Post-Earthquake Haiti: ‘Always there is Opportunity’

Dr. Ralph Ternier is director of community care and support at Zanmi Lasante, Partners In Health’s sister organization in Haiti. Here he reflects on his experiences during the country’s earthquake in 2010—and the five years since.

A few days ago we celebrated the 211th anniversary of the famous Haitian Independence Day. This tiny land of contradiction has witnessed stunning and unfortunate events over the last two centuries. Some people keep saying the nation is damned; others who are attached to the country speak of hope, solidarity, and compassion, especially after having faced one of history’s most destructive and deadly earthquakes.

In a few days we will remind ourselves how fragile and precious life can be. For many years into the future we will tell our grandchildren about that day of sorrow. Some might refuse to believe such a narrative. Even I was incredulous toward what the Dominican taxi driver told me that Tuesday evening five years ago.

I had left Haiti to go to the Dominican Republic at 4:30 p.m. on January 12—20 minutes before my people plunged into the deepest desperation. I returned to Haiti two days later in a small airplane with two Partners In Health colleagues. From the sky I could watch the chaos on the ground—people with their belongings running away from death, an abyss of curse.

From that day on, we spent the whole year rescuing, saving, and relieving as many as possible, guided by one label: TNTC (too numerous to count). Then the first cholera epidemic in the country’s history hit, stressing and weakening the health system further.

But always there is opportunity.

We have learned particularly in this last decade that all these unfortunate events and disasters must be a platform to revitalize the health system. Five years after the terrible earthquake, it is important for us to reflect on our major achievements, impediments, and perspectives.

In addition to the roughly 1 million people that received emergency and general health care, we pride ourselves on the legacy of the teaching hospital in Mirebalais that came from all the international support. During 2010, Zanmi Lasante (ZL) understood that this massive contribution to the public health sector wouldn’t be productive without sustaining the community health structure. Therefore we formalized all ZL community activities through the new department of community care and support.

Very often we ask ourselves how we would adequately fight cholera without these tireless workers who still go door to door to raise awareness of the epidemic and ensure that community members are safe and protected. In many narratives we’ll frequently link cholera and the earthquake: they happened the same year, they created panic and chaos, and they took away so many lives.

But we have become stronger in the wake of these disasters. Our network of community health workers has grown to 350 members, and we now have several thousand accompagnateurs—compared to fewer than 100 before 2010.

Challenges, however, persist. The earthquake destroyed most of the important public health facilities in several departments, especially in West, where the needs of the surrounding population dramatically increased. To respond to these needs, the community network stepped up to expand services, such as rehab and mental health care in the communities.

A few days ago, I drove into the so-called downtown of Port-au-Prince. At points I felt as if I was living in 2010 as rubble is still piled on many avenues. One of my friends in the car from the diaspora asked me how I kept morale and stayed in the country. With a beaming smile I responded with what someone had told me the day I came back: “This country cannot be worse; it can only be better.”

After five years, everything that we are doing for the health system, for the patients, must be better, better than what it was before 2010, better than what it was during the cholera outbreak—better for the sake of our beloved lost during these tragedies.