June 2002

Riding the Road

The middle-aged peasant woman sitting next to me squeezes my thigh with her fingers. It startles me at first, but then I realize it is her expression of being quietly afraid. She probably hasn’t been in a car a dozen times in her life, and for her it’s a frightful experience. We’re riding the road in the battered white Toyota Land Cruiser the hospital uses for hauling everything short of leaky drums of diesel and long construction materials. Today we’re an ambulance of sorts, transporting two patients a three-hour round trip for diagnostic studies we’re not currently doing at our smaller facility. Haiti has mountains—lots of them—and we’re testing a couple today—up, then precipitously down, then up again like a roller coaster with rocks, ruts, and tooth-rattling bumps. Jean-Jacque is picking his route with care, but we’re still getting jarred around, and we all need to hold on to something—or someone. The Toyota is a rugged beast, but the Haitian roads have taken their toll. A merely troublesome rattle beneath needs quickly to be distinguished from one which means imminent breakdown miles from help or service. It’s mid-day, the sun is high, it’s warm, and the dust of the dry season is sifting through the windows—we’re riding the road—and holding on.

As I turn toward her I see the woman clutching my leg has tears which have streaked the dust on her ebony cheeks. Indeed, she has much to fear besides the road. She has a mass in her breast—a big hard one, accompanied by several firm lymph nodes which I found under her arm. She didn’t need the worried clinical look on my face yesterday to affirm her own suspicions—she knew. Perhaps a breast lump is a woman’s greatest personal fear, regardless of her color, her country, her culture. By the physical findings, I’d say she has advanced disease and needs an operation soon. She naturally has fear of that, and the additional haunting fear that she’ll never be able to pay for it. Her husband is a vegetable farmer. They haven’t much but four children and a few goats. Maybe her church or her family can come up with a little to help her. The hospital will have to absorb some of the cost, too. We’ll work with her to get her the treatment she needs, and she’ll pay what she can. Rural Haitian people are proud through their poverty. Respect, fairness, dignity, and hard work are concepts they live by, and which lift them above their grinding circumstance. I squint against the sun that filters through the taller trees now as we jolt along, trying to formulate a management plan and reflecting. Life is hard for these men and women—and their children, too. We need to ride the road with them—and help them hold on.