The earthquake hit Port-au-Prince a year ago Wednesday, and I began my trip to Haiti the next Saturday.

While the world’s media converged on the capital, where the earthquake hit, photographer Greg Rec and I headed to the northern part of the country, to the city of Cap Haitien. We traveled with Nate Nickerson, executive director of Konbit Sante, the Portland-based nonprofit that had been working to improve the public health system in Cap Haitien for a decade.

As journalists with the Portland Press Herald, my former employer, we were following our local angle on an international story. We would witness the flow of refugees from the south, 90 miles to the north, to be treated at what is generally considered the poorest hospital in the poorest country in the world.

While the rest of the world focused on a Haiti devastated by an earthquake, we saw the sad reality of a Haiti untouched by the destruction. We had full access to operating suites and recovery rooms at the Justinian Hospital, where doctors and residents worked without sleep to deal with the influx of patients.

The Western idea of “hospital” is vastly different from the Third World version. Restrooms are open latrines in the middle of the grounds; chickens are everywhere. There’s a pervasive biological odor throughout the hospital and stains up and down the walls.

Throughout our visit, it was impressed upon us by Nickerson and by observations and interviews that the earthquake was just one more thing for Haitians to deal with. It was the latest thing, to be sure, and devastating — but this is a nation that faces constant struggles, never-ceasing obstacles.

Haiti presented us with daily escalations in “bad.” The city streets were obviously urban Third World; the hospital was worse. And as bad as the hospital was, our foray into Petite Anse, the city’s poorest slums, was almost surreal.

We walked with a Konbit Sante doctor into Petite Anse, across causeways of refuse, through pools of fecal-contaminated waters, to visit her patient, a newborn baby who lives with his mother and siblings in a shanty built on a garbage dump.

The children who lived there followed us along, crying out “mange, mange” — creole for “eat.” They were hungry and wanted food. I can close my eyes even today and see them clearly. I think I always will.

But I can also see Dr. Youseline Telemaque, the Konbit Sante doctor who was bringing health care to the slums. Without her, that newborn wouldn’t be so plump, his mother would be largely ignorant of how to care for him. Without her and the other Konbit Sante health officers in the slums, there would be no such help for the poorest of the poor, the forgotten who live on garbage because no one will force them from it, claim the “land” for their own.

I can see the work Nickerson and others from Maine have done and continue to do in Cap Haitien — people like Drs. Sam Broaddus of South Portland and Carol Kuhn of Belfast, who have worked alongside Haitian colleagues at the Justinian to improve the lives of others. I can see the pumphouse at the Justinian, installed by Gary LeClaire of Eddington. It may not sound like much, but that pumphouse serves to keep water from being contaminated by the latrines. It’s as important as the uninterrupted power supply systems LeClaire installed in the Justinian’s operating suites, ensuring the lights stay on when the power goes out, as it often does.

I see the medical depot, stocked with donations from Mainers. I see the fire extinguishers in all the hospital buildings, no longer useful to Maine Medical Center, but critical to the Justinian. I see the neonatal units, also donated by MaineMed.

On the ground in Haiti, I was proud of the work Mainers have done to help their fellow men and women, fellow humans who remain in desperate need. I’m still proud, as their work and support continues, even as the memory of an earthquake fades from our general consciousness.

I know I will always be able to close my eyes and see the children, hear them, smell the slums. I will not forget Haiti, and the need there.

And I know that Maine will not, either.