My goals for my week in Haiti have gone from “bring medical care to some of the world’s neediest populations” to “prevent tarantulas from falling on my head while I’m asleep.” I think this started when our driver pointed out the “tarantula field” as a landmark on the way to the venue, or when the program director described the tarantulas that lived in his bedroom. My bed is covered with mosquito nets, which should mean nothing can get in, but mosquito bites all over me suggest some invisible flaw with this plan, so I’ll be horrified every time I see something dark stuck on the walls
But at least some things are going well. We have recovered the suitcase. See, there’s this guy called Big, who’s the ringleader of the baggage handlers outside the Port-au-Prince airport. The Port-au-Prince airport is built about ninety seconds on foot from its parking lot. Just outside the airport gate are nice people who offer to carry your luggage to the parking lot for you, of which Big is the biggest and the loudest. If you accept, once you get to the parking lot they charge you between $20 and $50 for this “service”, which in Haiti is like a week’s salary for a normal person. Now, to be fair, Port-au-Prince is hot, crowded, and scary, and luggage can be heavy. But really, it’s not worth $50 and it’s not like if you didn’t have Big to carry your luggage, you’d carelessly leave it in the middle of the sidewalk or something.
The first time my dad and I went to Haiti, we got tricked by Big and ended up paying him a lot of money to carry our luggage. The second time my father went to Haiti, this time without me, he was fooled again by Big, who had devised the ingenious tactic of claiming to represent the charity we worked for and holding a sign with his name. this This third time, he was ready and he wasn’t going to be fooled. Sure enough, we told all the baggage handlers that we didn’t need their help, carried the bags to the parking lot ourselves, and…
…carelessly left our suitcase in the middle of the sidewalk. The suitcase with fifty pounds of vital medical supplies.
We found out about four in the afternoon, maybe three hours after we arrived at the Partners in Development compound where we are staying. We panicked, called the airport, nothing. Then the next morning, my mom, who is back in California, got a call, which she said she assumed was a prank call because it was someone with an outrageous Caribbean accent saying something about pink polka dots. Finally, he decoded it to say that the airport in Haiti was calling because they had found our suitcase and our home number was on it, and that we should go claim it if we wanted it back.
…and yes, the pink polka dots. This was the most embarrassing part. My mother for some whimsical reason decided to bring us a pink suitcase with polka dots, so we had to suffer the indignity of asking all over Port-au-Prince if anyone had seen a pink suitcase with polka dots everywhere. But at least we found it.
Medical supplies have proven useful, but not as useful as one might expect. To be honest, Haitians do terrible patients
I have found it difficult to appreciate exactly how confused Haitians are about some things. Gail, our program director, explained that she has a lot of trouble with the staff in the Haitian office because they don’t understand the concept of numerical ordering. Not only do they “don’t want to” or “it never occurred to them”, but after months and months of trying to explain, they don’t understand that sorting alphabetically or numerically is a thing. Not only has this messed up his office work, but it makes dealing with the Haitian bureaucracy, terrible at best, positively unbearable.
Gail told the story of the time she asked a city office for some paperwork on Doctors Without Borders. The local official pulled out a drawer full of papers and looked at each paper individually to see if it was what she wanted. Then he started looking for the next drawer. After five hoursthe official eventually said the newspaper was not in his office.
Part of that is Haitian education. Even if you’re one of the lucky ones who can afford to go to school, your first problem is that the schools can’t afford the paper: one of our hosts told stories of Haitian high school students who they were at the level of Western 5th grade students. because they forgot everything – they couldn’t afford the paper to take notes!
The other problem is more systemic: schools teach everything through uninspired lecture, even when it’s completely inappropriate: a worker in our camp ran a “computer” course where no one ever touched a computer: he was just a teacher standing in front of the class. saying “And then you’d click on the word FILE at the top of the screen, and then you’d scroll down to where it said SAVE, and then you’d enter a name for the file…” and so obviously the People come out of class with no idea how to use a real computer. There’s the question of money – they couldn’t afford a computer for every student – and a cultural question where going to school is seen as nothing more than an annoying, ritualistic intermediate step between having enough money to go to school and get a comfortable job that requires education.
There are some doctors and nurses, who are just as bad, although towards our complex, which is run by this great charity which seems to be very much in charge. We heard horror stories of people graduating from nursing school without even knowing how to take a blood pressure: a nurse working at the clinic would just inflate their blood pressure readings and give completely absurd numbers like “2/19”. This is something else. Haitians have a culture of not admitting they’re wrong, so when cornered, this nurse absolutely insisted that the blood pressure had been 2/19 and made a big fuss. There are supposed to be doctors that aren’t much better, although as I mentioned our doctors are great.
But I was going to talk about the patients. I really don’t blame the patients. I think they are reacting as they can to perceived inadequacies around nurses and doctors. But they seem to have this insane mentality, exactly the opposite of what prevails in some parts of the States, where medicine is good. In particular, getting more medicine of any kind is always good and will make them healthier, and doctors are these weird heartless people who will stop them from taking a stomach medicine just because they might not exactly have a stomach problem. moment As a result, they lie like hell. I didn’t realize exactly how much they were lying until I heard the story, now a legend in our clinic, of the man who came in complaining of vaginal discharge. He had heard of a woman coming in complaining of vaginal discharge and had been given a lot of medication for it, so he thought he should try his hand at it. And this was not an isolated incident either. Complaints will go into “modes”, so if a guy comes in complaining of an earache and gets a lot of meds, on the way out he’ll mention it to the other patients in line and they’ll all mention the earache too. or so the translators and veteran staff have told me.
I have yet to meet a man with vaginal discharge, but many (most) of the female patients I have seen have just complained of pain in all parts of the body and seen if any of them stick. A typical consultation will be a boy complaining of fever, cough, sneezing, stomach ache, body ache, stomach ache and headache. The temperature returns to normal (not that our thermometers are any good), the abdominal, ear and throat exams reveal nothing and we send them off with vitamins and tylenol or maybe ibuprofen.
My cousin Samantha and my friend Charlotte, who have both come with us, have studied medical anthropology and think this is fascinating. Maybe I’m a little fascinated by it, but after the intellectual clarity of med school, where every case has textbook symptoms that inevitably lead to a clever but retrospectively obvious diagnosis, I’m mostly annoyed.
Also, if I ask a question of the form “do you have X”, people almost always say yes. “Are you coughing?” “Yes”. “Are you coughing up sputum?” “Yes”. “Is the sputum green?” Yes.” “Is the sputum coalescing into polka-dancing little sputum people on your handkerchief?” “Yes.”
A depressing number of our patients have fallen into two categories: patients with self-limiting illnesses so mild that we can’t do much for them, and patients with illnesses so massive and inevitably fatal that we can’t do much about them. There are a few who fall in between: some asthmatics, hypertensives, diabetics, people with UTIs and other bacterial infections, a man with serous fluid in his knee that my father drained, but they are depressingly few. And even when we can help them by giving, say, an asthmatic a month of asthma medication, it’s worrying to think what happens when the month is up. Going back to our clinic requires traveling through terrible Haitian roads and standing in line with two hundred other people and waiting for even a doctor to see you, so I don’t know how many people come back for refills or what the effect of having to do it on the quality of life.
To be honest, I think a lot of what we’re giving is placebos. And placebos have their uses, but here I think we’ve lost the comparative advantage of our competitors, the sorcerers, who can take a placebo away from us. One of our translators’ grandfathers is a voodoo priest, and he was describing some of the things he did. It looked pretty impressive, though at least no chickens get hurt during any of our treatments.
But we have certainly helped a few diabetics, people with bacterial infections and the like; and we’re hooking up a lot of kids with vitamins (not to mention stickers) so I think we’re doing pretty good. And it’s 9:30pm on my fourth night here and I still haven’t seen a tarantula, so I’m pretty hopeful on that front as well.
My dad loves working in Haiti and has become best friends with all the translators and always goes out to Port-au-Prince to see the sights and get a taste of the social life. I think it’s great for my education, great for my resume, and great to help people, but I’ll take a breath such a sigh of relief as I get back on the plane to the States.
Oh, and I’m sick. I think it’s a reaction to pollution or bug repellant. Horrible sore throat burning and runny nose. Still no vaginal discharge, she thought.