The masks the translators wear aren’t for disease. They’re for the smell — foul, thick, choking the air. It’s the smell of rotted flesh, of infected limbs needing amputation, of infected stumps needing yet another amputation.

Dr. Mike Ettner, emergency department physician from Kootenai County Medical Center, walks through the crumbling green-and-white halls of Haiti’s Hinche Government Hospital. As the cries and moans fill the air, family members beg him in Creole: Please, my mother needs pain medication. Please, where’s my son’s medicine? They promised they’d bring him medicine.

Two hundred injured and dying people pack into 150 beds. The flies are thick, swarming and buzzing in the blood and pus. A man stomps through the halls with insecticide, spraying swarms, and spraying patients. Rats — big rats— skitter past patients’ pads. A sign on wall says: Do Not Urinate Here. There are no bathrooms.

And yet, the 5-year-old boy, the boy in traction in a full-body cast, the boy who had a concrete block land on his femur, the boy whose leg is destined for amputation — the boy is smiling. He’s holding the transistor radio Ettner gave him. He’s laughing. He’s in pain but refuses to cry.

“He looked so much older than children his age,” Ettner says. “He might even feel he’s fortunate.” For the first time, people are giving him gifts.

For the first time in his life, he’s being fed consistently.

Volunteers from Yale and Dartmouth and plastic surgeons from Operation Smile work alongside Ettner as he changes dressings and passes out painkillers. Last Monday, he gave anesthesia to 15 different patients, readying them for amputation revisions. Two are children with horrible burns covering nearly half their bodies. The streets outside are crammed, practically un-drivable. The city of Hinche’s population of 60,000 has risen, from the torrent of refugees, to 200,000.

“In the cities, on nearly every street corner, you can see someone building a coffin,” Ettner says. But that’s not new — it’s just worse. Suffering, even suffering on this scale, is hardly new to Haiti.

People in Haiti rarely live past the age of 48, Ettner says. “Besides Bangladesh, I can’t think of any other countries that are just actually hopeless,” he says. He hopes an ethical leader will rise from the rubble, but he doesn’t foresee that Haiti will ever escape its ceaseless cycle of poverty and corruption.

Ever since 1964, when he first read about Nobel Prize winner Albert Schweitzer, Ettner wanted to be a missionary doctor. It was the only dream he’s ever had. He had planned on spending his life saving the sick and injured in Africa.

He and his wife lived with the Maasai tribe in Kenya.

They spent three years in Micronesia. And 25 years ago, he flew out to the Dominican Republican. There, he met Haitian sugar cane cutters. There, he first fell in love with the Haitian people.

“I discovered Africa was 600 miles off the coast of Florida,” Ettner says.

For the last six years, Ettner’s been flying to Haiti to put on clinics with the Haiti Endowment Fund, a mission organization focused on food, medicine, water and ministry. His trip this January was scheduled long before the earthquake.

All his research, all his experience with the Haiti people just deepens his pessimism for Haiti’s future. There are too many people in too little space. There’s no clean water. No farmable land. It’s a place where a dictatorship collapsing only leads to a dictatorship rising, where racism morphs into new racism. “It’s an endless vicious cycle,” Ettner says.

To truly save Haiti, Ettner wrote in a paper in 1984, you’d have to take everyone off the island, and let the land heal, untouched, for 1,000 years.

It’s a place infected with corruption and pessimism, he says. Most of the buildings have no windows, for two reasons: to keep out evil spirits, and to keep out evil men.

Ask a Haitian how they’re doing, and you’ll hear, “Pa pi mal,” Ettner says. Literally: “Not a little bit bad.” The implication: It’s bad, but it can get worse. It can always get worse.

Ettner's in a cab in Miami, ready to head to Haiti.

He asks his cab driver — a Haitian — if all this earthquake aid will benefit Haiti. The cab driver laughs. “Only the politicians,” the driver says.

Political sleaze extends to the hospital. The Hinche hospital is ruled by Dr. Prince, a general surgeon and one-time ally of former president Jean-Bertrand Aristide.

Before the earthquake hit, he was under investigation for murdering a fellow doctor. But he’s still the one holding the hospital’s keys.

At 5 pm sharp, every night, Prince shuts down the generators. “He would lock the operating room so we couldn’t get in,” Ettner says. “He’s hurting his own people.” No operations are allowed on Saturday or Sunday.

Doctors and surgeons would plead to be able to continue to operate. No such luck.

Prince claims it’s because he doesn’t have enough fuel to run the generator longer — but Ettner says more than enough fuel has already been donated. Ettner believes that Prince is trying to sell the extra fuel, trying to consolidate his power further.

“There were people who hadn’t been operated on,” Ettner says. “Three weeks from the earthquake, they’re still waiting to have their femur fractures fixed, and burns grafted.”

Ettner blames Dr. Prince for that delay. Prince would lock the supply cabinets, he says, forcing Ettner to stockpile supplies on a gurney. “He considers me his close friend,” Ettner says. “I wanted to tell him how evil he was.” But Ettner couldn’t. He needed to fake camaraderie, to avoid worse consequences.

“The people are good,” Ettner says. “The people, when they become politicians, are evil.”

If Haiti’s long-term prospects are so hopeless, I ask Ettner, why is trying to save Haiti worth the effort? He says it’s partly because he hopes the suffering may be alleviated for some. In Ettner’s time there, the team at the Hinche hospital saw 2,000 to 3,000 people. And, he says, partly it’s because, as a Christian, he believes there’s a life — a hope — beyond this life.

“We’re not out to change the world,” Ettner says.

“We’re just out to change the world for one person.”

Despite corrupt politicians’ trying to profit from the aid, he says, the donations — the donations you’ve sent — have done good.

In that filthy hospital in Hinche, Ettner looks upon the dual faces of Haiti. In the hospital administrator, he sees the fear, the evil, the corruption that’s strangled Haiti for centuries. In the smiling suffering boy with the broken leg, he sees resilience and — if not hope —perseverance.

“These people are worth rescuing and lifting up,” Ettner says. “What other people could stay under rubble for 17 days and still be alive?”