It has been three weeks since Dr. Beth Sloand returned from Haiti, but the images of the disaster-torn country still haunt her. Sloand, a professor at the Johns Hopkins University School of Nursing, was part of the JHU Go Team, a rapid response team for disaster medical assistance that deployed to Haiti after the Jan. 12 earthquake. Sloand has worked in Haiti for years as a clinician, educator and researcher. Nonetheless, she was deeply affected by the post-earthquake reality.

“It has always been true for me, over the past 10 years and countless trips to Haiti, that the transition from Haiti to home is far more difficult than the transition from home to Haiti,” wrote Sloand in her JHU blog. “At the end of the visit, you leave Haiti. But Haiti doesn’t leave you. It has a way of clinging to your heart, never far away. This truth is even deeper in 2010, post-earthquake Haiti.”

I, too, have vivid memories of Haiti from the few days I spent in port there eight years ago. I can still easily conjure up the sights and sounds of shouted Creole and brightly painted buildings. Sloand is right: Images of Haiti — a whole other world — never leave you.

Today, Haiti is in a state of shock. The first day for the JHU team of 10 physicians and nurses at the Port-au-Prince Hospital threw them into a whirlwind of challenges and chaos. Sloand’s day was spent in the pediatric wards — four Red Cross tents filled with children and parents, all sick, many recently post-operation, and most with no homes to return to.

“There were many children who needed care, but few people to deliver it. Supplies were difficult to come by … There was no nurse and no doc in the pediatric ward — none — from midmorning until hours later.” Sloand drew on her hospital nursing experience and managed the IVs, pain medications, dressings and antibiotics. “A bit overwhelming,” she wrote, “but there was not much time to think about it.”

Outside of the hospital tents, there is simply no place for patients to go. An infant tent was crowded with 30 small cribs, with only a few inches separating them. IVs hung from the tent ropes. “Parents slept under the babies’ cribs at night, on a piece of cardboard or sheet or whatever they had,” Sloand wrote. “How do you discharge people who have no home? Conditions in the tent camps scattered throughout the city are much worse … it is difficult to know that recovering surgical patients will be living there.”

Everyone is sleeping outside. Between aftershocks and structural instabilities, Haitians are afraid to sleep or work in the few surviving buildings. Instead they stay in tents, improvised affairs of sticks lashed together with sheets or towels or shirts stretched across. Privacy is an unattainable luxury.

When life-altering disasters strike — a house fire, a car accident, the death of a spouse — friends and neighbors lend support. Someone next door brings over a casserole. Your sister calls to check on you. But right now, every single Haitian has been affected by the earthquake. There are no neighbors to bring over a casserole, no familiar faces of anyone who isn’t also grieving. Haitian nurses do the best they can to help relief crews, pulling night shifts before returning to tent cities and improvised encampments on the side of the road.

The Johns Hopkins team found lodgings on the floor of what was a hotel conference room with several other relief crews, giving them shelter and, when the water was on, occasional access to showers. The crowded room was filled with mattresses, a few cots and mosquito nets crisscrossed with impromptu laundry lines. “We eat one meal here, dinner,” wrote Sloand. “The rest of the time, we eat whatever power bars or trail mix we brought and whatever MREs we can handle.”

Tragically, a Haitian nursing school not far from the university hospital was among the many buildings that collapsed. This center for the training of Haitian health care professionals — exactly the people most needed right now — has become a tomb of rubble. “The bodies of many nursing students are still there — somewhere between 70 and 140 … I am still struck every time I walk past that building,” said Sloand.

This is the crux of Haiti’s new challenge. So many of the lives lost are the very professionals most needed to rebuild the country. Survivors are grieving. And yet they are carrying on. For all of the international help, the Haitians, ultimately, are rebuilding their country.

The courage of Haitian survivors as they pick their way from the rubble has been truly inspiring. The town of Leogane, not far from the earthquake’s epicenter, is the site of one of Haiti’s first nursing schools. The school mobilized within a half-hour after the first quake, setting up 10 aid stations around the town. Dean Hilda Alcindor reported that 5,000 townspeople were cared for in the school’s front yard and that the students delivered six babies.

As school co-founder Dr. Ruth Barnard commented, perhaps one day those babies will grow up to attend the school and become nurses themselves. They certainly will be needed.

In the meantime, much of the world — like Sloand — has Haiti on their minds. But if you ask Sloand, “The truth is, the real heroes are the men and women, boys and girls of Haiti who have survived and are working each day to pick up the pieces of their lives and go on.”

Sloand is an assistant professor at the Johns Hopkins University School of Nursing. Her blog can be found at http://www.son.jhmi.edu/blogs/blogs/bsloand/default.aspx.

Meg Adams, who grew up in Holden and graduated from John Bapst Memorial High School in Bangor and Vassar College in New York, shares her experiences with readers each Friday. For more about her adventures, go to the BDN Web site, bangordailynews.com, or e-mail her at meg@margaret-adams.com