By Tim Plaut, MD
August, 2008
“God Bless you for what you do.” “It is amazing that you folks do this.”  “Those kids get so much out of what you do….” I hear these types of quotes frequently from folks who know about my trips to Haiti with Asheville’s Mission Manna.

I have been to Haiti four times now, with medical groups from western North Carolina, on mission trips that focus on hunger and providing medical care for children in the region of Montrouis, about 2 hours north of Port au Prince.  At first it was an adventure, a chance to “do some good” and explore a country that I had never seen.

Sure, I knew that Haiti is a poor country but having grown up in Appalachia and traveled the world while in the Navy, I had seen poverty before. I had seen kids with stunted growth before in Tunisia, North Africa, while helping build a school as part of a US Marine Corps good will mission.

But I had never seen kids dying from simple hunger up close before. I had never imagined the sight of a child scooping water with his hands out of a refuse filled ditch, while a donkey urinated in the water he was drinking. Who in America can imagine a “tradition” called Te, where the mother mixes spice in a dirt cake to feed her children at bedtime to quell pangs of hunger?

The first time I came home after a week in Haiti, (which, by the way, is a mere 2 hours by plane off the coast of Miami), I was so angry at the unfairness of it all that my wife had to ask me to stop telling the kids not to complain, to settle down, to in effect “get off my high horse” and live happily with the life I have here.

If it was so bad, why do I continue to go and look forward to the next trip as soon as I get back? I think everyone who has made trips like this and continues to do this type of work ask this question of themselves.

On the way home, our group arrives back in Miami en route to North Carolina. We all share a kind of high, a quiet appreciation for a job well done. There is a discussion of certain cases we saw, remembering the tragic and reflecting on the good. And it never fails, eventually someone says something like, “I think I got more out of this trip than I gave.” This gift is hard to describe but we have all felt it, an inner sense of calm. An enrichment of the soul. A return to the basics.

We go to Haiti with the idea that with all we have here in America, all the blessings and gifts we were lucky enough to be born with , that it is time to give back. There is a conscious choice to leave our families, sacrifice a week’s worth of income, and spend a large amount of money to go to a sometimes dangerous place to help people we don’t know.

We do it because we can make a difference, however small in this big world of ours. We see many of the same kids every time we go, keep records on their growth and health status, provide AK-1000 and provide worm medicine and vitamins to each child we see, usually between 1,000-1,200 per trip. We do it because we can; in America we have the resources, will and determination to help the poorest of the poor. We volunteer and head out on that first trip to the unknown with the gusto and zeal of conviction, conviction that we are blessed, lucky, and it is time to pass our gifts on to less fortunate folks… and the next year we come back.

We return because of the love. Love for these incredibly dignified people, who persevere though drought and famine we can only imagine. Love for the children who start out so afraid of these white people but quickly trust us because their parents do. The love that develops within our group, the volunteers from America and Haiti, that carries us up the mountains when the tap-tap breaks down and we have to hike in. And mostly, the love we are given. Each trip brings more hugs from friends we have made and the kids who remember us from last year. It is a basic human need to be appreciated and we leave Haiti feeling fulfilled.  For all the sacrifice we make on these trips, the Haitians sacrifice more. They make sure we are fed, when they have nothing to eat. They make sure we have a place to sleep (like a church in the mountains), when they sleep on the dirt. They make sure we know how much we mean to them. I just pray that they know how much they mean to us.

By Margaret Ida Lozier

During a recent visit to Montrouis, I was asked to see a mother and baby on the day after I arrived. My husband, Luxo, and I parked on Route National 1 and then slipped and slopped our way up a muddy quarter-mile creek bed trail to the yard where this woman lived. A wooden fence gave way to a yard of mud-cement huts, bordered by the same muddy creek that we’d encountered on our way up the hill.

Curious to see a white lady, most of the neighbors and family were by this point looking and coming to carry me, the clumsy “blan,” over the creek and into the yard. “Mesi, Mesi,” I said, thanking them profusely for their efforts before assuring them that I could handle the narrow canal. “I’m a mountain-girl too,” I went on to say. “A little muddy water won’t hurt me every now and then.” I’m always rather amused by how inept white people are thought to be in Haiti — not because we are dumb or unable, but more because we are assumed to expect very regular help at the inconvenience of others of a perceived lower social order.

Nonetheless, I sought to prove to them that I too was just common-folk and so I teetered over the cracking limbs that had been laid across the water to form a bridge. I was laughing, as were those around, amused by my balancing act as I stepped over the water in tow of Luxo, who at 6′-4″ tall, all but stepped over the creek in a single stride.

In the yard, which was sloping upward at a sharp angle, were several crumbling single-roomed huts, in addition to an abundance of dirt-covered children. The children all watched wide-eyed as we entered, unaware that I was assessing the degree of their malnutrition as I made my greetings. Precious as they were, their red hair and swollen bellies, runny noses and mosquito scarred legs, all spoke of the poverty in which they live. So too did their mothers’ tattered clothing and bare feet. As I scanned the area for signs of where to begin, I noticed an emaciated mother and infant lying on a sheet in the far corner, the mother trying to muster enough strength to sit up.

As we made our way to mother and child, we explained that we had come to check on their condition and see what we might do to help. Managing to give a little grin and a nod, the ailing women sat with patience as we organized our supplies. Several family members came our way also, curious as to what we were about to do. After struggling to get the demographics of the mother and child correctly noted, we began talking with the family to find out more about the situation.

The 23 year old woman, Crystalline, ran through a brief history of her illness, seemingly already drained of any hope or faith that she might recover. As she told me her story, I wondered what it might be like to be in her shoes, especially given that she and I were so close in age. As the story goes, she gave birth to a son, the infant beside her, on June 9 of that year. She had no prenatal care and no problems during pregnancy but had no idea of how far along she may have been at delivery. Her son, who was born in the yard of her home on the barren island of La Gonave (13 miles across the water from Montrouis), was thought to be healthy and in good shape at his birth, however no doctor or midwife had been present to confirm.

It was about that time that she felt herself beginning to become progressively weaker in health and vitality, with worsening bouts of diarrhea, vomiting, high fevers, weight loss, loss of appetite, weakness and dizziness. Within several weeks, Crystelline was also concerned about the well being of her new son, Jamesley, whose symptoms were presenting themselves’ quite similarly. Though she reports having breastfed Jamesley for a month or more, she had stopped doing so after being told by her family that her milk was making the baby sicker, not to mention that she was too weak from not eating to feed the baby.

I listened patiently, taking note of Crystelline’s comments and the thoughts of others gathered in our midst. I checked the baby and the mom — lymph nodes swollen, dehydrated, starving and in discomfort. As I thought rather sullenly, I told the mom that what I really wanted to do was to take them (as well as another very thin young woman in the same yard who I suspected had malaria) to the local clinic. The diagnostic thoughts running through my mind were: HIV/AIDS, typhoid or some similar intestinal infection, and a lack of nutrition (and hope). At the clinic, I knew that lab work could be done. I also hoped that in the event they were chronically ill, infected with AIDS and/or tuberculosis, the clinic, funded largely by USAID and the WHO, would take efforts to make them aware of the free services and medicines they could receive on a long-term basis.

Though I confessed to Crystelline that I may be able to temporarily help with some of their symptoms, we would need to deduce what was causing both her and her baby’s decline in health. I was thankful when she readily agreed to go to the clinic and I made plans with her family to return the next morning. Praying that we could make some difference, Luxo and I slid our way back down to our car, talking about the complexity of the situation and wondering what we might find out from the clinic. Moreover, having been told by Crystelline that the baby’s father had been killed recently in a slum of Port-au-Prince, Luxo and I felt even more urgency to our task.

Early the next day in the sunny, Haitian morning, Luxo and I arrived back at the yard. We were greeted warmly and offered chairs in which to sit and wait until those we were taking were ready to go. In Haiti, going to the doctor cannot be done in pajamas and comfort clothes — it is an occasion in which people dress as formally as they might in preparation for church. To Haitian peasants, a clinic is a place where those with luck (chans as it is said in Kreyol) are able to pay to receive the medical help they need. As such, it takes great care and much time to dress and bathe those going to clinic, even when they are on their last legs of life (and may still have many miles to walk in order to get to the clinic, knowing that they may still be turned away if they don’t have enough money).

Once such preparations were made, several of the women in the family headed back down the hill with us, carrying Crystelline for short bits and trying to decide who would accompany the three ill patients to the clinic. At the road, we piled those going into the car and made it without incident to St. Paul’s Clinic on the other side of Montrouis. Once there, we had the ladies sit on the waiting benches outside the clinic and explained to the few folks we knew working there the reason we’d arrived. After paying for their registration, Luxo and I left our new friends waiting at the clinic while we headed to a nearby school to dispense worming medicine.

Later in the day, we returned to the clinic to fetch those we’d left and to make further payments for their visit and lab work. I urged Luxo to find out what the results of the visit had been, but because the doctor had already left for the day, we had wait until the next day to find out. Then, arms full of prescriptions, we all left to return to the family’s home. Encouraged by the progress made, I was hopeful when we dropped them off at their home.

Luxo and I returned to the clinic the next morning and Luxo went in to speak with the doctor about his findings while I waited in the car. A moment later, Luxo appeared, climbing quickly back into the car, looking ahead only at the road and reporting dryly that both had tested positive for SIDA (the word for AIDS in Haiti). Just as we had feared, both mom and baby have only a few years left of life, if that. As for the other woman, she had tested positive only for malaria and some other form of STD. That same day, we took food to Crystelline, some basic staples for her and the others in the yard, and various powder formulas and milk for Jamesley. We also gave the family a supply of vitamins. Crystelline told us that she had indeed been told the same thing by the nurses and doctor the day prior, and though pleased by the medications she had received to treat her secondary infections and symptoms, she was concerned about her inability to feed her child.

Listening to her troubles, her struggles with money, her living situation and her poverty was perplexing, disheartening and frustrating. I found myself unable to take it in. One must realize that Crystelline’s life is reminiscent of the reality of life for most Haitians. Within this one village, I know of thousands more families in similar situations — losing family members and children, unable to find work and/or go to school, lacking sanitation and knowledge about how to protect their health, in need of basic essentials in order to survive.

As the week went on, I got so busy with other folks and other work that I was unable to return to visit with Crystelline before I left. I was admittedly confused about how and/or if to help her and Jamesley, and now upset that I don’t know what, if anything, I could do. Moreover, as thoroughly awful as this sounds, in some ways my thoughts led me to consider that perhaps I should let go of worrying about Crystelline’s struggles because with so many other families that need help and have a better chance at survival, perhaps resources would be better expended elsewhere. This is not to say that I didn’t want to help Crystelline and her child, or to say that I didn’t have sympathy or compassion for their hardships. Simply put, this is the reality of what it’s like to deal with, understand, navigate and move forward with work in the developing world.

Despite all the sadness of this story, there is some optimism to be found. Crystelline’s story is of value to those of us who do have the resources to make a difference in more and more lives like those of Crystelline and Jamesley. This past week, I was able to work with hundreds of kids, some of whom I was afraid may not have made it this long, who Mission Manna continues to help. If it were not for the efforts of the doctors, nurses, and all of you who have given your time, talent and money to Mission Manna’s work so far, there would be far too many more stories like Crystelline’s to report. Even more, I would not have been able to afford to treat so many kids with medicines or to take sick folks to the clinic for testing and follow-ups, if it were not for people like you who are making a very real difference in the lives of individuals, families and communities in Haiti.

For all of the tears to be shed for Crystelline and her family, there is as much gratitude offered to each of you from various families in Montrouis. These are not just silent thank you’s either. They are real words of appreciation and thanksgiving that I have been asked to pass on to you from our friends in Haiti. As time progresses, I find a steady increase in such gratitude offered to Mission Manna. Because of your generosity and support, we are increasingly blessed to reach out to more and more individuals in Montrouis and its surrounding areas. We thank you for your continued support of Mission Manna and ask that you keep Haiti in your prayers.