CARREFOUR, Haiti -- It was on the fourth day that I realized how far I had come.
Sweat was trickling down my back. My glasses were slipping down my nose. Clamoring around me, pressing into my personal American space, dozens of Haitian men, women, and children awaited my attention for a brief encounter: to have their age, weight, and heart rate taken and recorded.
The simple exchange with me, no health professional, put these rural people one step closer to the day's goal: their turn with the American doctor installed for the week, along with several helpers like me, at their mountainside village.
Prepared to wait as long as necessary for this rare medical access, the patients were eager to undergo my halting "intake" routine. They graciously repeated their age as many times as I needed to understand the answer in Creole. With solemn dignity, they allowed me to place, sometimes ineptly, my stethoscope upon their chests; they kindly removed their shoes, stepped onto the scale, and waited there until I squinted down and read the numbers.
Somewhere in my long afternoon on the crowded, shady porch of the St. Rock Clinic high above Carrefour, I found myself immersed in and entranced by a Haiti I never could have experienced as a tourist.
Not that this troubled and long-abused western half of the island of Hispaniola gets many tourists these days, with a caretaker government, a collapsed infrastructure, United Nations troops in tanks, and spasms of murderous thuggery that include armed holdups of well-appointed vehicles caught in the wrong section of the capital, Port-au-Prince, of which Carrefour is a suburb.
Yet outside the city, in mountain villages cooled by tropical winds, where the blue Caribbean winks in the distance, tethered goats munch scrubby grasses alongside yellow chalk-dust roads, and roosters start crowing from palm-tree precipices long before dawn, Haiti is a lovely place.
Our seven-day stay at the St. Rock International Clinic was organized by Ralph Stowe, the Hull man who founded the clinic on an arid mountainside in 2002 after nearly three decades of volunteering visits around Port-au-Prince. All of us shared the ideal of bringing help to the poorest nation in the hemisphere, though some of us lacked the medical skills that were the principal cargo of this trip. Nevertheless we hoped to support and streamline the work of Dr. Ruth Johnstone and two nurses, Catherine Liberles and Maureen Dryja. There were also Catherine's sister Bernadette Hamilton, from Baltimore; Jack Riley, the business manager for a Milton Roman Catholic parish that is considering affiliation with one on the mountain; Stowe, and me. Finally, Jeannita Mercuis of New York, a Haiti native and longtime friend of Stowe, was our interpreter and managed our meals and a hundred other details of our stay.
In one week, we experienced the beatific face of Haiti and the angry one as well. While we spent most of our time in the mountainside community where the clinic is located, we passed through Port-au-Prince going to and from the airport, and spent one full day in the city. There, smoke rose from small hills of trash, blanketing the air with a toxic pall for blocks; pigs and dogs roamed freely, rooting amid sewage-strewn piles; all roads seemed choked with foot traffic and vehicles; and people squatted by the side of every road, selling things from sugar cane to cellphones. Often they stared at us, unsmiling, as we passed by riding in the open bed of a pickup truck, tense in our otherness, haves bobbing in a sea of have-nots.
In contrast, we were welcome guests at the clinic, appreciated not only for the medical care we brought but for our English-speaking (and English-teaching) abilities, our digital cameras, and our comical fracturing of Creole, an Africanized French. Our foreigner status engendered not enmity but interest, and our presence occasioned two communal dance nights on the clinic porch, with lilting guitars, clinking kitchen-utensil percussion, and a phenomenal bass crafted from plywood.
Over seven days, more than 300 people in the mountain community of about 25,000 got checkups and medicines, and the clinic's pharmacy was organized and updated for the full-time Haitian nurse and part-time doctor who manage things year round. In the bargain, we got 12-hour workdays, unequivocal appreciation, dozens of new friends, a week away from New England's November chill, and a sense of living simply.
We had no running water and no electricity but for an hour or two each evening with a noisy generator, to recharge batteries on a few medical devices and light the examining room and pharmacy for the last few patients. We slept in two open-air rooms in the clinic set up as dormitories. Stars blazed in the night sky. Citronella candles warded off mosquitoes and backlighted the quiet evenings, when Stowe would enjoy a Cuban cigar and share stories from his years as a Haiti devotee.
We strengthened our legs walking the steep mountain roads before, or sometimes after, work, exchanging a "Bonjou" or "Bonswa" with everyone and sometimes trading candy or nutrition bars for the favor of a photograph. Our hair was soft from being washed in pure rainwater from the cistern.
(There were squeals in those "showers" of unheated water, which one poured over one's head from a plastic pitcher while hunkering over another plastic tub so the rinse could be reused to flush the toilet into the clinic's below-ground cesspool out back.)
Though named after the St. Rock Roman Catholic Church at the crest of the mountain, the clinic is nondenominational and not affiliated with the church or the parish's primary school, launched seven years ago with one class and now serving more than 300 children, kindergarten through Grade 7. A careful alliance exists between St. Rock's pastor, who has high ambitions for improving the mountain community for his parishioners, and Stowe, who shares those goals but welcomes all patients, including many who attend a Baptist church on a neighboring ridge and others who follow Santeria (a fusion of traditional African beliefs with some elements of Catholicism) or do not worship at all. The clinic's open-door policy made us feel welcome on all the dusty paths twining around the mountain, and makes the building a secular social institution of sorts.
Half a dozen children in the community and several adults, too, showed up nearly every day seeking not medical care but connection. Some, like Mura Guerrier, a 15-year-old we took to calling "Professor Creole," had taught themselves enough English to share sometimes hilarious conversations, about books, words, families, the United States, and Haiti. We learned bits of Creole from them, listened to school lessons, admired artwork and writings, and sometimes agonized among ourselves over how to help them.
Here we were, in a 19th-century village struggling to catapult into the 21st century. Malnutrition and high infant mortality are local facts of life, as are cellphones, plastic bags, and lottery tickets. A teenage girl in a high-fashion Spandex sundress rubs her flat belly and says "grangou," hungry, in an appeal for a treat. The community is suffused with hope and also with frustration, as 6-year-olds haul buckets of water home from the spring at dawn, filthy and barefoot, then scamper to school two hours later, scrubbed and uniformed, for lessons in language, math, science, and history. Because they are getting an education, these children may be the last generation to stay on the mountainside, hauling their own water and cooking over charcoal; yet this community is multiplied a thousandfold across Haiti, on many mountainsides not served by a St. Rock Clinic or a school.
The terrible inequity was like a pebble shifting around in the shoe: always there, and occasionally excruciating. The visible reality that our work in the clinic was helping the people of the mountainside could not be dismissed, yet even as we took coffee and oatmeal in the morning, or sat down to a modest supper after a long day, we could glance past the clinic doors and wonder if this or that child had eaten such a meal all week. We handed out hundreds of nutrition bars on our walks, and thousands of vitamins at the clinic, yet we never invited anyone to fill a plate at our table. To do so, we believed, would engage a vast, unquenchable need and transform the clinic from a source of hope and care into a divisive, demeaning, and ultimately failing endeavor.
The internal conflict was most acute on the day we left, following a frantic rush to finish labeling in the pharmacy, pack what clothes we had not given away, and say goodbye to dozens of new friends. All of us were yearning for home, the loving families we missed, and also the comforts and freedoms that mark our usual lives. We also knew that after we left, operations at the clinic would deflate to a minimal level, staffed 35 hours per week by a Haitian nurse and her aide, and a Haitian doctor on Fridays only. The folks who came to the porch for art, games, and conversation would go back to their usual pastimes, mostly work, and we would fly off to hot showers, flush toilets, and a holiday season choking on excess.
Nevertheless, we had made deals, and no end of plans. I accepted sculptures to sell, a student manuscript in English to correct, lists of books to send back, and the e-mail addresses of a few savvy young men who sometimes trek down the rutted chalk road to the cyber cafes of Carrefour.
We all expect to return to the clinic next year, better equipped medically, and Stowe will go several times before that, continuing to nurture the tree he has coaxed into taking root. Liberles will hold a fund-raiser; Riley will organize a library exchange between the St. Rock Primary School and his parish. Dryja hopes to sponsor Mura's little brother Wooby, for school tuition and supplies. And I will try to learn Creole, perhaps in a language exchange with one of the many Haitian immigrants in Boston.
For now, Mura's bright smile and funny questions pop up often in my thoughts, along with the breathy refrain of those dance nights, and the fingers curled in mine while we swayed to the music or while I held babies whose mothers were being weighed. I know something now about Haiti that I had never expected to know, and it has changed me.
Adele Foy can be reached at a_foy@globe.com.
