FacebookTwitterRedditEmail

Haiti in the Shadow of the Citadel

The Citadel staring down on the plain of northern Haiti. Photo by John Carroll.

The instructors of the course were Haitian physicians and US ED physicians and Physicians Assistants. The course was held at New Hope Hospital which is located a few miles south of Cap Haitien. We were outside on the large hospital patio. The patio had a roof but no walls which protected us from the sun but allowed a breeze to keep us fairly comfortable in the 90-degree heat.

I learned a lot through the excellent lectures, simulation workstations, and the extensive course syllabus. The course was rigorous and covered a large spectrum of medical emergencies from neonatal distress, obstetric complications, pediatric emergencies, toxicology, and adult and pediatric trauma.

From the patio, one could look for miles in a panoramic view in three directions over the lush flat land of Plaine du Nord. Looking west I watched young farmers with their hoes tilling the black dirt to plant banana trees and corn. Looking 15 miles south one could see the Citadel fortress high on top of a 3,000-foot mountain called the “Bishop’s Cap”.

The Citadel was built by Henri Christophe, a key leader during the Haitian slave rebellion (1791–1804), after Haiti gained independence from France at the beginning of the 19th century. This massive stone structure was built by up to 20,000 workers between 1805 and 1820 as part of a system of fortifications designed to keep the newly independent nation of Haiti able to repel any French incursions. (The French never returned.)

Legend has it that King Christophe would show his power and control to visiting world leaders by marching his men along the top of the wall of the Citadel. When Christophe would yell “jump” at a certain corner of the wall, the next man in line would leap to his death.

Haiti has always been a country of extremes. Essentially all of the students in this CALS course were online via a mobile device or laptop. The lectures were dignified with PowerPoint. As I listened to the instructors talk about pulse oximetry, sonography, and CAT scans, I couldn’t help but think how separated we were from the young farmers working only yards away from us in the Haitian sun. They were farming the same way that their ancestors farmed as the Citadel was being built over 200 years ago.

To offer critically ill patients, and trauma victims, and women having obstructed labor good medical care, Haiti has to have young professionals who know what to do. And this CALS course provided the universal basic steps at advanced life support combined with focused clinical pathways to give the patient the best chance at survival.

But the young Haitian physicians in this course cannot care for extremely sick patients by themselves. There needs to be structure in Haitian society for this to happen. Haiti lacks structure.

What is structure? It is good roads to transport the sick. It is electricity provided 24/7. It is clean water. It is diagnostic technology to help make the diagnosis of a head injury or an inflamed appendix. It is laboratories to analyze blood quickly. It is hospitals that function well to care for the patients even if they cannot pay. This is structure.

Haitian professionals and the bare-chested Haitian farmers are working in the shadow of the Citadel. The divisions in Haitian society are obvious. These two groups can benefit together only if structure is provided for both. The State of Haiti is responsible and is the only entity which can make this happen.

More articles by:

John A. Carroll, M.D. is a physician working in Port-au-Prince.

bernie-the-sandernistas-cover-344x550
July 23, 2019
Patrick Cockburn
Why Boris Johnson is Even More Dangerous Than Trump
Christopher Ketcham
The American West as Judeo-Christian Artifact
Jack Heyman
Whitewashing American History: the WPA Mural Controversy in San Francisco
David Mattson
Through the Climate Looking Glass into Grizzly Wonderland
David Macaray
Paul Krassner and Me
Thomas Knapp
Peckerwood Populism is About Political Strategy, Not Personal Belief
John Kendall Hawkins
Assange and His Wiki Wicked leaks
Howard Lisnoff
What Has Happened to the U.S. Since the Kids Left Woodstock?
Victor Grossman
“How Could They?” Why Some Americans Were Drawn to the Communist Party in the 1940s
Gary Leupp
Minnesota, White People, Lutherans and Ilhan Omar
Binoy Kampmark
Lunar Narratives: Landing on the Moon, Politics and the Cold War
Richard Ward
Free La Donalda!
July 22, 2019
Michael Hudson
U.S. Economic Warfare and Likely Foreign Defenses
Evaggelos Vallianatos
If Japan Continues Slaughtering Whales, Boycott the 2020 Tokyo Olympics
Mike Garrity
Emergency Alert For the Wild Rockies
Dean Baker
The U.S.-China Trade War: Will Workers Lose?
Jonah Raskin
Paul Krassner, 1932-2019: American Satirist 
David Swanson
U.S. Troops Back in Saudi Arabia: What Could Go Wrong?
Robert Fisk
American Visitors to the Gestapo Museum Draw Their Own Conclusions
John Feffer
Trump’s Send-Them-Back Doctrine
Kenn Orphan – Phil Rockstroh
Landscape of Anguish and Palliatives: Predation, Addiction and LOL Emoticons in the Age of Late Stage Capitalism
Karl Grossman
A Farmworkers Bill of Rights
Gary Leupp
Omar and Trump
Robert Koehler
Fighting Climate Change Means Ending War
Susie Day
Mexicans Invade US, Trump Forced to Go Without Toothbrush
Elliot Sperber
Hey Diddle Diddle, Like Nero We Fiddle
Weekend Edition
July 19, 2019
Friday - Sunday
Rob Urie
The Blob Fought the Squad, and the Squad Won
Miguel A. Cruz-Díaz
It Was Never Just About the Chat: Ruminations on a Puerto Rican Revolution.
Anthony DiMaggio
System Capture 2020: The Role of the Upper-Class in Shaping Democratic Primary Politics
Andrew Levine
South Carolina Speaks for Whom?
Jeffrey St. Clair
Roaming Charges: Big Man, Pig Man
Bruce E. Levine
The Groundbreaking Public Health Study That Should Change U.S. Society—But Won’t
Evaggelos Vallianatos
How the Trump Administration is Eviscerating the Federal Government
Pete Dolack
All Seemed Possible When the Sandinistas Took Power 40 years Ago
Ramzy Baroud
Who Killed Oscar and Valeria: The Inconvenient History of the Refugee Crisis
Ron Jacobs
Dancing with Dr. Benway
Joseph Natoli
Gaming the Climate
Marshall Auerback
The Numbers are In, and Trump’s Tax Cuts are a Bust
Louisa Willcox
Wild Thoughts About the Wild Gallatin
Kenn Orphan
Stranger Things, Stranger Times
Mike Garrity
Environmentalists and Wilderness are Not the Timber Industry’s Big Problem
Helen Yaffe
Cuban Workers Celebrate Salary Rise From New Economic Measures
Brian Cloughley
What You Don’t Want to be in Trump’s America
David Underhill
The Inequality of Equal Pay
David Macaray
Adventures in Script-Writing
FacebookTwitterRedditEmail