As many people know, some of the greatest opportunities in the game of life lay hidden, disguised as changing plans and unexpected situations. When I had to defer the start of medical school for a full year because my PhD research was not finished in time, I did not know what awaited me. I ultimately accepted a six-month research internship working at an HIV/AIDS clinic in Port-au-Prince (PAP), Haiti.

Haiti is the poorest country in the Western hemisphere and the only modern country to arise out of a successful slave revolt. The people are resilient, resourceful and tough. They also smile, tell jokes, love their families and try to live good lives, just like you and me.

Of course, many of the things said and written about Haiti, and PAP in particular, are true: The crowds and filth in PAP make New York City feel like an unpopulated suburb; you must watch your wallet and learn the local language if you are to navigate the city; and be prepared to refuse beggar after beggar. But the most challenging issues seemed to lie deeper.

One particular day in the STD clinic proved particularly eye opening. When asked if they had more than one partner, women would usually reply “no.” But then when asked about their husband, many calmly replied that he had many partners.

If asked about their husband’s condom usage, the answer was often “never.” After we explained the risks inherent in this behavior, one response from a woman was “God will protect me, I am a Christian.” Another said, “My husband is a Christian and says the Bible says not to use condoms.” Or better yet, I also heard, “If I get sick, it is God’s will.”

These were some of the most devout women I had ever met. Most of them had never been to school. Illiterate, yet they persisted with an unshakable faith. This surprised me because I had heard religious U.S. citizens describe Haiti as dark, unreligious and even God-less.

This issue of faith overriding evidence/science came to light later in the year, when in a meeting with some of the clinicians an argument broke out as to whether mission work was harmful. Several physicians were claiming that with missionaries came more patients claiming that prayer would heal any malady they might face, and thus HIV prevention and/or treatment mattered little.

Unfortunately, many poor patients cannot read to learn that 0 percent of HIV cases have been healed through prayer alone (even when that HIV is contracted from the mother at birth). While there is no doubt mission work has provided much relief and aid throughout history, it is paramount that missionaries and others understand both the culture they are entering and the role that medicine and logical, evidence-based thinking plays in helping the world’s poor.

When patients believe irrational things (e.g. prayer instead of medicine will heal them), they pay for it with their health, their lives. They deserve better.

I would be remiss not to try to boil this and my other experiences from Haiti down to a few simple lessons:

1. No one chose to be born into extreme poverty in Haiti any more than you chose to be born into your situation.

2. We could all be a bit more empathetic.

3. We should all be more informed and more engaged about/with other cultures.

4. While religion has given people hope when all else is gone, it also appears to have a darker side in some circumstances, allowing people to believe in unfounded superstition rather than evidence-based medicine.

5. Johnny Price once said that if you want to live a small life, never leave your city and never read a book. I echo this and add “and never engage people unlike yourself.” Personal growth can be difficult and uncomfortable.

There is no doubt that Haiti is dangerous in many ways, and not everyone should visit. However, this doesn’t mean you should ignore Haiti and the numerous other cultures around the world like Haiti.

If you are able, visit, meet the people and learn the culture. You might be surprised at what you find: people who laugh and cry. People who tell jokes and work hard. People just like you in so many ways, yet so very different.

Too often we look down at third base and think we hit a triple, when really we were born there. Most Haitians were born in the dugout, hoping just to get up to bat.

Additional Facts
Dr. Matthew L. Goodwin is a medical student at Weill Cornell Medical College in New York City. He grew up in Greenville and attended Furman for both his undergraduate and master’s degrees, and he recently completed his doctorate degree. Read his blog at http://doctorgoodwin.blogspot.com and write him at mlg2008@med.cornell.edu.

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