May 6 2010. Petit-Goave, Haiti
The sea has no memory.
It blew hard here last night, on the one week anniversary of our time here in Haiti. We spun twice around the anchor in the shifting gales as lightning split the skies and torrential rain washed all the salt and heat from our boat, and dawn showed the clear blue waters of Petit-Goave turned a deep murky green from the mountain and city runoff. Trash floated everywhere as streets poured their refuse into the sea, and I forbade the crew from swimming over the side until the water cleared. I didn’t know how long it would take, but the water off Petit-Goave drops off to over a thousand feet only a half mile from the port, and within two tides we watched the dirty green water sweep out to sea and be replaced with the normally deep blue open ocean water. On the second incoming tide, the water cleared and before the peak we could clearly see the coral and sponges of the reef below us. The sea showed no sign of the storms and rain of the night before, and it rolled on towards the shore as it has for thousands of years .
Thus the sea has no memory. It does not remember the earthquake, it does not remember Haitian independence, it does not remember the greed and corruption that spiraled Haiti down into depression and darkness, it does not remember all the failures and setbacks that have continually plagued Haiti. The tide rolls out, new water rolls in, and the face of the sea remains impassive to all the things that steal hope from a people.
It is amazing how much incident can be packed into each day. The week we have been here has flown by but also feels like a million years ago. Already we have seen so much, and things are not totally what I expected (in some ways things were EXACTLY what I expected). Devastation is everywhere; there is no work, no economy, everyone is hungry, there is nothing to rebuild with, everyone is living in tents…and yet somehow people still get up in the morning and go out to find work or food for their families. It is shocking to me that there are still people here who can have hope—the belief that things tomorrow might be better than today.I have seen Haitians who have literally lain down in the dirt and given up, and I cannot judge them that decision because from where they are standing there seems to be no hope at all. In the face of all we have seen, people still can have hope. From the rubble people try to build normal lives, and from high in the cracked remnants of buildings plants thrust out and reach towards the sun. Life, as Ian Malcolm says in Jurassic Park, cannot be contained. It is a powerful force, and when barriers and challenges are put in front of it, life finds a way. The human spirit is an extraordinary thing and I feel lucky to glimpse a small snapshot of its power, and to have the opportunity to do everything we can to help foster it and encourage its survival. New challenges get thrown up in front of us at every turn—how do you get 20,000 pounds of lumber, building materials and medical supplies through the complicated customs process, off the boat onto the broken,
half sunken pile of rocks that is the Petit-Goave dock?
Dr. Tania DesGrottes from the health center and her uncle Hughes DesGranges fought hard to get our material cleared in, and we negotiated for 4 days to make sure everything would be allowed in without taxes and levies being applied (‘import duties’ are being charged on many aid supplies people are trying to bring in). We pulled our boat bow first up the dock in a narrow cut just deep enough to hold us. We side-tied to a derelict ferry boat half-aground, and with our anchor roller hanging over the dock and twisted metal, and only a few feet of water between our keel and the rocks, we disconnected our forestay, built a 20-foot ramp out of 2 x 6s and plywood, and daisy chained all our material over the bow and onto the dock into the hands of 20 Haitians who volunteered to help us, and from the dock into the back of a UN truck the Sri Lankan forces deployed here loaned us to transport our supplies to the health center.
How do you get medical care to mountain villages too far for people to walk to the clinic? Pack your bags with gear (flashback to my backpack in Africa), pile into a truck and drive until you can’t drive any further. Then get out and walk until you find the people beyond the reach of medical care. Find an abandoned tin-roof palm shack, set up a makeshift pharmacy and hang a sheet up for privacy in exams, and start seeing patients. Treat people and advise people with health knowledge until the sun is low and your supplies are gone, then walk back.
How do you show pregnant women the beating heart of their unborn babies when there is no power in the clinic to help motivate them to take good care of themselves during their pregnancy? Use 21st century portable ultrasound technology (thank you Orthopedic Center of Illinois for sponsoring this vital piece of gear!) and scan as fast as you can. How do you transcend the language barrier to speak with patients directly and speed up your clinical work? Learn French and Creole FAST. How do you counter the lack of education when so many schools have collapsed and so many parents have been killed in the earthquake? Build a school—no power tools available? Enlist the help of the surviving Haitians whose children will benefit from education and clear the ground, dig the holes, pour the concrete,scrounge the additional materials needed, and start putting up walls.
How do you diagnose people when the laboratory and imaging tools we have come to rely on are not available? Take a history, examine your patient and do what doctors have done for a thousand years—practice clinical medicine. How do you treat people when long-term medications and expensive treatments are not available? Be creative and adaptable and use whatever you can to effect a positive health outcome for your patient—high blood pressure? Stop eating salt in everything and drop your blood pressure 10-25 points right away. High cholesterol? Eat a couple grapefruits off that tree over there every day (grapefruits
inhibit the metabolism and uptake of cholesterol). Euthyroid goitre? Stop eating cassava (a staple here) as it inhibits the uptake of iodine into the thyroid; eat breadfruit instead. No baby food available? Mash up a particular banana found here, or the ubiquitous squash with some milk and sugar and vitamins (I can carry a lot more vitamins than baby food) and make a nutritious baby food. Give people the knowledge and tools to better manage their own health and their own futures.
We have seen hundreds of patients in the clinic already; Rachel has assisted Dr. John from New Hampshire (a surgeon we met here who is also working in the clinic) in removing lipomas and disfiguring tumors, worked with an Italian Orthodontic surgeon doing reconstructive dentistry and has been conducting cleanings and dental health education in the clinic. Noah and Captain Riggs have tirelessly worked to design and coordinate the school building. Sky has shoveled rubble, organized the thousands of pounds of supplies now piled in the clinic storeroom and fitted hundreds of Haitian children one by one in clothes that were donated (rather than handing out bags of clothes which could end up anywhere). Nick Wansten has been triaging patients, managing collapsing patients in the clinic until they could be treated, and assisting in clinic. Nick Larsen has struggled all day in the heat to maintain our power reserves and keep the boat’s essential systems operating—a huge challenge in itself; imagine building a house and filling it with sensitive moving parts and wires, then dipping it in salt water and shaking it as hard as you can, and you scratch the surface of what it means to maintain a ship at sea.
In addition to the work we do on shore, of course all of us continue our shipboard duties. We clean, we cook, we maintain our generator and engines and conduct repairs when inevitable breakdowns occur (for some reason usually in the middle of the night AFTER we are all showered), stand anchor watches through the night, scour the market for occasional fresh produce or a new oil filter, fish for our protein, take care of Giles and Tweek, prepare our gear every night for the next day, plan our operations on shore, coordinate with the clinic, the UN, and other groups that have found their way here, and the thousand other things that have to be done every day to achieve our mission here. As I said, a lot of incident gets packed into every day, but it is an exciting feeling to have worked for so hard and so long, with so many people behind us, to be here finally doing exactly what we planned to do. And every step of the long road here was a choice—to continue to build solutions for all the challenges we face, or to lay down and give up. There are people in Petit-Goave who have not given up, and their willingness to keep getting up and trying to rebuild their country inspires us to stand alongside them and help.
It is surely the sailor in me that sees the sea as a source of the power of hope in Petit-Goave, but everyday here the people wake to the face of the sea, rolling in as it always has, with no memory of the pain and sadness of yesterday. Christopher Columbus said that “The sea shall grant each man new hope, as sleep brings dreams of home.”
Maybe at some subconscious level the sea reminds the people of Petit-Goave every day that the future is an unwritten book, with storms and calms, murky water and deep clear blue, and all possibilities for suffering and happiness waiting to be discovered if only we make the choice to keep living. And the people of Petit-Goave HAVE no choice—they can either lay down and die, or they can choose to get up and keep trying, and every day there are Haitians that make that choice.