The Better Side of Haiti


   By: Dr. Matthew Fisher

   2013-01-28 03:01 PM

The Haitian people have had a difficult and troubled history since they were first taken from Africa as slaves by Europeans in the early 1500s. Since then they've faced almost continual hardships as they were enslaved by colonial powers, fought for their freedom, suffered from disease and poverty, and endured challenging governments who showed limited interest for the citizens' welfare. On January 12, 2010 Haiti suffered a devastating earthquake with an estimated death toll of over 300,000. The capital, Port-au-Prince was leveled and 1 to 1.5 million Haitians were left homeless. Many more people died from starvation and disease in the earthquake's aftermath. The earthquake dropped Haiti's 2010 life expectancy down to 30 years from a previous average of 60 years. In June of 2011 and 2012, I had the privilege of being a member of teams providing medical and dental care to residents of the second poorest neighborhood in Port-au-Prince. Since the media tends to publicize tragic and negative events, many positive accounts of the Haitian people and their lives have gone unreported.  This is an attempt to provide some insight into the positive side of life in Haiti, and into the high quality of character that persists in many Haitians despite the immense suffering and tragedy they've experienced.

There are several things that are quite striking when one initially arrives in Haiti.  For me these were the severity of the poverty, the intensity of the heat, and the quality of the Haitians' appearance. They tend to be very well groomed and wear clean clothes in good repair. This is especially impressive when you consider our patients' typical living conditions. Their homes have dirt floors, tin roofs, and plywood, tin, or occasionally cinder block walls. There is no running water and only a few homes have electric lighting. Water is hauled by hand from wells, clothes are hand washed in tubs and air dried, and food is cooked over coal fires. No one has access to showers, and washroom facilities are the outhouses scattered throughout the neighborhood. Add on top of these challenges a climate with oppressively high daily temperatures of 40-44°C, substantially hotter even than in the neighboring Dominican Republic. In spite of these obviously significant barriers, even the poorest Haitians maintain a dignified appearance. Men wear button-up shirts and dress pants, and women wear brightly coloured dresses. This contrasts sharply with North America where people with the best sanitation facilities in the world within their own homes may appear in public with ill-fitting, torn, worn, or stained clothing. And while appearances are only external, it's even more impressive that the Haitians' mannerisms emphasize the dignity and respectability they demonstrate outwardly.

The most striking thing about actually interacting with Haitian patients is the high quality of their personal manner. Inherent to their presentation and behavior are the qualities of humility, respectability, patience, and gratitude. The Western world could learn an important life lesson from the humility of Haitians. Many people in the West live in a state of competition and are often consciously or subconsciously trying to demonstrate their superiority over their neighbor. This is apparent in our society's drive to acquire and be recognized for buying a luxury model car, a larger or nicer house, updated home decor, the latest fashion trends, or to improve one's appearance and so on. North Americans often talk about how much money so and so has, and about whose business and investments are most profitable. In stark contrast is the humility of the Haitian people. Talking with them makes me evaluate myself and my society and realize how empty our superficial material pursuits are. More importantly, their soft-spoken attitude and gentle, unassuming nature makes me realize how destructive and base is the pride and arrogance which is so prevalent in the first world. Humility makes people teachable and receptive to helpful suggestion. Pride and arrogance are inherently self-deceiving and prevent people from even realizing how poor and decrepit their character actually is. And although our team went to Haiti to give, through the Haitians' character we all received and learned much more than we gave. I certainly learned a lesson about what quality of character really looks like.

One of the great joys in providing medical care in Haiti is working with people who are patient and well-mannered. Patience is another virtue Haitians possess far in excess of any other group of people I've encountered. In order to get into the clinic, they stand in line in 44°C temperatures for 2-3 hours.  When they get inside the clinic, they wait 30 minutes in triage and then another 30-60 minutes before they see a physician. Not one of my patients complained about how long it took to see the doctor. The sense of entitlement and self-centeredness so prevalent in North America is nowhere to be found in Haiti – and it's wonderfully refreshing! Instead, people are grateful to receive something as simple as a supply of Tylenol to treat their headaches or joint pain. It's even more remarkable that children from infants up to teenagers wait this whole time in the oppressive heat without food or water, but still don't complain or act out. Instead they are quiet and exceptionally well behaved. How often in North America does a physician go into the exam room where a mother and child are waiting and find the child opening cupboards, playing with expensive medical equipment, throwing toys around, or being disruptive? I didn't see anything resembling this type of behavior in Haiti. Furthermore, not one Haitian child even so much as whimpered when I examined them. I have no idea what their secret to child discipline is, but I suspect it is concomitant with the respectful and dignified character that is prevalent among the Haitian people.

If the character of the Haitian children is an indication of Haiti's future, there's plenty of reason for hope. One memorable example was when a team member gave a group of children his digital camera.  He doesn't speak Creole but the children indicated through gestures that they wanted to use the camera.  They loved to press the button and see the picture appear on the screen. So this group of about ten children, all of whom live in abject poverty, disappeared into the neighborhood with the camera.  Much to our surprise (no one expected to see the camera again), the children returned an hour later with the camera full of pictures of themselves and the community. Contrast this with the fact that I've had two cheap bicycles stolen from my backyard in a little over a year, in a country where the children lack nothing. The creativity and joy of the local children in Haiti was contagious, and by the end of our time there we couldn't help but play with them after clinic. Some of them have fungal or parasitic infections, but in spite of this they are full of joy and love to sing, dance, and play creatively with anything that may be at hand. They have no toys, they live beside an open ditch full of rank raw sewage and garbage, they wear only worn out sandals on their feet, but they can make a game out of anything and are overwhelmingly positive.

In spite of the obvious struggles Haitians experience in their daily lives, they have been strengthened by hope to overcome their afflictions. I didn't have one patient in Haiti who hadn't lost a spouse, child, parent, or close friend during the earthquake.  Many had lost several. Many of those who survived were pinned under rubble for a period of time and suffered permanent physical impairments. The stories are varied but all tragic. One woman brought her daughter who was burned on one side of her face and body when the boiling stove pot landed on her during the earthquake. An elderly gentleman, blinded by cataracts, came in for pain medicine because a cinder block landed on his neck while he was washing during the earthquake. An elderly woman walked 4 kilometers in 44°C temperatures with a blood pressure of 250/150 to receive treatment for her hypertension. But the light of the people's hope and strength illuminates even the darkest of experiences. Although there is much sadness, it somehow coexists with thanksgiving and gratitude for what wasn't lost in the earthquake. Their strength and courage in the face of adversarial forces of emotional and physical suffering, poverty, and loss is both astonishing and powerfully encouraging. The population's resilience and determination have grown proportionately to compensate for the lack of what they have been given in life. Not one person complained about the life they had been given, and all demonstrated hope and optimism for the future.  The young Haitians we hired to translate for us provide many examples of the beauty and power of hope. Most of them are from poor families but endeavor to better themselves by working to pay for schooling, and learning English in order to gain employment. Many of them live in the hill country around Port-au-Prince and travel 2 hours each way on foot and by bus, in the heat, to work at the clinic.  One young man taught himself Chinese using Google translator. Another managed to learn English without any schooling. Many of them have no idea how they will pay for schooling in the future. But they still talked with passion and conviction about their dreams and plans to better the lives of themselves and their families through education and a career. This dedication to personal and community growth against all odds is inspiring and moving. If suffering produces endurance and perseverance; perseverance, character; and character, hope; Haitians are clearly the beneficiaries of character and hope in abundance.

As members of the wealthy western world, we tend to deal with life superficially by centering our lives around material pursuits. Haitians subtly demonstrate a maturity that comes from too much experience in dealing with a harsh reality of human existence: the struggle between life and death itself. Even children in Haiti have developed a sense of maturity and community that far exceeds the North American norm. It was not uncommon for 14 and 16 year old girls to bring in their ill 6 year old neighbors and cousins for treatment. Haitian families have responded to the epidemic of orphans left by the earthquake and disease by taking in and caring for their extended family members. These early teenage women took full responsibility for learning the proper medication dosing and treatments of their sick relatives and neighbors. This practice of voluntarily becoming your neighbor’s keeper was manifested in many other situations during our time in Haiti. I met several people who manage orphanages for children who lost parents in the earthquake. This is done completely out of love, because they will never receive any profit or material benefit from this work. Our translators regularly advocated for people. One day my translator went out into the street and brought to the clinic for treatment a woman who had been beaten by her partner. Another day he made contact with a young girl on the street who had a severe urinary tract infection. He advocated for her to be treated after we had already closed the clinic – and may well have saved her life! We spent one day seeing patients in a rural area outside Port-au-Prince and were short two translators in this location. Without being asked, an unemployed young man living in the community volunteered to spend the day translating for us, and asked for nothing in return. I made several friends who although they are poor themselves, regularly spend their weekends distributing their own food and hygienic supplies to hungry local children, and to the inmates in local prisons. Our clinic itself was set up, organized, and secured by twenty or more Haitians who worked for free even though they struggle to find employment in the fractured economy. This generous attitude and selfless giving of care, food, and love to one's neighbor has undoubtedly kept post-earthquake Haiti from being in a far worse condition than it is today. 

In summary, the Haitians are beautiful people. They embody a spirit of humility, joy, gentleness, love, and hope. Many of the vehicles and building walls are painted in bright colours and are adorned with messages of hope and optimism. In spite of the obvious devastation in Haiti, messages of 'Merci Dieu' abound on the sides and windows of many of the 'tap-tap' buses. Although they are materially poor, many Haitians are rich in their positive attitude, gratitude for what they have in life, and hope for the future. Unfortunately, it is the violent and criminal actions of a minority who have given Haiti a reputation in the media of being a dangerous place. Obviously the statements made and examples given here are generalizations and therefore don't apply to everyone. But in my experience they accurately represent the norm of the common people in Haiti. The suffering I witnessed was eclipsed by the beauty of the people's spirit, and our time with the Haitians was life-changing. I left Haiti both times having learned many valuable life lessons, and feeling full of joy, thanksgiving, and hope.

M. Fisher, B.Sc., M.D.

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