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Orphans

WITH PERSEVERANCE, I EVENTUALLY found Pere Luc, who had built his orphanage at Delmas 48. In our first odyssey to find him, we had been off by only six blocks. In Miami, under the vow of obedience to his order and the dominating personality of Brother Paul, he was distinguished from the other brothers only by his accent and dark skin. Back in his native Haiti, he had come into his own. He had started by taking in orphan boys he found in Cité Soleil. When their numbers grew beyond what he could care for in his home, with the help of the Archdiocese of Port-au-Prince and a benefactor from Miami, he founded his orphanage, Bercail Bon Berger (Sheepfold of the Good Shepherd). Soon, with the help of an Irish monk, Brother Charles, he was father and mother to 200 boys.

Stories like Pere Luc’s are commonplace in Haiti. With decades of political violence and inadequate resources for health care, orphans are a “growth industry.” No one seems to know how big the problem really is. The government has no reliable statistics. The Catholic Church estimates that 200,000 children are institutionalized orphans, and it certainly seems that orphans and orphanages are everywhere in Port-au-Prince. Most are run by religious groups or individuals of goodwill, both Haitian and missionary. With a huge



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The Zombie Curse: A Doctor’s 25-Year Journey into the Heart of the AIDS Epidemic in Haiti Orphans WITH PERSEVERANCE, I EVENTUALLY found Pere Luc, who had built his orphanage at Delmas 48. In our first odyssey to find him, we had been off by only six blocks. In Miami, under the vow of obedience to his order and the dominating personality of Brother Paul, he was distinguished from the other brothers only by his accent and dark skin. Back in his native Haiti, he had come into his own. He had started by taking in orphan boys he found in Cité Soleil. When their numbers grew beyond what he could care for in his home, with the help of the Archdiocese of Port-au-Prince and a benefactor from Miami, he founded his orphanage, Bercail Bon Berger (Sheepfold of the Good Shepherd). Soon, with the help of an Irish monk, Brother Charles, he was father and mother to 200 boys. Stories like Pere Luc’s are commonplace in Haiti. With decades of political violence and inadequate resources for health care, orphans are a “growth industry.” No one seems to know how big the problem really is. The government has no reliable statistics. The Catholic Church estimates that 200,000 children are institutionalized orphans, and it certainly seems that orphans and orphanages are everywhere in Port-au-Prince. Most are run by religious groups or individuals of goodwill, both Haitian and missionary. With a huge

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The Zombie Curse: A Doctor’s 25-Year Journey into the Heart of the AIDS Epidemic in Haiti demand and limited resources, the orphanages operate on the margin—taking the maximum number of children they can and hoping that Providence will provide food and clothing for them from month to month. Health care is a luxury few can afford. Some have volunteer doctors who will make sick calls. Most do not. Thus, Project Medishare and its volunteers soon found a welcomed niche in providing screening and preventive services to these children. There are now several orphanages that we visit regularly. Some are newly constructed specifically as orphanages. Others are little more than formerly abandoned buildings. So far, we’ve found only two with small rooms sleeping 10 children or fewer. Most have large dorms with hundreds of bunks, frequently three tiers high. Dorms like these are designed to allow the orphanages, in their compassion, to care for the maximum number of children they can. Unfortunately, the design fosters the spread of tuberculosis. All it takes is one unidentified active case, and soon most of the children are infected. Coming from desperate poverty, with tuberculosis and HIV frequently claiming the lives of their parents, and with immune systems weakened by malnutrition, new infected children arrive weekly. It’s impossible for most of the orphanages to identify and quarantine these sick children. And yet a visit to a Haitian orphanage is not a trip back in time to some Dickensian Bleak House. Love matters, and at least in the orphanages Project Medishare has worked with, love abounds. I am forever amazed at how outgoing, friendly, happy, and grateful these children are. Even when scars are deep, they somehow heal. For example, Enoch lost his parents to the sinking of the ferry boat Neptune. He has not spoken a word since. To his fellow orphans this does not matter. They accept his silence as they do Michael’s blindness and Donnell’s frequent infections—brothers all. What Enoch can’t or won’t express with his words is surpassed by his smile, gestures, and touch. The chaos of the playground melds into discipline at a single word from Père Luc or, for that matter, from me. Ron was

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The Zombie Curse: A Doctor’s 25-Year Journey into the Heart of the AIDS Epidemic in Haiti right: They do teach politeness in the schools, even the orphanage schools. Delmas is one of Port-au-Prince’s busiest neighborhoods, and Delmas 48 is a congested thoroughfare linking Delmas to Museau. Bercail Bon Berger rises up the side of a hill behind a high wall and a large red iron gate. Outside the wall, the sidewalks are filled with market women selling their produce directly from the street, exquisite tomatoes and eggplants, oranges and onions stacked in pyramids. The din of bartering is compounded by the honking of cars and the roar and crunch of large trucks downshifting to ascend the route. Miraculously, these sounds reflect off the wall but do not penetrate the orphanage itself, where the only sound is that of 200 children talking, laughing, shouting, and reciting their lessons. If there’s hope for Haiti, it’s to be found in places such as this. The courtyard behind the wall is flanked on one side by a newly built school and on the other side by the clinic and chapel. Going up the hill is a small garden and pigpen, a large playground, and a library. The path traverses back and forth, leading to the dorms, the kitchen, the bread bakery, and the rectory for Père Luc and Frère Charles. Play, work and study are not confined to their respective areas, but happen randomly throughout the complex. I was visiting Bercail Bon Berger with a team of medical students and my younger daughter, Suzanne, to screen for tuberculosis and to hand out toothbrushes. The toothbrushes were Suzanne’s idea. She had decided on a career in dentistry in second grade, after a busy but nonlucrative internship extracting her classmates’ baby teeth. Intrigued with my stories of Haiti, and filled with her interest in dentistry and the familial volunteer spirit, she conjured up the idea of Project Brossé-Dent (which could be translated as either “Project Toothbrush” or “Project Brush Your Teeth”). Project Brossé-Dent—distributing toothbrushes and toothpaste donated from dentists’ offices and giving classes in Creole on dental hygiene—succeeded beyond our wildest dreams. Can you imagine the power of a tooth-

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The Zombie Curse: A Doctor’s 25-Year Journey into the Heart of the AIDS Epidemic in Haiti Suzanne and some of her toothbrushes. brush to a child who has never had one? Whatever tears were provoked by the prick of the tuberculin test evaporated as each child received his prize, along with a simple message—“Pou prevni maladi dan pike, bwose dan-w chak jou” (“To prevent cavities, brush your teeth every day”). In secret I reflected on the irony. My own daughter following in Régis’s footsteps. She was 17 at the time. We stayed for mass after Suzanne distributed the toothbrushes. Père Luc conducted the service in French, with the children singing a capella in Creole, accompanied only by homemade tambours. Perhaps the French and African heritages of Haiti could live in harmony after all, I thought. Suzanne later played her flute, accompanied by the boys with the tambours. As we were preparing to leave, chatting with Père Luc and Frère Charles, four figures caught my eye. Even while they were still in my peripheral vision, their significance registered instantly. My eyes flashed to them and then to Suzanne. She also knew.

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The Zombie Curse: A Doctor’s 25-Year Journey into the Heart of the AIDS Epidemic in Haiti Two nuns, dressed in their traditional Sisters of Charity habits, flanked a gaunt-appearing woman carrying a toddler. The toddler had a bushy head of hair that made his head seem twice the size of his body. He was wearing a hand-me-down T-shirt and no pants. Suzanne returned my glance with her eyes and mouth wide open. It was transparent. The mother was dying of AIDS and was giving her child up before she died, at least knowing he would be well cared for. Frère Charles muttered with his incongruous Irish brogue, “Oh, no. Another one. The good sisters bring us two or three a week.” Père Luc, Frère Charles, and the two sisters exchanged greetings and then sat down with the mother to do the paperwork. The mother was too weak to stand without the nuns’ support. Somehow, the child ended up in Suzanne’s arms. The child sensed the tragedy of his separation intuitively and began to wail. Upon affixing her mark to the papers, his mother kissed him and left, aided by the nuns. “Probably hours, at the most days, left,” I assessed. Luc, Charles, and I launched into a long discussion about how the orphanage could cope with what seemed an inexhaustible demand for its services. Meanwhile, the child continued to cry with its head buried in Suzanne’s shoulder. Suddenly I realized we were running late. We were past due at another orphanage. “Okay, team. Pack it up. Say goodbye. We’ve got to go!” I barked. “What do I do with him, Dad? Can we take him home with us?” “No, Suzanne. He’ll need to stay here. Give him to me.” I took the child and gave him to one of the older boys. “Take him to the kitchen for some food and then to the playground,” I explained in Creole. Later that evening at the hotel, Suzanne was somber. “What will happen to him?” she implored. “I’ve still got his tears on my T-shirt.” “Assuming he doesn’t also have HIV, and there’s a fair chance that he does, although he looked healthy enough, he’ll grow up at the orphanage. His memory of his mother will fade, but hopefully it will always be there. Père Luc will be his father, and he’ll have 200 brothers.”

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The Zombie Curse: A Doctor’s 25-Year Journey into the Heart of the AIDS Epidemic in Haiti “It’s so sad.” “Every child at the orphanage has a story like that. Multiply that by thousands of orphanages, and that’s a small part of the tragedy of Haiti today. Multiply that by the hundreds of countries around the world in the same boat as Haiti and, guess what? You’ve experienced firsthand something that’s probably the most important historical event of your lifetime. Listen. Let’s make a vow. We’ll keep coming back to check on him. We’ll watch him grow. Next trip, you can bring him a toothbrush. Someday when he’s old enough to understand, we’ll tell him of his mom and her last courageous gift to him. You’ll need to work on your Creole.”