Then Michelle remembered Dr. Anne Beckett. At that time, Anne was an intern in internal medicine and pediatrics, dividing her training between Brigham and Boston Children’s Hospital. She had worked for PIH in Haiti for a year during medical school and had been involved in coordinating the care of countless patients sent to the US for surgery after the 2010 earthquake.
Michelle and I called Anne to ask her advice on housing. She explained to us that most of the patients PIH had brought from Haiti to Boston had stayed with Dr. Hermide Mercier. Hermide grew up in Haiti and went to medical school there before moving to Boston in the 1960s, where she studied public health. A leader in the Boston Haitian community, Hermide provided health education through courses and radio and television programs, and worked for the Massachusetts Department of Health on projects related to HIV and tuberculosis. She had also housed nearly two hundred patients for PIH over the preceding decades, including many following the earthquake. PIH called her a “guardian angel.”
Anne called Hermide, who said she would be delighted to host Janel. Moreover, several other recovered patients from Haiti who had been living with Hermide since their surgeries were willing to help take care of him. Could it really be that we’d found someone who not only had the time and availability to care for Janel and drive him to appointments but also was a doctor, had help at home, had served in this role countless times, and was Haitian? The situation seemed impossibly ideal.
Within a day of contacting Anne, the housing piece had been solved, just as within a day of applying to the Ray Tye Medical Aid Foundation, the financial piece had been solved. It seemed that if we asked the right questions of the right people, we got the answers we were hoping for. With Anne and Hermide offering to join Martineau, Michelle, and me, we felt we had a great team in place to advocate and care for Janel. Though the negative response from the first neurosurgeons we had contacted had given me pause, the ease and sense of inevitability with which things were beginning to fall into place made it feel like we were on the right track. I felt inspired and humbled to be swept up in PIH’s work in this way, and amazed by everyone’s generosity toward—and solidarity with—a person they had never even met.
With housing, funding, and a plan for rehabilitation in Haiti (if needed) in place, we got the green light from the Brigham administration to proceed. With evidence of medical necessity and a hospital willing to provide free care, we had what we needed to apply for a visa.
It was early December, three months after Martineau first emailed me about Janel. I was headed back to Haiti.
3
Approaching the departure gate in Miami for my connecting flight, I heard the counterpoint of countless animated Creole conversations, the cacophony of crying babies, and the characteristic chiming of Haitian cell phone ringtones. I smiled. It felt like I was already in Haiti. I sat down and pulled off my overstuffed backpack filled with clothes, a mosquito net, books and neurology journals to catch up on, and a two-week supply of instant oatmeal packets, dehydrated vegetables, ramen noodles, and CLIF bars to supplement the rice-and-beans meals served in the staff house down the road from HUM. I thought about pulling out a neurology journal to leaf through but instead leaned my head against my pack and dozed off. It had been a hectic past few days of packing and taking care of last-minute tasks at work, chores at home, shopping, and phone calls before leaving the country.
Just as I fell asleep, I was jolted awake by people pushing past me and stepping over me. At the first mention of boarding, nearly everyone at the gate made a mad dash for the boarding door. The airport staff tried to direct everyone to look at the boarding group on their tickets. Nobody did. It became clear to the staff that many passengers didn’t speak English. A Creole-speaking airport staff member appeared and announced in Creole that passengers should look at the boarding group on their tickets and sit down until their group was called. About half of the passengers looked at their tickets, but most stayed crowded around the entrance to the jet bridge. The gate agents gave up and let everyone board in the order they approached.
Once on the plane, I saw flight attendants resolving conflicts between people who arrived at their assigned seats and the people already sitting in those seats. If your main form of transportation in Haiti is the taptap—a pickup truck with a metal roof over the back that fits as many people as can squeeze into it—the idea of an assigned seat may seem foreign. Or even if it’s not, if you can’t read the ticket, it’s hard to figure out your seat assignment. The adult literacy rate in Haiti is only 60 percent, with less than a third of the population going beyond primary school, where most schoolteachers are unqualified or have received minimal training. Even though public school is free, parents must pay for school uniforms and school supplies, costs that are often out of reach.
As I made my way to my seat amid the chaotic boarding process, I passed a wide-eyed flight attendant, her painted-on eyebrows raised nearly to her hairline. “First time flying to Haiti?” I asked.
She nodded slowly, looking past me at the pandemonium.
I smiled at her. “I speak some Creole if you need any help translating,” I offered.
She forced a preoccupied smile, then, suddenly alarmed, looked over my head and pushed past me.
“You can’t bring that on here, sir!” she shouted to a man trying to fit a large, tattered cardboard box with a television sticking out of it into an overhead bin. He either didn’t hear her or didn’t understand and kept trying. She tried to approach him and was nearly hit in the head by a huge trash bag of belongings being swung up toward an overhead bin by another passenger, who then tried to stuff it in. I wondered how all of these oversize items had made it through security and how they would fare in cargo when the flight attendants required them to be checked. But can you blame the passengers for trying? I doubt Amazon delivers to rural Haiti.
As we were taxiing to the runway, an elderly man got up from his seat and started walking toward the bathroom. The flight attendants frantically yelled at him (in English) over the intercom system to sit down, but he kept on walking down the aisle. If he could navigate getting into and out of a crowded taptap while it swerved on mountainous dirt roads slowing just enough for people to jump on and off, then the enclosed, spacious 737 must have seemed like a safe place to maneuver by comparison, active runway or not. The plane stopped on the runway, and two flight attendants guided the man back to his seat.
Once we made it to cruising altitude, I headed to the bathroom. Opening the door, I nearly bumped into an elderly lady in a broad-brimmed purple church hat who was perched on the toilet with her purple dress pulled up above her waist. I immediately looked away and apologized as I shut the door, but the peeing passenger had seemed completely unfazed. As I turned around, one of the flight attendants sitting behind the bathrooms rolled his eyes and slowly shook his head. “Sorry, they never lock the door on these Haiti flights,” he said with disgust before turning back to a solitaire game on his iPad.
Less than a third of Haitians have access to a hygienic latrine, let alone a toilet, so it’s common in Haiti to see men, women, and children going to the bathroom along the side of the road. If squatting in plain view of passersby is your standard for privacy, then locking the bathroom door on a plane may seem superfluous, and it might not even bother you if someone accidentally entered. I thought of trying to explain all this to the flight attendant but decided against it. After all, maybe the lady just forgot to lock the door.