Education: the Key to Lifesaving Programs

Haitian Run – Haitian Led: At Hands Up for Haiti, our Medika Mamba malnutrition program is an essential part of our work to ensure a healthy future for the children of Haiti. Our doctors, nurses and trained community health workers (TSKs), all members of the communities that they serve, go into the community to identify children at risk and enroll them in the malnutrition program before it is too late to save them. As with all of our programs, the fighting malnutrition Medika Mamba program is Haitian run and directed by local staff who know how best to assess the needs of the communities and have a more meaningful impact. Our Haitian leadership is supported by a US based team of experts in nutrition and pediatrics.

All of HUFH’s Haitian staff embrace this model and strive to succeed. They know that the key to their success is education, education and more education, as well as collaboration with aligned organizations. To that end, last month our entire malnutrition program team went to the offices of Meds & Food for Kids (MFK), the nonprofit organization based in Cap Haitien that manufactures Medika Mamba, the nutritional supplement we use in our programs to treat severely malnourished children.

Nurse Youselene Pierre examines a child for signs of malnutrition.

 

Mme Youselene Pierre-Louis, a nurse and one of our malnutrition program leaders, explained why this training is so important to her, to the staff and to the children and parents in the program: “The training I took at MFK was very beneficial because it makes me and each program worker more knowledgeable and also helps us include many more children into our programs. As a nurse, I know that childhood malnutrition can cause permanent damage and even death, I am filled with gratitude and a sense of achievement when I serve in this program and I manage to save children with malnutrition. And more that gives me great pleasure: we share our education with parents, and many parents correctly apply the sessions of education that we conduct at each visit to the program. Because of this we are seeing more excitement, compliance and success in our programs.”

With their reinforced skills and additional knowledge, our program staff returns to their communities, identifying malnourished children, admitting them into our programs, and helping to secure for them and their families a healthy and productive future.

Our team will continue to attend monthly education sessions run by HUFH’s in-country medical director, Dr. Rose-Laure Jeanty.

To view the class, click here.


Dr. Allison Platt: A Doctor of Distinction

Dr. Allison Platt, Hands Up for Haiti’s president and a pediatrician in private practice, has been selected as an honoree by a panel of experts for the sixth annual Doctors of Distinction Awards in Westchester County. This award recognizes health care leaders for their outstanding dedication and commitment to medicine that impact our community each and every day – “Doctors who go beyond the diagnosis.” Allison has been judged as the best in the “No land too far category.”

Allison was well-chosen for this award — for the work she does as a pediatrician, for the inspiration that she imparts to young doctors in training to give of themselves beyond the boundaries of the US, and most notably for her medical humanitarian work in Haiti.

Away from her office, Allison serves as President of Hands Up for Haiti, working to further HUFH’s mission to provide lifesaving healthcare to the most sick and impoverished people of Northern Haiti. As President, she raises awareness of how impactful it is to be a member of a grass roots organization like Hands Up for Haiti that facilitates profound and positive changes in the communities that we serve. To this end, she travels to Haiti as a volunteer trip leader, working alongside her Haitian colleagues to deliver direct care to thousands of children and their families. Understanding how vital clean water is to the prevention of disease, Allison is also the co-Program Leader of HUFH’s Community Water Project, a program that has built 13 wells to date, providing clean water to multiple local communities and thousands of Haitian families.

 

She works tirelessly with our team in the US and Haiti to help make HUFH’s vision a reality: Haitian Run + Haitian Led = Lifesaving Programs that Build a Better Future.

Allison is most proud of delivering support to members of the Haitian medical staff and providing them with education, equipment, and funding. She believes that the community-based approach is a model for other organizations trying to tackle the problem of setting up and maintaining sustainable health programs.

Closer to home, Dr. Platt has been a pediatrician in private practice for the past 13 years in Mt. Kisco, NY as part of CareMount Medical. On a day-to-day basis, she provides preventative and comprehensive care for infants, children, adolescents and young adults from birth to 21 years of age. Helping to mentor and inspire the next generation of physicians, Allison is also the Clerkship director for the New York Medical College Longitudinal Integrative Clerkship and a preceptor for their medical students.

Dr. Platt has been consistently named one of the “Best Doctors in America” since 2011. Additionally, she has been included in New York Magazine’s Best Doctors 2019 issue and previously named one of the Top Doctors – Westchester Magazine 2018 and 2018 Exceptional Women in Medicine.  

Looking ahead, Allison hopes to continue working towards a brighter and healthier future for children and their families regardless of where they are born in the world. 

Congratulations to our very own Doctor of Distinction!

 


NJ Governor’s Awards recognize Dr. Mary Ann LoFrumento and HUFH

Congratulations to Dr. Mary Ann LoFrumento, HUFH co-founder, past president and director of our Global Health Program. Dr. LoFrumento was recently awarded the NJ State Governor’s Jefferson Award for Public Service in the Ambassador Category for her work with Hands up for Haiti.

The Jefferson Awards, an official recognition program of the United States Senate, was created as the nation’s oldest and most prestigious recognition program for volunteerism and public service. Receiving a Jefferson Award places the nominee among the most distinguished individuals in America as part of our national community of service. “These individuals represent the good that is happening all around us. It is a program of ‘multiplying good’ to encourage volunteerism in America. The New Jersey Governor’s Council on Volunteerism partners with the Jefferson Awards to recognize extraordinary volunteers from New Jersey.

The Ambassador medal recognizes individuals whose exemplary volunteer service beyond the borders of New Jersey have made the world a better place.

What the Governor said about Dr. Mary Ann LoFrumento:

Dr. Mary Ann LoFrumento has worked with Hands Up for Haiti, a medical humanitarian organization, to organize and implement programs focused on women’s and pediatric health. She works with clinics to provide health screening and address vaccination, nutritional and prenatal needs. Dr. LoFrumento has worked with birth attendants and midwives on emergency care of newborns and helped design educational programs to address family planning, cervical cancer prevention and the prevention of STDs and relationship violence.

What HUFH says about Dr. Mary Ann:

Mary Ann is one of HUFH’s energetic and visionary co-founders. The award could not have gone to a more worthy, generous, energetic and compassionate person. We are so proud of our co -founder and past President, Dr. Mary Ann LoFrumento and everything she does, for her patients, residents and students, her community, her Haitian family, and for HUFH. Congratulations to our very own ambassador!

Congratulations to our very own ambassador!


Walking in Another’s Shoes-Understanding Why People Flee

What makes us care? What makes us want to help another person? What makes us want to make the world a better place? Is it empathy, compassion, or understanding? Is it learning the facts and educating oneself about the reality of another? In other words: walking a mile in another’s shoes. At Hands Up for Haiti, we believe it is all of the above and that is how we are working towards a better and more compassionate and caring world. In these challenging times when feelings are running high about what to do about families arriving at our borders, an understanding of the conditions people flee from is essential to finding humane solutions. 

 

What is so special about the Hands Up for Haiti missions is that they are truly about understanding and providing care. There is no hidden agenda beyond working together with our Haitian medical staff to deliver life- saving medical care and clean water to people who have limited access. They are also about mutual respect and building a bridge of understanding between our volunteers and the people they care for.

 

It is about watching children play despite the lack of toys, witnessing the joy of a mother celebrating surviving childbirth and holding her newborn to her breast, seeing people nourished by their spirit when there is little to eat, and communities dancing and singing in a joyous celebration of life. It is watching people love their families especially their children.

 

For our volunteers it is also learning about the “gap”. The large one that exists between people in the developed world and people in developing countries. The gap in health care: Where someone lives or dies depends on geography. They are witnesses to the horror of diagnosing a young child with diabetes and hearing they may not be able to get insulin or meeting a woman who has incurable cervical cancer and will die from a treatable disease. The gap in hunger: Having enough food or not. They may hold the hand of a child whose skin is bloated from severe malnutrition or measuring the height of a child who is stunted from lack of nutrition. The gap in clean water: Turning on a faucet or walking miles to carry a bucket of water that may carry disease and treating children suffering from diarrheal illnesses.

Our volunteers usually react with a mixture of empathy and anger. Empathy because they are holding that child’s hand or walking side by side with the women or hearing the stories through the voice of our translators. And anger because they know this is an injustice and struggle with the question of “why” and what can be done.

A HUFH volunteer can never forget what they experienced and learned working in Haiti and they begin to understand the reasons people flee their homes to find a better life or even just to survive. When they witness the extreme poverty and childhood mortality that every family in Haiti faces, they can also begin to understand what is happening in the rest of the world as people flee extreme poverty, violence, and war.

 

At HUFH, we heal, we teach and we support life-giving health programs that meet the needs of the present generation and pave the way for a healthy and safe future for all Haitians. Our programs are community based, led by Haitians for Haitians, giving families an incentive to stay at home rather than flee.

Every volunteer may not walk in another’s shoes, but they do follow another’s footprints and begin to understand what life is like for the millions of people around the world who live in poverty. This is how we will leave a legacy of impactful programs and how we hope to build a more humane and compassionate world.

 

 

 

 

 

 

 

 

 

 

 


Recap: HUFH’s Annual Gala in Honor of Dr. Jill Ratner!

Hands Up for Haiti (HUFH) is proud to have honored Dr. Jill Ratner, co-founder of HUFH and a devoted medical humanitarian, and to celebrate the positive impact she has had on the lives of countless children and their families both here and in Haiti, at its Annual Celebration Dinner on March 23. Jill, who has served as HUFH President and is currently its US Medical Director, is dedicated to ensuring quality health care to those in Haiti who otherwise have no access to doctors or life-saving care, and to ensuring the sustainability of HUFH programs by collaborating with our staff in Haiti to provide necessary tools, education and support for the Haitian medical community as they deliver direct care and by spearheading a community health worker program.

The evening was our most well-attended and successful ever, both fun and informative, featuring lively music, delicious food, a fun and engaging auction, and dancing -- all with a Haitian flair. Guests attended from far and wide: staff and supporters from Haiti, including our immediate past in-country Executive Director, Dr. Manol Isac and his family, members of the Cap Haitien Health Network, represented by Dr. Ted Kaplan and his wife, Elisabeth, Jill's colleagues from CareMount Medical, her co-residents from Babies Hospital, and volunteers, family and friends from all over the country.

Guests were treated to a video created by Flying Dreams Productions and narrated by Dr. Mary Ann LoFrumento, also a HUFH co-founder (and Jill's co-resident in training), highlighting Jill's vision in helping to create and grow HUFH, the work that Jill has done on the ground in Haiti and the work that our organization, Haitian staff and program leaders, and volunteers do to improve lives in northern Haiti by implementing and improving life-saving health care programs. Click here to view the video and enjoy a taste of the evening.

Jill spoke about how our organization continues to make a lasting difference in Haiti nearly 10 years after its founding, and the need to give back and the joy of doing so -- to make a difference. She also spoke of the evolving mission of the organization as we have transitioned from sending visiting teams focused on delivering care to instead delivering lasting impact through our Haitian led, Haitian run programs and ongoing support of the Haitian medical staff.

Dr. Allison Platt, HUFH's current President, shared with us a story from the first trip that Jill led in 2010 - the beginnings of HUFH. Jill's team was sitting in a Tap Tap, a Haitian taxi bus, when the roof began to cave in, so collectively Jill and her group of volunteers lifted up their hands up to lighten the load: Hands Up for Haiti got its name!

Dr. Wendy Marx, HUFH Vice-President and Gala Chair, presented Jill with a painting by Thermitus Jean, our enormously talented in-country executive director, of Jill surrounded by some of the Haitian children she helped. We also created for Jill a memory book of her years in Haiti, which included personal notes from volunteers, staff, and patients, both here and in Haiti.

Finally, we heard from Samson Desamours, a Haitian volunteer who Jill met on her first trip, about the direct impact that Jill and her work have made on him and all of his Haitian neighbors.

Contributing to the enormous success of the evening were the generous event sponsors and Champions for Children. We thank them all and urge you to support those who support HUFH. To see the full list, please click here. Special thanks to photographer Randi Childs and auctioneer Jamie McDonald.

Allison quoted a Haitian proverb: "Men anpil chay pa lou," which means "many hands (make) the load lighter." To both those who joined us on March 23, and those who weren’t able: While there is so much to do to improve the quality of health care in Haiti, we appreciate your generosity and your willingness to stand with us as we work hard to make a difference in the lives of as many Haitians as we can.  Please lift your Hands Up for Haiti and stand with us as we follow Jill and her co-founders' path and make a lasting impact for the most vulnerable children and their families in Haiti!


Haiti’s Clean Water Problem and What We are Doing to Fix It

There are so many health and medical-related challenges in Haiti that it is often hard to prioritize who and what to treat. While the problems are numerous, the funds needed to tackle them are lacking.

Malnutrition, clean water, helping mothers and children severely lacking in basic medical care – these are just a few of the mounting health issues that continue to plague this island nation.

But, as Mahatma Gandhi once famously said, “Action expresses priorities,” so I’ve chosen to focus my efforts on building water wells.

Just a few short years ago, we launched the Hands Up for Haiti Community Water Project to bring clean water to remote communities and to educate on water safety and cholera prevention. Our goal is to reduce illness by providing access to clean water for thousands of Haitians for many years to come.

Pumping water – the gift of life!

The program launched with tremendous success but we are at a crossroads and we need your help to sustain the effort. We have only built 11 wells to date; so many more communities are still without access to clean water.

With just a small donation from you, we can sustain the community water project and ensure more and more Haitians receive its life-saving benefits. In fact, each well costs only $3,500 to build and maintain, providing 4,000 people with access to clean water for 35 years!

Moving forward, I will keep you posted on the growth of the program. During the water team’s most recent trip to Haiti this month we worked with our in-country liaison to identify a new well-site in Dondon, a remote village with little access to health care other than the programs that HUFH offers to fight malnutrition among children and hypertension in adults. We will continue to report back then on the latest developments.

The future is theirs: teaching water safety to the next generation


Is It Enough to Save One Life? The Miracle of Hermano – The Heartbreak of Those We Reach Too Late

Returning to Haiti always fills me with mixed emotions. The opportunity to make a difference and positively impact the health and lives of individuals that have so few opportunities to access medical care is an exhilarating feeling for a doctor. The chance to reunite with old team mates, to see the experience through the eyes of first timers, to tell the story once again of some of the amazing life experiences that have occurred on previous trips and to know that something will happen this week that will be equally as powerful keeps me coming back for more. The biggest draw of course is seeing the Haitian people once again: the individuals that you know, that have become a part of your lives, the children you have watched grow, the faces in the crowd that wave to you either recognizing you or not, but just glad to see you there.

Then there is the apprehension- knowing that we will see patients with ongoing illnesses that can’t be cured in a day, examining once again other patients I have followed from afar, working to make sure they got the care they needed while being 1000 miles away, patients having limited resources, struggling through barriers of language, money, illness and lack of ability to negotiate the frail system of health care in Haiti, and the patients who we get to too late.

For me the story is always complicated and fraught with emotion and challenges. On my previous trip to Haiti one year ago, I saw three critically ill patients, two boys with advanced bone infections, each of whom had been sick for months before the team arrived, one also suffering from severe malnutrition. The third patient was a nine-month old boy, who weighed nine pounds, the size of a two month old in the US. His heart was pounding out of his chest; he suffering from acute malnutrition and was in cardiac failure. His mother had a blank stare on her face, no expression, as if she couldn’t think or do anything about her son’s condition. And she was right. Without cardiac surgery this child would not survive. I looked her in the eye, and through a compassionate translator I told her this was the day we could save her son’s life. What we did that day would be the deciding factor.

9 months old Hermano in the hospital

I’ve gone to Haiti many times in the last seven years. I have seen many sick children. Some get better before the week is out. Some are placed in our malnutrition programs, and some are hospitalized as these three children were. Because of our partnership with Sacre Coeur Hospital, we were able to speak directly with the physicians and ensure the best care possible for these three boys. They would get care. Outcome is less certain.

Fast forward. Within one month of being seen by our team, one of the boys died of sepsis, a fulminant infection. The other died in the operating room. I was heartbroken for them and their families: children should not die. But we had gotten to them too late. Their disease was so advanced that treatment and survival was not in the cards. Only Hermano, the little cardiac baby with the ventricular septal defect, remained.

It took ten months, many trips to the hospital, delays because of anemia, and then a diagnosis of tuberculosis requiring nine months of antibiotics. It took all the efforts of Dr. Mary Ann LoFrumento, HUFH’s President and a US pediatrician, and Dr. Dieula Toussaint, HUFH’s in-country malnutrition program medical director, to ensure this child got ongoing care, and arrange for a partnership between Hospital Universite in Mirebelais and Haiti Cardiac Alliance to get him the care he needed. Not only did we need to address Hermano’s other health issues before he could have his surgery, but a birth certificate for Hermano and a passport and visa for both mother and child needed to be obtained. Dr. Manol Isaac, our in-country Executive Director, facilitated this with help from the Director of the Ministry of Health in the North, Dr. Ernest Jasmin. Hermano and his mother were flown to the Cayman Islands in April of this year, surgery was successful and he returned home soon thereafter.

Exactly one year after I first told Hermano’s mother that we would help, I stood in the same spot in our small clinic in Shada and again saw this mother and this child, but I did not recognize either one. The mother was smiling, appearing well, and her eyes glimmered as she showed me Hermano, a now thriving child, able to kick and scream the way most toddlers do when they see a pediatrician.

Is it enough to save one life? I really don’t know the answer to that, but I know that it feels right. In this world so much is out of our control, the hardship and inequities of rich and poor, those who benefit from health care and those that do not.

Because of the story of the two boys who died, Hands Up for Haiti has committed to having programs at the remote site of Dondon where those two boys lacked care for so long, and perhaps future children will not suffer the way they did. We continue to work to improve care to those who might not otherwise be reached.

For Hermano, our little boy with a whole in his heart, that hole is fixed. As a group, the best of humanity came together and saved this boy from certain death.

THE SURGICAL CARE AND HOSPITALIZATION FUND SAVES LIVES

Donate

Please reach out with your hearts and your dollars to make the care of these children possible.

Hands Up For Haiti is a recognized 501(c)(3) organization, and your entire donation is fully tax-deductible to the fullest amount allowed under the law.

If you would like to do more, please also share this page or send it to someone you think might want to help support these efforts.

Mesi anpil – Thank you very much for all your support.

 


Judy McAvoy: In Loving Memory

The Hands Up for Haiti family is deeply saddened to announce the passing of Judy Rhineschmidt McAvoy, our dear friend and a founding member of HUFH. Judy served on the Hands Up for Haiti Board of Directors since its inception and was an active trip leader and program director.

Judy was a registered nurse whose career was devoted to children and mothers. After the devastating earthquake in Haiti in 2010, Judy went on our inaugural trip to Haiti to administer medical care to communities that had never before received care. Since that time, she traveled back to Haiti several times each year. Judy spearheaded programs to further educational opportunities with Haiti’s nursing schools and students, and worked tirelessly to improve newborn survival by promoting breast feeding and teaching Helping Babies Breathe, newborn resuscitation skills, to traditional birth attendants.

Judy was beloved by our staff in Haiti. Dr. Manol, our in-country director, summed up the feelings: “Nurse Judy was a model by her inspiration and how she encouraged the people to do well. I feel the same inspiration to let you know how much it’s important to manifest desire and do actions to love each other and help the people who count on us which was almost the whole mission of my dear Judy.

This past year she was honored by Hands Up for Haiti for all of her contributions, surrounded by all who she inspired, including many nurses who had traveled to Haiti with Judy on the first nursing education mission. Fellow nurse Hope Bechard said, “Judy always told us to dream big. She was the nurse that you met once and thought, ‘I wish I could be half the nurse she is.’ She will be remembered by so many nurses and nursing students that she has inspired along the way and her memory and light will continue to shine through each of us as we work in this profession.”

Judy was an amazing, dedicated person who was an inspiration to us all. We will miss her passion, quick wit and the smile that lit up a room each time she held a baby in Haiti. Judy’s passing leaves a hole in our hearts, but her legacy and spirit will live on in the many people of Haiti who she has helped, especially the mothers and children.

Judy is survived by her husband of 43 years, Jim, her two sons, Tim McAvoy and Brendan McAvoy and his wife DeAna, her daughter, Erin Gallagher and her husband Jason. She is also survived by the love of her life, her grandson Archie, as well as her three sisters, Linda Jaffe, Nancy Martone and Katie Cassell. We extend our deepest condolences to the entire family.

Judy’s family has requested that for those who wish to honor Judy’s memory, and in lieu of flowers, to please make a donation to Hands up for Haiti in her name.  To read more about Judy’s amazing life, here is a link to her obituary.

 


Worth the Wait: The Journey of the Ultrasound

A young woman lies on the examining table, anxious and unsure. She tested positive for pregnancy, but after being seen at a local clinic, she was diagnosed with an ectopic pregnancy, a potentially life-threatening situation when an embryo implants in the fallopian tubes rather than the uterus.

She sought help at Justinian University Hospital and arrived at the OB-GYN clinic where Dr. Nelly Osias, a dedicated obstetrician and gynecologist who heads HUFH’s cervical cancer program, and Dr. Cyril LeConte, the head of OB-GYN at Justinian, were training residents on the use of an ultrasound machine. They used the machine to examine the woman; as the images became clear they revealed something unexpected, with much better news for this young woman.

The ultrasound machine is an amazing tool used routinely in the US and other developed countries. It is a piece of equipment precious and rare in Haiti, and this particular one, a portable ultrasound able to be moved to the bedside of any patient, was donated through the efforts of HUFH. But like many things in Haiti that take time and effort before they produce good results, this machine took a journey of its own, a journey that took 18 months from the time it arrived in Haiti until it was in the hands of the doctors at Justinian, who in turn used it to help our young patient.

In November 2015, Dr. Judy Banks, an attending obstetrician/gynecologist at Morristown Medical Center in New Jersey, generously donated this ultrasound machine for use in the early – and frequently life-saving – diagnosis of problems during pregnancy.

Dr. Judy Banks conducts training on ultrasound techniques.

Doctors from Justinian University Hospital.

 

 

 

 

 

 

 

Dr. Banks led a HUFH mission to Haiti to donate the machine to our partner hospital Justinien University Hospital, a government run teaching hospital, and to hold workshops on prenatal ultrasound techniques. The mission was a great success and more than 30 doctors took part in the workshop. The donated ultrasound machine was placed in the care of Dr. LeConte.

Dr. Nelly Osias, Dr. Cyril LeConte, Dr. Judy Banks, Dr. Liza Lizarraga, and Dr. Manol Isac.

The team left Haiti believing that all was well and they had done a good thing. The ultrasound machine would immediately begin to help the doctors recognize breech pregnancies, or twin pregnancies, and also to help a mother know how long she had been pregnant and when the baby is expected.

But after a few uses, a computer software problem occurred, rendering the machine inoperable. Despite efforts in Haiti and in the US to correct the software problem, the machine needed to be returned to be re-programmed by the manufacturer. Our in country team went into action and when the next HUFH team arrived, they delivered the machine to Dr. Chris Raab, an attending at Nemours Children’s Hospital heading a HUFH pediatric global health team. He picked up the machine and brought it back to Delaware. Dr. Mary Ann LoFrumento, HUFH President, traveled from New Jersey to Delaware to retrieve it. Then Dr. Banks contacted the manufacturer and sent the machine to be repaired. The tech staff fixed the software and updated it just in time for Dr. LoFrumento to bring it back with another pediatric Global Health team in May 2016.

Dr. LeConte and Dr. LoFrumento

Nothing in Haiti is ever guaranteed to go smoothly. Dr. LeConte was thrilled to have the machine back and celebrated how well it was working with Dr. LoFrumento, but the machine could not be put to use: Justinien, like all public hospitals in Haiti, went on general strike while the ultrasound machine was being fixed in the US, as doctors fought for better wages and better conditions for their patients. Dr. LeConte said he would safeguard the machine in his office until the strike was over.

It was not until earlier this year that the strike ended with the government acknowledging the poor conditions at the public hospitals and vowing to help the situation. The strike had caused a great deal of hardship in the country but the doctors and nurses knew they had to fight for better conditions and better pay. Patient care resumed at Justinian and the ultrasound machine was finally where it was supposed to be: in the hands of the residents at Justinian under Dr. LeConte’s supervision, where it is already helping to save lives.

On this day, Dr. LeConte and Dr. Osias did not accept the previous clinic’s diagnosis. After viewing the ultrasound results, they decided it might not be an embryo in the fallopian tubes but rather a cyst in her uterus (a false pregnancy result because of the hormones produced). The patient was admitted and a procedure was done to remove the cyst. She left smiling and relieved of pain as well as anxiety.

Like many things in Haiti, the ultrasound took a long and arduous journey before it ended up in the right hands. But the volunteers and staff at HUFH do not give up! Sometimes it takes a while to achieve something . . . . but with persistence, dedication, creativity and a bit of heavy lifting, the whole village accomplishes the task.


Global Health Education: Leaving Something Behind and Taking Something Home

Children in orange and plaid school uniforms with hair neatly parted in matching bows shout “blanc, blanc,” and wave at our rickety van as we pass. Palm trees grow at the road side along with banana trees and rows of cactus bushes displaying that afternoon’s clean laundry. Locals push wheelbarrows full of coconuts or steer their donkeys carrying lumber. Goats and chickens mill around in vast green fields leading up to lush mountains.

 

In February 2017, I had the opportunity to travel to Haiti with a team of pediatric residents from Alfred I. DuPont Hospital for Children to provide medical care for children in partnership with the organization Hands up for Haiti (HUFH). HUFH is a medical humanitarian organization working to create a sustainable health care system in northern Haiti through building partnerships with local community and medical leaders, and visiting medical teams. With programs in maternal child health, malnutrition treatment and prevention, and clean water and pollution initiatives, among others, local teams and visiting providers collaborate to deliver care and support communities in remote areas

Dr. Tamar Goldberg (second from the left) with Dr. Chris Raab (fourth from the left) fellow team members and in country HUFH staff.

Based in the rural sea-side fishing village of Bod Me Limbe, each day we travel to surrounding schools, churches, clinics, and even living rooms, to provide pediatric care to children. We pass taxi pickup trucks brightly painted with religious slogans like “c’est mon destin” (“this is my destiny”) and motorbikes overflowing with 5-6 children each, shuttling them to and from school.

At our work sites, children gather outside on benches and wait first-come, first-serve to be seen. We unpack our traveling pharmacy of antibiotic, antiparasitic and antifungal medications for diagnoses ranging from skin infections (mostly tinea and scabies) to gastroenteritis, rheumatic fever, headaches and skin burns.

Children with pneumonia and ear infections get standard dose antibiotics without concern for antibiotic resistance, and all kids are given hand-prepared baggies of multivitamins. Suspecting hepatitis and heavily reliant on my physical exam, without ready access to imaging or laboratory tests, I prop children across their mothers’ laps to palpate for hepatosplenomegaly. I treat empirically for malaria in a little boy with fever, body aches, scleral icterus, hematuria, decreased appetite, and hepatosplenomegaly. I see my first case of chicken pox (since I don’t remember much about my own personal itchy experience at age 4).

Children with bloated distended abdomens, vague generalized abdominal pain, and decreased appetite get deworming medication. So much of the illnesses Haitian children face are related to poor water sanitation, with 1 out of 10 Haitians lacking access to a clean water source and 1 out of 3 lacking access to a proper toilet. 1 out of 9 Haitian children die before the age of 5, with almost 20% of the deaths related to illnesses caused by unclean water.

Through translators, we counsel families about purifying water through boiling, chlorination tabs or iodination. We discuss dental hygiene, swimming safety, fire safety, breast feeding, nutrition, and guidance about when to seek higher levels of medical care. We coordinate a sexual education program for local teenagers, providing counseling about pregnancy and sexually transmitted infections – answering many questions about HIV and, yes, you can get pregnant even if you have sex in the ocean. I check weight-for-height z-scores and refer children to the HUFH malnutrition program through which children receive Medika mamba, a peanut-based ready-to-use therapeutic food distributed worldwide to treat pediatric malnutrition.

Millions of children around the world do not reach their developmental potential because of the influence that chronic poverty, poor health, and inadequate nutrition have on early childhood development. Children in Haiti are faced with a disproportionately high number of risk factors that predispose them to neurodevelopmental disability, including neonatal infections, malnutrition, malaria, anemia, and other social determinants of health.
As part of my work in Haiti I pilot a developmental assessment tool designed specifically for the local Haitian pediatric population. This developmental project will be an ongoing partnership with HUFH, as we work together to create an appropriate measure that could one day be used as a screening tool for high risk children who need additional support to reach their full developmental potential.

 

Through the HUFH global health elective, you not only have the opportunity to work closely in partnership with the local Haitian medical team, but you are granted a unique integrative cultural experience as well. After work each day, we return to the village to play clapping games and Frisbee with the eagerly awaiting local kids. We attend a voodoo dance party, a celebratory wake in honor of a recently deceased village elder, practice Creole with the locals, and watch from the shore as teenage boys cast their fishing nets off the sides of their boats to catch that night’s dinner. In the evenings we discuss ethics, barriers to care, quality improvement efforts, and review nutrition and infectious disease medical curricula.

A key part of the HUFH mission is to train a future generation of doctors and nurses to deliver effective health care in a country with limited resources. My work in Haiti was not my first exposure to health care in an underserved area – with a specific interest in global health, and previous experiences in Haiti, Uganda and Ghana, I am dedicated to working with others to improve the access and quality of pediatric care around the world; such a goal can only be achieved through partnership with local communities.

Through global health I have developed an increased awareness for health care inequity and the social determinants of health; with each experience I gain valuable skills in the clinical art of medicine, preventative care, public health, research and education. I look forward to collaborating with HUFH throughout my career as the Haiti developmental assessment project evolves and as we work to inspire others to broaden their impact to the global community.

Tamar Goldberg, MD is a second year pediatric resident at Alfred I. DuPont Hospital for Children. She will be starting her subspecialty training in pediatric neurology and neurodevelopmental disorders at Boston Children’s Hospital in July 2017.