A Night in a Haitian Hospital

I watch her umbilical hernia expand and contract with every deep inhale followed by a forceful cough. She lays her sweaty forehead down after every coughing fit, exhausted from the ordeal. Her dewy skin smells sickly sweet, almost like warm, melted ice cream. I sit with her in the tiny yellow office to hook her up to the nebulizer. Sometimes we have to turn on the generator just for her. No amount of medicine or breathing treatments will improve Sara's fever and breathing. The decision is made: we must take her to the hospital. My heart sinks at this thought. I have little faith in the quality of care provided and fear the trip would be pointless. This is not the U.S. This is a third world country with limited resources and shoddy hospitals. I am unaware of just how different it will be.

We drive through the streets of Port au Prince in our beat-up, but trusty white van. It is still light out, but the sun is setting fast. Rays of sunlight flicker in between houses as if angels are messing with heaven's light switches. We pass a street market and women are closing up shop, putting away the goods that didn't get sold. Men are hopping over puddles and trying to catch a tap-tap home before they stop running for the night. Children in rags chase each other in the streets where the sewer runs and where chickens peck at nothing but gravel. I see a pregnant woman, with a full basket on her head, squat and relieve herself in the gutter. I wonder how many times a day she has to do that.

There are some things I've grown accustomed to since being here: the absence of personal space; seeing things like people urinate in public; trash on the ground; tiny, concrete houses with corrugated metal roofs all stacked up haphazardly on a hillside. I've learned that 3 o'clock means anywhere between 3:00 and 3:59. I know the proper fair for a tap-tap ride and that refusing to pay higher is acceptable. I'm learning words and customs and that jokingly calling someone crazy is no joke at all. I've grown used to greeting people when you see them and to be warmly greeted in return. My body has mostly adjusted to the warm and humid weather, although my sweat glands have yet to catch up. Hearing children play, laugh, and fill an orphanage with song has become the familiar soundtrack of my life. Doing business with the local ice cream man from the outdoor balcony has become routine. He calls to us and stands back to see us over the gate. Some days we wave him off and other days we pass money down to the gate guard who then does the money-ice cream exchange for us. I've grown to like this ice cream that comes in a cylindrical, plastic sleeve and is very much like a fat, creamy Otter Pop. Not accomplishing a single task on my to-do list has become the rule, not the exception- and not because I was being lazy. I have come to expect difficulties and an insane lack of logic or efficiency.

I love this tiny little island and her beautiful people, but I cannot get used to the frustrating fact that there are so many obstacles that prevent good things from happening. Maybe it is because of my love for these people that the injustices bother me so much and I refuse to simply accept them. This is a place where one must bring his or her own bed sheet to the hospital if he or she wants sheets to lay on. This is a place where one must send a family member out to buy medical supplies and bring them back because the hospital doesn't have them. All these truths about this country and the health care system here are racing through my mind as we approach the gate of the hospital. The hospital we choose is one of the nicest in the area. It felt like an oasis when I visited the first time. There is cleanliness, organization, and efficiency. People quietly wait in lines. Bed sheets are provided. Staff is dressed professionally. As hopeful as it is, I am still wary.

We approach the guard at the front gate and he asks for our appointment papers. We tell him that we don't have an appointment and need to go the emergency room. He shakes his head and says we can't enter without an appointment. "To the emergency room?" I ask incredulously. I shouldn't sound so shocked. Things that don't make sense happen all the time here. I take a deep breath. I remember a doctor I met the day I toured the hospital. He was a young red head and wore scrub bottoms with Crocs and a t-shirt. He was kind, but hurried when we spoke. "I'm a friend of Dr. So-and-So. He said I could come anytime I needed to," I tried. Apparently the t-shirt and disheveled hair was misleading as he seems to be some sort of big wig around these parts and all of the sudden it doesn't matter that we don't have an appointment. "But only one of you can come in with the child." I don't hesitate; the obvious choice is me. I make my way to the emergency room with a toddler-sized sweat mark on my shirt, a sick girl on my hip, and a diaper bag over my shoulder.

The ER is one giant room with gurneys and chairs, no curtains in between. I check in with a rude, but semi English-speaking nurse. We eventually are shown to our bed and chair and wait for a doctor to come. I feel almost guilty for being there. The room is full of women with very, very sick children. Sara manages to sleep while I hold a mask to her face. One woman's infant is too sick to eat and her breasts have become painfully engorged. She sits with an emesis basin on her lap, exposes her breasts, and begins squeezing her milk into the basin. I take out some crackers and begin to eat. With the first crunch, twenty-two black eyes are on me. My white skin is a built in spot-light itself and everything I do and stand for is on display for all to see. I offer some crackers to the lady next to me and she willingly takes some and then passes one over to a friend. I have a sack full of snacks. I wonder how long it has been since these women have had something to eat. I feel guilty for not sharing more, but I am worried about my blood sugar dropping and becoming a patient as well. I turn to face little Sara. She is chubby and stubborn. She is well enough to fight treatments and medicine and fills the bed with her rolly legs. We are quite the pair; with my white skin and her chunkiness, we are so different from the rest.

A woman next to me begins to yell for help. The nurse at the desk barely responds. It is well into the night and her cries jolt us from our half-sleep. I know by the intensity and abruptness of this mother's cries that something isn't right. The nurses don't seem to care. Her intensity escalates and is in a near panic, screaming, "My baby! My baby!" Her baby is about eight years old and not breathing. Finally some nurses come over and almost too calmly grab a bag valve mask and began CPR. It only lasts a few seconds until they stop all together. As they escort the mother out, her wails echo through the empty corridor and ring in my ears. Three feet from me lays the first corpse I've ever seen. I am amazed at how fast rigor mortis set in. The girl's arms and hands begin to contract and flex inward. We all just stay in our seats while a nurse takes twine and binds her at the ankles and wrists and then places her in a body bag. Sara throws up and the nurse points me toward a janitor's closet. The deceased girl is still on the bed as I walk past it to get a mop. They say the passage of time leads to increased age and weight. I have spent just one night in a Haitian hospital and leave much more than just a day heavier and older.