Chicago Doctor in Haiti: The Dangers of Working in the Field

Port au Prince, Haiti - In Haiti, I have been in charged with driving to and from AMURT’s mobile medical clinic assignments in a worn-out musty olive-colored Toyota Land Cruiser. I can tell you definitively the unwritten practice in the U.S. of “Big Truck Wins” does not apply here. It’s just the opposite because smaller vehicles are better able to maneuver around the dips, cracks, crevices, potholes, rubble and winding roads; which you come upon quite unexpectedly and frequently. The inclines here are as steep as those I drove on in San Francisco. Cars here are supposed to be driven on the same side of the road as in the U.S.; but it’s a miracle just to make it through at all, so the rules of the road are generally shunned.

Forget the "right of way", too. Pedestrians and cars dodge each other, but I feel particularly sorry for the vendors pushing heavy carts full of liquor and motor oil. At night, the streets are unlit and many cars don’t have lights. All you need to drive in Haiti is a working engine, as I quickly learned.

The AMURT building, where I stay, is in the Delmas section of Port-au-Prince off Delmas 31 and Delmas Road. Forget about going anywhere in a reasonable period of time on Delmas Road. I never thought I’d see anything more congested than the early-morning Lake Shore Drive commute to downtown Chicago, until Delmas Road. Exacerbating the problem are “tap-taps,” Haiti’s shuttle buses that transport folks around town. When it’s time to get off, people bang on the sides of the vehicle, hence the name. Tap-taps are colorful, but hugely annoying because they stop abruptly anywhere and at anytime. A passenger can be let off in the middle of the road as easily as a “tap-tap” on the side of the bus, it’s unpredictable and dangerous.

The worst vehicle I was in wasn’t the Cruiser with the absent shock absorbers. It was a mid-size type of Mack truck, which transported our medical team, college students, medical supplies and tables and chairs. I had the luxury of sitting in the cabin with the driver and another Haitian support staff. Nothing seemed functional and I wondered if it would actually run. All of the gauges were busted and the dashboard was so dusty and decrepit, it looked like it hadn’t been driven in years. It reminded me of the dashboard of the car in the movie “Planes, Trains and Automobiles,” after John Candy had driven it between the two trucks and decimated it. This truck did serve its purpose; it got us to camp and back. A good example of how everyone is making do with what they have.

I was also recently told that one news organization paid more than $30,000 for protection of its news crews covering the Haiti earthquake. In this day and age of shrinkage, that’s a lot of money. I never felt unsafe, not for one minute. We traveled in groups, functioned under the auspices of a “helping” organization, and only traveled during daylight.

One day we worked late and returned to AMURT after 7 p.m. We were harshly scolded by the administrator, who warned us of the dangers in being out in this unstable environment after dark. The dangers weren’t always obvious. For example, believe it or not, one of the worst problems is the mosquitoes. They are fierce and aggressive in Haiti after dark. Insect repellent is not entirely effective. Treatable malaria and untreatable dengue fever can be the consequences of bites from infected mosquitoes. Most international workers take anti-malaria pills.

We were also told that drinking and driving is rampant at night. Don’t forget about the roaming Haitian prisoners. One source told me about 4,000 prisoners escaped after the earthquake. All of these are good reasons to complete our work during the day and stay on the compound at night.

The dangers of an interrupted and dysfunctional life weren’t exclusive to members of the international community. One of the most dismaying realizations from working in four-tent-cities was the gripping reality of abuse. I treated a woman with severe facial cellulites, which came from being knocked around by her husband. In another instance, I was puzzled when young girls complained of “female” itching because I didn’t see any signs of a medical condition that would cause it. Then it hit me and I began to ask the question in Creole through a translator, “Have you been with men?”

The girls, as young as 11, averted their eyes and replied “no”, but the harsh reality was that girls and women were being raped every day in the camps. We all knew it.

Like every city in the world, Port-au-Prince has its “good” neighborhoods and its “bad” neighborhoods. Shantytown Cité Soleil, home to 250,000 of the poorest Haitians, is widely considered the most dangerous area of Port-au-Prince. One of our translators refused to take the medical team there. Armed gangs roam the streets and there is no police presence. Violent events are frequent and expected. We had a patient situation where the Haitians involved lived in this decrepit part of town and we had