To spend a day at Port-au-Prince’s Bernard Mevs hospital is to see people suffering the worst of the worst – things like enormous tumors, horrible strokes, malnourishment to the extreme.

But a day in the northern village of Bord de Mer Limbe is to see where the worst takes root. It’s a place without running water, without electricity, without paved roads. Set against the ocean, it’s a place where prior to the earthquake, 14% of the population lacked adequate sanitation. Nothing has improved.

This is where Team Broken Earth’s rural team started their clinical work in Haiti. They reopened for a day the shuttered clinic at the village’s edge. By the time the gates swung open at 8 am, 50 or so adults were lined up at front. An impromptu market of a dozen sellers set up at the gates, peddling drinks and fried plantains.

The team divvied up the available clinic space. Two paramedics triaged patients at the front, dietitians worked in the open-air courtyard and the physicians split the exam rooms – two physicians to a room. That meant two physicians, two translators and two patients in each small examining room.

TBE’s rural team treats patients who lack regular access to any healthcare provider. Their goal is preventative, aiming to halt the progress of problems that are prevalent at places like Bernard Mevs.

Dietitian Jen Woods used photos and measuring cups to demonstrate to her patients how much they should be eating, and what, in order to ward off malnourishment, which leaves the region’s children extremely prone to infections.

Among adults, hypertension is prevalent. Villagers don’t have access to a doctor or nurse who could check their blood pressure regularly. Even if they did, there are very limited medications available. I saw the region’s makeshift pharmacy one afternoon. It’s a beat-up jeep driven by four men who illegally sell pharmaceutical drugs, real and fake, from their vehicle. They advertise by calling out to villagers through a tin loudspeaker strapped to the roof of the jeep. “Do you have a belly ache? Do you have a headache? We have pills!” they shout.

James Rourke, Dean of Medicine at Memorial University, said patients in Port-au-Prince have much more access to medicine than those in rural areas. “There, at least, they can get cheap medicines on the street.”

Even when medications are available, there’s little monitoring of blood pressure in Haiti, resulting in what Dr. Rourke called the “tragedy of untreated hypertension.”

“That was brought home to me on my last visit to Port-au-Prince. At Bernard Mevs, we saw 45 and 50 year olds with strokes. Our goal here is to give people medication to control hypertension and prevent strokes, and give them medication at a cost they can afford.”

– Christina