With a brisk nod, the minister used one of his cell phones to begin calling colleagues in the immigration office. While the minister was on the phone, Martineau looked around the office, impressed with its luxuriousness. So this is how things happen in Haiti when you are rich and connected, he mused. Maybe with such connections, he thought, he would have been able to get his passport in time to make it to the conference he had wanted to attend in the US a few months ago. And maybe he wouldn’t have nearly died when he was fourteen years old.
Martineau was born with some swelling in his groin, diagnosed as a congenital inguinal hernia. His mother heard about a group of visiting American surgeons and was able to get him a hernia repair operation for free when he was still a baby. But the surgery failed, and three days later, the hernia recurred. Since he had no symptoms from it aside from mild swelling in his groin, he and his family ignored it.
Martineau’s mother moved with him and his sister to Port-au-Prince, hoping to find a job there. She didn’t find one. Instead, she sold water. Each day she walked to a small spring about two miles outside the city, filled a bucket, carried it back on her head, and went from door to door in their neighborhood, selling the water. When the bucket was empty, she went back to the spring, brought a newly filled bucket back on her head, and continued making her way through the neighborhood. She went back and forth to the spring more than ten times every day. The other children in the neighborhood teased Martineau for being the son of the water seller—even among the poor, he was considered poor. Martineau, his sister, and his mother shared one room in a small three-room concrete house with a tin roof, and his family ate two meals a day: breakfast was a cup of strong coffee to try to stave off hunger until the afternoon meal.
When Martineau was seven years old, his mother withdrew him from school so she could try to get him another surgery for the hernia. Every day for several weeks, Martineau and his mother made the thirty-minute trip to the General Hospital of Port-au-Prince in the back of an overcrowded taptap and waited among large crowds outside, hoping to get an appointment. Unable to read or write, Martineau’s mother had difficulty navigating the hospital. At one point she managed to meet a young woman surgeon who promised she would try to help them. They met with her twice, but then they never saw her again. Martineau’s mother thought it was because the doctor knew she couldn’t afford the surgery. Dispirited, she gave up.
At age fourteen, Martineau awoke one Sunday morning and vomited. He had his morning coffee and vomited again. He noticed his groin was even more swollen than usual. Then his abdomen began to distend like a balloon about to burst. Over the course of the morning, he began vomiting uncontrollably. His mother took him back to the General Hospital by taptap. This time it was an emergency, and they didn’t need to wait in line. He was rushed to surgery. Martineau’s intestines had become entrapped in the hernia—incarcerated, in medical terminology—and sections of his bowel had begun to die, a condition that can be fatal if not treated promptly.
Telling Janel’s story to the minister had reminded Martineau that at one point he had not been so different from Janel: a poor boy in need of surgery but with no money or connections to make it happen. Perhaps if there had been someone to advocate for him, he wouldn’t have lived for fourteen years with the ticking time bomb of an unrepaired hernia and wouldn’t have nearly died when his bowels became strangulated in it. And here he was, providing that very advocacy for Janel, giving, in his words, “a voice to the voiceless” and being “a defender of the weak.”
“I was thinking that although I did not have the opportunity to get the care I needed until it was nearly too late,” he later told me, “somehow the universe offered me the possibility to offer this opportunity to someone else.”
The minister hung up the phone, smiled, and said the immigration office would be expecting Martineau the next day. On the back of his business card, he wrote the phone number of a colleague who worked there and handed the card to Martineau. Martineau accepted it gingerly with both hands as if he’d been given a precious jewel, and he thanked the minister for his kindness. As Martineau left the lavish office, he was amazed at how seemingly easy it was to navigate the Haitian system when you knew people in power.
Martineau awoke the next morning to news that anti-government protests were scheduled in Port-au-Prince not far from the immigration office. A government stalemate had delayed parliamentary elections, raising concerns that President Martelly could rule by decree. Protesters were demanding that he and his prime minister resign. Driving through mass protests in Port-au-Prince means risking having one’s car windows broken by rock-throwing protesters or, worse, having the car set on fire.
Martineau parked at the immigration office and walked through the masses of people assembled on its grounds. He described the scene to me as “exactly in the image of Haiti”: poor people who can’t read or write spending months there without getting an appointment, rich people walking in and out with their papers on the same day, and hustlers looking to cheat the vulnerable poor.
After several failed attempts at reaching the minister’s contact by phone, Martineau finally succeeded and was told to meet the official in his office up a set of stairs. But security guards at the top of the staircase refused to let him enter, and despite several attempts to call his contact, Martineau again couldn’t reach him.
Martineau remembered he had the business card of the minister of the interior in his wallet, and showed it to the guards. As if he’d said the magic word, they opened the doors and escorted him into a smoke-filled suite, where the faces of political figures he recognized from television and newspapers appeared to float in the haze emanating from their cigarettes.
Martineau provided the minister’s contact with the paperwork from ONI and the photo of Janel from the day before. Thirty minutes later, he left with Janel’s passport in his hands. What had taken him months to do for himself through the normal mechanisms—normal at least for those who can read and write—had taken about forty-eight hours with connections to the right people.
Janel now had proof that he existed.
The visa process was much simpler. Back in Boston, Anne filled out an online form for a medical emergency visa for Janel on the website of the US embassy in Haiti, and the appointment was granted a few days later. Anne and I wrote a letter of medical necessity committing to provide all care free of charge and got it signed by Brigham and PIH. Martineau took this letter, the visa fee, and Janel to the consulate and received the visa within hours.
Anne and I asked the Brigham admitting office to book a bed on the neurology ward, the neurosurgery team to book an operating room slot in the following week, and the Ray Tye Medical Aid Foundation to book a medical flight for Janel on an air ambulance.
On December 24, Martineau arrived at the Port-au-Prince airport at sunrise with Janel and his mother in an HUM ambulance. An airport official escorted the vehicle directly onto the tarmac, where the medical flight awaited. A young, blond flight nurse stepped off the plane in a one-piece zip-up uniform that Martineau thought looked like a space suit. She greeted Martineau, asked him about Janel’s medical condition, did a brief physical examination, and then loaded Janel onto a stretcher.
“I felt like a hero at that moment,” Martineau later told me, “because I followed the patient through the whole process. It felt like an extraordinary accomplishment. I felt proud of myself, but I also thought: I did not deny my origins. What happens most of the time to the middle class in Haiti is that once they come from the rural regions to Portau-Prince and they succeed, then they completely forget their origins, their roots. So in my case, thanks to God, I didn’t have that problem. I know my origin. And so I think it’s normal that I help poor people who are like how I was.”