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Measuring accomplishments on a small scale is relatively easy – you made the car run or you finished the term paper. Success, or its ugly stepbrother failure, are black and white, as clearly as a car is turned on or off. Unfortunately, once a projects starts to grow, so do the complexities when measuring outcomes.
While trying to determine the level of success I had in my month long medical mission in Haiti, I was struck with just the number of factors that goes answering this question. On a large scale, if someone was observing my daily activities from a blimp above Port au Prince, I made an impact in line with moving ten grains of sand in a desert. Millions of people are still out there without a proper supply of food, water, and adequate shelter. But to dwell on the facts that I did not cure the entire country, would leave me a shattered wreck. I would not be able to look at myself in the mirror knowing that I left a country that was still in such dire need of help. So, to avoid posttraumatic stress and to more adequately answer the question of my personal success in Haiti I avoid the large picture, I pop the blimp that was following me.
With the aid of our translator Sophie, a Haitian student, we take patient histories and conduct physical exams. We deal with a variety of complaints, including sore throats, headaches and gastro-intestinal issues. Many of these are due to poor air quality, sleeping outside and lack of purified water. Other patients come in with growing infections or fractures left alone in the fear of an amputation.
Once the sun hits height, the van takes me to a field hospital on the outskirts of the airport. Over there the number of patients grows and their maladies are more complex. Medical specialists worked at a frenetic pace. At any time a motor vehicle accident, a gunshot wound, or a wounded child could come in with the roving foreign ambulances that circulate around the city. Resources are basic but adequate. Traumas are brought in, stabilized, and then either wheeled into surgery, transported to an observational bed, or in the rare case discharged.
In the evening the oppressive humidity subsists just slightly, the streets clear of traffic and homemade roadblocks are erected to keep cars off of certain roads so that people can sleep on them. Driving home, an hour before the next day is set to begin, the faces of people I possibly helped come reeling through like a blur of brown. Certain ones make the video in my mind stop: the post-op with sepsis, the fractured leg of a four year old, a pregnant girl with pre-eclampsia, the TB patient, the child with malaria…my team helped them all. Every day is different but each one brings small victories. Amidst the heat, sweating and endless lines of patients waiting for someone to listen to them, we are able to administer to those in need and make a drastic difference in the wellbeing of many people.
I do not really know how to quantify success. Much like I do not know how to say how happy or how pretty a person is. But the smile of a healthy girl, who hours before was lying in a tent awaiting her death and her grateful father who insists on taking your picture so that he can tell people who is responsible for saving her life, that is success. That is happiness. And that truly is the prettiest smile in the whole world. If only her smile stays with me for the rest of my life I will know
that my time in Haiti was well spent.
Jonathan Eisenberg of Needham
Measuring accomplishments on a small scale is relatively easy – you shovel a path through heavy snow or you complete a term paper. Success, or its ugly stepbrother failure, is black or white, as clearly as a car is turned on or off.
While trying to determine the level of success I had in my month long medical mission in Haiti, I was struck with just how many factors go into answering: How successful was I?
On a large scale, if someone observed my daily activities and assessed them on a macro level, I made an impact in line with moving ten grains of sand in a desert. The obstacles and remedies in Haiti are simply overwhelming. To dwell on the fact that there are millions of people still there without a proper supply of food, water and adequate shelter, was unacceptable in my mind. I would be uncomfortable knowing that I left a country that was still in such dire need of help. So, it is imperative that I avoid the large picture.
My team consisted of two medics, a doctor, and a driver. In the mornings we would be driven to a tented clinic that operated between two mounds of rubble that were once buildings. With no identifying sign for the clinic, people just seemed to find us. Other than a few folding chairs, a table with a notebook for registration, and some scattered medical supplies and drugs, the clinic could have been easily overlooked.
Each day, twenty to thirty people arrived with various injuries in the hope that a trained medical professional would be there to assess them. With the aid of our translator Sophie, we would take patient histories and conduct our physical exams. Without Sophie, our hand gestures and pantomiming of ailments amounted to confused stares. We would also attend to a clinic approximately fifteen minutes away. Between the two clinics, my team and I were responsible for the medical care of over seventy people per day.
We dealt with a variety of somewhat mundane complaints including sore throats, headaches, and GI issues. Many of these issues were due to the poor air quality, sleeping outside, and lack of available purified water. Other patients came in with more dire needs. When our team surmised that a specialist was needed, we made sure that the patient was seen that day…even if it meant driving the patient to the hospital. With many miles accrued and hours spent with each hospital administrator, we were able to produce and distribute an indispensable list of contacts that clinics and field hospitals around the city worked from in a more efficient manner to communicate with one another.
 Once the sun hit its height and the patients in the clinics were assessed and appeased, my van would take me to a field hospital next to the airport. The number of patients grew, and their maladies more complex. Medical specialists worked at a frenetic pace, all the while steering clear of the front gate and bed number 1, where at any time a major trauma could come in with one of the roving foreign ambulances that circulated around the city. Even in the disaster-strewn rubble of the city, people still got into fights, drivers made accidents, and children dismissed the rules of gravity.
The oppressive humidity subsided just slightly at the end of the day and the streets were cleared of traffic. Homemade roadblocks were erected to keep certain roads car free so that people could sleep on them. Driving home, an hour before the next day was about to begin, the faces of people I had helped came reeling through my mind like a blur. Certain patients made the video in my mind pause: the post op with sepsis, the fractured leg of a four year old, a pregnant girl with pre-eclampsia, the TB patient, the child with malaria…my team helped them all. We found a surgeon for the girl, we located a pediatric orthopedic surgeon to assess the child, another child received his medicine, and the pregnant girl was transported to an obstetrics hospital. Every day was different but each one brought several small victories.
I do not really know how to quantify success much like I don’t know how to say how happy or pretty a person is. The smile of a healthy girl who, hours before, was lying in a tent literally awaiting her death due to a growing infection and her grateful husband who insisted on taking my picture so that he could tell people who was responsible for her living…that is success, that is happiness, and that is truly the prettiest smile in the whole world. If only her smile stays with me for the rest of my life, I will know that my time in Haiti was well spent.
Jonathan Eisenberg of Needham is a medical student at the University of Vermont. He worked as a clinician at two primary health care clinics in Port au Prince in Haiti for the non-profit organization Housing Works.
Photo © by Jonathan Eisenberg of Needham
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