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Image by Mary Chind. Haiti, 2013

Dr. Chris Buresh sees plenty of reasons for skepticism about American assistance to Haiti, but he refuses to slip into cynicism.

Buresh, an emergency-medicine doctor at University of Iowa Hospitals, has been leading medical teams to rural Haiti for years.

Buresh has watched his own teams and countless other groups try to help residents of the impoverished nation. He's seen some efforts lead to nothing but dependence. He's been frustrated when money and hard work fail to make a longstanding difference in people's lives. But he's also witnessed progress come in fits and starts.

The Iowa group now focuses on one town, where it goes at least four times a year, so it can provide consistent, predictable assistance, including training to local health workers. Des Moines Register photographer Mary Chind and reporter Tony Leys accompanied the team to Haiti in March.

Buresh sees some sustained good coming from the way the 2010 earthquake raised Haiti's problems into the U.S. consciousness. He knows that some Americans are tempted to give up on Haiti as a hopeless basket case, where billions of dollars in assistance have failed to fix the problems.

"I don't have a good answer for those people, other than to say these folks are mothers and fathers and brothers and sisters and children, just like you have mothers and fathers and brothers and sisters and children," he said. "I think it's really cynical to say, 'Why bother?' These are human beings."