Some Basic Things Need To Be Changed Claude Hillel

19 March, 2010 — Getting into Haiti two weeks after the quake with Ekip Bon Fwa was difficult. I wanted to be there and to help, and the process to do that was very very difficult. I don't understand why given things were difficult, but it was very difficult. I felt that there were hurdles that could have been eased by more communication and coordination between people that were already there on the ground.

Onboard the USNS Comfort

Once I left Port-au-Prince and got on the ship, I felt that I was doing good work. There was so much to be done all the time. We were not enough physical therapists for the amount of people that we were expected to see. There was a very high turnover in the patients. The second they were — not even functional — the second they could stand up they were discharged from the ship. So our work was quick and we had to target basic needs.

Motivations were different on the ship, in terms of helping people. You have a lot of people that were volunteering, and there were also a lot of people that were asked to be there — I mean, military. I would have liked to be surrounded by people that had the same drive that I had. I was the only civilian physical therapist on the ship. I feel I would have liked to have a couple more Claudes — to be a little bit more caring, I guess.

I was not very happy with my command. Although there was a need for us, we did not stay to meet it. I think the mission of the ship was to help initially, but not to provide anything more sustained than that. They were trying to minimize their footprint and you could feel it when you were on the ship. One day a ward would be totally closed and you would be wondering where were those patients. They were just discharged — and not always ready to be discharged.

That was my first exposure to military so I cannot just criticize. I understand that they've got a mission and they stick to it. I don't know the parameters they used to set their goals, but it was evident in my experience that they did not like us much.

I got on the ship on the 23rd of January and I got off on the 28th of February. Towards the end we were doing mostly visits to hospitals, daily. We would go to the various places and do a gross assessment of their needs in terms of supplies, in terms of manpower, that kind of thing. We would make recommendations after we got back on the ship about how we could help them. Sometimes we visited the same hospital a few times when there was a big need. Other times was just a one-time visit.

When I left the ship there was less than a hundred patients on the ship. When I got on there were about eight hundred patients. So, by the time I left they had been discharging quite a bit of patients. They started letting go of medical professionals. There was only a few nurses and there was only two physical therapists left.


I think the most important story for me was Pierre. Pierre was a little boy who got on the ship a day after I got on the ship — he got on the ship on the 24th. He was hit by a car, unknown location, and he was found by some man on the side of the road and brought to a satellite Miami University hospital. They couldn't care for him so he was brought on the ship on the 24th. He was in the ICU. I cared for him for a month.

I wanted to find his parents. I think that if we had gotten consent from his parents to bring him to the States, he could have been brought here like many others. But as the rules became very rigid after that missionary thing [the nine US Baptist missionaries who kidnapped thirty-three Haitian children and attempted to transport them into the Dominican Republic on 29 January], he couldn't be taken to the States without that consent. So he stayed in the ICU for the whole time. Very very slow progress — started breathing on his own, he started opening his eyes — slow progress, but definitely progress. By the last week he was sort of smiling awkwardly, but it was maybe involuntarily.

But they had to discharge him. We took him from the ICU to a place called Real Hope for Haiti, a little bit outside of Port-au-Prince in Cazeau. The journey there, it was long and it was on unpaved road, and for him to go from the ICU to that trip was probably not the best way to get him there. I was also very unsure about leaving him there. The people there were very caring but they definitely looked like they were understaffed for the number of patients that were seen there. So we left him there, the nurse and I that took him, and we kept in touch with the nursing staff.

I just found out last Thursday — suddenly — yeah. He represented so much for me. We never found his parents, we never found family. Although there was starting to be some momentum in finding his parents, everything stopped when he died.

I haven't known Haiti normal

It's so funny, I haven't known Haiti normal. In '86 I was there, just before the coup. That trip was for convalescence. I was in college and I caught mono. I was in Montreal and so we're buried by snow. My aunt said, "Why don't you come down here? It's warm!" I was taken from the airport to their home, which is a little outside of the capitol and stayed there for a few days. She was right, I got better! It's a very peaceful area, a very safe area. And then, it's while I was there that the coup happened. Afterward I saw chaos and everything.

I never really lived what Port-au-Prince would be like normally, just because I never made it there on a normal day. Despite everything that's going on, Bon Repos is a very peaceful, quiet little haven. I mean, it's fallen and shattered, but you don't feel it as much as they do in Petionville for instance.

It was not the size or the strength of the earthquake that caused all of this. It was the poverty, and the only way it's going to get better is if the help is sustained. If they publicize the thing we went through and then it stops — no, it's got to be sustained.

There's been forty thousand to fifty thousand major orthopedic injuries. We're not talking sprained ankle. There's been a rough estimate of at least ten thousand amputations, four hundred fifty thousand homes and fifty thousand businesses and one point five million homeless people. It takes time to recover from all this. My hope is that the efforts will be sustained.

Volunteers and NGOs

Also the NGOs must start working differently. With ten thousand NGOs in Haiti right now, you wonder how come there's still — there's like this, I would say, pissing contest. Things should be more centralized in some ways. I felt that things were very chaotic when I was there. Things should be streamlined so that the resources are used more efficiently.

To people like me, people that want to go there and volunteer, I think that there's a need for anybody with any type of skills to be there. I think it doesn't just need to be just health care professionals. There's a need for people to give a hand, and they just have to go. There's enough to be done. My brother is coming back from Haiti tomorrow. He went with a group of architect friends of his. They brought a bunch of tents and they were there for a few weeks.

Being able to tag along with a large organization was frustrating because they make you jump through so many loops. I just went not knowing what was going to happen, and things happened! If you want to help, you can help. Don't let the bureaucracy of the NGOs stop you. And money is not enough.


I hope this didn't sound too frustrated or angry in any way. I've had people tell me over the past few weeks that sometime I sound frustrated or angry talking about things. I'm just trying to be critical of this current system we have and I hope that some positive things come out of it. I think people do the best they can with what they've got. A lot of things are improvised and nobody can rehearse this, but there are some basic things that need to be changed in the way we react to catastrophes like this one — like the coordination of efforts.

As you know the United Nations suffered their biggest loss of lives of staff in their history. That loss cost in terms of the coordination of the effort and can explain part of the problem at that time but I think there was also problems in the way various organizations talked to one another.

A little story

Just another little story. We went to the General Hospital one day. I arrived there with a few therapists and a lot of supplies — crutches, bandages, and walkers. The director of the hospital welcomed us with open arms. He guided us to where the outpatient physical therapy was and told us that we would be greeted by somebody from Handicap International.

We were greeted by this person from Handicap International that said they basically did not need our help. We're surrounded by people waiting — people sitting on the ground, people suffering, people poorly bandaged, people needing assistive devices — and somebody said that they don't need me. It was a weird thing; they basically told us that unless we were going to be there for many days — they needed the sustained help. And I said "Well, we're here now. We've got five hours, and we can make a difference."

And they said, "No."

I pointed out to the person who was there at the time — I said, "I can see right now about ten people that are not wrapped that need to be wrapped — amputees that is. I can see people that are being carried by their relatives and friends because they don't have a cane or a walker. And we have all this with us. So how can you just stand here and tell me, we don't need your help?"

We had to go back to the director. He came back and said, "You've got to let those guys help us."

Trust me when I say this. We helped so many patients that day, in just a few hours. We had instructions with illustrations, and we had bandages. We were busy! I don't know why that reaction there was so not welcoming.

But Handicap International — they were very rigid. I mean, I would have liked to have the luxury of seeing a patient every day at the same time and schedule. In a normal situation, that's the way you do things. But in a disaster relief situation, you do what you can. We were able to help patients that day. But I have to say, we had to push ourselves in. They were not welcoming, they didn't want to share the territory. They were all about putting their big banner — they had a big banner in front of the clinic.

To this day, I'm still upset about it. Because it was not once, it was not twice, it was three times. And we're talking to a different level of people. The people at the hospital were very welcoming. They were so grateful for our help. But the NGO that was on the ground there was not.

The military's response is very often in those situations — when they're face-to-face with an NGO reacting like that — is to step back. They're very concerned with their perceived motivation to do things. They want to minimize the footprint. I think that if it was not for me pushing my way in that day, we would have left. We never went back to the General Hospital after that thing.

The next ten weeks

On Monday I'm going to the Albert Schweitzer Hospital in Deschappelles, which is near Cap Haitien. It's about sixteen hours away from Port-au-Prince. And there, we're setting up an amputee program. I think they've got a lot of donations from a large prosthetic manufacturer called Hangar. I'm the first of a series of physical therapists that will be going there and working on prosthetic rehab. That's all I know for now. There are people coordinating the supplies getting there. But in terms of me, specifically, and what I'll be doing, I think I'm just setting up the program, and I'm going from scratch — that's my impression. That's why I am staying there for ten weeks, is to give it a little bit of momentum.

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