A few months ago, I was fortunate to travel to Haiti for a week as part of a medical team, specifically to the city of Leogane, the epicenter of the 2010 earthquake. I remember being haunted by the news images of the unimaginable devastation and human misery that hit Haiti and the subsequent cholera epidemic that followed. Located only a few hundred miles off the US coast, Haiti still struggles with high rates of infectious disease, malaria, dengue fever, maternal and infant mortality, and malnutrition, and it lacks an adequate infrastructure to ensure safe drinking water, garbage/sewage control, and safe housing.
In the US, and particularly in Boston, we are so fortunate to have access to the best of medical care, diagnostics and treatments. I am proud to work for an organization providing this care through so many talented clinicians, nurses and staff.
So when I was told by a Boston nurse organizing a medical team that she was having some difficulty finding clinician volunteers, I knew just where to look! I began asking my colleagues if they might be willing to join me for a challenging week, sacrificing personal comfort, to share their medical expertise and treat those less fortunate. Dr. Barbara Peters, an internist at the Concord practice of Harvard Vanguard, and Dr. Moira Cunningham, an internist at the Copley practice of Harvard Vanguard, enthusiastically answered the call to duty.
Our final medical team to Haiti consisted of 5 doctors, 2 NPs, a PA (me), and 4 nurses. Two non-medical spouses and a high school student would run the “pharmacy” and eye glass distribution station. Kathy Beagan, RPh, at our Wellesley Harvard Vanguard pharmacy, organized the donation of various medications and supplies and our team received hundreds of donated eyeglasses and toothbrushes.
The day before departing for Haiti, we packed up 10 large duffle bags full of medical supplies for the week. Our entire team met for the first time in Port au Prince, Haiti the next day. We had been warned that getting medical supplies and medications through customs in Haiti can be challenging. Our team made it through customs with one small scuffle but no losses, and we set off to our base of operations for the week at the Hospital Saint Croix, approximately 20 miles west of Port au Prince.
The drive to Leogane became a blur of sights, sounds and smells far from the familiarity of Boston. The air was heavy with humidity and charcoal fire smoke. The streets were choked with traffic, people, dogs, chickens, and street vendors selling everything from food to mattresses. Children selling bags of drinking water swarmed our truck at every stop holding their arms up to our windows.
Our team stayed at the hospital for the week in a vacant wing set aside for medical volunteers, complete with old crank-style hospital beds and a cook. Meals consisted of rice, beans, plantains, mangoes, chicken or goat meat, and plenty of home roasted peanut butter and coffee. Each evening after dinner our team worked together for a couple hours packing up medication and supplies for the next clinic day.
On our first day in Haiti, a Sunday, we visited a nearby orphanage to meet and play with the children. The compound consisted of a group of wooden structures built over a dirt yard. The children appeared well fed and cared for by a Haitian staff. As we walked through the gate, a small crowd of children formed and greeted us by taking our hands or wanting to be held in our arms. Their faces and smiles were so sweet. They were thrilled by our gifts of coloring books, crayons, stickers, and bubbles and got busy right away playing. They really enjoyed having their pictures taken and to then view their image on the camera.
Most popular were the tootsie pops that Dr. Barbara Peters and her husband, Dr. Ted Benzer, brought, which caused a candy stampede! It was so precious to watch the children share their pops with the less gregarious among the group, offering to share plenty of licks. They never squabbled or hoarded their rare treat. Each one of us shared smiles, laughs and games with the children that day. Many of the children fell asleep in our laps.
On the first clinic day, we awoke early and packed ourselves and medical supplies into the open beds of three pickup trucks and set out for a village high in the nearby mountains. The few paved roads were still visibly damaged from the earthquake and we passed so many buildings still in rubble. Turning sharply off onto a dirt road which then morphed into a dry river bed, we continued along a very steep dirt path to the top of a ridge to find an unoccupied school which would serve as our clinic site for the day. I couldn’t help but recall a known fact: the #1 cause of death among travelers is motor vehicle accidents – but we all made it intact.
Our patients for the day were already lined up on benches in their best dress waiting quietly and patiently, with several children in tow. Many had been there for hours. We quickly unpacked our gear and arranged tables for triage, clinician consults, a private female exam area, and a pharmacy. We were often joined by a Haitian dentist. Dr. Moira Cunningham was thrilled to finally have an “office” with a window – a spectacular view of the surrounding lush mountains and ocean!
Each clinic day was a variation of this routine. Each morning we would be asked to see several patients waiting outside of the hospital entrance who could not afford care at the hospital. One morning I was asked to consult with a woman selling mangoes from a cart by the side of the street in front of the hospital. She had uncontrolled high blood pressure and had run out the medicine that had been given to her by a previous medical team.
We set up our clinics among the ruins of an old church or school or under a canopy of trees in an open field. Collectively, we saw around 200-300 patients a day. With the help of our Haitian Creole translators, we discussed our patients’ concerns, examined them on a bench or on the ground, reviewed their vital signs and utilized a few rapid lab tests we had brought with us for urinalysis, blood sugar, pregnancy, or malaria to formulate a likely diagnosis. Patients were directed to the pharmacy table for their prescribed medication. We took care of injuries, skin wounds, malnutrition, asthma, respiratory infections, stomach ailments, high blood pressure and diabetes, to name a few. We gave out vitamins and anti-parasitic medicine. We tried to explain the cause of their medical condition, a challenge as many Haitians believe in sorcery, that their illness was “sent” to them by another person whom they had angered in some way. I learned that voodoo practices can still be common in Haiti.
Dr. Moira Cunningham summed up many of our feelings that week when she said, “I found that working as a doctor in a completely different setting made me aware of how much I still love being a doctor and that the elemental relationship between doctor and patient transcends the setting and available tools.”
I was challenged that week in Haiti to use my intuition as well as my medical knowledge when caring for patients. The long days brought plenty of smiles, sadness, exhaustion; the heat and humidity was oppressive and I was covered in dirt and sweat by day’s end. But I continued to marvel at the Haitian peoples’ strength and resilience through all of their hardships. I know I didn’t cure all ills that week, but hopefully I touched each patient in some small way – with a smile, my stethoscope or my hand.
Would I do this again? Yes, in a heartbeat.