Update from Port-au-Prince, Haiti
March 12, 2010
Joshua hasn’t always had this much attention. He was found after the earthquake hit by some rescue workers who were searching through the rubble for survivors. Joshua was significantly dehydrated, malnourished and bleeding profusely from deep lacerations to his arm. In the aftermath of the biggest earthquake to strike Haiti in more than a century, he had been left alone to fend for himself in the dust and rubble. Somewhere between eight and ten years old (no one is sure), Joshua is non-verbal and struggles from the debilitating effects of Cerebral Palsy. He has clearly never received treatment for the disorder, which has especially stunted in his development. Yet when you look at him, Joshua stares right back into your eyes, offering facial expressions and hand gestures that tell you he understands much more about what is happening than he can convey.
Some weeks after abandoning him in the quake’s aftermath, Joshua’s mother learned of his new home at CDTI. She has dropped by a couple times since the quake to try and remove him from the hospital before his wound treatment has been completed. Joshua’s mother uses him to make a living, dragging him with her on the streets as a token of helplessness to use to beg for money. To her, she once told the hospital staff, he is nothing more than a dog.
Ironically, the Jan 12th earthquake brought about the most loving and committed family Joshua has ever had. Ever since some of the staff members, including Julie “Jitterbug” (nickname) Pearce, brought him in for emergency treatment at Sacred Heart, Joshua has been the heart and soul of the hospital. Nurses give him pats and high-fives as they walk by; doctors offer him candy after his checkups; his days living in the tents at the hospital have been so great to him that Joshua is rarely seen without a huge smile on his face.
As beautiful as his story of rebounding from disaster sounds, Joshua nevertheless underscores a huge problem facing Haiti. With the emergency phase of relief interventions over, the healthcare in-country is now at a critical transition point where the private hospitals and clinics that opened their doors to the earthquake victims in the initial days of the disaster are now running out of funds. Their contributions for the past two months are no longer sustainable and without external support, each one of these novel public/private operations—critical in filling the dearth of healthcare facilities in Haiti—will have to close.
Staffing is the clearest example of the shifting needs. The volunteers who are coming for 2+ week assignments are fewer, and holes are becoming increasingly apparent in the hospitals’ available human resources to handle the increased patient loads from the ongoing health crisis. The initial emergency that connected their separate worlds has now abated, leaving behind large long-term healthcare challenges that have to be addressed by more permanent solutions on the ground. There is little or no clarity about where patients at many private hospitals would go, should the doors close to this option.
We saw this most clearly with our physical therapist, Mel Hoffman’s, departure. On her final day, she made the rounds to the thirty or so patients she had befriended in her daily physical therapy sessions saying goodbye. Spending the entire afternoon, Mel finally came to Joshua’s bedside. After spending some time with him, she gave him a long hug and slowly turned to leave. Before Mel had taken three steps away, Joshua was screaming and crying hysterically. Any doubts I had had about his ability to understand the circumstances around him were dispelled at that moment. It was clear that he knew exactly what was happening. With a heavy heart, Mel went back, picked him up and rocked him for ten minutes while he cried, wetting himself in the process. Eventually she handed Joshua over to another one of the staff, stood up and walked away for good, but it was clear that neither she nor Joshua would ever be the same. Two worlds, brought together for a short while by a common hope were sliding apart once again by their uncontrollable fates.
Much like Joshua, Haiti is in transition, reluctantly being handed over to those who will have to care for its long-term development. Indeed, despite the contributions of so many from around the world, healthcare in Haiti will inevitably have to become Haitian once more. But the international community needs to do more to ensure that this transition takes place effectively and responsibly. Haiti can’t afford to be left behind again. Despite the questions that remain for Haiti’s future, the strength of its people remains resolute, shown most clearly by Joshua. As Mel hugged him one last time before walking out of Sacred Heart and back to her life in the United States, I watched as tears ran uncontrollably down her face and Joshua, the child with little hope for a normal life in the future, wiped them away.