Joanne Silberner at work in Mirebalais. Image by Ansel Hertz. Haiti, 2012.

March 9, 2012. It's my last day in Haiti before coming back to the U.S.

When I do these reporting trips, I’m convinced at the beginning that all the work is in the set-up. The reporting and writing are certain to flow. Months ahead I start lining up people to be interviewed, which is a challenge when the communications cultures around the world are so different–the folks I met with in India, for example, read their emails but didn’t reply for days or sometimes weeks. As a result I plagued them with emails, and I left Seattle thinking I had nothing set up. I had to wait on most of the Haiti interviews, since I had no way to figure out people’s cell phone numbers (and despite the near-universal poverty, everyone here has cell phones).

There’s the travel arrangements (Do I really want to take local airlines? Can I tolerate the 24-plus hours of traveling it will take me to get from Seattle to Uganda?). And finding hotels–in a lot of developing countries, there are very expensive hotels for rich people, and for poor people, very rudimentary places like a place I once stayed at in Uganda for $10 a night that had no plumbing and no electricity. Finding something in the middle, with working wi-fi, can be a challenge. There’s also finding the right fixer–the on-the-ground person who does everything from translating to setting up interviews to getting me from place to place.

Then there are the visas. None needed in advance for Haiti or Uganda, thank God. But getting a journalist visa (different from a tourist visa) for India proved a three-week-long nail-biting odyssey for me. The visa folks wanted me to submit seven copies of my script (what script?!); the name of my producers and assistants (I wish!); a list of the video equipment I’d be bringing (I do radio and Internet), and more. A few years ago when I was planning a trip to Nigeria, I started applying for my journalist’s visa five weeks in advance. I was told to come back to the embassy the following week, which I did. And then the following week and the following week. I got my visa one day before I left. The Indian government was kinder. I got my visa with two weeks to spare.

Once on the road, I realize it’s the reporting that is the hardest part. In Uganda, there was asking a mother whether she’ll use what little money she has to bring her child with cancer back and forth to the hospital for chemotherapy, or for school fees for her other daughter. In India, it was asking a husband what it was like to see his wife in pain from terminal cancer.

There’s also the physical challenge of getting from place to place. I’ve yet to make an international trip that hasn’t included some very uncomfortable time on the road. In Haiti it was the highway up to the towns in the Central Plateau. It should have been easy–the road is newly paved, and a six hour trip now takes an hour and a half. But with more than its share of hairpin turns, it’s a dizzy journey. In Uganda I stayed in Kampala, the capital city, where the roads have potholes that can swallow a motorbike and a Land Rover suited for off-road travel is a good idea. Walking from place to place is a hazard. The city has grown up with no sidewalks, and people walk in the road, dodging each other as well as the cars and motorbikes that are meanwhile dodging the potholes. My consolation on this trip is that I’m doing most of my reporting in and around hospitals, so if I get hit there’s likely to be medical care nearby.

And then there was the small earthquake. I got to Haiti soon enough after the 2010 quake to experience a 6.9 aftershock. Yesterday’s quake was just 4.9, but it was enough to send many Haitians outside for the night. After the 2010 quake, I took a course in earthquake preparedness. So while I’m here I keep my shoes next to the bed at night, and my passport in a money belt around my waist (in a best-case scenario, the instructor said, there will be a long line of Americans waiting to get their passports replaced at the embassy, and in a worst case scenario, the passport can be used to identify my body). I always keep my recording kit packed and waiting at the door, and pray that it doesn’t come to that.

There’s another on-the-ground challenge in Haiti: the near-constant hum of political discontent. I focus on health care, and I don’t tend to keep up with local politics. But I should have: our ride taking us back to Port au Prince from a hill town failed to arrive. The driver said the chance for riots was too high after a presidential press conference about whether the president has dual citizenship with the US (he said he didn’t). And since I’m coming home, I may miss some key interviews that I had spent weeks planning before I left on the trip.

So now that I’m returning home, once again the work begins. And I’ve got the deja vu realization that the hardest work wasn’t the planning or the reporting, but in these final steps.

I’m headed back to gray and rainy Seattle, to my loving partner, to clothes free of the grit and dirt that seem to be ubiquitous in developing countries, to the culture shock of supermarkets filled with 28 choices of soft drinks. I’ll be back at my sparkling clean home with a full refrigerator and water I can drink from the tap, in my basement office where I will hole up and figure out how to convince you that as important as HIV, TB and malaria are, global health is much more than that. I’ll try and work all this planning and traveling and reporting into stories that will show you that there are many many adults and children in poor countries who are facing cancer with the same courage and fears as people in developed countries, but with far fewer options.

Project

More people in poor countries die from cancer than from HIV/AIDS, tuberculosis and malaria combined. Joanne Silberner looks at the human toll of cancer, and possible solutions.

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