracked the walls of the hospital.  I arrived in Port Au Prince 9 weeks after the devastation.

Hospital Sacred Heart, March 20, 2010: Just before we turned into the gate, a man walked in front of our vehicle.  “Look,” I said, “He has a bird.”  He was cradling a small, brown sparrow in his hands.  “Little bird of heaven”, I thought … and then, as the truck pulled forward and we piled out – I saw the tents turned into a hospital, where people lay on cots, sometimes 8 to 10 to a tent – plus family.  Many were missing limbs – arms and legs were bandaged stumps propped up on filthy sheets. One little girl in a wheelchair came forward to greet us. Her smile broke through the grief and rubble of the once plush hospital.  The earthquake rendered the hospital unsafe for patients, so they spend their days in the heat and heartache of the tents.  Men and women were together, there was no way to bathe and many had to use a communal bedside pot as a commode. 

My nurse friend and I didn’t know where to begin in this tent triage.  Someone barked out, “You two, take tents 0,9,3 and 6.” I took a deep breath and walked into tent #0, where six sets of dark eyes pleaded for help.  “Bonjour,” I said, “Madame, Como Ou Ye?” “How are you?” “Fe mal, Fe mal.”  The woman had her leg and hip crushed in the earthquake and she had a large incision along her upper thigh.  I gazed around the tent, a woman in her early 20s was missing her leg from the knee down, another woman had pins sticking up and holding the bones of her arm in an awkward salute.  Wherever I looked, I saw orthopedic injuries – children in wheelchairs, a beautiful, smiling young man sat legless.  Next to him was a 3 year old baby burned over 40% of his body, completely immobilized and wrapped in gauze.  I placed a tiny bracelet on his foot – the only part of his body that was exposed.  Later, I helped a mother feed her two children because she was too sick and weak to move from her cot.  The children were 1 and 3 and stayed on their mother’s cot all day while she slept because they had no one else to care for them. 

The day was exhausting, everywhere we turned, another patient appeared. This one need a dressing change, this one’s heart races since the earthquake.  I’ve heard that so often here – the symptoms “since the earthquake.”  It is as if time stopped on January 12, 2010 , and then started again.  Except this time, everything was different.  “God formed us anew from the dust,” the pastor said at the church on Sunday.  “Even now, we are afraid of the ceilings as we close our eyes.” 

As we finished seeing the last of our tent patients, someone grabbed me. “Can you change her dressing?”  The woman was in a wheelchair with abrasions and hardware coming out of her leg.  I’d never changed a surgical dressing like this before.  “Oui,’ I said and smiled at the woman.  “Merci, she whispered weakly.”

Merci, Merci, all around me I heard that word – a word that sounds so much like Mercy in English.  Merci, Mercy.  I could no longer distinguish between the two. 

Most frequently, people will ask me if things have changed in Haiti since the earthquake that “silenced a quarter of a million voices in a single night.”  (Paul Farmer)  Certainly, there are many people and organizations working hard to rebuild, reforest, devise clean drinking water, facilitate micro-industry, provide medical care and food for so many who remain sick and hungry.  There is also a growing awareness of the problems and failures that donations and do-gooders have brought to this struggling country.  When I answer the question of how have things changed post earthquake, I am like one of the seven blind men trying to describe what an elephant looks like by describing the part he is touching.  I can only tell you my experience of what I have seen change and not change in one mountain village.
July 21, 2010:  Last night, lying sleepless under the mosquito net, I counted on my fingers the number of times I have been to Haiti with a medical aid team.  Starting in 1998, I have been here fifteen times.  That’s almost four months of witnessing the strength and courage, the faith and perseverance of the people who live here.  That is thirteen years of watching their suffering and hardship, hunger and desperation. 

Not much has changed in the thirteen years as far as I can tell.  Well, yes, cell towers have arrived, and at least in Port Au Prince, there is a service network.  Since the earthquake, I cannot guess how far it reaches.  But even from here, in my perch above Port Au Prince, I still see the same scrawny crops in the fields, the same barefoot farmers, men swinging machetes, roaming goats and women carrying their burdens upon their heads.  I hear still the faint stereo sounds of roosters, stray dogs, and babies crying.  People walk up and down the steep cobbled streets that become rivers of debris in a downpour.  “Bonjour, Bonjour” at very turn.  Children still stare wide-eyed, their distended bellies angry with worms.  Mothers carry them to the clinic, still hoping for a cure for poverty.  I watch the faces of the elders, noting the turn of their mouths, the level they hold their stare.  I want to know what has changed.

January 12, 2010.  Everything and nothing has changed since then.

The clinic at Covenant Hospital in Mombin Crochu serves as a place where American and Haitian doctors can work side by side to relieve suffering where pain and suffering is plentiful.  Although this is a densely populated area with close to 35,000 inhabitants spread out over approximately 25 square miles, the majority of the people living in or near Mombin have no means of transportation and are literally cut off from both emergency and preventative medical care.  Only a very small percentage of the population has access to clean drinking water or latrines which results in serious outbreaks of Typhoid Fever, Cholera and gastro-intestinal parasites.  An alarming percentage of the children are malnourished and the estimated life expectancy is 53 years with HIV/Aids, Malaria and Tuberculosis cited as the primary causes of adult death.

Even amid the terrible hardship, the clinic and community are improving.  This past February’s mission trip allowed our small group of doctors, nurses and volunteers to serve several hundred people in need of surgery, dental procedures, orthopedics, and general care. For almost twenty years, Village Partners International has been actively involved in helping this community achieve continuity and sustainability in the health care provided and the administration of the clinic and hospital. For those of us who have returned year after year, we have born witness to this gradual improvement.  This is due in part to the younger generation of medically trained Haitians who have chosen to return to their place of birth to help move it forward by giving back to their people. Through partnership with VPI, there is a growing stability to the hospital and a new ability to care for persons within the community and outlying areas. There is great pride in the success of projects initiated by Village Partners International. There are now programs in public health and education within the community. The Food for Healing program continues to offer nutritional support for the patients, and is ongoing. Currently 60 orphaned children are being cared for which is an increase from 30 last year.  The lunch program for these children offers nutrition to those who would otherwise go hungry. The Moringa Project will be restarted when the rainy season returns and the newly launched Mobile Clinic is an exceptional outreach that offers much needed health care, health education and preventative measures to remote and difficult to access mountain communities on the outskirts of Mombin Crochu.  The Mobile Clinic has established a consistent vaccination program, an active HIV/AIDS screening, and a public health program addressing: nutrition, hygine, pre and post-natal care and the prevention of sexually transmitted diseases.  Fundraising for the VPI Mobile Clinic was begun after a request from the Haitian doctors.  In their words, “Human health in this area is in a precarious situation with a very high mortality rate for all ages of the population.”

What if your dream was to simply be able to feed your child, to vaccinate her against measles, polio and meningitis, or even to offer her clean water to drink?  These things that we so often take for granted are still unaddressed in much of Haiti today. EVEN after a global response to the earthquake that pledged billions of dollars in aid, EVEN after such famous names as Bill Clinton and Sean Penn vowed to help change conditions, EVEN after thousands of aid workers and missionaries flooded the country, EVEN as I speak . . . I see the faces of those we did not or cannot help …

Sunday, Feb. 23, 2014:  Yesterday, in the clinic, we said “Yes” to 4 surgical patients a day.  We will be performing surgery for 6 days, so that’s “Yes” to 24 people.  We said, “No” to the 40 year-old woman with a baseball-sized thyroid that is impacting her looks, speech and soon her ability to swallow because the anesthesia machine that showed up sometime after the earthquake is broken and no one knows how to fix it.   We said “No” to the 7 year old boy with a cyst that could possibly be connected to his brain. “No” to the 3 month old girl with  a growth coming from the back of her skull that looks like a sinister, soft fruit.  “No” to the woman with a lump in her breast that is surely cancer. Then there are those we said “No” to who are suffering with hopelessness  – those who even surgery cannot help.  The 9 year old boy with spina bifida, who will be incontinent all of his life and the beautiful 3 year old girl whose physical growth is severely stunted and whose legs are distorted because her bones aren’t growing normally.  Her 3 month old sister may have the same hereditary deformity.  The list goes on and every year, I have a list like this.  This is the heartbreak I leave with every time I go.  And I return, again and again  . . . because of hope.

                                                                                                Terry Deal
April 16, 2014

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