Thursday, June 2, 2011


We arrived at the small medical clinic in Petit Trou de Nippes about five hours after we left Port au Prince that morning. The distance is only 75 miles but the unpaved roads, traffic, and small lakes and rivers we had to drive through to get there made the drive take quite a while. Halfway through the trip my Haitian colleague Catherine asked me if I felt like I was in a blender due to the jostling of the Land Cruiser we were driving in. We just pretended we were getting expensive lower back massages the whole way.

Like the other clinics I’ve visited on this trip, this is the only one serving the 25,000 people who live in the area. Unfortunately, this one currently does not have a doctor because he left for a training course in Port au Prince and they fear he’s not coming back due to the poor pay he’s receiving working at the small government clinic. So it’s currently being run by an extremely young but committed first year resident who just graduated from medical school last year. I asked her if she felt ready to be running a medical clinic just one year out of school. Before she answered yes, she hesitated and looked around at the two nurses, social worker, administrator, pharmacist, and lab technician who were sitting on the bench across from her waiting to hear what she’d say. It seemed like she wanted to reassure them that she could do it.

Like the doctor on the island of La Tortue who asked for a better boat to get his patients across the ocean to the larger hospital, the doctor at this clinic also asked for better transport. However, she wasn’t asking for it so she could send patients to other facilities, she was asking for it so they could have a way to get women into her clinic to deliver their babies. The only “ambulance” the clinic has is two broken down motorcycles and they said they wouldn’t want to transport pregnant women on motorcycles even if they were working. That made sense to me. Or I should say it made sense for a brief moment. They went on to say that pregnant women usually come in to deliver on horseback or are carried in a chair or lying down on a door carried by their neighbors like pallbearers.

At that moment, I flashed back the advice I received at the labor and delivery class my wife and I had attended a few weeks ago in preparation for our son’s birth. “Partners,” she said, “watch out for potholes when you’re driving to the hospital. They are a killer when you’re pregnant.”

There are some things about working in Haiti (and the developing world in general), that are consistently frustrating. Visiting this hospital reminded me of two of them.

Nearly 100 doctors and over a thousand nurses get their degrees every year in Haiti. However, because they are paid so little by the government to work in public facilities, most do not remain for long. It is not uncommon for a doctor to make $500USD a month while a nurse can make between $250 and $350 depending on her level of training. And these are pre-tax salaries. Imagine a doctor making $6,000 a year. It’s insulting. Therefore, most of them either leave the country or work for NGOs in Haiti who pay them a decent wage. So while plenty of doctors and nurses are trained every year, many rural areas are left without a way to care for their people.

But I would say that by far the thing that makes you feel the worst, is that most of the things they are requesting can be provided with a relatively very small amount of money and yet they’ve been dealing with these problems for years. The doctor on the island of I’le a Vache asked if we could fix the leaky roof in his exam room so when it rained he and his patients wouldn’t get wet anymore. The doctor on the island of La Tortue needed $1,000 to dig a well so he could put running water in his hospital. The doctor in Petite Trou de Nippes said her dream would be to have an actual ambulance but she’d be happy if they could have some gurneys or stretchers so women wouldn’t have to be carried in on doors. The medical director of Beraca Hospital wants a sterilizer so they wouldn’t have to disinfect their instruments in a pot of boiling water on the stovetop anymore. The nurse on I’le a Vache needs a raise from $300 a month to $350 a month because her parents spent all their money to send her to school and now she’s responsible for taking care of her three siblings. And the administrator in Nippes, who was extremely proud to show me the professional patient records and filing system he keeps on all the patients who come in, said he needed a new desk because the one he’s using is just a piece of plywood sitting on top of two oil drums. For some reason, that one made me feel the worst. This guy was working for almost no pay (and often goes months without even getting a paycheck) yet was very proud of his work. The least you could do is give him a desk.

You could raise enough money from a bake sale to solve most of these problems. In fact, the Haitian doctor I was travelling with who had been working in the states for the last 30 years promised to personally pay the $1,000 for the well because of the thought of working in a hospital without running water was unbearable to him.

I take some comfort from the fact that I work for an organization that can help respond to most, if not all, of these requests. However at the same time I know we’re just scratching the surface. There are thousands of health facilities all over Haiti that need wells dug, leaky roofs fixed, and new desks for their administrators.

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