The Ghosts of Haiti

I walked the grounds of the main hospital in downtown Port-au-Prince today, surrounded by ghosts – images and sounds rushing back of the early days right after the 7.0 earthquake here nine weeks ago.

I was here with our Emergency Response Team from International Medical Corps the day after the January 12 disaster. In the area we dubbed the “forest,” about 500 patients had lain on the grass or on hospital beds, many with infected crush injuries teeming with maggots, their blank stares reflecting how numb they had become from the pain – or their faces contorted in pain. Moans, screams, praying, chanting, sometimes just eery silence.

Today, the forest was quiet. No live patients lying next to dead ones, bloody bandages and IV bags strewn about. No doctors and nurses frantically wedging themselves into tight corners to dress and disinfect, transport, or declare dead. Today all I saw were tidy tents with a few post-operative cases inside. Sturdy chairs outside the tents provided a comfortable waiting area for loved ones. The place looked small, simple, organized. All I could hear was the breeze in the trees.

I stood there, awed by the transformation, and wept for those who lived here and went home, those who lived here and had no home to return here, and those who died here.

I exited the forest and walked toward the pediatric ward. How many times had I walked this path – to the pediatric and maternity wards, the supply warehouse, the blood bank, the U.S. military’s hospital headquarters? I looked to my right, waiting to come upon the nursing college, where as many as a hundred nurses had perished that day, where every day the powerful smell of their decomposing bodies hung in the air. As I passed an empty lot, covered in a neat layer of rocks and crumbled cinderblock, cordoned off by concertina wire, I yelled out to my colleagues, “Where is the nursing college?! It was right here!” This was the former nursing college… razed… gone… the bodies and bones of Haiti’s future interred underneath.

Time marches on.

We then walked to the two ICU tents, where a group of doctors and nurses rotating through from Chicago-Rush Hospital, the University of Connecticut, and other institutions were tackling about 30 urgent cases, from typhoid fever to congestive heart failure. Suddenly, as I stood next to one woman’s bed I saw her begin seizing. She had gone into renal failure. A team of about 8 docs and nurses responded quickly. Amid the commotion, her husband and son moved outside the ICU tent, where they gazed inside watching in terror, praying she would live. The medical team administered CPR, gave the woman epinephrine injections, and after about 15 minutes of vigorous, sweat-inducing pumping on her chest they were able to revive her. She was dead, then she was alive.

I think back to the early days at the hospital - we didn’t have any of the equipment I see before me today: dialysis machines, portable ultrasounds. Amputations were done without anesthesia. Antibiotics and powerful painkillers were precious and ran out quickly.

In the bed across from her was a beautiful, young woman who had suffered massive complications in childbirth and lay limp as her mother and grandmother together washed her face, massaged her limbs, mixed a little food for her that she tried to eat without choking. It was a striking contrast between medical advances hard at work on one side of the room, and simple, loving care on the other.

The fact is countless patients who’ve come through University hospital would not be alive today if International Medical Corps weren’t there. We’re treating anywhere from 500-800 patients a day there – plus another 1,200 or so at our mobile clinics in 18 sites in earthquake-affected areas across Haiti.

It is astonishing to see how far we’ve come. And yet I am surrounded by tremendous degradation, pain and suffering. Areas like downtown Port-au-Prince and Leogane (the epicenter of the quake) are still complete disaster zones, awash in rubble. In many ways, they look no different than they did nine weeks ago.

So many people ask me about all the money that’s been raised in the U.S. and other countries for Haiti relief - is it getting to those who need it most? The answer is resoundingly yes – but millions were affected by the earthquake, in a place already buckled under by poverty and disease. They need health care, shelter, food, clean water. It will require herculean efforts, over the long-term.

We knew when we first arrived here on January 13 that we would need to stay for the long haul, doing the training of local health workers that is the hallmark of our work around the world and that will help Haitians rebuild and take care of themselves.

We have a responsibility to those ghosts – that we learn from what happened in those early days and move forward, caring for those they left behind and helping Haitians to carry on.