Is There Light in the Midst of Darkness?

Have things gotten better in Haiti?  Do you keep in contact with your friends in Haiti?  Have you been back there? How are things at the hospital?  These are questions people ask me every day.  We are long due for a Haiti Bones update, so read on for answers to these four questions.

Have things gotten better in Haiti?

People hardly pay attention anymore to headlines like this recent one: Haitian Town’s Pleas for Help Went Unanswered Before Massacre.  Many other horrific events don’t even become headlines because it is just more of the same.  The trajectory continues on a downward spiral and no amount of suffering, violence, or tragedy is interesting or surprising anymore.

Some gains against the gangs in central Port au Prince forced three of the major gang leaders to Carrefour, which created a hotbed of conflict around our hospital. It is difficult for patients to get to us due to gang extortion and control on the major roads.  Currently there are 1,200 foreign troops in Haiti attempting to suppress the gangs.  More are promised…  The government has recruited 700 Haitians to join the army, which was disbanded many years ago. They have also recruited an additional 4,000 new recruits for the police force. Assuring that there will not be any collusion between the policy force and gangs reminds me of when my friend in college got a job with campus security to keep the rest of us out of trouble.

Sadly, Carrefour has no electricity since the gangs took over the power plant. The hospital must generate power 24/7, and most of our employees have no electricity in their homes. We spent considerable time and resources investing in solar, a backup battery system, and new generators, but still, proper expertise to manage and troubleshoot the system is not always available when needed. Nonetheless, we are persevering and continue to work through the issues.

Do you keep in contact with your friends in Haiti?

Rarely does a day go by that there are not messages, a Zoom meeting or a phone call from Haiti. Administrative meetings typically start at 5am Pacific Time at the beginning of the Haitian workday. Jere Chrispens, our CEO, and I have remained highly engaged, supporting the work from afar as best we can. Even so, my role as Medical Director is not what it should be. We have some appointed liaisons onsite and would be happy to give up our leadership titles, but there is a strong desire amongst the medical and administrative staff for us to continue on with the current team efforts.  My duties mostly involve ordering supplies and equipment, working out administrative issues with medical staff, advising on cases, and ensuring adequate support for taking care of all the patients who do not have the resources to pay for their care.

Have you been back to Haiti?

No. We left our house with a carry-on suitcase in February 2024, with return tickets a couple of weeks later. That is when things spiraled out of control.  The airport was attacked and flights were cancelled.  For a short period of time planes started to fly again until bullets penetrated Spirit, JetBlue and American planes from ground-level fire on approach over the city. At that point the FAA forbade any US carriers to fly to PAP. That remains in effect until Sept 2026 when it will almost certainly be extended. It is not absolutely impossible to get there. Cap Haitian in the north or Santo Domingo would be alternate access points, however the ground travel is extremely uncertain and high risk for foreigners.

A shipping container of supplies is delivered to HAH

How are things at Hôpital Adventiste d’Haiti (HAH)?

There are challenges but with effort, prayer, and resources, they are surmountable.  With all the chaos around us, it is a miracle that the hospital still exists. And even more impressive is that it is functioning at a very high level. I am particularly excited that patients without the means to pay are still welcome and able to receive the highest quality of care in the region at our hospital. Ten years ago when times were much less turbulent, the hospital was in financial distress, poor patients were turned away, and most of the rooms were empty.  Today we have a bustling hospital that serves all patients especially those who lack access to proper healthcare.

Two young Haitian orthopedic surgeons who rotated at our hospital during their residency finished their training and are now running the orthopedic service.  They do excellent work.  In addition to them are Dr. Jimmy, general surgeon, Dr. Darius, OB/GYN, and three anesthesiologists. They get paid a small base salary, as well as  an incentive-based wage that rewards them for working hard, and they are all striving to do that. Our dental program and outpatient, inpatient, and ancillary services (imaging, lab, and physical therapy departments) are all continuing at full force. Even the cafeteria recently appointed a new chef. Hospital staff are giving 5-star reviews about the new menu and quality of food.

Over 60% of hospitals in Port au Prince have closed, increasing the crucial role of our hospital to provide care that simply is not otherwise available.  Doctors Without Borders (MSF) has shuttered several of their facilities in Port au Prince.  One of them reopened near our hospital but they do not offer surgical services. They now refer their surgical cases to HAH (and provide financial support), which is a huge complement to the quality of care being provided at our facility.

Materials and supplies are exceedingly difficult and costly to obtain locally.  Big efforts continue for that, and in spite of the increased cost, it is important to support local vendors. In most cases it is still better than trying to import supplies.  There are some items that are not locally available. We were able to ship a 40’ ocean container earlier this year with some key pieces of equipment. In addition, we are able to ship smaller quantities through a freight forwarder based in Miami. We are in the process of transacting a new oxygen pump, washable linens for the operating room, and 120 large oxygen canisters.  

Scott with oxygen tanks.

Celebrations are a big deal in Haiti. I am happy to report that at our hospital they are still happening!!  Some very special celebrations took place in honor of International Nurses Day at HAH. We appropriated some extra funding to encourage our staff who are living and working in such difficult conditions.

Most recently, the Adventist University of Haiti next door just celebrated graduation, including a whole new class of nursing students! If you’ve visited HAH in the past, you likely know Patrick Torbeck (pictured left), the caretaker of the volunteer housing area at the hospital. Some generous supporters helped him through nursing school, and it is very exciting to see him graduate as part of this class. He is the first of his family members to achieve such a high level of education. It will be wonderful to see him continue his exciting journey and provide loving care for the patients in Haiti who need it so much.

Please keep our institution in prayer and know that whatever resources you may be able to direct toward sustaining this work are greatly needed and will be watched after carefully.

By Scott Nelson
Scott and his wife Marni lived and worked at HAH full time for 6 years starting in 2018