The plane’s engine gently comes to life, subtle and quiet as a dishwasher, and soon we accelerate through takeoff, forced back into our seats by the mounting speed. I turn to the only other passengers — a mother and her son, who one month ago suffered extensive burns over his body, burns that are healing, but not well. “Eske nou anfom?” — Are you OK? — I ask.
Their home, the island of La Gonâve, is known for some of the poorest living conditions in Haiti. Their house has no electricity or running water. Yet the woman and her boy had arrived at the airport in their Sunday best. The contrast of their poverty and the opulence of the private jet carrying us to Boston could not be greater, yet they seem unaffected by it. I imagine they must be preoccupied with thoughts of what awaits them in the United States.
The boy, Jean Michel, was badly burned by kerosene spilled from a lamp, an accident all-too-common among Haitian children who grow up in small homes with no electricity.
The family had a hard time describing how he was burned. “It just happened. He felt it burn on his back and side,” his dad explained to me the day before. Jean Michel nodded slowly in affirmation and didn’t add much when I questioned him directly. The story is further obscured by the evident shame they feel that the burn happened at all and the cultural stigma such wounds carry in Haiti. I didn’t press. I could see these are loving parents, doting on their child.
Haiti Air Ambulance, the island country’s only emergency medical helicopter, had picked the family up from La Gonâve. Shriners Hospital in Boston offered him free care, which would entail several surgeries and extended physical therapy. Our plan is to fly him to Boston through the generosity of a family who had donated the use of their plane. My job, as a doctor who speaks Creole, is to accompany them in case any problems arose in flight.
While Jean Michel’s burns have started to heal, he walks with a limp, his head hung low and his shoulders hunched. The skin is contracting, pulling his head down. Even sitting up causes him pain, as the weight of his head and limbs draws continuously at the fragile tissue. Without intervention, his stoop would become worse, his arm more contracted against his side and less functional. His left hand, pink where the skin has yet to grow back, already lacks fine-motor function. As he sits, uncomfortable in his stiff shirt, I realize he has no idea what lies ahead of him, the pain and difficulty of the rehabilitation, the stark contrast between his tiny home on La Gonâve and the bustle of Boston, where he’ll likely spend a lot of time between surgeries.
He reminds me of one of the first patients I met in Haiti’s rural central plateau in 2006. Islaine was 8, tall and lanky for a malnourished girl. Her hair was braided into three pigtails that stuck out at different angles, and I could not see her face from where I stood behind her. Her screams, however, filled the pediatric ward and could be heard throughout the hospital. “Amwe! Amwe!” she cried out as the nurses debrided her, scrubbing her exposed tissue to allow the wound to heal properly and protect it from infection. Jean Michel will undergo some of this painful ritual, but with more pain medication and high-tech bandages than Islaine had received.
Rosmene and her son recline uneasily on the leather couch and I help them with their seat belts. The couch is large enough for four people, yet mother and child sit close to each other. Chilled by the plane’s powerful air conditioning, Rosmene asks for her suitcase to grab her sweater. As we take off, she clutches her Bible and her son, her two most valuable possessions. I reassure her and explain that we’ll hit some bumps as we ascend over the mountains that surround Port-au-Prince.
At 45,000 feet, the sun doesn’t set until 9 p.m. Our pilots double as flight attendants, serving drinks and food. Both Rosmene and Jean Michel politely decline the offer of a brownie. I chat with the pilots for 20 minutes, asking questions about lift and engine power, trying to sound intelligent. When I return to my seat, I find my fellow passengers stretched out on the couch, more comfortable now and covered in blankets, sound asleep.
I feel terrible waking them up an hour later as we approach Boston, but even private jets require passengers to be seated and strapped in for landing. I watch the altimeter on the screen in the passenger cabin plunge as we descend, feeling completely safe but in awe of the power of the machine as it carves up the sky, rising and accelerating and plummeting as needed, mostly at the behest of the computer that calculates the auto-pilot.
Then we hit a storm outside Boston and are forced to circle for 30 minutes before passing through some of the roughest turbulence I’ve experienced. Fear of a crash doesn’t seem to cross Jean Michel’s mind. He’s struggling to maintain his posture in a way that doesn’t put pressure on his wounds. He’s not in acute pain but suffers a dull ache in too many places to count.
We deplane in Boston in a soft rain. I escort Jean Michel and Rosmene to the car service that will take them to the hospital and bid them farewell. Then the pilots and I fly to New York, landing just before midnight. As the plane’s only passenger, descending its stairs to a waiting black town car, I can’t help but feel for a moment the pleasure of the rich and famous.
I sleep six hours in an airport hotel and return to Haiti on a commercial flight in the morning. My journey is over, but Jean Michel’s is just beginning.
Vincent DeGennaro is an internal medicine doctor and global public health specialist in the University of Florida’s Division of Infectious Diseases and Global Medicine. He works mostly in Haiti with the nonprofit Innovating Health International. See his An American Doctor in Haiti blog. Email him at firstname.lastname@example.org.