Finding hope in Haiti

I have been reflecting a lot about my trip to Haiti last spring as part of a medical mission. Before my departure, I tried to imagine all of the different emotions I would feel based on what I had heard from others who had gone and what I had seen on TV. I expected to feel sadness, grief, anger (at the situation), or possibly even helplessness. When I finally reached my destination, however, I felt an emotion that I wasn't expecting: hope.

My team spent a week in a field hospital on the outskirts of Port-au-Prince managing patients in a combined emergency department/ICU setting. I was excited about going when I first volunteered, but as the departure day loomed closer, I have to admit I grew more and more apprehensive. I was not nervous so much about my safety, as I knew the organization supporting the trip had been in Haiti for many years and knew the political climate well. They would never allow us to go if they thought we would be in danger. I also knew that the four preceding teams did not have any problems. What I was worried about was how much I could contribute.

As a PA, I have two and a half years of experience in emergency medicine and 8 years of experience in hospital internal medicine. While I have worked overseas before in a European hospital, I had never worked in such an underserved area. I was worried about knowing how to manage patients with so few resources available. After all, I am used to the abundance of accessible resources in a US or European hospital. At the end of the day, though, I adapted and overcame. I was able to make do with the resources on hand and comfortably managed a wide range of conditions with the support of my team.

On first review of my trip, the chance that I might leave Haiti with a sense of hope seems like a crazy notion. After all, the situation was dire. Large populations of people still live in tents without access to basic services such as security, health care, running water or sewage, and schooling. Our team witnessed the direct effects that a lack of reliable primary care had on the population. For example, we saw patients in their 30s to 40s presenting with end-stage complications of cancer, rheumatic heart disease, chronic malnutrition, and untreated hypertension. We managed patients with conditions that one only reads about in textbooks in the United States. Although the Haitian physicians with whom we worked were extremely hardworking, bright, and determined, they often lacked the appropriate training and resources to manage the complicated patients they encountered. There are very few residency-trained physicians and even fewer resources for practicing physicians to obtain further education or training.

This is the first area in which our group saw hope. After some discussion, we decided that a focus on health care education would be a sustainable effort to support the people of Haiti. To accomplish this, subsequent teams would provide education not only for physicians but also for nurses and clinical support staff. The hope was that by educating health care providers in Haiti, we would be able to provide them with the necessary skills to provide a high level of medical care to their patients…even after the medical mission came to an end. This type of change would be an indirect but lasting contribution to patient care in Haiti. Changing the focus to an educational-based model was encouraging to me.

The other hope that I found in Haiti came from the inspiring individual stories I encountered. Whether from people, who overcame severe injuries from the earthquake, or families, who fought to stay together, there were signs of hope in all of the suffering that I witnessed. One of the stories that I found particularly inspiring was about a group of disabled orphans with whom we visited. Prior to the earthquake, the main hospital in Port-au-Prince took in some of these children but didn't have the resources to fully care for them. After the earthquake, an aid organization took the children to make space at the hospital for the wounded and was able to find temporary living for them. When the opportunity arose for the organization to acquire an estate from a businessman who left the country after the earthquake, the organization transformed it into a healing and supportive oasis in which the children could live. Several small cottage industries were started on the property, making it into a self-supporting enterprise where the children can live long-term. Since education is the key to rebuilding, the organization also plans to open up a daycare center that will educate disabled children about their disabilities. The daycare center will also provide a place where children with special needs can go while their parents work, hopefully encouraging more families to stay together.

I don't want to mislead you into thinking all is well in the reconstruction of Haiti. The need is greater than ever, and so many basic needs are still not being met. There is a desperate need for government services, reliable access to free health care, quality education, and ongoing security. However, the stories of hope should serve as a reminder of how important it is to help those less fortunate. Oftentimes we see only the disaster through the eyes of the media and forget about the actual individuals who are impacted. The trip flooded me with a whole range of emotions from apprehension about my ability to contribute, to sadness about what I was seeing, to finally being able to see hope in people's stories, and, subsequently, to feeling the desire to do more. I hope to return to Haiti next year to help with the continued educational efforts for Haitian health care providers. I also hope that this inspires you to volunteer, whether it is on a local, national, or international level, to help those in need.