Tuesday, February 02, 2010

Bearing witness to Haiti

My friend Jeff Swartz, the CEO of Timberland, recently took his company plane to Haiti to help deliver relief supplies and personnel. What he saw left a searing impression. I share excerpts of his note to his staff. (To supplement Jeff's letter, I present this picture of Faina. Hers was one of several lives saved by BIDMC and other doctors last week. Story here.)

Last week, I visited Haiti, in the company of Bill Shore, the founder and executive director of Share Our Strength, and a Timberland Board member, and chair of the Board's Corporate Social Responsibility Committee, and in the company of Wyclef Jean, a 12 time Grammy award winner, a Haitian musician and activist, Timberland’s partner in an effort to plant trees and reforest Haiti, as part of our global Earthkeeper efforts. The visit was in response to the earthquake that struck Haiti 3 weeks ago; our visit was an attempt to focus Timberland’s Earthkeeper resources temporarily on disaster relief. The trip was emotional and powerful; I left Saturday night and was back in the office Tuesday.

So, what’s so hard about a brief note that describes the heroism of the many doctors we saw, the heartbreak of the destruction we saw, the inspiration I felt with Bill and Wyclef, and the indignation I felt at the world’s well intended but inept efforts to cope with this disaster?

Maybe it is the scale of the disaster, in the context of a country already ravaged by history. Maybe it is the raw, emotional experience of being amidst death and destruction, and in the presence of the dying. Maybe it is the feeling of futility that waited for me at each stop we made in Haiti. Yes, we made a difference, but we did not even scratch the surface of the pain and agony.

For all these reasons and more, I have not done my job by you; I have not been able to bear witness to you from Haiti. So, below, I have tried to right that wrong. Call this note, “bearing witness” -- but “bear with me” also works -- it is a very long note. Long for the reasons I cite above, and long because it is hard even now for me to say simply why a bootmaker flew to Hell and how the experience of that Hell affirmed my belief in the mission of commerce and justice. So, here goes:

1.30am Saturday night in Manchester, NH. One backpack, with no change of clothes, just a camera, a notebook, malaria pills, and my Bible. Drove to Manchester with Billy Shore; not a lot of chit chat.

On the plane, Wyclef Jean was waiting, exhausted before the trip began. He was going back to Haiti for the 2nd time since the quake — many of you saw him on CNN two nights after the disaster, with his wife, telling stories about transporting 10s of dead bodies to temporary morgues. Wyclef is a man of many faces — we know him as a musician and a celebrity, for sure, but if I jump ahead and tell you about Wyclef by the end of this voyage, I would speak of an immensely gentle, noble, powerful man — one part dreamer, one part prophet, one part revolutionary.

And on the plane, strangers -- physicians from Partners in Health. When the earth shakes and the flimsy medical infrastructure disappears — PIH calls on physicians and nurses and medical students — and they drop what they are doing, like the doc from San Francisco on our plane, like the med student from New York…they pack their backpacks, grab whatever medical supplies they can round up…and we meet them, 1.30am, bound for Hispaniola.

(After arrival, a helicopter trip to Haiti.)

From the air, in a little over an hour or so, you flit across beautiful inspiring mountains and along magnificent beaches, from the Dominican Republic to Haiti. There is a large lake that demarcates between the two countries, on the route we flew, but you don’t need a map to know where one world ends and another begins. The lush agriculture on one side of the lake leads to a more hardscrabble agriculture on the other; the big (ok, functional) highway on the DR side leads to one lane each way winding on the other. We can see the aid trucks crawling along on the Haiti side. And in minutes, Port au Prince looms ahead, dense, destroyed, honestly not to be believed, from the air. A densely packed city, an up and down city of folded hills, and everywhere you can see…cataclysm. You have a city that started with basically no functioning infrastructure – and then the whole darn thing falls down. So what’s left? A world of pain, and human spirit.

First stop, Cite Soleil – the City of the Sun – which is the worst slum in Port au Prince. Clef says, not a lot of blanche (white people) in Cite Soleil ever; should be interesting. Just what I’m looking for — interesting. Because as the convoy weaves through the city, I am reduced to holding the video camera in my lap and filming my knee. I can’t believe the physical destruction. Nor the swarm of humans walking. People walking in the streets — this is one of the overwhelming images of this voyage. Where are they going? What are they seeking? Walking, everywhere. Streets choked with dust and detritus and despair, and folks out walking. Whole blocks just leveled.

Our convoy pulls to the curb under the bluest sky and with the blazing sun as witness. Within 30 seconds of Clef’s appearance on the sidewalk, there are ten thousand young people around us. On a retaining wall in front of us, clogging the wide street, everywhere the eye can see. Beatles en route to Shea Stadium; I’ve never seen a crowd like this, form this fast, be this close.

We are in the Cite to feed the hungry. We’ve already seen a UN convoy heading from the airport to distribute food and water—white armored personnel carriers, soldiers in body armor and combat gear, turret gunners manning loaded weapons, sirens blaring, trucks roaring through the clogged streets—to hand out 50 lb bags of rice. Clef reminds me that good intentions don’t feed people. 50 lbs of rice not all that helpful, when there is no pot, no cooking fire, and no clean water anywhere with which to cook the rice. The Yele model is a little different—we brought food from the DR, food that Yele purchased, and somehow, in this destroyed city, Clef’s team cooked 8,000 hot meals of Haitian cuisines (goat stew). Someone “found” 8,000 styrofoam take-out trays, from one of the destroyed restaurants somewhere in town. And found a truck. Here’s the truck, here’s the meals, here’s Clef with a bullhorn shouting in Creole, and here is a mighty river of the hungry, lining up to be fed. With sweat pouring off of everyone, we began to hand out the meals.

We are working hard in the sunny version of hell, but despite everyone’s best efforts, of a sudden, it starts to get tense. The Yele volunteers are shouting at the folks in line in Creole, "Don’t push, don’t push," but you could see in the eyes of the mothers and the fathers and the children, everyone watching the pile of cooked meals in the back of the truck get smaller and smaller and a sense of despair and maybe even panic begin — will I get a meal for my child before they run out? And so all of a sudden, the business of Sunday lunch heads in the wrong direction — the river of hungry humans becomes a raging river, pressing forward, starting to crush each other and us. And so the security guys – with good intentions – shove themselves in front of us, and everyone started taking out their weapons and I heard safeties being taken off and I knew we were not far from a really bad situation.

At this point I was crushed behind a wall of security people, up against the open back of the truck. In front of me, not 3 humans deep away, there was a little girl. And someone must have stepped on her or something – she started to cry. In the raging ocean of human suffering—her tears and her fear was too much for me. So I reached between 2 security guys and put my hand on her and shouted in French,”Its ok, I’m gonna get you.” I couldn’t lift her up; I was wedged too tightly -- but now I was back in CEO mode and so I said to the security guy in front of me, “Get me that little girl.” And he did -- lifted her up and passed her back to me and I held her tight, in my arms, and she was sobbing and so was I. I held onto her, maybe 8 years old, talking to her in French, and after about 30 seconds she stopped crying. Because the crushing that was hurting her — that’s gone now. I’m holding her and we’re behind a security guy and so she’s not going to get crushed. So she stopped crying.

My view of the world says, she should have still been crying. But her view of the world is, no. I may not have a home, I may be hungry, I may be living in hell – but that’s normal. That isn’t worth crying over. If someone is hurting me on top of all that, then I’ll cry. I handed her a meal and off she went – as if to say, I’m going back to the normal despair of my day and I can handle that, don’t need your help, thanks a million and have a good day.

We went back to handing out the food. The crush didn’t go away, but the fear of a bad scene did. I’m still kinda pinned against the truck; from under the truck, a little brown hand reaches out and grabs my cargo calf. I look down, and there is a little hand clutching my leg. Can’t see the child — he or she has crawled through the densest crush of people I’ve ever seen, wriggled under the truck, and grabbed me — signaling, "I beat the line, now give me a meal." I slipped one down to the hand; the hand grabbed it and vanished. My heart still has not come back — a child, figuring out how to get a meal.

From Cite Soleil we drove through destruction towards Bel Air, our next destination. Nothing belle about Bel Air; the sun is starting to wane in the sky, birds are chirping, but this neighborhood is destroyed, concrete smashed like you cannot imagine.

When we get there, Wyclef disappeared to talk to some of Bel Air’s residents and I was left standing there with Billy, and feeling the smell. One of the security guys said to me, “You know what that smell is, right?” And I’m thinking no, but I bet you’re gonna tell me and he said, “That’s dead people.”

When Clef came back he said, “Smells bad,” and I am quick to agree, but he says, “No – it smells really bad. No rescue teams have come here. No rescue teams will ever come here.” If there was some way someone was still alive amidst the rubble in this corner of this sad city, they were left to die. Clef led us here because he had work to do to try and negotiate with angry young men, no more violence. And while he worked at that, I kept an unwilling vigil with the dead.

We left Bel Air, but in my heart, I can still see it and hear it and smell it. Leaving them there, men, women and children entombed in rubble – it’s just not right.

Our convoy headed up into the hills. Billy asked me, "Where are we gonna sleep?" One of the guys who has been driving us around says, "Come to my house, you can sleep there." He has an undamaged house? He does, higher up in the hills. And so, Haitian rhythm — I got a little girl’s bed, with teenage movie stars taped to the wall, and Barney the purple dinosaur on little girl sheets, and Billy got the room that belonged to the older daughter. Security guys sleeping on the dining room table and living room chairs.

I sent my kids one last note, opened my Bible and studied for 15 minutes, and was asleep in my clothes with my boots on without even realizing it for 4 precious hours — no dreams, no thoughts, dark and silent and asleep.

Dawn was signaled by the roosters and a rosy sunrise. We headed downtown to University Hospital, the biggest hospital in Port au Prince.

We found a mixture of desperation and dignity like I’ve never encountered. In the sweltering sun, big strong young men and women from the 82nd Airborne, taking care of business — securing the hospital, and helping the PIH doctors. We watched a big blond trooper from somewhere shoulder his M4, and bend down to pick up an old woman who was too sick to walk any further, and carry her with dignity and caring to the triage station in the bright heat — a grey file cabinet resting on its side. We watched the medics triage the sick, and then we walked into the hospital itself.

How shall I tell you what we saw? Civil War technology, 21st century doctors, pain and suffering, grace and dignity. Post operative “wards,” nothing more than cots stacked in the open air, every single patient having experienced at least one amputation from the crush injuries that could not be treated otherwise. David Walton, a young PIH physician told me as we walked through, we have saved their lives to this point by amputation — but 100% of the patients you see are real mortality risks. When they are “discharged,” which they have to be — we have many many more behind them waiting for these cots — where will they go? How will they be kept free of infection?

A surgeon from New York showed us the “operating theater,” a medium sized storage room that hadn’t fallen down in the quake. Four army cots, propped up on blocks, so the surgeons wouldn’t have to bend un-naturally. IV’s hanging from the what looked like repurposed coat racks. Most of what they were still doing was amputations. Because after enough time has passed and wounds haven’t been treated, there’s just nothing else you can do.

They told us, when children came in hurt, they cast them as quickly as they can in order to immobilize the victim -- because in some of the crush injuries, if you move it you could take out blood vessels and someone could bleed out. So they immobilize with casts, but then when it comes time to deal with the actual injury, the cast needs to come off again. Do you know what you can’t take a fiberglass cast off with? Scissors. Scissors don’t cut through fiberglass — and so the docs can’t get to the wounds. Because you need a cast saw, and guess what? They didn’t have one at University Hospital.

Dr Dave said, “We’ve really got to find a cast saw,” and I said, what do you mean, find? And he said, “Well, we know they have cast saws at the airport, we’ve been sending SOS messages for 4 days and we can’t get them here.” Not 5 miles away. So now I’m all ready to go storm the airport and thankfully Billy Shore said he had a better idea … whipped out his iPhone – can you see the irony of standing in this place and Billy’s on his iPhone? And he sent a note on Twitter that said, “Anybody got a surgical cast saw I could use?” and the network goes whacko and an hour later there are 3 of them being Fed Exed to Yele Haiti people because they’ll do whatever they have to to get aid to those who need it.

Before I left for this hastily-planned trip, people – many of them rightfully disgruntled family members – demanded to know what I hoped to accomplish with my visit. I always replied, honestly, that I didn’t know and wouldn’t know until it happened ... but that I had faith that we would find a way to share strength. A week later, and plenty of tears later, I am still not sure.

Yele would have served the meals without me. University Hospital would have gotten a cast saw, eventually. Somehow, nothing I did would have gone undone. So CEO as disaster volunteer, not a good model. But, CEO as witness — that is a different story.

What my eyes have seen, my heart has felt. And so this voyage is just beginning.

The good that comes from this journey lies rather in what happens next.

It lies in the limitless kindness of Bill Shore — who worked his cell phone to reach Senator Bob Kerrey, the Congressional Medal of Honor winner from Nebraska, who lost his leg in combat in Vietnam, and who spent more than the last decade building a prosthetic “industry” in Vietnam, so his former enemies could have prosthetic care for their wounds. Billy used to work for Kerrey, and moved by what he saw — 70% of Haiti is young people, and so 70% of the amputees face a life long challenge of prosthesis — Billy persuaded Kerrey to begin to set up a prosthetic network in Haiti. Lives will be saved and destinies altered by this kindness.

We are working with Yele, to ensure that the pipeline from the DR to Haiti is open and working, so aid can go not to a UN depot, but to the people who need it so desperately.

And, Yele and Timberland are continuing to work together, more intimately than either imagined, to set up an operationally sound approach to helping our brothers and sisters in Haiti. I’ll be back in touch with more information as our partnership continues to evolve, and to share with you the ways in which we’re hoping to bring our vision of commerce and justice to bear for Haiti’s citizens and survivors.

Thank you for bearing witness to my experience by reading this far. I wish I could leave some of this out; I wish most of it hadn’t happened. Thank you for kind words you’ve shared; I needed your strength and I still do. Most of all, thank you for building a community at Timberland whose values give me license for such a journey -– not in an indulge-the-crazy-CEO way, but in a “of course you should go, why are you still standing here?” way.

No clever conclusion to write — because this voyage is hardly begun. Home from hell, changed and different, but unrelenting in my view that the path to heaven lies true north by commerce and justice.

Yours in service,

Jeff

4 comments:

mdspencer said...

One of the best descriptions I've read.

Richard Wolfe, MD said...

For the record, although Mike Cocchi and John Jesus helped quite a bit with the little girl's care, and the work we did to get her to Sacre Coeur Hospital probably contributed as well, many other physicians and nurses from other systems did more than we to save her. If anyone should get credit for the save, it is a pediatrician from Central Mass.

Mark said...

Paul,
We have been getting results using our medical supply distributor (Owens & Minor) to ship larger supplies directly to our ground team's staging area in the Dominican.
Fed-Ex Freight is now down to a four day delivery period. Just an idea to help expedite supplies to your team. Good Luck.

Paul Levy said...

Transferred from Facebook:

Paul and Jeff, It would be impossible for me to only "comment" on this post of Jeff's travel to Haiti. I was in Nicaragua at the time of the earthquake and felt that, somehow, I was in the wrong place; Nicaragua's poverty level 2nd to Haiti's.It's that feeling Jeff describes as wondering if what you are doing will make a difference. I can answer: YES it does.

And, interestingly, the book I was reading was The End of Poverty by Jeffrey D. Sachs. There needs to be an addendum as PIH director, Ophelia Dahl, has stated that there will from now on be a before, and an after, earthquake measure of poverty in Haiti.

Thank you Jeff for bearing witness and to Paul for sharing this with the Facebook world. Count me in as a nurse wanting to help in any way possible in the relief effort.
In solidarity,
Mary, RN, BIDMC

Jill: NP waiting to deploy to Haiti also.

Kim: I am unbelievably moved, and so thankful to those of you who are in a position to do something (physically) to help. As much of my support as possible is going to PIH - bless all of you who have a hand in helping to ease even the tiniest bit of pain on the scene itself.