Whatever affects one directly, affects all indirectly." "font-weight: bold;">- Dr. Martin Luther King, Jr.
While riding in a taxi in New York City the radio was tuned to a Spanish language station.
Your accent doesn't seem to be Spanish," I remarked. Are you Hispanic?"
No, I'm Haitian. But I like Spanish music."
My driver came north many years before, he explained. He had been an accountant in Haiti and earned good money there
- by Haitian standards. But I like it better here."
The tragic earthquake of Jan. 12 struck at the heart of Port-au-Prince, capital of Haiti. Badly constructed buildings
crumbled with the terrible shaking, trapping many thousands of people.
Almost three quarters of the people in Haiti live on $2 or less per day. This unbelievable poverty makes it the
poorest country in the western hemisphere and among the poorest in the world. Building codes are not part of such
poverty. Migration to cities is common all over the world, including Haiti. It is ironic to realize that many people
who were injured or killed in Port-au-Prince might have been safe if they still lived in traditional wood homes
rather than modern concrete structures.
This devastated city has become the focus of the media, with minute-by-minute reports of horror. A few minutes
watching CNN display graphic accounts of private tragedies - bodies unceremoniously being spilled from a dump truck
into a common grave, a beautiful 11-year-old girl caught in a splintered building who was freed but died from her
injuries, people breathing through cloth to mask the smell of death.
We live in an amazing age. We can see and hear immediately such personal stories of devastation. Highly skilled teams
of helpers started to arrive within days with sophisticated equipment and trained dogs to free trapped people. The
Internet is used to send and receive word of friends and relatives in the affected area.
Those of us who live in a rich country, such as the United States, at this time in history often don't appreciate how
lucky and privileged we are. We have grown up with the expectation of comparatively easy, relatively safe lives. Most
people of the world do not share our good fortune. The worldwide media make obvious the disparity between rich and
The contrast between rich and poor was brought home to me by one of Durango's expert doctors. He told me he is
frustrated because he cannot get to Haiti to help. I don't think he fully understands what would await him: scores of
injured people and no organization, no laboratory tests, no x-ray machines, no medications, no casts for broken
bones. Many people are dying alone, surrounded by collapsed concrete and the stench of death.
In addition to not being able to practice in any way that he is accustomed to, he would be using precious food and
water that is needed by the Haitians.
Tragedy visited people in the past, too. In rich countries, our expectations and ability to respond have changed
The explosion of the Indonesian volcano Krakatoa in 1883 is an example of a historical catastrophe. Lava and
superheated gases killed nearby people instantly. Tsunamis triggered remote devastation. The short-term death toll
was more than 100,000 people. For the next five years, people died because of the climate being 2 degrees Fahrenheit
colder. Clouds of gas and ash shot into the stratosphere kept out the sun's heat and decreased agricultural
How has the world changed in the century and a quarter from Krakatoa to Haiti? Most of us are financially much better
off than a century and a quarter ago - although Haiti lags behind. Our willingness to accept risk is another large
People died young in the 19th century. If you were involved in an accident, it was perceived as an act of God, not
someone else's fault. Accident prevention - including building codes - was almost nonexistent. Medical care was
rudimentary, just as it is in Haiti now.
One of the reasons Haiti is such a poor a country is because many of its most industrious people leave - such as my
taxi driver. Another reason for poverty is the high fertility rate. The average woman will bear four children during
her lifetime - twice the number borne by a U.S. woman. The percentage of Haitian couples using contraception is low.
A tragedy such as hit Haiti is a horrendous way to reduce population. Complying with people's wishes to limit their
fertility by providing modern contraception is much more humane.
Richard Grossman practices obstetrics and gynecology in Durango. Reach him at "mailto:firstname.lastname@example.org">email@example.com.
© Richard Grossman MD, 2009