I have asked my International Podiatric Medicine and Surgery Fellow, Fairuz Parvez, DPM, to be a guest blogger for me this month. We made a trip to Haiti to work on the Step-By-Step Haiti Diabetic Foot Program July 14 to 19. It was Dr. Parvez’s first trip to Haiti and I asked her to write about her impressions on her first visit. I believe you will enjoy her insights. When asked about my experience in Haiti, at first I did not know where to begin. If I were to sum it up in a word, it would be: shocking. It was eye opening to say the least. I was at a loss for words when I first landed in Haiti. I knew there was some structural destruction but I did not truly understand at what level, the depth of the devastation, and why it was still so. I was as guilty as the next American assuming Haiti was not so bad off. Boy, did I get a crash course in the reality of things there. The first thing that shook me to my core was just how impoverished the country really was. I have visited developing nations in the past and even there you can find modernized areas with better conditions and buildings that are comparable to those of the west. With Haiti, almost the entire country looks like the ghetto of a developing nation. High rises are almost nonexistent and modern buildings are truly in the minority. Most buildings are primarily plaster or poorly constructed one-floor concrete-ish structures. Then you have the tent cities and makeshift shacks that line the sides of the road. Yes, I know, I know. You are probably thinking the same thing I was. “Well, what about those innumerable fundraising efforts for millions of dollars by members of Hollywood and various philanthropists? It has been five years since the earthquake. What’s been going on since then?” The issues with Haiti are more complicated and deeper than just some physical damage to some buildings from the earthquake. If it were that simple, Haiti would have been “fixed” by now. Haiti has been in dire shape since long before the earthquake. If anything, the earthquake was sort of almost a service to the country. It forced the world to pay attention to a country that is so desperately impoverished and functionally broken at the most basic, fundamental levels. The country needs far more than a few well-meaning philanthropists throwing some money at it. That will not solve any problem. The country needs help to establish foundations and basic infrastructure in every field from healthcare to finance to education to agriculture and even to tourism. Without the right kind of help, Haiti will only fall deeper into despair. As Dr. DeHeer so astutely put, “Haiti is devastatingly endearing.” It truly is. You see people in absolute, abject poverty along the streets in Haiti. Yet there they are, trying to carve out a meager existence, selling their wares. Somehow, they still push forward. Yes, invariably, with international efforts, a culture of dependency has also developed. Nonetheless, this has not completely taken over the psyche of the Haitians. There is great enthusiasm among them when they are afforded an opportunity to learn something new. However, things are still in a fragile state. After my week in Haiti, it us clear that our support is necessary more than ever. Sure, coming to Haiti and doing a handful or even a large number of surgeries on a mission visit is satisfying, but useless nonetheless. I have always planned to do mission work, knowing it would be part of my practice in the future in some way. But after my visit to Haiti, my entire perspective shifted. Most of my concerns and thoughts seem so insignificant now. I realize I can’t just go to an impoverished country and provide treatment/perform surgeries, and expect to think it made some sort of difference. It is simply not enough. That old adage “give a man a fish, you feed him for a day. Teach a man to fish and you feed him for a lifetime” rings true here. This is the only thing that will truly make a difference in Haiti. We really need give our Haitian colleagues the proper tools (be it medical equipment or medical training) so they can help themselves. Only then can they truly recover and grow. Now before I give the impression that my trip to Haiti was a bust, let me clarify. It was a great success. The best part of my trip to Haiti was discovering that the organization, Step by Step Haiti, is doing all that and more. It was truly wonderful working alongside our Haitian colleagues. They took our direction and instructions so enthusiastically. They were exceptionally eager to learn what we had to offer. They asked insightful questions and truly try to apply their newfound knowledge to help their fellow citizens. There are real efforts now happening in the communities to educate and reach the average Haitian citizen. They see there is a chance and it is encouraging. It was quite enriching and exciting seeing our colleagues not only treat patients, but be able to demonstrate that they are actively sowing the seeds for preventative care in limb salvage as well. There is still a long way to go but progress is surely happening. Once these clinics are fully established around the country with appropriate tools and protocols, we hope to establish a Haitian medical residency as a tradition for coming generations. I am proud to say I have been consumed by my trip to Haiti. I am just getting started and am anxious to do more. All in all, my first trip to Haiti has been truly satisfying. With all of the wreckage I found, I also saw a silver lining. It is with this silver lining that hope springs eternal in the human breast. Hope for a better future for our Haitian brothers and sisters.