The House of Life: Chapter 5

This is my fifth trip to the FOTCOH clinic in Haiti. Each time it seems to hit me during the first few days of clinic just what these people must endure on a daily basis and what they must have to do to get themselves to our clinic.

Young and old alike walk long distances to get to the clinic. There is nobody dropping them at the door or there waiting with a wheelchair. The ground is rocky and uneven and is difficult to navigate, even with good legs, but they come, as there is no other option.

We helped a 90-year-old man down our road this morning. At first he refused my arm to lean on. Earlier he had told another team member he could make it himself but it would just take some time. Young mothers come with babies or children in tow with nothing but a towel to dry themselves and shield their children from the hot Caribbean sun.

We had several sad cases today. A woman who everyone thought was eight months pregnant actually had other issues causing her abdomen to swell. The medical team all discussed her condition, which, as a non-medical volunteer I mostly did not understand.

 What I did understand, loud and clear, was this woman would die soon, and there was nothing that could be done for her because of where we are: Haiti.

–Paul, Non-Medical Volunteer
January 2012

 

*

 

After five years of working with Father LaBourne, Dick began to feel out of place.

When he arrived in Marigot in early 1984, he knew before the trip was over he would need to discuss with Father LaBourne how he felt. He didn’t feel he was serving much of a purpose anymore. He enjoyed working with Father LaBourne, and, for a long time, he thought that he was playing an important role. But as the years went by, he knew he could be doing more. He wasn’t overworked by any means. In fact, the opposite was true—it came to a point where he felt like not much more than a guest returning to Haiti to eat other people’s food—food that Dick thought should have been feeding Haitians who needed it more than he did.

He didn’t want to come to Haiti anymore unless Father LaBourne could give him something to do that was worthwhile in a different way—in a more lasting way. He loved being in Haiti and working with the Haitian people, and he wanted to continue to serve them, but he needed to know that he was helping their lives in a more sustained way.  

He waited until the last day of his trip to talk to Father LaBourne. Dick assured him that St. Anthony’s would continue to send funds to St. Dominic’s, but he didn’t want to come back to Marigot without a new spark of purpose. He asked Father LaBourne if he had any suggestions of something else he could do. To Dick’s surprise, Father LaBourne didn’t think for long. He asked if Dick had noticed how many Haitians were sick in St. Dominic’s Parish. Dick answered ‘yes’—of course he had noticed. He had seen a lot of sick people over the years. Dick had met people that he knew were suffering from malnutrition, diarrhea, and tuberculosis. He saw a lot of people with colds and bad coughs. And to make matters worse, no adequate health care facility existed near Marigot for Haitians to rely on. The only public hospital in the Sud-Est department was the St. Michel Hospital in Jacmel, which was lacking in many ways as a health care facility. It was dilapidated, dusty, and unsanitary, and it did not have proper equipment or medical personnel. And what’s more, even in a medical emergency, it was, and is, required to pay for treatment and medications in advance. If a patient needs to stay overnight at the hospital, it is up to family members to bring food—otherwise, the patient will go without eating while in recovery.

            “Is there any way you could come back to Haiti with doctors?” Father LaBourne asked Dick.

Dick paused for a moment, not knowing how to respond. He had no experience in the medical field or with medical professionals. He honestly had no idea if it was something he could do. But Dick was in awe of Father LaBourne’s suggestion, and he was excited by the possibility of a new venture. He told Father LaBourne he wanted some time to think about his request. He had tough questions to consider if he was going to figure out how to bring doctors to Haiti.

Dick left with no concrete plans to return, but with a new mission in mind.

 

*

 

Father LaBourne had given Dick a challenge—a big one. Although he was ready to take on a new task, the request had not been what he was expecting. But despite his reservations, Dick thought this could be exactly what he was looking for—if he could get doctors to come to Haiti with him, he might just be able to help the Haitian people for the long term.

First came the matter of where to start. At home, Dick talked to Barb about the new plan, and she confirmed what he already knew—they didn’t have any ties to the medical community in Bartonville. They did know of one nurse who worked at a local hospital, however. They had met her through church, and although they didn’t know her well, Dick figured it was worth trying to speak with her.

As luck would have it, the nurse knew a resident who had been to Haiti previously with a volunteer medical group, and she offered to put Dick in contact with him. Dick didn’t waste any time getting in touch, and, after listening to his plan, the resident agreed to accompany Dick to Haiti. Without much convincing, Dick had secured his first medical volunteer ever.

From then on, Dick dedicated his free time to recruiting volunteers. He talked to anyone who would listen. As a deacon, he went on a weekend retreat with a women’s group where he mentioned his need for medical volunteers. From that, two nurses agreed to join him. As word got around that Dick was looking for medical personnel to work with him in Haiti, a second resident agreed to sign up for the trip. During another church-related meeting, Dick recruited a non-medical volunteer, an ex-Marine from Peoria, to help with carrying supplies, cooking, and cleaning.

Although Dick was enthusiastic about the willingness of people to participate, he was also forward with the new volunteers about what to expect in Haiti. He wanted to make sure they understood he couldn’t make too many promises. Since he had never done anything like this before, he didn’t know exactly how it would work. He knew the team would have a place to stay and cook food. Father LaBourne had offered the parish hall of St. Dominic’s Church to host the clinic. Otherwise, Dick didn’t know what it would be like for them. He couldn’t make any guarantees about the process of treating Haitian patients, or what particular illnesses or injuries they might encounter. They would have to bring all their own supplies, their own medicine, and whatever equipment they might need. They would have to make educated guesses about what to pack—additional supplies would not be available. The team understood they would be limited, but everyone was ready for the challenge.

Once the team had been recruited, it was time to start collecting supplies. Dick and Barb talked to the St. Anthony’s congregation about the new medical mission, and church members started bringing in donations. People purchased pain relief medication for the team to take with them to Haiti. They bought bandages and wound dressings to give to Dick. They purchased vitamins and toothbrushes and soap. Dick remembered receiving a donation of five thousand antibiotics from a local doctor, which at the time he thought was a tremendous amount. (He would come to find out that it was not that much at all.) After months of collecting donations, everything that was donated fit into six flight bags.

Deemed the “St. Anthony’s Medical Mission,” the team in the end consisted of two residents, two nurses, and two non-medical volunteers, including Dick. Dick called Father LaBourne to let him know when they would be arriving in Marigot. Father LaBourne promised to get the word out to the community so the Haitians knew when to come to the parish hall.

The team arrived in Marigot in January 1985. It was exactly one year after Dick had last left Haiti.

*

 

The team’s plan was to be in Haiti for one week and to see as many patients as their limited resources would allow. But just as they arrived in Marigot and began to unpack their supplies, they ran into a problem. Father LaBourne told Dick they were required to get permission from the Department of Health to treat people at the clinic. He had only found out the previous day—having never worked with a medical team before, he didn’t know a permit was needed. He and Dick left the parish hall to meet with the medical director at the Department of Health in Jacmel. The team waited nervously, wondering if all their efforts preparing were lost.

Fortunately, after only a short wait to see the medical director, Dick and Father LaBourne were granted permission to treat patients. They returned to the parish hall with the newly issued permit and told the team the good news—they would be allowed to start seeing patients the next morning. They had only lost one day. Although it was a minor setback, it made for an important lesson learned for future trips, and it was the beginning of the established relationship between Dick and the Department of Health—each time he was to return to Haiti, for many years to come, he was obligated to ask for a new permit.

The team woke up the next morning anxious to get to work. They starting setting up the clinic in the parish hall, which wasn’t too difficult considering the small amount of supplies they had. They used wooden benches from the church to create a waiting area and placed boards on top of sawhorses to make exam tables. Since the parish hall did not have separate rooms, the team pinned sheets to strings that were then hung up across the room, creating exam rooms to give patients a small amount of privacy. Dick had arranged for William Penn to translate for the team. Since he couldn’t translate for everyone by himself, he recruited his brother, Churchill Penn, as well as two other local Haitian men to work with the medical team so that each volunteer had an interpreter alongside them.  

Dick was looking forward to the day too—but his excitement was mixed with trepidation. Though he was confident he had assembled a capable team, he was less sure of his own ability to oversee the operations of a medical clinic. Adding to Dick’s anxiety was the realization that news travels fast in Haiti, and the number of Haitians that showed up to the clinic was astounding. Father LaBourne had more than gotten the word out. When the team was ready, Dick opened the doors to the front of the parish hall, and he saw hundreds of people eagerly waiting outside, crammed against the walls of the parish hall, all trying to get into the building at once. Taken aback by what he saw, Dick reflexively slammed the doors shut. He had not anticipated a large crowd at all. He suddenly realized that the logistics for the clinic were not going to cut it with the number of people that had shown up. How was he going to decide who came in and who stayed outside? How was he going to determine who should be seen and who shouldn’t? He was starting to panic. He knew he had to figure something out, and fast.  

 

Dick came up with a plan. The parish hall didn’t have just one set of doors—the building had six sets of doors surrounding all four sides. He started by opening one set of doors and choosing which patients would come in first. He then closed those doors, and gave the medical team some time to see the patients that had been brought in. While the doors were closed, people pressed tightly against them, waiting for them to open again. But Dick didn’t open the same door twice. He opened a different set of doors, and found a much smaller group of people waiting. As he moved around from one set of doors to another, no one knew which doors to crowd around, giving Dick a chance to pull in a few people at a time before quickly shutting the doors again.

The clinic ran slowly, and was not terribly efficient at first. The supplies the team had so diligently collected for the trip turned out to be not nearly adequate. They had no way of testing patients, so it was difficult to treat anyone unless the ailment was obvious, like a visible injury. Otherwise, if a patient didn’t know exactly what was wrong or how to describe their condition, they could not be treated. Because of limited equipment, medications, and medical supplies, the team spent most of the week taking care of colds and treating minor wounds. They were able to do suturing and provide vitamins, and they could hand out pain relievers and prescribe antibiotics. But they were unable to treat diabetes, or to treat hypertension or asthma—conditions that they were seeing a lot of. Medically speaking, everything the team treated was simple. They could do so little relative to how many people needed treatment, which discouraged Dick greatly. By the end of the week, the team had seen just over five hundred patients. The medical mission overall had been trying—a test in itself.

Dick was frustrated. The first clinic had been incredibly hard for him. So many people were in need that it was difficult to feel as though they were doing any good. But he had seen that the team had been able to provide some treatments for the patients throughout the week and that gave him the confidence not to give up. He left Haiti knowing he had to go home and grow the team, and bring more medications next time. He felt that the only other option was to let the medical missions die. And Dick wanted to grow. He would take what he learned and put it into use for planning for the next year. He had faith that he could make it work better, and he was determined to improve the medical team’s operations before returning to Haiti.

 

*

 

Once Dick got back home, he went straight to work expanding the medical mission—this time, with a better understanding of how to prepare. He worked to collect medical supplies and medications for the following year. Items that weren’t donated to Dick that he knew the team would need, like additional bandages, gauze, tape, rubbing alcohol, swabs, and thermometers, he and Barb raised money to purchase. Dick recruited a few new volunteers, and some of the members of the first team signed up to return. By the time they were ready to leave for Marigot, one year after his first trip, Dick’s team had grown from six to eight members.

The second medical mission team arrived in Haiti in January 1986. As the volunteers worked to convert the parish hall into a medical clinic, Dick went to the Department of Health to get a permit. Although they had collected a much larger amount of supplies than the previous year, once the team was set up and prepared to see patients, they found that all the medications they had brought for the whole week fit onto one single table.

By the time Dick returned with the permit a few hours later, the crowd had already started to gather at the hall, and he could tell immediately that it was even bigger than it had been before. It was amazing. Hundreds of Haitians stood outside waiting for the doors to open, anxious for the opportunity to be seen by a doctor or nurse. Luckily for Dick, he had anticipated the large crowd. On top of hiring interpreters to work with the team, he had also hired a few additional Haitians to guard the doors of the hall so the team would have more privacy. And, hopefully, the added staff would mean that Dick could better manage the flow of the patients coming in and out of the clinic.

As the week went on, Dick and the team became more aware of typical ailments that affected their Haitian patients—scabies, worms, hypertension, diabetes, and machete wounds topped the list. The team was better prepared to treat some of the conditions than they had been before. The first year, they did not have medication to treat scabies, but having seen how rampant it was, they brought enough scabies medication to treat every child that was seen at the clinic, which was, in itself, a big process. Back then, in the early 1980s, scabies wasn’t treated with a liquid dose of medication—treatment involved washing each child with a special ointment. So that they could wash the children in the parish hall, the team set up baby pools as washing stations.

 

But some of the ailments the team saw they were not completely prepared to treat. Although they had brought bandages and ointment to care for wounds, no one expected to see as many burn wounds as they did, and many were extremely severe. Because Haitians mostly cook outside over open flames and because the pots of hot water or hot oil for cooking are exposed and low to the ground, they are prone to tipping over, spilling onto those who are cooking or, more often, small children who have wandered too close to the fire. The team also hadn’t anticipated seeing so many machete wounds—deep cuts on the body and severed ears and fingers from men working in the fields. Some of the cuts were so old they had healed themselves, leaving permanent and intense scarring.

 

Dick took notes every chance he could on how to further develop the clinic. He was constantly thinking about what he could do next time to be more prepared. He was gaining knowledge from the medical standpoint, but his biggest struggle was still maintaining control of the crowd. Even with help from additional Haitian staff, he was still having a difficult time regulating the flow of patients. It was no longer a matter of how they were entering the building—it was more of an issue deciding who entered the building. It was not an option to see everyone who needed to be seen, let alone everyone who wanted to be seen by a doctor. Dick tried his best to choose those who needed help the most first, but so many people fit in that category—the elderly and mothers with their small children, pregnant women, the injured, the sick, those with burn wounds. Those who had been in motorbike accidents, those with machete cuts. Those with chronic illnesses, those who had never seen a doctor in their lives, those who were so ill that even Dick knew a doctor would not be able to help them.

 

 Outside the parish hall walls, it just seemed as though the crowd went on forever and ever.

 

*

 

 

By the time Dick returned to Haiti the next year he was fortunate enough to establish a relationship with a group in Jacmel that could offer him assistance with the clinics—the Missionaries of Charity. The Sisters of the Missionaries of Charity ran a hospice facility. It was a sad place, but a welcoming facility, and the Sisters took care of patients as best as they could. Sometimes Haitians stayed until they died, and sometimes they got better and were well enough to return home.

 

Dick reached out to the Sisters after a severely malnourished child came to the clinic and the team was unable to help the boy—they simply would not be in Haiti for long enough to treat him properly. Dick thought maybe the Missionaries of Charity could assist him. They agreed to take the boy right away and made sure he was treated properly for malnutrition. From then on, Dick took patients to the Sisters when the medical team couldn’t provide for them, something that was incredibly important to him. The Sisters were also kind enough to offer to work as translators for the medical team.

 

 Dick loved the Sisters with a passion. He thought they were lovely people, and he was grateful for their willingness to work with him and the team. He would leave St. Dominic’s Church early in the morning, before the clinic started, to pick up two or three Sisters and bring them to the parish hall. The Sisters would translate for the day, and then he would take them back home. Whenever the Sisters were in the car with Dick, they all sat in the back seat together, lined up shoulder to shoulder, and they prayed, rosaries tightly clenched in their palms, eyes shut, as the car bounced up and down the road.

 

Dick owed his relationship with the Sisters to the head nun, Sister Patsy. Sister Patsy was from India and was a deeply spiritual person. Down to earth, she possessed a quiet confidence Dick notice almost immediately. He thought that Sister Patsy was a jewel. For him, she was the epitome of what Mother Theresa inspired nuns to be—he had nothing but the highest praise for her. And for her part, Sister Patsy was impressed with what Dick was doing in Haiti to help the poor. This mutual admiration allowed the pair to grow close quickly. It got to a point where Sister Patsy trusted Dick so much that she told him he didn’t even have to call before bringing in sick patients.

When Sister Patsy left Jacmel a few years later, she first relocated to Port-au-Prince to a much larger facility. The new position was more dangerous and taxing on Sister Patsy. Eventually, she went back home to India. The head nun that succeeded her was, unfortunately, not as willing to work with Dick, and she did not allow him to bring patients to the Sisters anymore. Dick’s relationship with the Missionaries of Charity dwindled, but Dick never forgot how much they had meant to him under Sister Patsy.

 

 

*

 

 

 

            Dick found that trying to get the medical teams in and out of the country could sometimes be scary. During the 1980s and into the 1990s, militia forces controlled specific areas of Haiti, and a few times he was worried about the situation he was getting the team into. But nothing compared to the time Dick got an Uzi held to his belly at the airport.

 

As usual, the team had been stopped while going through customs to have their bags searched when they landed in Port-au-Prince. But this time, customs officers confiscated all of their bags immediately. Dick didn’t even know it was happening at first—one of the volunteers came over and told him that all the supply bags had been taken. Dick looked over to see an airport security officer walking away with the team’s medications. He became distressed. He ran over to the officer and asked him where he was going. The officer didn’t respond—he kept walking. Dick caught up with him again, just as a Haitian military officer intervened by sticking a gun in Dick’s gut. Dick threw his hands up in the air and started to back away. He told the officer he understood that he needed to back off, but he had to have those bags. Without the medications, the clinic could not function. The officer said the bags had to be searched more thoroughly. Dick frantically asked when they would be returned. He was told to come back the next day and talk to someone in the customs office across the street from the airport.

 

Dick was furious about losing a whole day of seeing patients, but nothing could be done. He would have to wait. He made arrangements for the team to stay at a guesthouse in Port-au-Prince. The next morning, he was at the customs office the moment the doors opened. Immediately, he was passed around from person to person, from one office to another, until finally a customs officer instructed him to sign a form, acknowledging that he was bringing medications into the country. Dick signed the paper and asked again when he would receive his bags. The customs officer pointed to another office across the hall. He entered the office and was asked to pay a fee for the release of the medications. Dick paid the fee, collected the bags, and left to meet the team. He was livid about the situation, but thankful that they were now on their way, which was what mattered in the end. So many Haitians relied on the team, and Dick couldn’t begin to think of letting them down.

 

*

 

Martin returned to Haiti with Dick when he was thirteen years old—this time as a medical mission volunteer. Dick and Barb’s other children, although supportive of what they were doing, were older and had made lives for themselves that kept them busy with work and family. It wasn’t easy for them to take time to travel to Haiti to see what Dick and Barb were so involved with—Barb with her fundraising at home and Dick leading the medical teams. It was nice to have Martin along. Dick was glad he would have an opportunity to see how the clinic was functioning and how different Dick’s work in Haiti was since the last time Martin was in the country. Unfortunately, since the trip was not scheduled during a break in school, Barb couldn’t leave, but she did let Martin go—under the condition that he would still do his homework while away.

Martin did whatever Dick asked of him, and although he wasn’t allowed to get involved with any major medical cases, he did everything the team did, except drink rum, of course. He packed vitamins into bags to be given to patients. He helped prepare food. He also helped set up the clinic each morning and clean up at the end of each day. Martin made new friends with some of the Haitian children who came to the clinic and also got to visit with some of Father LaBourne’s children, who he had befriended on that first trip to Haiti. Martin was, and still is, the youngest person to have volunteered with the medical team.

 

*

 

One morning just after the team had finished setting up, a woman came to the clinic with her head wrapped in a turban. She said she had been having headaches recently, so Dick brought her in to see a doctor. The doctor removed the turban and found an enormous growth on the side of the woman’s head. After examining it, the doctor decided it must be removed—it would be a minor surgery, but an important one for the woman’s comfort.  

The team weighed their options—they could take her down the road to the St. Michel Hospital, but there was no guarantee that medical personnel would be available to perform the surgery. They could send her to Port-au-Prince, where better medical services were more likely, but it was a long distance from Marigot, which would make it difficult to ensure that the woman was treated properly. It would also be more expensive to send her so far away. Or, a third option was that the medical team could perform the surgery right there at the parish hall.

The team was comfortable handling the procedure itself. They had the supplies and medications to do so, but they had one big problem—it was much too dim inside. The team went outside and looked around the building to see if another location would offer sufficient light and space. Right next to the hall was a cornfield. The field was not densely packed—it was full of cornstalks, but the rows had a few feet of space between them. It was an unorthodox option, they knew, but not only would the field offer enough room and sufficient light, but the cornstalks would provide a little privacy.

The volunteers brought out two wooden benches from the hall and set them down side by side in the cornfield. A sheet was laid across the bench, and the woman lay down on top. As the doctor and nurses prepared for surgery, a Haitian interpreter stood close by, fanning the woman to keep flies away. She received local anesthetic and remained awake for the surgery. A few hours later, after the growth had been successfully removed, the doctor wrapped her head. A short rest later, the woman said she felt fine, and she was sent home, with the request that she return one more time before the team left Marigot.

The woman came back to the parish hall a few days later. She was recovering well from the surgery and was able to leave the clinic without her head wrapped in bandages, and without the need to wear a turban. Before the team left Haiti at the end of the week, Dick saw the woman once again, walking down the street in Jacmel. She gave him a big hug, a huge smile spreading across her face. She was elated to no longer need to cover her head, and it was all because of the medical volunteers.

            Dick was proud of what the team was able to accomplish—in a few years, they had gone from not being able to do much, to being capable of handling small surgeries and finding ways to treat people that they previously thought not possible. And it was making a big impact on the lives of their patients. Dick was even starting to see returning patients. He felt that meant the Haitians trusted them, and that made him greatly appreciative of the team’s efforts and the good work they did.

Dick and Barb knew that they owed everything to the volunteers. People who were strangers to them were signing up to go out of the country with Dick, and trust him—even though he didn’t have a medical background. They were willing to sleep on the floor in sleeping bags, carry their own gear, and pay for their own flights. They agreed to work in an environment with little privacy, not knowing what kind of conditions they would be treating ahead of time or what patients they would see. Every day was a mystery, but the volunteers rarely got frustrated by the unknown. They never seemed to get overwhelmed by how many people needed to be treated—they simply did as much as they could for as many Haitians as time would allow, finding satisfaction in knowing that the work they were doing was truly helping. And, over time, it had become apparent to Dick, without a doubt, that the medical teams were making a difference in Haiti.  

 

*

 

Just a few days after the surgery in the cornfield, a Haitian man was brought into the parish hall complaining of chest pains. Dick could tell the moment he saw the man that he was in bad shape—he could not breathe well, he was sweating badly, and he could barely walk. An examination determined he was experiencing congestive heart failure. He urgently needed to be taken to a hospital.

Father LaBourne was out for the day, which meant the team did not have access to a vehicle to transport the ailing man. Dick asked William Penn to call an ambulance. Calling an ambulance in Haiti is not like calling an ambulance in the United States. In Haiti, ambulance drivers have to be paid in advance, or they will not take a patient with them. Dick told William Penn he would take care of the cost—he just hoped an ambulance was available.

Not much later, William Penn returned to the parish hall and told Dick there was an ambulance at the hospital and it would arrive soon. In the meantime, the team tried their best to keep the ailing man comfortable. He desperately needed oxygen, but they didn’t have any to give him, so they used a piece of cardboard and fanned him to try to give him air.

Almost two hours went by before Dick heard the sound of a van pulling up to the parish hall. He was relieved initially, but when the ambulance drivers did not come inside a few moments later, he was confused. He figured the drivers must have gone to the rectory to check in with the church staff. Dick continued to wait. The drivers still didn’t appear. Fed up, he walked up to the rectory to find out what was keeping them. He found the two men sitting down eating in the kitchen. Lorriane was feeding them, and it didn’t seem like they were aware of the emergency at hand.

Dick told the men they needed to get to the parish hall urgently—a man was dying. But the drivers did not get up from their chairs. They continued to eat, seeming annoyed by the interruption of their meal. Dick became irate. He walked over and grabbed the back of one of the chairs and pulled it away from the table, forcing the driver to stand up to avoid falling to the floor. He tossed the chair down, and stormed out of the rectory. The drivers now knew Dick was serious, so they followed him, leaving their food behind. The man was on his way to the hospital just a few minutes later.

Two days later, Dick went to visit the man at the hospital to see how he was recovering. When Dick entered the recovery room, instead of seeing someone who was unable to catch his breath, he saw a man who was alert and, though weak, was chatting with his family. When the man saw Dick, his face lit up. He shook Dick’s hand rapidly, grasping it with both his palms. He thanked him over and over. He was so grateful the volunteers had made sure he got to the hospital. Without the medical team’s help, the man would not have survived.

            Though Dick and the entire team were thankful for the positive outcome, the situation had made everyone, especially Dick, more aware of their naiveté about doing business in Haiti. He realized that just because “ambulance” signaled emergency in the United States, didn’t mean it did in Haiti. He felt softer toward the two drivers—just because they were driving the ambulance, didn’t mean they were trained to expect an emergency.  Dick knew he didn’t want another lapse like that. He made up his mind: If he was going to continue to have successful medical missions in Haiti, he’d have to learn to think like a Haitian.