“You’ve got mail.”
It was Wednesday afternoon on April 14 and I was at my desk going over my last minute tax preparation. I clicked open the email, “Dear Emmaus Medical Mission Family, Mission #23: a team of doctors, nurses and medical students will depart tomorrow (4/15) for Port-Au-Prince, Haiti. Along with Fr. Reginald from the Catholic Archdiocese in Port-au-Prince, and with the help of Miami based "Amor en Accion", the team will work and treat patients living in the actual tent cities. The team will be working out of St. Rose Of Lima Church where they will load their bags with medicines daily and go out to treat the infirm who are too sick or too afraid to leave their tents. They will take the 30,000 pounds of donated medicines with them. The team will also visit an orphanage of 200 children run up by Partners in Health.” It continued, ”Thanks to your generosity and outpouring of donated medicines and supplies, the team is well equipped and will be able to treat thousands of our brothers and sisters.”
The earthquake in Haiti was magnitude 7.0 with an epicenter near the town of Leogane about 16 miles west of the capital Port-au-Prince. About 3.5 million people lived in the affected area. It was devastating with an estimate of over 230,000 dead, another 300,000 injured and 1,000,000 made homeless.
I turned down the volume on my iPod and gazed out the window as our plane was approaching the island. The sky was a deep blue and the yellow sun warmed the earth. The white villages dotting the lush mountains and valleys looked idyllic from up here. I had caught a flight to Miami just a few hours after I received the email green light and met up with the team at the airport. The logistical nightmare had been solved. I had received all my vaccines including hepatitis A and B, polio, tetanus, typhoid, and was taking malaria pills. I had packed weeks ago knowing that we would be leaving on short notice.
The runways were lined with military vehicles, helicopters, and supplies. Eventually we got through immigration and customs, and exited the airport into utter chaos. This felt like a war zone. There were swarms of people begging. One of our doctors gave some money and a near riot ensued. We quickly formed into a tight group, ran across the broken road, and jumped into waiting transport vehicles, which carried us toward our base of operations on the opposite side of town. As we sped past I witnessed in disbelief a devastation of Biblical proportions. I was in a nightmare unable to awake. Between mounds of rubble where buildings once stood there were intact ones although on closer inspection most of these were structurally unsound. Construction standards are low in Haiti since the country has no building codes. Buildings are built on any free piece of land wherever they can fit, even on slopes with insufficient foundations.
The streets were crowded with throngs of humanity. We drove by vast tent cities covering virtually every piece of open land, including parks, sidewalks, and even the narrow median strip dividing the road. People with shovels were digging through crumbled buildings looking for bodies to bury. I saw murals painted on crumbling walls of a face crying and the caption “Please help us.” The job was overwhelming. What good could the few of us do?
We drove east of the airport up into the hills overlooking the downtown to the Tabarre neighborhood. The house we stayed in was surprisingly large and pleasant. It was surrounded by a large gated wall and purple bougainvillea and tropical trees grew in abundance. We had three security guards around the property, although I did not feel the need. We were accompanied by two Haitian priests who knew the area and also translated for us. Our international group comprised Catholics, Jews, Muslims, and atheists all united with the sole goal of helping others in need. I wondered why it takes a disaster for different people from various countries and with various beliefs to get together and work for a common purpose.
I usually woke around 5:30 am, took a cold shower, did a little yoga on the patio, and had breakfast. A nearby convent and school for children had collapsed killing many of the nuns, but three of the survivors prepared our meals, which were delicious Haitian cuisine. Breakfast included eggs, toast, cheese, oatmeal, plantains, and coffee. After eating, we piled into three vans, and drove to areas with the greatest casualties and least access to care to set up our clinics. Because the roads were deeply rutted dirt and all but impassible with fissures from the quake, endless potholes, and collapsed bridges, the 15 mile trip would take us two hours.
There are almost no traffic lights anywhere, and the few we saw were not obeyed. There are not even yellow lines painted between lanes on the “highways” and the drivers are more reckless than in China. The cars swerve back and forth into oncoming traffic to avoid fissures and potholes, and we had to plead with our drivers to slow down since we feared being casualties ourselves. Pedestrians and motorbikes crisscross between cars in a game of chance. I guess they feel invincible being the few to survive the catastrophe. The roads are dirt, which was kicked up into the air making breathing difficult. Many who we treated had eye irritation from the dust.
There are severe gas shortages with mad chaotic lines at the rare stations with gas selling for $6/gallon. We couldn’t wait the hours in line so we found black market suppliers on the edge of town who would funnel in a gallon for $15.
We travelled to the parish of Ste Andre de Leogane, which was the epicenter of the quake since other medical teams had mostly stayed within the city. The main structure in the village was the church, which was rubble. A small schoolhouse remained and there we set up our clinic. We carried hundreds of pounds of medicines in duffels from our truck into the classrooms. We set up triage in one room and pediatrics in another. Angel, the other GI doc, and myself worked alongside Landy and Royya in a classroom perhaps 6 meters by 6 meters. We put desks together to hold medicines and to use as examination tables. We were inundated with the sick and suffering. We saw patients with trauma, malaria, leprosy, scabies, various intestinal infections and parasites, and also untreated diabetes and hypertension. I was surprised by the numbers with post-traumatic stress disorder.
Invariably their complaints began with the quake. On further questioning, I would learn that they lost parents, and sons and daughters. Sometimes they had found the bodies of loved ones under the rubble of their homes and sometimes they were simply missing, presumably buried in the mass graves along with thousands of others. Some patients were trapped themselves for days until finally rescued. We treated hundreds of people each day, but there were thousands more left untreated. A great rabbi once said, “It is not your responsibility to finish the work, but you are not free to desist from it either.”
It was humid and the temperature was up in the 90’s so I had to remember to continuously hydrate with bottled water and once felt guilty about surreptitiously wolfing down a power bar for lunch while hundreds waited in long lines in the hot sun. Finally in the late afternoon our drivers and security guards forced us to finish up even though many went unseen, since we were told it was dangerous to stay and travel after dark.
I felt exhausted but somehow elated on the long bumpy ride home. The streets were packed with humanity bathing in the open, cooking dinner on charcoal fires, and hanging out. There is no pure water so everyone gathers around wells with hand pumps to bathe, do laundry, wash dishes, and carry large buckets of water on their heads for miles back to their tents. Their present home was built with four sticks in the dirt covered by a bed sheet with a couple of sleeping mats on the ground, so the sidewalk was their living room. Occasionally we were shocked to see adult men walking the streets butt naked, apparently they were mentally disturbed, which should not really surprise us. But there were also children playing and carrying on like everything was perfectly normal apparently oblivious to their surroundings.
The presidential palace was in ruins with its Baroque domes collapsed. I thought about the abuses of trust and power perpetrated by those in charge, but I felt sorry it had come to this.
On arriving back at our base, I showered and changed for supper, which was fish, beef, or goat along with rice and beans, plantains, various vegetables, and fresh fruit juice. I stuck to the non-meat options, which were delicious. We would sit around the table after dinner for conversation but I would retire exhausted at around10:00 pm, while the younger members of our party would drink the local beer and stay up until 1:30 am. The first night I slept in a room upstairs, but it was sweltering and I got little sleep so thereafter I slept downstairs in a tiny room with six guys on mattresses on the floor.
After breakfast the next morning, we drove outside of the city to a farming village and set up clinic under a tarp in a field next to the destroyed church. Church benches were used as our exam tables and to hold our pharmacy. Goats, steers, and stray dogs wandered in and out as I took histories and performed physicals. The people were both humble and grateful for our care, “Merci beaucoup.”
On our last day, I slept until 6:30 am. After breakfast, we cleaned up and packed. Lunch was plantain patties, rice and beans, beet salad, and sweet potato bread pudding for dessert. We drove over mountain roads to a church on the other side of the city. The streets were crowded with men, women, and children in their Sunday finest walking miles to church. We stopped at the church, which had collapsed crushing many and services were set up in the courtyard under a tarp. On one end of the courtyard was an outdoor staircase where weddings had been held and at its foot was an unmarked mass grave.
A clinic was set up on the other side by a remarkable Haitian physician, Dr. Jocelyn Maron, who had lost contact with her son after the quake and feared he was killed. When they were reunited days later, she went to the church to give thanks and out of gratitude set up the clinic. She has been working there ever since. She set up large medical tents with rows of cots where patients with crush injuries are being cared for.
Mass was in French and Creole with accompanying guitar, bass, keyboards, and choir. Sitting there in this once vibrant city surrounded by hundreds of survivors singing and praying in their mellifluous tongue, filled me with awe at their indomitable spirit and gratitude for all the bounty life had given me. My Christian friends said that Mass in the US and Belgium did not have this passion, this emotion. I think that passion is born of misery, of loss, of suffering. Life renews itself out of the rubble and broken bodies.
On our way to the airport we stopped at an orphanage, the New Life Children’s Refuge. It was a self-sustaining community with a water purification unit, a vegetable garden, chickens, rabbits, and tanks of tilapia. There was a soccer field and a playground. Tents in the center housed American college students who would come for a week or two to lend a hand. They felt this was more important than spending their Spring break in Cancun. The children were playing happily outdoors. There was a long row of wheelchairs supporting double amputees and those with severe neurologic injuries, the cripple and infirm together with the healthier ones. All were well cared for and loved. We left bags of supplies and toys.
Americans were grief stricken after 9/11. The Polish people were in mourning after their leaders senselessly died. But what words describe the decimation of an entire country, a capital city in ruins, hundreds of thousands buried beneath rubble, their crushed and decaying bodies filling the air like the stench of rotten garbage, the whimpering cries of a mother for her lost child, or of a little boy for his buried father. There are no words. God in his wisdom didn’t teach us those words.
An old tale tells of a son walking with his father. The boy is distressed as they pass hungry beggars in the street, see people with crippling illnesses, and witness other scenes of suffering.
“This is terrible,” the boy says to his father. “How can God allow this? Why doesn’t He send help? “He did,” the father answers. “He sent you.”