By noon steady sunlight streaming through the small windows of the critical care unit had become tributaries to the stiffling humidity and heat on the ward. A few volunteers had arrived to assist the patients. They were cherubic faced US college students who wore bright yellow t-shirts announcing their affiliation with a Scientology group. They assisted with turning the patients, changing dressings, and running errands. In search of water I walked out of the unit, first past the white, then the green iron gates to arrive outdoors. I stopped and allowed my eyes to acclamate to the bright light and to survey the scene. One of the main arteries of the hospital grounds coursed directly in front of the unit. The road was congested with soldiers, transporters, doctors, patients, and families only barely avoiding crashing into one another.

A few lumbering trucks delivering supplies blared their horns in hopes that a path would somehow open up without someone getting trapped beneath their wheels.

"The Forest" stood directly across the road and I could hear voices, mostly women, joyfully singing church hymns. All around the outskirts of "The Forest" and along the road that encircled the medical campus, tents had been erected. Each tent or set of tents was labeled with the following information:
1. Service provided: Pediatrics, Post-op, Pre-op, etc.
2. Physician in charge: Dr. "Bruce", Dr. "Jim", Dr. "BB", etc.
3. Affiliation: Association of Haitian Physicians Abroad, Red Cross, Red Crescent, International Medical Corps, Swiss, Norwegian, etc.
The International Medical Corps (IMC) was responsible for coordinating the medical efforts at the hospital. They consisted of physicians with disaster relief experience. In essence they served as the de-facto leadership since so many in the hospital administration had been directly affected by "The Event". The biggest challenge that the IMC faced was how to coordinate all the responders in the most efficient manner, how to transfer critical patients when needed, and how to get necessary supplies and equipment.
In the rush to provide services reflecting the expertise of various groups, the medical campus had been splintered into silos that were now struggling to integrate not only with themselves but also with the Haitian faculty of the General Hospital. This was a problem even within particular fields such as surgery where battle lines were seared along institutional affiliations: Mt Sinai, NYU, Boston, etc. Some groups were more successful than others at bridging those divides and found a way to work together. Others, feeling wronged when it came to access to patients and procedures, packed up and left Haiti before completing the time they had promised to serve.
As I stood in front of the unit, a thin young man about seventeen years old wearing a black knapsack approached me. He was one of many such young men I had seen lurking around the hospital grounds. Some worked as transporters, others as interpreters, but the vast majority didn't seem to have a role. Reaching my location the young man briefly raised his open right hand as a form of greeting, and nodded his head while reading my name. Physicians had begun to write their names directly on their shirts or on a piece of white medical tape that they then applied to the left upper chest region. My "name tag" read: "Dr. Fritz".
Given the popularity of the name "Fritz" (or of its derivation) in Haiti, the young man quickly surmised my background and began speaking to me In Creole. After introducing himself as Jean-Marc and telling me of his losses in the quake, he proceeded to ask for my assistance in securing a job at the hospital. I listened quietly and intently but then in turn had to explain my limited role as a visiting volunteer to the hospital. Jean-Marc remained unconvinced that my status as a physician could not somehow secure employment for him and although he continued to smile politely his disappointment was unmistakable. Many other such encounters would take place in the days to come, and my ability to assist would not improve. As Jean-Marc walked away, I wondered whether a similar life with limited opportunities would have befallen me had I not gone to the US at the age of 10. This was my first time back to Haiti since I left...my first chance to reflect, on the ground, how different things could have been, and to wonder how different things will be.
As a group we were here to help repair broken limbs, overworked hearts, clogged kidneys, inflammed livers, drowning lungs, swollen bellies, and infected wounds. We labored tirelessly in the operating rooms, in "The Forest", in the critical care unit, and in the tents.
But perhaps those whose suffering could most easily be alleviated...those representing Haiti's future...those like Jean-Marc...we simply did not see at all.