Haiti: Rebuilding Lives, Day by Day

In Jacmel, the injured look to MSF staff and each other for help rebuilding their lives

Haiti 2010 © Mashid Mohadjerin

Two-year old Claudia, above, is the youngest and most inspiring patient on the Jacmel Hospital's post-operative ward.

“I came back from school, did my homework,” remembers a tearful Jean-Rosemay, who is barely 14, “and just before five o’clock, I sat in front of the TV to watch the day’s episode of Frijolito when the walls fell on us, killing my mother and my three sisters.” This was the last day of her life as she knew it, but only the first of the two she spent under her family’s destroyed house in Jacmel, a village on Haiti’s southern coast.

Jean-Rosemay’s legs were crushed under the rubble and, since her rescue, she has been treated by Doctors Without Borders/Médecins Sans Frontières (MSF) surgeons and doctors in Jacmel hospital. The intensive care ward, like the rest of the hospital, fell victim to the violence of the earthquake and is now located in one of several big tents in the hospital courtyard. The two rows of beds are filled with survivors of all ages. Some have had arms or legs amputated. Others are recovering from broken bones. And some, like Jean-Rosemay, are fighting not to lose a limb.

Every couple of days she is brought on a stretcher to the operating theater for an in-depth wound cleaning and re-dressing. This regular ritual is part of the struggle to stave off infection and save her leg. The treatment is painful as surgeons need to clean the wound deep into the muscle. Even though she is under anaesthesia, she sings every time she is in the operating theater. It is her way of relieving stress. “I am amazed by Jean-Rosemay’s strength and resilience,” says Nicole Dennis, an MSF nurse. “In fact, this determination is shared by most patients on this ward. They have been through so much but have a great attitude. I saw a 30-year-old man who had been amputated from his right arm and when he woke up, he was at a complete loss. The following morning he told me. ‘I’m going to make it.’”

Patients seem to gain strength from each other. Some may find motivation in the youngest patient on the ward, Claudia, a two-and-a-half-year old girl who was orphaned by the earthquake and who had her right leg amputated below the knee. Despite her injuries, she keeps trying to get up and walk. When sitting on her bed, she covers her amputated leg with a blanket, as if it were a temporary inconvenience she wants to hide.

But resilience has its limits, and tears start flowing when survivors recount the moment that changed their lives forever. Coming to terms with severe injuries, the loss of loved ones, and the loss of pretty much everything else is an immense challenge. Not knowing what will happen next makes it even harder.

Mental health professionals are starting their work with trauma patients in the hospital very soon. This support will be crucial in helping people cope with the shock the disaster caused, the loss of family members and, in some cases, a new disability.

For instance, Odette, 56, had her arm amputated to the shoulder. MSF surgeons grafted a piece of skin from her thigh to cover the stump. As if the psychological and physical pain of the experience were not hard enough, however, she faces the tough prospect of life after the hospital. When she is fit enough to be released, she will have to adapt to a life with only one arm while living in an unfamiliar place—a tent, perhaps, or maybe on the street. Having lost her house, she’s not sure where she’ll go.

Leaving the hospital is usually a moment of celebration, but in Haiti today, it often means stepping into profound uncertainty while bearing the impact of a tremendous psychological trauma. It means living on the street or in a camp and struggling to get even the most basic necessities, such as water, soap and food, not to mention proper shelter. Leaving the hospital, in this instance, does not mean going home.

MSF teams are working hard to provide essential support to families who have lost everything. In Jacmel alone, MSF distributed hygiene and cooking kits to about 1,800 families. A race against the clock has started as the rainy season is looming. Much more needs to be done to provide shelter for people before April.

Nothing will give Odette her arm back, though, and nothing will give Jean-Rosemay her sisters and mother back. But over time, the lives of the survivors can be rebuilt. Physical and mental recovery may take a long time for many Haitians, but Nicole Dennis, the MSF nurse, believes that “one day at a time, it will all come together.”