There is a hospital in Haiti, on the edge of the Artibonite valley. If you walk up in the hills behind it, past the painted mud huts roofed with palm fronds, past the goats flapping their ears, and the laughing little boys, up the rocky paths through the sugar cane, and you look back into the valley, you will not see the hospital, only the water tower rising above the trees. Beyond the trees, rice paddies glow brilliant green in the sun, lined with irrigation ditches and coconut palms. Then, bending and twisting through the valley like a series of lakes and flood plains, flows the Artibonite itself. In the distance rises the Massif des Montagnes Noires, and away to the west lies the blue Atlantic. There are no cars, no power lines, no billboards, no smog. No airplanes or traffic break the silence, only the occasional bleating of a goat or crowing of a rooster. From a distance it is paradise. Up close it is not.