THE NEGLECTED AND ABUSED: A PHYSICIAN'S YEAR IN HAITI

By Joseph F. Bentivegna
Michele Publishing Co.
2317 Silas Deanne Highway
Rocky Hill, Ct. 06067

Reviewed by Bob Corbett

Mother Teresa of Calcutta is one of the most admired and respected persons of human history. Yet her approach to human suffering is a serious challenge to the American spirit of efficiency. Mother Teresa and her sisters, The Missionaries of Charity, do not mount efficient, high tech programs to change the political, social and economic lives of the poor. From their world of faith, they see Jesus, their God and Saviour, in the poorest of the poor, the rejected, the neglected and abused of Bentivegna's title. The sisters serve the individual, providing more loving comfort than medical healing, and do virtually no activism for systemic change.

Joseph Bentivegna, "Dokte Joe," spent one year working in two facilities of the Missionaries of Charity in Port-au-Prince, Haiti. As a young physician socialized to American efficiency, trained in the best tradition of Western medicine, Dokte Joe set out to save people as best he could. His book is a reflective journal of this year of service. And save people he certainly did. He recounts many moving and detailed stories of his successes with patients. Yet his account is not a braggart's list of successes. Far from it. He recounts many failures, tales of those who died, sometimes, on his own analysis, from his mistakes.

Bentivegna makes an important discovery. The task of the physician, even in the history of Western medicine, is not only to cure, but also to comfort. He wrestles with the concept and ultimately fails to incorporate it into his inner person.

Joe Bentivegna comes up against the "Mother Teresa syndrome" and rejects it. Comforting the individual is not enough to count as success. He realizes he cannot fix Haiti. He has heart breaking experiences of healing people only to return them to the impoverished environment which destroys them in short order. The moving story of Louis is a classic example:

He arrived at Sans Fil (home for the dying) gaunt, febrile and coughing from tuberculosis. Two months later, the tuberculosis was under control. He had gained thirty pounds and was confident that he could now make a living. There was a problem, however, he had no place to go. Undaunted and sporting a huge smile, he left anyway, thanking all of us for helping him. His only possessions were a snapshot of himself taken by a generous visitor, a Liberty Bowl T-shirt, trousers, and a Minnesota Twins baseball cap. Two days later he was back. Day found him lying at the front door, tears streaming down his face, clutching his now tattered picture.

Day was prepared for anything; he was used to Haiti. Louis's shirt was filthy, the trousers torn and the cap, long gone. His eyes were sunken deep into his head and he had lost at least five pounds. He could barely respond to my questions.

"Do you have a family?"

"No."

"Friends?"

"No."

"Did you have a place to sleep?"

"No."

"Where did you sleep?"

"Under the tables in the market place with the crazy people."

"Did you eat anything?"

"No."

"Did you drink anything?"

"No."

There was no way he could survive in the real world of Haiti. This is why so many roamed the streets begging, looking for cars to clean, trying to do odd errands, or becoming prostitutes; it was that or nothing. Many Haitians could not get enough money together to buy food or rent a place to sleep. They forever roamed around, until some social organization helped them, or, more commonly and tragically, they lay down and died.

Time and again Dokte Joe would struggle with a patient to return him or her to health, only to see the patient in the same shape, or with a new disease, or dead, within weeks. Certainly one can understand the frustration such work brings. Bentivegna approvingly cites Albert Schweitzer's claim: "There is no human life not worth saving." Yet his book is the laying bare of a profound inner struggle as to whether or not his work in Haiti was worth it.

Joe Bentivegna worked for a year in two facilities, both run by the Missionaries of Charity: the house for the dying, Sans Fil, and the children's home. I know both quite well, perhaps even better than Bentivegna. Since 1983, the year of Bentivegna's experience, we started taking work groups to Haiti to work mainly in these two facilities. Since then hundreds of volunteers, young children, high school and college students, adults of all ages, even senior citizens, have joined us in providing comfort and care to these neglected and abused who come to the two facilities. Perhaps it is fortunate that most of our volunteers are not medical personnel. They, too, wonder why are they there, what can they possibly accomplish? In our evening discussions, or small group meetings over a beer or coke, the question constantly arises. What good am I doing? Am I perhaps doing harm? The only answer which makes sense is the very one Joe Bentivegna at times gives in his book -- though ultimately he rejects it: The value of the work is the comfort, the joy, the dignity given to this person now, perhaps just as he or she is dying.

Bentivegna seems caught in his western training. In order for his work to be satisfactory he must save the patient, returning him or her to a productive life. Bentivegna's right -- he can't do that in Haiti. The entire weight of a horrendous social, economic, political, historical disaster presses down on the patient. Bentivegna or any of the rest of us cannot change Haiti. If this is our demand we will fail miserably.

Yet one can give comfort to this human now. Bentivegna says this often, but just can't live with it. It's quite interesting to note that his journal of a year almost never mentions the hundreds of volunteers who come to Haiti, as our work groups do, to comfort people in the same two places where Dokte Joe worked. There are even a few rather nasty remarks like:

Visitors frequently came to observe. They were a diverse crowd ranging from idealistic college students to religious zealots. There were Club Med stragglers who wanted to absorb the Haitian experience. They asked me about the incidence of venereal disease, especially AIDS, then returned to Club Med. There were American nuns with their stretch pants, Nike sneakers, Lacrosse shirts and Minolta cameras, wondering why I was not smart enough to figure out they were nuns. There were the sixties leftovers in their wide-wale corduroys and sleeveless T-shirts, with their bald heads, thick sideburns and bifocal wire-rimmed glasses. There were doctors vacationing from their suburban practices, making useless suggestions to which I responded with a polite smile.

However, in general the volunteers just don't exist for Bentivegna. He and his two sidekicks, Day and Nick, seem to be the only non-patients around. The Missionaries of Charity sisters appear now and again, but there is a conspiracy of silence concerning the volunteers. I find this both ironic and symptomatic. Ironic in that the volunteers' primary activity is to bring comfort and that they do. Symptomatic in that the comfort Dokte Joe so knows the people need is just not enough to merit recognition. In fairness, however, Dr. George Leonard, a long-term physician volunteer at Sans Fil, tells me that our PEOPLE TO PEOPLE groups are quite exceptionally hard working well-prepared volunteers. George says many volunteers simply just get in the way! They do need some guidance and preparation, which they often do not get.

Despite these minor concerns, Bentivegna's book is an extraordinary and important book. He has an incredible wealth of experience in Haitian health care and clearly explains the frustrating and devastating health problems faced by the people. His treatment of the structure of health care and the nature of Haitian malnutrition are the most accurate I've ever read. He is at his best when he passionately describes his daily experiences giving detailed accounts of cases, analyzing the general conditions of health. Fortunately these passages overwhelmingly dominate his book.

I find the book so insightful about the plight of the Haitian poor's health problems, and so clear about what's going on in the lives of the people in the home for the dying or the children's home, that I'm urging every volunteer worker on our work trips to read the book with care before going to Haiti. I'd recommend it to anyone who has a serious interest in understanding Haiti, and the devastating effects of sickness and disease among the Haitian poor.

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