An anecdotal account of Haiti's medical situation created by structural violence and negligence. Go to Peoria's Medical Mafia and PMM Daily to see Peoria's role. Also see Live From Haiti and Haitian Hearts.
Thursday, January 28, 2010
You Have to Read this Article!
January 25, 2010
On Street Tracing Haiti’s Pain, Survival Goes On
By DEBORAH SONTAG and GINGER THOMPSON
New York Times
Photo by John Carroll
PORT-AU-PRINCE, Haiti — Avenue Poupelard in the center of this devastated city pulses with life and reeks of death almost two weeks after the earthquake.
Before what Haitians call “the event,” it was a chaotically bustling street of lottery kiosks and cybercafes, gated homes and shacks, churches and schools.
Now, a coffin maker spends the day hammering wood as fast as he can get it, while the body of a 6-year-old boy decomposes in the ruins of a school. Hundreds of displaced residents squat in the junked cars of a mechanic’s lot as a lawyer, writing briefs, camps under the bougainvillea of her uninhabitable villa. A fiery pastor preaches outside the ruins of his church; street vendors hawk small plastic bags of water; an AIDS clinic reopens briefly each day for patients who survived the earthquake but ran out of essential pills.
And, bound in muslin like a mummy, a cadaver lies beneath a sign that screams “S O S,” deposited there by neighbors as if to underscore their cry for help as they struggle to reconstitute some semblance of community and move forward.
“We are not blood relatives but we are all the dispossessed of Avenue Poupelard,” said Franc Danjou, gesturing at those around him in one encampment. “We must pool our resources — and get help! — or in a year this community will be dead.”
Over a quarter-mile stretch, Avenue Poupelard, a residential and commercial strip in the area called Nazon, offers a panorama of life in the ruins of the Haitian capital where a stricken heart still beats.
A complete damage assessment is impossible without tax and property records, which are not available. But of 53 buildings examined on Avenue Poupelard, only six appeared to be intact. Twenty-three are completely or partially collapsed. And the remaining 24 show damage ranging from cracks to crumbled walls, with daily aftershocks presenting a continuing threat.
Despite such widespread destruction — and an incalculable number of deaths — almost no one on Avenue Poupelard seems to let himself cry, not even the children. Grief is still buried under shock, and there is a stoic determination to face the future because, no matter how tenuous, it is far less frightening than the immediate past. It is daunting to imagine the recovery that lies ahead. But in this one pocket of the city, as elsewhere, life of a survivalist sort goes on.
Some small businesses — a barbershop here, a tiny food stand there — are stirring back to life. Political debate, a sign of normalcy, is resurfacing, with many openly cursing President René Préval for making few forays into hard-hit areas.
Food, water, shelter, sickness and death: these continue to be urgent problems even as some help is finally arriving. For many on Avenue Poupelard, the trauma of loss has created an almost existential vertigo. Nora Jean Phillipe, an office worker who sat beside a tent with a box of Pop Tarts in her lap, was keenly, almost obsessively, focused on one thing: excavating her family’s birth certificates from their destroyed house.
“Please understand,” she said. “I lost my home. I lost my son. Somehow, I have to find a way to salvage our identity.”
Determined to Stay
The Legros family settled into their villa on Avenue Poupelard over a half-century ago when the area was affluent and surrounded by farmland. As he grew up, Michel Legros, 53, owner of a popular radio station, Radio Maximum, watched the neighborhood grow denser and more socioeconomically mixed.
Late last week, Mr. Legros and his sister Gladys Legros, a lawyer, opened their gates, ushering visitors onto the patio in the shadow of their elegant house, which is still standing but badly damaged.
Mr. Legros is a well-known political activist. “Politics sticks to him like a disease,” his sister said. His patio, shaded by palm and banana trees, used to serve as a meeting place for the Democratic Convergence, a largely elite political coalition opposed to former President Jean-Bertrand Aristide, a champion of the poor. Now the Legros family sleeps there alongside the many less privileged, displaced neighbors they have invited in.
Most of his friends, Mr. Legros said, have abandoned the country, but he refuses to go. “If you hear there is one person left standing in Haiti,” he said, “you can be sure it’s me.”
Despite his bravado, Mr. Legros, unlike many of his neighbors who have repressed the horror of the earthquake itself, keeps reliving it.
After the earthquake struck, he said, he rushed downtown, where his cousins owned a small hotel and found it a pile of heavy concrete slabs. After learning that his cousins were buried inside, he saw an employee, whom he knew only as Rudy, lodged in the rubble, crying for help. He ran to search for equipment to help get Rudy out. But with Port-au-Prince wrecked from one end to the other, Mr. Legros found that his political connections did not help — not on the day of the earthquake, or for the two days after that.
By the time Mr. Legros secured a bulldozer, Rudy was dead.
“I feel impotent, and that impotence bothers me a lot,” he said. “But what bothers me even more, is that my country is impotent.
“My God,” he added, “what has happened to Haiti?”
Crossroads of Need
Avenue Poupelard crosses a major north-south thoroughfare, Avenue Martin Luther King. At their intersection, a sign in English — “We need help. Food. Water.” — has arrows pointing both east and west.
To the immediate west lies the AIDS clinic opposite the car repair lot; to the immediate east, the coffin maker — who is charging his neighbors $125 per plywood box, about a quarter of the average yearly income — and a cybercafe offering free phone calls to the United States. Among those thronging the PMS Cyber Café late last week, one caller was recounting how a cousin had died at the hospital: “They cut off his leg,” he said into the phone, “so I don’t think he wanted to live after that.”
Across the street from the cafe last Thursday, a community center was converted into a triage unit by American doctors, volunteers with a Catholic missionary group who tended dozens of survivors with crush injuries and fractures. The patients included Linda Saint Alain, 27, who had languished in pain with a broken back on the patio of a family home since being dragged from its wreckage during the quake.
The American doctors quickly determined that Ms. Saint Alain needed to be transferred to a hospital, and helped her brother put her onto a flatbed. Before leaving, the brother jumped down to hug Gaston Jeaneddy, a voodoo priest and community leader who had arranged for the rescue team to visit the neighborhood.
“No one person can fix all of Haiti,” said Mr. Jeaneddy, a short, muscular man with the bark of a drill sergeant. “Each has to fix his own piece.”
Earthquake injuries are not the only urgent medical problems on Avenue Poupelard. The quake has left many thousands of Haitians who have H.I.V./AIDS without the antiretroviral medication that they need to stay healthy. On Thursday, scores of newly homeless Haitians managed to make their way to a dermatology clinic on Avenue Poupelard, where a guard let them wait for assistance on the wooden benches of the open-air waiting room.
The clinic, which used to focus on leprosy and now treats many AIDS patients, is damaged but standing. Its staff members, many of them also homeless, have been showing up for a couple of hours a day to dispense pills.
One patient, Yvose Descosse, 38, wore a turquoise flower in her hair, and twisted her beaded necklace as she spoke in a soft sing-song. She had walked three hours to the clinic from her tent city in the sprawling slum of Cité Soleil. Having missed an appointment the day after the earthquake, she had run out of pills and found herself racked by diarrhea and vomiting — on the streets, no less.
Further, she added, patting her very small belly, she was eight months pregnant and the father of her baby had been killed during the earthquake.
“I needed to come to Poupelard, where they will help me,” she said, covering her face with her hands.
Seated near her, Claude Chevalier, 24, a medical student who has H.I.V., said the earthquake had killed his mother, father and sister and left him completely alone. “Everyone in Haiti is in the same situation,” he said, closing his eyes briefly, then shrugging.
Not everyone can shrug. For some, the dispiriting reality inspires grim thoughts. Florence Mabeau, a former Red Cross janitor, said she almost envies her teenage daughter for lying unconscious at the General Hospital: “I wish I could sleep through this nightmare,” she said.
Ms. Mabeau was squatting in the mechanic’s yard opposite the dermatology clinic, where about 300 people have taken shelter in junked cars. It is one of the largest encampments in the neighborhood, with extended families crowding into broken-down vans and painted jitneys. At night, they reserve the best car seats — where there are seats — for the babies, and sleep in the open air.
Conditions are harsh. The people pool their pennies to buy small packets of water and spaghetti, they have no running water or electrical generator and diarrhea is rampant. And now, most have little patience for questions about where they were when the earthquake struck. What’s gone is gone, some say, slapping their hands. But others cannot help but yearn for what they lost.
Huguette Joseph, 53, who shares a yellow Nissan bus with 10 children and grandchildren, said she did not have much before the earthquake, living in a leaky, one-room house. Still, she said, “I had my own house. I had my own kitchen. I had my own pots for cooking. I had shoes on my feet.”
Sermon Amid the Ruins
Before the earthquake battered the large Evangelie de la Grâce Church, Pastor Enso Sylvert said he routinely drew hundreds of worshipers who spilled out onto the sidewalk for Sunday services. Now he has a gravel lot and a circle of folding chairs, but during a morning service last Thursday, his faith was on fire. He wore a salmon shirt, bounced on the balls of his feet and thrust his Bible in the air, working a crowd of displaced residents into a good-spirited frenzy.
“We call the president ‘Onion,’ ” he said in a chant, using a Creole insult. “We call the ministers ‘Onion.’ We call the government ‘Onion.’ Our only hope lies with God.”
For a couple of hours, the service enlivened the camp beside the church, a ragtag assemblage of working-class and poor neighbors who once coexisted in the various structures — main house, cottage, shacks — on an old villa property with an empty, cracked swimming pool. Jean-Claude Gouboth, 36, a thin, serious man in an Italian soccer shirt whose small store was crushed in the earthquake, lived in the main house, now damaged.
That made him the de facto leader of the impromptu refugee camp, a post that he did not appear to relish. Life was not easy before the earthquake, he said, with three children to put through school and mounting debt to the bank underwriting his business. But now his 3-year-old girl had been killed by the quake, his wife and other children had fled to the countryside, and he was sleeping with the neighbors in his rocky backyard.
“We are trying to stay on friendly terms, but sometimes there are disputes,” he said, citing not a squabble over scant resources, but a theological debate about exactly what God was trying to say when he shook Haiti to its core.
Jesumelle Gustave, 44, who lives in the rubble of the church, does not participate in such esoteric conversation. She thanks God, she said, for leaving $4 in her husband’s pocket when the earthquake killed him, money that she has needed to sustain her family of five, including a son with a broken back and an amputated finger.
“How merciful is God!” she said, as the little boys in the encampment kicked a soccer ball onto Avenue Poupelard and across the street to a schoolyard where some friends are living.
Two slim teenage girls ran past them in flip-flops, mattresses on their heads. The school, its roof knocked off, has one wall chiseled away to reveal a blackboard chalked with the chemistry homework assigned the night the earthquake struck.
“We don’t have school anymore in Haiti,” Sophonie Daniel, 17, said. “Can we come to your country to study?”
Her friend Danuela Bayard, a 21-year-old marketing student, chimed in: “We are young, and we don’t want to waste our time in life. This earthquake just paralyzes our lives.”
Damien Cave contributed reporting.
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