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