CECILE-ANNE MULLER journal of Nov trip 2010

Dear family and friends,

As many of you know, I spent 2 weeks in Haiti this past month, joining a very small NGO (about a dozen volunteers), founded by a couple of fellow church members.

Before going, I promised to write an account of this trip, so here it is. Basically it’s my diary and kind of follows its timeline. It’s factual therefore pretty dry. Its primary use is to record my memories, but I hope you will enjoy it.

I apologize to those of you who speak only French. Maybe Guy-Louis could translate?

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I first heard of the group when the founders, Bob and Denise Snyder, talked to my church for a fundraising drive. They were charismatic and passionate about their charitable mission. They had been the first ones to enquire about that mysterious parish in Haiti with which a church authority had twinned us some time before. Usually, parish twinning means no more than an extra Sunday Mass collection every so often. But Denise was curious. And some 10 years ago she went on a fact-finding mission, just by herself. She came back appalled. Haiti has been her lifework ever since. Her husband Bob got hooked too. They have adopted this sister parish, Riviere Mancelle, located in a remote, mountainous area of Northern Haiti. They started this mini NGO, FeedHaiti.org. They gathered a few interested people and a team now goes to Haiti every year in late fall when the sun lowers its clout a bit, to implement specific projects. Bob and Denise tirelessly go from church to church of any denomination to raise funds. They will talk to anybody who’s willing to listen. They have Fr. Jadotte, the Riviere Mancelle priest, go every year to Tennessee to campaign with them.

Riviere Mancelle is the wider area that Fr. Jadotte serves, named after the eponymous river that meanders through the region. He has a main rectory in the central hamlet, Kalabat, and over half dozen chapels in remote hamlets. Chapels may be a couple miles from each other, but travel is by foot only and it can take several hours from the rectory to say mass to any one chapel. Within the Riviere Mancelle parish, there are four elementary schools supervised by Fr. Jadotte and a religious order of nuns. The academic level is low. The teachers are folks that may, or more often may not, have gone through high school. Since illiteracy among adults is close to 100%, these little kids who will at least know to read and write are bearing the seeds of a better future for Haiti. In all the hamlets, church and parish school form a closed compound, the town center, so to speak. In Kalabat and Chateau, one of the other hamlets, there are also small dispensaries.

The parish schools charge a fee: $75 a year, including books and uniforms. Few locals can afford to send their children to school at that price when their daily earning is little more than a dollar. The first project the Snyders developed ten years ago was a child adoption program to expand the school enrollment. It has been quite successful thanks to the generous response of American sponsors to the Snyders’ ceaseless and passionate fundraising efforts. The combined enrollment of the four schools we support now reaches around five hundred. It’s a lot, considering there are only a few hundred people in each hamlet.

On her first trip, Denise also noted that children were going to school munching on sugarcane. She discovered that parents gave them these to much on in lieu of meals to allay their hunger. Kids and parents alike were eating only once a day at most, in the afternoon. (Alas, some still do). So Denise started a school lunch program, again funded by American sponsors. Denise now thinks that the kids don’t seem as malnourished as in the past.

Other projects completed over the years include bringing spring water to the rectory with an outside faucet for the wider public, installing solar panels on its roof for a few hours of evening light, and building several solar ovens. As these are useless on cloudy or rainy days, our two engineers started building “rocket stoves” to replace the traditional three-stone fires that are smoky and inefficient. This year, they were planning to build several more to serve the various lunch programs.

I just had accumulated my two weeks of annual vacation when I heard the Snyders plead their cause, so the timing was right for me. This year’s mission had an urgency borne of the triple tragedy that befell that nation already under the weight of crushing poverty: The Jan 12 earthquake that killed up to 350,000 people and left over a million crowded in dingy tent cities; hurricane Tomas that ruined crops and submerged entire towns; and now, cholera. The Nepalese UN peacekeepers emptied their latrine directly in a river adjacent to their camp. Cholera is endemic in Nepal and many Nepalese are asymptomatic carriers. Once in the river, this latest scourge spread like wildfire to the whole hydrographic system, as a direct consequence of poverty:

Because there is no electricity and no running water, people wash in the rivers. For lack of latrines, they use the rivers (and anywhere on land too) to relieve their bodily needs. For lack of clean water source, they drink that river water. And for lack of roads, they use rivers to travel, crossing it over and over for hours to reach their destinations.

Tuesday, Nov 9 and Wednesday, Nov 10

So we are six to board an AA plane in Nashville on that afternoon. We get acquainted. Besides Bob and Denise, I meet Bob Fairchild an engineer, this is his 4^th trip; a true scientist, logical, methodical; I will quickly discover that there is no problem he cannot solve. There is Rita, a massage therapist who served as a pharmacist during her one previous trip. She’ll be a pharmacist again, but she will generously practice her wonderful skills on us and our patients. She brought her son Mike who just graduated from engineering school. A bear of a guy, easy going; I am pulled to model my reactions on his no sweat attitude. While Bob and Mike will do their things, Denise, Rita and I will form the medical team. We brought over 600 lbs of medicines, donated by church members who responded generously to our appeals. Among these meds were 60,000 doses of Cipro, a cholera lifesaver, donated by a Tennessee hospital.

. After spending a short night in a Miami motel, we join with our interpreter, Jean Eloizin, in the airport at 5am. Jean is an inspiring success story: He is from Riviere Mancelle, our very destination, and knows most of the people there. In his twenties, frustrated by his inability to develop his potential, he immigrated to Florida. After some years and by the grace of God, he obtained his green card. He met his Haitian wife, Melicia, in Miami. She was from Gros Morne, the town close to his village, so they were already kind of family. Their life has been one of industrious enterprise, of study, of hard work at simultaneous jobs and of saving for their growing family. They have three daughters. The oldest, Patricia, just graduated from Tufts University. While in college, she did volunteer work in Haiti on agricultural projects. The second, Erika, was born with cerebral palsy. The third, still in high school, is poised to emulate Patricia’s accomplishments. These girls represent the best hope for Haiti: Grandparents never went to school, parents never went to college, but these bright young girls will have all the skills necessary to participate to the reconstruction of their country, and thanks to their parents’ wise guidance, they have the eagerness to do so.

It is the third time that Jean serves our group as an interpreter. It gives him an opportunity to see his parents and visit with childhood friends. I am immediately won over by Jean’s wide smile, which conveys strength of soul and gentleness combined, and by his warm bear hugs. Instant affinity and trust. As we are to work close together, I’m happy that it’s going to be with him.

A last leisurely stroll on plush carpets along gourmet coffee shops, eateries for all tastes and luxury shops while waiting for the plane, and we were off. Off a world that titillates all appetites to create more cravings along a lengthening spiral of self-centeredness, a world enslaved to degrading desires, a world that sucks up the world’s resources for its selfish ends making the rest of it poorer. And into its underworld, a world of hollow bellies and minds stunned by misery.

Port-au-Prince arrivals: A hangar, bare cement floor, no air-conditioning in the stifling heat because there are no doors, just gaping holes. One carrousel for several planeloads, hundreds of people cramped together jockeying for position, and one small wooden bench for people who’d rather wait till the crowd thins out. We meet a young American family, father pushing mother in a wheelchair, 2 little girls in tow. We chat a bit while waiting. They are moving to Haiti to serve in an orphanage; unsung heroes of charity.

Finally we get our 800 lbs of luggage together. At customs, we declare we have nothing in our luggage, no food, no medicines. The agents don’t care and don’t inspect our bags. We pass the first hurdle.

Our drivers are waiting for us in the two Land Rovers of the Gros Morne nuns with whom our group partners. They help us fend off the army of porters who want our business. One Land Rover carries most of the luggage and the other the rest and the eight of us. We are very crowded. The vehicles skirt Port au Prince, so we see little of the capital: A few tent cities; some buildings with concrete floors piled up like pancakes; many wooden shacks standing, as they withstood the quake better than concrete buildings. Past the city, we see mountains on the right, deforested, with wide swaths of denuded soil falling from summit to base. We bump along a rutted road that our driver navigates skillfully. This is national road #1, the best in the country. It is paved, of sorts, until Gonaives. It has quite a few long stretches of unpaved sections, rocks more than dirt, collections of potholes. Our Land Rover slaloms between the potholes. The car rattles, shaking us this way and that. We hang on to each other. People and animals on the road, all walking. Mangy dogs, and a lot of goats. These are tiny; they are not milk goats: They are not fed but left to fend for themselves, so they never have extra milk. They are used for meat. It is the only meat we’ll ever eat in Haiti we’re told, so we better get used to the idea.

A few tap-taps, old pickup trucks that serve as public transportation. Some trucks, and a fair number of “motos”, these tiny, lightweight motorcycles driven by people of means. They are overloaded, 3, 4, 5, up to 6 people on one. We pass crowded and dusty little towns, Kabare, St Medard, and St Marc, the epicenter of the cholera epidemic.

Gonaives is a big city, couple of hundred thousands maybe. It has electricity. Jean mentions he owns a house there and if he has the time, he will go back to check on it. He’s worried because just last week, Gonaives was up to ten feet under water, thanks to hurricane Tomas. What happened to his rental unit?

After Gonaives, no more semblance of pavement. Pure dirt and rocks, all the way to Gros Morne, the big city near Riviere Mancelle. No gravel, but rocks of all size, pointy ones that protrude high over the dirt and are murder on tires. Bob comments that on a past trip he got three flat tires between Gonaives and Gros Morne. We shake like laundry in a washer. The constant jarring gives me a headache. The hope of arriving soon keeps us steady.

Gros Morne has over 20,000 people, a good size city. No electricity, no running water, not one paved road. Houses have no window panes, just big holes. Glass seems inexistent. As there are no gardens, houses are right along the dirt roads that are called streets. We can imagine the dust that must cake the walls inside.

The city is bustling: A multitude of stalls with baskets full of vegetables and cheap gadgets. Lots of school kids going back home. There must be several schools as we see different uniforms. We even pass a school bus that is full of kids for a change. Outdated American school buses usually find a second life as public transportation in Central America. Road dirt, thick and smoky, fills the air. Along the city streets I see a single outhouse. Where people do their things is a mystery. Bob the engineer, a Haiti pro, says people defecate anywhere. A refined method is to do it in a plastic bag and toss the plastic bag on the road. “Beware of plastic bags!”, he sermons. Brief stop in Gros Morne to say hello to the nuns, Sister Pat and Sister Jackie, in their compound. Pat is an agronomist among other jobs, she has reforested an entire mountain. We can’t see her right now says the volunteer who greets us, she’s in the States, visiting her gravely ill mother. Jackie is a nurse; we can’t meet her either, she practically lives in the hospital caring for cholera victims. The hospital has a generator, I’m told. I’m wondering if it has glass windows.

So we leave for our final destination, Garsen, one of the hamlets of the Riviere Mancelle parish. The 100 mile trip between Port au Prince and Gros Morne took us 4 hours. Garsen is maybe four miles away. It will take us over half an hour on the narrow rocky road. We are dead tired. It’s 4 pm and the sun is low. People walking, all carrying heavy loads on their heads, five gallon paint buckets, parcels wrapped up in twine, some with chickens hanging from the sides. Goats tied up to the side of the road munching on weeds. Rare motos flying by.

Fifteen minutes out of Gros Morne, we are stopped by a young man frantically waiving us for help. He has 2 companions near his moto, one a woman lying still on the road. The man explains she just fell ill with cholera, they are trying to bring her to the Gros Morne hospital, but she’s so weak she fell off the moto. And could we give her a ride? The woman is cachectic, immobile, like in a coma, in a pool of liquid. Her dress pulled up. She obviously had a constant outpouring of diarrhea and vomiting. In our overloaded vehicles we don’t have the space for an extra cat. What can we do? Both drivers say no. Everybody in the group hesitates too. Even Denise and Bob, the ones with the oversized heart, realize we can’t take the woman on board. And I, maybe not the only one, acknowledge the muted but rising fear of contact with the dreaded cholera. I secretly feel relieved when Denise says we can’t help. The victims’ friends will have to prop her up on the moto and make good speed to the hospital. My relief is tainted with guilt. A last thought: We give the only drink we have on board, a Coca-Cola, urging the men to force the lady to take some. And off we proceed. Shaken and silent. Will the lady survive? If not, will we be responsible for her death? How much cholera will we meet? How can we help? Out thoughts torture us.

Finally, the last climb to Garsen. Up the last hill, excited kids crowd along the cars and cheer us along. Jadotte is waiting for us. His cooks have prepared a feast on their three-stone fires outside the house proper. His house in Garsen has some evening electricity thanks to Bob’s solar panels. Not enough to heat water though, and the shower has nice but cold, oh so cold, spring water!

Our first meal is typical: Fresh avocado, fried plantain, rice with beans with a tasty red sauce, a delicious pumpkin soup, popcorn, and goat meat, “cabrit”. Freshly squeezed papaya juice. We’ll have these staples daily from now on. Goat meat is mostly bones; spices and herbs make us forget its origin. Corn is skillfully popped by hand: We’ve never had burnt popcorn in our daily servings.

For the rest of our stay, we will have avocado breakfast, lunch and dinner. Fresh juice too, mostly papaya and passion fruit but some mango too. Mango season is over but banana and papaya are going strong. Papaya, mango and banana trees abound around.

After supper we chat, old friends get reacquainted over Haitian coffee spiked with Kremas. Kremas is a delight: 1/3 rum, 2/3 sweetened condensed milk, cloves, ginger, and vanilla. Definitely jazzes up Haitian coffee whose flavor trails far behind Starbucks’. Plans are made for our work. We’ll rest at Garsen another day before proceeding to the center of the Riviere Mancelle parish, the bigger Kalabat hamlet where the rectory is. We’ll set up our clinic there. The engineers will do their thing separately. We’ll also travel to a couple of outposts.

Night comes early; it’s pitch black by 6pm. The little light bulb does not receive much nurture and won’t last long. In Miami we woke up at 4 am and we’re tired. So we’re in bed before 8pm. I room with Rita. Rooms have no window panes of course. Just gaping holes covered with a sheer flimsy curtain. Our heavy sleep doesn’t mind the constant crowing of insomniac roosters below our window.

Thursday, Nov 11

The first daily Mass, at 6:30 am. Fr. Jadotte reads the gospel by candle and flashlight. A handful of villagers, and our whole contingent of Americans. After the readings in Creole, Jadotte asks Bob Snyder to do the readings in English. Same for the homily: After Jadotte’s homily in Creole, Bob is asked to do a homily in English. Bob is a fervent Christian and his homily is uplifting.

The rest of the day we do little. The little elementary school is attached to our house. We watch the kids going to their classes. There must be close to a hundred of them. Vivacious kids, all in pink uniforms. They look so cute. They wave at us before entering their respective classes. The kindergartners look at us as if we were Martians. They’ve not seen Whites before. Some call “Blan, Blan!”

They look proud of being able to go to school. Even with the schoolchild adoption program, the children attending school form a minority. Down to the littlest ones, they all seem conscious of their privileged status.

Three rooms, two grades per room. Window holes are crossed with a cement lattice that keeps the rooms dark. Since there is no electricity, I’m wondering how teachers and kids can read their books. Wooden benches without a backrest, cement floor, a blackboard. Old, rudimentary schoolbooks, much dog eared. The teaching method is obvious: repetition. Through the window holes, we hear a teacher point to letters or numbers on the blackboard while yelling their names, and the whole class repeats in unison.

Jadotte has organized a school assembly in the church which is fifty feet from the school. Kids proudly sing to us beautiful welcoming songs in Creole and English. Next, we Americans, do speeches. Denise pours out her love for the kids. They know that if they are in school it’s thanks to her. She’s Mama Denise, their much beloved benefactor. When she comes it’s with a big check for the schools. Next is Rita, who has brought inflatable world globes, and she explains where Haiti is. It’s well above the kids’ understanding, but just right for the teachers who don’t seem to have ever seen a globe. They crowd around Rita’s and look for Haiti. They seem awed. I’m last. Being the one medical person, my speech is about cholera. As the kids are learning French in school, I speak in French; it’s good for their education. In very simple and explicit terms I describe how the germ is transmitted to the mouth by dirty hands. For the teachers I explain how to purify water with Clorox. It is sold in markets in tiny bags of a couple of ounces. Bigger bags would be too expensive. I explain to the kids why and how they must wash their hands after pooping. In real life, how do they wash their hands at home? Nobody has running water. At best people poop in the river and can wash their hands in that water. But often they poop in the field, and have no water to wash their hands with. Never mind toilet paper, it’s unknown.

I make a strong point that they have knowledge now, they must teach their parents; and I repeat it over and over: They must be their parents’ teachers. It’s true for cholera and true for everything else. Any kindergartner here reads better than his parents.

After the speeches, Denise opens several bags of candy and distributes them one by one to each kid. They are ecstatic; candies are an exceptional treat here.

Noon: School lunch time. The kitchen is close to but separate from both the school and our house. It houses two traditional, smoky three-stone fires and a preparation table. The cooks bring the rice and bean mush that forms the school lunch. Kids eat in their classrooms. After lunch they wash their tin plates in the faucet in the school yard, thanks to our engineers who installed it some years ago, drawing the water from a spring high up on the hill behind. An occasion for much splashing and fun.

Our lunch is much more substantial: Like last night, a several course meal, avocados and friend plantain, rice and beans, cabrit, fruits. Our living quarters, dining room and bedrooms, are all on the second floor over the school. The cooks have to climb up a set of outside stairs to bring us the food. They do it so graciously!

In the afternoon, a brief school session until 2 pm and the kids are out running. Many of them will walk over an hour to get back home. Most will have to cross the river many times. They take their school shoes off to keep them dry. Uniforms too have to be kept dry. They are often dirty, and that’s understandable since they are washed in the river that is turbid and muddy.

Many kids return after a short while, having changed to their usual rags. They love being around us, they giggle. The little ones touch us to see if we’re real. A few older kids go back inside their classroom and scribble on the board. There are a couple of kids, points Emmanuel the school guardian, who hang out but have never been to school. The oldest is ten, says Emmanuel; he looks like six. Shy, big eyes, more eyes than body, it seems; he’s so tiny. And more raggedy than most. His clothes are filthy. And he’s dirty from hair to toes. No shoes. But many don’t have shoes either I notice. He stays in the back, maybe he’s ashamed of not being able to go to school. His presence on school grounds betrays his yearning. Emmanuel says he’s an orphan and lives with some distant relatives who don’t have money for his schooling.

The other kid goes to school, says Emmanuel who knows everything. But his parents can no longer afford his school fee and next Monday he will not be allowed to go back to school. It looks like he knows it. He appears withdrawn. Our schoolchild adoption program doesn’t have enough sponsors. The dirt-poor school can’t make exceptions. I make a note of their names: Jonel Fadeus and Jidelson Louis Jeune, or something like that. Neither one knows how to spell his name. I promise myself to sponsor them as soon as I return to the US. Meanwhile we give them candy.

What wasted potential in these kids! A later day we saw one that took two bucket lids, placed them vertically and tied a flat piece of plank in between. A broom handle at right angle to the contraption, and voila, he got a mini-wheelbarrow to carry his bucket! In the States he would make a wonderful engineer.

With nothing much to do, we watch the engineers repair the “Gator”, this tiny vehicle with six wheels and tires made of solid rubber, a gift from some donor. The Gator can climb up any slope and cross any river providing it’s shallow enough. Jean-Louis, the illiterate jack of all trades at Garsen, is helping Bob and Mike. He can’t read or write his name but can repair anything. The Gator gets fixed quickly.

The afternoon is young. We have time to visit Boucan Richard, another hamlet in the parish. Like Garsen, it has a chapel and a small elementary school. Denise is anxious to see the school kids there. We prepare our bags of candy and we inflate our world globes and here we go. We are getting used to the bumpy roads. Short ride, less than an hour. The kids, a hundred of them, are waiting in lines for us in the courtyard around the solar oven, all in their brightly colored uniforms.

As in Garsen, the kids serenade us with welcoming songs and they sing beautifully. Some in Creole and some in English. They have rehearsed long and hard, their tunes and unison are perfect. And they have prepared gifts for us, baskets loaded with papayas, bananas, and passion fruits. They are excited to see us. Again Denise greets them with all the love in her heart. She has tears in her eyes when she addresses these kids, neatly dressed in their uniforms, intently listening to her, the hope for a better Haiti. Rita gives her globes away and I make my cholera speech. Kids and teachers alike listen somberly: They’ve seen cholera death in their midst. The high point of the assembly is when Denise empties her bags of candy in the kids’ hands.

The teachers give us a tour of the school. A copy of the one in Garsen. Wooden benches and a blackboard. No windows. Two grades per room. We can’t stay long. We’ve to leave by 4:30 if we want to return to Garsen before complete dark. Denise reassures the kids she will be back next year as always.

Back in Garsen: Before dinner I take a brief stroll in the hamlet. It’s very small. Most people are dispersed on the flanks of the various hills around us. There seems to be only a few houses near our compound. Simple affairs: slabs with four walls. One room, two at most. Wooden door, window holes. A three-stone fire outside. The paths have all kinds of litter, and the one I travel has a suspicious wetness in the middle. Kids follow me, laughing. They are very friendly. Candy is one English word they know: They want candy; alas I don’t have any.

Friday, Nov 12

Finally we leave for Kalabat. Kalabat is located in a different valley. To reach it we have to go back to Gros Morne and start in a new valley, of Riviere Mancelle.

On the way, we pass the place where the cholera victim was; no sign of the trio. Yesterday we learned that the Gros Morne hospital has been so deluged with cholera patients that it has locked its doors and is turning patients away. Did that lady on the road make it in time? A prayer for her, hoping she did and that it was not too late for her. Leaving Gros Morne, we follow the Riviere Mancelle bed. For many miles we are actually in the river bed, half dry in that season. The driver carefully selects dry segments when they are available, and has to go in the water when they are not. It is always risky because it is hard to judge the depth of the river. Teeden, our expert driver, has done it many times, it’s no sweat for him, but it looks scary to me, river naïve as I am. It’s when we have to go in the water that the ride is bumpiest; the river bottom is not as flat as the dry sections.

Midway to Kalabat, the Land Rovers have had it. Some days they can go all the way, and some days they can’t. It depends on the water level. Today, the level is too high at this point. At L’Attrell, we all alight, people and the mountain of luggage. The rest will be by foot, a forty-five minutes walk/wading combo. Porters are waiting for us; skinny people used to carry heavy loads. Women grab our suitcases and swing them onto their heads, 40lbs bags, and proceed walking. Bob Snyder has a handicap and must use a donkey. Two other donkeys carry the heaviest bags, a good 200lbs per donkey. There are no horses in Haiti, no cows either.

So we walk. The river gorge is narrow. The path sometimes ends against a cliff. It’s time to cross the river and go to the other side to pick up a new path. Same thing for that path: It ends against another cliff and we have to cross the river again to grab another path. And so on. Thus, we cross the river about 22 times. The water is not too swift, and never reaches higher than the knees. At times, we meet women doing their laundry, with naked toddlers playing and doing their thing in that water, contributing to the spread of fecal-borne diseases. There are no fish in any Haitian waters. Killed a long time ago. Pollution I presume? After a while, I enjoy the river crossings better that the walking on land. The paths are filthy, somewhat muddy, so full of donkey poop that it hard not to avoid stepping on some. Bob keeps reminding us that people too poop on the road. We have to learn to differentiate the two. So, I prefer the river. Since we can’t see its bottom, I don’t have to worry about what I’m stepping on. As long as we don’t put our feet in our mouths, we will be safe. The only nuisance is the gravel that inserts itself under the feet. I have to empty my shoes often. And I skid several times. One of the porters, a lady carrying one of our heavy bags on her head, notices my lack of balance and grabs my arm with her free hand, steering me along the best shallows.

Finally, Kalabat! A hamlet on a hill overlooking the river, the center of the Riviere Mancelle area, with the church/rectory/school/dispensary compound at the highest point. The rectory is brand new, as the old one was destroyed in the recent earthquake, although over a 100 miles away from the epicenter. It is big, two floors, seven bedrooms. The kitchen is separate, as usual, but it’s an enclosed building, fancy! The dishes are washed under an outside faucet. As Denise humorously states, there are many bedrooms, but not a single sink in the house. There is one flush toilet, and one shower with no windows. So at night we have to hang a flashlight over the shower head. Cold water of course. That makes for economy: Only Jean, Haitian born and used to cold water from birth on, takes long showers. The rest of us Americans, we take our showers at lightning speed. Since there are no sinks, we use water in a cup to brush our teeth and spit it outside the window. First, we warn people below, of course. Jadotte uses bleach to purify the spring water we use for drinking.

Jadotte has 3 cooks in Kalabat, and one lady who does the dishwashing. The cooks are young girls, smart and efficient. The dishwasher is an elderly widow that Jadotte employs to give her a little money. Perhaps feeling guilty about her severe stutter that makes her unintelligible, she smiles broadly all the time, displaying her toothless gums. As in Garsen, we feast on avocado, papaya and mango juice, fried plantain, cabrit and more cabrit, rice and beans with delicious sauces, some green veggies, potato cakes for dessert. And the heavenly Kremas to enliven a dull (to my taste) cup of coffee.

The church is less than 100 feet from the rectory. It too has suffered from the earthquake: Long cracks from top to bottom on the right side of the façade. On the apse, even bigger cracks. Jadotte has no money for repairs. The school behind the church has suffered from the quake, and is close to being unusable. Bob Snyder is planning to rebuild it. Next to the school is the nuns’ residence. There used to be two nuns, but there is only one at the moment. The grapevine whispers that the one who left couldn’t stand the one who’s staying and she quit. It’s hard to live together if you’re only two and don’t like each other.

Before dinner, I take a leisurely stroll down to the river. There is a permanent little market by the shore. Three women squatting near their baskets of rice and beans and some trinkets. The passersby don’t respond to their calling. The women don’t mind, they’re busy chatting.

Again I room with Rita, in a tiny room with glass-less windows that let in strong, cooling breezes at night. The climate is tropical, and we need only a sheet at night. We keep the door wide open, it’s too hot.

Saturday morning, Nov 13

While the two engineers are busy building rocket stoves, our medical team finally gets to work. We’ll operate from the little dispensary behind the school. It’s a tiny three-room, dilapidated building that doesn’t deserve its name. Two rooms in front and in the back, a dark room that serves as a pharmacy. No lighting.

Up front, the room on the left is where we will be seeing patients; it has a rickety table, an old exam bed and a cabinet with a few meds in complete disarray. The room on the right is the nursing room, with four cots touching each other. When we enter it this morning, we find all the cots occupied with people, all silent and still. They look like skin and bones, and are hooked to IV bags hanging from nails in the wall plaster.

A young lady comes out from the back. She is Philo, a recent graduate from nursing school. She was visiting the area when cholera struck. She was hired by the nun who directs the parish school and is staying until the epidemic is over. We’ll quickly discover how precious Philo is and we’ll bless God ceaselessly for sending her to Kalabat. As she introduces herself to us, she mentions that since the onset of the epidemic, a week or so ago, she’s seen 30 cases of cholera just in Kalabat, this little hamlet of a few hundreds. And no deaths!, she smiles proudly.

There is no governmental presence here, and no big relief agency like Doctors Without Borders or World Vision or the like, nobody but little Philo who dropped in from nowhere. She has no medicines but she gets IV bags from the Gros Morne hospital. When she has to, she walks/wades to Gros Morne, two hours away if she can’t rent a moto on the way. I suppose that on the way back, she carries the case of IV bags on her head, like everybody else.

We unpack our meds, and give Philo tons of Cipro. We also have antiemetics for the vomiting, and antidiarrheals for diarrhea although their use is controversial in cholera. “What providence!” she thanks us. She had no oral medicines at all until we came.

For the sake of hygiene, we’ll conduct our clinic in the left room without going to the cholera room on the right, unless Philo needs our help. She will need it only once. She is well organized and nothing fazes her.

Cholera

In the days to come, cholera will intensify its grip. An average of six patients will come in daily, usually brought in on homemade stretchers by relatives; and at any time of day or night. We will often be awakened by the shouts of people passing by our dorm on their way to the dispensary. We learned later that Philo slept only 3-4 hours a night during our stay.

No deaths until we came. Alas, death did come. By the time we left, the hamlet had had ten deaths, just at the dispensary. In the remotest areas there were many more deaths reported by the grapevine, of people who did not make it to the dispensary. Kids and old people.

In the dispensary, the cholera victims were mostly elderly. The only child that died in the dispensary was a twelve year old girl who was brought to us so dehydrated that she was beyond salvation. Philo managed to put several bags on saline in her and she revived a little. But Philo’s efforts were too late: The little girl died a few hours later. All that was left of her was a tiny lump under a blanket, waiting for the parents to build a casket for her.

Death knocked even around the rectory where there is spring water and where Jadotte is purifying the drinking water with Clorox. He has given strict orders to the cooks. Fresh produce is thoroughly washed with clean water before consumption. I did observe the cooks washing their hands frequently at the spring water faucet. Despite all these precautions, Paulo, the compound guardian who lives on site, had two relatives who died of cholera during our stay. We, Americans, are on guard. We’re constantly rubbing our hands with the antibacterial gel we brought, and never, never touching our mouths with our hands. Alas, Haitians don’t, can’t imitate us.

The cholera toxin opens the flood gates that hold body water behind the colon. When these gates open, there is a deluge of tissue fluids pouring through the colon and exiting the body en masse out of both ends. Bodies can lose 20 lbs of water in a day. The body tissues become as dry as beef jerky. Dehydration is so massive and so quickly massive, that cholera can kill within hours of the first symptom. That’s why rehydration is so vital. Alas, when people often come too late; even if they start early for the dispensary, it may take them 4 hours or more to get here, like folks in Danti, a parish hamlet we did not visit because it’s that far. By the time these folks get here, they’re half dead, veins are flat, with their walls sucked up as if they had been vacuumed out. The only time Philo called me for help, she had tried to stick a poor cholera lady over a dozen times without success. She wanted me to try too. With less experience than her in that field, I gave her little hope. Late that night, with Philo holding a candle for lighting, I tried arms, hands, feet, even neck, without success. The lady had lost so much water that she was weighing 60 lbs at best. Seeing our failure, her relatives carried her to a Voodoo priest nearby. He was not successful either: she died an hour later. As days went on, we heard more and more funeral wails rising from the river, that crossroads to everywhere. As sad as it was, we had to get used to them. For the sake of efficiency, emotions had to be checked.

During our stay, the cots were always all occupied, and the one baby crib as well. Every morning, before seeing our regular patients that were waiting outside in a long line, I used to check the cholera room to say hello to the new arrivals and find out who survived. Mostly to bring a smile and words of hope to these people waiting between life and death. Patients couldn’t answer my greetings; they were still, too weak to move or speak. By the time they reached us, they usually had lost all the water they could lose without dying; so there was little diarrhea on the cots. We were grateful for that as we didn’t have a single basin that fit under the patients’ bottoms. Still some residual retching. They were all so gaunt! The lifeless skin was stretched tight over their bones, the muscle layer that dried up was almost absent. That they were surviving was a tribute to the resiliency of the human body.

Relatives squatted near their sick loved ones, holding their heads over a bowl while they were vomiting, wiping their drool, trying their best to make them comfortable. There was little room for these relatives as there was barely enough for the four cots. Most relatives waited outside sitting on the steps or on the dirt. At dusk Philo lighted a candle so the insiders could see a little.

Treatment was simple: immediate IV bags, one in each arm at the same time, running as fast as we could make them run, over and over, until the patient could sit up. Phenergan as antiemetic. By mouth, as we had it only as pills. One pill after another. Despite the continual vomiting, a little got absorbed in time, and slowly it was taking effect. Then and only then could we give the lifesaving Cipro. We didn’t bother with oral rehydration solutions: By the time Philo’s patients came in they no longer were able to swallow anything. We relied on IV saline. The method worked when patients did not come too late. Thank God Philo never ran out of IV bags, although she had to walk hours to get them.

When one died, we covered the body with a blanket and waited for relatives to pick up the body. The cot was quickly cleaned up with the poor means available as it often was needed soon after.

Saturday, Nov 13 and Monday Nov 15---Thursday, Nov 18

So, we set up clinic on that first day in Kalabat. We quickly establish a routine: We’ll see patients in the room on the left, the way I do in my clinic in the US. Jean and I sit together by the table, I talk and he interprets. Knowing his folks, he also advises me, and his advice is precious. He sees signs I don’t see. He knows how much pain actually lies behind the poorly worded pleas and he knows the reason why; he knows what it means when people say “I feel air in my heart” and weird things like that; he knows how people live and asks for the details that are clue to a diagnosis; he knows who’s poor and who’s poorer. How much medicine we give depends heavily on his estimates. After the consult, I write the “prescriptions” on a piece of paper, and the patient shows it to Rita and Denise in the pharmacy room, and they in turn give the needed meds, if we have them. Jean gives the final instructions in Creole. A long line patiently awaits us every morning, sitting outside on the one bench or standing. They arrive early to make sure to be seen, some at dawn, and it’s about 5 or 5:30pm by the time we see the last one. For many it may be the only time in their lives that they will receive any medical care. This became the pattern until we left for the US. We see an average of 35 patients a day. We cannot work too late because the building has no lighting and the windows are small. After 5pm we have to use flashlights. We do the best we can. Without any diagnostic tools, it is difficult to ascertain the true conditions of the patients. And our means are so little for the severity of the conditions we meet!

When patients finally get their turn to see me, I always ask their age. The old people lower their heads, giggle, smile embarrassingly and confess they don’t know it. They’ve never known it. Jean expertly eyeballs patients’ age and it’s always less than I think. He knows how fast people age here.

They barely know their names either, don’t even know how to pronounce them correctly and, not knowing the alphabet, have no idea how to spell them. Even some younger folks have difficulty estimating their age. Only among the older school kids do I find people who do.

Many old folks complain they can’t see. Their thick cataracts are obvious. Alas, nothing can be done. The closest ophthalmologist is so far, he is as unreachable as the moon, and as expensive. Most old folks are edentate. Younger ones have mouths full of rotten teeth. How can I advocate tooth brushing when they don’t know what a toothbrush is? And knowing that if they ever used one, it would be with river water, no cleaner than a cesspool?

Of the women, I always ask how many kids they have and how many are living. It’s always around ten, sometimes more, and many have died in infancy. All women complain of vaginal infections. No wonder, knowing in what water they bathe and how they live. Lodgings are a cement slab at best, enclosed by four walls with holes for windows and a wooden door, the whole thing topped by a tin roof. Sometimes that slab is divided by a wall, forming two small rooms. Banana mats on the floor. Usually not a piece of furniture besides the essential five-gallon paint bucket people use to gather river water for their daily needs. That water will be used mostly for drinking and cooking since all washing, body and clothes, is done in the river.

We’ve not brought enough antifungal cream and we quickly run out of it. All we have left is some ineffective anti-itch cream. And there is no way of finding out if their pain is due to a more serious sexually transmitted disease.

Women age prematurely. A thirty year old looks forty and a forty year old looks fifty. After that, most have lost their teeth and their faces are lined deep with hardships.

In addition to the meds that they may need, I prescribe massages since Rita, our self-styled pharmacist is also a wonderful masseuse. This is the only time in their lives these women will have been pampered. So, whether they really need it or not, they get a massage.

The most common complaints are gastrointestinal, pain, bloating, burning. We dispense a lot of antacids. I suspect a lot of conditions are due to parasites. By luck I discover a cache of expensive worm medicines in the cabinet and I prescribe them liberally.

Among adults, there are many backaches and other musculoskeletal complaints. Knowing their hard lives, bent down scratching the earth for grain little better than chickens, or carrying heavy loads on their heads over rough terrain, no wonder. All we have is ibuprofen and Tylenol.

There are a lot of skin diseases, some unidentifiable. There is this cute little one and a half month old baby, nice and plump thanks to a healthy mother’s milk, but he is covered in sores: Whether it is scabies, fungi, bacteria, or any of a number of parasites, it seems to be all of them at the same time, and then some. I don’t know what to give him. I finally give him a little of everything.

Many, many kids are mangy. Sores over their heads, and most of their skins.

As a rule, all little kids are small for their age. Every kid I see in the clinic looks malnourished. Stunted growth in most of them despite Denise’s school lunch program. Jean Eloizin laments that people are so small nowadays that Haiti no longer has a soccer team that can compete internationally.

A 12 year old boy with the stature of a 7 year old complains he has stomach pain all the time. After poking into the nature of his pain, it looks like his cramps were just hunger pangs. I ask him: “How many meals a day do you eat?”

He lowers his head, “Once”.

“And what do you eat?”

“Rice, some beans if we have some”

“Can you show me with your hands how much you eat?”

He makes a small fist.

No wonder he has stomach cramps! The children’s vitamins we brought would do nothing for them. It is useless to prescribe more food when it’s not available. This kid was not going to school so had no meal there. Even the school kids may be underfed. Some parents take advantage of the school lunch program to save on home staples at night. The kids we see have their shares of big bellies and stick legs, and reddish hair instead of black. All signs of malnutrition.

A couple of kids come in with 106 degree fever. They had walked an hour to see us. We load them with fever reducer and antibiotics, and make them wait until their fever drops to 102 before letting them go. Another day, a six-year old little girl comes with a severe otitis, pus flowing out of her ear like water from a faucet. She is screaming. Probably has mastoiditis. I urge parents to bring her to the hospital in Gros Morne. But they have gone once already, the treatment there didn’t do anything, so they refuse to go back again. I do load her with antibiotics but I know she needs surgery. What will happen to that child?

I see several huge goiters, all in women. Nothing I can do for them. They need serious testing, not available here. So many severe conditions, things we don’t see in the States, I begin to take them lightly. What can I do for them?

Big facial tumors. Huge scrotal hernias. An enormous bony tumor in a young man, on the side of his right arm near the wrist, bigger than a grapefruit. One horrible thing after another; as time goes on I get inured to these tragedies. One afternoon, a couple brings their seven month old baby girl. They’re concerned that her head has been getting big for a while. I almost recoil in horror: The child has a humongous hydrocephalus! It is busting her eyes out. Her protruding fontanel is so tight it feels ready to pop out. She’s not reactive, she may already be brain dead. I implore them to bring her right away to the hospital. I tell all of these patients to go to the hospital in Gros Morne. Most say they can’t do it. The hospital charges a fee that they can’t afford.

On the first day, the last patient is a skinny lady, as they all are, hiding something under a neck scarf. “I’m Stephanie” she says while cautiously unrolling her scarf to reveal a huge abscess, a good five-six inches long, at the base of the neck on the right. So swollen with pus, two inches tall. I have to lance it and evacuate that pus. Thank God I find a scalpel, forceps and scissors laying around, plus packing tape. Alcohol for sterilization. Lortab for anesthetic. She cries when I cut the abscess open, and cries louder when I extrude the pus by big gobs. There are many onlookers, so I order them to sing church hymns to comfort the patient. They do, and it is the most beautiful religious concert choir we’ve ever heard. They are Seven Day Adventists, they tell me. The lady quiets down and I can finish the procedure in a good enough fashion. But what is the infectious agent? Impossible to do a culture. Besides the usual culprits, it could be TB. Not knowing, I give her multiple antibiotics by mouth and schedule repacking daily. Next day she comes, and everyday; little by little the infection abates and the wound is getting clean. But it is not closed by the time we have to return to the US. I tell her she must go to the Gros Morne hospital for follow up. I fervently hope she does, but will she? In her living conditions, it is a sure thing that the abscess will reform without proper care.

In the US, we had collected a dozen pairs of no longer used prescription glasses. People in need of glasses try them one after the other. They always find one that fits their needs. How moving to see their joy at being able to see! This is one program we’ll have to expand.

A man comes in one day, crazy with grief. He buried his only child the afternoon before, a 16-year old boy, felled by cholera. The man is here for stomach pain. While he is waiting in line to see me, a neighbor runs to him and tells him his wife just died. “Of grief” says the neighbor. Whether grief or cholera, this poor man had lost his whole family in one day, and is overwhelmed with grief himself; and likely with cholera too. No fancy support system here. Besides cholera treatment, all I can do for him is to give him a sleeping pill.

Everyday I see mild cholera cases, leaving the serious ones to Philo, the IV specialist. When people come with vomiting and diarrhea, I ascertain how many people live in the household and give enough medicines for all of them. One young lady has sixteen relatives living in the same house. When sixteen people live in a small shack and drink from the same pail, they will all eventually get the germ. We have plenty of antibiotics and I dispense them freely.

So, day after day the line waits patiently for us outside the dispensary, hoping for miracles. They gratefully thank us for what they think are wonder drugs. Alas, it is mostly some ibuprofen and an antacid, and never enough to treat their multitude of problems.

Their multitude of complaints spans the whole body from head to toe, with heavier grip on the digestive and musculoskeletal. Little things, like the ever-present abdominal pain, and big things, like the emaciated, jaundiced elder with a belly like a nine-month pregnant lady, with prominent veins. Probably liver cancer. I have nothing to give him besides ibuprofen and a sleeping pill.

Friday, Nov 19

Johnny is passing by to say hello. He’s a young man who does sundry things around here for a living. He was orphaned at a young age. He has no family left and has gone only to elementary school. He is ambitious and wants to go to high school but he has no money. One of his part-time jobs is with Sister Pat of Gros Morne, the agronomist. One of her projects is to make bleach from scratch and sell it cheaper than what’s found on the market. As Johnny explains, it is easy to synthesize: The ingredients are just table salt and water. The last ingredient is difficult to obtain: electricity. A byproduct of electrolysis is bleach. So Pat and Johnny have this mom and pop operation in the nun’s compound. The electricity comes from the solar panels on the roof. These can’t keep up with the demand and our self-made chemists have to wait until the evening to use what’s left of the available electricity. But they have a fairly smooth operation by now. They sell bleach at a quarter of the price of bleach on the market. And they sell selectively to the poor. Bleach is a lifesaver at 30 drops per bucket of dirty water.

A break in our routine today: We travel to Chateau, a hamlet up the river from Kalabat. Once more we crisscross the river many times. Since we are going up river, the current is swifter. It is harder to keep a good balance. A school kid going back home keeps tabs on me like an angel and grabs me whenever he sees me slipping. On the way we pass a market, Provo. People are lining the path with baskets full of rice, beans, fruits and other staples, as well as trifles and trinkets. Much calling and yelling. People jostling each other. Donkeys laden with heavy packages. The path is wet with water obviously mixed with a fair amount of urine of various origins, and dotted with donkey poop and other kinds of poop. Dodging these is a skill, and not always successful. I do prefer walking in the water. After Provo, a last steep hill that is breathtaking, and finally, after walking an hour and twenty minutes, we reach Chateau. It’s a tiny hamlet, a few houses, doesn’t look that it has a hundred people. Jadotte has the usual compound church/ school/ and dispensary. The dispensary is not staffed; the nurse quit the week before without giving a notice.

So, again we open our bags of medicine and set up shop. The population is so scarce that we see fewer than 20 people. Same complaints as in Kalabat, mostly enteritis and backaches. We have plenty of time to relax, munch on the lunch we have brought and enjoy the magnificent view of the mountains, the palm trees, the fat papayas and bananas that are protruding from their trees all around us, the shimmering river meandering way below, and the gentle breeze that is caressing our skin. The smoke that is rising far away is a voodoo ceremony, says Jean who knows everything. On the mountain opposite us, we spot the thin silhouette of a woman slowly trudging up the steep slope with a hand raised up to steady the five-gallon bucket of water perched on her head, holding a little child with the other. She looks so graceful, she makes it look so easy! But it is so far up from the river! How can she do that everyday, as she must? I am awed by the hard life of people here.

Such a lush landscape! Haiti could be a Tahiti or a Hawaii, a little paradise, instead of the failed country that it is. How it is what it is and not what it could be is a mystery to me. It is a generous earth, eager to reward those with the skills and the tools to tend it. Jadotte has a bamboo tree in his yard. Last year it was cut to the ground. Today, it is a good fifty feet tall.

To compare with Guatemala, a country that I know a little, villages there have a tight society with directing and respected elders; people work together within communities. Not so in Haiti where poverty has reached rock bottom and people are no longer able to help each other. In addition, in Guatemala, there is a minimum of infrastructure: The countryside everywhere is rapidly getting electricity; the government is paving a lot of roads. Not so at all in Haiti. No electricity anywhere beyond the few big cities, not even in good size cities. No good paved roads beyond the capital. The country is frozen in the Medieval Ages.

People have such potential! I see it in the kid with an engineer’s mind, in illiterate Jean-Louis who can disassemble an engine and put it together perfectly, in Johnny who’s not gone past 6^th grade but knows how to make bleach, and in so many others. But the only potential that can express itself here and flower is the capacity to endure. And endure they do: backbreaking labor, futile labor, filth, hunger, diseases of all kinds, endless suffering.

On our way back to Kalabat, we pass Provo. Market has ended; the path is strewn with litter. The return trip is easier since we are going down river. Back home, we all take long showers to scrape that slimy river water off our skin. Coffee with Kremas does the rest to restore our spirits. I check the cholera room: Still full; no deaths today.

We see little of Fr. Jadotte during our stay. He is traveling from hamlet to hamlet for his priestly duties and to Gros Morne on errands. He walks endless hours a day. To get to Gros Morne he uses a moto part of the way and the bouncing is giving him a serious backache and a sciatica. He can’t sit up and can’t sleep. Rita gives him massages and is teaching the cooks how to give massage. We give him ibuprofen for the day plus a Flexeril for a good night sleep. We usually see him for dinner, or after dinner whenever he can return. Thank God he was here when a tarantula a good six inches wide ventured in the dining room during our supper. He was prepared: he grabbed a can of Baygon and smothered the poor thing to death.

Saturday, Nov 20

This is our last clinic day before packing for the return trip. More of the same. Another long line of people outside the dispensary. The lame, the blind, the skinny mangy toddlers, the babies whining in their mothers’ arms, the bent over elderly that walk supported by a relative, it looks like a biblical scene. How I wish Christ was here! Alas, we don’t perform miracles. As each one unfolds a lifelong list of miseries, I realize that perhaps the best healing agent right now is our listening. With all the compassion that their infirmities easily elicit, we listen attentively. It looks like nobody ever listened to them before. And the more I realize my little pills are useless for their huge problems, the more hope and encouragement I offer.

I see that this never ending flow of suffering is hard on Jean. In the tottering elders he recognizes the energetic men of his youth. This edentate woman is his aunt. Many patients were the playmates of his childhood. He hears the good news and the bad. “And what happened to cousin so and so?” he enquires. “Oh, he died a while ago!” The comparison is striking: Jean is a vigorous man who has acquired some of the American thickness in the middle, he wears prescription glasses and his perfect teeth show skilled care. The friends he left behind are thin and wiry, with not an ounce of fat on their bodies. There is some tiredness in their stride, born of too many long walks with too heavy loads. Their carriage betrays a life of exertion. Most of their teeth are gone. It’s among his old friends that Jean sees the lame and the blind, and the ones with inoperable tumors. They chat about old times, but in his strained smile and a hint of sadness in his voice, I feel the desperation that seeps in him.

A little lassitude sets in among the four of us, compounded by a sense of frustration, of the futility of our efforts. The engineers can see the results of their work: At Boucan Richard, they have hooked up an electrified fence to the solar panels to protect the storeroom where the sacks of rice for the school lunch program are kept. Last month, hungry thieves broke into that room and stole the sacks. The engineers have also built three rocket stoves and the cooks won’t have to breathe smoke for hours. Plus they’ll save trees by using less charcoal.

But the medical team does not have this sense of accomplishment. Most of our meds have indeed been distributed. But they can’t produce lasting good. All we could give for chronic problems was for a few weeks treatment. Not enough. Pain will be back too soon.

We are feeling the inadequacy of our help. No testing, not enough meds, not the right meds. And mostly, our help was not the appropriate kind. The most urgent help is better hygiene. A monstrous problem in this medieval society. People need clean water first of all. And latrines, which are inexistent. And they need many, many more things.

Convinced too of the importance of proper excreta disposal, Denise says she will be applying for a grant to build latrines. Building materials, shovels, etc, demand some outlay. Donations have precipitated to a low with the recession, and the FeedHaiti project has no money.

We’ve done our part in teaching. We’ve gone to every classroom in every one of the four parish schools. We have talked about germs, dirty and clean water, about washing hands after pooping, how to purify water, etc. We have instructed the teachers to instruct the kids. We have talked to kids individually and in groups. We have supervised hand washing sessions. We have planted a seed. There is hope for the next generation.

What troubles me is that the only adults we’ve seen are the sick ones who visited the clinic; very few. With no or few tools, farming requires backbreaking work. Men are tied up to their fields. Women are forever fetching river water in their paint buckets, washing clothes in the river, and cooking for hours over a smoky fire. What is fun for American Boy Scouts is slavery here.

On previous missions, our teams have installed a public faucet on each of the four church grounds; they deliver spring water captured from high up on the mountain. It may not be completely clean but is much safer than the river water. People who live near the churches come get this water for their daily needs. But many more, in this area where people live far apart on plots hanging on mountainsides, cannot get this clean water. For them, the river is more accessible.

I can’t wait to work with the group on the latrine project. If only people wouldn’t leave their excreta in the water or on the bare soil! Simple trench latrines would be a gigantic step forward. Until then, the cholera will maintain its virulence for a long time. Estimates predict that a cholera epidemic can last up to a year. In areas where people are cholera naïve and have no immunity to it, cholera can decimate the population. We have to do more to stem its onslaught.

The number of cases reported by the press is vastly underestimated. In the many remote villages of the countryside like ours, cases are not reported, period, because there is no governmental or NGO presence at all. We had ten deaths in one week in a tiny hamlet, of which there are hundreds, maybe thousands in Haiti. And that number was itself an underestimate since these are only the cases we’ve seen in our dispensary. Most deaths have been at home, unknown to all but close relatives.

Sunday, Nov 21

The trip is winding to a close. It is drizzling. It is Christ the King Day. The church is full. Long, beautiful Mass, gorgeous Creole songs. Vibrant harmonies are flowing to Christ crucified; songs of love to the One who understands their sufferings. Faith here is not tepid, its expression not languid. People are belting out their faith, their hope of redemption. If their souls can be redeemed, why not their very lives? Christ is King, and people are feeling comforted by the promise of His kingdom where there is no hunger, no death, and no cholera. Fr. Jadotte preaches a stirring homily. Even though it is in Creole, we intuit the content from his passionate tone and we are moved.

People are decked in their finest. All clothes here are rejects from third hand American stores. What Americans no longer want ends up in Central America or Haiti. No cotton in a world that can’t iron it. It’s all polyester. Kids are so cute and their mothers look so regal in their brightly colored Sunday clothes! Their joyous smiles are hiding the toils that keep these clothes clean.

But they promptly go home to change and in the afternoon we see them in their usual rags doing what they do constantly, getting water. They start early: We see five-year olds carrying quarts or gallon jugs over their heads. By the time they are twelve, they’ve graduated to the five-gallon buckets.

Fr. Jadotte again is in agony with his sciatica. After lunch, Rita and her trainees, the two young cooks, give him a long massage. We make a note to send him some lidocaine patches.

We pack up and clean up. Monday we are leaving early. The flight is at 5 pm and we have a five hour drive ahead. A treat is awaiting us: We won’t have to walk/wade to L’Attrel, the midpoint to Gros Morne. The water is low and Teeden will pick us up right at Kalabat and drive us to Port au Prince. We will stop in Gros Morne to give Sister Jackie the remainder of our medicines. We are so grateful not to have to crisscross that river, that harbinger of disease, the nemesis of all who have to live by it and off it, that cruel master that hides seeds of death within its gift of life!

Monday, Nov 22

After an early breakfast, it is time for the last photos, the last gifts and the last goodbyes. We thank the cooks and the dishwasher who also did our laundry by hand. We even thank Paulo, a ne’er do well, whose laziness irritated us constantly. His main job is to sweep. He does little of it, and he does it badly. He grabs his broom only when he sees Jadotte coming around the corner. When he sweeps the church steps, he starts on the lower one, pushing the dirt to the ground below. Then he goes to the second step and pushes its dirt onto the first step. And so on. At the end, the only clean thing is the top step. As to the pile at the bottom, he leaves it there. When it’s time for a clinic day faraway, he puts the heaviest bags on the head of women while he selects the lightest for himself. Jadotte has scared him at times with threats of suspending his pay, but it’s not effective. Today, Paulo is all smiles; so we hug him as we hug his coworkers. He lost two family members to cholera after all.

Denise is almost crying about Willy. William is a tiny black goat, a gift from a grateful lady. Her house had been destroyed in the January earthquake and Denise had it rebuilt for her. Bigger, two rooms instead of one. The cooks took Willy and put it in the antechamber of death behind the kitchen where the dishwasher was just hanging the head of our preceding dinner upside down to dry, it was still bleeding. Politely the cooks were waiting until Denise left to lead Willy to its predestined fate. Since the gift a couple of days ago Denise has been talking about starting a Save Willy website. But she knows it’s useless. Willy is a goat and goats are dinner, and that’s that. Denise doesn’t give up. She begs Jadotte to spare Willy. At the last minute, a compromise is reached. He will give Willy back to its original owner and urge her to spare his life. Denise is happy.

It is time to board the familiar Land Rovers. The bouncing and jarring are no longer bothering us. Between Kalabat and Gros Morne we cross the river fifty times maybe, following people and donkeys that are doing the same. While we are approaching the big city of Gros Morne, we see hordes of women doing their laundry in the shallows, and hordes of kids playing in the water, many stark naked.

In Gros Morne we have a brief stop at the nuns’ to give our medicines away and to buy some Haitian crafts for fundraising resale in the US. Sister Jackie gives us a last gift of freshly squeezed mango juice, such a treat!

Back on the road to Port au Prince, we see columns of UN peacekeeping trucks and tanks. Indeed the soldiers look Nepalese. There have been some protests against them in Cap Haitien, the second biggest city on the North coast. Fire has been exchanged, a civilian died.

In Port au Prince, we intend to stop at Matthew 25, this hospitality house that has wonderful arts and crafts for sale. It is downtown so we cross the city. But first, Jean wants to show us a property he has there. When we get there, he discovers that his property has been transformed in a tent city. Tent after tent stuck to each other in long rows separated by a narrow path wide enough for a single file; one toilet for hundred persons, as typical. No work, the few people we see look bored, hopeless; most of them are on the streets, in the markets, where there is life and activity. Kids will always find a way to play: They are kicking an orange for a lively game of soccer. Jean didn’t know his property had been requisitioned. He is happy that it is being put to good use.

He is leaving us at this point: He wants to spend one more day in Port au Prince where he has family and friends. Sad, emotional goodbyes. Jean is a wonderful person. He is enterprising, selfless, and dedicated. The best interpreter we could have hoped for. We couldn’t have done our work without him. In Riviere Mancelle, the locals know him as the boy who made it and made it big. He was always accosted by people who were begging him for money. Prepared, he had filled his pockets with bills and was giving them away freely. At times he had to hide. Like when he went to see his parents who live some distance from the hamlet: He waited until dark to escape under the cover of the night. Or when he took a day off to see his house in Gonaives. He came back at night, crossing the river in the dark. He was depressed on his return: His house had been covered with mud up to the roof during the hurricane and was unlivable. It was not even accessible, as the road in front was not passable. Yes, I’ll miss Jean, my Haitian half.

Leaving his tent city property, we see more and more of the same. These tent cities cover the whole city and beyond, they occupy all previously free spaces, and they can be huge, miles long. We see more tent cities that upstanding buildings: They are everywhere, on our left, on our right, in front of us and behind us, above us on the hill and below us. Seas of white and blue tents. They are housing 1.3 million people. For these folks these tents will be home for a long time to come, an unforeseeable future. It is dry today but during the recent hurricane the tents were invaded by mud.

Humongous traffic jams in that city where the traffic lights no longer work. Choking dust everywhere. Little by little we inch our way towards Matthew 25. An island of peace and serenity in this city that lacks both. This house of hospitality is part of the Parish Twinning Program of the Americas and is directed by Sister Mary Finnick. Mary radiates goodness and love. She has many charitable projects besides hosting volunteers on their way somewhere. One of them is sponsoring local artists and using some of the profits from the sales for her various charities. Beautifully carved sculptures of Christ, Mary, Joseph, and of the suffering people of Haiti. Brightly colored metal work. Hand woven baskets, clothes embroidered by hand. We buy as much as we can stock in our luggage.

At the airport the departure wing is pleasantly air conditioned, unlike the arrivals hangar. Employees pay no attention to the prominently displayed weight of our baggage on the scale. Most of them are exceeding the 50lbs limit, but nobody cares.

Finally, we are off to Miami and Nashville. How easy it is to forget misery! While waiting in Miami for the next plane, we splurge on greasy, overprocessed American fast food. It would seem decadent if we reflected on what we’ve seen in Haiti, but we are not reflecting, we are regressing.

Back around 1am at the Snyders where I left my car. The Snyders were predestined to end up in Riviere Mancelle: To get to their property, we turn off the road onto a dirt path. This path crosses a little river, no bridge, just like in Haiti! We have to be careful as the water can get high. Denise says that at times it is not passable, and they just stay home.

And back to my own home in Cookeville around 2 am. The first thing I do is to strip before entering the house and take a shower until I run out of hot water. I frantically scrape the Haitian grime and germs off my skin until it gets raw. I put my shoes in bleach till morning and immediately do two loads of wash. I can’t go to sleep until I have eliminated all traces of Haitian misery. It is past 4 am when I finally get satisfied and go to bed.

But I was not satisfied for long. Discovering the utter destitution that grips Haiti was a life changing event for me. If the Guatemala that I know is a third world country, Haiti belongs to the 4^th world; and at times, it seemed like the netherworld, horrifyingly inhumane and hopeless.

The faces of the living in their suffering and of the dead after their final struggle are now haunting me. I see the brain damaged baby and her parents who didn’t know it, the little girl screaming with mastoiditis, the old man supporting his cancerous liver with such dignity, the man disfigured by his huge facial tumor, they are all at the top of death’s list and I hear their cries of anguish. They may be forgotten by the world, but I want to immortalize them here: Baby Ouesbellie Duplan, little Oudjina Alizot, Mr. Oradie Tazin, and Mr. Aurelius Oralio, may your sufferings not be for naught; may they find relief in our compassion and our prayers.

I worry about Stephanie who may not have gone to the hospital to continue her much needed care. And I see so many more in those waiting lines, new faces every day, but all quietly bearing their suffering and yielding to fate because they have no other options!

These are the faces of Christ and they are my faces. We are our brothers’ keepers because we are all one in humanity and in Christ. How can I put that misery aside in a corner of my life and live the rest of it in luxury? These Lazarus are begging for crumbs under my table. I have much to ponder but the call resonates loud and clear. I hear John the Baptist claiming “Pharisee, produce good fruit as evidence of your repentance!” and Christ himself “Whatever you do for one of the least brothers of mine, you are doing to me.”

As long as I need to work for a living I will spend every annual vacation time in Haiti in fraternity with these brothers and sisters of ours. Denise and Bob have several projects to which I can participate: latrines, medical services, school lunches, child sponsoring, etc. I’m starting to study Creole which, for the French native that I am, shouldn’t be difficult. I hope to be proficient in it by my next visit.

Love and Charity are the staff of life, indeed the very life we share.

God bless you all,

Cecile-Anne