The earthquake happened thirty days ago today.
Haiti's president declared that today is the first of three days'
mourning and remembrance. The US Embassy, most UN offices, and every
official building (of those that are still standing) was closed today.
And as far as I could tell, the vast majority of Haitian citizens did
NOT stay home. They dressed in the best clothing they could assemble,
and walked to church. And there they stayed for the better part of
the day, preaching, listening, mourning, singing, and remembering.
During the morning, Brother Jim and I drove through the city and
southwest along the coast to Leogane. We were officially providing
transport to the Haitian deputy director of the Foi et Joie (Faith and
Joy) school system. Unofficially, at least in my case, I was still
trying to wrap my head around the sheer magnitude of the earthquake.
And, in the drive, I finally "got" it. When we drove in to
Port-au-Prince three weeks ago, we came in from the northeast. We saw
very little damage until about eight miles from the airport, and even
that was relatively mild. The southern portion of the city, where we
conducted our triage, treatment, and transport operations, was much
harder hit, but we still got to go back to our base camp and get out
of the "flat zone" on a daily basis. By contrast, on the drive to
Leogane, everywhere I looked I saw earthquake damage. Even the road,
which used to be one of the best roads in Haiti, was an oddly artistic
slalom course of cracks and mini-chasms. But what struck me most was
the people gathered amidst all this chaos today. White dresses and
headscarves were the uniform of the day for most of the women. To a
guy living comfortably in a tent with a knapsack of clean scrub tops,
it was frankly humbling to realize the amount of effort that had gone
into finding and cleaning Sunday-go-to-meeting clothes. And the
churches were not full; they were overflowing. Tarps were hung as
awnings for overflow congregations at every gathering place we passed.
Where the churches themselves were damaged beyond use, the people
simply gathered outside. They were there when we left in the morning,
and they were just starting to go home when we made our way back into
the city at mid-afternoon. And they will do the same thing tomorrow
and on Sunday.
The other thing that struck me was the difference in the recovery
operations going on in Leogane and Port-au-Prince. Port-au-Prince
looks like a war zone. It looked that way when I got there a week
after the quake, and it looked pretty much the same today. By
contrast, Leogane looks like there had been a war there, but the war
was over. Some buildings had clearly been identified as
non-salvageable and were now being used as combination rubble piles
and cement-block quarries. Other buildings were actively being
repaired, and in a serious way. The fallen debris had been pushed to
the edges of things -- the edges of the roads, the edges of the
property lines, the borders and margins of the cleanup areas, so that
the rebuilding could take place in a mostly cleared space. The city
was being rebuilt. It wasn't very far along, but it was clearly
moving intentionally and directly toward that goal.
This was what surprised me most about Port-au-Prince when I was
finally able to look at it in context. The city is being cleaned up.
The streets are being cleared, at least enough to get vehicles
through. Crushed buildings are being dug through to recover bodies,
and salvage materials. But the city is not being rebuilt. The
refugee camps are being made progressively more solid, even if the
short time that I have seen them, making the transition from bedsheets
to tarps and tents to wood and cement blocks. But the actual process
of rebuilding the city of Port-au-Prince appears to be stymied by two
factors. First off, the city is like an overstuffed and utterly
disorganized coat closet. In order to get it back into some semblance
of order, the closet has to be emptied out. Port-au-Prince was so
built up before the quake that it is very hard to find empty spaces in
which to pile the rubble while rebuilding. This leads into the second
problem with rebuilding Port-au-Prince. I perceive a lack of decisive
local leadership in the rebuilding process. In other words, I don't
see any concrete signs that the Haitian "government" has any clear
plan for putting this city back together. There may well be a number
of legal issues that further complicate this process (unambiguous and
legally protected property rights would top that list). But everybody
in Port-au-Prince still seems to be waiting to see what's going to
happen in terms of actually rebuilding. Those are just my overall
impressions, for whatever they're worth. I don't know what else to
say about it, other than that's what occurred to me after making the
trip to and back from Leogane today.
So anyway. After we returned from Leogane, I sat down with Jim, and
we discussed what we were going to do for the rest of the day. We
both agreed that we couldn't really move forward any further on the
schools project today. So we resolved to do something that has been
gnawing at me since our first hellish days here: we went looking for
some of our former patients.
Emergency medicine is a somewhat impersonal business, even moreso in
mass casualty situations. You work as fast as you can to properly
identify and treat life-threatening injuries, you stabilize your
patient to the point where they will live until they receive
definitive medical care, and you move on to the next patient.
Psychologically also this approach keeps me, at least, from being
overwhelmed by the seemingly never-ending masses of patients. I do
the best I can, and then I commend that patient into the Lord's care.
If a patient has a chronic or long-standing medical condition,
however, it complicates things. To what extent can an emergency
medical provider devote additional resources to managing chronic
conditions? To further complicate the issue, to what extent can an
emergency medical provider address chronic NON-medical conditions --
which in the case of all my patients in Haiti, included the fact that
they live in one of the poorest countries in the world, and are likely
to be crushed to death by poverty even if they survive the earthquake.
This is a touchy subject for me. I came to Haiti as an emergency
medical responder, hoping to care for patients who had been injured in
the earthquake. But the more time I spend here, the more I perceive
the real problem as being the Haitian government. The rulers of Haiti
have crippled the Haitian economy, raped a beautiful country, and
condemned the vast majority of Haitians to live and raise families in
a continuing cycle of menial labor, odd jobs, and grinding poverty.
The CIA estimates that the average per capita income in Haiti is about
$550 per year and the country was an economic wasteland even before
the quake. Government officials somehow have enough money to buy
Land-Rovers despite modest official salaries, but the foreign aid
money to build roads and schools and hospitals just vanishes away. So
when I treated earthquake victims with crushed hands or rotting flesh
or broken bones, I also had to consider what to do about the
life-threatening pre-existing condition of being an ordinary citizen
In Haiti there is a profound temptation just to give money away to
people. After all, if a beggar at a stoplight asks for a dollar, I
can certainly afford that, can't I? The problem is, if every foreign
visitor gives a dollar to a beggar at a stoplight in a country where a
teacher only makes twenty dollars a week, then even the teachers will
start begging on the street corner. So, during my time here with Team
Rubicon, I did my level best to provide medical help to people who
needed medical care. We did the best we could with what we had
available, we treated our brothers and sisters as we would want to be
treated if the tables were turned, and we commended them to the Lord
and prayed that they would be OK. And generally I can sleep at night
also. But sometimes I wonder if I've really done enough, and
sometimes, that keeps me up. On a brighter note, sometimes I just
like a particular patient and I want to make sure that he or she is
OK. So today, on this day of remembrance, Brother Jim and I went
looking for the young man with the crushed and infected right hand who
we had cared for on January 18th. We wanted to find out if he was OK.
We wanted to make sure his physical injuries were healing. If we
could do something to improve his current living situation or increase
his odds of making a full recovery, we wanted to find out how we could
help. And I wanted to write down his name, so that I can tell it to
you, so that all of us can can keep him in our prayers. And so, we
went looking for him.
But we couldn't find him.
The camp at Manresa is now a neat collection of well-framed tarps and
individual living areas. The picnic table where we set up our triage
area is now under a giant tarp with a USAID logo. There are many
children, playing with simple but wonderfully designed homemade toys
made out of empty water bottles, twigs, plastic sheeting, and thread.
It was a world away from the grotesque injuries of January 18th. It
felt good to be there, as though we had earned the right to visit.
But the young man was not there.
We will try again tomorrow. However, unlike my last trip to Haiti,
this time I actually have return plane tickets. I fly from the
Dominican Republic Sunday morning, which means that I can stay in
Port-au-Prince no later than 5PM on Saturday. This has become
something very personal to me, but I feel as though I am running out