Haiti, After the Quake

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It has now been ten weeks since a catastrophic earthquake

struck Haiti on January 12, killing over 200,000 people, injuring a similar

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

Haiti?

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.

You were working

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

good water.

 

sense of how the distribution mechanism is working, in terms of food, water,

and medicine?

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

tarpaulins?

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.

And how do you try to

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

well.

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

on-the-ground activities.

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

Cross, for example, is down there – they could donate directly to them.  There’s a foundation called Mandate 3, which

has been set up by the founders of SOLO, which was expressly set up for people

to donate to disaster relief for Haiti.

Finally, were you able

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

died.

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).