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Leaving on a Jet Plane - for Haiti
Haiti is part of the West Indies, bordered by the Atlantic Ocean to the north and the Caribbean Sea to the south. It's located just south of the Bahamas and west of Jamaica. Cuba - Haiti's western neighbor - is less than 100 miles of warm water away. With an average year-round temperature of 80 degrees and sunny skies almost every day, Haiti would seem to be an ideal place to live, or to enjoy sun and surf.

But politics and poverty have placed their indelible stamps on this country. It has been described by one author as a "crumpled, worn-out, unvisited land in the Caribbean" where millions of its residents are "hungry, poor and diseased." Not much of an invitation to those planning their winter escapes.

Even though most US travelers choose other destinations in the Caribbean, Ralph Greco, MD, professor of surgery at UMDNJ-Robert Wood Johnson Medical School (RWJMS), left Newark Airport for Port-au-Prince, Haiti, on March 28, for his eleventh visit to the country. Traveling with him were RWJMS colleagues Alan Spotnitz, MD, assistant professor of cardiothoracic surgery, and Barbara Trattler, RN, director of perioperative services, as well as three surgical residents. One will spend a month working in Haiti.

Although Greco did serve as tour guide, his plans did not only include visits to the beaches. The group's destination was the Albert Schweitzer Hospital built by Andrew Larimer Mellon and Gwen Grant Mellon in rural Eschapelle, in central Haiti, in 1956 - where they spent seven days. This almost-modern medical center - built on the site of a former tropical fruit company plantation and modeled after Albert Schweitzer's hospital in Africa - has relied, in part, on the expertise of medical personnel from throughout the world, who spend anywhere from one week to several years working there.

Greco's first trip to the country in 1971 was a requirement of the surgical residency program at Yale Medical School. What he found there surprised him. "Not only did we do all kinds of surgery every day, but I learned lessons on life, politics and the triumph of the human spirit. The people have very little in material goods, but they have a very rich culture," he says. Greco describes Haiti as a "a little chunk of Africa in the middle of the Caribbean."

He volunteered for another three-month stint in 1972. "We did some incredible things," he remembers. The hospital serves a population that has little income. "No one is turned aside," says the surgeon. "People pay what they can."

Greco says that malaria, typhoid, TB, gastroenteritis and malnutrition are prevalent problems in Haiti. "Children are particularly affected," he explains.

Besides long days in surgery, Greco says: "We had some wonderful adventures. Unfortunately, we are all victims of the press. Most outsiders only know about Haiti's political problems, nothing about its culture or about its art." Greco has traveled the country collecting Haitian art. These early trips set the stage for a lifelong attachment to the hospital and its founders, and to the country.

His latest visit had particular significance - he returned in an ambassador's role to lay the foundation for future ties between RWJMS and this highly reputed hospital in the middle of the rural countryside. After a 1997 visit, Greco was instrumental in bringing satellite telecommunications to the hospital, which had never had long-distance telephone lines, or e-mail. The project was funded by Johnson & Johnson.

"This has had a tremendous effect," he says. "E-mail provides immediate personal and medical communication with the outside world." He is currently assembling a roster of faculty members at RWJMS who will serve as medical consultants in various specialties to their counterparts at the Haitian hospital. He is also setting up an elective rotation for residents at the school who are interested in serving at the Albert Schweitzer Hospital to interest faculty members in volunteering their time and services there.

"I think the residents and faculty who choose to come here will love it," says Greco. "Modern medicine has such a high degree of dependence on technology. It's interesting to learn that you can actually do almost all diagnoses correctly without CAT scans. You can do most things with your hands, your eyes and your judgment.

And residents will get the opportunity to do all kinds of surgery - ob/gyn, thoracic, urological, gastrointestinal, orthopedic. This goes back to the days before subspecialization.

"All in all," he says, "coming to live and work in Haiti - even for a few weeks or months - is a grand adventure."

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