MedCity Influencers

A healthcare perspective on the reality in Haiti

As the six-month mark has arrived, there’s suddenly been more about Haiti in the news, tales of paralysis and corruption and despair. But almost all of these reports are from people who’ve flown in for a quick visit – one Esquire reporter even starts his story describing how he didn’t step outside his hotel during his […]

As the six-month mark has arrived, there’s suddenly been more about Haiti in the news, tales of paralysis and corruption and despair. But almost all of these reports are from people who’ve flown in for a quick visit – one Esquire reporter even starts his story describing how he didn’t step outside his hotel during his one-week visit, and only went on drives with his “facilitator.” So what IS actually happening? To find out, I went to people who’ve been consistently involved with Haiti since the earthquake. So who are these people?

Enoch Choi is an amazing individual – a Palo Alto Medical Foundation physician who has, in his free time, organized teams of healthcare providers to go each month to Haiti. Enoch’s approach is different from the usual large relief or non-profit organization – his groups are lean, mean, guerrilla teams with healthcare providers who each pay his/her own way and take a 7-10 days of vacation time to work like dogs. There’s low/no overhead, and these teams can move in and out of areas of greatest need with their own supplies. More importantly, Enoch’s groups are still going to Haiti, long after most agencies and volunteers have pulled out. One team is heading to Haiti now, with more teams scheduled for August and October. By September, over 100 healthcare providers (doctors, nurses, therapists and pharmacists) will have gone to donate a chunk of their own time to those still struggling to survive, and suffering from, the aftermath of the earthquake.

The backbone of this incredible, sustained effort is Jesse Mendoza, the on-the-ground organizer for these teams. Jesse is the point man for security, provisions, lodging, and facilitating where the team should see patients each day. Just imagine trying to do his job – catapulting yourself, without a speck of knowledge, into the worst disaster situation known, and then getting to know everyone and making the impossible happen. Since the earthquake, Jesse’s spent way more of his life in Haiti than he has been home in Gilroy with his lovely wife and toddlers. Jesse is affiliated with Jordan Aid International, a non-profit that stepped up to partner with Enoch (who is now on their board) to be a fiscal agent, to make it possible for people to make a charitable donation, and to help make this important work happen.

I interviewed these two people, who have lived and breathed Haiti for the last six months, and whose own personal lives have been devoted to this effort. These two are not celebrities who have swooped in from time to time and blown out again. These are people who have traveled the worst parts of the city, serving the suffering and talking to individual Haitian. They have stayed with it long after the cameras have left. I asked them what they thought about the situation in Haiti and where things stood six months after The Day The Earth Trembled.

1) How Haiti has changed, or how has the approach you/your teams use has changed?[Enoch] Back in February, the camps were a month old and fluid, with areas set up nightly as shelter, in a way tolerated by government and owners. But now, I hear that as those locations have become unliveable, or have tried to get back to their initial intended purpose (e.g the pool hall), the evacuees are sent to desert-like locations in the boondocks, like Camp Corail, where there is no way for anyone to earn a living. For some of the camps who are less well-supported, people have to resort to stealing from other camps for sustenance. It sickens me to hear that these folks are tempted to move from Port-Au-Prince with the hopes of “owning” their tents in these arid wastelands, in an unsustainable location. In February, I took hope in the UN convoy that we tried to sneak into to get through the border at night, because it was a visual symbol that aid was getting through. Now, I’m so upset to see news reports of a pileup of heavy equipment and supplies stuck in Dominican Republic at the border, unable to be imported due to Haiti’s government-blockade.

[Jesse] I would have to say what has made the most impression on me over this time is the thought that these people have lost and suffered so much and are still standing holding on to HOPE. I have seen so much of what the earthquake’s aftermath caused – in terms of debris, the dead and the injured, an entire city literally collapsed and was left in ruins, yet the Haitian people have not allowed all of that to stop them from living and pursuing their hopes and dreams. Having traveled there 5 days after the earthquake I witnessed a city that was literally paralyzed. Everything was just so recent, people walked the streets with a look on their face of disbelief at what had just happened, without direction as to where to go or what to do. I recall seeing people carrying their loved one’s found body parts in bags, and others just sitting on the sidewalk with their frail frowning faces of sadness. It was a hopeless scene over all. Every month thereafter, the Haitian people have encouraged me to know that you can have hope in the midst of misery. I was uplifted to see on my ongoing trips that the people just started to get back to what they knew to do. To live. They started to sell things on the side of the roads, cooking and opening their shops and marketplaces. It’s a small thing, but I was also moved one day when I saw a group of young men playing basketball.

2) You have stayed with Haiti over the long haul. How are people trying to survive and adapt during these months? It seems that there is still so much need and the change of weather is now complicating the relief efforts. We have had to change our approach in many aspects because the Haitian Government is now placing lots of restrictions on how and what you can do. For example, in May we heard of a tent city just outside of Port au Prince where there are currently over 5 thousand people without any running water, food or resources. These are folks that have moved to higher ground near a UN camp called Corail. We were specifically told that we could not go and help these people medically without Government authorization. I’m sorry but I had to make the call of going with or without authorization. These people are in so much need and need help urgently! Our team treated over 2 hundred people that day. And it’s not just people in tent cities. There is a young policeman whom we hire continually for our security. I didn’t realize until May that he literally lost all he had. His home, his wife and his only daughter. He has survived only by the work that we give him while we’re there. He is a very responsible young man, always there and always on time.

3) What can you tell us about the children – about the present or future of Haiti? [Enoch] The children who touched me the most were a young girl and her younger brother, who were my own children’s chronological age but appeared 1-2 years younger due to malnutrition. When I asked them who was taking care of them, they said “aunties” but when I asked who they were so I could explain to them how to administer their medicine, none were to be found. Apparently, their parents were in Jimani trying to buy items to sell in Haiti. Even these middle class children were at risk, with parents who were affluent enough to be in business but with no one to carefully watch their kids as they tried to recover. I wondered where the grandparents or other relatives were, and I realized they were likely dead. It was heartbreaking to have these children come and cling to my arms as we packed up at the pool hall, with me not knowing when their parents would return, and how these precious children would be provided for, as they asked me for food and water. I worried that if these children of some means were at risk, how could orphaned children and more neglected children have hope for their future?

[Jesse]I would add, though, that in spite of all that’s happened, the children of Haiti are playful and still have a smile when they see you. I was impacted back in April when our team delivered 4-5 babies on that trip. One night I was in the JPHRO make-shift field hospital and saw a woman who delivered her baby at about 8pm and then left the hospital that night with her newborn baby in the rain. She lived just down the hill in the Petionville Club refugee camp. I was haunted by the thought that the home in which this baby was to live is made of plastic tarp walls and plastic sheet-roof over mud floors. My eyes get teary every time I think about this. But this is the reality of the homeless people of Haiti.

4) The massive piles of rubble have become a visual image of Haiti’s destruction and paralysis. Is the rubble as big a barrier to progress as it seems to be? [Jesse] This has been one of the biggest things that has impressed me. I saw firsthand the initial aftermath, debris everywhere. I remember seeing large amounts of debris on the streets, so much that you would have to find alternate routes to get anywhere. For the most part there hasn’t been much large machinery moving the collapsed buildings. Rather, it has been lots of manual labor. To this day it’s not uncommon to see large groups of men and youth clearing up debris with picks and shovels. Groups of youth can be seen sweeping the streets and keeping Port au Prince clean as much as they can. Much of what I initially saw has been cleared up to this point. But there are still large buildings left in ruins to this day. If they were to continue to clear up by hand as they have I estimate that it would take them several years to achieve clearing it all up. I have to say though – the Haitian people [emphasis is Jesse’s] are hard working people.

[Enoch] JPHRO started moving rubble 2 days ago, but are one of very few organizations doing so. It is a huge barrier. The government is blocking progress. Much more could be done if they allowed the heavy machinery in to work.

5) Finally, is there something about Haiti, or Haitians, that you think people are not hearing in all the gloomy coverage about how things have not really changed? [Jesse] I see that the media is no longer covering what is still happening, or the effects that the rains are having on the 1.5 million people who still find themselves homeless. Not to mention the sicknesses and diseases that are being seen as a result of a broken infrastructure.

[Enoch] It surprised me to hear from KQED’s 6 month anniversary broadcast that a journalist who’d been there before and after the quake said that many of those in tent cities were better off than before. I found that comment insensitive to the suffering, both physical from injuries, and emotional from losing loved ones – but it surprised me and made me think. I realized that for some of the survivors, having regular food and water, as well as free medical care, that this was an improvement, since most went without medical care since they couldn’t afford the fee-for-service system. It makes me glad to think there’s some improvement, but I wonder for how long, as volunteers leave Haiti and are unwilling to continue caring for survivors.

Reading about Haiti from this country, it’s easy to get overwhelmed and cynical about how to help. If people like what you’re doing and want to contribute, how can they? [obligatory conflict-of-interest notice – Although she went to Haiti as a member of Enoch’s February team, Doc Gurley is not paid, is not affiliated, and does not receive any gifts/support, nor funds of any kind, from JAI or Enoch Choi]. [Jesse] Please help us in our efforts to continue to help the people of Haiti. They need you! You can read more about what we’re doing and give toward our efforts by going to our website: www.jordaninternationalaid.orgThere is a PayPal link, and if you specifically want to sponsor or offset the cost of sending a healthcare provider to Haiti, you can write their name on your donation.

Dr. Jan Gurley is a board-certified internist physician who writes regularly at Doc Gurley: Posts from an Insane Healthcare System

This post appears through the MedCity Influencers program. Anyone can publish their perspective on business and innovation in healthcare on MedCity News through MedCity Influencers. Click here to find out how.