It has now been ten weeks since a catastrophic earthquake
number and leaving an estimated one million people homeless. Even as the attention
of the rest of the world turns elsewhere as the quake recedes into memory, the
Haitian people continue, with the help of aid workers and other assistance, to
recover from its impacts.
I spoke this week with my friend David Schullinger-Krause,
who recently spent a week in Port-au-Prince as a volunteer medic.
How did you wind up in
Housing Works is an organization in New York that primarily
works with impoverished people with HIV. It’s called Housing Works because
their theory is that, until people have a place to live they can’t do anything
else. Once they have a place to live, then they can have a shower, put decent
clothes on, apply for a job and the rest of it. And they went to Haiti, and
they were working in a couple of HIV+ clinics down there. And one of the people
who was down there was a graduate of SOLO [Wilderness Training], and after the earthquake they found
that they needed a lot of hands, so they sent an e-mail to SOLO, asking if
there was anyone who was available to come on down and help. So when I saw
those e-mails I said yes, sure, I’ll go.
specifically in the medical arena?
Yes, entirely medical. Essentially, what we were doing was
practicing walk-in clinic primary care kind of medicine. I and one of my
colleagues would go to the clinic in the morning. There was someone there to
screen them, take vital signs, then we would sit down and interview them,
figure out what was going on, do examinations as necessary and then prescribe
as best we could. We didn’t see anything critical or life-threatening, or at
least nothing dramatic. There were a lot of people down there with high blood
pressure and stuff like that. If it was beyond our knowledge, we would refer
them elsewhere. There are a lot of doctors down there right now.
background is that this is a deeply impoverished country with ongoing health
issues. Could you distinguish between those existing issues and anything that
more directly related to the earthquake?
We saw a lot of trauma: bones that had healed badly, that
sort of thing. There was a lot of depression because, you know, 300,000 people
died and everybody was affected by that. And it was all in a very focused area
of Port-au-Prince. The earthquake didn’t stretch much beyond that downtown
neighborhood. It was once you got into that small area, probably just a few acres,
of Port-au-Prince that all the damage occurred. So all the deaths were
affecting the same group of people within Port-au-Prince, or at least that’s
how it seemed.
We saw a lot of skin problems, because people are sleeping
in tents and hygiene is an issue. Aches, pains, and muscle issues that I
suspect were because people were sleeping on the ground.
A lot of hygiene-related issues. It’s pretty hard to stay
clean down there. There isn’t a lot of running water, people are bathing in
buckets. There are a lot of gut problems, probably related to people not having
sense of how the distribution mechanism is working, in terms of food, water,
It seemed good to me. I can’t speak to food and water, but
certainly medicine. There was a group that was based in a compound in a school;
and at one point one of us mentioned we didn’t have any doxycycline at the
clinic and we sure could do with some, and someone said, “Oh go see the folks
at the school.” So we wandered down there, and there was a huge tent, about the
size of a two-car garage, absolutely stocked with just about every medicine
I’ve ever heard of, and millions that I hadn’t. And we wrote down on a piece of
paper – they had this form that you fill out – that we needed some doxycycline,
and this woman went off and grabbed a thousand doses and gave it to us. There’s
tons and tons of medical resources in the country right now.
And it appears to be increasingly well-coordinated between
the various groups. At one point just before I left, this same group at the
school said to us, “We have more doctors than we know what to do with. Could
you use any of them?”
The downside is that one of the things people are worried
about is that a lot of the local pharmacies have gone out of business, either
because of the earthquake or because of the sudden drop in demand because
there’s all this free medication. So a concern is, when all these aid agencies
pull out and this flood of free medication dries up, where are people going to
get their meds? Somebody sooner or later is going to figure out a solution for
that, because it’s not a secret. It’s something people are concerned about.
There have been a lot
of reports that the rainy season is imminent. Is there a great medical concern
about how the consequences of that, given that so many people are living under
Yes, definitely. Everyone is very concerned about the
prospect of an epidemic [of diarrheal diseases], because getting
rid of human waste is just open-trench drainage. If that floods, it’s going to
be just awful. People are going to be sleeping in their own filth, and it’s
going to spread through those tent cities really fast.
get ahead of that?
Get people out of those tent cities and arrange for
drainage. It’s an engineering challenge at this point, I think. A lot of those
diseases, you can be immunized against them, but we’re talking hundreds of
thousands of doses being delivered – well, now. It was pretty rainy when I was
down there, so it’s already upon us.
The other thing is that we were told that in the tent cities
prostitution is really prevalent. People are doing whatever they can to earn a
few bucks so they can buy some food. I’m sure we’ll see an epidemic of STDs as
There’s also a lot of what is obviously PTSD. I’m not a
psychiatrist and I’m not qualified to diagnose, but it’s really obvious when
you see somebody walking around like a zombie and they say they can’t sleep at
night and everything hurts. So we were doing a lot of stuff like giving people
Benadryl and saying, “Here, take two of these at night,” so people can get some
rest, at least.
everybody has the necessary expertise or the wherewithal to be able to provide
on-the-ground assistance. But I imagine for those people who want to be able to
help, the key is to donate to organizations that put that money directly into
Yeah definitely. That’s going to be the most effective and
that’s going to have the most impact. I went down there and I saw probably 75
patients over the course of a week. So at least the people who sent me money to
help pay for the airfare and things like that, at least they know that those 75
patients received medication — and my expertise, however humble that may be –
thanks to their donations. They know their money went directly to those people,
instead of sending a check to the Haitian government that -- well, God only knows where it would go.
So if people have a favorite aid organization – the Red
has been set up by the founders of SOLO, which was expressly set up for people
to donate to disaster relief for Haiti.
to get a broader sense of what conditions are like? Obviously you had your own
particular part of Port-au-Prince where you were working, like you said, but
were you able to see anything beyond that?
We did have one afternoon drive down into the central area –
you saw the pictures I’m sure of the wrecked presidential palace and the
national cathedral which is essentially nothing more than a couple of walls
now. There was a hospital that was pancaked; it used to be six floors high and
now each of the floors is separated by just four or five inches.
But it was distant enough in time that it was wreckage
rather than an immediate tragedy. I was sort of expecting more disaster
medicine, more trauma, until I thought about it and realized it was six weeks
after the fact, so most of those kinds of injuries had healed or the people had
The whole country just looks depressed. Even those people
whose lives are continuing on more or less as normal – their businesses are
open, and people are buying things, their lives are going on – still looked a
little shocked. And the tent cities were just horrible. It's like every little bit of
footage you’ve ever seen of every refugee camp anywhere.
Even using the word
tent is somewhat glorifying it, isn’t it?
It is. They’re tarp cities, really.
Any idea how many
people are living in these tarp cities?
I couldn’t even begin to guess. They’re everywhere. There’s
tarp cities here and there and then, almost every city block there’s a tarp set
up that somebody’s probably sleeping under. We saw a lot of roads that had
essentially been blocked off because people set up their tents there because
they needed somewhere to sleep.
The hopeful piece though is there is an awful lot of people
just getting along, getting on with their lives. I think living in Haiti before
the earthquake prepared people very well for living with that extra degree of
deprivation. People are still
shell-shocked, and there’s a lot of grieving for loved ones, but at the same
time the street markets are still there. People come out and set up their
wares. There’s still buying and selling. The grocery store was open and
stocked. It was hopeful in that way.
(Photos by David Schullinger-Krause. With thanks).