After the apocalypse

Dr. Harvey Belik and nurse Tammy Dolgin returned recently from an aid mission to quake-stricken Haiti. In a conversation with ‘Metro’ they recall scenes of incredible destruction and chaos and a hugely grateful population.

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February 26, 2010 19:42
Dr. Belik treats on of his younger patients.

harvey belik 311. (photo credit: Courtesy)

 
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Around the middle of last January, something extraordinary happened in a nice house on a quiet, tree=shaded street in the suburban community of Ra’anana. A pleasant, mild-mannered, soft-spoken, sparely-built, 49-year-old doctor of family medicine decided one night to drop what he was doing, take temporary leave of his patients, friends and family, and go to Haiti to help the devastated country’s earthquake victims, in whatever way he could.

Harvey Belik, who immigrated to Israel from Melbourne, Australia in 1988, was formerly the medical director of Maccabi Health Services’ Ra’anana branch, and was now quite happily settled into a busy private practice. Yet he saw the appalling news reports from Port-au-Prince and, with a bit of a nudge from his family, decided he had to do something.

Without any professional experience as an aid worker, Belik did have one previous brush with disaster relief. He, along with his wife and three children, had spent a week in southern Thailand on their way home from a family visit to Australia in 2005.

“This was two months after the tsunami. There were no bodies floating around at this point, but the place was still devastated. I did some medical work at some camps for disaster victims, and the family also helped to rebuild,” he recalls. 

Perhaps as a result of that experience, it was Belik’s family members who ultimately got him to go to Haiti.

“Haiti had a 7.1 earthquake on the 12th of January,” he says. “I heard the news, knew where Haiti was, and I thought, ‘Well, that’s terrible. What’s for dinner?’ Then we became very proud of the IDF field hospital getting there and setting up so quickly. Some days later, my son Daniel said, ‘So, aren’t you going?’ And I thought, ‘Well, maybe I could, but I don’t really want to.’ But then other my son Yonatan looked up on the Internet reports about Israeli NGOs working on disaster relief in Haiti. There were four NGOs doing this; I wrote to all of them.”

One group told Belik that the amount of time for which he was available was not long enough, another told him they don’t take people they don’t know.



“So I thought, ‘Great. I did my bit. I’ll donate money to some organization, and that’s it,’” he says. 

Fortunately, however, one organization had the good sense to rethink its earlier hasty decision. Belik received a telephone call from Natan I-Relief, part of the Israeli Coalition for International Humanitarian Aid and named in honor of Abie Nathan, late philanthropist and peace activist, whose daughter, coincidentally, lives in Haiti and was briefly unaccounted for after the earthquake. Natan told Belik to pack his bags and be ready to leave in two days.

“The hardest part was wondering whether I could do this – physically, professionally – and wondering if I had the skills and the temperament to do what was needed. And, whether I could manage the separation from my family and my comforts,” he relates. “But my wife Loretta was very supportive. The kids all wanted me to go. They kept asking me, ‘Are you going?’”

Loretta Belik recalls, “I think that because Harvey is a doctor and he has both the skills and the best bedside manner I know of, he was just the right sort of person to go. It would have been a shame for him not to go.”

Belik adds, “So I realized that I’d be representing the family, that I’d be representing Israel, and representing the Jewish people. Still, I was hesitant about how I would cope, going into the unknown. I like going into the known.”

While no one tried to dissuade him from going, Belik did feel the need to tell one special person in his life the proverbial ‘little white lie.’

“I told my Mum that I was going with the IDF, so she was happy,” he says. “Of course, I wasn’t really going with the IDF, but I was hoping I would be in their camp so I wouldn’t have to worry about security. The other four Israeli NGOs in Haiti were based with the IDF but, as it turned out, we weren’t with them at all.”

SO BELIK canceled his commitments, notified his patients about his imminent departure, and sent what turned out to be a crucial email message to Tammy Dolgin, 53, longtime friend, associate and practicing nurse. Native of Los Angeles, resident of Kochav Yair, wife and mother of three with one granddaughter, Dolgin is the full-time family nurse at the US Embassy in Tel Aviv. Belik’s message to Dolgin was essentially, ‘I’m going to Haiti. Come with me.’ Dolgin was willing and, almost before she knew what was happening, was on her way to the Caribbean.

“I got a late phone call about 7:00 in the evening, telling me that in this delegation that Harvey was going on, a space had just become open. They asked whether I wanted to leave, said they were leaving at 6:00 in the morning, and told me I had to be at the airport at 3:00 in the morning. So, I said yes,” she recalls.

As with Belik, Dolgin’s decision was backed up by a very supportive family.

“I hung up the phone and told my husband. He said, ‘Great. Let’s figure out what we have to do,’” she says.  “We made a plan, and we did it.”

Almost incredibly, Dolgin then went back to work that night at the US Embassy in Tel Aviv “to finish some things I had to take care of before we left,” she says.

The following morning, the group left for Haiti.

“We were the second delegation from Natan,” Belik says. “The first delegation left two or three days after the earthquake. That team consisted of a doctor, a professor of travel medicine, a social worker and a logistics coordinator. They went into the great unknown, specializing in post-traumatic stress disorder (PTSD), which is treated by empowering the victims to become survivors, to get organized, to make decisions for themselves – to get up, get up, get up!” he says. “We were Natan’s second delegation, consisting of me and Tammy, and three social worker/psychologists, who are also experts in PTSD.”

The team did not enter Haiti directly, but flew first to the neighboring Dominican Republic, with which Haiti shares the Caribbean island of Hispaniola. Landing in Santo Domingo on the 24th of January, the team had no idea what to expect. They were greeted by an impeccably dressed man at the airport, holding up a sign that read, “Israeli Doctor.”

Belik smiles as he recalls, “It’s great to go into the great unknown – earthquake, riots, crime, disease and death – and there’s a guy in a suit and tie holding that sign up. And then, a Dominican man came up to us and said, in perfect Hebrew, ‘I am the Dominican Ambassador to Israel.’ The ambassador happened to be home at that time, and was able to plug us in to the Dominican relief effort for Haiti.”

The team was taken to a staging area from which the Dominican-Haitian Chamber of Commerce was organizing daily trucks of supplies to the St. Marie Catholic Church community in Port-au-Prince. The group was put on a hired bus, headed west to Haiti. “The bus was filled with plastic bottles of fuel for the long journey, and it broke down twice. The second time it broke down, we got on a public bus, with all the locals and the noise and meringue music, which was really a lot of fun,” Belik says. 

The bus stopped at a Dominican civil defense base at the border with Haiti at around 3:00 a.m. The place was pitch-dark, with no food, water or electricity. The team pitched a tent and slept on the ground. At dawn, the Dominican civil defense group with whom the team would be traveling made their preparations for going into Haiti – prayers for their safety, and tetanus, diphtheria and measles vaccines for their continued good health. Deciding that his usefulness began there and then, Belik helped administer the vaccines.

AS THEY crossed into Haiti on the morning of the 25th, the team members were advised to doff their jewelry as a precaution against crime, and don facemasks to protect against the smell of dead bodies.

“I didn’t do either,” Belik says.

Moving through the countryside, eagerly waiting to see something, they finally began to come upon small groups of houses, of which one or two lay in rubble. As the team moved closer toward Port-au-Prince, the number of buildings increased, as did the ratio of ruined buildings to those still intact.

The team’s most frightening moment occurred after they arrived at a Dominican food warehouse, where Dominican aid workers had set up a mobile soup kitchen to feed disaster victims. A crowd of people broke through the barrier set up by UN troops and tried to storm the warehouse and mobile kitchen. As the team made what Dolgin recalls as a “mad dash” for the bus, they quickly became aware of what hunger drives people to do.

Upon arriving in Port-au-Prince and meeting up with their NGO’s first delegation of aid workers, whom they were soon to relieve, the team members were surprised to discover that although the earthquake destruction was extensive, it was not universal. Some buildings stood, others fell.

“There are factors that led to the destruction – the quality of the buildings and the quality of the underlying soil,” Belik explains. “In some areas, there was little or no destruction. Areas where the poor were living were totally destroyed. Somebody gets some land, the land gets subdivided, people build without any supervision. It’s anarchy. There’s no government there – well, the government is there, but it’s there just to rip everybody off.”

Despite being billeted in a relatively stable, well-built hotel, the team members were soon to feel the jarring effects of a number of unnerving aftershocks.

Although the team arrived in Port-au-Prince 12 days after the earthquake, the scene that greeted them was still virtually post-apocalypse.

“It was just black at night,” Dolgin recalls. “There was no electricity. It felt like another world. There were people in the streets, with no light. It looked scary, but it really wasn’t. People were just out. There wasn’t anything to do but be out and walk around and look for food.”

After debriefing the outgoing delegation, the team set up to work in the compound of the St. Marie Church, a Catholic mission community founded 40 years ago that had, before the earthquake, a hilltop complex of schools for children, a vocational school, dormitories, a Catholic retreat, and around 3,500 residents – a number which quickly swelled to upward of 5,000 as people from neighboring areas came to get food, shelter and medical help. The buildings were mostly destroyed by the earthquake, with one collapsed school trapping several nuns and children.

“What we saw was tent after tent after tent, and not really tents – more like sheets and mattresses and people cooking,” says Belik. The church had a generator, ensuring electricity for parts of the day.

“The clinic was destroyed, so there was a tent with a German missionary nurse around 70 years old called Sister Marie. And she was seeing around 150 – 200 people a day,” Belik recalls. “They had good medical supplies from the Dominican Republic, and whatever they had salvaged from the destroyed clinic. She introduced Tammy and me to the crowds of patients as ‘doctors from Israel, sent by Abraham and Moses.’” With the help of Sister Marie, Belik quickly worked out a reasonably efficient means of communicating with his Creole-speaking patients.

“I’d speak kind of a Yiddish German to Marie, which she would then translate into Creole,” he recalls. “But I could manage the basic history and know if someone was in trouble. Although the people are rather stoic, you could tell pretty much by looking at them what the problem was.”

Usually, it was obvious, says Dolgin.

“There were a lot of fractures, and a lot of big, open wounds,” Dolgin explains. “These were wounds that were obviously from something heavy falling on them. They had either not been treated at all, or had been treated once and not been followed up. They required some serious cleaning and dressing.”

“We saw a lot of little kids, vomiting and with diarrhea, whom we had to treat for dehydration. And a lot of colds and coughs,” Belik adds.

There were, according to Belik, four major waves of earthquake-related injuries. The first wave, which Belik’s group missed, were the “crushing injuries” seen right after the quake, in people who were pulled out or dug out of collapsed buildings. All of these injuries required intensive care, some required amputations. The second wave consisted of infections that had developed in people’s wounds. Belik’s team saw and dealt with hundreds of those. The third wave involved treating pre-existing chronic diseases which became more severe as people began to run out of their usual medicines after the earthquake. People who may have had high blood pressure, for example, were now in danger of strokes and heart attacks. The team’s response to those cases involved finding the proper medicines quickly.

“And the fourth of these various plagues were typhoid and cholera,” Belik says. “When we realized that the clinic was more or less under control and other doctors – Haitian doctors – came in to help, Tammy and I decided that our most important work was to help educate these people to wash their hands after the toilet. By toilet, I’m talking about a bucket in their tent, right next to the food.”

Dolgin adds, “We saw that we needed to help them understand how important it was to maintain – actually, to learn about – proper sanitation. We did some public health education. And we also took the opportunity to branch out and go into some of the neighborhoods that hadn’t yet had any medical care.”

Although neither Belik nor Dolgin had planned to venture into these areas, they were prepared.

“We had a box from the UN called a Kit 1000, which is supposed to contain enough medical supplies for 10,000 people over a three-month period,” Dolgin says.

Although the team did not witness the street fights and riots over food that international TV audiences saw on CNN, there were one or two tense moments during their stay in Port-au-Prince.

“We were in the church compound where we knew the people,” Dolgin recalls, “and where the atmosphere was very friendly and cooperative. Then another NGO came up into the compound with food donations. They weren’t quick enough, or organized enough with their food coupons. So this very genteel community gathered around their truck very aggressively. The NGO just had to pack up and leave, and the people chased them all the way down the hill.”

And later, when Belik and Dolgin began to venture outside the compound and into some of the surrounding areas, there was “Machete Man.”

“We went to a community on a hillside, where people lived in shacks, even before the earthquake,” Belik says. “The patients began to line up. There was this guy who’d been playing dominoes with some other guys. He must have lost, because he looked pretty angry and drew a machete.” Dolgin interjects, “It was a big machete, and he was really mad.”

“He was walking around, shouting menacingly,” Belik says. “But I had 20 people in front of me, and there were people in front of Tammy, and they didn’t seem to be worried. So Tammy and I just kept an eye on him from time to time. We got out of there okay.”



In the end, they got out of everyplace okay, as the victims were uniformly grateful to receive the duo’s medical care – often the only medical attention any of them had received since the disaster. Belik recalls venturing out to one neighborhood that had received no assistance and was calling for medical help. Ignoring advice from all quarters that the neighborhood was too dangerous and that their lives would be at risk, and then hunting down a driver who was willing to take them there, Belik and Dolgin set out on their mission.

Traveling most of the route by car until the driver refused to go further, and then having to walk the rest of the way, the two were greeted by a very grateful community.

“The people there were very helpful. They brought out a table and chairs,” Dolgin says. “Community people helped us count out the medications that we needed to administer. We helped them, and it turned out to be a very rewarding experience.”

DURING THE days that Belik and Dolgin were busy providing medical care, the other members of the team, under the direction of team leader Moshe Farchi, Ph.D., were engaged in continuing the first Natan delegation’s work in PTSD. Their work revolved around the theory that there is a “window” of roughly one month after a traumatic event during which people can be successfully treated for post-traumatic stress disorder. Patients left untreated for that crucial month go into a PTSD from which they never recover, with the usual symptoms of depression, crippling passivity and helplessness.

Picking up right where the first delegation left off, the team’s social workers continued the work of helping the 5,000 disaster victims in the St. Marie compound regain control over their lives. This involved putting them in charge of their own rehabilitation – defining and prioritizing tasks, organizing work groups, organizing the lines of people waiting for food, and generally making their own day-to-day decisions. As the trauma victims were helped to assume increasingly greater degrees of responsibility for their lives, they became survivors – free of PTSD.

The team’s final, crowning achievement in Haiti was to help the community reopen a school and get it up and running.

“It was great,” says Belik. “The IDF provided a huge tent, and the community brought out furniture that survived. It was a rebirth.”

Dolgin adds, “There were at this point 3,500 people still in the compound. Some of those people were teachers; some of those people were administrators. So little by little, our group found out who those people were, helped them to organize themselves, helped them see that they were capable of putting some order back into their lives. We motivated them to start school, and they did.”

The opening of the 400-pupil elementary school – festooned with the flags of Israel, Haiti and the Dominican Republic – was broadcast internationally by CNN, and made the front page of the New York Times.

With the opening of the school, the team’s work was done. With so much of Haiti still in rubble, the group could only hope that their work would be a model that members of the compound community could teach to others, for replication elsewhere throughout the devastated country. The team said their goodbyes and returned home on February 5.

Both Belik and Dolgin agree that, despite everything they saw and experienced in quake-ravaged Haiti, their readjustment to normal life in Israel has been painless and easy. One of the major reasons for this, they both say, is the degree to which their NGO realizes that one can get PTSD while fighting PTSD, and that helpers must themselves be helped.

“Our group was so psychologically minded that we had debriefings every night,” says Belik.

“Every night we sat around together and everyone told the group about their day. That made a big difference,” Dolgin recalls.

Remembering a Spanish doctor they met on the bus on their way into Haiti, Belik says, “He spent a week in a town down the road from Port-au-Prince with a group that was completely unsupported. They were left alone to do everything themselves, without any psycho-social support. We spent a day with him in Madrid on our way home, and he said he still can’t sleep at night.”

On one occasion that neither Belik nor Dolgin is likely to ever forget, the overpowering need to talk and express days of bottled-up emotions actually led Father Jacques, the 76-year-old officiating priest of St. Marie Church, to sit down, gather his thoughts, and “confess” to Dr. Harvey Belik. After days of having the responsibility for 5,000 people resting on his shoulders, the old priest needed to unburden himself to someone.

Belik and Dolgin both say that helping the people of Haiti was among the most meaningful and fulfilling experiences of their lives.

“I think that the usual idea is, ‘What are we supposed to do about Haiti? It’s on the other side of the world, the people don’t look like us, they don’t live like us, they don’t have the same religion as us,’” Belik says. “But it was good helping people, because people are people and that’s what we have in common. Which is really everything.”

So, are they ready to go off again, to help the victims of the next major earthquake? Dolgin says, “Yes! And next time I’d like to get there at the very beginning.”

Belik quips, “Actually, we want to be there even before the earthquake happens.”

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