Comfort zone expansion

First and foremost, I want to to thank Will and his father, Dr. Boyce, for sharing this experience with us. Everyone should know that Will and his father have been doing humanitarian work in Haiti for several years. They consistently make substantial sacrifices to help improve the quality of life for some of the least fortunate people in the world. Watching them in their element has been a great experience for me. I came from up an upper-middle class upbringing in the suburbs of LA and have never really made any significant sacrifices for other people such as those that many people down in Haiti are doing on a daily basis. Part of my decision to go back to school and become a doctor was to develop skills that would allow me to make those kind of sacrifices for other people. When Will asked me if I wanted to go on this trip with him I thought it would be an excellent way to see how I responded to this type of work.

The organization we came to volunteer with was started by an american priest turned doctor, Father Rick. He runs a handful of sister hospitals in one of the nicer (relatively speaking) parts of port au prince across from the UN compound. His children's hospital is apparently the best and well respected children's hospital in the city.

Recently he started a new project in Cite Soleil, the poorest slum in all of Haiti. He's building a small hospital within a few hundred yards from the ocean...... and in Haiti, the closer you get to the ocean, the worse off you are..... shit literally runs downhill in a hillside city with open air sewage. His committment to serve the poorest of the poor is truly inspiring. Without a healthcare facility in Cite Soleil, the people of the community really have nowhere to go for their healthcare needs. However, operating in such a slum does come with some substantial safety concerns. The area has a history of substantial violence and gang activity, just like any other slum. Father Rick's approach to operating in an area like this is to get the local community involved and to ensure they know that if their family members become ill, his hospital will restore their health.

While the Cite Soleil hospital is still under construction, they decided to start a tent clinic right next to the construction site to start seeing patients. Since this clinic was new, this is where the organization needed the most help. Dr. Boyce jumped on the opportunity to see patients at the clinic upon arrival and had gone down to Soleil with just an interpreter and a few duffle bags of medications. When we arrived, we were asked if we wanted to go down to Soleil as well. Will thought it would be a great experience for us so we decided to go.

Driving into Soleil the first day was completely shocking to me. I'd never seen anything close to the poverty level that is present in Soleil. We went down with two of Father Rick's personal security guards and were also told that all of the construction workers on site were instructed to serve as security as well. Both our personal security guards and the construction workers had considerable ties to the community. The significant security presence gave me some sense of comfort, but I was as far out of my comfort zone as I'd ever been.

We set up the clinic and the first day went very smooth. We probably saw about 50 patients. A Spanish surgical assistant treated wounds and Dr. Boyce saw all of the other patients. We helped out by setting up, taking vitals, organizing and dispensing medicine for Dr. Boyce, performing urine tests, and helping out as needed. Since Will speaks Spanish and Creole, he was able to do some interpreting for the Spanish surgical assistant and his father. We also came with a young Haitian interpreter, Jean, who speaks five languages, and a young Haitian man, Junior, who is getting ready to start medical school in Haiti. We saw many diseases that day. One elderly woman was suspected to be in an advanced stage of a cholera infection and probably would have died that day if Dr. Boyce didn't come down to the clinic. Dr. Boyce called up the hospital and had them send their ambulance (possibly the only one in the city) down to pick her up. We saw a handful of children with suspected malaria (a highly curable disease), many men and women with urinary tract infections, a lot of body pains, wounds, common infections, scabies, malnutrition, and some common colds.

A few things really stood out to me that day. It felt great to be part of a team that truly made a difference in other peoples lives. I also noticed that for being incredibly impoverished, the patients we saw, for the most part, maintained great hygeine and appearance. If you took many of those patients out of Soleil and put them in any of the major cities in the US, they would not stand out at all. Despite their desolate conditions, poor Haitians have a lot of pride. Lastly, as we were getting ready to leave, the ambulance had not arrived yet for the woman with cholera. Many of the team members were ready to leave, but Dr. Boyce refused to leave until the ambulance arrived. Some of the team members objected to this, but Dr. Boyce stood his ground and even said he'd stay by himself if everyone else wanted to leave. I was really touched by this gesture. What a man!

We went back to Soleil the next day and everything was going great until a few gang members started a little altercation outside our tent. I could feel the tension in the air. Our security guards and the construction workers were able to prevent the altercation from getting ugly and we continued to see patients, but during the moments when the tension was high, I really began to question the prudence of my presence. We were warned that Haitians were very demonstrative in their interactions with each other, but I still felt incredibly vulnerable, more so than any moment in my life. We made it out safely, but the rest of the day and night I thought long and hard about how I felt. Was jeopardizing my own perception of safety worth it? I was presented with the dillemna that all global health workers working in a high risk environment have to face. I feel a little guilty about it, but I reached the conclusion that my sense of safety isn't something I am willing to jeopardize and that I wanted to stick to the confines of the more established hospitals for the remainder of the trip. It really takes a very special person to go into a situation like a tent clinic in Soleil. At this point, I don't think I am one of them, but I will continue to reevaluate because God knows these people need the help. Maybe I am just a few more experiences away from having the comfort zone of Will, Dr. Boyce, and Carla, or maybe I just wont get there. Regardless, this has been a great slice of life and I am grateful to Will and his father for sharing this experience with me. These are the type of lessons you just can't learn in a book. You have to feel them for yourself.