Lending Hands in Haiti

David Ubogy and Beth Dowell live in a comfortable home in a Chicago suburb but on January 20, 2010, they took a huge step out of their comfort zone and embarked on a courageous journey where they worked separately offering their assistance in Haiti. I got a call on a Sunday morning that “Someone needs to tell their story!” So I called them and met with them within hours of their Tuesday departure. Later that day, at eight at night, just after they put their two boys to bed, we sat down to talk.

David is a pediatric critical care specialist and Beth is a family practice physician. Beth's mission, a needs assessment trip for The Heartland Alliance with three colleagues. David's mission, to work at the Hôpital Albert Schweitzer with two other doctors, returning to this hospital he was introduced to by Beth and her father. Beth's father, Duane Dowell, M.D., rotated his practice on the East Coast to Haiti once every three years in the 1960's. In that practice, two physicians worked to support three doctors. Rotating each person's service, each of three of the doctors took one year every three years, and worked in Haiti. Every third year, Dr. Duane Dowell and his wife, Vera, moved to Haiti with their three children.

David gave me an article to explain some of why he and Beth are moved to help in Haiti. It is an insight into what would draw physicians to the task of working in a nation like Haiti. It is an essay by Ralph S. Greco, M.D., Stanford, California, “The Cardboard Box” from the Journal of the American Medical Association, August 2, 2000.

Greco's essay opens with this sentence “The Haitian sky at night is breathtaking, a sea of jet ink in which flow shimmering stars more numerous than can be imagined. Or is this an illusion to hide...starving children....impoverished villages?” The name Haiti is taken from the Arawak word for “mountain.”

Greco tells the story of William Larimer Mellon, Jr., whose life was influenced by the life and work of Dr. Albert Schwietzer in West Africa when he visited there with his wife, Gwendolyn Grant, later visited Haiti in 1951 for the first time. Mellon went on to Tulane to attend medical school and, later, he and his wife went back to Haiti and founded The Hôpital Albert Schweitzer in 1956. It was built on a former plantation in the Artibonite Valley. It has been serving the people there since then. Dr. Greco says the Schweitzer philosphy of 'reverence for life' is alive and well at the Mellon hospital. Mellon was also responsible for advances in irrigation and agriculture as well. Schweitzer influences Mellon. Mellon influences Greco. Greco influences Ubogy and Dowell.

”The Cardboard Box” refers to the fact that despite the fact that Mellon was a very wealthy man, he chose to be buried in a cardboard box as a symbol, a reminder that “where resources are scarce, life expectancy is short. In such an environment, the goal must always be to revere and nurture the living, above all else.” He planned his burial like this, in a cardboard box, in contrast to the generally practiced tradition of locals of spending exorbitant amounts of money on funerals.

Greco wrote this article in 2000, two years after he returned to Haiti with three of his students. He said “My goal was to resurrect this profound experience for a new generation of surgeons who may benefit as I did a quarter century ago. My hope is that they will learn that the world is a bigger place than a US hospital can possibly convey, that poverty and disease are a way of life in many parts of the world, and that as physicians, we and our skills can make a big difference in the world, and that as physicians, we and our skills can make a big difference despite the absence of financial remuneration.” This must be true of almost every doctor who leaves for the shores of Haiti. There is personal financial sacrifice involved in this mission for most of them but by the opportunity to serve, many of them become once again in touch with why they became physicians in the first place because of a “...desire to better the lives of our fellow human beings and alleviate the pain and suffering of innocent children.” This is Dr. Greco's summary of the experience. For David and Beth, Dr. Greco articulates much of what they believe.

Because Beth Dowell has the unusual background of having spent much of her childhood in Haiti while her father worked in the Hôpital Albert Schweitzer, she knows Haiti well. It is her home away from home. She went to school there, learned to love the Haitian people and culture and she speaks Creole. Haiti gradually become a second home to David Ubogy, too, and he is well-informed when it comes to Haitian history, politics and culture. He does not consider himself as fluent in Creole as his wife but he is clearly knowledgeable, describing how the language evolved from French and was only codified relatively recently compared to other older languages. Creole has an efficient use of pronouns, for instance, David explains, using only one word for many similar masculine and feminine pronouns that we would use in English. Haitian Creole differs from Creole spoken in the American South he mentions. “Creole is the traditional English way to spell the Haitian language. But the correct way in Creole itself is Kreyol.” David says. The language evolved when men and women from tribes which spoke different languages were abducted for purposes of servitude by the French. They had no common language and for this reason thought not to be able to conspire against their captors. The language Kreyol evolved from words they used and language they heard from the French.

Beth and David are graduates of Oberlin College in Ohio and attended medical school at Case Western Reserve in Cleveland. They met in January 1988 on a scuba diving trip organized by Oberlin College to the Cayman Islands. At the present time, Beth works at the PCC Community Wellness Center in Oak Park and David works at the University of Illinois, Chicago, Hospital and Shriner's Childrens' Hospital.

In 2000, with a 2 year old with special needs in tow, David and Beth had just completed their residencies and looked around to see what it was that they wanted to do next. They decided to make their way to Haiti to work for a year.

How do people come to have social consciences that lead them to lives like this? Both Beth and David agree that their respective family members had social consciences, although David says Beth's family acted on it more. Beth's parents, former Methodists, wanted to become missionaries but the proselytizing did not suit them. They just wanted to be of service to those in need. David describes himself more as an agnostic with a Jewish background although all of the Dowells are now Unitarian Universalists. Both of their father's were doctors and that modeling showed up in the next generation in both families. David's father, George, whose specialty is general internal medicine, now works as Medical Director for a Substance Abuse Clinic in Greenwich, Connecticut.

Beth's brother Scott Dowell, fluent in French and Kreyol is also an MD. a pediatrician and epidemiologist at the CDC. He travels around the world as a specialist investigating outbreaks and medical situations. David is as proud of brother-in-law and father-in-law, father, and brother, as he is of his wife. David's brother, Seth, is a pediatric neuro-psychologist at Oakland Children's Hospital.

Will there be significant changes as a result of the earthquake and the attention and resources that will converge in Haiti? Will life change radically and improve? David thinks that is hard to say. It hasn't happened yet despite efforts over many many years. Haiti is the poorest country in the Western Hemisphere and it has the highest infant mortality in the Western Hemisphere.

Beth says that organizations are urging participants to think of the efforts now as long term. She remembers how living in Haiti changed her world view. It changed her perspective on school, for example. In the US, kids complain about school. There, children would walk for an hour to get to school and their parents would make great sacrifices for them to get an education.

Beth's assignment did not call for hands-on medicine on this trip, although it would be impossible for her not to help if she is presented with a situation where her help as a doctor is needed. Her purpose will be assessment work.

David, on the other hand, will be practicing his specialty, pediatric critical care. How will he handle the intense scenes he will face? He expresses the fact that he is apprehensive about seeing all of the corpses, acknowledging that this is an experience he has never had before. Beth talks about the irony of the situation now with bodies being buried in mass graves because she says Haitian customs are very reverent when it comes to death and burial and Haitians spend a lot of money on funerals.

David gives two answers to the question about how he will deal with the images he sees and the critically injured patients he will encounter and treat. First of all, over the years he says, “I have managed to ease into the emotional handling of higher and higher levels of serious conditions” . That is not to say that he does not have anxious moments with patients who are in a serious state of decline, naturally, he does. He describes these moments in the way that only doctors must experience, dry mouth, knot in stomach, vulnerable feeling in hands. It is like all senses are on high alert. But in Haiti, there are not the machines and technology, maybe what we lay people think of as extreme measures here in the US, that a doctor can utilize, and it seems as though a person's fate on every level medically is different, now especially. With the highest infant mortality rate in the Western Hemisphere, it seems as if the people, sadly, also have different expectations. “There will not be the technology for critical care, at least there will be very little,” David says. He will be more reliant on his basic skills as a physician.

David knew he wanted to be a doctor when he was in the third grade but he had a change of heart as an adult. He credits Beth with putting him back on course. They express to each other a deep and genuine concern for one another's safety on this trip but Beth ends with an expression of respect and appreciation for the Haitian people. “ Haitians are appreciative and generous to a fault” , she says. David adds “People are cooking and bringing meals to Hôpital Albert Schweitzer.

”What do you want people to do with regard to Haiti?” I ask. Beth responds, “Stay aware. Donate.” She points out that even the things brought in to the country, donated goods, can have unintended consequences and can impact the goods being sold and produced by citizens in country by driving down prices impacting their earning a living. This can be negative and detrimental to the Haitians tender economy.

”Many people have had the instinct to go help in Haiti but well-meaning people can be more of an obstacle than help sometimes during a recovery like this and we have to remember that” Beth points out. “They would (and we will) be competing for the same meager resources of food, water, and shelter as the victims of the earthquake and this creates a problem” . Heads of state and celebrities with good intentions can be more of a hindrance than a help at this time, she points out. They take the focus away from the work being done. They require security and care.

I ask about the time frame for the trip to Haiti and what their accommodations will be like while they are there. David answers “Beth returns January 28. I return January 30, 'Si Dye Vle'. That's Kreyol - If God Wants It.” (God must have had other plans for David to stay longer. Read the note* below about the change of plans for him related to me by his mother-in-law, Vera.) He continued, “Beth will probably be camping. Hopefully in the protected yard of a private home. If I and my companions make it out to Deschapelles, we'll be fine. They have a large campus with guest housing. Running water for a few hours daily, intermittent electricity.”

On my way to talk with these two remarkable people and professionals, parents of two boys, there is an interview on NPR with Karen Armstrong who wrote “The Case for God” . Armstrong says “Compassion is the truest litmus test for spirituality” . Doctors Beth Dowell and David Ubogy, filled with compassion and respect for the Haitian people, are on their way to Haiti this week of January 17th, 2010. They are the arrows sent forth from and in the tradition of their families. This is what will help the Haitians survive Beth says, “They are so close to their families, they help and support one another, just as we do.” Beth's parents will remain behind in the Midwest this time and dedicate themselves to hearth and home with their two grandsons.

*Update from Vera Dowell Tuesday, January 26th.

Dr. & Mrs. Dowell have received emails from Beth and David every day since they left. Beth reported that agency Beth was in Haiti to represent, The Heartland Alliance found an agency to partner with. David signed up with Hope but has been asked to work on the US Navy ship “Comfort” where he will aid in the operations there helping with pediatric intensive care for the next three weeks.

Beth will be home January 28th. While she was there, Beth was in contact with her brother, Scott Dowell, M.D., who was there doing work for the Center for Disease Control (CDC).