Haiti: A Country of Contrasts

Today was my first day in Haiti, a country of contrast. Even before getting off the plane, through my window seat, a clear contrast

between the countryside and the capital, Port-au-Prince is seen as the
concrete and buildings of the city stretch up from the coast climbing
as a concrete vine up the sides of the nearby mountain side only to
abruptly end and become sparsely populated rural countryside.

Upon exiting the air-conditioned airport at 9:00 am, wherein planes
from various countries dock and leave with relative precision and
efficiency, such that pilots from across the many different
surrounding nations are able to interact safely, I see a capital city
that doesn’t have a garbage service, a capital city where the fire
truck leaks gallons of water while careening down the narrow streets,
a capital city where swine literally feed in the rivers that double as
a laundry machines and latrines.

Our crew and baggage tightly pack ourselves into two vans because
having each volunteer check their one hundred pound maximum and hand
carry it to the clinic is more efficient than using the non-existent
mail service. On our three hour serpentine path through the mountains
we see contrasts between palatial villas along the coast and the road
in front of these very same villas with pot holes that could swallow

We finally arrive at our clinic just before noon. We see a clinic
built by the generous donation of our donors—a solid structure build
upon a rock foundation. It is in this building we will eat, sleep,
and bond for the next two weeks.

At the same time, starting at 6:30 am tomorrow, this very same
structure will be the place of contrast for local Haitians. Some will
have a diagnosis of hope and a second chance at life, and sadly due to
the limitations of our clinic and the nation itself others will have
an honest, but frank diagnosis concerning how to spend their final

Seeing the stark contrast in Haiti between rich and poor, between
healthy and sick, between our lives and theirs can only cause one to
pause in hushed introspection. Our lunch today consisted of rice and
beans, a tomato sauce, and a spicy coleslaw. After nearly a five hour
exposure to Haitian daily life, I for the first time made sure to eat
every single grain of rice from my plate, lest throwing out a few
grains of rice indirectly be an insult to our Haitian cooks. My
thoughts have been clouded since my arrival between my life and work
in a busy emergency department in Chicago, and what normal is for a
Haitian. I expect this contrast will only be highlighted tomorrow
when I see my first day’s worth of patients some of whom have traveled
more than 4 hours to come to our clinic, a ray of hope for many in
Haiti, a country of contrasts.

Robert Aitchison MS, PA-C
Jane R. Perlman Emergency Medicine Fellow
Division of Emergency Medicine
NorthShore University HealthSystem