Image by Andre Lambertson. Haiti, 2010.
Joel Sainton visits Silly Remercile and her two small children in their tent in Carrefour, Port-au-Prince. Image by Andre Lambertson, Haiti, 2010.

PORT-AU-PRINCE, Haiti — Much has been damaged by the earthquake that struck Haiti last January. Much has changed for so many people.

But some things remain constant. Joel Sainton will get up each morning prepared to walk for miles, visiting people with HIV, the virus that causes AIDS. He will sit with those who are not feeling well, sing, pray and counsel. If he has money or food to give them, he will. If he needs to refer them to a clinic, he does.

Sainton calls these people his "congregation," but he has no actual church. Instead, he leads a group called APIA (Association of People Infected and Affected by HIV/AIDS) that serves people who are HIV-positive and those with family members who are living with or have died from the disease. More than 200 of them have registered with his non-governmental organization for moral, spiritual and material support as they deal, mostly in secret, with the illness.

Sainton, a 38-year-old itinerant minister, is a member of the Pentecostal Church of God, one of a growing number of working-class evangelical churches challenging the dominance of the Catholic Church in Haiti. He is tall and slim, a man who moves with the contemplative gestures of someone conserving his energy — as if he knows just how much energy he has to expend to get through a day in the Haitian heat, and how little food he will have in his system.

On a recent Saturday morning, Sainton presides over a gathering of people living with HIV/AIDS, held on the landing outside the one-room apartment he shares with his sister, in a badly damaged building in Carrefour.

The road to the house is rocky, full of bricks and large clumps of cement, rubble from the houses that once lined the route. The building smells faintly of urine and cooking food. About 15 people sit in folding chairs and a few formal chairs. There are two men, two teenage boys with their mother. The rest are women of various ages.

The meeting begins with a short devotional led by Sainton. He is animated, filled with contagious energy and joy. He calls on people by name, and nudges them to share their experiences. "Sister, you just went through a hard time, but God has made you better, eh?" he says, smiling at a middle-aged woman who tells a brief story of sickness and God's mercy and the son who cared for her.

Drawing out the closed-in

One young woman looks stern, unengaged. Sainton suggests she must be having boyfriend problems. A soft smile creeps into her face, and she insists she does not have a boyfriend. She says she is in pain — deep pain inside her body.

The testifying goes on. Those present listen and groan in agreement and understanding.

These HIV-positive people speak with an unusually sophisticated knowledge of the technical matters of their health. Without warning or prompting, they announce their CD4 counts, indicating the level of white blood cells in their bloodstream. This number is critical: A count of less than 200 is diagnosed as AIDS. (The average person has a count of more than 1,000.) Here, the numbers range from 250 to 1,200; the gathering offers praise and supportive words, depending upon the count.

Illness hits close to home

In 2003, a year and a half after his wedding, Sainton's wife became ill and was hospitalized. She tested positive for HIV. He took the test, too, and tested positive. The news, he says, came as a shock.

At the time, Sainton was in training to become the pastor of a congregation. He was full of ambition and faith in God for the work before him.

The reaction of church leaders, however, was something he did not expect. "They said my wife was a criminal. They said give her back to her parents right away. I said no, we got married for life. They said they received the order from God to put my wife out of the house."

Sainton refused and was ousted from the leadership.

Eventually, the sickness took its toll on his marriage: His wife left him. He says he is still married to her and would never consider marrying anyone else. But his devotion now is to his work.

Sainton's APIA was formed out of a need he felt as a Christian with HIV. He recalls his unease at a party in 2004, hosted by one of the HIV/AIDS agencies that had helped him. "They were playing music, and everyone was dancing — but I did not feel comfortable with that," he says, shaking his head and smiling. "The way I felt so bad, that is the same that other Christians that have been infected (would feel)."

So he decided to form a Christian network to reach out to those suspected of being HIV-positive, get them tested, then help those found to have the disease. The organization serves everyone, he says, regardless of faith.

"Organization" overstates what is at best a hand-to-mouth operation. For the most part, Sainton says, he relies on gifts from individuals and the occasional offering when he preaches at one of the many churches throughout Carrefour.

"Grass-roots organizers like Joel Sainton are the thread that holds the torn fabric of society together when the state does not or cannot provide for its people," says Leonard Doyle, spokesman for the International Organization for Migration in Haiti. "This is how Haitian society has always worked, but the problems the country faces are much more severe since the earthquake."

Before the meeting begins, Sainton quietly explains that this gathering will be short. Normally, he serves refreshments, as many come hungry and walk great distances to get here. But he does not have any money this week.

It ends with the reciting of the 21st Psalm and the Lord's Prayer. Sainton embraces the members with fervor and laughter, teasing this one and laughing with that one. He thanks them for coming. Stay in the faith, he says. Take your medication. Try to be strong.

A question, and an answer

Eventually, he is alone. He takes a seat and his body becomes deflated. His lively eyes grow sunken, and his fatigue is palpable. He is no longer "on." He no longer needs to be the physical embodiment of resilience and encouragement. He speaks slowly, almost haltingly. "Yes, I am tired. I am very tired."

Faced with the overwhelming needs of those he serves and his inability to do more, he says he sometimes despairs. But the work sustains him because he believes this is a calling. His faith is intense, at times irrational, but always a source of reassurance and peace for him.

Once, he says, he asked God why he had been given such burdens to bear. " 'You gave me the ability to talk to others, how can you let me get caught in that trap? Tell me what I have done that made this thing happen.' And God answered me, 'Did Job sin?' " — a reference to the pious biblical figure who loses his health, his wealth and his children. "He wanted to show me that he needed Job to accomplish the mission. So I came to understand that I had a mission."

Sainton is facing eviction from his room (the building is marked for repairs) and has no idea where he is going to move. He is leaving it in God's hands. He is waiting for miracles — to help him find food for himself and his sister and his two adopted children, to find food for his extended congregation. Most of them are displaced, most of them are hungry, most of them are struggling with the challenges of being HIV-positive in a time of cholera.

Most of them, he says, are worse off than he.

This story is part of a series of reports on life in Haiti after the earthquake in partnership with USA Today, PBS NewsHour and the Pulitzer Center.

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A post-quake exploration through poetry. A special feature with poetry by Kwame Dawes, photography by Andre Lambertson.

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