THREE HOURS NORTH OF PORT-AU-PRINCE IN HAITI'S ARTIBONITE RIVER Valley, a tortuously rocky road cuts through flooded rice fields and past primitive mud huts where families huddle at night with windows tightly shut to keep out evil spirits. At Deschapelles, the road forks and creeps up to a rambling building of gray fieldstone in a campuslike setting. In front, a giant mapou tree, sacred to the Haitians, sits with its tangle of exposed roots. Reclining, ailing bodies crowd the hospital steps, waiting to be admitted. Others sell drinks or food. Some even sell advice on the surest way to make it past the guard at the door.

Under the breadfruit tree in the courtyard of l'Ho pital Albert Schweitzer, a plaque reads: "Help life where you find it." They are the words of the hospital's namesake, the renowned medical missionary and Nobel Prize winner who before his death in 1965 inspired followers to leave their comfortable surroundings to try to bring medical care to the developing world. In Laos, in the Cameroons, in South America, hospitals have been dedicated to Schweitzer. And for the past 30 years in Deschapelles, Dr. William Larimer Mellon Jr., one-time college dropout, Arizona rancher and grandnephew of American industrialist Andrew W. Mellon, has been on a mission as remarkable in its own way as the one that took Schweitzer from the concert halls of Europe to a clinic in Africa.

When the hospital opened on June 26, 1956, Larry Mellon feared that competition from the bocor, the witch doctor, might prevent the natives from coming. But the Haitians began to line up in the predawn darkness that morning. "We had worried that no one would come. Well, so many people came and we had said that we would see everyone so we worked until 11:30 that night," recalled Mellon's wife Gwen.

Working long, grueling hours in the hospital, the Mellons and their staff treated tetanus, malaria, typhoid and other diseases that were no longer common in the United States. But Mellon saw that treating disease was only half the fight. Four years after founding the hospital he turned its operation over to others and went to work in the countryside, working on public health projects and struggling to improve the regional economy. Laboring side by side with the Haitian peasants, Mellon struggled to improve the quality of life in the Artibonite Valley.

Today, at age 76, Mellon is seriously ill and can no longer work long days in the tropical sun. It is a time of transition for l'Ho pital Albert Schweitzer as it faces a future without its founder and guiding force. But Mellon's influence endures. Without religion as an inspiration, he has succeeded in attracting an international roster of prominent doctors to work in frustratingly primitive conditions. And he has done it in the midst of the Caribbean's most volatile political situation, gaining cooperation from government and peasant alike to provide at least a ray of hope in the midst of Haiti's seemingly overwhelming problems of poverty and ill health.

Thirty years after its tentative beginnings, the self-sufficient hospital spreads over a 100-acre campus. A diesel-run generator supplies electricity and water comes from two capped streams. Living in attractive low-slung stone cottages that dot the campus, staff and their families shop at the commissary and send their children to either the French- or English-speaking school.

But l'Ho pital Albert Schweitzer is much more than a hospital. Down the road, in the reforestation nursery, plastic domes cover thousands of seedlings that represent hope for Haiti's devastating deforestation problem. Crafts workers create hand-woven pillows, carved furniture and Italian-inspired ceramic dishes that are sold in Port-au-Prince or in the hospital's store.

In the community health office, a dozen Haitians sit behind reams of paper, laboriously transcribing information collected by the agents sanitaire. Eighty of these health agents travel throughout the valley, visiting homes to detect diseases in their early stages and referring the sick to a local dispensary, one of seven that relieve the hospital of some of its burden.

But despite these achievements, the obstacles facing the hospital are still immense in a country where infectious diseases cause close to 20 percent of all deaths, where there are still only 1.4 doctors for every 10,000 Haitians and where tuberculosis, malaria and now AIDS pose daunting problems of public health.

Exorbitant diesel prices mean that a quarter of the hospital's budget must go to fuel costs; some programs have been cut due to budget restraints. And the hospital has been the victim of its own success: with each "tap-tap" -- as the gaudily painted bus is called -- that pulls up in front, another swell of infirmed Haitians struggles up to the hospital steps. Those who live in the hospital's 620-square-mile district have been referred by a dispensary. Many, though, come from distant reaches, where there are no dispensaries or efficient hospitals. Having heard of the "Great Hospital," they come in droves, straining the hospital's already fragile resources. The hospital admits as many as possible, turning away 30 percent of the adults and 5 percent of the children.

Because of this strain, the future of the hospital is "uncertain," according to Dr. Jim Fett, the hospital's medical director. "The institution cannot continue to meet needs within its district unless two things happen: one, there be more resources made available, and two, outside the district there develop medical facilities and programs that are effective," says Fett. The Mellons look forward, they say, to medical facilities eventually developing outside the district. But in the meantime, they strive to keep costs down and the present situation under control.

Sitting in their living room with the wooden, louvered doors open to the breeze and the rolling mountains in the distance turning orange and then purple in the late-afternoon sun, the Mellons talk quietly of life at the hospital after they are gone.

With intense, unblinking eyes, Mellon speaks slowly, deliberately. "They call this the transition. I guess it will pass from some hands to others, you know. But the only thing that strikes me . . . is that there are more patients, more doctors, more expenses. I hope that it isn't off the track." He pauses. "I think that it may be on the right track."

From the stereo, a Mozart sonata wafts across the breeze. On the white couch rests Mellon's French horn, a sleeping lizard perched in its crest. An oboe sits on a nearby table.

"We're making a big effort to make it more financially palatable for other people to take over," adds Gwen Mellon, pulling her gaze in from the distant mountains. "Larry doesn't believe in financing something for the long haul after we're no longer here. He believes in doing it for a while but that it should be picked up by somebody or some group of people."

Hardly the portrait of a typical medical-missionary, Mellon seems even less like a descendant of famous American capitalists. A gentle, humble man, the only form of ancestor worship he exhibits is for Albert Schweitzer. "If nothing else, Schweitzer was practical and simple," he says. "He didn't use . . . big words. His ideas were certainly Christian ideas, yet he didn't put a tag on them." Like Schweitzer, Mellon is practical and simple and quietly spiritual. And like Schweitzer, Mellon has inspired others to emulate his example. But William Larimer Mellon Jr. was not always at such peace with the world.

Born in 1910, to May and A.W. Mellon, Larry Mellon struggled to come to terms with his unearned wealth. A restlessness characterized his youth. Prep school at Choate was tolerable but he quit Princeton after his first year. By 1935, discouraged with a sour marriage and discontent in his job at Gulf Oil, Mellon drove west out of Pittsburgh.

Ignoring the advice of the Gulf Oil experts to settle in Pecos County, Texas (later an oil-rich area), Mellon bought a large ranch in Arizona. Undaunted by hard labor, he dug wells and built fences. He rode long hours moving Mexican steers in the desert sun. Sleeping in a tent and driving an old pickup truck, Mellon was content to live a modest life that barely resembled the one he had left behind.

Then he met Gwendolyn Grant Rawson, who had moved to Arizona from New York to establish residency for a divorce and was supporting herself and her three teen-agers by giving riding lessons. Their friendship blossomed into a courtship, interrupted briefly by Mellon's service in World War II. After the war, he returned to Arizona and they were married.

Mellon invested in cattle and profited. He bought a larger ranch and built a spacious home with a swimming pool. With careful planning and a little luck, he had become a successful rancher and, more important, a self-made man. Yet somehow, it wasn't enough.

Mellon's mother had once told him that the most honorable thing he could do was to be a medical missionary. Her words must have echoed in his mind when, in 1947, he saw a Life magazine photograph of Dr. Albert Schweitzer. In midlife, Schweitzer had left a career as a world-renowned philosopher, theologian and musician to become a medical missionary. "The World's Greatest Man," as the article had called Schweitzer, triggered Mellon's thoughts: what is the societal gain in ranching, he wondered. He wrote to Schweitzer who responded with cautious encouragement.

Selling the ranch, Mellon moved his family to New Orleans. His first task, at age 39, was to piece together his neglected undergraduate education. Blitzing the premed requirements in 15 months, he enrolled in Tulane Medical School.

The Mellons used their vacations to search for sites for a hospital. They traveled to Peru, and to the headwaters of the Amazon, where they considered establishing a floating clinic. In 1952, while in Haiti to collect information for his thesis on tropical ulcers, Mellon approached Haiti's President Paul Magliore, who said he would donate the abandoned headquarters of the Standard Fruit Co. The stone cottages were still intact and the only medical facility serving the valley population of 250,000 at the time was a small dispensary.

The biggest challenge was getting the land, says Mellon. "We had to take what the government gave us. But in retrospect I wouldn't want to be anywhere else."

While Mellon finished school in New Orleans, his wife commuted to Haiti to supervise the construction of the hospital. Gwen Mellon, 75, has played a major role in the hospital ever since. Little happens at l'Ho pital Albert Schweitzer without Gwen Mellon's supervision. "She's like the Holy Spirit -- she's everywhere!" exclaims Dr. Jaime Olle', a visiting doctor from Barcelona.

Still, the problems facing hospital personnel can seem overwhelming. The director of surgery, Dr. Everett Sargeant of Ontario, Canada, begins his mornings making rounds in the wards with the surgical staff. Most of the patients who fill the hospital's 116 beds suffer from malnutrition, the stepping stone to tuberculosis, malaria, typhoid, meningitis, and scores of other diseases. "Sixty to 70 percent of what we see is based on a lack of food and water," laments Sargeant. "If we could solve those problems, we would eliminate half of our work here."

Under tall, pitched ceilings and slow-twirling fans, the staff members move from bed to bed, repeatedly murmuring, "I don't know" and "It could be that . . . " Uncertainty comes with the challenge of working in such primitive conditions. The doctor cannot rely on machines here, according to Sargeant. With no specialists to pass the patient to, "you're pushed to the limit all the time. It's scary, you squirm a lot, but if you can't handle that you're going to be the judge in the end, then you shouldn't come down here."

Sergeant pauses to console a frightened girl with a severed leg. By the time her parents brought her to the hospital, gangrene had claimed the lower half of her broken leg. The Haitians' tendency to wait too long before coming to the hospital frustrates the visiting doctor. Money, distance and lack of education often keep the patients away. Another boy had been operated on for typhoid perforations in the colon that result from drinking bad water. Sargeant shakes his head. "I asked the mother why she didn't bring the child in earlier. She said that last month she didn't have any money. She had just finished paying for his operation in 1980. Now he's back for the same thing." Often the Haitian patient first visits the bocor, the witch doctor. Charging several times the hospital's fee, the bocor performs his magic, frequently compounding the problem. Then the patient turns to the hospital.

Sargeant continues down the hall to the children's ward. Naked babies sit in the middle of the cement floor; their bloated bellies and sparse, reddish hair indicate severe malnutrition. Families huddle around the "biafran" beds, the short cots that their children sleep in. Ominous signs read: "When empty, remove this bed." A slight breeze struggles in through the screened windows; a deafening din fills the malodorous air.

Last year, 52 expatriates like Everett Sargeant volunteered to work at the hospital. Over the years, thousands of doctors and nurses have contributed their services. At one point, Yale Medical School regularly sent resident ophthalmologists for short stays. Many volunteers have returned repeatedly, and a group of them recently formed an alumni association with a newsletter and an annual reunion.

For the Haitian staff, visiting doctors from Europe and the United States are educational boons. Last year, for example, a burn specialist showed the staff how to do skin grafts, a welcome lifesaving skill since the open fires that are used in place of electricity often lead to accidents. Weekly continuing education seminars feature subjects like "Typhoid Perforations at HAS," "Low Risk of AIDS to Contacts" and "Zombie: The Secret of Haiti's Living Dead."

Education at all levels has always been a goal of the Mellons. In the early days, when the Haitians used to tie up their donkeys in the side courtyard, Mellon would show them how to care for the sores created by the crude, wooden saddles. Today, in special clinics held in the same courtyard, mothers learn about caring for infants, midwives about family planning and families about sanitation. Tattered posters remind mothers to "Bay pitit nou Vitamin A," to give their babies Vitamin A. With the 80 percent illiteracy rate, written descriptions often are useless. Homemade charts with crude drawings illustrate health issues like the linkage between illness and drinking river water.

The pervasive theme of education is most apparent in the community health department run by Dr. Roland Mercier. Raised and trained in Port-au-Prince, Mercier, like the other Haitian doctors at the hospital, is dedicated to helping his country. "In my mind," he says slowly, "if I choose to be a doctor, I did not choose to make money. I want to help my people, the Haitian people. The best way I can do it is to work in the rural country." With a staff of 130 in his program, Mercier, 28, oversees 80 health agents, seven dispensaries, a mobile vaccination team, a tuberculosis detection and treatment service, an agronutrition program, sanitary education and the construction of wells and latrines.

Community health has always been an important part of Mellon's program. "For the first three or four years, I worked in the hospital all the time just going from the house to the hospital. I began to develop some funny ideas like everyone in Haiti was sick," he says. Mellon noticed that the same diseases kept MELLON 16

Last year, 52 expatriates like Everett Sargeant volunteered to work at the hospital. Over the years, thousands of doctors and nurses have contributed their services. At one point, Yale Medical School regularly sent resident ophthalmologists for short stays. Many volunteers have returned repeatedly, and a group of them recently formed an alumni association with a newsletter and an annual reunion.

For the Haitian staff, visiting doctors from Europe and the United States are educational boons. Last year, for example, a burn specialist showed the staff how to do skin grafts, a welcome life saving skill since open fires in place of electricity often lead to accidents. Weekly continuing education seminars feature subjects like "Typhoid Perforations at HAS", "Low Risk of AIDS to Contacts", and "Zombie: The Secret of Haiti's Living Dead".

Education at all levels has always been a goal of the Mellons. In the early days, when the Haitians used to tie up their donkeys in the side courtyard, Dr. Mellon would show them how to care for the sores created by the crude, wooden saddles. Today, in special clinics held in the same courtyard, mothers learn about caring for infants, midwives about family planning, and families about sanitation. Tattered posters remind mothers to "Bay pitit nou Vitamin A . . . ", to give their babies Vitamin A. With the 80 percent illiteracy rate, written descriptions often are useless. Homemade charts with crude drawings illustrate health issues like the linkage between drinking river water and illnesses.

The pervasive theme of education is most apparent in the Community Health Department run by Dr. Roland Mercier. Raised and trained in Port-au-Prince, Mercier, like the other Haitian doctors at HAS, is dedicated to helping his country. "In my mind," he says slowly, "if I choose to be a doctor, I did not choose to make money. I want to help my people, the Haitian people. The best way I can do it is to work in the rural country." With a staff of 130 in his program, the Mercier, 28, oversees 80 Health Agents, 7 dispensaries, a mobile vaccination team, a t.b. detection and treatment service, an agro-nutrition program, sanitary education, and the construction of wells and latrines.

Community health has always been an important part of Mellon's program. "For the first three or four years, I worked in the hospital, all the time just going from the house to the hospital. I began to develop some funny ideas like everyone in Haiti was sick," he says. Mellon noticed that the same diseases kept reappearing. Once he started traveling through the countryside, he realized why: without fresh water for drinking or agricultural skills to grow nutritious foods or sanitary living conditions, the peasants were prone to life threatening diseases. Turning over the hospital operations to others, Mellon went to work in the countryside.

Providing the district's villages with drinking water was Mellon's next challenge. Every morning, after stopping in at the hospital, Mellon spent the day in the surrounding mountains, capping springs and laying pvc pipe to direct the flow down to the villages. "L'docteur", as he was known throughout the valley, asked each village to contribute to the costs; the people would be more willing to protect an investment than a donation. But Dr. Mellon never ordered lor directed the Haitians who worked with him; his knees were as deep in the mud as those of his helpers. "He was always active -- digging latrines, laying pipelines -- and always talking with an uneducated Haitian struggling for survival, treating him with the same dignity that he would the U.S. Ambassador to Haiti," says one ex-volunteeer.

Mellon added other projects to his agenda. After 12 or more years spent capping streams, lhe began to drill wells in the villages. A Texas oilman helped him to assemble a machine which Mellon and his assistants used to drill over 100 wells. At one point, he built a tile factory; the people needed better roofing supplies, he reasoned. Adding a veterinarian to the hospital staff, Mellon taught the Haitians to raise cattle; and he set up a system of tenant farming.

Whatever the role, Mellon always worked within the cultural framework. He is "very tolerant of the Haitians' way of doing things . . . except for the impact on their health," says Bill Dunn, the hospital's Executive Director. "Then he will try to change their attitudes about sanitation, about nutrition and so forth. But he always tries to . . . understand what the culture has brought into the minds of the people and why people do things in a certain way."

The recent political upheavel that resulted in the exile of President Jean-Claude Duvalier has hardly affected the hospital, other than to keep volunteers temporarily away and to disrupt patients' abilities to reach the hospital. From the beginning, Mellon made the decision to remain apolitical. "We tried to ask the government for very little," he says. Even after thirty years, Mellon still views himself as a guest in Haiti, and is there only to do his job.

Over the years, Mellon had little contact with either "Baby Doc" or his father "Papa Doc" - President Francois Duvalier, the two dicators who ruled Haiti from 1957 until last February. One Saturday during Papa Doc's reign, he recalled, he received a telegram saying: "Come to the palace. Signed Dr. Duvalier." Donning his white suit, Mellon sped off in his jeep.

"It was quite frightening, actually," says Madame Mellon. "In those days, you never knew why you were being summoned." Arriving at the palace, Mellon was told by a guard to return on Monday, that the President only sees "blancs" (whites) on Mondays. When he did return, Mellon was greeted by Duvalier, who awarded him with a medal for his service. Thanking the President, Mellon returned to the hospital and to work.

The Haitian government has traditionally recognized the need for foreign doctors, and few could argue with the success of Mellon and his colleagues. Incidences of life threatening diseases declined dramatically among the valluey's population of 165,000(CHECK THIS FIGURE). He inspired others who implemented their own ideas, like the mobile vaccination team or the health agents. With their help, he was able to eradicate neonatal tetanus; resulting from a Haitian tradition where the midwife covered the umbilical cord of the newborn with charcoal and dung, neonatal tetanus was the number one killer when Mellons arrived in the Artibonite Valley.

Over the last thirty years, Mellon said, he has copied Schweitzer's ideas as faithfully as possible "because we believed in them. As things would come up, I would say 'What would Schweitzer do?'." Yet Mellon recognized the differences between Gabon in the early 1900's and Haiti in the 1950's. "Schweitzer didn't have all the answers," said Mellon. "No one has all the answers." But he a springboard, a set of general guidelines for living.

Today, a new generation is asking themselves "What would Dr. Mellondo?" and recognition of the Mellons' work extends beyond Haiti.Each year, at Mellon's prep school, Choate in Wallingford, Ct, students fast for a day, donating the proceeds from money saved to the hospital. Recently, he and Gwen received the Family of Man award from the New York Council of Churches, an award reserved for those who expressed a commitment to improving life and promoting interracial harmony. The Mellons join a distinguished list of previous recipients that includes Bishop Desmond Tutu of South Africa and Mother Theresa of India.

But life is changing at l'Hospital Albert Schweitzer. Suffering from the debilitating effects of Parkinson's disease at age 76, Mellon can no longer be closely involved in the daily life of the hospital. So with the type of careful thought and foresight that has enabled the hospital to survive for thirty years, the Mellons are preparing for a transition.

As Mellon's health wanes, the staff grows keenly aware that Schweitzer's hospital in Lambarene nearly failed after his death. Schweitzer was a forceful personality and his death left a vaccuum. Many fear that the same thing will happen in Deschappele.

But there are conscious differences between the two hospitals. Mellon modestly centered his hospital around someone else, and he hopes Schweitzer will continue as the guiding spirit after the Mellons are gone. Also, while Schweitzer ran ever detail right up until his death, the Mellons are willing to let go of their creation. In addition to delegating responsibilities to others, they established a board of directors which, like any American corporation, governs the policy making for the hospital.

A major question, of course, is money. Through the Grant Foundation, a Pittsburgh based non-profit foundation named for Gwen Mellon's family, the hospital collects contributions and gifts of medicines and equipment. Other members of Mellon's family also have donated. But neither the Mellons nor the board solicit donations. In the future, they say, the hospital must evolve to meet a reduced budget.

But the hospital has evolved before to meet setbacks and will again. Bill Dunn, the executive director, is not worried. "The hospital is always changing to meet changing needs," he said ". . . and it's in transition in terms of the ebb and flow of the people -- the strengths, the weaknesses, the interests, and the biases -- of the people who make up the organization."

In the meantime, with the Mellons' tireless optimism and love for life as their guides, those at l'Hospital Albert Schweitzer will continue to help life where they find it.