Skip to main content
You have permission to edit this article.
Life and Death in the time of Cholera: Beth Macy's 2010 story from Haiti

Life and Death in the time of Cholera: Beth Macy's 2010 story from Haiti

  • 0

Editor's note: This story originally appeared in the Dec. 11, 2010 issue of The Roanoke Times. Former Roanoke Times Reporter Beth Macy chronicled the The Angel Missions Haiti trip to Port-au-Prince and Limbe, Haiti, on Nov. 10-17, 2010. Macy’s trip was funded by the Dart Society, a nonprofit dedicated to supporting journalists who cover violence and trauma, with collaboration by the Nieman Foundation for Journalism at Harvard University, of which Macy was a 2010 fellow. In conjunction with the U.N.'s acceptance of its role in the deadly 2010 cholera outbreak, it is being republished. 

PORT-AU-PRINCE, Haiti — Bitho Peter lies on a dirty air mattress covered with a dirty sheet while a cluster of doctors from Maine crouches next to him, wondering if his leg can be saved.

Peter, a 23-year-old with the yellow eyes of sickle cell anemia , has a chronic ankle infection, a gaping, pus-filled wound that requires something not easily accessed here in the poorest country in the Western Hemisphere: regular medical attention. If the infection spreads to the bone, his foot and lower leg will have to be amputated.

It's the kind of wound the Maine doctors expected to be treating when they signed up for this weeklong mid-November trip, organized by Roanoke County-based Angel Missions Haiti .

The surgery will take place tomorrow, after which the team is scheduled to care for the wounded and sick in the city's tent cities and slums. Three of the five are residents, young doctors about to learn what it's like to treat scabies, worms and a spate of respiratory infections triggered by the ubiquitous earthquake rubble and the scattered, sour-smelling fires.

That's the schedule anyway.

Meanwhile, a cholera epidemic  the first in Haiti's history — is seeping south toward Port-au-Prince . At the moment, one death has been reported in the capital, but 724 Haitians have died nationwide from the water-borne bacteria, most of them in the north.

Angel Missions Director Vanessa Carpenter , 49, is busy preparing for its arrival and doing what she usually does on her monthly mission trips: lining up medical supplies, networking with other humanitarian groups, bossing people around.

As her husband, Tom Carpenter , put it a week earlier: "When she's in Haiti, she's Mach 3 with her hair on fire."

That afternoon, one of her three cellphones rings, as they always do, and the plans shift abruptly, as they usually do.

"It's Haiti," Vanessa says, by way of explanation.

The U.S. military has called on her before during times of crisis, but, this time, it's the United Nations on the phone. Cholera is slamming the city of St. Louis du Nord , and a U.N. helicopter is on standby waiting to transport the Maine medical team north.

A hospital there is inundated. A hundred new patients stagger in daily. Staffers are overwhelmed. Supplies are drying up.

Dr. Chiedza Jokonya of the Maine-Dartmouth Family Medical Residency program gathers her team to warn them: What they witnessed in the clinic today will be a stroll in the suburbs compared with what's awaiting them up north.

"You'll be in cramped rooms full of people who could be dead by the end of the day," she explains. "People will die because there won't be enough of you to get all the work done."

Jokonya, Zimbabwean-born and British-educated, is known as "Chi" (pronounced chee ) to friends and colleagues, a name that fits her no-drama even keel. The 40-year-old pediatrician tells her charges they'll have to be hyper-vigilant to prevent needle sticks.

She's brought along plenty of antibiotics but didn't think to pack HIV prophylaxis , so everyone will have to double-glove. More than 120,000 Haitians, or 2.2 percent, are infected with HIV.

The choice is theirs, she tells them. If someone doesn't want to go, he or she should speak up now, and the entire group will stay in Port-au-Prince, no questions asked.

For a few seconds, no one says a word. Then third-year resident Dr. Lalaine Llanto breaks the silence.

"That's why we came here," she says. Meaning, to help.

The rest say they're in, too — as long as they're able to return to the capital by Tuesday, in time for Wednesday's flight home. Presidential elections are scheduled for Nov. 28, and no one wants to be stuck in Haiti at a probable time of political unrest.

No problem, Carpenter says.

But Chi has volunteered enough times before to know that things can change here on a Haitian dime. It's Haiti.

She wonders: Will they really make it back on time? And what shape will they be in when they do?

* * *

Three months earlier, Vanessa was at home, working her Haiti contacts — only this time from the comforts of her suburban two-story, in the shadow of Fort Lewis Mountain . It's been her Christian calling for 12 years now, ever since a church friend in Illinois invited her on a mission trip to an orphanage and Vanessa responded: "Haiti? What state is that in?"

She was a well-known foster parent at the time — "the baby whisperer," the social workers in Chicago called her. She was often the only foster mom willing to take on certain high-needs children, including abused kids and crack babies . Though she has a high school education and no medical training, Vanessa has managed to distinguish herself as a child-welfare advocate wherever she goes.

Some say it's through sheer force of personality. Vanessa calls it faith.

Sometimes, she watches the video from that first Haiti trip just to relive the initial shock: Pulling up to the orphanage, they meet two machete-wielding guards, at which point Vanessa turns to her friend and says, "Donna, we're not in Kansas anymore, are we?"

She's run the nonprofit from her Glenvar garage-turned-office since 2003, when the family moved to the Roanoke Valley. It's filled with medical supplies, Maltese puppies (she breeds them as a mission fundraiser) and frequent interruptions from her kids. She has 17, most of them adopted, but most are grown, with "only seven" still living at home.

Before the earthquake struck Port-au-Prince Jan. 12, Angel Missions focused solely on children, but the needs are so great now that Vanessa's Haiti staff serves entire families. Entire neighborhoods, actually.

"You think it can't get any worse in Haiti, and then it does," she says.

Everyone who works in Haiti has a tally of earthquake losses, and this is Vanessa's: her mission's Jeep, the top story of a surgery center that was just about to open, her next-door neighbors in Port-au-Prince and many other friends and former patients.

She was in Virginia the day of the quake but flew to Haiti the next week to run triage for the USNS Comfort , the Navy hospital ship where the worst of the injured were sent.

She's spent more than half her time in Haiti this year connecting American medical teams with sick Haitians and getting the severest cases to the United States. "Her super power is: She gets people out," says Roanoke County's Sondra Masten-Daroshefski, a nurse who pulled post-earthquake duty with several Roanoke colleagues in February — and ended up fostering an injured 10-year-old orphan boy.

Vanessa's husband Tom, a laid-off project manager, runs the household and Angel Missions paperwork. Eventually, they'll move full time to Haiti, where they plan to build two schools and an orphanage. But they're trying to get their teenagers through high school first.

For now, they're living frugally, mostly off their savings. According to tax returns, neither earns an Angel Missions salary, and all donations go directly toward the mission.

Tom describes his wife's work in Haiti as a spider web. It looks chaotic from the exterior, but, from the inside, the connections she's forged among other missions, non governmental organizations and the U.S. military are beautiful and complex.

At the center of the web is Vanessa's main weapon in her battle to boost wellness in Haiti: a 25-year-old registered nurse named Keziah Furth — aka, Kez — from Brookline, Mass . She's a blond-haired, blue-eyed powerhouse who speaks perfect Creole, and she's now the primary care provider for more than 300 tent city and ravine dwellers.

Vanessa's only full-time medical employee in Haiti, Kez was visiting friends on the outskirts of Port-au-Prince when the earthquake struck. She rushed home to retrieve her medical supplies and found her own house still standing — but many of her neighbors' homes collapsed, some with friends buried inside. "I remember thinking as I climbed over the rubble: 'I'm probably walking over the bodies of the women who sell me fruit and vegetables.' "

"The big NGOs [nongovernmental organizations] were able to provide a lot of the tents," Vanessa recalls. "But Kez was there, literally patching people up."

And she's still out there most days, asking them how they are and seeing what they need, whether it's a case of clean drinking water or a lesson in cholera prevention.

Kez refuses to be paid by Vanessa, but Angel Missions picks up her rent and most of her expenses. Friends and relatives send donations, and, every summer, she works as a camp nurse in Maine; it helps her cover the school fees she pays for 14 neighborhood kids, many of whom she also feeds.

Vanessa relies on Kez to run the mission when she's home in Virginia. "Kez is me — only younger and skinnier," she says.

At the end of the Maine team's first day, Kez begs her boss to let her fly to the northern city of Gonaives to help friends who are inundated with cholera patients in two of that city's slums. "These are good people who have flown down here at a moment's notice when I needed them most," she says.

Earlier in the day, Vanessa told her she had to stay with the doctors. But suddenly, everything's changed.

As the doctors prep for their flight north, Kez gets ready for Gonaives. Everyone's on cholera duty now, rushing to mix oral rehydration supplies and pack antibiotics.

Timing is key, they know — the difference between life and death. Most cholera patients have mild symptoms. But among the 20 percent who get very ill, those who can't access treatment to replace the fluids lost to vomiting and diarrhea can die within four hours.

When the body is dehydrated, it compensates by rerouting blood from nonessential organs to the brain, heart and kidneys. But in severe cases (especially among malnourished Haitians), the compensation isn't enough, and poor circulation to the brain causes confusion, then loss of consciousness. The kidneys shut down, and, eventually, the heart fails.

That's what the residents remember from their textbooks anyway. They've never seen it in person.

* * *

By the time the team arrives via helicopter in Cap-Haitien, the plans have shifted, again. The group has been redirected to a hospital in Limbe called Hopital Bon Samaritain, which is treating upward of 100 cholera patients a day. So far, 13 have died. Supplies are running low, and the staff doctors there are overwhelmed and exhausted.

Earlier that day, Vanessa spent $4,000 on IV fluids for cholera patients. But when she checked in for the flight, the helicopter was already filled with supplies bound for another city, and she couldn't bring hers aboard. It's Haiti.

It's Thursday, day two of the trip, and the routine planned for the week has vanished, replaced by a blur of daily, sometimes hourly, problems.

By dusk, they land at the airport in Cap-Haitien. A city of 200,000 that flooded in the wake of Hurricane Tomas a few weeks earlier, it's now especially prone to cholera, a bacterial disease spread through contaminated food and drinking water.

Rioting is about to break out, a response to rumors that United Nations peacekeepers from Nepal have imported cholera to Haiti.

But right now, the team has no idea it may be in danger.

"Blan ! Blan!" people shout — Haitian Creole for white person or foreigner — as the hired driver navigates a pickup through the city's muddy roads, most of which are reduced to a single lane and riddled with mattress-sized potholes. Drivers honk like New York cabbies, and motorcycles roar around blind curves with three people to a seat.

Most of the city's population appears to be standing on the streets, as if waiting for a parade. Back in Glenvar, Vanessa had said, "Machetes are tools, not weapons!" But the people clutching them now are grimacing and seem not to have farming in mind.

Nina Miller , a residency faculty member, sits in the back of the truck, which is half-filled with hospital cots that have been lashed down with rope. Nina clutches the rope with one hand and offers friendly waves with the other.

A few people wave back. Uniformed schoolgirls rub their stomachs — to indicate hunger — and a few bystanders flip her off and shout, "Blan! Go away!"

The roads are so bad that it takes 90 minutes to drive the mountainous 16 miles to Limbe, a small city of subsistence living and roadside enterprise. Old men dry cacao beans on blankets, and children carry river water in plastic containers balanced on top of their heads.

By the time they arrive at the American-run hospital , the doctors are cold, bruised and hugely relieved. They laugh when they read what some jokester has carved into an entranceway wall: "KANSAS."

The last light moment of the trip has just occurred.

* * *

By dusk Thursday, there are so many cholera patients that the hospital can no longer contain them to a single indoor ward. A picnic shelter has been converted into an overflow wing, and so has a UNICEF tent.

Patients lie on soiled cots in outdoor walkways, some retching and others barely able to move. Bags of IV fluids hang from strips of ripped bed sheets, which dangle from the rafters.

"Last night, we went through 120 serums in a 12-hour period," says the hospital manager, Shawn Hodges , whose physician-grandfather built the sprawling compound of white stucco buildings in 1953. It's a Colonial-looking enterprise, part-Californian in design and part-African outpost, and it definitely has seen better days.

Brookline, Mass., native now living in Port-au-Prince and working as the Angel Missions nurse. Kez persuaded the doctors to defy United Nations orders to stay put when the cholera riots broke out.

Founder William Hodges started it with several missionary friends but ended up going it alone when his colleagues turned out to be more interested in saving souls than treating the sick, Shawn says. Vanessa, whose work in Haiti has been similarly viewed by some missionary colleagues, nods her head.

"You cannot go in and preach to people with sick children and tell them God loves them without also helping them with their sick children," she says.

The team throws on scrubs and gloves (already abandoning the double-glove rule), and all modern-day practices are out: Thermometers are the backs of hands. Medical charts — what medical charts?

Tape used to secure IVs onto arms becomes a bandage once the IV is removed. Splints are torn pieces of an old cardboard box.

By the end of the night, the doctors are recycling gauze, IV tubing, even needles.

Some patients are so dehydrated that it's hard to start an IV. It's nighttime, and Vanessa walks around, holding the ward's rusty desk lamp so the doctors can see better to find a vein.

Electrolyte-rich hydration fluids are passed out to the patients who aren't vomiting, with instructions to take "bwe I piti a piti" — small sips . But the hospital's also short on plastic cups, and patients begin hoarding them for family members who might get sick later.

Some parents drink the sugary-salty drink that's meant for their children, thinking it will protect them from sickness. In a country where 60 percent of the population doesn't have clean water to drink, they know that this serum, at least, is safe.

Second-year resident Dr. Suhas Pinnaka , the youngest of the team at 34, stands in the middle of the tent, turning circles and wondering what to do. He's never seen anything like this, not even in his native India: Here, patients have to bring their own bedding and even their own bowls to capture vomit and waste.

Here, entire families come to the hospital, as if they're camping out, which, in fact, they are. When he catches a teammate accidentally giving a cup to a patient who already has one (but has hidden it away), he goes back to retrieve it. "At least that's something I can do," he says, shrugging.

Chi has already identified several patients on the brink of death, including a year-old baby who's in the cramped, stuffy cholera tent — but has severe pneumonia, not cholera. The Haitian doctors were so busy, they missed it.

On top of that, with his glazed eyes and distended belly, the baby seems to be starving. There's no time to move him to the pediatrics ward now, so Chi goes to work draining the sepsis from his stomach. First, though, she needs a nasal gastric tube, and there's none to be found. (At Haitian hospitals, patients have to buy most of their supplies before they use them. The tube is secured later, from the hospital pharmacy.)

"Let's save this baby," she tells a resident, who fishes supplies from their backpacks on command.

Back in the hospital office, Vanessa is Mach 3 as predicted — calling and e-mailing everyone she can think of to recruit more volunteers, more supplies, more translators. (The only team member able to communicate verbally with the patients is Chi, and she's fluent in French, which is similar to Creole but more formal.)

"I'm calling Kez. I'm calling the military. I'm calling everybody!" Vanessa says.

That night, two men lie back to back on the concrete walkway, their heads perched on makeshift pillows and their bodies clad in ill-fitting suits. Flies buzz on their unflinching bodies. Cholera corpses.

When a team member walks by and does a double take — this is where they lay the dead people? — a relative of another patient laughs and shakes his head.

As Vanessa put it before the trip: "Haiti's so bad, so crazy. . . If you really tell the truth, no one will believe you."

* * *

By Saturday morning, the baby is hanging on, barely. His name is Saintilus Duval , and he has refused food for a week. Chi outlines her plans to find oxygen for the boy while Lalaine , one of the third-year residents, slumps into a chair and recaps her night.

"We had one mortality," she tells her boss. There were 20-some new admissions, and all the other patients needed their IV lines changed at the same time. "It was just me and Suhas, and all the IV lines were dry," she says.

"I'm very stressed out. I'm yelling at Suhas, 'You knew it was dry. Why didn't you replace it?' But we were both just overwhelmed." It was an elderly person who died — a feather of a woman, no more than 90 pounds. Neither doctor knew her name.

Miller, a nurse practitioner, worries that Chi is spending too much time on the baby. "With this many patients, we all need to be triaging," she says.

The baby's father is pleased but equally surprised so much attention has been heaped on his son, the youngest of his three children. The family arrived at the hospital on foot, two days before the Maine team did.

Many of his neighbors weren't so lucky. "They died so fast, they didn't have time to get here," Chago Duval says, through an English-speaking hospital visitor.

The night before, a mother and two children staggered into the cholera ward on the verge of death, having left the husband and grandmother along the side of the road. They had died during the walk to the hospital, and the mother had no choice but to continue on with her sick kids.

Asked what he does for work and how he feeds his family, Chago and the translator both laugh. Silly American. "There are no jobs in Haiti," Chago says. "When God wants to give us food, we have food." He does have a garden, and, sometimes, he gets construction work in the Dominican Republic, three hours away.

Third-year resident Dr. Prativa Basnet has worked in Third World conditions in her native Nepal before — but never anything this bad. The people here are so desperate for comfort that many refuse to leave when she tells them — via emphatic gestures and with the help of Haitian nurses — that the worst has passed. For the sake of their health, it's time to get away from these germs .

Saturday night, a man shows up carrying his dehydrated 7-year-old son. The boy's pupils are dilated, and his breathing has slowed to five breaths per minute. (Normal is 20.) Lalaine tries to revive him by starting an IV in each of his arms. But before the fluid can do its magic, the death rattle begins.

"In the U.S., I could have intubated him to make him breathe," Lalaine says. "I could've given him meds to get his heart rate up. I could've drilled a hole into the bone for quicker rehydration."

It's the first child death of her career, the first that could have been prevented with better technology and quicker care.

When she tells the team about it, Lalaine is most disturbed by this fact: When she pronounced the boy dead, his father didn't even cry.

It's self-protection, in a country where 50 percent of children die before they turn 15. The World Health Organization projects the cholera epidemic will last six months to a year in Haiti, infecting as many as 650,000 people.

"The cholera will go on even longer than the earthquake crisis," Vanessa explains. "It will probably affect more people."

But on Monday, it's not cholera that ends up killing Saintilus Duval , the infant the team came to refer to as "our baby."

It's pneumonia. Hastened by hunger. And poverty.

The morning after his son's death, Chago Duval returns to ask the Americans for money to bury his boy. He's not crying, either, but he is rubbing his stomach.

Hospital workers advise the team not to give Chago money. The man still owes the hospital from a prior hospitalization, and, besides, if they give money to one family, then others will swarm them demanding money, too.

But later, Vanessa dispatches two people from the team to discreetly deliver 250 Haitian dollars — the American equivalent of almost $7 — and some granola bars.

"Merci," he says, and heads immediately for the gate.

* * *

It's Monday, the team's last day in Limbe, and the doctors are so tired, they're punchy. "I picked up my dirty clothes after my cold shower this morning and said, 'Hmm. Which smells less?' " Chi says, trying to lighten the mood.

Within the hour, they learn that, in fact, it's not their last day here: The U.N. has canceled their flight back to Port-au-Prince because of rioting in nearby Cap-Haitien. Protesters are angry at the U.N. for allegedly introducing cholera to the region, a detail later confirmed by epidemiologists across the globe. That morning, there were 900 reported cholera cases in six of the country's 10 provinces.

U.N. soldiers have killed two protesters in Cap-Haitien, and local gangsters have set up roadblocks where they're burning tires, hurling rocks at foreigners' vehicles and siphoning gas from their cars. "They're blaming the Nepalese, and politicians are using that to denigrate the U.N., especially with the elections coming up," Chi tells the group.

She knew about the Nov. 28 elections when she confirmed the trip but thought the group's Nov. 17 departure date would give them plenty of time to leave Haiti ahead of any political unrest. She hadn't planned on cholera, though.

The team is on edge. It's a classic instance of hurry-up-and-wait: Their bags are packed, but they've been told it's not safe to leave the hospital compound.

That afternoon, rocks slam against the hospital gate. The protests have hit Limbe.

"Where are the police?" Suhas asks the hospital manager.

"At the police station," he says.

Monday night, protesters torch the Limbe police station.

At 3 a.m. Tuesday, Chi and the others awaken to more rocks — closer rocks. Protesters are now hurling them at the fence outside their bedroom windows. Rumors have circulated that the Americans are sending patients home to die.

That morning, Chi re-packs her bags. This time, she gathers emergency medical supplies — all the last bits of gauze, tape and needles she can get her hands on — stuffing them into her backpack.

They're in real danger now; there's no denying it — trapped by the very people they've been called upon to help.

Instead of leaving the supplies behind for the Haitians, as she'd planned, she's taking them with her.

For her team.

* * *

At 9:30 a.m. Tuesday, the team is scheduled to rendezvous with the U.N. helicopter on a nearby soccer field. It's too dangerous to drive to the airport in Cap-Haitien, so coordinates have been gathered for the field a half-mile away.

"How do you make a five-minute journey safely? That's the question," Chi says.

"Could we walk?" Nina asks.

"No, you guys are too blan," Chi says.

By midmorning, the U.N. deems the flight into Limbe unsafe. A no-fly order has been issued across the region, and the group is told to remain on lockdown and sit tight.

Kez is a three-hour drive away in Gonaives and wants to come rescue the group, Vanessa explains. "But I've ordered her to go back to Port-au-Prince. It's too dangerous up north."

Vanessa is crippled by a migraine, so Chi makes the executive decision: "We're stuck here, waiting for the U.N., but face it, we're a low priority. With the elections coming up, the longer we stay, the worse it's going to get."

She issues an SOS to the group: "Call anyone with connections you know."

She calls her boss in Maine, who contacts the office of U.S. Sen. Olympia Snowe, R-Maine . Staffers in the office of U.S. Sen. Mark Warner, D-Va., contact the U.S. Embassy in Port-au-Prince to see about retrieving the group.

It's 2 p.m. The team is distracted by the flurry of phone calls and e-mails when in bursts Kez and three of her Christian missionary friends from Gonaives. They were expressly told not to come, but even Vanessa concedes: She's glad they did.

On their way to rescue the team, they picked up three local men to help them find the hospital — and provide muscle — as they negotiated passage through six roadblocks.

The doctors are initially reluctant to hop into the industrial-sized Kia pickup they've brought to haul everyone back. They've been told by everyone — including the U.S. Embassy — that the safest route is to stay put and wait it out.

"After the flood in '08, the embassy was supposed to come get us, too — and we waited and waited and waited," says the driver, Emory Wilson , who runs a school mission in Gonaives. It was 12 days before the embassy persuaded the U.N. to bring in water and food for the missionaries and the 49 children they'd rescued, says Wilson, a former chemical-plant supervisor from Waynesville, Ga.

Finally, Kez and the missionaries persuade the doctors to load their things into the truck. "It looks scary, but it's not," Kez says. "You just get out at each stop, and you talk, and you get the locals to help you."

They're facing a three-hour drive to Gonaives. The roads are mountainous and bumpy, lined with banana trees and shacks, and the uncertainty of even more protests erupting as nightfall beckons worries everyone.

As the truck pulls up to the first roadblock, a mob of machete-wielding protesters approaches the group. Someone lobs a stone at the truck, hitting rescuer Brian Smith in the hand.

"Chi, let's go back! Let's go back!" Lalaine says.

Tucked into the back seat , the medical residents are wearing do-rags and sunglasses, trying to mask their south Asian skin. Even though Prativa is the only Nepali in the group, no one wants to be mistaken as a friend of the U.N. peacekeepers. For the first time all week, it's better to be white here than it is brown.

Smith, 46, a former Navy man who does construction work in Haiti and Pakistan, leaps off the truck like a high school track hurdler, rushing toward the protesters with his chest out and his Creole at full volume. He slaps the back of one hand against the palm of the other, Haitian-style, for emphasis.

The recruited townies help him convince the protesters that the team came here to help Haitians, and harming them will only make the epidemic worse: If you hurt the people who help you, no one else will come.

The crowd rolls back the boulders and tamps down the tire fires and lets the truck pass. So it goes through the next two roadblocks, although the passage of time is slippery now. It seems to stand still as the team fears what it will find lurking around each new curve.

The fourth roadblock is different. A dump truck is parked diagonally across a bridge, blocking it. As Smith leaps out to negotiate, a man in a Jimmy Buffett T-shirt bashes out the window of the dump truck with a bat, then charges toward the Kia.

At that moment, Chi wishes the protesters had guns instead of machetes. At least with guns death might come swiftly. Lalaine thinks only of her kids, ages 6 and 8. Vanessa prays silently; if anything happens to this team, fewer people will want to travel to help the Haitian people.

The doctors scream as Smith and his recruits try to corral the man before he reaches the truck. But another protester gets to him first and distracts him — by pulling down his pants.

"He's just lost someone in his family to cholera," Smith explains later. "By the time we got to him, he was collapsed in tears."

The team waits for 10 excruciating minutes before the key to the dump truck is finally located and the bridge unblocked.

Forty minutes into the journey, the sixth and final roadblock is broached . The cost of passage: Smith gives the locals he'd recruited the equivalent of $6. He throws out packets of oral-rehydration mix to the protesters standing below.

The mountainous three-hour ride to safety is finally, gloriously under way.

* * *

It's Nov. 30, two weeks since the harrowing hospital rescue. The return from Limbe culminated in a U.S. Embassy escort from Gonaives to the airport in Port-au-Prince the day after the escape.

The team has reassembled in Portland, Maine, to honor Chi, who's receiving a humanitarian award for her work in Haiti and Zimbabwe.

After the ceremony, Vanessa and the team regroup in Chi's townhouse to rehash the week. Viewed from a distance, the events in Haiti feel surreal, like the folk-art landscapes hawked on the streets of Port-au-Prince.

Some residents have had trouble sleeping, thinking about the baby and others who died on their watch. Lalaine found herself on call at the hospital one week after their return, delivering five babies back to back.

"I like staying busy," she says. "I don't want to think about the boy I saw die in front of me. I don't want to think about how I could have saved him if we had been here."

Prativa can't shake the image of a woman who arrived just as the team was evacuating Limbe. "She died on a stool; she didn't even make it to a bed.

"People are dying for no other reason than they live in Haiti."

As the team leader, Chi feels responsible for having placed the team in danger, but she also knows there's no such thing as security in Haiti; there's only the illusion of control.

When Vanessa explains that the next two Angel Missions teams have already canceled their 2011 trips to Haiti — fearing the cholera — Chi shakes her head. "You don't get cholera from caring for people," she says.

All five members of the team say they're determined to go back, likely next May. As of this week, more than 2,000 Haitians have died of cholera.

Back in Port-au-Prince, Kez has returned to business as usual, walking the ravines and tent cities. When she's not on cholera duty, she's treating people for scabies, worms and a growing number of vaginal infections, which she blames squarely on the government's slow response to the earthquake: When women have to urinate outdoors amid rocks, dust and untended rubble, it's hard to stay clean.

To prevent cholera, she reminds everyone she passes, please, wash your hands.

Be the first to know

* I understand and agree that registration on or use of this site constitutes agreement to its user agreement and privacy policy.

Related to this story

Get up-to-the-minute news sent straight to your device.


Breaking News

Sports Breaking News

News Alert