Mirebalais University Hospital

 Zanmi Lasante logo at entrance of new university hospital.

When I arrived back at La Villa Creole, I inquired about travel to Mirebalais to visit the new Partners in Health University Hospital.

“How long does it take to drive to Mirebalais,” I asked the gentleman at the front desk.

He paused, and then responded, “When do you plan to travel?”

“Today or tomorrow.”

He looked concerned, so I added, “Is the road to Mirebalais safe?”

“Yes,” then he paused and searched for the right words, “but for you it is different,” he replied.

I stated the obvious, “You mean because I’m white.”

“Yes. If the traffic stops, there are gangsters who might shoot you for your money.”

This confirmed my concerns in the traffic jam last night. I had read and heard this is a concern everywhere in Haiti, but especially for the road north through the mountains to Cape Haitien on the coast. Mirebalais is about 60 km from Port au Prince and south of the region considered the most dangerous. 

“Which day would be safer, today or tomorrow?”

“Today, for sure,” he replied. “Today is much safer. The bad people will be at church and with their families.” Gangsters have faith and families too. 

The new university hospital sounds like a potential place for me to help out. The teaching aspect is especially attractive. I emailed Partners in Health before I left but there was not enough time to arrange a formal visit, so I thought an informal visit would be worthwhile. The safety of the two-hour trip to the hospital is a concern, but I reasoned that if I am not up for the trip, how could I possibly consider helping out at all?

Sam was waiting outside and I asked him to pick me up in three hours. I wanted to make the trip, spend an hour at the hospital, and be back at the hotel with lots of daylight left. 

Now, five hours later and safe back at the hotel, the trip did not seem dangerous at all, but there is a randomness to danger, and fortune favoured me. I wonder how many trips are necessary for randomness to catch up with me? The traffic only slowed and stopped once, and Sam locked the doors before I asked.

New housing project on Highway 3
just before the road goes up into the mountains.

The road up into the mountains to the central plateau is quite different from the trip over the mountains to Jacmel. The central plain between the two mountain ranges is a low delta and the road up to the northern mountains passes through a desert-like region with varieties of cactus that reminded me of Los Cabos. The central plateau, by comparison is a lush tropical area with banana and coconut palms.

Mirebalais University Hospital - Partners in Health - Zanmi Lasante. 

The Partners in Health website has an announcement that the hospital is open, but when we arrived the site was deserted. Perhaps the official opening occurred, but there were no patients or health care staff at all. Well, at least I know how to get there.

Jacmel - Three Years after the Earthquake

Beauty Salon in Jacmel

Most of the two weeks I spent in Haiti in March 2010 were in Jacmel. The memories from that time are intense and emotional. I returned to find out what happened to the city and to the hospital where I worked.

Tent where I worked in March 2010, now collapsed.

Much as changed. The hospital is no longer controlled by security. The long lines of patients are gone. The tent that I worked in has been raised up on a wooden platform, presumably after it flooded during a rainy season, but the platform was poorly constructed and the tent collapsed and this extra hospital room is no longer functional. The Medicines Sans Frontiers tents are no longer there. The tent with the Cuban doctors is gone. All that remains is the original hospital with an obstetrics area, an ophthalmology area, an emergency and outpatient area, and a small inpatient service. The grounds seemed deserted by comparison, which I guess is good. Hopefully this means that health has returned to the community.

Tiled street art in Jacmel.

Jacmel looks positively prosperous. The rubble is gone. The community plans are for the city to be a major tourist destination with facilities for cruise ships. The harbor looks adequate. After the quake, a Canadian Armed Forces Vessel was offshore. Canadian soldiers helped rebuild the airport at Jacmel.

Political art in hotel in Jacmel.

Haitians are a creative people and Jacmel is a creative hub for the country. The art and music in the streets and in the cafes is exciting.

The bold colors and the cultural, religious, and political themes of the paintings, the masks, and the carvings are distinctive and exceptional.

Tropical bird sculpture in Jacmel Cafe.

Music is woven into how the Haitians move and talk. Some of the music reminds me of New Orleans and I wonder if this Louisiana city traces the Carnival sound to Haiti.

Haitian mask in Jacmel hotel restaurant.

While in Haiti, I am reading a wonderful set of three novellas by Marie Vieux-Chauvet, who wrote about the persecution during the years of the Duvalier dictatorship. Vieux-Chauvet lived during my parent’s generation. She was a gifted writer and she has helped me put Haitian culture into historical perspective. 

Traffic in Haiti

Traffic jams exist in every major city in the world. My past records for gridlock were both in Ontario. In the late sixties, travelling with my Mom from Calgary to Toronto, we spent two hours on the 401 just north of Toronto. Nothing moved for those hours and then miraculously the traffic flowed quickly into Toronto. I remember my Mom was very tired and cranky. During the seventies, on my way home to Toronto from the Formula One Canadian Grand Prix at Mosport, I spent another two hours in a traffic jam.

Today I set a new record. On the way back from Jacmel to Port au Prince the traffic stopped in Carrefour, which is only about 10 miles from Port au Prince. The traffic moved so slowly, perhaps a meter a minute at best, and mostly not at all.

Now, I knew the traffic would be bad. The traffic was bad when I visited in March 2010 after the earthquake. Yesterday, the trip from the hospital to the hotel took 45 minutes to travel a modest 8 km. This morning we left for Jacmel at 6:30 AM, but this was not early enough to beat the traffic. We took 45 minutes to get out of the city. So, based on this, I asked the driver what time we needed to leave Jacmel to arrive back at the hotel at 5:30 (before dark) and he said 3 PM, but 2:30 would be best. I made sure that we left just before 2:30 PM, but the traffic stopped at Carrefour just after 4 PM. I gave up three hours later and asked the driver to turn around.

Fortunately, we had just passed a sign for Auberge du Quebec, a hotel I recognized as ranked in the top three on Trip Advisor. I asked the driver to turn around, and now, at 8 PM, I have a cup of hot tea, and an Internet connection, poolside. There is a Haitian wedding in progress in the restaurant. All is well. Now, this hotel is not La Ville Creole, but this hotel is far better than sitting in the dark in traffic with literally thousands of Haitian men and women walking by a car with a Blanc inside. I felt like a sitting duck.

After the first hour in the traffic jam I asked Samuel, the driver, who speaks OK English, if this kind of traffic is common. “Yes,” he replied.

At the 1½-hour mark, I asked the same question. “Yes,” he replied but with less conviction.

“So,” I responded, “what is the longest you have spent to drive from Carrefour to Port au Prince?” He thought for a bit and then responded, “Two hours.” 

At two hours, I suggested we turn around and go the Auberge du Quebec. Sam did not want to turn around. He wanted to stay in the traffic. He told me that we would lose whatever progress we had made if we turned around. I was not comfortable with his logic. He counseled patience. As best as I could tell, my patience was exceptional.

At the 2½-hour mark I asked Sam to turn around. Took us almost half an hour to go back the four blocks to the hotel, which was buried in some very dark streets off the main road.

Sam told me he “hates traffic,” which must be a real problem for a driver in Haiti. He was clearly frustrated in the traffic. He never lost his patience but he got close a few times with other drivers who were more aggressive. We had to wait a long time to cross the traffic to turn towards the hotel and when he finally did turn he pressed the pedal to the metal and roared in front of an oncoming pick-up truck.

What surprises me is that traffic moves at all in Haiti. Most of the cars are ten or twenty years old. No one in their right mind would drive a new car on these roads. Very few cars do not have multiple scrapes and dents. I suspect you can predict the age of a car by how many corners are pushed in. My sense is that it takes less than a year for one corner, and about ten years for all four corners. There are broken down cars and trucks beside the road everywhere. Two of the tires on Sam’s Nissan SUV were close to bald. He was careful with potholes with good cause. 

The roads are narrow, full of potholes, and there is no real concept of lines. Any side of the road is fine if the oncoming traffic is slow. Traffic accidents are the number one cause of death and serious injury at the hospital. The roads are filled with motorcycles, which weave around the cars with reckless abandon. Some motorcycles carry three people. Helmets are not common. 

There are lots of trucks and buses, all overloaded, and every open truck has passengers on top of whatever the vehicle is transporting and some of these people look as if they might be sleeping, which really amazes me. Perhaps they are tied onto the truck. Every bus has at least one person standing on the rear bumper and holding onto the luggage rack above.

Breathing in traffic is an issue. My lungs have been assaulted. They feel heavy and about an hour into the traffic jam I developed a dry cough, which I am sure is related to the toxic effects of gas and diesel fumes mixed with dust.

I arranged a driver back to La Villa Creole at 6 AM. Hopefully the traffic will have cleared by then, and I will find out if the traffic is any better from 6 to 6:30 AM.

Religion is Important in Haiti

A few nights ago, the mother of one of the NICU babies had some questions about her son. The Haitian physician was busy with a new premature infant and could not talk with Mom. He asked me to explain the situation with an interpreter. This baby is the sole survivor of the original four premature infants who were in the NICU when I arrived and he is just hanging on, stable over the day, but still precarious. I found an interpreter at the triage station and he explained word-for-word what I wanted to say to Mom. I described the clinical situation as I saw it. The baby has meningitis and a serious intestinal infection. The baby stopped breathing at least twice during the day while I was around. There are a variety of bad case scenarios for the baby. I mentioned perforation of the intestine, a new blood infection, increasing lung disease, and hemorrhage in the brain, any one of which could cause deterioration and death. Mom accepted this with sadness. I asked her if she had any questions and she replied, “God knows what will happen.” I hear a variation of this occasionally in Canada (God only knows), but more as a hackneyed statement about life. For this Mom, the words were literal. 

Haitian pastors have visited the unit three times while I have been in the unit. The same two men have visited on two occasions and three women on one occasion. They stand in front of a bed and pray for the child. The older man shouted loudly, with an almost angry tone, as if to make sure that God heard his call for the child to improve. The other man looked up to the sky, swayed his hips, moved his arms around like a choir director, and sang prayers. The women who visited staged a variation on this theme. The senior woman asked for the help of God and the other two sang prayers. The pastors prayed only for a specific child. I presume this means the family is a member of the same church. Two Catholic Nuns visited the unit yesterday. They were dressed in a traditional white habit. Both were older women, likely about my age. 

Umberto is the “Go to” person on the unit. He is a young Haitian with good English skills and he has worked for the hospital for several years. He does not have any formal medical training, but he performs a variety of tasks. He knows where everything is in the unit. His official job is to serve as a translator, but he certainly performs well above this pay grade.

Umberto is a devout Christian and his passion is music. He sings in the church choir and over the next week he will perform in two church events.

I asked Umberto why the recent democratically elected leaders have not helped the poor, and he responded that the rich people prevent the leaders from doing their job. “The rich get richer and the poor get poorer. That’s in the bible,” he reported with finality. Faith is clearly at the center of Umberto’s personal world.

The actual biblical reference for Umberto’s quote is Matthew 13:12, which reads, “For whosoever hath, to him shall be given, and he shall have more abundance: but whosoever hath not, from him shall be taken away even that he hath.” 

I have always interpreted this phrase to be a description of what is common but not as a description of what should be. My sense is that Umberto thinks differently. For him, God (the Bible) is the official explanation for the poverty of the Haitian people. Haitians are poor, and since God permits the poor to get poorer, Umberto accepts this. I didn't ask Umberto, but to me this implies that Umberto might believe that God allows this suffering for a reason, presumably a good reason by God's account. This is the Problem with Pain, that CS Lewis wrote about. According to Umberto, although Haitians are doomed to be poor, God offers them heaven so long as they live a good life.

Religion is a strong force in Haiti, whereas in Canada many churches struggle to maintain membership in their congregations. The people in Haiti are poor and they suffer. Canadians, by comparison, are fabulously rich, and Canadians live the good life. Religion thrives in the midst of suffering because faith offers the poor some hope for deliverance, perhaps only after death, but deliverance from their suffering all the same.