In the scabies section where I spent much of my time, we witnessed and unending cycle. There were no facilities for proper hygiene, and because we couldn’t speak the language fluently, we made little progress in our attempts to educate people in self-care. Two of us would set up in the morning with two plastic basins of water. On some days there was enough water to change the basins once during the course of the morning’s work, but more often the water we started with was the same water we ended with. Countless babies and mothers, children, and a few fathers shared each basin. Staff members generally had one towel each and a metal box with our supplies: a special medicated shampoo, Isodine for cleaning, cotton swabs, Mercurochrome, Kwell (a commercial ointment containing DDT that was used to eliminate scabies – banned in the U.S.) and a mild skin lotion.

Scabies are little animals similar to ticks or chiggers that burrow under the skin. They are spread by touching affected skin or through contact with infested clothes and bedding. Scratching causes infection and produces little sores with pus. We treated people whose bodies were covered in sores. The scabies concentrate particularly between fingers and toes, under the breasts of females, around the cracks of the buttocks, and on the private parts of both males and females. The itching is agonizing.

Most often we would treat mothers and infants, knowing we were not getting to the whole family or addressing the problem of contaminated clothing and bedding. After treatment we used our limited Creole to tell them not to wash that day but to wash well the next day with soap and water. We knew most of them had no soap and the water they had access to was most likely gutter water.

The first person I worked on was a young woman who lived on the streets. Her entire body was covered with small abscessed sores. She was feverish and weak. The blue dress she was wearing looked as though it had never been washed, except perhaps by the rain. She had no shoes and no underclothes. Her body smelled not only of sweat but of decaying tissue, an odor we grew accustomed to at the clinic. She was small, quiet, sweet-faced, and complied humbly when I asked her to remove her dress. Her buttocks were a continuous scab. There was not an unmarked spot on her body. With gloved hands I washed her and shampooed her hair, applied Mercurochrome to her sores and Kwell everywhere except on her hair and the delicate tissues of her face.

She showed up regularly and I cleaned her sores and helped as much as I could. One day she showed up so ill land feverish that she was too weak to stand. An American priest had arrived that day and was working with me. When I told him her history, he asked that I keep her there while he went off to his room to retrieve one of the dresses he had brought with him, gifts collected by his parishioners for the poor. I managed to remove the blue dress, which by now was as stiff as cardboard, and helped her into the new one the priest offered. I tossed the stiff garment into a corner, telling the girl I would wash it. I was busy with a long line of people waiting for treatment and when I turned my attention back to where the girl had been resting, she was gone. So was the old blue dress.

At the end of the day the priest came back and apologetically told me he was leaving in the morning. The conditions were too unbearable for him. I remembered a time several years earlier when I had accepted a job at a rest home and worked the night shift. At one o’clock we had to make rounds, going into rooms and switching on bright overhead lights, waking people up and subjecting them to an invasion of privacy while we checked their bedding and bodies to see if they needed changing. In the morning I combed through the tangled silver hair of one of my charges before wheeling her to the breakfast room. Tears of gratitude spilled down her cheeks for that simple attention. When I got home I burst into tears and couldn’t stop crying. By afternoon I called and quit.

One day as I was walking through an outdoor market, I looked up and saw the young girl walking toward me wearing her blue dress. We exchanged greetings and I asked her how she was. She answered with a shy smile and nod Her skin was scarred but looked much better. A few weeks later I was working in the scabies room and looked up to see a nun helping a young girl in a blue dress into the room. She had been found lying in the street, too weak to get up. Her skin was as infected as it had been the first time I saw her. I felt the futility of this vicious cycle and remembered what Peace Pilgrim had said when we told her we were coming to work in Haiti.

“I myself work on the causes of suffering, but I bless those who work on symptoms.” Then shaking her head she continued, “You’ll find conditions that are symptoms of greed and exploitation. Hunger and poverty are actually symptoms of symptoms.” I hadn’t stopped to consider what she meant, but now I was seeing firsthand. We would clean this young woman’s sores again, offer temporary comfort and relief and then send her back to the conditions that caused her suffering. She would persevere, as well as she could, with grace and grit.

Once again I managed to get her into a clean dress and even gave her an extra blouse to take with her. It would undoubtedly be sold, as the first dress we had put her in had been. But this time I confiscated the stiff blue dress, now in tatters, and took it to another room where I buried it unceremoniously under the garbage in a waste basket. It was easy to feel that the situation was hopeless; but I also know that someone had to feed and clothe these people until enough of us who had the means and education could diligently address the cause of this intense suffering.

The causes of this gross imbalance were all around us, as Peace had noted - greed and exploitation. Large, mostly American countries had control over big parcels of land. These companies had resources that could have been used to foster self-reliance in the local population, training people to grow the nutritious food they so desperately needed. Instead, the companies were using up precious water supplies to grow tobacco and sugar cane, paying wages that kept the people impoverished.

Another imbalance was the lack of adequate resources for the treatment of conditions afflicting the poor, and the lack of safety in various drugs that were used in the clinic. Quell, banned in the U.S. in 1972 because of its known health hazards, weighed heavily in my mind. Many women who came to the clinic for treatment of scabies were pregnant. They would expose their pregnant bellies and beg for Kwell to alleviate their suffering. I applied it, aware that it would be absorbed into the fetus they were carrying. Not explicitly knowing the potential consequence at the time, impaired neurodevelopment in children, but my apprehension was palpable.

Dotted throughout Port-au-Prince were islands of lush green landscaping behind walls that housed tourist hotels. In contrast, a carboard shack where people took turns sleeping in shifts stood on bare earth baked hard by the sun. The shack stood near a home surrounded by a high iron fence. It was the only real house in that area. As with the hotels, I could look through the bars at lush green plants and trees laden with tropical fruits. Only once did I see a person, no doubt a maid, with eyes cast down and a basket of fruit under her arm, scurry into the door and out of sight.

Despite the poverty and disease, the gaiety of the people and the grace with which they moved stood out. A rhythmic pulse seemed to beat at the heart of the culture, even reverberating in the beat of voodoo drums when the sun went down.

We might have felt some shyness or guilt about our perceived status or white skin, but any such feelings were laid to rest after our first ride on local transportation. As we stood conspicuously among a group of black natives clamoring to get aboard a tap-tap (a van that opened from the back and had benches running along the sides) people good-naturedly stepped back as eager hands reached out to pull the three of us inside.

We were pushed into seats, and all eyes were fixed on us. A.Z., wearing shorts, looked around and then down at his bare legs. A couple of women started to giggle. He looked at them and in a serious voice asked if they were looking at his legs. He picked one leg up and waved it around as he continued speaking English, still looking serious. Without understanding a word he was saying, the entire bus was soon laughing and having a gay time. I don’t think one person got off until we did. Two women followed us a short distance and then ran up and pulled my hair from behind. Startled at first, I looked around and they burst into giggles, covering their mouths. I laughed too, guessing that my smooth straight hair was intriguing to them.

Another time the two Andys and I were at the big market square where we shopped regularly, when some of the women sellers started pointing at me and asking questions. We didn’t understand but AZ indicated through gestures that the three of us were together. They must have been asking which of the two of them was my husband, because they seemed to get the idea that I was married to both of them. A great ruckus broke out, and women from all over the market began following and cheering me. Faces lit up whenever we came into the market after that. I can only imagine the stories we generated.

Back at the clinic AB had taken charge of the TB patients and directed the giving of injections on Saturdays. The banana lady, a merchant we always bought from at the market, was a Saturday regular. It was obvious that her familiarity with us gave her some status, and one morning she boldly pushed her way to the front of the line. AB saw what she had done, and picking up a foot-long demonstration model of a syringe, pointed it at her, indicating that he planned to use this one on her if she didn’t go back to the end of the line. She got his point and in mock fear threw her arms up and ran to the end of the line screaming, while the crowd cheered and laughed.

During our stay groups of Americans would come for three-week periods, usually sponsored by a church. Very often the groups would include a nurse, a priest, a dentist or doctor, and five or six others with varying backgrounds. We enjoyed many new acquaintances and friends from among the visiting workers; a bonding of kinship and fellowship developed naturally among us. In these dramatic circumstances, people often left with a positive feeling having participated in something very special.

We established a close working relationship with a dentist named John and his wife, Sue, who expressed this sentiment in a letter Sue wrote to us later:

John went back to his office and I went back to my work with the mentally disabled. The month in Haiti has never left our consciousness, however, and you must know that our mission trips influence whatever we do. The seven years in mission work did not compare with this last year. In other years we saw poverty but it was rural – in mountains or jungles. Poverty in Port-au-Prince was different. The crowded conditions, the filth, and the disease were so tremendous this year. We were lucky to have such good companions during our stay. That too, was new to us, because we had always worked alone. Living together in a communal setting with seven strangers could be dreadful but, in this instance, it was beautiful. There was never a cross word or an argument.

We all benefitted from the privilege of working together, although the Andys and I didn’t live in the complex with the others, where the limited space was better used for short-term volunteers. Two days after arriving we had found a monthly rental at L’Habitation Hatt, a complex of apartments. Our unit was like a townhouse, with a small living room and kitchen downstairs, and a bedroom and bathroom upstairs. The only furnishings were AZ’s sleeping mat tucked under the staircase downstairs and the two mats in the bedroom upstairs. The staircase itself substituted for chairs.

Despite the fact that we had arrived in January, the weather remained hot and humid. My legs would feel like lead when we trudged home at the end of the day, sweat rolling down our faces and soaking our clothes. The sisters assured us that this was the most pleasant time of year. By summer they described how several times a day they stopped to slip out of their saris and wring them out before putting them back on.

We called the last incline on the road home “the grinder.” From the top of the hill we could see the wet, shimmering blue of water. Within minutes we would luxuriate in the refreshingly cool and heavily chlorinated swimming pool. It became a place of refuge for us and our coworkers at the end of the day. It was where we gathered to “disinfect,” as we jokingly called it, after a day’s work among the sick and daying.

Cheryl Canfield, CCHT, 2024