My Haiti story (written after my visit there)

(From left: Isabelle, Esther, Me, Marci and Fernande)

It is Isabelle Maxi's dream to have a "beautiful village" in Haiti for her people, one with well-built houses and working toilets.
Maxi, who is in her late 20s, is the village leader of a tent city in Port-au-Prince that has been home to about 556 families since the January earthquake that left about 250,000 dead and 1.3 million homeless.
At the end of September, when I visited Haiti, with piles of rubble and rotting garbage in the streets and the thousands of people still living under tents and tarpaulins, this dream seemed nearly unattainable for a country that was the poorest in the Western Hemisphere even before the quake.
Instead of sturdy homes and clean, drinkable water, Maxi's village is a labyrinth of flimsy tents and other make-shift homes cobbled together with found objects, like tin and tarps.
These homes don't offer much protection from the elements, leaving their occupants to bake in Haiti's hot sun and then get soaked during torrential rains, including the deluge brought by Hurricane Tomas in early November, which was followed within weeks by a surge in cholera cases.
Maxi's tent city is located in Damien, a section of Port-au-Prince, the capital and largest city in Haiti, which shares with the Dominican Republic an island that's southeast of Cuba. The front of the encampment lies near a moderately traveled dirt road, while the back of the camp abuts lush, green vegetation.
There used to be a pig farm here. There are still pigs in concrete pens, but others stray at will among the tents. The stench from the animals wafts through the air.
"We are living with pigs here," said Maxi. "It isn't good."
There are no toilets, showers, sinks, electricity or drinking water. In a large yellow container on the premises, there is water for cleaning and bathing but it isn't filtered for human consumption.
During the tour of the tent city, Maxi told me that I was going to see a "good house." What she led me to was just a wood frame enclosure covered with a tarp.
Scattered throughout the encampment were ditches dug in no clear pattern to keep the area from flooding. They were cluttered with accumulated trash and debris.
Providing clean water and sanitation services is an enormous task in Haiti. Before the earthquake, access to safe drinking water was among the worst in Latin American and the Caribbean, while access to sanitation was among the worst in the world, according to a report by the International Federation of Red Cross and Red Crescent Societies.
The earthquake has made a bad situation so much worse.
The quake devastated the already fragile water and sanitation systems near the epicenter and left about 1.5 million people without access to safe drinking water or a toilet, according to the Red Cross report.
In Haiti, fields and alleyways are the bathrooms for many, and showers are nowhere to be found. Streams and other bodies of water became the places where Haitians can clean themselves. Everywhere I traveled, I saw people bathing outside -- in the streets near available faucets, in rivers and outside of their homes with a bucket of water.

I often saw people filling bottles with water that accumulated in puddles. Many walked around barefoot through the waste and garbage on the ground.
Since the earthquake, a large proportion of sanitation services continues to be provided by international agencies and partners. But, the current situation is not sustainable and these agencies are stretched beyond their capacity and mandate, says the Red Cross.
In 1998, according to Partners in Health, a Boston-based nonprofit that has worked in Haiti for decades, the Inter-American Development Bank awarded $54 million in loans to the Haitian government to improve the country's patchwork of crumbling public-water systems.
The money was intended to bring clean water to people who, for many years, had been denied it, with devastating consequences for public health. Ten years later, however, this money has not produced a single improvement to Haiti's water supply in the city designated to be one of the first recipients, says Partners in Health.
About 70 percent of the population lacked direct access to potable water at all times and the percentage of the population without access to safe drinking water increased by at least 7 percent from 1990 to 2005, according to a 2008 Partners in Health report.
The agency contends that massive debt has precluded spending on desperately needed infrastructure projects. In 2003, for example, Haiti's debt service was $57.4 million; the Haitian government's combined budget for education, health care, environment and transportation was $39.21 million.
Meanwhile, the Haitian people continued to endure shattering poverty. After the quake, many predicted the country was at risk for a secondary disaster in which people who survived would succumb to preventable disease.
This prophecy has come true.
In October, there was an outbreak of cholera, a bacterial infection that typically spreads through contaminated water.
The easily treated infection that causes severe watery diarrhea and dehydration has sickened 66,593 people and killed an estimated 1,523 people, according to the Ministry of Health.
According to CNN, the Pan American Health Organization said it was planning to treat 400,000 cholera cases within the next year, up from a previous estimate of 270,000 over several years, as a result of the outbreak in Haiti.
Treatment usually includes oral rehydration, where those infected drink a solution of water, salts and sugar. But severely dehydrated people may also need intravenous fluids, a treatment routine in many countries but not widely available to Haitians.
Without rehydration, about half of people with cholera die. With treatment, the number of fatalities drops to less than 1 percent, according to the Mayo Clinic, a medical nonprofit.

I wanted to go
Because of these tragic conditions and the destruction caused by the quake, people from around the world went to Haiti to help with relief and recovery efforts. Among them were Franklin County residents, and I wrote several stories about them for The Recorder. It didn't take long for me to have the same thought that many had.
I wanted to go.
I contacted Partners in Development, a nonprofit based in Ipswich, Mass. It was founded in 1990 by James and Gale Hull to promote education and economic advancement in the developing world. Gale Hull is the organization's president and I worked with her to plan my trip.
Partners in Development works in Haiti and Guatemala. It has a child sponsorship program; a small business loan program, which lends participants capital to start or further a business; a housing program that moves families from inadequate housing to sturdy homes; a medical program, which was established in 2003 to provide basic medical treatment, preventive care and health education services.
Maxi works in the pharmacy at Partners in Development's medical clinic in Haiti. It was there that I first met her.
Maxi, who is not a pharmacist, and the other nonmedical staff work in a room that is about 10 feet by 10 feet, not much bigger than a large closet. The shelves were stocked with different medicines, including antibiotics, to help fight bacterial infections, high blood pressure and the common cold and flu.
While I was there, I packed many different kinds and colors of pills into small plastic bags.
Maxi had been studying pharmacy at Universidad Tecnologica de Santiago, a college in the Dominican Republic, for about a year before the earthquake. She came back to Haiti on Dec. 29 to visit her mother.
Maxi was walking on the street during the earthquake, which caused buildings and homes to crumble. The upstairs of her mother's house was destroyed. Maxi went to live in a tent city, where many people fled. "It is my first experience like this," she said.

Maxi's responsibilities
Maxi is the liaison between her tent city and several nonprofit organizations offering help, including World Vision. This organization provides three meals each day. During one of the meals I witnessed, children were eating small amounts rice and beans out of metal and plastic containers, many sitting in the dirt near their tent homes.
Many of the children bore the signs of hunger: exposed ribs and distended stomachs. One out of every four children in Haiti suffers from stunting, a sign of chronic hunger and malnutrition, according to Partners in Health.
Maxi also tries to get medical attention for people in the tent city, like helping them get to the hospital or a local clinic. But, access to medical care is limited in Haiti, with not enough personnel and technology to care for the residents.
While I walked through the tent village one day, a woman came up to both me and Maxi, gripping a young child against her chest.
Upon looking closer, we could see a large, abscess-like lump protruding from the child's behind. I snapped a picture and, when I got back to the clinic, I showed it to Hull. She said the child needed to come to a clinic but likely won't because it is miles away. This is why the organization runs mobile clinics that can go directly into neighborhoods and tent cities.
I don't know the outcome of that child's condition.
I talked to several Haitians about why people are living in the tent cities in such deplorable conditions. Their answers included destruction from the earthquake, which I expected, but also explanations that I hadn't heard before.
I was told that some people left their rural homes to come to Port-au-Prince because the tent cities had access to free food. Others came to the encampments because they feared their homes would collapse on them.

A new home
During another visit to the tent city, I helped deliver a new tent with a Partners in Development group that included four other American volunteers.
After dusk, we piled into the nonprofit's red SUV, filling every seat. Two people had to sit in back of the truck. As soon as I stepped out the truck, I was met with smiles by the tent city's residents.
We walked through the maze of tents until we got to a small piece of cleared land, which we were told was the site for a family's new "home" -- the tent we were delivering.
The tent that we brought was enormous -- one of those tents that has several different "rooms." It was too big for the plot of land.
While the other adults discussed where to put the tent, I noticed a little boy nearby -- McClory, who was then 7. He was lying in a different tent, crying hysterically and screaming. All I could see were his little dark feet sticking out from inside the tent.
A member of the family getting the tent, he has cerebral palsy and cystic fibrosis, an inherited disease that causes thick, sticky mucus to build up in the lungs and digestive tract. He also suffers from constant seizures.
When I asked about him, Hull said, "He is going to die."
Soon, the sun began to set and cell phones came out to help illuminate the area. We had found a larger plot of open land for the tent.
After unpacking the tent, poles, stakes, rain cover and other accessories, we went to work, getting help from one of the family members. Sweat was pouring down our faces and the mosquitoes were biting.
Several people were yelling out directions, others were trying to read the instructions on the tent's package, but the commotion quickly settled down and, suddenly, the tent was up.
When I visited the encampment again, McClory was sitting strapped into a wheelchair, covered in black flies, his skinny and frail body thrashing. He looked so weak!
Haiti has the highest rates of mortality for infants, children under 5 and women in childbirth in the Western Hemisphere. Diarrhea, respiratory infections, malaria, tuberculosis and HIV/AIDS are the leading causes of death, according to UNICEF.
Of every 1,000 children born in Haiti, 72 of them will die before the age of 5. In the U.S., that number is eight out every 1,000 children born, says Partners in Health.
UNICEF estimates that 5.6 percent of Haitians ages 15 to 49 have HIV/AIDS. This includes about 19,000 children. Drugs to combat the disease are extremely scarce in a country where about 60 percent of people, primarily in rural areas, lack access to basic health care services.
Many children also don't have access to education. A little over half of primary school-age children are enrolled in school. Less than 2 percent of children finish secondary school.
Approximately 1,000 children are working as messengers, spies and even soldiers for armed gangs in Port-au-Prince, says UNICEF.

Cite Soleil
Cite Soleil is a shanty town located on the outskirts of Port-au-Prince. It is one of the biggest slums in the Northern Hemisphere. Despite dating back to the 1960s, it has virtually no sewers, stores, electricity, health care facilities or schools.
Cite Soleil was originally built to house thousands of manual workers, but now it is home to about 300,000 people, the majority of whom live in extreme poverty.
After arriving in Cite Soleil in a truck, I opened its door and was immediately struck by the smell of sewage and the sun's intense heat, which only made the stench worse.
We walked across a bridge over a canal filled with black sludge in which floated rubbish and excrement.
I visited the home of 29-year-old Woodeman Joseph, who works with Partners in Development as a translator. He lives with his mother, grandmother, four brothers and a friend in a small three-room house. He says his family has been living in Cite Soleil since 1990. His sister died in the earthquake, a topic that Joseph doesn't often discuss.
"Living there, it's not good," said Joseph. "It's a shame but it makes me strong."
Everywhere we walked, I kept my eyes on the ground because I didn't want to step into human waste.
We visited another home that four people shared, a one-room tin structure, with a single bed made of blankets on a dirt floor.
Hull said many of the homes built by Partners in Development are for families from Cite Soleil. So far, the nonprofit has built about 40 homes in Blanchard, a section of Port-au-Prince where the organization's clinic and compound are located.
Hull said Cite Soleil wasn't affected as much as downtown Port-au-Prince by the earthquake. The shanty town doesn't have many of the concrete houses that came toppling to the ground during the quake.

Building houses
Hull described the rebuilding efforts in Haiti as a "mess."
"It is going slowly because there really is no infrastructure and there was no true leadership before the quake," she said. "Haiti has a very bureaucratic and corrupt system."
"The corruption has always been there but it is very bad at this time," she said. "Aid is stuck in the port because people are waiting for bribes and kickbacks (and) the president says he can't do anything about it."
Larger nonprofit organizations that have received funding are hesitant to release money because of the "confusion and lack of coordination and past corruption of the government," said Hull.
I helped Partners in Development's construction team for several days. They were working on the interior walls of a concrete home, applying concrete to the walls like plaster. So, my job was to help mix the concrete.
In the 100-degree heat, I used a pick ax to break up what looked like white dirt and stone. Then, a team of two, usually me and my new Haitian friend, Maxime Genois, took turns with two jobs -- one of us would sift the rock and dirt material into a wheel barrow and the other would shovel the rock mixture into the sifter.
Then, the sorted material had to be sifted again before it could be mixed together with water to make concrete.
I watched as the concrete we made was spread on the walls of the home. A house is something needed by so many in Haiti, especially after the quake.
Even in the grim conditions I encountered during my visit, I was always greeted with smiles and "bonjous" (hellos) from the people I passed, even those who had been waiting for hours at a clinic.
The people of Haiti welcomed me to their homes and never made me feel unsafe or unwanted. They welcomed me into their community, constantly asked me questions and were always there with a helping hand.
When I visited the tent city with Maxi, a group of children were always at our heels, following us and looking inquisitively at us with their dark-brown, sparkling eyes.
They would tug at my tank top, pointing at my camera and asking "photo?" Upon seeing their images on my digital camera, the children would squeal in delight, ear-to-ear smiles plastered across their faces.
At night, Maxi, who |doesn't have any children of her own, lets some of her village's children sleep in her tent. Each day, some of the food she cooks is saved for the little ones.
Maxi embraces her unpaid position as village leader and there wasn't an ounce of hesitation in her voice when she said so. When asked what she likes the least about her job, she said "nothing They have chosen me."
Maxi's face lights up when she talks about "her children." "The important thing is the children," she said. "My dream is a clean village."