Monday I arrive at Port au Prince Aéroport Toussaint Louverture. Michel our hospital driver is running one hour late. Normally he is always on time but today he had to take a more circuitous route than normal to avoid the fiery barricades and mobs of people that have taken to the streets.
People are riled up because the president is trying to install a prime minister accused of a string of corrupt deals. Luckily I make it through customs OK with four heavy bags of equipment for the hospital. This was facilitated by an eager baggage handler who put my bags through an x-ray machine and quickly stacked them back on my cart while whispering something in my ear. I knew what it was about. As soon as we got around the corner he wanted $50USD. I smile and give him $10, which I justify as a tip for handling the bags rather than a bribe for customs. Before long Michel arrives, and we set out from the airport taking the back streets across town. Each time before making a turn Michel looks down the street to check for barricades. When we see smoke, flames, or mobs we take the alternate street, sometimes going in the desired direction. With minimal traffic on the road we arrive at the hospital a little faster than usual.
Jere Chrispens, our CEO is not able to fly to the US on Tuesday after a fire breaks out in the airport gift shop, coincidentally about the same time the president of Haiti is supposed to depart for the UN general assembly. Flights already in the sky out of JFK and FLL are diverted and all arrivals and departures are cancelled for 24h. This is great for me because I get an extra day to work with Jere on hospital administrative issues.
Wednesday arrives. The ortho clinic is almost empty except for all of the faithful moms who bring their babies each week to the clubfoot casting program. There is almost no public transportation, there are fuel shortages, and the economic situation only continues to deteriorate. But nothing can get in the way of a mom watching out for her baby. They might not have food or means for anything else in life but they still show up to the clubfoot clinic so their babies won’t grow up disabled, ridiculed and disregarded in an already challenging life. Thankfully most of our employees live close to the hospital and loyally show up for work, albeit in some cases having to bypass rock throwing and gunfire.
Thursday is unusually peaceful except for some trauma cases that arrive including a 6 year old girl with an elbow fracture. I specifically mention her for a few reasons. It’s not because the case is so rare or amazing, but I am excited that she showed up to our hospital only one day after suffering a type 3 supracondylar fracture (Type 3=bad). In the past our hospital has had a reputation of being elitist and inaccessible. When hospital finances were tight prices were raised and poor people were turned away. In addition to not taking care of the poor, hospital finances continued to struggle. It has not been easy to show how lowering prices and creating accessibility can actually improve hospital finances, not to mention our bigger reason for being here. But this is happening.
It is by a combination of factors, not the least of which are the blessings that come from generosity. We started something called “Pwogram Ijans Aksidan” which means something like program for urgent accidents. This is a package deal that gives a 75% discount to trauma cases that present less than one week from the time of injury. In the quest to give the best treatment to the most people with a set amount of resources it makes sense to take care of injuries soon after they occur. We have many cases that present months after injury with complications or neglect. Instead of coming to our hospital at the time of injury, they went elsewhere or nowhere at all because they could not afford our hospital. Now out of work for months having spent whatever they may have had elsewhere, they need help. So this little 6 year old girl shows up at our Salle d’Urgence (ER) with an acute injury and I am excited. Her dad was processed through our new financial counseling office, given an affordable price and she got a 20 minute operation that will avoid a lifetime of disability. Multiple factors have impeded this process from gaining traction, but finally we are seeing the fruits of our labor. We would love to give it all for free, but there are other implications to that… too complex for this discussion. In any case we now have a system to make treatment possible for all and to avoid turning people away. It still has glitches but these are getting less and less.
The political situation continues to escalate throughout the week with plans for the most massive destruction ever to take place on Friday. People are demanding that President Jovenal step down. He gives a small speech – at 2am on Friday, no one seems to pay attention. People are angry about double digit inflation, fuel shortages, no electricity and billions of dollars that are unaccounted for. They take to the streets. Banks are closed, schools are closed, all major businesses are closed and the city is locked down. I see a couple of major fires already burning downtown when I go for my 6am run. Fires, road blocks and destruction persist throughout the day.
At the hospital things are eerily calm but we are safe. We do surgery and then I have time to tend to my many other responsibilities. Finally Friday night arrives and I have enough time to enjoy dinner before getting called to the salle d’urgence.
On Sabbath afternoon I take a walk down by the bay with Patrick to visit some of our patients. The conditions down there would be shocking to even the hardiest of missionaries. We see Jervens who previously had a colostomy after getting clogged up on cement that he ate, we see Michena who had burn contractures on her foot, and Jackson who had a life threatening infection, all of whom were treated at our hospital. I hear repeatedly “Bonswa blan” (good afternoon white) “Mesi mwen blan” (thank you my white). Then they bring me to see a 3 day old baby. The parents again thank me profusely for saving the mother’s life and for their baby. At first I don’t know what they are talking about, I am an orthopedic surgeon. But then I realize they had come to the hospital with mom in distress a few days before. They had no money. So I directed them to our new financial counseling office and they got treated. The system is working!!