Rain

Bike Shop Port-au-Prince

Street Vendors

It is raining tonight. Noisy, big-drop, rain in sheets. It is perfect.


Today was the third day of my trip to Haiti with Project Medishare. In this small hospital (4 bed ICU, 2 bed ER, 2 OR’s) the clinics are insanely crowded and “the gate” is always busy with people wanting to make their way into the emergency room. It is safe here. Clean. Dry. There is food. There is a bed . . . if you are sick enough.

Today I think I got it – I started the day a bit disgruntled, feeling useless and extraneous. I helped an oncologist with a paracentesis on a terminal cancer patient, picked a stone out of some adorable child’s ear, and then had to leave the compound – what more is there for a pediatric surgeon to do?? I had already “ruled out” appendicitis in my overnight observation patient and sent a man to the “cholera tent” who I was sure had cholera . . . I needed a better view of what I was doing. I got a much better view . . .

Warehouse

We left the compound to go to the warehouse and check out the supplies we might need for a few up-coming surgeries. But I left, mostly to leave. Haiti is a country of rubble. No one lives in the buildings anymore. They live in tents, neatly arranged along the major thoroughfares. Haiti has little industry save the street merchants, the electric company, and the beer brewery. The dogs in Haiti are not even skin and bones -they are flesh, hanging on wires like some sick stick figure drawing, roaming the streets, climbing the burning piles of garbage, hoping to find a scrap to eat. There are goats, everywhere, picking through the refuse, playfully jostling each other in the steaming desolation. We saw a pig moving towards a rare bit of shade to hide and wallow in a shallow pit of mud. Everywhere we looked, there was dust floating in the air, like some veil over the scene full of people, goats, dogs, pigs, rubble, mud, street vendors, life in Haiti.

On arrival to the warehouse we were let into a locked and guarded compound. Inside, we looked down aisles of dusty donations some useful but many expired, archaic products. The rubble of the street seemed to be sitting on the shelves, taunting me and my expectation of finding something different. After gathering a box of useful goods, we walked to the back of the warehouse where the damaged ventilators, tens of dialysis machines, broken hospital beds and cribs, laid useless, in a small nation, overpowered by refuse. We were there, in the epicenter of the garbage dump staring at a tragically symbolic representation of what has happened to these people who deserve so much more then our sloppy seconds.

It was frightening, and humbling - so much material waste. These people struggle to get by – living in a dollar store world that we have “given” them. They are ALWAYS impeccably dressed, ALWAYS incredibly tidy, ALWAYS sharing beautiful, gleaming smiles – yet they are forced to live in this dusty, rubble laden environment.

I returned to the compound with a perspective on “donation” that made me angry. How can you expect a wonderful people to rebuild a country on our left-overs?? Our rejects?? Our expired goods?? How can you ask a people to make a better life for themselves when you offer them only what you would not, could not use?? This is not giving. This is not generosity. This is dumping your trash in a giant landfill of need and hoping to feel better about yourself. Don’t. Haiti has enough to clean up already. Don’t send them your shit to clean up too. Send them the good stuff - the BEST stuff.


I was beaten by this idea. Beaten and feeling useless. In an attempt to make a small difference, I started cleaning up the ICU. The supply shelves needed some organzing and I just sorted and disposed of the trash. In the process, I found lemon mouth swabs and my ICU nurse was thrilled that his patient would finally get a respite from the taste of an ET and NG tube . . . small, oh so small, victories. I threw out half a bag of trash from just two shelves and then I had to stop. . . .

We were all sitting outside at dusk when Alex came to tell me there was a “surgical emergency” at the gate. A 30+ year old gentleman had excruciating abdominal pain and a new “bump” above his umbilicus. He had vomited a few times and come in . . . simple problem, simple fix, just what I needed. After evaluating our patient, I took the internal medicine doctor into the OR and we fixed the man’s incarcerated supra-umbilical hernia. Small victory, but on my stage, in my arena, and just what I needed to prove to myself that I was offering something here.

It is hard to imagine you can effect change by fixing a hernia, taking a rock out of a kids ear, cleaning up an ICU shelf or two . . . but perhaps, you can.

Sitting outside on the roof, after my case, I drank a Prestige with my teammates and laughed about the silly things we had been through that day. The rain came to wash the dust away. We ducked into the ICU to check on the patients and make sure the night shift was okay. And now, here I am, trying to capture 12/27/10 so it doesn’t slip away.