Two months doesn't sound like a very long time, unless you're maybe missing a limb, living on the floor of a 10310-ft tent with 5 to 9 others like you, your house reduced to rubble and some unimaginable number of family and friends having been killed all in one day—the one day you somehow survived. On most days, I am an emergency department physician assistant at New York-Presbyterian Hospital/Weill Cornell Medical Center in New York City. Last March, for 10 days like the one described in this article, I was a medical volunteer at the Harvard Humanitarian Initiative Disaster Recovery Center at Love a Child Orphanage (HHI DRC-LAC) in Fond Parisien, Haiti, caring for some 38 pediatric patients. Today is my last day, and already I know my life will never quite be the same.
■ 6:00 AM
I emerge from my tent just before sunrise to a bruised sky and cross the dusty compound to the staff bathroom. Amidst a chorus of roosters echoing in the distance, I utter a sleepy "bonjour" to other staff already walking about. As I head to the morning staff meeting, I am thinking about "my kids," and I cannot imagine that I will be able to say a proper goodbye.
■ 7:15 AM
Coffee consumed and teams assigned, Keri and I head to our rows. Keri is a school nurse from rural Alabama and has been my partner for the last 7 days. I have my patient list and sundry medical equipment loaded into my camelback (along with 2 liters of treated water flavored with Gatorade), and Keri has her rolling suitcase of wound care supplies. We slather on sun block and head off to divide and conquer.
She tells me she will come get me when she's done with the simple wound care so we can tackle our "sick" kids. I see my first patient sitting out in front of her tent, smiling as I approach.
"Kóman ou ye, J.M.?" (How are you, J.M.?), I say. A tiny 5-year-old voice replies, "Pa pou mal" (not bad). Noel, my interpreter for the day, joins me and we begin assessing the patients. While I have learned more Creole than the four or five phrases I came with, Noel and her interpreter colleagues are our voices and our good intentions made real.
■ 8:00 AM
The sun is searing my skin as I stand outside the last tent in this row checking my list. I am grateful there is a light breeze, though my clothes are already soaked in sweat. I have seen nearly half my patients when Keri comes to tell me that S.J. is ready for her dressing change. I am grateful for the reprieve, as I've just told another tent full of patients and family that today is my last day and, among hugs and high fives, composure is difficult.
We enter a tent full of giggling preteen girls, and for a moment I forget I'm in Haiti after the earthquake. S.J. smiles shyly as I enter and greet her, and I marvel at her. She is a 13-year-old girl with a poorly healing gluteal flap and femur ex-fix. For weeks she appeared completely apathetic, wet the bed, and refused to get up, her wounds often soaking in urine despite all prior attempts to help.
A few days ago, we surveyed all the children, classifying them into UN-speak: orphaned, separated, and unaccompanied—all degrees of heartbreaking, and often permanent, loss. Noel informed us that S.J. had been a domestic servant, or "restavek." She was given away at a young age to perform domestic work for and live with a family that, while fortunate to receive her services, had ignored her needs for love, nourishment, education, and play—an all too common story in Haiti. When I told her she would not go back to that family because there were programs to help kids like her, she said nothing. Yet later that same day, she was sitting outside her tent for the first time and smiled at me when I walked by. We finish her dressing change, and although she appears indifferent, I see her follow me to the door with her eyes and smile when I look back at her.