Haiti Reflections: Environs and Accomodations

Before I continue the story I want to give a little bit of a description of where we were.

As previously described, Chantal is a small village with a population of about 1,500 people (in pre-earthquake times). But even in the far southwestern reaches of Haiti, there is nothing The Google doesn't know or cannot see. It can see Chantal:

You can see that Chantal is indeed a small place, and like many small villages all over the globe, the church is one of the largest structures. It doesn't dominate like European cathedrals, but its presence is unmistakable.

The main road is paved, smooth and nice to travel on but the rest are gravel. The market place is crammed full of stalls that are just corrugated sheet metal roofs held up by tree branch poles. It's really pretty large. More on it in a later post.

Within this little village, we worked in an enclosed area that contained the clinic and the nuns' residence (please forgive me if there's a proper name for this, a la 'parsonage', but convent doesn't sound right to my simple Protestant ear). While we did venture forth from this area on a couple of occasions, it was our universe for the bulk of our time in-country. Here's a detailed picture of that universe:

The Barracks is the name I used for the men's dorm. I used the term enough that I did hear one other team member using it in conversation and whoever he was talking to knew what he meant. It was a smallish building (wild-assed guess here is that it's 20'x30' but I wasn't really paying attention) that was mostly open inside. There was a T-shaped divider that made three "rooms" but the wall didn't go all the way to the ceiling so we could all talk to each other (and hear each other snore, roll over, etc.). The rear few feet were also walled off to create a restroom area. These walls didn't go all the way up either so your daily ablutions were also audible throughout. The restroom had a sink with a mirror, a flush toilet and a "shower." It was a cold-water shower - a mixed blessing in the tropics - and didn't have a shower head. It was just an overhead 3/4" pipe. It was funny listening to others showering because you could tell when most of them stopped splashing water on themselves and actually immersed in the stream. It was an act announced with a tell-tale, "Ungh!" as cold water hit an overly warm body.

Our beds were simply a mattress on the floor. We took our own sheets (mine were treated with permethrin so that I would sleep unaccompanied by creepy crawlies). After a long day of hard work, I had no problems with the level of comfort being provided. But then again, it got to pleasant temperatures at night so the lack of A/C and fans wasn't a problem. Just open, screened-in windows for climate control, and for allowing us to clearly hear the dogs and roosters.

The roosters were really something else. They stopped crowing around dinner time. This break lasted long enough for them to catch their breath and then announce with a hearty "Cock-a-doodle DOOOO!!" that it was now 10 p.m. and time to go to bed. Sporadic crowing would go on throughout the night until about 3 a.m., at which time it would begin in earnest. All-out, full-throated rambunctiousness would erupt at 4 a.m. When the church bells tolled at 5 a.m. and again at 5:30, it was time for us to surrender, get up and start the day.

For those who were on the team, this picture (honestly unretouched) will explain something about the roosters, perhaps confirming a few suspicions:

Father Yves and the nuns made sure we were well cared for. We had a near-limitless supply of bottled water, which was very comforting. But we were also well-fed. Breakfast had scrambled eggs (which everyone seems to have loved), real oatmeal, bread, peanut butter, honey, bananas and mangoes. Dinners were equally generous with a different meat each night (fried), fried plantains or bananas, fried potatoes and rice and beans. It was all good food, if a little bit of a challenge for ones statins. The only problem noted by many was that when we had chicken, it wasn't one of the roosters.

Lunch was "on our own." We were told ahead of time to bring protein bars and that we would have to sneak in a bite when we could. It wasn't an easy thing for any of us to do when we were surrounded by people who were underfed, malnourished or starving. More than one person said they found it hard even to drink water in front of the locals.

So that's about it for our basic room and board. Next, set up and clinic day number 1.

Haiti Reflections: Day 1 - March 15

Shelagh dropped me off at Port Columbus and I left cold and rainy Ohio early in the morning, headed for Miami where I would meet up with a large part of the team.

Juliet Geiger, my professional counterpart from Pennsylvania and the one who suckered me into this trip*, did two things very important to this phase of the mission.  First, she kept everybody up-to-date with her blog (http://chantalhaitimission.wordpress.com/).  Second, she created a document with everybody's picture, flight number/time and contact information so that we would know each other when we got together.  It worked well and about ten or eleven of us met and started to get acquainted prior to boarding.  We would all become very familiar with each other in the next 24-36 hours.  Dr. Sarah John gave us a short briefing on what to expect when we got there.  *OK, so she didn't sucker me.  She's not that type.  She said she was going and asked if any other state trauma coordinators wanted to go, to which I said yes.  I'm very, very glad she asked.

I was a little nervous before leaving home because I was going on this trip without really knowing anybody.  Juliet and I had some professional interactions but we had no previous social contact.  I'm an experienced international traveller but I was going into this one on more faith than I normally put into my planning.  (But now that I type that, I realize that 'faith' and 'planning' are pretty much mutually exclusive concepts.  Deities, karma, kismet, luck and other similar constructs are all notably absent from the Emergency Management Agency's disaster plans.)

The flight was on a Boeing 767 that was filled to capacity but had very few Haitians.  I sat next to and had a pleasant conversation with a man named Bob Cox from Minneapolis who was going down to build a church and a school with his church group.

When we arrived in PAP (that's Port-au-Prince, but I'm too lazy to keep typing it out.  Get used to it.) and it was exactly what Sarah had told us in our briefing: a third-world airport.  There is one runway, no taxi strip (see picture).  That, for the uninitiated, means that when you land, you stop, turn around and then taxi on the runway to get to the terminal.  This also means that no other planes can land until you are out of the way.  (It works the same ponderous way on take off, too.)  It must have been a logistics headache of the first magnitude during early phases of the earthquake disaster relief.

The terminal was of reasonable construction with rather dull painting and non-existent decor, air conditioned and surprisingly orderly...up to the immigration desk.  But once we had our passports checked and stepped past the desk, it was a baggage claim free-for-all.  Baggage claim wasn't dangerous or scary...there was just no order and no sense of direction.  Nobody was even certain that the baggage coming out was from our flight or another.  It may well have been from multiple flights as there was only one conveyor.  It probably took us 45 minutes to an hour just to get everything gathered up and get the group reassembled.

Then it got worse.

When we stepped outside the building, there were many, many people there to help us with our bags.  They were the equivalent of Skycaps and all were uniformed but apparently earn their living through tips.  They all spoke English and they were extremely persistent in letting us know that we needed help, specifically their help, with our bags.  It was an unfortunately long distance from the terminal exit to the parking area.  Father Yves Francois, who met us at the terminal, managed to hustle us to the waiting buses with what was, in retrospect, a minimum of hassle with the Skycaps.  It was stressful for most of us at the time because we had no idea of how long the badgering was going to last.

Our bags were loaded on one bus, we were put on another and we departed for Chantal.  Through PAP. During rush hour.  It took us two hours just to get outside the PAP metro area.

It has been 15 months since the earthquake - one of the worst ever in terms of lives lost.  The devastation is still evident in the rubble of the collapsed buildings.  The National Palace is in the same condition and posture now as it was immediately after the quake (I saw it but wasn't able to get a picture so here's one I found on Flickr).  Tent cities are everywhere and are enormous rabbit warrens of disaster relief shelter tents and makeshift tarp tents.  But remarkably, PAP is recovering.  Despite having crap for infrastructure before the earthquake and losing a significant chunk of that in the earthquake, progress is being made.  Buildings are being torn down (there were some big buildings that still looked perilous, but not as many as I expected) and the main roads and sidewalks are passable.  The trade off for this progress was putting all available garbage removal resources into rubble removal.  It was apparently a conscious decision of the Haitian government to do it this way.  As a result, the garbage accumulates in the gutter or in a few Dumpsters and is occasionally burned (more on that particular fragrance in a later post).  Having been in those streets and seeing the state of the buildings over a year later, I can't say I blame them, my inner public health wonk notwithstanding.

According to Google Maps, the trip from PAP to Chantal is 216 kilometers, about 134 miles:


View Larger Map

Google Maps also says it takes a hair over 3 hours to get there.  But Google Maps doesn't take unpaved roads into consideration.  Or three rivers with no bridges that need to be forded.  Or carnivals taking place during Lent in villages on the main road.  Our trip was closer to eight hours.

When we arrived in Chantal, we stowed our gear, got shown to our quarters and hit the sheets at 0130 on March 16.

Haiti reflections, intro

I've now been back from Haiti for five days.  I was back to work for two of those.  But my head and my heart are still in Chantal.

It was an incredible experience.  We saw an extraordinary number of people - over 8,000 - who had no other access to basic medical care.  The people, both the Haitians and the rest of the team, were amazing.

I kept a diary on my trip but I can't really do justice to the trip by simply transcribing it here.  I was so tired at the end of each day that I only recorded events, not what I thought and felt.  I'll try to get those down here on the site.

Going to Haiti

Dear family, friends and colleagues,

On March 15, I will be departing for a one week medical mission to Haiti. This mission is through the Care to Share program sponsored by the Catholic Diocese of Palm Beach, Florida. Juliet Geiger, my professional counterpart in Pennsylvania, has created a blog to get the word out in hopes that it will inspire others to join us or to donate. It can be found at http://chantalhaitimission.wordpress.com/.

The town we are going to is called Chantal. It is 250 miles southwest of Port Au Prince. It is a very rural community with subsistence farming and some rice agriculture. It is normally a village of about 1,500 people but that has doubled with refugees from last year’s earthquake.

Why Chantal? The big NGOs are set up pretty well in Port Au Prince and the Haitian government asked that other groups travel to the hinterlands to care for the displaced. There are over 2 million internally displaced people in Haiti right now. With the surrounding mountain villages and seaside villages many hundreds more folks come to clinic there, often walking 4-5 hours to be seen.  There is no doctor or dentist or pharmacy within hours of Chantal by vehicle.  Two nursing sisters at the local Church run a small dispensary and are providing us with a site. One of the team members who is returning said they (7 doctors, 7 nurses, a dentist, a pharmacist and 20 non-medical helpers) saw 4,000 people in four days last August.

At this time, the team is all but complete but we are still in need of physicians and in special need of a dentist. Juliet’s blog has contact information if you (or a physician, or a dentist you know) are interested in joining us.

So what do we need? Money works really well (Juliet’s blog has the information on where to send your generous donations). It will be used to build a permanent clinic in Chantal, buying water purification systems (www.edgeoutreach.com), and stocking the Chantal clinic with medications and medical supplies. Through special relief programs like Crosslink and MAP International (www.map.org), $1,500 dollars will purchase $13,000 retail value of medications to treat diarrhea, malaria, anthrax, hypertension, parasites and cholera.

We can also use medicine and vitamins that we can take with us. Once again, Juliet’s blog has some good details.

In terms of durable medical equipment, if you happen to have otoscopes or ophthalmoscopes sitting around, Chantal’s clinic is in serious need.

Finally, we can always use prayers and good wishes.

Please let me know if you have any questions (and to get two out of the way: 1) I still have all my marbles, and 2) yes, Shelagh knows that I’m going).

Thanks and God bless!

Tim

Suffering for Your Art

Below is the text of an expository essay I wrote.  It's less expansive than what I want but the essay's word limit forced brevity on me.  It also limited my ability to explain why the suffering part of nature photography is the fun part of it (mainly because that's an entire Master's thesis in psychology).  I may expound on this later as it's a great topic.

“If you’re a nature photographer and you’re not suffering for your art, you’re doing it wrong.”  This is a saying among nature photographers and summarizes the deficit of comfort and surfeit of failure which one usually needs to endure in order to capture a good image from the wild.  Whether shooting pictures of landscapes, flora or fauna, the nature photographer needs to be prepared to work in conditions that are beyond their control and not of their own choosing.  They also need to be willing to accept serial disappointment and failure. 

When one mentions the word “photographer” many people think first of wedding and portrait photographers.  These photographers have almost complete control of their environment.  They control the lighting, the setting and the subject.  They can pose their subjects and anticipate many of their needs, such as what additional lighting will be needed for the church where the wedding is held or which flattering backdrop to use for a portrait. 

For the nature photographer, however, control of lighting, setting and subject is beyond a luxury; it’s largely impossible.  You, as the nature photographer, can do things to enhance the chances of favorable conditions, but in the end you are at the mercy of the elements and the subject.

Lighting can’t be controlled by the nature photographer, but it can be understood and steps taken to account for it.  The best natural light comes in the hour after sunrise and the one before sunset.  This means early to rise and late to bed, guaranteeing little sleep, especially during the long days of summer.  But if the light is bad because it’s overcast, you have to try again tomorrow or the next day.

The nature photographer’s working conditions are, like the lighting, whatever God gives you that day.  It can be freezing cold, blistering hot, or stormy.  The terrain can be dangerous cliffs, leech and mosquito infested swamps, burning sands or snowdrifts.  These conditions are dictated by the setting in which the subject can be found.  This means that if you want polar bears as your subject, you will be headed to the frigid climes of the Arctic Circle, and if you want pictures of toucans, you’re off to the jungle.

For the nature photographer, patience is a not a virtue, it’s a necessity.  You must be able wait for hours on end for your subject to appear, or you can spend hours or days trying to hunt it down.  Even if you are lucky enough that your paths do cross, your subject is not going to pose and your encounter may be so fleeting that you are left with an image in your mind’s eye but not in your camera.

It is rare for a nature photographer to get a good photograph without having endured some discomfort or inconvenience.  Travel to remote places; bad weather and lousy lighting; uncooperative or absent subjects; harsh, hostile or dangerous environs; these are all some of the miseries nature photographers must suffer to do it right and create their art.  It is fortunate that nature photographers take sort of an ironic pleasure in these sufferings so that nature can be brought to everyone else.