Ben Stubenberg
20th Annual Solas Awards Silver Winner in the Travel & Healing category
It’s our last night in Haiti, and nobody wants to leave. Spicy aromas from Creole lobster, shrimp, and red snapper caught that afternoon waft through the humid air and invite us to dine. We take our seats at the table set for us on the beach at the water’s edge under a black Caribbean sky strewn with a billion stars, bright and sharp in the absence of ambient light. A breeze blows in from the sea, and we let the serenity of the moment settle over us.
Dr. John Brusky, an anesthesiologist who has led many of these surgical missions, taps his glass. All eyes look to him. “65 surgeries. It doesn’t sound like much in a country of nine million people. And there are so many more just as anxious, just as hopeful as those we treated last week. But we do what we can with the skills that we have. Tonight, 65 people no longer suffer, and some spared an early death. We got to know each one of them and the Haitian staff that worked alongside us. We touched their lives, and they touched ours. Once you do something like this, you never want to stop.”
* * *
Tell someone you are going to Haiti, and you’ll likely elicit a furrowed brow at the wisdom of such travel, however noble and altruistic the goal. After all, the TV images portray Haiti as a land saturated in violence, poverty, and disease. A basket case of hopelessness that never goes away. There is an assumed knowledge that nothing can be done by those who have never set foot there.
But the handful of hardy travelers who find themselves in Haiti—foreign aid workers, missionaries, medical teams, and other volunteers trying to make a difference—know better. They see up close not just the social fractures but the striking resilience against all odds. A place where riveting encounters fuel the senses, tug hard at the heart, and wander through dreams long after the visitors have returned safely to their beds back home. And those lucky enough to spend any time Haiti will talk incessantly about what they saw and felt for pretty much the rest of their lives.
Count the surgical team from Milwaukee in this eclectic club. The general surgeon, urologist, otolaryngologist (ear/nose/throat), two anesthesiologists, and four operating room nurses are not part of any organization or even have a name for their group. They choose their fellow travelers ( based on attitude as much as competence) and pay their own way. Sometimes they bring a spouse, child or friend along to share the experience. Irreverent, stoked, and decidedly brassy, they delight in the prospect of surprise and astonishment that awaits them in the land that everyone else stays away from. Missing from their DNA is the gene that governs the need for structured, worry-free travel. They know the risk and factored it in long ago.
Undaunted by repeated U.S. State Department warnings that no place in Haiti is safe, the Midwestern doctors and nurses gear up and come together every year to operate on the poorest of the poor. But it isn’t pity or piety that drives them. It’s a chance to do right, to use the skills they have to heal and relieve suffering while connecting on the most human level with those who share that mission—Haitian and American. A mission at once simple and profound. At the same time, they relish the excitement of moving through a place that is metaphorically off the charts and way outside anyone’s comfort zone. It’s a rush but with an overriding aim: treat those most in need even as that also entails making agonizing choices of who doesn’t get treated and must wait.
* * *
The journey starts with a flight from Ft. Lauderdale, Florida in a small 17 seater twin-engine aircraft that takes off at sunrise. The plane banks right over the Atlantic and sets a southeast course that takes us low over the archipelago of Bahamian Islands fringed by white sand beaches. As the sun inches higher and brightens the sky, a dozen hues of mesmerizing turquoise sea come to light. The water is so clear that we can see massive swirls of underwater sand dunes that spill into the deep just beyond the reefs.
After three hours, the jagged green mountains of Haiti’s north coast come into view, and we descend into Cap-Haitien’s airport. As we walk down the stairs from the airplane, we are met on the tarmac by the big, charismatic, man-in-charge and former fire chief, Ardouin Zephirin. The team always feels at ease when Ardouin shows up. There is no problem too big and no threat too serious that he can’t fix.
The doctors and nurses pass through the musty little terminal and proceed to the baggage claim to gather their supplies for the hospital that are packed in big duffle bags. But customs officers stop them and say that duty must first be paid. But these are humanitarian supplies for the hospital, the team explains, and should not be taxed. The customs officials remain resolute. No duty, no bags. Ardouin steps in and has a word. A couple of minutes later the customs officials nod and wave us through.
The team climbs into a waiting minibus, and off we go into the honking maze of traffic dominated by the ubiquitous transportation system known as “tap-taps.” These small converted small trucks painted red and blue and emblazoned with “Blood of Jesus” and a dozen other biblical references cram in as many people as possible. They compete with giant freight trucks, hand-pulled carts, and donkeys carrying hefty sacks of rice. Cheap Chinese motorbikes, often with a passenger or two on the back, scurry and weave between everyone.
The slow drive along the main road to town takes us past rows of clapboard shacks, half-built concrete buildings with rebar sticking out, and market stalls selling everything from used bicycle parts to fresh mangos to cheap clothes donated by US and Canadian churches. Piles of garbage also line the streets waiting for pick-up, someday. Charcoal smoke, exhaust fumes, and the sizzle of cooked fish and meat mix with music blasted from boom boxes—konpa, meringue, reggae, hip-hop, and zouk.
We enter Centreville (downtown) where the scene softens. Here tidy wooden gingerbread buildings wrapped with intricate wrought iron balconies recall the raffish French Quarter of New Orleans. Indeed, Cap-Haitien had once been the capital of the French colony then known as St. Domingue, the richest European possession in the Caribbean.
The team looks for changes since their visit a year ago and notes the prevalence of cell phones. Market ladies with impossibly large baskets balanced on their heads press cell phones against their ears as they make their way through the congestion. And they act if they had has much right to the road as any car. Nobody dares challenge them.
Haiti has been largely insulated from the impact of mass tourism that forever altered other Caribbean societies and thus exists in a kind of time warp. What we see is what all of the West Indies once looked like, except, of course, for the cell phones that signal the onslaught of modernity. But no one on the team laments the change brought by the electronic invasion. Haitian market ladies are not here to entertain us with our nostalgic notions of what they or Haiti should be.
Our minibus, its shock absorbers nearly gone, rumbles though the countryside dodging goats, cows and giant potholes. The squalor becomes more pronounced as the congestion eases and the city falls away. Nonetheless, men, women and children all walk tall and straight and with dignity. No one in Haiti slouches.
* * *
When we arrive at the Hôpital Bon Samaritain in the town of Limbé 45 minutes later, a long line of maybe 100 people has already formed outside the gates. A month earlier, the hospital had put out the word that the Milwaukee surgical team would be back. No one wanted to miss the chance to be seen and hopefully treated for an ailment. It could be months before another surgical team comes through with the specialists needed.
A half century earlier in 1958, American Baptist missionary doctor Bill Hodges took over the hospital with his wife Joanne, a nurse. They were actually set to move from California to Japan with their three small children to manage a Baptist hospital there as part of a post-war mission. But for some reason the Baptist church redirected Dr. Hodges to Haiti where he was needed more. Neither Bill nor Joanne complained about the radical diversion and adopted Haiti as their new country.
Incredibly, Bon Samaritain survived decades of coups, invasions, uprisings, and chronic funding shortfalls, largely through the Hodges family’s perseverance and dedication. Patients pay what they can, or nothing at all, and the rest of the meager budget is made up through donations from North America and Europe, including from visiting medical teams.
The Wisconsinites waste no time and begin triaging to determine priority based on urgency, hospital resources, and team’s specialties. By early afternoon, the surgeons and nurses have scrubbed for the first surgeries using two small operating rooms.
One woman in her 20s has a massive goiter the size of a grapefruit popping out of her neck. She feels ashamed and hates going outside her little shack. Five men with enlarged prostates haven’t been able to pee. The urine has been backing up in their kidneys causing them unbearable pain. A woman complains about severe stomach pain. When the general surgeon cuts into her, he finds that a cancer has spread throughout. The disease is too far gone to do anything. He sews her back up and nurses give her pills so she can die as painlessly as possible in a couple of months.
The day before the team had arrived, a pregnant woman had been rushed in to deliver twins. One child was born live but the other had died and remained inside the womb and slowly decomposing. One of the surgeons extracts the dead child, a boy. An orderly takes the boy and places him in a cardboard box that will be his coffin.
The woman falls unconscious under the strain and cannot nurse her surviving baby who is badly dehydrated. Other women in the maternity ward volunteer to be the wet nurse. But none of the prospective wet nurses have been tested for AIDS and could put the infant at risk. Finally, a bottle with a nipple is found and filled with water with a little sugar and given to the baby, who survives.
A man in his early 20s hasn’t been able to eat anything solid in months because his jaw is deteriorating, a condition knowns as osteoradionecrosis. The otolaryngologist surgeon takes a look and estimates that he will die in a year if he is not treated. But there is no titanium jaw anywhere in Haiti to replace his natural jaw once it is removed. Even if there was one, the surgery would take ten hours are require other specialists. That would mean that a couple of dozen other patients waiting for treatment would not get the surgeries they need. The team decides that the only way to help him is to bring him to Milwaukee for the jaw replacement operation—essentially giving him a winning lottery ticket that will save his life.
The list goes on. There is no end. The team works 11 hour days on the most pressing cases. The doctors and nurses have earned a special place in the hearts of Haitians living in this part of the country. People 50 miles around know their names and their medical specialties. Their city, Milwaukee, that has become synonymous with hope.
After dinner at the simple hospital cafeteria, it’s open mic night in the bungalows on the hospital compound. The music is turned up and the jokes fly. The edgier the better. It might relieve a little stress but it’s more about just having fun and living in the moment before worrying about the next day’s slew of operations.
The biting paradox is that a decade into the 21st century, it’s still the small hospitals like Bon Samaritain that serve much of the developing world’s population. Operating on shoestring budgets, they are the only hope for millions of people afflicted by horrendous diseases that have either been largely wiped out in the West or can be easily treated with early detection.
The Milwaukee doctors and nurses don’t do this work alone. And this is important. The Haitian medical staff integrates into the team because they are as competent as any in the US. More than that, the Americans and the Haitians bond. Real tears are shed when the team arrives and when it leaves. They have grown to love each other as equals who share their joy and sometimes despair for a short period every year.
Of course, the Haitian medical staff is paid an achingly small fraction of their US counterparts. Haitian operating room nurses make just $50 a month, even though they could step right into a US hospital operating room and hold their own. That economic chasm between us and them is not missed by anyone.
* * *
Ardouin, who has been checking in on us from time to time, arrives on the last day of the surgical mission as we pack up. The doctors and nurses make a last check on the patients and say long farewells to the staff before leaving. The team looks forward to visiting Haiti’s most famous tourist sight and spending a couple of days of R&R at beach front hotel. In that respect, they turn into tourists, albeit in a place where there are none. And that raises a perplexing question: Can one really enjoy a country where death come early and often and survival is a daily challenge? Should one? Do teams like ours become indulgent onlookers as they drive past the dispossessed on their way to a tourist attraction and a hotel that is forever out of reach of all but a tiny number of Haitians? Is there not more suffering to relieve?
Of course, these thorny questions matter to the Milwaukee team. But shouldn’t they too experience the treasures that Haiti offers to visitors and feel the psychic high where every turn is worthy of a National Geographic© cover shot? What’s the alternative? A gloomy disposition or even a guilty conscience in the face of so much poverty is hardly a more appropriate response. The doctors and nurses are healer and travelers. And isn’t real travel about discoveries and connections with others? Even better if the people one meets along the way can pee again without pain.
The team isn’t thinking heavy thoughts as they take in the countryside between Limbé and Cap-Haitien. Ardouin’s SUV with three nurses in the back seat follows the minibus. Everyone is relaxed and finally kicking back after a long week. But this is Haiti, a land of never ending surprises. Suddenly, Ardouin speeds up and passes the minibus before cutting in front and hitting the brakes hard in front of three big rocks blocking the highway..
A bandit comes up and sticks his face through the open window on the passenger side. Ardouin barks at him in Creole to move the damn rocks out of the way pronto and spews out a series of violent threats. The nurses keep their cool. They know Ardouin, as do those riding in the minibus. Ardouin’s force of personality works and the intimidated bandit backs off. He orders his minions to move the rocks aside, which they quickly do. Ardouin steps on the gas and speeds through with the minibus practically on his bumper. Another car that had seen what was happening promptly pretends to be in our little caravan and also speeds through.
Road blocks are not uncommon in Haiti, especially around Port-au-Prince. In most cases it’s best not to stop and either turn around or plow through. In the north the occasional bandits typically target UN food trucks rather than extorting money from drivers. After they rob a truck, they let it go and distribute part of the food, mostly bags of rice, to the local population. This way they can look like Robin Hoods and gain popular support. The keep the rest of the food, however, and sell it on the open market.
* * *
The must-see sight in all of Haiti is La Citadelle, the largest fortress in the Americas. This massive structure resembling a medieval castle sits prominently on its own 3000 ft high mountaintop outside Cap-Haitian. Construction began soon after Haitians won their freedom from the French in 1804 in the only successful slave rebellion in the history of the world. It took the formerly enslaved 15 years to build it under the most brutal conditions at a cost of some 20,000 lives. The imposing fortress, now a UN World Heritage Site, was meant to repel another invasion by France to reclaim its former colony.
The feared invasion never came, however, and Napoleon had no interest in reclaiming the country. He had already lost 50,000 troops in the first attempt to take back Haiti in 1802 to return the highly profitable sugar and coffee plantations back to the slave masters who had survived the revolution. Yellow fever and fierce resistance from a disciplined force of Haitian soldiers fighting conventional and guerrilla warfare combined to win the day for the rebels.
Broke from the defeat after the loss, Napoleon needed cash to raise a new army to realize his greater dream, the conquest of Europe. President Thomas Jefferson got wind of Napoleon’s predicament and made a $15 million deal for what became known as the Louisiana Purchase that doubled the size of the young United States. But none of that would have happened but for the Haitian Revolution.
The improbable victory and singular accomplishment of Haiti’s slave rebellion is seared into the consciousness of every Haitian regardless of status and however destitute. The victors quickly ditched the French name for the colony and renamed the new country Ayiti, the name given by the original Taino Indians meaning “land of of high mountains.”
The town of Milot sits at the foot of the mountain below La Citadelle and is the starting point for the 7 mile hike to the summit. The road that merges into a switchback trail gets steeper and harder as the Milwaukee hikers near the fortress looming above. Some in the group take up offers by guides who have been following alongside them (and looking for signs of fatigue) to ride their mangey ponies instead of continuing on foot. Finally, the team stands before the massive gray walls of La Citadelle. Everyone is blown away. We enter the doors and begin a second arduous climb up the steep castle stairs. The first stop is huge room with rows of cannons in perfect condition pointing through slats and seemingly quite ready to be fired against an invading force today. The group climbs further up past the massive cistern, the bakery, and the soldiers quarters built to keep 5000 men holed up for year if necessary.
On the ramparts at the very top, we stop and take in the jaw-dropping 100 mile view in every direction. The fortress has no guard rails or safety signs. So everyone is careful when walking along the edge so as not to fall 400 ft to the bottom. Legend has it that King Christophe, the first king of Haiti following the Revolution, ordered a platoon of his unquestioning troops to march straight off the top to demonstrate to a visiting foreign dignitary his absolute power and control. Haitian guides at the Citadelle dispute this tale, but the audacious tale persists.
The splendid view only lasts a few minutes before a mist drifts up the side of the mountain and soon envelopes the fortress in a fog. An eerie feeling sets in that we are not alone, that those from that violent and proud past are among us. In Haiti, many believe that no one completely dies. The spirits of the dead and even the dead themselves intertwine with the living, especially at night or when a thick fog blots out the sun.
The team decides it’s time to head back down the winding trail for a stop at the ruins of the San Souci Palace. This is where King Christophe held court in the early 1800s and put on lavish parties for his entourage and many visitors from abroad anxious to see for themselves the the transformed order of society where the ex-slaves now ruled. Sans Souci (No Worries) even had an early form of 19th century air conditioning by running cool water from mountaintop springs through pipes.
* * *
Ardouin leads the way to the Cormier Plage Beach Hotel. The route takes us back through congested Cap-Haitien and then up another winding, rutted road to the top of a high hill overlooking the city and the bay. As the road descends down the other side of the hill, it makes a sharp bend to reveal a dramatic seascape braced by green mountains dropping into the ocean. Although most of the team has made this trip many times before, the stunning sight always beguiles as if they are seeing it for the first time. There is a bit of anxiety as Ardouin and the minibus driver must navigate the narrow road while skirting the edge of an alarming precipice. A blown tire or some loose rock could off could have us careening into the surf below. But we put our trust in the drivers. What choice is there?
We roll past tiny fishing villages along the shore where working sailboats rest on quiet beaches before reaching the entrance to the hotel. It’s not a normal entrance, however, where the car just pulls up to a lobby. Rather it’s tour through a jungle garden filled with breadfruit, avocado and mango trees, tangled vines, giant ferns, birds of paradise, all kinds of orchids, and hundreds of blue, red, green, and yellow parakeets. After a few minutes, we come upon a humongous thatch roof covering an open air cafe and bar looking out on the sea that paints the perfect picture of solitude and tropical bliss. No standard Caribbean resort here but a real piece of Haiti, even with an ancient Taino canoe. If only the armchair TV commentators who tell everyone that Haiti is a hell-hole could come here. But they never will. So we’ll keep a secret.
The gang has no interest in checking in to their rooms. Instead, they stroll over to the Tarantula Bar overlooking the beach and the blue water. The bar tender, Franklin, recognizes the doctors and nurses from last year and pulls out cold Prestiges for everyone. That’s Haiti’s national beer, a lager that wins gold medals in international competitions. Check off another surprise for Haiti: world class beer. The hotel manager, Jean-Bernard Simmonet, comes over to welcome us back and lets us know that he will be setting up a special dinner table for us tomorrow before we leave. We are back with old friends and belong here.
The team takes over two sides of the square bar, loudly toasting and laughing and telling jokes. We notice but largely ignore the other characters hanging out. They tend to be UN Peacekeepers, aid workers, staff from the embassies in Port-au-Prince taking a break, a notorious well-off Haitian family, and a couple of guests more circumspect about their business. In Haiti every visitor has a compelling story of why they are here because anyone here is, by definition, prone to risk taking and adventure. No one needs introduction to chat, but, beware, fact and fiction blend seamlessly at the Tarantula Bar.
Frenchman Jean-Claude Dicquemare and his Haitian born wife Kathy Bussenius built the family run hotel in the 1970s. Jean-Claude was actually born in Vietnam when it was a French colony, fought in the Battle of Algiers, and SCUBA dived with Jacque-Yves Cousteau. Not surprisingly, one of his passions is searching for sunken treasure ships strewn along the coast.
Kathy was born to German immigrants who settled in Cap-Haitien before World War II. A gourmet chef without peer, she manages the kitchen. No one, but no one makes Creole food like her. If Anthony Bourdain had done a show on this place and her cuisine, he never would have left. Kathy also happens to be one of Haiti’s leading authorities on Taino Indians who greeted Columbus when he arrived along these shores in December 1492 on his flagship, Santa Maria, on his way back to Spain. It is certain that he sailed past Cormier Plage Beach Hotel and may well have dropped anchor off shore. After a couple of Cormier rum punches, Columbus and his ship with billowing sails sometimes come into view.
* * *
The next day the team decides to explore the rugged coast instead of lying on the beach. So they hire a boat powered by a single 30 horsepower motor to get a closer look at the steep valleys laced with silvery waterfalls and dotted with hidden coves. A mesmerized Columbus seeing this coast for the first time called it “paradise on earth.” European troops sent to quell the Haitian Revolution 300 years later were equally awestruck. A Polish officer serving in the French Expeditionary Force wrote this about what he saw: “If the country were at peace, it would surpass nearly all of Europe in the beauty of its women, its crops, its forests.” The sentiment echoes today two centuries later.
Sadly, not all of Haiti can claim this dazzling tableau of nature that has hardly changed in 500 years. On the other side of the mountain range to the south, barren, treeless slopes of caked brown earth run down to a muddy sea.
During the boat ride, we witness the serenity of three small fishing sloops with big brown sails filled with patches framing the blue ocean vista. The fishermen bring home the day’s catch much the same way they have done it for generations. Except now the catches are smaller due to illegal poaching by big foreign trawlers. So there is less protein to go around and more people suffer. Haiti’s wrenching woes are never far away, always just behind the seductive beauty.
Our boat putters along on until it reaches Amiga Island, a uninhabited cay the size of a big playground ringed by white sand beaches and windowpane clear water a few miles off shore. Columbus, ever present, purportedly set foot on this island. And here is where he likely met and befriended the Taino Indian Casique (Chief) Guancanagari who arrived with his entourage of 100 canoes. Somewhere further to the east, the Santa Maria became wedged on a reef or a sandbar and had to be abandoned. Rumor has it that Jean-Claude from the hotel may well have found the ship, the Holy Grail of all shipwrecks. But he’s not telling.
We splash about in the calm water and reflect on the fact that we are alone on this idyllic sanctuary that is literally off the charts, far out in the bay. Cell phones certainly don’t work out here. We assure ourselves that the captain has enough gas for the return trip. We certainly don’t want to miss dinner.
On the way back to Cormier Plage, we encounter perhaps the most incongruous scene yet while in Haiti—a giant cruise ship about to depart the long pier in Labadie. The 4000 or 5000 passengers are back on board the vessel after spending most of the day on a fenced-off, nicely-landscaped peninsula laying on the beach, jumping off pyramid floats, jet skiing the bay, and zooming down the longest zip line in the Caribbean.
We ask our captain of our little boat to drive alongside the floating white apartment building. As he approaches, we arch our necks to look up the long steel sides of the hull and for a moment see the world as the Haitians experience it—looked down on from up high. Not in a malevolent way, but the startling visual can’t help but symbolize the gaping contrast between us, traveling as Haitians, and them, voyaging as first worlders. The power, the wealth, and the lack of awareness is somehow on full display.
In a few minutes, the giant apartment with its endless sushi buffets, waterslides and cabaret shows will cast off and sail away from Labadie and disappear over the horizon as if it was never there. That’s OK. Maybe we shouldn’t be judgmental. Let people have fun and drop a few dollars on Haiti. But still one can’t help but lament what those passengers missed—the chance to see Haiti up close with all its chaos and courage and grit. The kind of encounters that have the power to change minds and spawn action. But that won’t happen on this strip of private cruise ship property designed to keep Haiti out and passengers safely inside and entertained with plenty of bread and circus.
We continue on, our little boat pushing against the late day current back to Cormier Plage before the sun sets in time for dinner.
* * *
As the week winds down, it’s worth measuring the impact the Milwaukee surgical team had when working side by side with the Haitian hospital staff at Bon Samaritain. The trip to Haiti cost the four doctors and four nurses $10,000. Add in another $3000 to keep the two operating rooms going at the hospital, and that averages out to $200 per surgery for 65 patients. It’s hard to beat that kind of return on investment even if the team works for free. That’s like a bag of groceries at Whole Foods for each person treated.
So do Haitians have a chance when most of the rest of the world has written them off? Consider this: If Haitians can endure and prevail time and again over the worst that human and natural catastrophes can throw at them, it seems fair to say they have the moxie and mettle to emerge from the mire. Along the way, Haiti might just teach the rest of us about making it through hard times.
As Dr. Brusky concludes his eloquent remarks under the stars while the sea laps the beach and our hair blows in the breeze, we raise our glasses and clink them together. As much as the doctors and nurses have given to Haiti, Haiti has given back more. And once again, this land of wrenching beauty has moved us as it moves every traveler with an open mind and a caring heart. We’ll be back. Haiti is forever part of us now.
~ ~ ~
Ben Stubenberg is a Caribbean author who has made dozens of trips to Haiti for more than thirty years, often working with medical and firefighting teams. A version of this essay was first published in the book Perplexities, a collection of short stories edited by George S. Rice Jr.