TELLURIDE – Last week, part-time residents and physicians Nancy Kerr and Mark Hauswald enjoyed a snowy day up on Telluride’s slopes.

Powder-day skiing was, in short, worlds apart from how the couple had spent the prior two weeks, working in a field hospital in earthquake-shattered Haiti.

“The degree of destruction is just intense,” said Kerr from their Telluride residence, following their stint at the Gheskio Camp hospital as members of New Mexico’s Disaster Medical Assistance Team (DMAT). “It’s one thing to see basic poverty. This is a few steps few beyond that.”

Kerr and her husband arrived in Port-au-Prince in mid-February, almost exactly one month after a 7.3-magnitude earthquake decimated nearly every corner of the city. The twosome – along with their DMAT group of nearly three dozen U.S. doctors, nurses, and specialists – were able to provide vital, albeit rudimentary, medical care for the injured and displaced victims of the Jan.12 quake.

What they weren’t able to provide, however, was steadfast reassurances that the future would be brighter for their Haitian patients.

Hauswald, a semi-retired ER doctor who has worked in comparatively austere medical environments across the world, called the post-quake scene in Port-au-Prince “stunning.” More than a month after the disaster, Hauswald said the question on everyone’s mind was not when this country would recover, but how – and even if it ever could.

“Money has, so far, gone almost entirely to medical care and orphan [care organizations]. But where it really needs to go now is to rebuilding infrastructure,” he said, noting that hardly any buildings remained standing after the earthquake since most had been built without adequate structural strengthening materials. Yet he acknowledged that the Haitian government and NGOs face a tough road ahead in supplying the country with what it’s going to need – like rebar, concrete, and more stringent building codes.

“That is what was most striking to me – that these medical interventions would have been relatively unimportant had this country had laws for building codes in the first place.”

He pointed to a recent BBC article that compares the level of destruction and loss of human life caused by the January earthquake in Haiti to other, similar strength earthquakes that struck in less deprived countries and took far fewer lives.

In her article “Why did so many people die in Haiti’s quake?” Lucy Rodgers notes that while size of the earthquake, as well as its proximity to the surface and to population centers, all play a role in an earthquake’s ultimate death toll, poverty is also an important indicator.

Haiti is the poorest country in the Western Hemisphere, a country where 70 percent of the population survives on less than $2 a day and millions live in densely-packed “shantytowns” and poorly constructed buildings. Hauswald and Kerr saw first-hand how the social elements of poverty collide with the technical elements of a major natural disaster, with devastating results.

Kerr, an OBGYN, recalled the story of one of the many patients she saw during their ten-day stint in the field hospital. It was a four-months pregnant woman diagnosed with placenta previa, a condition that will require a c-section at delivery. She was lucky to have a tent to live in, but it had no ground cover (meaning she and her family would have no way to keep dry when seasonal rains begin).

“I could just see [the husband] was so depressed,” Kerr said. Their doctor and parents had been killed. The husband had no job, and thus no way to provide for his wife and unborn child, even if they could find a local doctor who could perform the c-section. “I did what I could to try and calm him down, but I also knew that I was leaving. There has been much emphasis on trying to help the injured and homeless now, but what are people going to do in the future? How are they going to care for a child with pneumonia, or a birth with complications? They don’t even have a house to live in or a means of income. What kind of ongoing support is going to be available to them?” Kerr said.

After only ten days of witnessing first-hand the struggles Haitians face, Kerr and Hauswald have no answer to the question of what those people have ahead of them.

“In the short term, medical care, food, and shelter is critical – but longer term, it’s going to be important to rebuild in a way that everything’s not going to fall down again. Job creation and establishing a working agricultural system is also vital,” Kerr said.

Despite the rocky road ahead, Kerr and Hauswald both say they were struck by the resiliency they saw in their Haitian patients. “On top of it all, people were doing their best. They would come to the clinic clean and scrubbed and wearing their best outfits. They were playing soccer in the camps. But I have to wonder; where are they going to be a year from now? If they are still living in those tents, that would be bad,” Hauswald said.