Going Home

The following was submitted by Ben Trappey, fourth-year medicine-pediatric resident.

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I'm leaving today. It's hard to believe that I've been here for nearly a month. Part of me can't wait to get back. I'll be glad to see Emily again. And to be back to the comforts of home. And that the vast majority of my patients will survive.

However, Father Rick likes to point out that despite the difficulties and trials and struggles he's encountered in his many years in Haiti, he finds that life is much simpler here. After just a month here, I must say that I agree. People are easier to understand. Motivations are less complex. People come to you for help because they live in poverty and you do not. They are hungry. They are sick. They need a job. They need money. They ask. They do not use passive-aggressive manipulation to attempt to get you to do what they want without asking. You are either able to do something to help them or you aren't. Life moves on.

Father also likes to say that evil is not subtle here. It is ever present and comes in many forms--illness, infection, corruption, kidnapping, theft, armed robbery, and murder. It is easy to recognize, and it nearly all stems from the one great evil here.

Poverty.

You hear stories from people who have been here for a while. Times when they were robbed or forced to pay bribes or prevented from being kidnapped by a sum of money which would seem laughable to most Americans. But throughout all of the stories, there is always a common thread. There is rarely ever a question of motivation. There are very few senseless or random crimes. People rob and kidnap people for the same reasons they ask for help.

They need something, and you look like you can afford to provide it.

Cite Soleil is the poorest slum in Port Au Prince. It's a sprawling accumulation of homes built primarily of sticks and stone and tin and tarp which appear to be ever on the verge of tumbling down. It is quite possibly the most poverty-stricken and dangerous area in the Western Hemisphere and is effectively governed by the gangs who inhabit it. Father Rick has been going there for years--building more stable housing, providing clean water, and setting up impromptu street clinics. He has just finished building a permanent clinic and a bakery on top of a landfill there, and is in the process of building a hospital there as well. The clinic sits about a hundred yards from the ocean. Outside the windows of the clinic, you can see children playing atop mounds of garbage and goats and pigs foraging through the detritus as it makes its way to the sea.

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For now the clinic is staffed on varying days of the week by Father Rick, Sister Judy, and Dr. Charles (a Haitian physician). Father Rick, who is known as "Mon Pere" among the Haitians, is so well-known and liked there that anyone who is known to be associated with him is given privileged status by the gangs. It is not unusual for groups of young men with gold chains to go out into the street to stop traffic to allow the passage of any vehicle labeled with the decals of one of Father Rick's many projects.

Unfortunately for Dr. Charles, his car did not have such a decal when he first started working there. He was coming home from the clinic one day and was approached by a young man with a gun. He demanded Dr. Charles's wallet and told him, "My children are starving. If you don't give me your money, you will die, and they will die. If you do, everyone lives."

There is no subtlety there.

Dr. Charles gave his wallet to the man, who took the money from it and casually handed back the wallet with his ID and other belongings undisturbed. Dr. Charles now catches a ride to the clinic in one of Father Rick's vehicles, but he still goes back to Cite Soleil every day. Because people still need help, and the evil is apparent and almost understandable--"You look like you can afford to give me something that I need."

Despite the fact that this sort of very real danger is always in the back of my mind whenever I leave the safety of the St. Damien compound, I still wonder how I will cope with going back to the safety and comfort of my life in Minnesota, where I will face very different and much less weighty problems. I won't have to worry much about being robbed or kidnapped, but I will be plagued by the complexities of a life that some Haitians would literally kill to obtain.

I'm not sure how I'll adjust to that.

I imagine that for a few days I will be very aware of how very fortunate I am as I return to my very comfortable life and leave the struggles of this place behind. But I fear that I will slide back into the life I have spent my whole life living.

I'm afraid that I'll find my "First World problems" to be incredibly weighty. That I'll hem and haw over what restaurant to give the equivalent of several days wages for many Haitians in exchange for food which will slowly kill me. That I'll worry over how to afford more things I don't need. That I'll have anxiety over maintaining relationships I'm blessed to have. That I'll feel frustrated about some minor unpleasantness or some perceived slight at work.

I'm afraid that I will once again come to think these anxieties are all very natural and important, because I will lose perspective of what real struggle looks like--that I'll lose sight of what poverty and long suffering can drive a person to do. I fear that I'll fail to remember the beauty that lives inside of so many of the Haitian people, despite that poverty and the suffering--the patience of the families and patients sitting in the hallway of Urgence, the joy of the children playing in the orphanage, and the comfortable calm of the Madame Lazarus family sitting on her front step.

I fear that I'll forget the spirit of this place. And I'll complain.

Until I return here and am reminded how blessed I truly am.

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Kenscoff Orphanage

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Another group of residents and an attending from the U.S. arrived this week, and I was given the last two days off from work in Urgence. I used the opportunity to get out of the compound and see some of the rest of Haiti.

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I was able to catch a ride to Kenscoff, the site of an orphanage in the mountains that Nos Petits Freres et Soeurs (NPH) has been running for the past 25 years. It's only about 20 miles from St. Damien, but it truly seems like a different country. I suppose it's somewhat fitting that due to traffic and the condition of the winding mountain roads, it takes around 2 hours to travel those 20 miles.

The orphanage, which is home to some 450 children and provides school to hundreds more, is located 6,000 feet above sea level at the top of one of the taller mountains surrounding Port Au Prince.

The elevation allows for a much cooler and wetter climate where the locals grow onions, cabbage, turnips, and other vegetables in a patchwork of small fields precariously situated on the side of the mountain. One of the long-term volunteers at the orphanage told me that it's been said that "Haiti is the only place where you can kill yourself by accidentally falling out of your field."

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The guest house in which I stayed is at the far end of the orphanage and is, itself, perched rather precariously on the side of the mountain. From its balcony, one can see the small footpaths that crisscross the hillsides and valley below and allow people access to their fields.

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Since it is such a small community on top of the mountain and so many of the people in the area have benefited from the orphanage, I was assured by those who live there full time that it was very safe to wander around up there. I was able to find my way down to some of the footpaths and hike for awhile. The view was stunning. The absence of dust and noise was particularly striking after having spent so much time "down below" in the chaos that is Port Au Prince.

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The presence of pine trees seems particularly remarkable for Haiti, were most of the country is barren and deforested due to the demand for charcoal, which remains the country's primary source of fuel and claims millions of trees each year. The area around Kenscoff is one in which the felling of trees is illegal. However, when I woke up to leave the next morning, I could hear the sound of someone felling a tree under the cover of darkness in the valley below.

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In the evening, we walked a few hundred yards down the road from the orphanage to the home of Madame Lazarus, an incredibly joyful Haitian woman of indeterminable age, who sells canned goods, soda, beer, candy, and toilet paper from her front porch.

The long-term volunteers at the orphanage know her well, and we bought sodas or beer and spent the evening sitting around her charcoal stove on the front step of her small stone house. We watched motorcycles drive or people walk past on their way to Holy Thursday church services as she and her family regaled us with the news from the surrounding area--marriages, births, tales of disputes over the ownership of chickens (the Creole-speaking volunteers would translate for me when something was particularly interesting), and her smiling grandchildren sang/rapped for us and gladly finished off the dregs of our sodas.

It was lovely to be able to get a glimpse of the real life of a healthy and seemingly well-adjusted Haitian family, who would be considered indescribably poor by American standards, but seemed quite content as they spent the evening in the company of each other crowded around a little charcoal stove as the sun disappeared behind the mountain and night fell around us all.