PORT-AU-PRINCE, Haiti - Thomas Griffin was at his law office in Old City Philadelphia when the earthquake struck Haiti. He thought immediately of friends.
There was Jesula Mazilas, whose family of 12 lives in three concrete rooms in Cite Soleil, Port-au-Prince's largest slum.
And Mimi Dominique, the Haitian-born, Brooklyn-raised, no-nonsense manager of Lamp for Haiti, the medical clinic Griffin cofounded there in 2007.
And many more he had met over the years.
He vowed to get himself to Haiti, "even if I have to walk," to rebuild and maintain the clinic.
When he finally arrived over the weekend, Mazilas was the first person he saw, encircled, like a hen with chicks, by her barefoot kids. She lives near the clinic and is entrusted with its key.
A big smile lit up her face as she and Griffin hugged and exchanged greetings in Creole.
"Tout bagay anfom?" he asked. "Everyone in your family is OK?"
He was visibly relieved when she answered yes.
For a decade, Griffin has been coming to Haiti to document civil rights abuses and promote public health in Cite Soleil, which he says is "the place where capitalism's toilet flushes out."
A wiry man with an edgy take on global politics and an in-your-face passion for social justice, Griffin graduated from Georgetown University and worked for 10 years as a federal probation officer before attending Suffolk University Law School in Boston.
He started practice with a white-shoe firm in Boston, then moved to Philadelphia and partnered with two friends to create Morley, Surin & Griffin, an immigration practice with offices near Third and Chestnut Streets.
His latest journey to Haiti began five days ago with an e-mail blast to clinic supporters, saying he was leaving for a three-day assessment. He invited them to join him if they could but cautioned:
"As of today, I have no idea . . . where or if I will sleep or eat . . . so please understand I can't help much with logistics."
After a commercial flight to the Dominican Republic five days ago, he persuaded members of a pastoral relief team from a group called Global Grace to take him from Santo Domingo to Port-au-Prince on the small plane they chartered.
Although the airport in the Haitian capital was closed to large commercial craft to make way for air convoys of emergency supplies, Griffin's flight was able to land on a small strip at the edge of the airport.
His first contact was with Jim Morgan, medical director of Lamp for Haiti. Morgan, 45, an internist from Montclair, N.J., had flown in six days earlier. He looked haggard after long days at the clinic and nights as a volunteer at the Port-au-Prince hospital called St. Damien's.
That night, the men stayed at Dominique's house. They used flashlights because the city's power grid has not worked since the day of the quake, and Dominique's generator wasn't working either. They slept indoors. Because of dozens of aftershocks and fears of another cataclysm, Dominique's other guests slept on mattresses in the yard.
On Saturday, dressed similarly in plaid hiker's shirts and jeans, Griffin and Morgan set out to try to accomplish errands in a city teeming with traffic and jittery pedestrians.
Many roads have been closed because of mountains of debris. They needed rebar for reconstructing the clinic's wall. They needed tires for the clinic pickup. They needed two wheelbarrows to move the chalky cement ingredient known here as sab.
They needed to present their clinic's Haitian certificate of incorporation to the international aid groups established here to be eligible for medicines and food packages for their clients.
Chauffeured in a ramshackle Nissan pickup by the clinic's driver, Junior, the men decided to put off some of the errands until Sunday. They went directly to the clinic so that Griffin could have his first look at its condition.
After greeting Mazilas and all of her children, Griffin pressed toward the clinic, threading his way through the narrow alleys that separated the concrete-block houses. Small children trailed him, chattering in Creole and constantly reaching for his hands. Sometimes, a child would just grab one finger.
Arriving at the clinic, Griffin dropped his arms and stepped back to take in the big picture. The pale-green, peaked-roof building was intact. Only its perimeter wall was damaged.
"Tom is committed to seeing the project work," Morgan said. "There were times, early on, especially for me, because of my family and practice obligations, that the project had to take a backseat. Tom was like a pit bull. He was not letting go. That to me is his greatest asset."
It was established inside an abandoned house that once was occupied by a local drug lord, so its construction is more substantial than the norm here. It includes a level patio surrounded by a 10-foot wall and four shade trees. It is an oasis of calm amid the squalor.
Picking their way over the toppled perimeter wall's stones, Griffin, Morgan, and Dominique discussed how, precisely, it should be reconstructed and gave instructions to the clinic's maintenance man, Denis Musac.
The clinic's primary role is to provide medical care. But it is also a center for building community cohesiveness.
"Instead of just coming in with a big footprint," Griffin said, "we ask people what they want."
Because hunger is rampant, Lamp for Haiti is considering putting in a kitchen and a place to serve meals. Earthquake reconstruction might be a good time to expand, Dominique said.
After some discussion, Griffin and his colleagues agreed on what needed to be done first: Encompass some adjacent ground with a 3-foot-high stone wall, repair a chronically leaky water tank on the roof, and develop a plan to create a three-toilet outhouse in this place without bathrooms.
For the moment, creating a kitchen would have to wait.
"If we just have an open kitchen" without careful planning, Morgan said, "it will be overrun in 20 minutes."
On Monday, Griffin rose before dawn at Dominique's house, where she cooked plantains for breakfast. When she and Griffin arrived at the clinic a short while later, 35 people with tuberculosis, hookworms, and malnutrition-related illnesses were already waiting.
The nonprofit clinic derives its name, in rough acronym form, from the Creole words, Libete Ak Medesin Pou Ayiti, which mean "liberty and health for Haiti." Staffed by one doctor, two nurses, and six assistants, the program survives on donations and an operating budget of about $50,000 a year. It is open Mondays, Wednesdays, and Fridays and serves about 200 people a week.
The clinic treated lacerations and infections immediately after the earthquake, Morgan said. The most serious quake-related injury was a four-inch laceration on a man's wrist, which Joey Prosper, Lamp for Haiti's staff doctor, debrided and stitched closed. But the flow of patients with Haiti's endemic maladies is never-ending.
"The need is so great, we could go 24/7," said Griffin, but given the clinic's limited supplies, it operates just three days a week to be able to provide continuing care.
Everything is basic. The "pharmacy" is a damaged wooden cabinet. Patients are weighed on a bathroom scale. Most are women and children, like Paulane-Francois Altenor, whose 5-year-old daughter, Loveta, was treated Monday for intestinal worms and stomach pains. But there was also 85-year-old Paul Henri, who had a fever and a bad cough.
While many shanties in Cite Soleil remained standing after the earthquake, food-distribution delays and disaster profiteering - palm-size packets of clean water that usually sell for three cents now cost 10 cents or more - have made the lives of these patients more difficult.
In the clinic's simple examination room, Prosper lowered the top of Loveta's dress and lightly tapped on the child's chest and stomach to listen for blockages. He wrote her a prescription for antibiotics. After a brief wait, a nurse handed the pills to her mother through a barred window.
Because many patients are illiterate, staff members often draw circles on the prescription envelopes to indicate how many tablets patients should take. Next to the circles, they make a drawing of the sun if the tablets are to be taken during the day, and a moon if taken at night.
It is important for tuberculosis patients to complete their full course of treatment, which can involve taking pills for more than a month.
If they stop when they begin to feel better, they can develop a drug-resistant strain of tuberculosis. To keep them on their medications, the clinic's staff watch as they consume their first doses and then hand them small packets of rice and beans. Clients are told to come back in a day for another pill and to receive another ration of food. In Cite Soleil, that's a mighty incentive.
Juliot Alissage, pastor of an evangelical Christian church that serves Cite Soleil, said Lamp for Haiti's work had been deeply appreciated by his parishioners. "There were a lot of sick people here," he said, "and now they are getting better."
Griffin, who left for Philadelphia on Monday night, said he would come back to Haiti next month to buck up morale at the clinic and to measure post-quake progress generally in the country he has come to love.
Driving through Port-au-Prince in his final hours on the ground, past tens of thousands of people hiding from the sun under makeshift shelters affixed to trees and fences, his passion burst out again.
"We're 13 days into the disaster," he said. "The whole world knows about the disaster, and these people are living under bedsheets. It's crazy."
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