It'd been a long week. Several bunk beds later, even more tape measure and tool identification tests later, and even more more time spent explaining the merits of learning a skill and the delayed reward of being an apprentice first and then an accomplished tradesman later. A difficult concept to convey: delayed gratification. Especially when much of the population may go without a meal for a day or two. In the midst of all this I will miss faces and smiles and laughter.
As I said my goodbyes to the guys at the transition house, one boy who I had struggled to get to know and connect with, gave me a hug, looked me in the face and said, "We'll miss you." I smiled and tried to hide how surprised I was. I think this moment, more than anything, fulfilled that selfish little need to feel useful and beneficial. For some of these boys I had pushed them pretty hard, maybe too hard. I had not given a free lunch to anybody. They knew that when it comes to me, if they worked hard I would reward them... otherwise, they needed to get out.
What I've learned is that Haitians are strong people. They are smart, kind, funny, and resilient. The most frustrating thing to me about Haiti is not the people or the somewhat backward mentality of things. No... it's the unfortunate reality that 10s of thousands of purely altruistic and well-intentioned NGOs have given the local Haitian community little room to develop ownership, leadership and personal responsibility. Do they need to be educated? Yes. But in such a ways that their education can lead to financial and material independence from the NGO world. My hope for Haiti is not with Politicians and multi-million dollar budget NGOs... it's with the small handful of boys that taught each other how to read a tape measure and cut a 2x4. I taught one or two and they taught the rest. To a very small degree, I've worked myself out of a job and that truly is the greatest reward for any humanitarian volunteer.
Will we return to Haiti? Yes, for sure. It is a land pregnant with possibility and potential and I believe that in time the DNA of the NGO world will realize that the true goal of a servant is to become less so that those you serve may become more.
Mwen Renmen Ayiti
What Motivates Me
In America this wouldn’t have happened. There would have been somebody to help, another hospital with a NICU. At least there would be enough bili lights to go around. We wouldn’t have needed to drive to the other side of town bouncing little Doula all over the back of the truck. Her foot was barely the size of my thumb. Her skin was yellowish green from jaundice with little bumps all over her tiny eyes, presumably from an STD passed on from her mother. It was a sad sight. The doctors sped in and out of the makeshift triage. A woman nearly collapsed outside the tiny emergency wing, flailing in agony at the sudden news of a loved ones death. How is there not room for a miracle baby born 5 weeks premature, barely the size of my hand, in a tent city? It should be so much better, but it isn’t. This healthcare system is broken. This is Haiti. This is the Third world.
I have been here barely a month but I have likely seen more rare disease than many physicians in the U.S. After playing a match of soccer the other day, the nurse said, “That’s Jean, he’s lost thirty pounds from tuberculosis.” It seems that every other day I meet someone who has had malaria and the word on the street is that a couple of the local orphanage boys are spreading around mumps. Gas gangrene and systemic infections are not uncommon. This world is unlike the life I have lived thus far. The kids from the orphanage don’t want to take their medicine for intestinal worms because of how horrible it is when the worms come out of every orifice in their bodies. I never even knew this type of worm existed. A simple question confronts me as I gaze out my window at the neighboring tent city: What does this have to do with me?
Just yesterday one of our team members tested positive for malaria. Word spread quickly among the Americans working here in Port au Prince. A hushed silence seemed to reverberate in the guest house and subtle glances shot across the halls to where Angelo lay quietly on a mattress. We had ventured into a realm of sickness outside of our American conscience. Malaria is caused by a ‘third world’ parasite. We Americans shudder at the thought of getting malaria and pay a pretty penny for our doxy or chloroquine prophylaxis. Here in Haiti however, malaria is just another sickness and not nearly as bad as cholera. Yet, this is the reality here in Haiti. What should be simple is hard, and what is hard has become normal. Following a heavy dose of chloroquine, Angelo recovered in two days. This would not be the case for someone who lives in a tent city or the countryside. The disparate worlds re-appear and again I ask myself, “Where do I fit in this conundrum?”
Today I visit the only permanent hospital on the island of La Gonave, Haiti. An estimated 120,000 people live here and yet the only consistent healthcare available is the 30 bed Wesleyan hospital erected in 1958. As we walk down the corridors, I can’t help but notice the dark brown stains on the floor. I know what these are from. Then I see in the corner of the “operating room” a rusting World War II era sterilizing machine, a memorial to medicine’s history and a reminder of Haiti’s need. Above are four lights positioned over the operating table but only one works. We walk past the ‘NICU/Nursery’ and our guide quietly says, “This is the same room they use to triage patients who arrive with emergencies.” His face revealed the desperation of the situation. We swerve in and out of gurneys cluttering the halls with patients. I can feel the stares of the sick. I imagine that they must wonder why this white man walks down the halls of sickness simply observing their misery. The stares reveal the poignant reality that I have nothing to offer them. At least, not yet.
I tell you these stories because they are the memories that echo in my head and drive me to become a doctor. I feel that I am obligated to invest my American prosperity and education into the cause of providing quality healthcare for the beautiful baby Doula, or Jean who works tirelessly to get his tuberculosis medications, or the dirty island hospital full of the hopeful suffering. I know the learning curve of medical education is steep, but the faces I see in my dreams who long for relief will be my motivation.