A Plea for Haiti

By Sienna Miller

Global Ambassador, International Medical Corps

I came to Haiti as an ambassador for the International Medical Corps, an organization that I have been working with for over a year. Their teams arrived 22 hours after the devastating earthquake of 12^th January and have been a powerful and leading medical presence ever since.

I arrived in the Dominican Republic from London on the night of March 18^th, and met up with my friends Margaret Aguirre from International Medical Corps, and David Serota, a talented filmmaker who has come to document the long-term health care needs that lie ahead for Haiti.

We flew the following morning to Port-au-Prince and were met in the chaos by Andy Gleadle, our operations director, (the kind of 'man mountain' that you hope to be around in disaster zones like this one) and were briefed on the security issues we potentially faced. For starters, the local jail was destroyed in the quake, and as a result, 5,000 prisoners are free and roaming the streets. There were serious security problems in Haiti before the earthquake, but of course everything has now intensified. Three NGO workers were kidnapped the previous week, so Andy told us what to expect and how we would be protected (a two-car convoy at all times, watchmen by the tents etc). Afterward we drove to the guesthouse to meet the team, drop our bags and then head out to start the day.

Our first stop was St Louis, a neighborhood in Port-au-Prince, to visit Dr. Joseline Marhone. I sat with her in the shade of a tree, her patients surrounding us on beds in tents nearby, and asked her to share her experiences with us. Her house was destroyed in the quake, but thankfully she and her son were in the basement at the time and survived. Her two cousins upstairs did not survive. I found it so difficult to ask the questions that I suspected would be hard for her to answer. Journalism of this sort does not come naturally to me, but she explained that it helped her to talk about it. So she speaks, with a resilience and strength far superior to mine upon hearing her. She was the director of nutrition for the Ministry of Health in Haiti. The nursing school where she taught collapsed, killing every one of her students. She told us that she had found that the best thing for her to deal with her enormous pain was to keep busy and carry on doing what she does so well. To date, on the grounds of the ruined church where she once worshipped, she has treated over 4,000 people. International Medical Corps has provided her with the medical supplies and volunteers that she needs in order to do this. She is so beautiful and open, walking around with a smile that melts, wearing the same long blue cotton skirt that she was wearing on January 12^th when the earthquake struck.

My role here as ambassador is simple: we need to raise awareness of the road ahead for Haiti – and raise a significant amount of new funding through appeals to the public. Most people just don’t realize that the problems Haiti faces are really only beginning. This country was in desperate need before the earthquake hit. The problems they are now facing are tenfold. The onset of the rainy season, which is imminent, means that the temporary camps that are housing hundreds of thousands of people will be washed away. Water-borne diseases will be rife, nutritional needs will become even more prevalent and there is inevitably a massive increase in sexual and gender-based violence within the camps. Donors have been incredibly generous, but as always, much, much more is needed.

After a fitful night’s sleep in a tent with Marge, (gunshots, roosters, crying babies, the works) we have a cup of coffee and set off at the crack of dawn to visit some of the mobile clinics and projects set up in those early days after the earthquake by the stunningly beautiful and clever Dina Prior, who heads International Medical Corps’ Emergency Response Team. We drove to Petit Goave, three hours outside of Port-au-Prince. The coastal regions are far more difficult to access, and it takes an hour by boat to reach the small beach community of Platon. It looks like heaven to me. The kind of untouched postcard paradise we westerners are constantly searching for. White sand so fine it feels like flour, azure blue sea and old handmade fishing nets thrown haphazardly over the ancient palm trees. We are greeted with smiles and cheers by a beautiful group of men, women and children, so grateful for the work that is being done. However, they are hungry, incredibly poor, and virtually cut off from the essentials they need. Until International Medical Corps arrived here, they faced a two-hour journey just to receive any medical attention at all.

• WATCH a Video of Sienna's Visit to International Medical Corps' Programs in the Democratic Republic of Congo in 2009
  

The following day, we went to the General Hospital in downtown Port-au-Prince, and spent the morning being shown around by Dr Gabriel Novelo, who is overseeing operations for International Medical Corps, and Megan Coffee, an infectious diseases specialist who is handling the TB ward and patients with everything from HIV to typhoid. They were warm and generous, taking the time to explain to my untrained ears the many facets of their work. I was amazed to see that despite the sheer number of patients – sometimes 800 a day - they are on first-name terms with almost all of them.

Our last stop was at the intensive care unit tent. Everywhere I looked, there were doctors and nurses from around the globe. They all work incredibly long hours, as volunteers, helping the relief effort out of the goodness of their own hearts. I saw a woman die two meters from where I was standing. A team of doctors then spent ten minutes doing intense revival work, giving her CPR, adrenaline shots to the heart and defibrillation, basically demonstrating the relentless commitment that goes toward saving a life. I stood and watched, hoping and praying for a miracle, as her pulse was checked again and again without a murmur. Every ER doctor has experienced this hundreds of times, but I am a woman, in a tent in Haiti, watching something I never thought I would witness. They fought and fought, and miraculously, revived her. I saw a life lost and saved by the medical teams International Medical Corps has working here. I watched this woman fight for her life. I saw her husband crying, not only for himself, but for their two children, and marveled at the simple fact that these volunteer doctors have the ability to bring mothers like her back into the world.

Later that day we headed to Petionville, an enormous displacement camp, to visit a new facility we have within the compounds. These people, like most, are living in tents, except that this camp (or rather city) is in a giant basin-like valley. When the rains come, and they already have started, this and its 60,000 inhabitants could be washed away. Logistically moving that many people, with the imminent monsoon and hurricane season lingering like a time bomb, is a terrifying reality that they are all facing. We met up with my friend Sean Penn, who is doing incredible work here through his organization, the Jenkins-Penn Foundation. They are providing medical care and devoting their energies toward the protection of these vulnerable people. We discussed ways of collaborating and were taken on a tour of the camp by Sean and Pastor St. Cyr (who is holding daily services for those living here, a vital task for a devoutly religious population). There is an area where tents balance precariously on the edge of a ditch that drops 10 feet into what is now a dry riverbed. When the rains fell a week ago, that ditch became a raging river and two children very nearly lost their lives. International Medical Corps is bringing in floodlights to try and prevent disasters like these from becoming a reality.

The following morning, we headed back to the General Hospital, where I spent a few hours with two fabulous psychiatrists, Dr. Lynne Jones and Dr. Peter Hughes. Obviously there are massive psychological repercussions to a traumatic event like this, and previous mental illnesses have been exacerbated in many cases. They are treating patients in the general hospital suffering from a range of illnesses from psychosis to epilepsy. The care being given here is a vast contrast to what is happening at the old mental hospital next door we visited later. It is beyond anything I could imagine. This being the poorest country in the western hemisphere, education is not at the standard that we are fortunate to have in the developed world. The treatment here is archaic, the conditions inhumane. The people I saw were obviously seriously unwell. Some were screaming, some blissfully happy, very few are clothed and during my visit, most stood in tiny rooms, naked and covered in excrement. They push their heads through sharp and rusting holes in the iron doors to have a look at us, screaming for help. A mental institution is an intimidating thing to see for someone with no experience in this area like myself, but this made “One Flew Over the Cuckoo’s Nest” look like The Ritz. It was shocking and like everywhere in Haiti, desperately in need of funding.

The amazing thing is that this country has a spirit that very quickly gets under your skin. The people are friendly and welcoming, and everywhere I look, I witness examples of human courage beyond imagination. They are sticking together through what has been the most devastating earthquake in a hundred years and it is vital for the various NGO groups to do the same.

I suppose what I am attempting to do is use whatever means I have to generate some sort of attention for a country I feel utterly passionate about. I am not a writer, but one thing I have always somehow managed to do is garner press attention. I am now hoping to exploit that for a very good cause.

Please, if you can, donate now to International Medical Corps - an organization that is doing this incredible work, saving the lives and building a future for these beautiful people. To learn more about them and about how you can help their efforts in Haiti please visit www.imcworldwide.org.

• READ Sienna's Blog Posts about Her Visit to International Medical Corps' Programs in the Democratic Republic of Congo in 2009

My Mind-Changing Response to Visiting Haiti

By David Serota, Filmmaker with International Medical Corps

That is what this is. That is what Haiti is. On every level. In every way. From the Haitian people. To the people who were compelled to come here. All the way down the rabbit hole -- to me.

Standing in the rubble that was once Port-au-Prince and Leogane (the actual epicenter of the original earthquake) you are instantly struck by what those in the media could not capture and our Western sensibilities cannot address. I tend to enter a 'situation' with a "you know what they should do" mindset. The places I have been fortunate enough to travel to have reduced this knee jerk response to a certain extent but Haiti might have changed it for good. Changed me -- for GOOD.

Landing in Dominican Republic at night was like waking up in a dream. No sense of time or place. Driving through city streets, not sure what is on either side of you. It could be the ocean. It might very well be a cliff. A late dinner with most of the team I traveled with in DR Congo last Spring (Margaret Aguirre, International Medical Corps’ Director of Global Communications, and film actress Sienna Miller) and we headed back to the hotel. An early morning taxi pick up and then off to the airport once again for our flight to a place that was once the only thing on television and is now barely a mention on CNN or in the NY Times.

Woke up late and rushed down to meet everyone in the lobby. Our taxi wasn't there. So we grabbed another one and headed for the airport...the wrong airport. This not being realized until we got there. Through morning rush hour and then along a Caribbean coastline we motored to the right one. Luckily the plane we were on was delayed so we made it with plenty of time to spare. A reminder. When traveling, what can go wrong, will. Journey on.

Upon landing in Port-au-Prince you are thrown into the melee to come. Plane cargo trucks backing up to open bay doors where they throw your bags with impunity and then out into a traffic jam of people trying to exit gates that are dressed with people in need. Begging for something to make life...livable. Fortunately, the chaos was made easier as we were met by Andy and Crystal from International Medical Corps. International Medical Corps arrived less than 24 hours after the quake to deliver emergency assistance and I am here to document their long term response to Haiti's recovery. Crystal is the communications officer for the operation and Andy is our security advisor. International Medical Corps always travels in convoys. It is important to ensure safety, strength in numbers, and because people can always pile into one vehicle if the other breaks down. It is not for show and it is not for insurance reasons. It is standard operating procedure and another one of their lifesaving methods. Aid workers are often targets of violence. Three have been kidnapped in the past week here in Haiti.

The destruction is everywhere but it is hard to absorb. It felt like it could have happened 5 minutes or 5 years ago. But then it digs in a little. There are people in there. Hundreds of thousands of them.

One of my favorite parts about traveling with International Medical Corps is that they employ the local people and none more important than the drivers. This time we have Steeve. He is 27 years old. Learned all his English from television and music. Always in an oxford and slacks. Always rocking out to hip hop. They take you everywhere. They navigate the traffic and streets like they went to school for it. Avoiding pot holes that would have swallowed you up. We learned about his friend. Trapped in the quake. Steeve was at school for thematics. When the quake happened he jumped from the balcony. He and a few others went looking for a friend. Found him. Trapped. Only identified by his sneakers. They could not reach him. So for 10 days they passed him food and water with a rope. Eventually. Nobody took the food.

International Medical Corps has set up a guesthouse in one of the remaining structures still standing. They have 39 full time staff and around 59 rotating volunteers. It is compound like. High walls, metal gate, armed guards. But inside it feels a bit more like a college fraternity house. People live out of duffle bags, even those on 6 month rotations. Everyone is from a different country but they all have one thing in common. They have traveled extensively. Mostly doing aid work. They LOVE what they do.

The courtyard is a tent city. Not only because there are not enough rooms to house everyone but aftershocks are still prevalent. There was one last night. We threw our stuff down and were out the door to our first location.

The morning after the quake, a Port-au-Prince local, Joseline Marhone, opened an emergency clinic under a grove of trees adjacent to the wreckage of the Church of St. Pierre in the St. Louis area of Port au Prince, just a few miles from downtown and began treating the injured. Several of her medical students quickly joined her. A tent was erected, canvas sheets were put up and mattresses were hauled in to create a 13-bed in-patient section to the clinic. She sleeps in the pharmacy, which is outside. Her dinner table is an Igloo cooler and her bed is a worn out piece of foam. She tells me this with the most beaming smile you have ever seen.

At night we gather on the terrace, download our days and unwind with drinks and dinner. Everyone getting to know one another. Exhausted, I climb into my tent and go to bed. The sound of chickens who do not know what time it is, gunshots and screaming babies serenade me.

Early the next morning we take a long drive out through Leogane, a town by the sea. That is where we board a small motor boat to visit one of seven mobile clinics International Medical Corps is operating on that part of this island nation. Before the quake this area had never received any kind of medical attention due to the steep hillside making it only accessible by water. Once we arrive we immediately saw International Medical Corps’ presence. A field clinic steps from the beach outfitted with basic medical supplies. They even provide mental health specialists for those with psychiatric needs. It is a sight to see. We felt welcome. I thanked them then and I thank them here.

Dina Prior is the head of the Emergency Response Team in Haiti. Her job is to setup International Medical Corps after a disaster. Imagine that. Trying to coordinate, triage and implement a scalable RESPONSE in the midst of a communication blackout, in a city still shaking and still on fire. That night at the guesthouse she details for me the the first days. A rock star in every way.

There is an amazing lighthearted nature to the staff. Perhaps a primal response to the intensity of their days. The fight and then their flight. Save a life and pal around. All in a days work here.

Today we went to the general hospital downtown. The buildings were all left uninhabitable so International Medical Corps has set up tent clinics for every issue imaginable. TB and AIDS patients, an intensive care unit and a pediatrics ward just to name a few. While in the ICU a young girl went into cardiac arrest. The alarm on the monitoring machine sounded with the audible scream of a flatline. A doctor raced to her bedside and immediately began chest compressions. Nothing. More doctors. More compressions. Still nothing. They move on to the defibrillator and finally to adrenaline injections. Nothing. The tall doctor pressed with all his might. It was his first day on the job. The heat inside the tent was almost unbearable. The RESPONSE of International Medical Corps to save this girls life left me in awe. 20 minutes later, when many thought he should have given up, she responds on her own. Her future is unknown. Although her blood flow was maintained by the chest compressions brain damage might still be a result. The irony of tomorrow's health care vote is not lost on me. Every life deserves a fighting chance.

After that we went to an internal displacement camp of approximately 40,000 people in an area called Petionville. We went to visit Sean Penn and his personal efforts to address the disaster in Haiti by focusing his attention on these people alone. A gigantic task and an admirable one. He used his own financial resources to deliver a RESPONSE that is effecting change for thousands of individuals. Unfortunately the camp is set on a hill so when the rains come it will not be sustainable. We walked up that hill to the top where we found Sean and his camp. Both modest and dialed the compound is very cool to see. We chat for a short while and once again take a walk through the camp with our guide Pastor Sincere. Yes, really. The people stop you. The people thank you. I am overwhelmed by the RESPONSE.

Sean passes by in a small 4×4 vehicle and gives us a lift back up to the top of the hill. He stops and interacts with many of the camps residents. They know him. They like him. There are no cameras here. This is not a photo op. This is who he is.

Back at camp we talk about the upcoming rainy season and he details his next steps and we all trade observations and opinions. Unfiltered. Same team here. Sean says something that stuck with me. "The Haitian people are punished for their strength." It is true. In every Haitian you meet you see it. You feel it. They are STRONG.

Thing is, nobody is protected from the upcoming hurricane season. Housing for both International Medical Corps and the Haitian people is temporary. When the storms come...

Tomorrow is our last full day and I am sad. Not by what I have seen but that I am leaving. That is my RESPONSE. Haiti is in me now. And I will come back.

Soon.

Far From the Last

By Crystal Wells - March 22, 2010

March 22nd marks the 18th World Water Day, a date set aside each spring by United Nations proclamation to celebrate the importance of fresh water. For those living in the Developed World, it’s a chance to remember that an estimated 900 million people globally still lack access to the minimum daily required amount of safe fresh water. This is the story of what befell one of those 900 million.

Max is a petite 17-year-old Haitian girl, who lay in the ICU tent at Port-au-Prince’s University Hospital, her belly swollen and bandaged. In the next bed was another woman in the same condition.

Max, like the woman next to her, came to University Hospital with sharp stomach pain and a swollen abdomen. In the United States these symptoms would likely be appendicitis. Not in Haiti. Following the Jan. 12th earthquake that destroyed so much of the capital, hundreds of thousands now live in overcrowded, hastily thrown-together tent cities, at risk to something practically nonexistent in most of the developed world – typhoid.

I was introduced to Max and her attentive father, Jacksone, at the University Hospital, where International Medical Corps has been working since January 14. Her battle with the disease has been going now for two months.

When I learned why this beautiful, young, and otherwise healthy woman laid in a hospital bed for nearly two months, I had to share it. I share it for her and because I know the monsoon-like spring rains now bearing down on Haiti will certainly claim more victims amid post-earthquake Haiti’s large displaced population.

When the 7.0-earthquake hit the country more than two months ago, clean water and sanitation, already issues for Haiti, became that much worse. Heavy rains will only add to that misery and to the threat of disease, including typhoid.

The tragedy is that typhoid is easily preventable. Vaccination is routine for infants born in the Developed World. As a bacterial disease spread by eating or drinking contaminated food or fluid, typhoid is also prevented through clean water, sanitation, and hygiene.

Max’s story is similar to that of thousands of Haitians. Their home was completely destroyed in the earthquake and they were forced to live on the street, without even a tent for shelter. Clean water was also impossible to find.

“In the first few days, many of the water pipes were broken, so I would collect our water from them and boil it for my family,” said Jacksone.

Despite the boiled water, Max started to complain of stomach pain. The pain persisted for days and her belly began to swell. When Jacksone took her to the University Hospital, she was rushed into surgery to remove part of her bowel.

“In severe cases of typhoid, the bowel can swell and, like a balloon filling with water, it eventually bursts, leaking human waste into the rest of the system,” said Megan Coffee, an infectious disease specialist at University Hospital. “The only option at that point is to do surgery to repair the bowel and then clean the human waste away.”

And that is exactly what Max went through - and the woman beside her. “If she did not have surgery, she would have been in real trouble,” said International Medical Corps volunteer, Dr. Susan Levine from Connecticut.

I am told that Max will recover and, with the diligent care of International Medical Corps volunteer doctors and nurses, I do not doubt it. But as the spring rains prepare to roll in, I can’t help but wonder how many others here will suffer from typhoid in the coming months.

As I was leaving the ICU tent, Levine pointed out a man tossing and turning restlessly on his cot. “He is another one who came in with severe typhoid and required surgery,” she said.

And definitely not the last.

As we mark World Water Day, please help us spread the word about waterborne illnesses like typhoid by sharing this story with your family and friends.