Konbit Pou Ayiti

It was really raining in Cayes-Jacmel while I sat in the parking lot, waiting for nineteen-year old Nisley to get two x-rays. In the morning, as we were pulling out of my driveway onto the Route de Cyvadier, we collided with Nisley on his motorcycle. At the end of the driveway there is always a crowd of men, and this is for three reasons: first, there is a lottery place on the corner. Second, there is a wall low enough to sit on and watch the traffic going by. Third, there is a public water fountain across the street. It is always difficult to pull onto the road there, and the crowd of idle spectators makes it even harder to see if anyone is coming.

We weren’t speeding or rushing or reckless. It was an accident and nothing more. In all the bad luck of the situation, we spent a lot of time recounting the good luck. Nisley was alone on his moto; he had no passengers. He turned his bike as he saw our car turning onto the street, and so avoided a head-on collision. We were moving slowly and carefully. We hadn’t yet snapped our seatbelts, so the airbags didn’t inflate.

Our response to the situation was immediate; we loaded Nisley into the car along with two of his cousins who were at the intersection when the accident happened. Although I feared their anger and blame, they started talking about how this could have happened to anyone. People shouldn’t be just standing around there in the street, they said. It’s true that we had enough visibility to determine there were no cars coming and make a decision that we could pull out, but Nisley’s little moto was small enough to be obscured by two grown ups standing in the street, and the crowd in the intersection that morning had been around thirty.

We hurried to the Hospital St. Michel in Jacmel, about a fifteen-minute drive from where the accident happened in Cyvadier. Upon arriving we found the hospital mostly empty, and had to go up to a separate building to find someone who could examine Nisley. A group of moto-taxi drivers from Cyvadier were already gathered in front of the hospital, discussing the accident. They began with blame, feeling that it was our haste in exiting the driveway that caused us to collide with Nisley. After a few minutes, one of them said, hey, that crowd of people there in the street makes it really hard to see what’s coming. Accidents can happen to anyone, it wasn’t really anyone’s fault.

I have visited many hospitals in Haiti, from country clinics to the Port-au-Prince University Hospital to the famous Partners In Health/Zanmi Lasante complex in the Central Plateau. But I have never really had a reason to visit the Jacmel hospital before this accident. I was told in the past that Jacmel has a pretty good hospital, relatively speaking. So I was surprised to see the reality of the situation.

Nisley was laid out on a cot with nothing under him. Paint was peeling off the walls all around him where water leaks had turned the green paint black. A puncture wound on his ankle was poorly wrapped in gauze and left to drip, making a puddle of blood on and under the cot, attracting flies. People were allowed to come in and out of the room, and others gathered outside a door on steps leading to the parking lot. We purchased everything necessary for his examination from a nearby pharmacy, including gloves, an IV bag, gauze and sutures. I held Nisley’s head and his hand as the nurse put the IV into his arm, all the while telling him to breathe and try to relax. Although the nurse used some of the gloves we had purchased, he cut the tape to hold the IV to Nisley’s arm and hung it off a dirty pole before sticking the tube on. Nisley moaned and said, “I’m lost; I’m going to die.” I tried to distract him from the pain and somehow comfort him. Even though many family members had gathered, none came forward to take my place next to Nisley’s bed.

Eventually a woman came to give Nisley two small stitches to close the wound on his ankle. Three different doctors examined him and decided that the pain in his side warranted two x-rays to check for broken bones or internal bleeding. His medical records were hastily hand-written on loose-leaf notebook paper and we were handed a note explaining which x-rays to get of Nisley’s injuries. We pulled the car around to the side door and loaded in Nisley, four of his relatives, and his IV bag.

It was at that point that I became really appalled at the health care situation in Jacmel. Nisley’s cousin informed me that the only facility with x-ray capacity is a hospital in the town of Cayes-Jacmel, twenty minutes from Jacmel. As we began the drive, I perched on the console because there weren’t enough seats and turned around to catch Nisley’s eyes. He was lying across the laps of the other men. He locked eyes with me and gave a little wink when I said, “Ou la Nisley?” meaning, you’re with me? When we arrived in Cayes-Jacmel we turned off the main road onto a rocky, muddy, steep secondary road. I turned to Nisley’s cousin, sitting in the passenger seat next to me. “This must be a bad Haitian joke,” I said. “We have to go up a wout kraze zò (bone-breaking road) with someone who may have broken bones?” He chuckled and said, “It was a blan (foreigner) who built the hospital on the top of the mountain!”

And then it started to rain.

That’s how we came to be there, a group of people thrown together by chance and shared concern for Nisley, waiting for x-rays on the top of a mountain in the rain, hoping the rain wouldn’t come hard enough to flood the road we had to descend, or the main road back to town. It has only been a couple of months since four powerful storms, including two hurricanes, flooded this region, and if it rains hard for more than a couple of hours, the ravines fill with raging water and you better be on the right side! Before the films had time to dry, everyone came back to the car, carrying Nisley and sliding him into the backseat. No broken bones! And we were off down the mountain, back to the hospital in Jacmel.

Everyone talked about the bad roads and the recent hurricanes as we hurried to the biggest ravine, hoping we weren’t going to get stuck. We were able to cross without a problem and as we passed through Cyvadier on the way back down to town the rain stopped and the sun came back out. Back at Hospital St. Michel we saw a new doctor, a Cuban woman, and one of the original three doctors. After being hit by a Land Rover, Nisley was miraculously unbroken – not a single broken bone!! He was prescribed a pain reliever/anti-inflammatory and a B-Vitamin complex to help him heal.

Like any group of people experiencing something intense together, our little Nisley support team was riding high and sharing the relief. We headed back to Cyvadier to bring Nisley home, check out the damage on the moto, and find a traditional doktè fèy, leaf doctor, who will be giving Nisley healing massage for the next fifteen days.

Seven hours after leaving the house, we were hungry, exhausted, and ecstatic that our luck, or God looking out for us and Nisley – whatever you want to call it – we were just so relieved that we hadn’t killed or seriously hurt him. I went into Esther’s Restaurant in downtown Jacmel to wait for some excellent food to take home to the kids, and ordered a Coca to hold me over. At the table three men were talking about the situation in the country. One turned to me, “You like Jacmel?” he asked me in Creole. “Yes, I responded. But how can a city like Jacmel have only one facility for x-rays, and how can they put it in another town at the top of a mountain??” This set off a new round of debate about the problems in the country – from the government being accountable to provide services to the anarchic and often detrimental character of most international aid interventions.

As we complained, a representative of the World Food Program walked in and sat down at the table next to us. He asked if anyone could tell him how to get to Baie d’Orange. Hungry as I was at that moment, my thoughts immediately went to the famine-stricken communities in the Baie d’Orange area of Belle Anse commune, here in the southeast department. That is a story for the next blog, so to end this particular story, I can tell you that when we got home Esther’s fantastic goat, rice, beans and boiled plantains made the day complete. We talked about how life comes at your fast, and shared the exhilarated relief of knowing Nisley is going to be all right.