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The emergency team at Jude Anne Hospital, which provides childbirth care to Haiti's poorest women, no longer has to perform triage in the parking lot. Médecins Sans Frontières, which opened the hospital a year ago, has now added a second building.

That is how progress is measured in Port-au-Prince, Haiti's wretchedly poor capital, said Paul McPhun grimly. He is operations manager for the aid agency's Canadian section, which is responsible for the obstetric hospital.

McPhun and his colleagues were pleased that Prime Minister Stephen Harper visited Port-au-Prince two weeks ago on his tour of Latin America. They would have liked it better if he'd come to their hospital.

"We have an obligation to show politicians the realities of life in Haiti," he said. "We want people to see the humanitarian crisis, not just the recent security gains."

It is true, McPhun admits, that the scale of violence in crime-ridden Port-au-Prince has abated in the last year or so. But basic health services remain out of reach for most Haitians. The country has the highest maternal mortality rate in the Western Hemisphere.

Women simply can't afford hospital care. It costs $13 to deliver a baby in a state hospital, assuming no complications. That is six times the average daily wage of a Haitian who is lucky enough to have a job (60 per cent don't). A caesarean section costs $55, not counting drugs and post-surgical care.

Jude Anne Hospital charges nothing. It is one of five free hospitals run by Médecins Sans Frontières in the Haitian capital.

When it opened in March of 2006, the staff expected to handle 300 births a month. By September, exhausted medical teams were delivering 1,300 babies a month - about one every half-hour.

That's when the parking lot became a makeshift triage centre.

It is not surprising that Harper didn't visit the facility. It does not receive - or want - funding from the Canadian government. For Médecins Sans Frontières, neutrality is essential.

"We are one of the few aid organizations that can go into the slums," McPhun explained. "That's because the people with the guns know we are not affiliated with the police or the security forces, who receive support from Canada and the United States."

Nor would the Prime Minister and his entourage have found photogenic children or grateful aid recipients at Jude Anne Hospital. A mother who gives birth there has little to look forward to.

She has a 35 per cent probability of dying before her 40th birthday. Her child has a 12 per cent chance of dying before the age of 5.

She will live in one of Port-au-Prince's gang-controlled ghettos, where the threat of sexual assault and armed conflict are ever-present. She will probably be among the 56 per cent of Haitians who live on less than $1 a day.

Harper got a glimpse of this misery as his motorcade, guarded by armed United Nations soldiers, made its way through Cité Soleil, one of the poorest neighbourhoods in Port-au-Prince. He visited a hospital - Sainte-Catherine-de-Labouré - that receives funding from the Canadian government. He delivered a blood analysis machine to speed up its HIV/AIDS testing. He seemed genuinely moved by the hardship around him.

"I think all of us, as fellow human beings, as people who have our own families, can only begin to understand the true difficulties and challenges that so many people in this country face on a day-to-day basis," he said.

Harper stayed in Haiti for only six hours. His primary focus was improving public security. He made no change in Canada's aid commitment of $100 million a year.

McPhun gives the Prime Minister credit for going to Port-au-Prince. "I think a high-profile visit can only be a positive thing."

But he wishes Harper had stayed longer, seen more and recognized that healthy babies matter as much as safe streets.