HAITI: I Can’t Stop Thinking About Her

It’s been three weeks since I returned from Haiti and a fortnight since Hurricane Matthew made landfall along the southern coast of the Caribbean island, bringing its category-5 devastation to the poorest nation in the western hemisphere.

And in the time that has passed since my first visit to Ayiti (as they say in Creole), I can’t stop thinking about her.

Not the demure yet mighty woman named Josef, a 49-year-old farmer and mother of 12 from Haiti’s Central Plateau region, who gave birth to her first 11 children at home. It wasn’t until varicose veins compelled her to seek medical treatment at a local USAID-funded Project Medishare clinic that she learned about contraception and family planning. Josef delivered her youngest child, now age 7, in a hospital and then underwent a tubal ligation. Given the choice, she wasn’t interested in expanding her brood to a baker’s dozen.

Not Raphael, Josef’s fiercely bright 21-year-old daughter, whose first child died in infancy, and who now gets quarterly injections of Depo-Provera so she can decide when or whether she wants to become pregnant again. Haiti has one of the highest fertility rates (3.5 babies per woman) and at maternal mortality rate (359 per 100,000 live births) that is the worst on this side of the planet.

Not Chantal, the soft-spoken, exhausted mother of two-month-old baby Jackson from the Delmas 32, perhaps the commune (neighborhood) of the capital city Port-au-Prince most damaged by the 2010 magnitude-7 earthquake. Nearly seven years later, most of the rubble has been cleared and many repairs made in Delmas 32, but we still had to step carefully (several of my traveling companions slipped and fell) as we made our way through the steep-and-narrow lanes to Chantal’s back yard, where the new mom (a beautician by trade) listened patiently as a community health agent from J/P Haitian Relief Organization (J/P HRO) talked about breastfeeding and infant nutrition while our delegation of journalists, philanthropists, activists, and others observed.

Not Destine, the 28-year-old wife of a voodoo priest and mother of four young children, who told us about her plans to have her tubes tied. She appeared to be as skeptical as the rest of our delegation when a community health agent extolled the virtues of what most of us might call the “rhythm method” while her youngest child, a baby boy, napped nearby on a grass mat in the shade of a pistache tree. I wish I’d snapped a picture of her world-class side-eye when a health official mentioned vasectomy as another viable family-planning option. (So far, we were told, precisely one man has taken advantage of the free vasectomies offered by the nearby clinic.) Meanwhile, there’s a waiting list for tubal ligations.

Mothers and children wait to be seen at the Medishare clinic in Marmont, Haiti.
Mothers and children wait to be seen at the Medishare clinic in Marmont, Haiti.

Not the dozens of women—some babes-in-arms mothers, some married, some single, and more than a few young women standing on the threshold between adolescence and adulthood—and a few men, too, waiting in long queues to meet with health counselors on what turned out to be World Contraception Day (Sept. 26) at the Medishare clinic in the Central Plateau town of Marmont, about two hours north of Port-au-Prince. Marmont, where fully a third of children under the age of five suffer from chronic malnutrition, is mostly unremarkable but for one disturbing statistic: before the 2010 earthquake, the mortality rate for children under five was 187 per 1,000 births—the highest in the country.

Not the scores of mothers with children who lined the corridors and courtyards of the GHESKIO Hospital in Port-au-Prince. Some had come so their kids could receive vaccinations that protect against diphtheria, tetanus, whooping-cough, hepatitis B, and a kind of influenza that causes pneumonia and meningitis. But others had brought their children to GHESKIO for treatment in its pediatric AIDS unit. As we walked the grounds of the hospital, one of the doctors said something that stopped me in my tracks: The busiest HIV clinic in the Americas —in the Western Hemisphere—is a pediatric clinic in Port-au-Prince. Founded in 1982, GHESKIO was the first health care institution in the world dedicated to the fight against HIV/AIDS. And Haiti’s HIV/AIDS programs are among the most successful anywhere. The HIV-infection rate is just 1.7 percent overall—that’s about 130,000 people living with HIV—but each year GHESKIO’s pediatric AIDS department still sees about 800 babies, the majority of whom receive pharmacological treatments that prevent the transmission of HIV from mother to child.

Not the grandmother—or was she the mother—of the emaciated infant in the GHESKIO pediatric ward being weighed by a nurse. She was so thin. Malnourished. Wizened. Just like the baby she never took her eyes off of while the hospital staff dutifully and tenderly administered their expert care. I had to walk away. Too much. Too much….

Not Dr. Marie Marcelle Deschamps, GHESKIO’s passionate, indefatigable general secretary—the heroic physician who, for 33 years, never has looked away or allowed anyone else the luxury of doing so if she could help it. A native of Port-au-Prince, as a young woman Deschamps went abroad to study. “I returned in 1982 and I said I will never leave again,” she told us, adding that about 80 percent of Haiti’s “trained human resources,” i.e. physicians and other professionals, flee the beleaguered island nation, never to return. “If you stay, you are an optimist,” she said. The optimistic doctor has helped GHESKIO evolve into a center for comprehensive health care—particularly for Haiti’s most vulnerable women.

The Port-au-Prince metropolitan area is about the same size as Chicago, with a population of 2.6 million and no sewer system. Today, GHESKIO is flanked by The City of God and The Eternal City—massive slums that an estimated 200,000 Haitians call home. Deschamps recalled how, as a child, she would ride bicycles with her father along Le Boulevard Harry Truman, a central thoroughfare through the capital city that runs in front of the hospital. “Can you imagine?” she says to the latest assembly of sweaty, well-intentioned visitors to her busy hospital. “How did we let this happen?”

The busiest HIV clinic in the Americas

—in the Western Hemisphere—

is a pediatric clinic in Port-au-Prince.

After the earthquake in January 2010 killed more than 250,000 people, injured another  350,000, and left 1.5 million homeless, the GHESKIO campus became home to a tent city of more than 7,000 refugees. When the worst cholera epidemic in recent history broke out a few months later, Deschamps and her colleagues pivoted, creating a vast community health outreach that went into the City of God where the cholera outbreak did its worst. To date, the hospital has treated more than 33,000 cholera patients and helped to immunize more than 50,000 at-risk residents of the City of God against the water-borne disease. Deschamps’ latest project is a rehabilitation and training program for women (many of them survivors of sexual violence) where they learn an artisanal craft or skilled trade, such as sewing textiles, print making, mask making, and high-end carpentry—empowering women with actual power tools. Her energy and ingenuity, like her stubborn optimism, seem boundless.

As our group left the hospital after a couple of hours, I flagrantly broke two cardinal rules of journalistic detachment: I hugged the good doctor and I got choked up. “Merci, Dieu, pour cette femme,” I whisper-prayed in her ear. “Thank you, God, for this woman.”

But Deschamps isn’t the her who hasn’t left my mind since I left Haiti.


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(All photos by Josh Estey/CARE unless otherwise noted.)

The woman I can’t stop thinking about is someone I never saw.

On Sept. 25, our delegation, led by former U.S. Senate Majority Leader Bill Frist, visited a J/P HRO health clinic in Delmas. Frist is a medical doctor, heart-lung transplant specialist, and longtime champion of health care in the developing world. He was instrumental in the creation and passing in 2003 of the President’s Emergency Plan for AIDS Relief (better known as PEPFAR), a program that has supported lifesaving anti-retroviral treatment (ART) for more than 9.5 million people worldwide. Frist’s group, Hope Through Healing Hands, and CARE organized our “learning tour” of Haiti. The actor and activist Sean Penn, bless his heart, who spent many months living and working in a tent city on the golf course at Port-au-Prince’s Petionville Club among 50,000 displaced Haitians after the 2010 earthquake, founded J/P HRO, which continues to do impressive work on numerous fronts, including health care—no small gesture in a country where an estimated 40 percent of the population has zero access to basic health care and nutritional services.

While we listened to a doctor at the  J/P HRO clinic talk about community outreach and maternal health, I thought I heard a woman cry out and then moan. It was a Sunday afternoon, so the urban clinic was not busy and, therefore, relatively quiet. I kept taking notes and asked a few questions in my limping French. Then I heard it again: the unmistakable, primal sound of a woman in the throes of labor.

I couldn’t see her, but I could hear her.

I don’t know her name or whether she gave birth to a boy or a girl or both. I don’t know how old she is, whether it was her first childbirth, one of many, or her last. I don’t know if she is married or single or a widow or divorced. I don’t know whether she wanted the baby or if the thought of its birth terrified her.

I don’t know.

A week almost to the hour after our plane bound for Atlanta left Port-au-Prince, Hurricane Matthew arrived with its 145-MPH winds and misery, dumping an average of 20 inches of rain (and up to 40 inches in some areas) on an island where everything is unstable, from the government to the actual land itself—given to erosion and landslides after 200 years of rampant deforestation. There is scant infrastructure in Haiti of any kind and the country is still struggling to find its footing nearly seven years after the devastating quake.

The hurricane battered Port-au-Prince, but not as badly as it did the southern coast of the island where entire communities such as Les Cayes and Jeremie, were practically decimated. The death toll from Haiti’s latest natural disaster has exceeded 1,000, an estimated 175,000 people are homeless (again), and the UN says urgent humanitarian aid is needed for 1.5 million Haitians—about 15 percent of the entire population. And as the flood waters begin to recede, standing water throughout the country means Haiti is bracing for yet another torrent of water-related diseases, including a potential cholera outbreak worse than the last, not to mention malaria and Zika.

Back home in California, I’ve watched television coverage (such as it was and what remains) of the aftermath in Haiti. I’ve read the news, the analysis, and the pleas for aid from all quarters. (For suggestions about how and where to donate, click HERE or HERE.) In church and out, I’ve prayed for Haiti, for the people we met, and the millions more we didn’t. The morning the hurricane hit, Laura Sewell, CARE’s director in Haiti, told NPR there were 60,000 pregnant women in the country’s  south region alone. “What’s going to happen to those women,” she asked.

What happened to those women? What happened to the woman laboring in Delmas the week before? I’ve sent emails asking after her. So far, no word.

Still, I hear her courageously birthing new life and new hope into Haiti—a place too many people dismiss as hopeless.

And I just can’t stop thinking about her.

Not All Who Wander Are Lost: Nepal

With 36 hours left in our too-short sojourn in Nepal earlier this month, I yearned to escape the “strange, bewilderin’ time” of Kathmandu and its cacophony of humans, motorbikes, sequined lorries, tuk-tuks, rickshaws, giant hens and cockerels, wandering bands of ill-tempered goats, dozy cows, and incessant beeping that together comprise the intoxicating, maddening heartbeat of the capital city.

My 16-year-old son and I had hoped to make it far out of the city to Pokhara and the foothills of the Annapurna Range of the Himalayas, but time was not on our side. So we opted instead for an overnight in Nagarkot—a village in the Bakhtapur region of the Kathmandu Valley with what is generally agreed to be one of the best views of the Himalayas (including Everest) in country. If the weather allows it, that is.

Whether my boy and I were able to glimpse Chomolungma (as the Tibetans call the sacred, tallest mountain on Earth) didn’t really matter to me and he was more excited about the hotel pool and hot tub than anything else. I just wanted some quiet, alone time to reflect on our week in magical, mystical Nepal—my second visit to the country I first visited days after the devastating earthquake in April 2015.

Eight of us piled into our friend Gautham’s Mitsubishi I-guess-it’s-a-small-SUV for the two-hour journey (because of the aforementioned cacophony and thick traffic jams that produce much of it) to Nagarkot. Only three of us would be staying the night. The other five just came along for the ride and the chance to gulp some fresh(er) air in the mountains outside Kathmandu and stop twice (TWICE) for the delicacy known as King Curd (a cross between yogurt and custard that is best enjoyed in the Bhaktapur region; it’s delicious).

Of the nine of us, save for the driver I was the only passenger not to feel the effects of motion sickness as Gautham deftly navigated the switchback dirt mountain roads with potholes the size of small caves. (I’m generally a world-class nervous back-seat driver. But not in Nepal. Even amidst the craziness and hair-raising maneuvers, I don’t wear a seat belt. Nobody does. And the more nerve-wracking the driving gets, the more I laugh. It’s an unfettered, I’m-not-in-control-here kind of belly laugh.)

After Gautham, his lovely wife Reykah, their son John, soon-to-be-daughter in law, and chosen nephew Arjun grabbed some lunch on the hotel’s expansive deck facing the mountains, they headed back to Kathmandu, while my son and Gautham’s eldest child, David, adjourned to their room and the indoor pool.

Alone. Finally. I love my friends in Nepal and my traveling-companion child, but my inner introvert—which has taken to exerting itself with greater frequency in my 40s—really needed some solitude.

Terraced farms in Nagarkot, Nepal. Photo by Cathleen Falsani.
Terraced farms in Nagarkot, Nepal. Photo by Cathleen Falsani.

I placed my overnight bag in my room, grabbed my smartphone and my Canon (opting to bring only the short lens), and returned to the panoramic deck which, much to my chagrin, was occupied by a group of yuppie types from China, all smoking actual cigarettes and talking loudly into their cell phones.

I ducked back inside to find a more peaceful perch from which to (perhaps) glimpse the mountains and, alternately, watch the sunset over the valleys to the west. Three flights up and a few minutes later, I found myself on the rooftop deck of the hotel, completely solo.


I stood on the edge of a parapet and stared east, to where the Himalayas and Everest were supposed to be. I saw nothing but for the terraced farms of the verdant valley and wondered if I was facing the wrong direction. A quick check of a nearby map with arrows pointing in the direction I’d been facing told me that, yes, that was where the mountains were. But they were completely obscured by haze, clouds, smog and/or a combination of all three.

It’s not that I was disappointed or surprised. I knew before we alighted Kathmandu for Nagarkot that this time of the year, spotting the mountains was a dodgy bet. “If it rains tonight, even for ten minutes,” Gautham assured me before he left, “you will see mountains at sunrise.” So there was another chance and even if the Himalayas still were obscured at daybreak, Nagarkot is a beautiful spot no matter the weather.

The thing is, knowing the mountains were in front of me without being able to see them was, somehow, disorienting. They were there, right there, right in front of me—the most majestic range on the planet. But I was seeing through a glass dimly, if you will.

The sensation was strange, as if I were one of the Hobbits standing in front of Mordor just blinking into an abyss of wan sunlight filtered through a thick layer of khaki-colored smog.

A little lightheaded (Nagarkot sits at an altitude of 7,000 feet and I spend most of my time at literal sea level), I sat down at one of the many empty, metal cafe tables and pulled out my notebook, perhaps to write or doodle. After a few moments, I realized I’d been humming a musical phrase from Cat Stevens’ “Katmandu” song all day, so I took out my smartphone and (thanks to the 3G network in Nepal, even at such great heights) found a live performance of the song Cat gave in 1970. Played it twice. Sang along. Then I let YouTube take me, as it does, to the next song in the play list: Stevens’ “How Can I Tell You” from another live performance recorded the same year, a few weeks after my birth.

I found myself in tears. At first I wasn’t sure why, but as I reflected on the lyrics to Stevens’ ballad, I began to see what it was, or at least what I think it might have been.

Whoever I’m with
I’m always, always talking to you
I’m always talking to you
And I’m sad that you can’t hear
Sad that you can’t hear

Now in midlife, things aren’t quite how I expected they might be. My life and my physical person have changed in ways that sometimes bring more than a whiff of despair to my breath, which is, as someone taught me long ago, the truest form of unceasing prayer. There is much in my life that brings me unfathomable joy and I see grace all around me, all the time. And yet, there’s a sadness that lingers in the corners of my room.

Many people I love dearly have passed out of my life and this world in the last several years and I know that mourning is anything but linear. Surely that’s part of it. Disappointment as well. At things professional and otherwise that went pear-shaped and haven’t yet found their original form and maybe never will. That I’d peaked a decade ago and have since begun a slow descent into the never-ending adulthood of blighted hope.

All of that. The tears were for all of that. And still, I saw neither mountain nor setting sun.

So I decided to take a walk—something more than a stroll and less than a trek, even if I was wearing the hiking boots I’d bought before the earthquake last year and had worn (in Nepal) precisely once—that very day in Nagarkot. I thought I should at least try to get them dusty.

The grounds of the hotel where we stayed are expansive and had the feel more of sanctuary than resort. Being Nepal, there were Buddhist prayer flags flapping in the wind from trees and in courtyards; shrines and tiny temples to various Hindu deities, and brass prayer wheels affixed to the wall every few feet along the warren of corridors. I ducked out through one of those courtyards and kept walking downward until I found a trail that led along the edge of a bamboo forest (at least that’s how I’d describe it) along the eastern side of the property, in the direction of Everest and the clouds.

Lost in thought I walked and looked at flora until the path ended at the back side of the hotel amidst rudimentary construction equipment. I probably shouldn’t be here, I thought. Not exactly what the hotel management would want guests to see. But it was Nepal and the pervasive easy-breeziness of the culture assured me no one would come out yelling.

I walked on, as the path darkened and the pine trees on one side made a canopy with the bamboo on the other. Ten minutes later, after wandering without paying attention to direction or the setting sun, I stopped in my tracks, realizing I might be lost.

It was at that moment I heard Harold Ramis’ voice in my head. Ten years ago, I’d interviewed the late actor-director for my first book and he’d told me a story. Harold was born Jewish and embraced Buddhism as an adult. He described himself as “Buddh-ish.” I loved that guy. Anyway the story went like this:

    “Watching other people on their journeys forced me to think reactively about it: Well, what do I believe? You don’t believe in past lives, so if you don’t believe in the continuity of the soul, what do you believe in? I never was able to give myself over to another human being as a spiritual trainer or leader. I could never affiliate with an organization, any doctrinal organization. I could never have a guru or a spiritual teacher because I always believed it was so personal. It seemed to me logically impossible that there could be a concrete answer to a spiritual quest—by definition—and so anyone who said they had an answer was immediately suspect. I’m right now convinced that no matter how much I seek, there wouldn’t be an answer. It’s like when you’re lost in the woods, instead of running you should just sit down.”

Always remember to look up. Photo from Nargakot, Nepal by the author.
Always remember to look up. Photo from Nargakot, Nepal by the author.

It was that last part that echoed in my mind: “When you’re lost in the woods, instead of running you should just sit down.”

So I did. On a ramshackle wall on the pine side of the ersatz trail. And another sacred word came to mind, this time from Stephen Hawking who said, “Remember to look up and not down at your feet.” A favorite college professor used to remind us of the same. Look up. You’ll be surprised what you find if you change your perspective.

I looked up. And there, perhaps 100 yards above me in a clearing in the woods, I saw a man praying.

And then I heard faint music. I started to walk toward the man and the music, clambering through a rocky path in the woods until I came upon a house.

Once again, I stopped, worried I might be trespassing, an unwelcome guest and interloper. But this is Nepal, I told myself, and slowly walked toward the building when, surprising both of us, a young man appeared carrying a cup of tea.

“Namaste,” I said.

He bowed slightly, one hand in front of his chest in half of the prayerful posture with which most Nepalis greet each other. (His other hand still held the cup of tea.)

“I think I’m lost,” I continued.

“Where are you trying to go?” he answered with a the kind of genuine empathy and tenderness that is uncommon in most places.

Where am I trying to go? I thought, spotting someone in my peripheral vision. The praying man.

It wasn’t a man, per se, but a statue of Sri Chinmoy, a well-known Indian guru and meditation instructor who passed away in 2007. One of the mountain peaks in the invisible range in front of me is named for him.

“Is this an ashram?” I said.

The man bobbled his head in affirmation as Nepalis do.

“You’re lost?” he said.

“Maybe not so lost,” I said, as my voice cracked and tears filled my eyes. “May I sit down for a minute?”

“Of course,” he said.

I put my head in my hands and had a big boo-hoo cry like I haven’t in a long, long, clearly too-long time. And the kind man didn’t stare or shift uncomfortably. He just sipped his tea and stayed with me, looking up at the sky. I composed myself and said I was trying to get back to the hotel.

“Ah,” he said. “It’s just there.”

Sri Chinmoy’s statue, I quickly realized, sits a few dozen yards away from the hotel’s helipad. I wasn’t lost. I just couldn’t see where I was going.

The sun was almost down and I thanked him for his kindness, and began walking toward the hotel entrance. If it’s possible for one’s ears to come into focus, mine did just then, and I heard the music that was playing inside what turned out to be a kind of ashram gift-shop where the man worked.

A woman’s voice sang the Prayer of St. Francis of Assisi:

  Lord, make me an instrument of Thy Peace;
    Where there is hatred, let me sow love;
    Where there is injury, pardon;
    Where there is doubt, faith;
    Where there is despair, hope;
    Where there is darkness, light;
    Where there is sadness, joy.

    Oh Divine Master,
    Grant that I may not so much seek
    To be consoled as to console;
    To be understood, as to understand;
    To be loved, as to love;
    For it is in giving that we receive,
    It is in pardoning that we are pardoned,
    It is in dying that we are born into eternal life.

The singer was Snatam Kaur, an American-born Sikh musician and peace activist. I opened iTunes on my phone and bought it immediately.

Later that night, after dinner with my son and our friend, we all retired for the evening, hopeful that sunrise would bring a view of the mountains. I fell asleep listening to Kaur sing St. Francis’ prayer on repeat.

I awoke before sunrise and sat on my balcony alone in the dark, hoping to see the mountains at first light. When it came, I could see nothing but clouds and haze.

Still, the light was beautiful. And I had faith that the mountains indeed were there, even if I couldn’t see them, and that they would wait for me to return to find them another day.