Dan and I traveled to Jacmel one day to follow a family who was seeking medical care for their elderly father. We asked their permission to go with them to the hospital and they accepted, knowing that we would be able to share their story with others. The video below is what we found:
Dan, who is currently in medical school, wrote a reflection on this trip for the site which I am including here:
[…]I have spent the two years since wrapping the shoot in medical school, an experience that helps me to see some of the stories that appear in the film in a new light. One such story, which actually did not make the final-cut of The Road to Fondwa, but which is included as one of the extras on the DVD now being released, is the “Jacmel Hospital Trip.” It is a vignette which provides the viewer with a first-hand glimpse of one of the many difficulties that come part and parcel with life in the Haitian countryside, namely lack of access to medical care, and shows how one family struggles to cope when this reality manifests itself in their lives.
It took one part chance and one part invasiveness for Justin and I to have the opportunity to capture this story on film. We had just returned from a trip to Cap Haïtien in the North. Having arisen before dawn to catch a bus for the last leg of our journey from Port-au-Prince to Fondwa, we were tired and hungry on our walk up the hill to breakfast. As we took in the cool mountain air, we took the opportunity to reflect on the accomplishments of the recent trip and to set goals for how to be better filmmakers in the future. At one point, we passed a crowd of people who had gathered around an elderly man lying on a homemade stretcher, visibly ill. I asked what had happened. One bystander explained that this gentleman had been carried up to the road that morning from his home down in the valley of Fondwa, a place where no roads reach. His family was now desperately trying to flag down a “tap-tap” to take their loved one the 1.5 hours along the road to the nearest hospital in a seaside town called Jacmel.
Loading the man into the "Tap-Tap" for a trip to the Jacmel Hospital
I wondered how long it had taken to bring the man this far. It occurred to me that, given the great distances separating many rural homes from the nearest roads, it could have taken this family just as long to reach this point as it had taken Justin and I to make the long trip from Port-au- Prince. As we started back on our walk toward breakfast, Justin noted, in keeping with our conversation of the day, that if we really wanted to be better filmmakers, we would follow the man on his trip to the hospital. I understood immediately that he was right, but how to approach the situation? This man was obviously ill and the family in distress. Would it be right to stick a camera in their faces as they took on this ordeal? But after humbly explaining to a man who turned out to be the sick man’s son that we were making a film about life in rural Haiti, and asking if we could join them on the trip, we had taken the first step toward our goal.
The man who was sick, sitting in the front seat of the Tap-Tap
The first tribulation that we were privy to was the struggle to convince a tap-tap driver to take the man to the hospital. Most drivers were unwilling to put their work on hold to help out. Finally, the family agreed to pay one driver an exorbitant fee in exchange for a non-stop trip to Jacmel. The ailing man was uncomfortably loaded into the front seat and Justin and I hopped in back along with his daughter. She spoke not a word the whole way there. The trip was further delayed when the tap-tap ran out of gas and we had to stop on the side of the road to fill up out of the of the barrel of an enterprising local man. When we arrived at the hospital, the sick man was unloaded and carried by his family into the hospital’s front entrance. There was no where to put him down in the crowded waiting area, and the family was shuffled from one room to another before finally finding a table on which to lay their loved one.
The family physically carried him into the hospital and were waiting to be helped
After waiting close to an hour there, the family was told that there was a bed available. Again the man was hoisted up and carried. Being lifted as he was, without the aid of a stretcher, caused the gentleman clear discomfort. He grimaced with every manipulation of his body, but spoke not a word throughout. Once the family had finally laid him in a bed, they were told which medicines the father would need and his son ran off down the street to the nearest pharmacy to pick them up.
When things had calmed down a bit, Justin and I seized an opportunity to speak with the man’s daughter. Though her mind was understandably occupied with the more important concerns of the day, the woman managed to offer us some thoughtful comments about her father’s situation. When we asked why her father could not be treated closer to his home she looked back incredulously. Upon finally understanding that we actually expected an answer to this inane question, she explained that there was no one near their home who could treat a sick man. The nearest doctors are in Jacmel, and all it had taken this family to get there was about six hours from start to finish and more money than they cared to think about at the time.
Content with our footage, Justin and I left the family in peace. We never learned what happened to the ill man. Upon departing, we were able to offer a small contribution from our film’s budget to help with medical and transportation
costs. I hope that it helped them. But as for the dozens of other families at the hospital that day, some undoubtedly coming from even further away to seek treatment at Jacmel Hospital, they were on their own. Though I can not speak from experience, I believe that it is difficult to pay medical bills on a subsistence farmer’s earnings, and subsistence farming is how most families in rural Haiti get by.
In medical school I have learned about many of the circumstances that prevent some
populations within the United States from accessing medical care. While such issues should never be overlooked, for good health is necessary for anyone’s ability to live a dignified life, they pale in comparison to the barriers preventing the greater proportion of Haiti’s population from obtaining even basic public health services. Hospital care is one thing, but most living in rural Haiti lack even access to clean water, to say nothing of basic obstetric or nutritional services, interventions that are known to drastically reduce mortality and morbidity in resource poor settings at minimal cost. It is easy to be pessimistic when one considers the circumstances. What are we to do? Build hospitals to service Haiti’s entire rural population? Impossible, especially when one considers that many people in the United States still struggle to obtain such services. But it has been shown time and again in other underdeveloped areas that such fantastic measures are not required to achieve dramatic improvements in the health of such communities. With the work of just a few community health workers, most (yes most, not many … most) illnesses can be prevented before requiring expensive hospital care. Perhaps if such a system were in place in Fondwa, that man would never have needed to seek care in Jacmel. The University of Fondwa is trying to train such professionals.
Dan learning to 'branka,' which means to carry a man on a makeshift stretcher to find medical care.
Consider also the lasting economic toll that such a trip takes on a family. Maybe they had begun to save some money to start a small business, or to buy their own land (most farmers in Fondwa work on land owned by someone else, and either pay rent or a portion of their crop yield in exchange for the opportunity to work there). But with the untimely illness of a loved one, all of this hard-earned capital can be lost at the drop of a hat. This is an example of the phenomenon that economists like Jeffrey Sachs have called “the poverty trap.” Without the ability to amass capital, even just a small bit, no community can hope to improve their economic condition. And without affordable access to health care and other necessary commodities, it is impossible to amass capital. The absence of obtainable healthcare in Fondwa makes its impact felt on all areas of society.
Throughout the course of shooting and editing The Road to Fondwa, I often struggled with the ethical considerations that invariably arise when making a documentary that seeks to record and share the very personal struggles of some people who are put in some difficult situations. Was it ethical, for instance, to have intruded in this family’s life as we did when they were undergoing such a catastrophe? We asked permission before recording, but how much autonomy does someone in that situation have to refuse such a request when there are so many other pressing issues on his mind? We have obviously concluded that it is ok to share this footage, but with one stipulation: that something comes of it. The clip is shown with the intention of making known some of the struggles that people face when living in the deprived conditions ubiquitous to rural Haiti, hopefully galvanizing its audience to make a small step toward improving such circumstances. How can you help achieve this goal? Start by buying a copy of The Road to Fondwa. One hundred percent of the profits generated from sales of this DVD will be donated to the University of Fondwa, an institution committed to training professionals who will work in the Haitian countryside to begin providing its inhabitants with the basic services they so clearly need.
If you would like to download this story as a .pdf file you can do so by clicking here(1.88 MB)
