A staff member with Doctors Without Borders offers an insider’s view of the organization’s medical relief work in Haiti and how your thoughts and prayers are helping those in need.

In the days and weeks after the devastating earthquake in Haiti, beyond donating money, many of us felt helpless. What was most needed, of course, were doctors to help the wounded. Tonic spoke with Toronto-based staff member Isabelle Jeanson at the Nobel Peace Prize-winning medical relief group Doctors Without Borders/Médecins sans frontières (MSF) about daily life on the ground. Here’s her first-person account, as told to Tonic writer Darragh Worland.

Our plane touched down in Port-au Prince on Jan. 14 at 4:50 p.m. – exactly 48 hours after the earthquake. It had taken us 24 hours to travel the short distance from Toronto to Haiti, and we had no idea of what lay ahead. We couldn’t really absorb the full extent of the damage on the drive from the airport to the city, because the quake had wiped out all power and it was already dark.

One of our offices in a house that we rent in a neighborhood called Pétionville was surprisingly unaffected, so that became our base. The staff there had felt the building shake, but there was no damage to the structure. Our hospitals were all damaged, but the offices themselves weren’t as affected.

It wasn’t until the next morning that we saw how bad it was. You see the images on TV and in photos, but you cannot understand the destruction until you are there. It was like a war zone; like a bomb had gone off. Concrete buildings just completely collapsed or were twisted in half. There would be one building reduced to rubble standing next to another that was barely damaged at all. The damage was absolutely nonsensical.

In one neighborhood called Carrefour, medical personnel had set up makeshift tarps on the street outside of a hospital that had been destroyed. A lot of them were students who weren’t even qualified to be doctors. Everywhere there were people with horrendous wounds. It was like nothing I’ve ever seen in my life, because you wouldn’t see that kind of thing on TV. They were lacking supplies, they didn’t even have alcohol, but they were suturing wounds and doing the best they could to help.

I had arrived with three logistics people with us and two nurses, both Americans who had been with Doctors Without Borders for 20 years. We already had about 200 ex-pat staff on the ground, about 80 to 100 of which were doctors, with the other half being logistics and administrative staff. They were all affected by the earthquake. We lost about eight to ten national staff ourselves, people we knew and worked with on a regular basis.

This was a unique kind of emergency for us. We’ve never been so personally affected, where we ourselves were victims. It was a double whammy and that made it hard for us to continue with our work. We had a memorial service in Port-au-Prince while I was there. It was especially hard for me because I have been working with Haiti for three years and I’d already visited twice. I never imagined anything like this could happen.

We set up tents outside the office where we slept in sleeping bags on mattresses that we had in storage laid out on the floor. There were 15-20 of us all sharing the one bathroom in the office. On the worst nights, we’d get maybe four hours of sleep; on the best it was closer to six. But you just have to get up. It doesn’t matter how tired you are. Knowing there are people out there who need you, you just go, go, go, mostly running on adrenaline.

Doctors Without Borders has what we call “hospital kits” – huge, huge containers full of tents and equipment that can be assembled on the ground into temporary hospitals, which are really a series of interconnected tents. Each tent is about the size of a small house. The walls are blown up with air, so they smell just like a new inflatable raft. Then all the wiring and plumbing is installed. Even though I have worked with MSF for almost eight years now, it’s still mind-boggling to me that we can put this stuff together. At best, it takes a full 48 hours to get it all up and ready.

The biggest problem is finding appropriate terrain to set up and this was especially hard in Haiti. We need a flat surface, about the size of a football field. Luckily, that’s exactly what we found: a football field behind a school that hadn’t been claimed by any of the other groups or militaries. We don’t have nearly the resources of the military, but we’re really good at adapting to any situation. We bring in our own generators for power; we ship in water; and we have the technology to purify water.

My job as an emergency press officer is to act as a buffer between the media and the teams but, in Haiti, I also acted as an ear for dozens of the wounded. It was very frustrating for me. I wish I could have done something more. I wish I was a doctor. I found the best thing I could do was to walk around the wards and let people talk, which they seemed to appreciate. Just to let people know that you care is extremely important. It’s the solidarity and the compassion that is comforting on some level. I met so many people that I’m still thinking about today.

There was one girl in particular, a 19-year-old named Sinthia Chéri. She had a terrible wound on her thigh. She had been trapped under a piece of concrete for a long time, so the tissue had begun to necrotize. In a case like that, the doctors first have to remove all the dead tissue, which leaves a gaping wound too big to close. The wound is then bandaged and monitored, cleaned out regularly. We saw a lot of this kind of injury in Haiti.

Sinthia was special. She was so outgoing. Even though she was in a lot of pain, she wanted to hang out on her bed, talk about clothes and just be a regular teenager. Her optimism was amazing to me. I never guessed that she had such a tragic story, until a doctor who had seen us talking told me that Sinthia had lost her baby in the quake. She had given birth on Jan. 4. After the quake, they had nowhere to go. The two of them were sleeping in the streets, where it gets really cold at night.

I think the baby died of cold, about a week later, but I didn’t question her too much. When I asked her about it and why she hadn’t told me, she didn’t want to talk about it at first. She didn’t want to dwell on it. She was really sad. I’ve been worried about her, because the day before I left, she started to develop a fever. I’ve sent emails to find out how she’s doing, but I haven’t heard anything yet.

Now that I’m home, all I want to do is go back. Some of our staff will be there for months. The most immediate needs are shelter reconstruction and an economic boost. After the people regain their health, they need a place to live and work. When I was there, a lot of young men approached us and asked us for work. We were hiring staff, but there were huge lines of people applying for one job. The people are desperate to make some kind of income. Most people don’t have the money to rebuild their house, so they are at a loss of how to find a new home. For now, they live in temporary shelters, with bed sheets attached to sticks and trees. Others sleep on sidewalks or in the streets. Cars have to be careful at night not to run people over.

Doctors Without Borders has the supplies to provide care, but the health care system in Haiti is not working. Some people will need long-term care in rehabilitative hospitals and plastic surgery, especially burn victims. But for all those who cannot donate, words of solidarity are incredibly comforting. Finding bloggers and sending comments of support or participating in online forums, chat rooms and Twitter to send messages of solidarity can also contribute in their own way.

I have never had the chance to say this to anyone, but the response from the public was outstanding. When you’re working on the ground, that kind of solidarity is absolutely inspiring. The responses on our blog brought tears to my eyes. People wrote heartfelt, sincere words of encouragement, like “hang in there” and “you can do it.” That kind of stuff is so helpful on the ground. That is huge, absolutely massive to get that kind of feedback from people.

To donate, go to Doctors Without Borders.

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It’s 8:30 a.m. on a Friday in July, and Carol B. Tomé is starting to sweat. The chief financial officer of Home Depot Inc. (HD ) isn’t getting ready to face a firing squad of investors or unveil troubled accounting at the home-improvement giant. Instead, she and 200 other Home Depot employees are helping to build a playground replete with swings, slides, and a jungle gym at a local girls’ club in a hardscrabble neighborhood of Marietta, Ga. Dressed in a white Home Depot T-shirt, a baseball cap, and blue capri jeans, Tomé tightens bolts, while others dump wood chips, mix concrete, and sink posts. The company, together with nonprofit playground specialist KaBOOM!, plans to build 1,000 more such kiddie parks in the next three years — and spend $25 million doing it.

Is this any way to build shareholder value at Home Depot, where the stock has been stuck near $43, down 35% from its all-time high? Chief Executive Robert L. Nardelli and his troops think so. Last year about 50,000 of Home Depot’s 325,000 employees donated 2 million hours to community service. Now, Nardelli is trying to encourage more companies to volunteer at Home Depot’s pace. At his invitation, executives from 24 companies and foundations gathered for five hours at Home Depot’s Atlanta headquarters in May to discuss community service. Attendees included Lawrence R. Johnston of Albertson’s (ABS ), F. Duane Ackerman of BellSouth (BSC ), Gerald Grinstein of Delta Air Lines (DAL ), and William R. McDermott of SAP America (SAP ). On Sept. 1 these CEOs and others will kick off “A Month of Service,” an ambitious plan, developed with community group the Hands-On Network, to deploy corporate volunteers on 2,000 projects across the country, and raise the total number of volunteers by 10%, or 6.4 million, in two years. “We look at this activity with the same eye that we look at business,” Nardelli says.

Yes, companies have long paid lots of money — and lip service — to philanthropy and public service. But as Nardelli’s confab indicates, managers from all parts of American business are increasingly seeing social responsibility as a strategic imperative. In June, General Electric Co. (GE ) released its first “Citizenship Report” as a way for interest groups to assess its social performance from air pollution to volunteer hours. That followed the announcement in May of GE’s ecomagination program, which will invest billions in environmentally friendly technologies. IBM (IBM ) uses its On Demand Community — a 40,000-employee volunteer program — as a way to bring IBM technologies to schools and community centers and plug its brand. Even the legendarily hard-nosed Wal-Mart Stores Inc. (WMT ) has come around to the cause. “We thought we could sit in Bentonville [Ark.], take care of customers, take care of associates — and the world would leave us alone,” CEO Lee Scott said at a recent analyst conference. “It doesn’t work that way anymore.”

BEHOLDEN TO MANY
What’s behind this realization? At the very minimum, it’s clear that companies recognize it takes a robust, sharp public-relations strategy to navigate through the mines of today’s operating environment. Among them: increased regulatory scrutiny; a global, 24-hour news cycle; and communities hostile to scandal-tarred big businesses. But what Nardelli suggests is something deeper. In fact, it’s a growing embrace of so-called stakeholder theory, which posits that companies are beholden not just to stockholders — but also to suppliers, customers, employees, community members, even social activists. That’s quite a departure from the long-dominant notion that corporations’ only duty is to increase profits for shareholders. “Things have become a lot more interdependent,” says Nardelli. “There are a broader range of constituents.”

Such platitudes, of course, make critics cringe. The Nobel prize-winning economist Milton Friedman, 93, casts a long intellectual shadow over the debate. In a seminal 1970 New York Times Magazine article, he declared social initiatives “fundamentally subversive” because they undermine the profit-seeking purpose of public companies and waste shareholders’ money. Even today, Friedman, a senior fellow at Stanford University’s Hoover Institution, rails at the idea that managers elected by shareholders to run companies should spend their profits on social causes. “Adam Smith said in 1776: ‘I have never known much good done by those who profess to trade for the public good.’ It’s a good quote,” says Friedman.

There’s no doubt that a surge in community outreach and do-good deeds is, in large part, a gussied-up bid for good favor. Tarred by a raft of corporate scandals from Enron to WorldCom, social outreach can be a way to regain the high ground. That’s probably one reason corporate giving hit $3.6 billion last year, an all-time high, up from $3.5 billion in 2003, according to philanthropy research group the Foundation Center. Indeed, Nardelli argues that a “dark veil” hangs over big business. It is exacting tangible penalties: Based on its $91 billion market cap, Home Depot was required to shell out an estimated $1 million last year to fund the Public Company Accounting Oversight Board, an outfit created by the Sarbanes-Oxley corporate reform bill to monitor the work of auditors. In effect, say Home Depot executives, all public companies are paying for the sins of a few.

But more than mere public relations appears to be at work here. Companies are being forced to address the concerns of customers, employees, and investors — in order to keep them. Such pressure is why last year Gap Inc. halted relationships with 70 of its overseas factories over alleged labor abuses, and has for the past two years issued a social responsibility report. Or why Nike Inc. is now a world leader in setting safety standards for overseas workers. When the controversy over its sweatshops erupted several years ago, managers mistakenly believed they could afford to ignore the outcry simply by cranking out hip shoes. “It is no longer an option to sit on the sidelines,” says Bradley K. Googins, executive director of The Center for Corporate Citizenship at Boston College.

YOUTHFUL IDEALISM
More important, the calls for change are coming from inside the corporate walls. A new generation of employees is demanding attention to stakeholders and seeking more from their jobs than just 9-to-5 work hours and a steady paycheck. The number of Gen Yers — those born between 1977 and 1994 — in the working world has grown 9.2% since 1999, while the number of Gen X workers remained flat, and baby boomers declined 4.3%, according to Robert Szafran, a sociology professor at Stephen F. Austin State University in Nacogdoches, Tex. As a result, Home Depot and others are finding that burnishing an image as a socially responsible company helps to attract younger workers, at all levels. “One of the things we compete most for in the marketplace is our associates,” says Nardelli. “I’m not sure that was the case [two decades ago].”

Take Sewell Avant. The 25-year-old senior procurement analyst graduated from the Georgia Institute of Technology in 2002. During college, he cleaned churches and did regular social projects with fraternity brothers. Now he’s carrying on that tradition at Home Depot. He took a day off, without pay, to help mix concrete at the playground project in Marietta. His entire department will do more kiddie-park construction on a weekend in August. For Avant, volunteering adds meaning to his day-to-day job. “Employees are trying to marry their work and nonwork lives. If the company gives them a chance to do that, then they’re happier,” says C.B. Bhattacharya, associate professor of marketing at Boston University’s School of Management.

That’s why younger companies are baking the social responsibility concept into their culture — and demanding investors accept the cost. Costco Wholesale Corp. has long offered generous compensation to its workers, to the scorn of Wall Street and the detriment of its stock price. In the 1980s, networking giant Cisco Systems Inc. (CSCO ) opened its first office in East Palo Alto, Calif., a run-down neighborhood amid the prosperity of Silicon Valley. Cisco Chairman John Morgridge worked as “principal for the day” at a school next door. “We’re in business to get results. This is just a different currency,” says Tae Yoo, Cisco’s vice-president for corporate affairs.

Indeed, it has been a rude awakening for companies that have not embraced a more strategic approach to social responsibility. For years Wal-Mart has been a top corporate donor. But as the company’s image was pummeled by labor unions and lawsuits, research showed its fragmented giving generated little goodwill. The reason: Few people could remember exactly what — or whom — Wal-Mart supports. Now, it’s giving its community outreach a sharper focus. “Society has changed,” says Betsy Reithemeyer, executive director of the Wal-Mart Foundation. “If you are the gathering place of the community, then you have a responsibility to it.”

In fact, some executives argue that a company should develop a social responsibility platform — even if it doesn’t add to the bottom line. In 2003, Wayside Cross Ministries, an Aurora (Ill.) shelter for abused women and men, couldn’t obtain enough ground beef for meals. On hamburger days at Wayside, some residents ended up eating buns, lettuce, and tomato — no burger. Then grocery giant Albertson’s, through Jewel, its Midwest grocery chain, launched Fresh Rescue to boost supplies of perishable meat, dairy, and vegetable products for local food banks. The result: Last year, the Northern Illinois Food Bank supplied 386 shelters with 740,000 pounds of meat, double the number from the year before. The payoff for Albertson’s: goodwill — and perhaps a few more shoppers. “We don’t look for any statistics,” says CEO Johnston. “This has to be in the DNA of a company.”

Even evangelists such as Nardelli stop short of saying that companies should divert money from other strategic priorities to support corporate social responsibility. But at corporations like Home Depot and GE, good works are being bred into Big Business. “It’s just the right thing to do,” says Nardelli. Good PR? Sure. Money well spent? The goodwill refund could be in the mail.

By Brian Grow in Atlanta, with Steve Hamm in New York and Louise Lee in San Mateo, Calif.

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One of these wonderful examples is happening in Nogales, Arizona, where an American and Mexican medical staff is reaching out to poor, Mexican families with disabled children. The doctors and staff of St. Andrew’s Children’s Clinic seem to be more concerned about children’s health and suffering than immigration issues:

“St. Andrew’s Children’s Clinic does not allow an artificial barrier to block the hope and compassion it offers the poor. The clinic is a non-denominational, non-profit organization whose mission is to provide free medical treatment for disabled children of impoverished parents from Mexico.”

The clinic was founded in 1973 and is staffed by volunteers from the United States and Mexico. Among our border states, St. Andrew’s is the longest-running health project in the country. The clinic is funded primarily through donations, which is sorely needed considering the range of serious, pediatric, health issues they deal with.

“The children, from ages 1 month to 18 years, have a myriad of medical problems, from spina bifida to cerebral palsy, from Down’s syndrome to speech and hearing problems, and more. X-rays, laboratory tests, prescriptions, orthopedic devices, and hearing aids are just some of the aids these children need right now, or over time.”

The clinic practices medicine “the old fashioned way:” with hand written medical records and face to face conferences. Instead of using donations for computer equipment and office-software, they are used strictly for the treatment and care of the children. Every, first Thursday of the month, two-hundred and fifty sick children and their families come to the clinic looking for help and healing. None of these families will ever receive a bill for the treatment of their child.

“The estimated dollar value of time donated each year to St. Andrew’s Children’s Clinic is approximately $1.5 million. On board most Clinic days are 2 orthopedic surgeons and several orthopedic residents and students, 5 pediatricians, 2 neurologists, 1 pediatric cardiologist, 6-8 medical students, 1 ophthalmology therapist, 1 equipment technician to fit wheel chairs, walkers, crutches, and other aids. Nearly 100 lay volunteers make the day run smoothly.”

In a time of selfishness and mistrust of strangers, it is a blessing to witness these physicians and lay persons who are willing to selflessly give of their time and money to treat and care for those who are in need. The doctors and staff of St. Andrew’s, as well as their contributors, are to be commended for their love, dedication and sacrifice, which blesses these children and their families!

If you would like to learn more or make a donation, then go to the site listed below:

http://www.standrewsclinic.org/about/about.htm

Shiva from India, after surgery.

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