New Home in Cite Silence, Hinche
Evan Lyon MD
The Zanmi Lasante clinic in Hinche is experiencing what we call a ‘first pass’ phenomena in terms of HIV and TB patients. Prior to ZL’s rehabilitation of the grand but empty Hopital St. Therese, there was no capacity to diagnose or treat HIV. There was only very poor care for tuberculosis. Both TB and HIV are relatively common among the rural poor but now – and until we catch up to years and years of neglect – we are seeing even greater numbers of patients. These patients represent a backlog of the sick who survived a complete lack of accessible medical care.
Patients are coming in droves since we opened our doors in Hinche. There are always many to see in a single clinic day. One side effect of this richness of patients is that we rarely get a chance to know any one patient’s story well. One recent Friday, Mme Louis – as I will call her – came to clinic just to visit. She had completed TB therapy 2 months prior and was in good health. She also insisted that I visit her new home in Cite Silence, just 15 minutes from the hospital. The following Sunday I got a chance to visit with her in her new home.
After seeing our inpatients in the TB pavilion, we walked together to Cite Silence. It really is a quiet place. No electricity, paths too small for cars or trucks. We talked as we walked together, accompanied only by the sound of children playing, animals making their noises, and the wind blowing up dust. Mme Louis bought her small piece of land when she moved here from a nearby village. She had 7 children, most with the same father who never helped to raise them. She came to the regional capital to strike out on her own as a marchan in the bustling town market. She had managed to put most of her children through some school, several into high school. Recently she lost one of her sons – a man of 33 who wasted away of a ‘terrible cough and fever’ around the time ZL was becoming established in Hinche. This left her with two grandchildren to care for, in addition to her own three children still living at home. We will never know, but it seems likely that her son died of tuberculosis.
When she got sick herself with TB, she was living in what Haitians call a Jupa - a tent shaped lean-to with a few supporting sticks covered by banana fronds. The back wall of the shelter was two torn sheets loosely sewn together. The floor was mud. They had a metal bedframe without an mattress to sleep on. There was no cover for the front. Rain must have poured in during the rainy season. Mme Louis lived in this small, miserable shelter with her five children.
This picture is her and her family in front of their new home. Only the floor needs to be completed. I stood between the two rooms and admired the new building with her. "Wow." I said. "Beautiful windows, a tin roof, and three doors."
"Four," she corrected me. I was standing between the rooms in a door frame that most peasant homes only can cover with a sheet or curtain. There were four doors. Everything counts. She was very proud.
"I don't have any chairs. You'll have to come back when I have chairs so we can sit together in my house." I promised I would.
As important as the new home is for her families continued good health, our patient feared her land would be stolen from her without a proper house on the ground. Now it is there, and her family will be together and dry. And no one can take her property. When we were walking back to the hospital she thanked me three times, from her and her children. She seemed to forget saying it minutes earlier, caught up in the happy moment.
I wanted to pass along her thanks to everyone who helped build this new home.
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