How the Haiti earthquake impacted an Ohio dentist

Note: Kevin Henry, managing editor of Dental Economics, contacted Dr. Myriam Raber of Kidron, Ohio, a native of Haiti who has many family members in the country, to learn more about her native land and the earthquake’s devastation.

Henry: As a dentist who lived in Haiti, and as someone born and raised in the country, what were your first thoughts when you heard about the earthquake?
Raber: My first thought was about the safety of my family and friends. I have seven siblings who have families, my 82-year-old mother, and a large extended family in Haiti. I tried not to panic until more details became available. The evening of the earthquake all but one of my relatives was accounted for. By the next morning all of my family was accounted for. The first pictures that were shown on the 11 p.m. news included the collapsed national palace. That was the moment my heart sank. I knew immediately that there would be over 100,000 deaths. That was the beginning of a series of sleepless nights.

Henry: What are some of your childhood memories of Haiti?
Raber: I grew up in a period of relative calm in Haiti (1970 to mid ’80s). At that time the brutal dictator Papa Doc Duvalier had been succeeded by his corrupt but not sociopathic son. There were no major hurricanes, no organized gangs, and not yet the massive migration to the larger cities. I was free to ride public transportation and walk the peaceful streets from about age 10. My life revolved around friends, family, the next outing
to the beach or mountain, and basketball. Going to a Catholic School from the first to 13th grades, we were raised to help those in need as much as possible.

Henry: Your bio states that your family had limited access to quality dental care, and this is one of the reasons you eventually became a dentist. Is that correct?
Raber: That is correct. Even though my parents were medical doctors, there were few dentists in Haiti. I remember my first dental visit. The dentist told my mother that the cavities were very small and did not need repaired. There were no radiographs taken and no preventive care offered. I recall a period of two to three years between ages 10 and 13 when on my way to school, my dad would drop me off at the dentist's office, where he would put a sedative cotton pellet in several of my bombed-out molars. At the end of my visit I would walk the remaining mile to school. To this day I have an aversion to cloves. I also still vividly remember the sound and smell of those belt-driven handpieces. My father encouraged us to pick a "portable career," meaning the kind that would be of use anywhere in the world. Having grown up in a medical household, I knew I didn’t want to be a physician. But three of my sisters are physicians. My dad would treat 50 to 80 patients a day and come home very tired, only to have the latest medical emergency show up on the family doorstep. Dentistry is a much healthier lifestyle, and to me just as rewarding. Of course this past week I wished I were an orthopedist.

Henry: Tell me about the time you lived in Haiti as an adult and your practice while you were there.
Raber: My intentions were always to return to Haiti. Marrying an American changed my plans a bit. Two years after I graduated from dental school, my husband (an optometrist) was called to run an eye clinic at the Christianville Mission just outside of the Haitian capital. This was the very mission where as a teenager I had driven to see a visiting orthodontist. The mission was also in need of a dentist. It was a perfect fit for us.
The dental clinic provides free comprehensive dental care to 1,400 schoolchildren in the mission schools. There is one day a week where for a small fee the other community people have access to quality care. I was there from 1995 to 2001. I obtained grants to improve the facility. With these grants we went from two operatories to five. I trained some expanded assistants to work as dental therapists. We also accepted interns to teach them modern dentistry. For one year I taught the pediatric dentistry class at the state dental school. I worked alongside a Haitian dentist who is still there. The mission is located very near the epicenter of the earthquake. Most of the schools and clinics were damaged beyond repair. It took a few days to get word, but I was glad to find out that the entire staff is okay. My former housekeeper lost a child. Her name was Daphne. When I visited Haiti last June Daphne asked me if I would pay for English classes for her. I did. I am very heartbroken about her death.

Henry: In your opinion, will Haiti be able to recover from this disaster?
Raber: Haiti has to recover from this. Over eight million people have to go on living. The centuries of suffering have made Haitians a hard-working and resilient people. The question is how will the recovery be? I think there is a great opportunity for the international community to finally seriously help Haiti out of its downward spiral. There has to be a Marshall Plan time process for the country. The workforce is there and willing. The key is to keep conflicting international interests and corrupt Haitian politicians in check. Some backward Haitian laws will also have to be changed.

Henry: What are your thoughts/emotions when you see the images from Haiti?
Raber: There are no words to describe my emotions. I have cried a lot.

Henry: Do you plan to go back to Haiti?
Raber: I don't have such a plan at this time. My four children are ages 10 to 16. I have vowed to stay put until everyone is at least in college. My mother is 82 and still putting her skills to work. My entire family has been working 24/7 for the last week to provide relief in Haiti. I would be much more needed in Haiti than I am in the United States.

Note: The following was added by Dr. Raber. The e-mails printed here are unedited.

Now allow me to add a couple of things that may help you see where I am coming from. Below is an e-mail I have been sending to as many people as I can. I’ve also included two e-mails I received from my sisters yesterday:

“My apologies if you get this e-mail more than once. This is an appeal for my native country of Haiti, where I still have seven siblings, their families, and my mother. They are all OK. The country needs your help. Here is what you can do:

1. Donate money. No amount is too little. Go through your favorite charity, or here are two small ones I highly recommend:

** The Haitian Community Hospital, where my mother has been on the board for over 30 years. It is one of the few hospitals still standing near the Capital. The Web site to donate is www.haitihosp.org, Facebook page: Haitian Community Hospital

** The Christianville Mission, where we worked for six years, suffered major destruction. Its Web site is www.christianvillehaiti.org. Facebook Page: Christianville Mission-Haiti

2. Spread the word to all your friends, churches, synagogues, and social networks that help is needed now, especially money.

3. If you know of an orthopedist willing to volunteer in Haiti, please contact me privately.

4. I think it would be great if a large organization could send 500,000 to one million crank radio/flashlight/cell phone chargers sold by Eton and Radio Shack to be distributed with the food relief. This way there would be a way to communicate with the people long-term. If you have contacts, spread the word.

5. Write your congress people/senators that you care and that a long-term effort like a Marshall Plan will be needed even after the last TV reporter leaves.”

Here are the e-mails from my sisters:

“The situation is now more stable at the Haitian Community Hospital, although the needs are still great. Doctors have arrived from all over the world. I just spent three days working for the X-ray department night and day. This morning I took a break. I couldn't think clearly anymore. My job was emotionally tough. I started on Thursday and had to convince suffering people, some of who were going to get limbs amputated, to wait up to 48 hours for X-rays, and make sure that staff members to young volunteers to medical doctors would not sneak in people close to them. Sometimes I got angry and rude but it was a relief to those who were waiting. They felt that if I was defending their case with so much energy they didn't have to get angry themselves.

For 36 hours we did not have large films so most people could not have their X-rays done. I asked some people who came to the hospital on Sunday why they had arrived so late; I thought that maybe they had been caught under the rubble. They answered that they spent several days trying to find a functioning hospital that would accept them. Yesterday one of the patients, a boy of about 12, had been amputated the day before on his birthday; he was also the only surviving member of his family of four. On Sunday, a waiting nine-year-old who ended up receiving a morphine shot was yelling, "I've been dying since Tuesday!" A very affectionate father whose young boy had a broken arm said, "The only thing that helps me stay calm is that it is everybody who is homeless." He also said to me that, "Only his 10 months baby died." The earthquake is said to have struck in a very democratic way; the size of the houses didn't seem to matter.

> From my sister Josiane:

Hi everyone,

It is hard to actually describe what goes on at l'Hopital de la Communauté but we are feeling much better about patient care today. The first two days we had two Haitian orthopedists taking charge and seeing patients as fast as they could and three other doctors evaluating patients.

There were no aftershocks today, and that was a blessing because every time there is a tremor the patients scream and their relatives try to carry them out of the building. Today I looked around and felt like we were in a hospital and not a war zone. The main thing that happened was that a team of mostly Haitian-American doctors arrived two days ago and asked to take charge of sorting the patients by order of priority. The volunteers have been great.

There is a team of surgeons led by an American who lives in the Dominican Republic in charge of the two operating rooms. In addition, every morning our family has an organizing meeting about needs and distribution of jobs. All day yesterday new volunteers of all types arrived, and donated supplies arrived. One large truck and a bus came with a group of 28 young Haitian medical residents from the Dominican Republic. They opened a clinic under a tarp in the yard to screen new arrivals and send those who needed more than sutures and bandages inside the building. That helped those patients who are terrified of going indoors get some care.

Ten of the Haitian doctors from the DR came inside and helped with post-op care and wound care. My job yesterday morning was to walk around with the one non-Haitian from the Miami team, translate, and put a piece of masking tape on each patient's forehead labeling his level of emergency. Most of the patients were spread around an inner courtyard that is usually the main external clinic of the hospital. We set up a supply room in the dental clinic with a volunteer registration desk, a casting room in the regular consult area, a workers’ snack and coffee room in the administrative offices, and two major supply rooms, one for medical stuff in a meeting room and one for food stuff in an unfinished area on the second floor. Late yesterday, new teams arrived from St. Thomas (VI), and Jamaica. Many wealthier local Haitians were also there helping with translation, bringing donations, sorting donations, and managing patient families.

This hospital usually permits relatives to be here 24 hours, but the doctors from the U.S. told us that the place was too crowded and that only children could have a parent present full-time. That was very rough. One teenage boy who didn't want to leave his mother and sick sister signed up as a volunteer. We had to have lots of policing at the gate.

Yesterday we had two very touching stories. A 15-year-old named Ricky was alone for the first two days and I was very worried about him because he seemed to be sleeping most of the time. Another teen next to him told me that we had to watch out for him because no relatives were around and all his siblings were dead. Yesterday, Ricky sort of woke up and his mother came. When I came to see him with the doctor, the doctor told him he would need surgery on his leg. He told the doctor that he thought his leg was dead. The doctor said that he was right and that it would probably be amputated. Ricky said it was OK, as long as he could survive because he didn't want his mother to be alone.

The second story was a miracle baby named Angel. He was pulled out of the rubble on the fourth day. He was about four months old. His mother had been killed and his mother's cousin brought him in. The doctors looked all over and found nothing but minor cuts and scrapes on Angel's little body. We found him some Pedialyte and formula in the supply room and Angel turned into a charmer. Each one of us who went to look at the miracle baby and talked to him got a great smile. That was incredible.

I talked to a guy today who was waiting for a death certificate for his 24-year-old daughter. She was in class at an engineering school when the earthquake happened. He said that he couldn't understand how an engineering school of all places could be so poorly built that it collapsed. Yes, anarchy in construction is a common subject of conversation in Haiti and it usually refers to the shantytown, small improvised housing all around the capital. But now we say that all of it was improvised: the presidential palace, the tax building, the justice department, the Catholic cathedral, the Episcopalian cathedral, the fanciest hotel, and the fanciest supermarket. Or maybe nothing could prevent the collapse of all those important buildings.

The hospital still struggles with shortages and a lack of supplies. Most beds are divided into bed and mattress. One person gets the bed with some cardboard padding or matting brought in by the patient, and another person gets the mattress. Many patients are on stretchers. We've been told that the U.S. government will bring us 50 cots. We will still be short of sheets. One of the things we hope to work on in the next couple of days is infection control measures. We have gloves but there is a lot going on that is not hygienic right now and bacterial contamination is scary. Parents bring sheets and bedding from home, and too many people go in and out around the patients with no hand cleaning. Well, we will work on that tomorrow.

The stories outside the hospital are scary. I really don't have time to listen to the news on the few Haitian radio stations still functioning. One TV station shows CNN all day but when you are living through this, CNN is a bit irritating. Among the many dead are many important people, like the bishop of the Catholic Church, the head of the tax office, the senate president. We are actually not sure about what's the truth when we hear about who is dead, missing, or found alive because there is a lot of rumor and there have been no Haitian newspapers printed since the event. We hear that banks and U.S. government offices will open tomorrow morning. We hope that some supermarkets will open too.

Our house is full of people. Max came in to help at the hospital, Jeff came in with two journalists and a driver from the DR, Chantal and Sabrina are with us because their apartment is cracked, Louideur moved back into our yard with his wife, mother-in-law, and baby, and Guerda is there with her two daughters and grandchild. Brigitte took in a family also, and Tigeorges has one person.

In our neighborhood the Internet doesn't work except at Brigitte's house. Tomorrow the hospital might get some fancy Internet equipment. Two guys from the U.S. came and asked if the hospital needed a satellite communication unit. So, tomorrow we might have Internet and international phone connections from the hospital. That will be very helpful. I might be able to bring some photos.

Josiane