Then and Now: What I’ve Learned After Haiti’s 2010 Earthquake
Or, how to preserve my humanity in the midst of disaster
Thirty-five seconds is all it took for the fate of my home country to change abruptly nine years ago, when a 7.0-magnitude earthquake disrupted the serenity of what promised to be a routine afternoon in Haiti’s capital, Port-au-Prince. Little did I know that my personal experience in dealing with this natural disaster would derail my plans to pursue a career in medicine and to begin working for Partners in Health.
Today, I feel the need to narrate my own account of this tragic event with great detail, not just so that you know, but also so that I do not forget. Now that the journalists have left and the celebrity telethons have wrapped up, these explicit memories are all that I have left.
On a personal level, I witnessed how fragile life really is. A close friend of mine at the University of Virginia passed away as she, like me, was in Haiti visiting family for the holidays. I also witnessed the fragility of material possessions, since everything you own can disappear in a matter of seconds.
My grandfather’s museum of Haitian art collapsed during the earthquake, burying his life work in rubble. As time passes, these recollections continue to shape my intellectual interests and motivate my decision to work in global health so that I can gain a better understanding of the social causes of poor health in resource-poor countries.
On January 12, 2010, I was in the middle of my afternoon workout at an underground gym in Petion-ville, a neighborhood within Port-au-Prince, when the ground suddenly started shaking. I was underwhelmed at first. As the shaking grew stronger, I remember feeling a loss of control I had never experienced before, not only of my body but also of my surroundings, as though the world around me was crumbling. My first instinct was to make my way outside. I barely made it to the parking lot when a cloud of darkness and cement dust swallowed everything in front of me. A four-story supermarket had collapsed nearby. Somewhere in the distance, I could hear people screaming, “Letènel, Oh Letènel!” (Haitian Creole for “God”), but also singing prayers. Somehow it was reassuring; it meant the world had not ended.
Dust, fire, and smoke dominated the Haitian landscape for hours as piles of dead bodies were laid to rest alongside the roads. Centers of law, order, and functioning society were destroyed, and with them thousands of lives. Banks, churches, hospitals, hotels, and schools collapsed. Almost all means of communication and power sources were cut off. A city built to accommodate 200,000 people had reached the 3 million mark by January 2010, yet it was equipped with three functioning trauma centers. The only places to provide emergency care were empty parks and fields. While estimates of lives lost reach at least 300,000, no one has any idea of the official death toll since dead bodies were often disposed of haphazardly, with little to no documentation.
That night, my family and I gathered on the cracked asphalt just outside my driveway, sitting and holding hands anxiously as the aftershocks came one after the other. I felt guilty for being alive while so many had perished in vain. My helplessness vis-à-vis this tragedy only fueled my anger as I grew impatient for the opportunity to provide a helping hand.
The following morning, my brother and I filled my old pick-up truck with water bottles and headed downtown, the hardest hit area, to see if we could help. What we thought would be a simple distribution of clean water turned out to be a surprising medical adventure we will never forget.
We encountered such an overwhelming number of severely injured people, from pregnant women to small infants, that our truck quickly filled after a few minutes on the road. They told us they had been denied access by local clinics, but we decided to bring them back anyway. We found a Doctors Without Borders clinic up the road, where a group of people was banging on the locked gates. We knew we had to come up with something, as time was critical for those severely injured during the earthquake. My brother and I introduced ourselves as volunteers and urged the guards to open the gates. They must have thought we were foreigners, perhaps because of our light skin, and allowed us entry.
To this day, I cannot find words to describe what we saw as we walked through the giant gates. There were hundreds of trauma patients lying next to each other on the parking lot because beds were full inside. They screamed relentlessly in agonizing pain, while unsanitary pieces of clothing covered their open wounds. As we walked in, we realized it was impossible to not accidentally step on someone, whose desperate family members begged us for help.
For the next 72 hours, we became part of a makeshift staff of volunteers, supervised by one foreign doctor and two Haitian nurses. While we had no formal medical training, we were able to triage and identify the critically injured, bandage them, and provide them with pre-operative care before they were sent to a surgical facility. Unfortunately, the vast majority of our trauma cases did not make it that far; they ended up succumbing to their injuries.
Now, nine years later, some hard-hit sites in Port-au-Prince have changed dramatically, and most lots are cleared of rubble and tents. Some places have seen more progress than others, but one thing is clear: Haiti still has far to go before it can say it has been “built back better.” Efforts to decentralize resources from the capital city, such as the construction of PIH’s University Hospital in Mirebalais in the Central Plateau, provide a source of hope. Yet rapid urbanization in Port-au-Prince and Cap-Haitien, Haiti’s two biggest cities, put further pressure on weak public systems. Over the last four years, the Haitian economy grew at a stagnant rate of 1.2 percent, while population growth over the same period averaged 1.5 percent, further contributing to the state’s inability to provide for its increasing population. Meanwhile, rapid inflation has weakened the Gourdes, Haiti’s national currency, and made it even more difficult for families to meet their basic needs.
My experience volunteering at the Doctors Without Border clinic after the earthquake was an extreme case under emergency circumstances, but it is nonetheless characteristic of the many challenges facing health care in Haiti today. During tragedy, patients dealt with limited access to care, overcrowding, and an insufficient number of clinicians, medical supplies, and equipment. The same problems still plague both public and private health care facilities on a daily basis.
The government allocated only 4.2 percent of the national budget to support health care last fiscal year, with an estimated 90 percent of those funds going to personnel salaries. Because external donors have contributed to the health sector since the earthquake, the Haitian government has had very little incentive to increase its share of the budget dedicated to health care, leading to massive underinvestment in public funding.
Given the dreadful conditions under which the vast majority of Haitians live — dire poverty, malnourishment, and restricted access to clean water or sanitation, it should come as no surprise that disease disproportionately affects the poorest and most vulnerable. Poor health outcomes are not a result of biology, but a direct result of national and international policies fostering poverty and inequality. Until we can address the economic, political, and social conditions in which people are born, live, and work, we will not be able to improve the health of people in resource-poor countries like Haiti.
Personally, I believe the Haitian government can build back better by dedicating a significant portion of funding to developing human capital, specifically through the education and health care sectors, to ensure the country’s long-term competitiveness. We need to have greater ownership and accountability of foreign resources, obtained through multilateral institutions and nonprofit organizations, so that we can fund national priority programs. (Only 1 percent of more than $9 billion in earthquake donations flowed through the Haitian government, according to a report by the Center for Global Development. The majority of that money got funneled to private contractors and international NGOs.) And we must look to alternative models of development beyond the Western world. Haiti could learn a lot from Rwanda and its turnaround after the genocide.
The anniversary of the January 2010 earthquake churns up many memories for me, but they are not all bad. I witnessed great kindness, grace, and humanity in the midst of natural and institutional chaos and rupture. While Haitian resilience has been duly recognized around the world, what hasn’t been reported is the spirit of solidarity that crystallized from this mournful episode. I know Haitians who lost loved ones in this tragedy and yet were still eager to share their food, homes, time, and lives with complete strangers. One of the Haitian nurses I became acquainted with at the clinic lost her teenage son when her house collapsed, yet she insisted on unconditionally helping my brother and I because, she thought, it was the right thing to do.
I strongly believe in Haitians owning their destiny and solving their own problems with the right leadership and good stewardship of foreign resources. We have a young population and an influential diaspora eager to participate in the country’s political and economic development, both of which give me huge faith in what lies ahead.
I firmly believe that, given the chance, I too can make a difference. I owe it to myself and to the millions of displaced Haitians who lost so much in the 2010 earthquake, but especially to the nurse who, despite losing everything, still managed to preserve her humanity.