The quiet hum of the nuns' prayers seemed almost surreal in juxtaposition with the chaos outside the van. The pavement was barely visible beneath the teeming mass of people in the market, so the van was forced to slow to a crawl; we beeped and crept forward as the crowd reluctantly moved themselves and their wares out of our path. It was barely past eight in the morning, but it was already sweltering in the sun and we were close enough to the passersby that I could see the beads of sweat rolling down their faces. I saw everything from fruit and meat to disposable diapers for sale, but I had to wonder who had money to buy these things and how much anybody might make after a long day of work here. "This is the real Haiti," my friend, Sister Judy, said in my ear. She had brought me along to work with her in the clinic run by the Missionaries of Charity on the edge of Cite Soleil, and already I could tell that this day would be nothing like working in the NICU at St. Damien.
When we arrived at the clinic, we were compelled to literally step over bodies to enter the building. I said, "Bonjou," to as many people as I could, patted some of the children, and silently asked myself what on earth we were going to do with this many people. Sister Judy told me that the nuns sometimes see 400 patients in one morning, and this is despite the fact that none of the sisters other than Judy (who is a nurse) have any medical training. They've learned how to treat patients over the years simply through experience, and they do the best they can with what they have. I followed them as they began to unpack buckets and boxes of medications and line them up on the table with practiced efficiency. The medications are donated and many are expired, but they're better than nothing. I noticed a recycled milk jug full of some sort of dirty-looking, yellowish cream on one end the table and asked Sister Judy what it was. She told me that it was a mixture of antifungal, antibiotic, and anti-inflammatory creams--slapping some of that on a skin infection (which are common) would cover most of the bases. I was slightly aghast, but I think I just said, "Oh." There were no fans; within five minutes, we were all soaked with sweat. There was one bowl of water and one towel with which we could wash our hands, although I don't remember seeing any soap and it seemed somewhat futile anyway.
Once the supplies were set up, Judy and I walked into the crowd to pick out patients. Some of them she knew we couldn't help, like the many emaciated, sickly-looking children who were simply malnourished--she would admonish the mothers for not feeding them appropriately and then direct them to the malnourishment clinic, where they can receive nutritional supplementation. Others, she would bypass for different reasons ("I never see the mothers if they tell me about their own problems before their child's"). After a few patients were lined up, we would start to take histories. Some problems were obvious and easily treatable (ringworm, anemia, respiratory infection). But with almost every patient, there was a list of ailments--an initial complaint ("I have high blood pressure,") would be discussed, and then as the conversation seemed to be winding down, the patient would add, "But my knee hurts too," and then later, "My stomach keeps me awake at night," and on and on. I personally was baffled by these exchanges and asked Sister Judy how she ever knows what's really wrong--to me, it seemed like all the patients just wanted medicine for something; they didn't necessarily seem that concerned about what that something was. Fortunately, Judy has twelve years' experience living and working in Haiti and is direct and no-nonsense, so she understands the culture much better than I do and is able to dispense advice and medicine quickly and send the patients on their way.
Miraculously, by close to noon, the crowd was thinning. Every single patient was seen, and I marveled at the sisters' capacity and tirelessness. The thought that I kept returning to, though, was how unshocking the clinic was to me. I have been in Haiti only three months, but already I am used to seeing crippling poverty, unimaginable suffering, and dire lack of resources. In some ways, this is good--I am still able to function in the face of atrocious misery and sorrow. But in other ways, it makes me worried--how can you continue to truly appreciate the magnitude of the crises in front of you when they are omnipresent?
