We Need Help

By Crystal Wells

This is a phrase I have seen over and over again during my time in Haiti. It is spray-painted red on crumbled walls. It appears on little signs jutting into the street outside camps and homes. I have seen it written in English, Spanish, French, and Creole. Some list specific needs, like food, water, and shelter.

But wherever it is written, “we need help” is like a small beacon of hope that someone, anyone, will come with assistance – that those in need will not be forgotten.

One month has passed since the 7.0-earthquake hit Haiti and millions are still in need of food and water, shelter and medical treatment. Thousands live in makeshift camps, with four, five, or six family members huddled beneath tattered sheets held up by sticks. There is little food, little access to clean water, and “we need help” will likely take on an even greater, perhaps more desperate meaning, as time passes.

You can already see this happening. Along the road to Petit Goave, a coastal area roughly two hours west of Port-au-Prince, roadblocks made of rocks and sticks now accompany the signs pleading for help outside the camps. Some of the roadblocks are discrete and easy to bypass, an attention-grabber more than a serious obstacle, but others quite literally block the road or, even worse, could demolish a vehicle.

We ran into one of these roadblocks while visiting one our clinics in Petit Goave at a remote camp on the top of a hill above the sea. The nearby camp had taken piles of rocks to make the road completely impassable and right as we stopped, a crowd quickly gathered around our car, protesting that relief had not come. We visited their camp and, like so many in Haiti, they had barely any food, completely inadequate shelter, and little access to clean water.

Our group heard their needs, told them of our clinic just up the road and our plans to build water and sanitation systems in the area, and we were soon on our way, the rocks moved to the side by the same hands who put them there.

But this is happening all over Haiti, people who have lost everything and have nowhere to turn but to broadcast their suffering with spray paint, cardboard, or rocks in the hope that someone will hear them.

Millions Mourn In Haiti

By Crystal Wells

The music started around 4:30 am, soothing and melodic, like a chorus softly praying into the early morning air. As the sun rose, so did the energy of the music, filling the city with percussion, rhythm, and cheers of “hallelujah”.

It was exactly a month since the devastating 7.0-earthquake hit Haiti and the sounds marked the start of a period of national mourning for the some 200,000 who died in the disaster. Streams of people, mostly dressed in white, flowed towards a stage erected near the remains of the Presidential Palace in downtown Port-au-Prince to take part in a national prayer service.

Some here call the earthquake “l'événement”—the “event.” Others refer to it by the terrifying sound of its destructive force: “Goudoum! Goudoum!” It’s a saying that started with children who, having no word for earthquake, invented one that mimicked the quake’s shaking and rattling. Whatever its name, the earthquake was a collective, near-apocalyptic experience that touched every Haitian—rich, poor, mother, child, brother, sister.

If their house did not collapse, a close friend’s did. Their family might have survived, but someone dear did not. So many remain missing, the majority lost beneath the rubble that is everywhere.

My second day in Port-au-Prince, my driver showed me a video he shot with his cell phone. It was of a casket. Inside, he said, were his wife’s aunt and her two children. They had just been recovered from the rubble, three weeks after the earthquake, partly decomposed and their faces scarcely recognizable. One casket was all they could afford.

Yet he felt lucky to have found them. Now, they could have a proper burial.

Memories of the disaster haunt the city and as cranes start to clear the rubble, fear of another, possibly even larger quake, hangs in the air. Even those with undamaged homes don’t dare sleep inside. Next time they might not be so lucky.

But on this day and the days ahead, it is time to mourn the dead.

Songs of prayer also hang in the air at the University Hospital, less than half a mile from the President Palace, where International Medical Corps is providing around-the-clock medical care to thousands of Haiti’s most seriously sick and injured. Patients in their beds, too sick to travel to the service, join together in song, often with their families beside them, some in groups as small as two and others large enough to fill two 30 ft-long medical tents.

The music lifts tired spirits. It stokes resilience, assuring those in song that Haiti will not perish, even if the rubble of this memory takes years to clear.

The Rainy Season Begins

The rain fell a few nights ago for the first time. It started off slowly, around five in the morning or so and then came down hard enough to wake me up. The first thought I had were the thousands of people living in tent cities beneath ragged bed sheets. Even a light rain could wipe out their small shelter and this one was just a small preview of what will inevitably come.

My translator arrived at my hotel about an hour later soaked. “This is nothing, boss,” he said. “In Haiti, it rains dogs and donkeys.”

Looking at the toppled buildings, mile-long food lines, and families crouched beneath nothing more than cloth and sticks, it is hard to imagine that Mother Nature will compound the already widespread suffering in the months ahead.

The rainy season in Haiti usually begins in April or May and hurricane season quickly follows between July and November. This mid-February rainfall could be the first hint of an early season, which would be a very unwelcome twist to the recovery efforts underway here.

I traveled out to Petit Goave, a coastal area of roughly 80,000 people 68 km west of Port-au-Prince, where our water and sanitation expert, John Akudago, is working to build latrines and clean water systems. Some of the first latrines will be in Beatrice, where approximately 2,500 people have resettled in some six camps that scatter the hillsides above the sea.

His first step: making sure that women are involved in the construction, from when the first shovel hits the dirt to the final product. “Women are integral to the success of water and sanitation systems,” says Akudago. “In each community, I tell the men that the women have to be included for this to begin.”

And included they were. In the camp that we visited in Beatrice, women stood alongside the men, digging the trenches for men’s and women’s latrines and received hygiene messages, like hand washing, to share with their community.

I spoke with one woman living in the camp who had eight children, ages eight to 20 years old. It did not rain like it had in Port-au-Prince, but she worries about when the rain will come. “But only God knows when,” she said.

To collect water, she must travel about 30 minutes roundtrip to a spring and back, but it is not potable, so it must be treated. The community, she described, is so happy and thankful for the latrines, made possible by the work of Akudago with International Medical Corps.

Back near Port-au-Prince at a camp in Carrefour, where International Medical Corps is providing health care alongside the local organization Hope for Haiti, some families were rebuilding their makeshift tents that were wiped out by the early morning rain. One young couple was lining the perimeter of their tent with cement blocks with the hope that it will keep the runoff out when the next rain comes.

Another woman, who lives with her daughter and grandchildren in the camp, worried that the babies would fall sick during the rainy season because they will often be wet and cold. “We have no toiletries and it is also hard to stay clean,” she continued, picking up her smallest grandchild from the muddy ground.

Akudago also dreads the rainy season for the hundreds of thousands of homeless. “Sanitation is a big problem, especially in Port-au-Prince, and when it rains, the human waste will spread,” Akudago explains. “I fear that there will be an outbreak of disease when the rainy season starts.”

The rain is inevitable, but its first appearance in Port-au-Prince in mid-February could mean that it is coming early, giving very little time for the homeless to find relief before their next drubbing from Mother Nature.

But is it?

Only God knows.

“...on my final day, my mind tired and body aching, I find myself wishing for a couple more days.”

By Dr. Solomon Kuah

Wednesday, February 10, 2010, 4:45 PM,
Port-au-Prince, Haiti

If only I had a couple more days . . . I have spent every day of the past 26 days working at the Port-au-Prince University Hospital. I am on the last notch of my belt, sun-burned, dozing off during the rare standstills, and wondering if I should be worried about urinating only once a day. I have battled sickness, heat exhaustion, dehydration, and near-narcolepsy without faltering a day. Now on my final day, my mind tired and body aching, I find myself wishing for a couple more days.

You've heard the story: it started 2-3 days after the 7.0 earthquake that found us at the University Hospital with nearly 800 Haitians near-death and wounded. On the first days we worked with our tools at our side, bobbling around with jump bags full of irrigation, splints, antibiotics, pain medicine, sharpies (triage), etc. The Haitians were strewn all over, lying on either the bare floor, cardboard boxes, stained blankets, or shattered hospital beds. Too broken to move, they waited for a shadow to fall over them that could signify a doctor or nurse coming to tend to them. Their faces were sad and they had no tears to cry, but if they could just reach into the shadow, someone might notice they were alive. Our relief team masked the shock and ignored the quiver in our hearts. We worked with speed and diligence. We were committed to these people.

As the days passed, we secured shelter and water for our patients. Other relief teams poured into the hospital and we evolved from the bumbling individual with 2-to-3 jump bags slung over each shoulder to a clumsy system at a maximum 57 agencies, all setting up shop around the patients. The system was anywhere from fast and fluid to confusing and redundant with some days a flurry of activity and others a standstill. We scurried around with faces of many colors while our patients lay still in their cots watching in apprehensive confusion, unable to move. I visited nearly every one of our original patients, every day for the past 26 days - maybe my unique 'Chinois' face would serve as one thread of consistency. One can only wonder if this reassured them.

Each day we chipped away at these numbers and the patients slowly got their much needed interventions. Smiles began to surface and family members occasionally danced in the space between tents. Most smiled back at me every morning, some would even wave, some would not, and others simply could not. Life was coming back into their bodies and now it was time to start preparing for their life outside the hospital. Rehabilitation and physical therapy centers having been popping up throughout the city over the past week and a half. As a center opened, we would offer them a transfer but most would initially refuse to go. They were afraid if they left, they would die. This is a society and culture bent by a failed state to not trust what they could not see. I would visit each center and 'report' back to the hospital. 'Reporting' used a phenomenon called 'tele diol' or word of mouth. It found most the centers calm, well staffed, and appropriately equipped. Upon return I would have one of the local Creole translators tell one family member, ˝the 'Chinois' doctor just came back from the rehabilitation center and he thinks it is very good.˝ By the next morning, nearly all were willing to go. Just remember, 'tele diol', it can be used for good or for bad.

It is my final day and we have approximately 90 of our original patients left. A third still require a final orthopedic or plastic surgery intervention, with the remaining waiting for the hospital rehabilitation facility to open. International Medical Corps has been working closely with Handicap International to open a rehabilitation/physical therapy center on campus. It is nearly complete with the truckload of equipment coming tomorrow. This means within a week we could potentially see one of our first patients walk out of the hospital by themselves. I've longed for that day. I will miss that day. If only I had a couple more days.

Although I am the only person left from the first International Medical Corps team I have had the company of my patients. I have three names: 1) 'Chinois', 2) 'Jackie Chan', 3) Dr. Sol, and 4)'the humble doctor'. One mother with an above-the-knee amputation of her left leg requested I support her as she guided me into the hospital courtyard. She took me to watch the children dancing and singing. We sat for 5 minutes, silent, until she said 'thank you'.

Combating Malnutrition in Haiti

By Tyler Marshall

International Medical Corps this week began delivering high-energy biscuits and ready-to-use food supplements to children’s homes in Port-au-Prince, marking the start of a three-month project to head off a possible crisis of malnutrition among orphans and other vulnerable children.

The first shipment, to the House of the Children of God home in northern Port-au-Prince, was for the home’s fifty-three resident children, with nearly two-thirds of them younger than three years old.

The home’s director, Pierre Rebe Blain, welcomed the shipment, calling it “extremely helpful”.

“This is what we need to complete the meals we provide,” Blain said. He added that he had been forced to refuse shelter to 80 children per month recently because he didn’t have enough food. While it is too early to assess the earthquake’s impact on malnutrition rates, International Medical Corps’ efforts focus on preventing deterioration among the country’s most vulnerable populations.

Most residents at his home, Blain said, are what he calls “half-orphans” – children being cared for by one remaining parent who were then forced to give their child up because they couldn’t sustain a normal household. The remaining parent (most often the mother) is allowed one visit every two months. “More would be too disruptive,” he explained.

A tour of the facility turned up three infants that International Medical Corps' nutritionist identified as potentially malnourished. They were immediately referred to a therapeutic center for special treatment.

The initial delivery was in many ways a pilot run and any snags were a reminder of the challenges presented when delivering assistance to victims. The International Medical Corps nutrition team were held up for nearly two hours by the city’s grid-locked traffic and a demonstration -- ironically, protesting the lack of food distribution.

While that and other minor delays did not compromise the project, they were a reminder of the enormity of the task ahead.

The Spirit of Haiti

By Tyler Marshall

After two weeks of as a volunteer with International Medical Corps in Port-au-Prince, Haitian-American physician Marie Kima said the suffering she saw there evoked a deep sadness, but that the spirit of the Haitians she saw and treated gave her strength.

“I tried to stay focused and work hard so I wasn’t overwhelmed by what I’ve seen,” she said on the eve of her departure. “I take my inspiration from the Haitian people and their resilience and the hope they show as they go about their daily lives.”

Kima is one of several Haitian-American medical professions who have volunteered to work with International Medical Corps since the Jan 12th earthquake and their knowledge of the Creole language has made these volunteers especially valuable as they interact with patients. Their links to Haiti also add an extra dimension to their own personal experience here.

She said she volunteered to come to Haiti because, “I just wanted to be there with them.”

Kima left Haiti for the United States as a pre-teen, studied medicine in the U.S., and now shares a two-person practice in Gainesville, Florida, specializing in infectious diseases. She thinks of herself mainly as an in-patient physician, but in Port au Prince, she chose to work in a mobile clinic in the hard-hit Petionville section of the city about four miles from the main national university hospital.

The clinic, perched on a small knoll, looks out on a sprawling makeshift tent city that has grown on what before the quake was a golf course

When she arrived, the foundations of a clinic were apparent, but little else. The first day, she treated patients protected from the sun by only simple sheeting supported by metal poles, which, she recalled, “kept falling on my head”. The next day a full field tent was erected that gave patients a degree of privacy and gave Kima a more sheltered space to administer medicine.

During her time at Petionville, she treated several cases of hypoglycemia--low blood sugar—that she believed were triggered by people not having enough to eat. She recalled one woman came in with a blood sugar level of 11 on a scale where 70 is considered normal. After spending time on an intravenous drip to restore proper levels, the woman walked home, Kima said.

Among her most memorable experiences was treating a young boy of about 10, who came to the clinic in the midst of an asthma attack.

“There was nothing to treat him,” she recalled.

Then luck took over. Her cousin, who had not seen her since the earthquake, suddenly appeared at the clinic.

“We embraced and then I asked him to take the boy to a local hospital, where he received the treatment needed save his life,” recalled Klima. “I definitely thought he was going to die.”

U.S.-Haitian Nurse Returns to Find Heartbreak, Hope in Haiti

As a child, Simone Adelugba listened to the national band play in a park in downtown Port-au-Prince, Haiti. Today, the park is a massive tent city, with tarps and sheets enveloping the now skeleton-of-a-stage.

“This used to be a very beautiful area,” says Adelugba, looking out the window of the car. “Now I can barely even recognize it.”

Adelugba has not been back to Haiti for 15 years, but when the 7.0-earthquake hit her home country, she did not hesitate to sign up as a volunteer nurse for International Medical Corps. “It was the right thing to do,” she says. “That’s what nurses do.”

A nurse for 22 years, Adelugba left behind a husband and four children in Maryland to rush into Haiti and begin providing medical care to those in need. “When I came in, I was in shock,” she says. “It was not the place I grew up. It was devastating, heartbreaking. The first day I had tears in my eyes.”

In her two weeks in Haiti, Adelugba has seen immense heartbreak, but one of the most difficult was the nursing school, where an estimated 145 nursing students were buried in the rubble, just seconds away from the University Hospital where she is providing around-the-clock care with the International Medical Corps team.

As she prepares to return home, Adelugba knows that amid all the tragedy her work saved lives. “I saw one lady who took a long time to get to the hospital,” she recalls. “She had an enormous blister on one foot and sores on the other. She did could not stand to walk to the hospital in her shoes because the pain was so great.”

Adelugba cleaned and dressed her wounds and, with time, it healed. “In the beginning, her daughter had to help her climb a flight of stairs, very slowly,” she says. “Now she can climb up the stairs by herself and travels to the clinic on her own. “She looked at me and said, “You saved me life.’”

Another woman came to Adelugba with an infant who was discovered crying as she lay beside her dead mother in the street. After treating the baby for a skin disorder, Adelugba asked the woman caring for the baby how she was feeding him. “She said with a spoon,” says Adelugba. “She did not have bottle for the baby. I knew I was not supposed to, but I bought her a bottle. You cannot hear those things and turn the other way.”

Adelugba hopes to return with International Medical Corps in March to continue her work. In the meantime, she remains confident that her home country will recover.

“When you talk to the Haitian people and see the hope in their faces, it gives you strength,” she says. “That hope in their faces is what tells you that they’ll be ok.”

Joseline is the face of Haitian optimism.

By Tyler Marshall

On Jan. 12th, the day of the earthquake, Joseline lost loved ones and a comfortable home. Her prestigious job as Director of Nutrition in Haiti’s Ministry of Health quite literally dropped out from under her when the ministry itself collapsed. In short, her world turned upside down.

A respected physician who also teaches as the National University Hospital, Joseline didn’t dwell on her loss. She didn’t hesitate a day.

The morning after the quake, she 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 to add more shade and mattresses were hauled in to create a 13-bed in-patient section to the clinic.

Now International Medical Corps is supporting the clinic with a volunteer physician, medications and food for those who reside in the makeshift neighborhood around the clinic.

Talking animatedly with a big smile, Joseline’s body language alone conveys the message that (1) the only response to the earthquake is to get on with rebuilding and (2) there’s no time to waste.

“We don’t have homes, we don’t have offices and we sleep right here at night and I’m practicing general medicine again,” she said with a big smile. “I’m available for anyone who comes here and we’ll stay for as long as we’re needed.”

On a recent day, the clinic treated about 60 patients—roughly half of them with earthquake-related wounds that required cleaning and new dressings. Physicians report a growing number of skin rashes, stomach problems and diarrhea—complaints that reflect the stress of maintaining good hygiene while living on the street or in makeshift tent camps.

International Medical Corps’ support began a week earlier, with the provision of a volunteer physician and badly needed medicines. Volunteer physician My-Charllins, who is Haitian-American, currently serves at the clinic alongside Haitian physicians. The other day, International Medical Corps delivered 2.5 metric tons of rice, beans, maize and vegetable oil to the residents of the little community—an action that clearly lifted Joseline’s spirits.

After treating the injured and sick for much of the day, at night her commute is short: she sleeps under the stars at her clinic.

“It’s satisfying to be tending to patients,” she said.