Sex, Drugs, and Public Health

October 24, 2010

Going to Hades – – –

Filed under: Uncategorized — cbmosher @ 6:41 am

– – – is how a colleague mis-pronounced what I’d said.

“Haiti,” I corrected. “I’m going to Haiti.”

They sent us to St. Marc, a city north of Port-au-Prince and beyond the zone of impact from The Earthquake.  But tent cities of blue plastic metastasized from the maimed capital, to line the road north, leaking streams of sewage like pus from sores. These clots of densely packed refugees from Mother Nature’s attack remained camped out, waiting. For something. For someone. The parched and stripped Haitian landscape around them gave no hint of where they’d find water.

Our van stopped at a roadside market halfway to St. Marc. The primary items for sale were food and water. The food was the same from every vendor – deep fried something. It looked identical on every platter carried by the competing hawkers. Water was sold in sealed plastic bags the size of your palm. This was the water I’d been warned about on the airplane by a flamboyantly dressed Haitian woman:

“Da water dey sell in bags – don’t you drink it. Bad.”

St. Marc is a densely packed town surrounded by thousands of farmers’ small plots. Our clinics were set up in churches scattered among the farm homes, barefoot kids, free range pigs, and roads as rutted and pitted as horse trails. To get there, we bumped alongside an irrigation canal churning with brown foam, in which naked children played and from which women scooped water.

Throngs of people appeared at the clinic doors from amid this landscape, and grew quickly to a chaos of jabbering Creole voices. We admitted them in a controlled manner, to sit and wait their turn, only to discover that the chaos was now inside, at our elbows.

From this outside squalor and the chaos of waiting people inside, we brought patients, one by one, to our tables:

A thin grandmother wearing a clean and colorful dress stood, in shoes, with two granddaughters flanking her. I was surprised to note that the old farm woman didn’t smell of sweat and mud. Both girls had ribbons braided into their hair and tied in bows. They wore clean Sunday-go-to-church dresses, and they both wore sandals.

“Dis one, she won’t eat, and da other is always tired.”

Intestinal parasites in both; medicine for the two of them.

A six year old boy, on his mother’s lap, wore a suit – dark slacks and matching jacket over a crisp white shirt. His shoes shined like black mirrors. He had a congenital problem that meant he couldn’t control his bowels. “Dey tease him at school,” his mother worried. “He maybe will drop out of school. Den how he get a good job?”

A teenaged girl stood mute by her mother’s side. She wore a clean dress of multi-colored flowers, and smelled of perfumed soap. Her face had no expression.

“She was in Port-au-Prince,” her mother nodded toward her, “when the earthquake hit. I brought her back here because she was so terrified to stay there. She lost her words.”

Lost her words?

“She hasn’t spoken since the earthquake.”

Luckily, we had a French-speaking counselor on our team.

After we’d listened, examined, then prescribed, they each smiled and thanked us effusively for the little we’d done.

“Merci, Doctor, merci.”

One middle-aged woman told me, “You are the first doctor I’ve ever seen.”

On our way back to the airport, weaving thru crowds of people who were barefoot again, incompletely covered by tattered clothes again, it was obvious to me that, while our medicines may have helped a few people for a few days, what the appreciative and classy people of Haiti really need is water which is separated from the sewage.

Real simple concept. Apparently, monumentally difficult in Haiti.

So maybe my colleague was right. The people are powerless to drink anything other than the contaminated water of Hades.

Ticking time bomb.

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