A Haiti Medical Missionary Trip
Part 1



What follows is a journal submitted to a woodworking forum by Dr. Kerry Forrestal, MD after a Medical Missionary trip he took to Haiti. It is reprinted here with his permission and is the reason and the method by which I became acquainted with Pastor Julio and is the how and why that our Starfish Pensite came about. This is Part I. Part II can be found at the link at the end of this page.


Sorry this took so long, but as promised to the group. It is a journal article on a recent Medical Missionary trip to Haiti published as an 51st anniversary gift to my parents in their local newspaper as a surprise.

**************************

Late January 2006: A Month Before Departure
Why Haiti? It is a question frequently asked as word gets out that I’ve signed up for a medical mission to Cap Haitian, Haiti. Elections are upcoming and violence is escalating. Many point out that there are kidnappings; I am aware of this fact, and don’t add that there are some 30 a day. I am comforted somewhat by the fact that there is a 5,000-foot mountain range between my group and Port-au-Prince. At 200-plus pounds, I’m a fair amount of person to lug over a 5,000-foot anything, and I’m hopeful that the kidnappers are lazy.

My team will stage in an area called Cap Haitian, in northern Haiti. In addition to "Cap," as the locals call it, we will be working in the villages of Borde, Juchereau and anywhere else we are needed. I will be accompanying an internal medicine doctor for adults and an obstetrician. My job is pediatrics and adults secondarily. Our group will also have several nurses to help get the job done.

I was advised not to have any expectations entering this trip, and yet those who have been there cannot help but share their experiences. I am told that a banana tree will likely be our office, and that the locals have no idea how to form a line. There is excitement among team members and unspoken trepidation as was pay attention to the upcoming elections. So the question remains, why Haiti?

The truth is: I don’t know. I’m going because there is a need. I’m going because my parents taught me that you have to give something back in this world. I’m going because I have a remarkable wife, Shannon, who made it possible. I’m going to Haiti so that my daughters know that being a physician is not about privilege, but rather about service. I’m aware that visiting Haiti for so short a time with 50 pounds of medical supplies on my back isn’t likely to change a whole lot. And yes, I know the story about the man chucking starfish back into the sea. It goes like this: An old man is walking on a beach littered with countless starfish stranded after a high tide. He sees a younger man busily throwing the starfish back into the water. The older, presumably wiser man tells the younger man that he can’t possibly make a difference amidst the unending numbers. The younger man picks up a starfish and heaves it into the water and replies, "It made a difference for that one."

Emergency doctors have a great ability to figure things out as they go. Perhaps once I get there, I can figure it out.

Day One: February 21
Our flights to reach Haiti are like decompression from civilization as we know it. The first leg of our journey involved interstates, large terminals and jet engines. We fly from Dayton to Atlanta and have to kill some time during a brief layover. I score some coffee and a magazine to pass the time. It seems a small thing to have coffee, flavored if you like, or the ability to select from nine kinds of tea. It’s something that I will later learn to appreciate a whole lot more.

The second leg brought us from Atlanta to Fort Lauderdale where things began to look a little different. No, Florida hasn’t changed, but as we walk toward the flights that service Haiti, we see the airlines are smaller. One of the nurses remarks that she sees "Bob’s Discount Air" and "We-Be Flyin" off in the distance. I’m not entirely sure if she is joking.

The plane that took us to Haiti was tiny. It barely fit our team of 12, one other passenger and another pilot. He sat in the back and I took comfort knowing that our plane has a spare pilot. One other observation about the flight: You never appreciate the safety instructions that they give before you take off until you cannot understand them. The only thing I understood was something about a water landing and that most sharks are not man-eaters. I think. After two and half hours, we are approaching our destination. As we came in over the mountains I was taken by the beauty of the land from afar: lush, rolling mountains in multiple shades of green surrounded by an inviting blue ocean. As we draw closer to Cap Haitian, we see areas of deforestation. Depending on which way you look, you either see ecological devastation or a Caribbean paradise. It was sobering to see smoke near the runway as we came in for landing. We are greeted by the Haitian heat. I think of the moment in the Tom Hanks film "Volunteers" when he walks out of his jungle hut and proclaims that they must be about a mile from the sun. We are a source of some interest to the locals, though I soon gather that we aren’t a novelty. The check-in station–a tall plywood box cobbled together by a distracted carpenter–proclaims "Missionary Flights International." Really.

Our experience at immigration and customs was the first confirmation that we are in a different world. Fortunately, we have a contact in Cap Haitian, a man named Wilbert (pronounced- Will-bear) Merzilius. Wilbert runs the Living Hope Mission, a non-denominational group, that helps the people of Cap Haitian and surrounding areas. Wilbert meets us at customs and thank goodness he does.

Four of us–Wilbert, our lead doctor, myself and a dour-looking Haitian who I assume was in charge of customs, all file into an office. As we did, the customs officials outside tear into our six carefully packed boxes of medications. These boxes are tightly packed, and I cannot help but wonder how we are going to repackage our supplies. Back inside the office, the customs agent offers a rapid-fire speech in Creole and starts punching numbers into an old adding machine. After arriving at the right number, guided by “strict” tariff fees, he shares the figure with our host and guide. Wilbert then leans over the man’s desk, clears the machine and starts inputting his own numbers. This goes on for some time until a deal is made. All told, it cost us two hundred American dollars and a bottle of our hand sanitizer, with moisturizer, to clear customs.

I will not be able to forget the first time I left the terminal. Americans have a much different definition of poverty. A homeless person living in the United States has access to more resources than most of the people we will encounter. In America, you can visit a mission for food and clothing, or an emergency shelter when it gets too cold for a steam grate. What Haitians define as "normal," I would soon learn, is far below the concept of poverty in America. No one, for example, has access to our version of a bathroom in the areas we visited because there is no sewer system. There are two kinds of outdoor bathrooms–a hole in the ground without walls or a pile of garbage. Public electricity, when it works, is available a few times a week. The roads resemble a motocross track designed by a sadist. The list goes on.

I also find myself bewildered by the Haitians themselves. Haiti is a land of desperate poverty and absolute want, but it is populated by people filled with an illogical and beautiful sort of grace. I do not claim to understand Haiti completely, partially, or even at all, but I believe there is something to be gained by sharing this experience. We spend the night getting to know our new hosts, Wilbert and his wife, Meg, a native of Ohio who has lived in Haiti for 14 years. We begin preparing our pharmacy. We spend a long time placing de-worming medicines and Flintstones chewable vitamins in plastic baggies. I wonder if we are making too many bags. By the end of the week, I would have increased he number tenfold.

We are acquainted with the voodoo drums and, soon thereafter, the "rooster brigade," the latter of which does not understand that 3 a.m. is not the optimal time to start crowing. We soon get acquainted with the Haitian uber-mosquitoes for which DEET is not so much of a repellent as it is an appetizer before their meal of American red blood cells.

Day Two: "My Love" of Juchereau
I suppose if this were a novel, I could tell you that I couldn’t sleep all night from the excitement of helping the poor of Haiti. I would also be lying. I fell asleep almost immediately as we started our trip the day before at 2 a.m. in Lima, Ohio, and did not arrive in Cap Haitian until 6 p.m.

I slept through the drums, roosters, mosquitoes and pretty much everything else. I didn’t feel rested, but I felt functional. Fortunately, our hosts understand the American need for caffeine as we had access to coffee. After a light meal, we load a pickup recently donated by a group in Texas and a van. Room was tight so I volunteer to sit in the back of the pickup.

My lungs and I are still not on speaking terms.

The roads are mostly washed out and when I use the term moguls, trust me that I am not kidding. First gear is the best friend of the drivers here.

We travel some two and a half hours and arrive at a small church in a place called Juchereau. The church is of stone construction with a metal roof, but it in no way seemed meager as we settle in. The first step leading to the church was quite high as the rainy season had washed away much of the soil from the area.

Our "waiting room" is a shady area on the side of the church and several pews that needed to be moved to make way for our clinic were carried outside to allow people to sit down as the temperature rose to well above 90 degrees. We set about seeing patients and it wasn’t long before "it" happened.

You can always identify a sick child, a dying child. They are unnaturally quiet; they lay in their mothers’ arms without interest in the world. Anyone in health care who has ever seen a child die will tell you that a screaming child doesn’t worry them. A quiet one scares them the most.

The young woman with a deathly quiet child sits down in the chair with an infant we judge to be a few weeks old, a month at most. The young woman is not her mother, but her aunt. The child’s mother had died three or four months before of an unknown wasting disease after long bouts of terrible diarrhea. It didn’t take much more of a description to know that she had died of AIDS. Before she did, she named her child "My Love." The aunt had tried everything to nurse the child, but the child was failing.

I take a deep breath as I begin my examination of My Love. Part of me thinks, "I’m trapped in a poorly written Hallmark special. The name just put it over the top." The infant was impeccably dressed, as are all the Haitians who would visit our clinics. After our interpreter, Julio, translates a few more of our questions it becomes evident that the child is suffering from the virus, too.

How do you tell someone what you know to be true? My Love will die soon. One morning she will wake up, perhaps with a cough and fever or that diarrhea that runs epidemic in the children of Haiti from the parasites in the water, and her condition will worsen throughout the day. My Love will not cry, nor will she struggle for she is already too weak. With perhaps no more than a whimper, the infection will overwhelm the remnants of her immune system and My Love will become one more of the faceless masses to die in the AIDS epidemic. (As you read this, that day may have already passed. I do not know her condition as information reaches us very slowly.)

Every person on our team has the same thought: "Take her home to the United States, bring her to the experts, and let our medical system have a shot at saving this child." Some will say that for the hundreds of thousands of dollars one could invest in a fight that will likely be lost, you could start an immunization program through USAID and save hundreds of children. While I know in the logical side of my brain that it is true and good math, it held no sway as I cradled this child. It was her eyes that I will remember the most. Her eyes were not dim or dull but rather drank in everything around her. They were curious eyes, those that belonged to any four-month-old. Those eyes will stay with me. We were quiet at lunch as the weight of the encounter stayed with us. We talk of it throughout the remainder of our trip, and as our experience in Haiti grew, so did our understanding of how common such things are.

I don’t know how many patients we saw that day. We did our best. Our interpreter, Pastor Julio, was amazing. He never fatigued. I’m pretty sure he could run the Boston and New York marathons back-to-back and still have energy to spare. I would learn later, while I lay in my bed exhausted, that Pastor Julio went back to his church and preached for three hours.

We drove back home and, after another two and a half hours on the road, I’m certain that there were more potholes than there were heading out. We sit down for a meal and I find more coffee. I retire to my bed to write down some thoughts and think about the day. We are returning to Juchereau in the morning, and after the first day there, I could not help but wonder why I had ever left the states. Though no one is looking forward to the ride out there again, it is far too dangerous to sleep there.

My thoughts return to My Love and I cannot help but think of my youngest daughter, who is near the same age. In another life they could have been playmates. Sleep comes and I miss my second night of voodoo drums.

Part II