Hurricane Matthew Relief Efforts: Saving the Children

When disaster strikes a place like Haiti, the first impulse as a medical humanitarian organization is to rush a team to help out on the ground or send lots of supplies without knowing if they are really needed. But there are many ways to help in a disaster and one of the best ways for a nonprofit like HUFH is to find a partner on the ground already involved in the affected area. Thanks to the Cap Haitien Health Network, HUFH was connected to No Time for Poverty (NTP), the nonprofit organization that runs the Klinik Timoun Nou Yo (Kreyol for “Our Children’s Clinic”) in Port-Salut on the southern coast, an area devastated by the hurricane with over 85% of the homes either destroyed or damaged.

Damage in Port-Salut in the South

Damage in Port-Salut in the South

Destruction in Port-Salut in the South

Homes destroyed in Port-Salut

 

 

 

 

 

 

 

The clinic roof post-hurricane

The clinic roof post-hurricane

Klinik Timoun Nou Yo is the only pediatric center in a large area serving 60,000 people. NTP’s mission is very similar to that of HUFH: “to provide children living in poverty with accessible, affordable, high quality medical care.” Michele Boston, NTP’s Executive Director, who was in Haiti immediately after the hurricane, just returned and reports on the impact that this help – made possible by the generosity of our donors and volunteers –  has made on the clinic and the community that it serves. With the help that we sent, NTP has been treating acutely malnourished babies and children.

Michele reports:

We have been operating with a full staff despite the fact that so many lost their homes. We have been providing food and clean water to our staff to at least lessen that burden.

Klinik Timoun Nou Yo (KTNY) was the first beneficiary of aid from outside organizations because we were the only anything up, running, and attending to the hundreds of children needing immediate care. . .

The clinic back in operation.

The clinic back in operation.

Our greatest need is feeding young children who cannot benefit from the food relief programs which are mainly aimed at feeding adults. Childhood malnutrition is rampant, even in babies under 6 months. In light of this, we focused our efforts in securing Medika Mamba for older infants and toddlers and nutritional supplements for babies.”

As we all know, there is no substitute for breast feeding as mother’s milk contains the most nutrients for baby and is the perfect baby food. Like HUFH, KTNY adheres to and promotes this practice: breastfeeding counseling is paramount in its well baby clinic and, in support of this training, KTNY actually bans baby bottles at the clinic. Michele reports, however, that particularly as a result of the hurricane, there are a significant number of babies who have no access to mother’s milk. This can be due to a number of factors: a mother may not produce milk, or might have inadequate quantities of milk for various reasons. In Port-Salut, there are many infants who are living with a caretaker rather than a biological mother.  The trauma of the hurricane did not help. Michele told of one breastfeeding mother who was so terrified by the Hurricane that her milk dried up. These babies need baby formula for their very survival.

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Thanks to the amazing outpouring of help from the Hands Up for Haiti community of donors and volunteers, KTNY is now able to fill this critical gap, supplementing donations of medika mamba for children over one year and purchasing formula in country.  As Michele said:

“That’s a lot of baby food! That’s a lot of nourished babies! We are overwhelmed by HUFH’s willingness to share funds. We promise to use them wisely and well. We send hugs and appreciation to Hands Up For Haiti!”

We join Michele in thanking each and every one of you again!

To support our hurricane relief efforts and our malnutrition programs, please click here.

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Liza and Nelly: A partnership (and friendship) to help save women’s lives.

Dr. Liza Lizaragga was in her last year of residency at Morristown Medical Center in New Jersey when she traveled to Haiti for the first time last November with HUFH. The focus of the mission was to donate two portable ultrasounds to our partner hospitals and hold workshops on prenatal ultrasound techniques. Dr. Nelly Osias, who was completing her OB-GYN training at Justinien Hospital in Cap Haitien at the time, was one of the residents who attended the workshop.  As soon as Dr. Liza began her presentation, it became clear that the translator was not up to the task of translating the technical medical material.  Dr. Nelly jumped right in to help. The two young women doctors worked together for the next two days; an immediate and important bond was formed between Liza and Nelly that would lead to an incredible effort to save the lives of women in Haiti who were dying unnecessarily from cervical cancer.

Nelly, on the right, jumps in to translate as Liza, left, lectures

Nelly, on the right, jumps in to translate as Liza, left, lectures

Sharing ultrasound skills and techniques: From left to right: Liza, Dr. Dieula Toussaint, HUFH physician, xxxxxxxxx, and Nelly (seated)

Sharing ultrasound skills and techniques: From left to right: Dr.Liza and Dr. Nelly (seated) demonstrate the ultrasound machine.

 

 

 

 

 

 

 

 

Liza and Nelly realized they had much in common. Liza explains, “We both grew up and trained in a developing country [Liza in Panama and Nelly in Haiti] and fully understood the struggles and health challenges that women, particularly those in developing countries, have to deal with on a daily basis.” After Liza returned to the US, the two continued to correspond, sewing the seeds for a collaborative cervical cancer project between Hands Up for Haiti and Haiti sans Cervical Cancer.

Cervical cancer is a deadly disease that if identified at an early stage can be prevented. Haitian women are at a disadvantage because their access to health care and basic screening modalities is limited. In the developed world, a PAP screening test and access to HPV vaccines have made this a rare cancer. In Haiti, it is the leading cause of death from cancer for women. Nelly and Liza realized this is an area in which together they could make a significant impact on the lives of many Haitian women and their families.

Nelly (left) and Liza

Nelly (left) and Liza

Nelly adds: “During my training and my days of practice on cervical cancer screening I have received a lot of patients with different problem and dramatic situation. Some of them have been diagnosed at an early stage. Some others unfortunately have been diagnosed in advanced stages due to lack of information about the problem. A woman, age 55, came to me with advanced cervical cancer.  All we could do was give her medicine for pain. She is mother to seven children.

Together with the help and support of Hands Up for Haiti and its benefactors they worked for nearly a year to establish a cervical cancer screen and treat program. In July, Liza returned to Haiti to work with Nelly and to continue the planning. They held a one day screening program and saw nearly 50 women.

Through collaboration and an ever-growing bond of professional respect and personal friendship, Liza and Nelly, under the auspices of HUFH and in partnership with Haiti Sans Cervical Cancer and GODOCGO, have just launched a small but very busy cervical cancer screening clinic in the town of Limbe in Cap Haitien. The plan is to screen 3000 women this year at this clinic site alone.

Dr. Nelly added:  “Our hope is to prevent those [advanced] cases by reaching out to all the women in this country in order to help them with necessary knowledge about gynecologic cancer and screen them on time to avoid such disaster. If we can set clinic for screening as well as reaching out through churches and other social group we can save our Haitian ladies. At first we will still have advanced cervical cancer stages because of the depth of the problem. However by working and teaching our ladies we know that will decrease considerably the severity of this problem. This will be possible by our willingness to help and with support of others since our country has limited resources.

Liza and Nelly in front of the new clinic in Limbe.

Liza and Nelly in front of the new clinic in Limbe.

Liza and Nelly: Support, Collaboration and Partnership to save women’s lives and develop a sustainable health care system in northern Haiti.

Follow our blog for more on the launch and implementation of the Cervical Cancer Screen and Treat Program and our partnership with GODOCGO to help make this happen.

About Liza and Nelly:
Dr. Liza Lizarraga graduated from the Universidad Latina de Panama in the Republic of Panama. She moved to Morristown, New Jersey to complete her residency training in Obstetrics and Gynecology at Morristown Medical Center-Atlantic Health System. She also has a Masters Degree in Public Health from Columbia University in New York City and currently works with Hands Up for Haiti, running the cervical cancer screening program, which aims to see and treat early cervical changes that could lead to cervical cancer in under-served women in Cap Haitien, Haiti.

Dr. Nelly Osias graduated from Escuela Latino Americana de Medicina in the Republic of Cuba. She returned to Haiti where she immediately completed another one-year study in integral and general medicine with the Cuban physicians in mission in Cap Haitian. She then completed her residency training and is presently working in OBGYN at Justinien hospital. Willing to reduce the incidence of cervical cancer, she is now working with Hands Up for Haiti in screening and treating early cervical changes in women in the North of Haiti.


A Donor’s Reflections on Her Impact in Haiti

I recently had the opportunity to go on a volunteer medical mission to Haiti with the nonprofit organization Hands Up For Haiti. This trip gave me the opportunity to combine my 25 years’ experience as a Registered Nurse with my role as Executive Director of the nonprofit organization Positive Legacy in an incredibly meaningful way.

I traveled with a team of doctors and nurses from the USA to deliver a week of direct patient care in northern Haiti. We were based at the Haiti Village Health clinic in the rural Bas Limbe region, one of two established clinics supported by Hands Up for Haiti. The Haiti Village Health clinic, originally opened in 2008, serves 30,000+ people, half of whom are children, living in 16 villages located within a 10-mile radius.

Clinic at HVH

Outreach clinic in the Bas Limbe region

While at HVH, we held pediatric outreach clinics together with a team of Haitian health care workers in several remote villages.

 

 

 

 

 

Waiting to be seen at the clinic in Shada.

Waiting to be seen at the clinic in Shada.

Our team spent our last clinic day at the second HUFH supported clinic located in Shada. The community of Shada, home to about 25,000 Haitians, is the city of Cap Haitien’s most impoverished area.

 

 

 

 

The nonprofit organization I work for, Positive Legacy, has provided $27,500 to Hands Up for Haiti and Haiti Village Health through a series of two grants in 2012 and 2015. Prior to the first grant this clinic did not have running water, adequate sanitation or reliable electricity. Positive Legacy provided $9,000 to the clinic in 2012 for the installation of a plumbing and septic system, flushing toilets and handwashing stations.

Viewing the water wells in Bod me Limbe

Consulting with a local engineer on the status of the water wells in Bod-me-Limbe

It’s hard to imagine that this clinic treated over 10,000 people during the cholera outbreak in 2010 without running water. Last year we were able to assist the clinic again with an $18,500 grant for the installation of a solar electric system. The clinic now has reliable electricity 24 hours a day, 7 days a week, allowing them to provide care with adequate lighting at any time of the day or the night.

 

 

The impact: The medical staff is now able to see patients, perform life-saving surgeries and deliver babies with adequate light even at night. For me personally, to be able to visit HVH and see the lives that we touched through Positive Legacy’s donations to HUFH, and to visit the clinic at Shada and see the care the staff delivered to those who might not otherwise ever get medical attention, reinforced for me the belief that we can make a difference, one person at a time.

Some staggering statistics about Haiti, the poorest country in the western hemisphere, where the population is approximately 10 million:

  • 59% of the population lives on less than US$2 per day
  • Life expectancy is 57 years
  • Infant mortality: 55 per 1000 births, compared to 6 per 1000 in the USA
  • 59 per 1,000 born in Haiti die before reaching their first birthday
  • An estimated 1 in 285 births will result in a woman’s death, a ratio about 16 times higher than in the United States
  • Prevalence of malnutrition (moderate to severe) is 22%
  • Only one-fourth of the population has access to safe water
  • In short, the overwhelming majority of the Haitian population is living in deplorable conditions of extreme poverty.

Over the course of the medical mission we provided care to hundreds of men, women and children. The most common problems we encountered were skin diseases, gastrointestinal illness, malnutrition, malaria and an array of other conditions.

The needs in Haiti are vast, and it’s easy to become overwhelmed when you are looking at mountains beyond mountains. The power is in knowing you can touch one life at a time, and that being human and open is all it takes to make a difference in the lives of others. Our grants have made a vast and positive difference in the lives of so many Haitian men, women and children. After witnessing personally the direct care that Hands Up for Haiti delivers in Haiti, the teaching that it accomplishes and the support that it gives the Haitian medical community, Positive Legacy has awarded additional grants to Hands Up for Haiti for work at Shada, Bas Limbe and elsewhere.

Making friends with Madame Bwa, the midwife at Shada

Making friends with Madame Bwa, midwife and community health worker at Shada

Hands Up for Haiti welcomes volunteers for their service trips to Haiti, and you don’t have to have a medical background to join them on a mission. Everyone has something unique and valuable to offer. I strongly encourage anyone that’s interested in giving a week of their time to the people in Haiti to consider this opportunity. You can check out Hands Up for Haiti at http://www.handsupforhaiti.org/

For more information on Positive Legacy, please visit our website at http://positivelegacy.com/

With thanks from Hands Up for Haiti

Dr. Manol Isac, HUFH incountry Executive Director and Dr. Mary Ann LoFrumento, HUFH President, presenting me with a plaque expressing thanks for the Positive Legacy grant


Hurricane Matthew: HUFH Responds

The extensive devastation caused by Hurricane Matthew as it crossed over the southern peninsula of Haiti last week has turned out to be much worse than originally feared. Over 900 people have been confirmed dead. Roads are washed away, farmlands destroyed just as they were ready for harvesting, and water sources are at high risk of contamination. The number of cholera cases is rising dramatically. Food is in short supply. Hospitals and clinics are receiving large numbers of injured and are low on supplies. 300,000 people have been displaced. And in some towns, 80% or more of the homes are destroyed. Because of damage to a major bridge on the highway, movement between the southern peninsula and the rest of the island is limited with aid arriving by helicopter and by ships.

Thankful that our clinics and staff in the north were spared, HUFH’s response to the devastation caused to Haiti’s southern peninsula by Hurricane Matthew is two-pronged and simple: shore up our own programs in anticipation of increased need in the north where we work, and provide direct help to organizations in the affected areas in the south.

Providing Direct Help to the South: Using funds raised through our emergency hurricane appeal, Hands Up for Haiti is providing direct financial aid to No Time for Poverty (NTP). NTP’s mission is very similar to that of HUFH: “to provide children living in poverty with accessible, affordable, high quality medical care.” To that end, NTP runs the Klinik Timoun Nou Yo (Kreyol for “Our Children’s Clinic”) in Port-Salut on the southern coast; the clinic is the only pediatric center in a large area serving 60,000 people.14502743_1078540212222426_8812988272212471262_n

The ED and founder of NTP, Michele Boston, just returned from Haiti, describes a devastating situation in the area served by the clinic. They are treating a lot of children with infected wounds, pneumonia and diarrhea. 85% of the homes in the area were destroyed, the water supply is becoming contaminated, there is little food available, medications are in short supply: everything we would expect after a disaster like this. NTP’s staff survived, although many lost their homes; NTP has been providing them with water purification tablets, shelter and food. Notwithstanding their personal losses, the staff came in immediately after the hurricane and made necessary repairs sufficient to re-open the clinic last Monday, and they have been open daily with a steadily rising number of patients. They are currently repairing their water filtration system, making certain to include a spout for community use. Based on what they have seen since the clinic re-opened, and the condition of the water and food supply, they expect to see a sharp increase in malnutrition and cholera, as well as infections caused by untreated injuries.

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Photo by Jason Beaubien/NPR

AP Photo/Rebecca Blackwell

AP Photo/Rebecca Blackwell

 

 

 

 

 

 

The clinic is in great need of oral rehydration packets and antibiotics to fight cholera and infection and nutritional supplements for babies and children. NTP has an established network to purchase the needed medications and supplies, but they need the funds to do so.

With your generous support, HUFH is providing funds NTP to purchase the supplies they urgently need to combat the effects of Matthew.

Strengthening our Programs and our Partners in the North: We expect cholera to strike even in the north and a sharp increase in malnutrition cases due to the extensive loss of crops. Using funds raised through our emergency hurricane appeal and medical supplies obtained through a generous grant from the Henry Schein Cares Foundation, Hands Up for Haiti is delivering direct care, educating the community on cholera prevention and safe water use, building and repairing water wells, and expanding our malnutrition program to new sites and with greater outreach. We are providing supplies to our partner hospitals, Hopital Convention de Baptiste, supported by Hope Health Action and Justinian University Hospital as they too gear up to treat and prevent cholera

HUFH believes that access to clean water will help reduce many major health concerns; to ensure this access, we have already built 6 wells that hydrate over 40,000 people. We are sending a visiting team  next week who, in addition to holding outreach clinics, will also teach community members about clean water, protecting the water wells that we have already built, and Cholera prevention. Additionally we will be teaching storm water management and implementing an effective storm management system to ensure water cleanliness. The educational sessions are designed to teach the whole family from children to elders.

Please help us prevent waterborne diseases, mitigate food shortages, and sustain our efforts to make certain that all Haitians receive the health care that they need. To help, please click here.

More about No Time for Poverty and the Klinik Timoun Nou Yo from their website: From their website: Klinik Timoun Nou Yo, provides the very finest in urgent and primary care, dental treatment, well baby evaluation and vaccination, breastfeeding consultation and education.  We also provide food supplementation and dietary consultation for severely and moderately malnourished children ages one day to five years (use Medika Mamba). The only pediatric facility in the southern region of Haiti, KTNY treats and serves an average of 70 children per day.  No fee is charged for vaccinations, food supplementation, donated medications, and vitamins.  No child is ever turned away for a family’s inability to pay.” 

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FEATURE PHOTO (TOP) BY Andres Martinez Casares/Reuters.


Saving Lives One Child at a Time: HUFH’s Emergency Fund Provides Life-Saving Care

He was the last patient to be seen at the Shada Clinic that day. I sat in a crowded room finishing up with a family in front of me, but glanced over to the triage table and saw this baby sitting on his mother’s lap, breathing rapidly with his chest barreled out, knowing that shape to the chest represented a chronic lung problem. From where I sat, I could see through his frail body, his heart beating in his chest. He was the size of a six month old but he was one year old. His eyes were wide and alert. He reached for objects – so uncharacteristic of his tiny size, but appropriate for his age.

His mother gave a great history. He breathing was labored since birth, and it had gotten worse in the last two weeks. He was no longer able to rest and sleep at night, but continued to nurse frequently, in small amounts. He is in the malnutrition program, but not because he is not breastfeeding. I surmised that he is using all his calories just to pump blood to vital organs, and that his little heart must have a defect (probably a ventricular septal defect or a hole between the ventricles) causing it to work inefficiently — and now his heart is starting to fail.

The nurses at the clinic know this baby. They have told the mother that he needs surgery. They have tried to send him to get a complete blood count to check for anemia, but his mother never took him. She has no money to pay for the test. I think she knows how sick he is, and she is waiting for a miracle.

Without our intervention this day, he will die very soon. I explain this to this young mother, who says she has no money. I explain to her that I will call the hospital and that Hands Up for Haiti will pay the bill, using donations made to our Emergency Fund. The mother sits quietly. I think she may have realized that we might just be her miracle for her baby.

Using the Emergency Fund, HUFH has made arrangements with two local hospitals to pay the hospital costs for patients who we identify as in need of further treatment. Because of this, I am able to put this mother and child on a motorcycle for $5 US and send them to Sacre Coeur, where Dr. Previl, the head of the hospital, is waiting for him.

For me, this is the essence of the care provided by HUFH. There is more to medicine than just showing up and seeing patients. For all the patients we treat with common place infections of the skin, intestines and lungs, this baby is the real reason why we are in Haiti. Without us, this child has no chance. Today, we gave him a chance.

I am not sure what it will cost – IVs, medications, an echocardiogram, and probably open heart surgery is needed. But with our Emergency Fund we will be able to help this child and his mother. It is through our commitment that this child has a chance to survive.

As Samson Desamour, a native of Haiti who has worked with us since our first trip in 2010, said about being a part of this team:

“We all came from different places and became a team working to make lives better for people you don’t even know. Each time, I think about why the volunteers from HUFH come here – coming despite risks but because Haiti needs so much – maybe even not feeling that you make a difference – but you do, you save one life at a time. These patients you sent to the hospital for care will be saved because you came.”

 


Hurricane Matthew UPDATE

Hurricane Matthew roared through Haiti Tuesday as a Category 4 storm, causing much destruction along the south and west coasts, including the cities of Jeremie and Le Cayes. Roads are washed away, farmlands destroyed just as they were ready for harvesting, and water sources are at high risk of contamination. 10,000 people are displaced from their homes. Communication is disrupted. Because of damage to a major bridge on the main highway, movement between the north and south is also disrupted.

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The Ladigue bridge in Petit-Goâve, connecting Grand’Anse, Nippes and South at the rest of the country collapsed- source Haiti Libre

Most of the area served by Hands Up for Haiti, including the city of Cap Haitien, was spared major damage or flooding. Many of us have witnessed first hand how severe the flooding can be in vulnerable areas such as Shada and in Bas Limbe at Haiti Village Health with heavy rains, even when not caused by a hurricane. We are very proud of all of our staff who worked hard to prepare for the storm, warned local residents in rural areas, and safeguarded our medications and supplies of medika mamba for our malnutrition program.

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Thermitus jean with our team at Haiti Village Health the day after the storm.

But while our clinics were not directly damaged, we still feel the effects of a disruption in farming and the contamination of water sources. After the earthquake, cholera started in the central plateau but quickly spread to the north where we work via the rivers. And when farmlands are destroyed right before the harvest, as they were by Matthew, there will be effects on the availability and cost of food throughout the country. In addition, the movement of supplies and people from Port au Prince to Cap Haitien may be limited by destruction to roads and bridges. We will monitor the situation carefully along with all of our partner organizations and hospitals. As we get more information, we will pass it along.

For those wishing to help out now, please go to DONATE-HURRICANE   where you can  donate to the Hurricane Emergency Fund. These funds will be used to help prevent waterborne diseases, mitigate food shortages, and sustain our efforts to make certain that all Haitians receive the health care that they need. We will work to identify partners who are directly assisting the people most affected. Thank you all for your prayers and for your support for Haiti.

Cover photo by the Seattle Times.

 


Malnutrition and Hospitalization in Haiti: Working Towards a Better Future

Last week I returned from my fifth trip to Northern Haiti. Every October, I lead a group of doctors, nurses and lay volunteers from the US and Canada on a medical mission. This year, our team treated 416 patients including 256 children and 160 adults. We gave community lectures to women’s and youth groups. We visited two newly built water wells for which our team raised the necessary funds and the sites for the wells we will build next year; each well will provide about 4,000 people with access to fresh, clean water for more than 35 years. And, during this week, we also referred two children for hospitalization, both for severe and life threatening malnutrition.

Allison Platt, Marilyn Jacobowitz, Johanna Navarrete and Elliot Barsh with happy children at the new Biclaire water well

Allison Platt, Marilyn Jacobowitz, Johanna Navarrete and Elliot Barsh with happy children at the new Biclaire water well

Malnutrition in Haiti is common and as an organization HUFH is trying to tackle this difficult problem through our partnership with MFK (Meds and Food for Kids). MFK produces Medika Mamba, a peanut butter based, vitamin rich food which is given to children 6-59 months who are acutely malnourished. As part of our malnutrition program, HUFH has provided treatment for more than 200 children. During this trip, I was able to see many of the children who have graduated from our program and are doing very well and that was gratifying. I also saw, however, two of the worst cases of malnutrition in my career, children so ill we had to have them hospitalized to save their lives.

How does an infant or child get so malnourished that they require hospitalization? Here are two stories…

Celestine is a six month old infant who was born two months premature. Her mother told us that she refused the breast, likely because she was too premature at birth to suck. The ability to suck develops around 34 weeks gestation, so at 32 weeks she was not able to do that or at least not well. Without this stimulation at the breast, her mother’s milk dried up quickly, leaving the mother with no way to adequately feed her baby. She could only afford formula sporadically and would ration it to two feeds a day. But to be healthy, a newborn needs to feed 8-12x/day and a 6-month-old 5-6x/day. Celestine was brought to Open Door clinic to see me on Tuesday, October 14 because she was refusing to eat and her mother desperately needed help. She dressed her in a beautiful white lacy dress and at first glance, Celestine appeared to be a small newborn baby. But when the mother removed her dress, my heart sank. I saw a cachectic infant with marasmus: severe malnutrition due to insufficient caloric intake. Her ribs visible, muscles wasting, too weak to support her head. She stared up at us, however, with her beautiful brown eyes while sucking on her fingers. Her weight 2.5 kg (5lbs 8oz)! “How is she alive?” I asked myself.

Celestine in her white dress

Celestine in her white dress

Dr. Allison Platt, Celestine with her mother, Dinia Joseph in yellow and Kristin Ward

Dr. Allison Platt, Celestine with her mother, Dinia Joseph in yellow and Kristin Ward

Immediately, I spoke with Dr. Dieula Toussaint (a Haitian physician, part of the in-country HUFH team) and we decided that she needed inpatient treatment at Hospital Sacre Coeur in Milot. Referring a child to the hospital in Haiti is not an easy task. First, we needed to figure out how to get her there. There is no ambulance to call and the mother does not have a car, phone, food or any money. So it was up to us. We decided to send Celestine and her mother to the hospital with Franz, one of our Haitian medical translators, and Dinia, my medical assistant here in NY. Having my own Medical Assistant go with her was invaluable, because I knew Dinia, a Haitian American fluent in Haitian Creole, would make sure that Celestine was admitted and cared for appropriately. I gave them my referral note and money from HUFH to cover admission costs and gas for the car.

What happens when you get to the hospital in Haiti? After they triage you, you get in line with your supply list, even if you are dying! In fact, there are 2 lines, one for those with money to pay and the other, much longer line, for those who will have to pay later. You see there is no obligation to treat anyone, not even sick babies! Families have to provide all the hospital supplies including medicines, IV fluids, IV tubing and bed linens to just name a few. While you are there as a patient your family will also have to care for you, bathing and feeding you. Dinia was born in Haiti but has lived most of her life in the US; before this day, she had never been to a hospital in Haiti. This experience really affected her: the lines, the very ill baby, the glaring disparities in the world… but thankfully, she persevered and made sure Celestine and her mother got admitted with their supplies and medicine.

The very next day, Wednesday October 15, at a clinic in Joulitrou, a father brought his 4 year old son, Wisely, to the clinic. His father said he became swollen with no appetite over the last 8 days. Wisely had an orange tinge to his hair and significant swelling of his face, abdomen and feet. At quick glance, he looked like a chubby little boy. But, unfortunately he suffered from a type of malnutrition called Kwashiorkor, a form of severe protein-energy malnutrition characterized by edema, anorexia and an enlarged fatty liver. He is at significant risk for liver failure, infection and death. How did this happen?

Katrina Bates, Cass King with Wisely and his father at triage.

Katrina Bates, Cass King with Wisely and his father at triage.

Wisely, his father and the referral note.

Wisely, his father and the referral note.

Wisely is the fifth child of six; the youngest is 18 months old. Wisely was breastfed until age 2, the recommended length of time in the developing world, around the time his mother became pregnant with his younger sibling. When he was weaned it is likely that his breastmilk diet was replaced with a diet high in carbohydrates (likely sugar) and deficient in protein. Milk, meat, and eggs are luxury items and infrequently attainable for families like Wisely’s. What to do? He went to the hospital in Milot for treatment. We arranged this with the head nurse of Joulitrou clinic, Carole. HUFH gave her the necessary funds for admission and transportation.

Right now, these children are receiving care at the hospital in Milot. We are in contact with the director of the hospital, and HUFH will cover all of the costs for the treatment of these children. Recognizing that both our visiting teams and our in-country physicians need to admit children to the hospital who do not have the funds necessary to receive care, HUFH is in talks now to formalize a referral program for our patients.

We continue to follow these children. After visiting the hospital a week later, Dr. Dieula reports Wisely is doing better than Celestine, but both are receiving treatment and slowly improving.

Dr. Dieula Toussaint with the parents.

Dr. Dieula Toussaint with the parents.

Wisely in the hospital.

Wisely in the hospital.

Celestine and Wisely in the hospital.

Celestine and Wisely in the hospital.

 

Yesterday, I was sitting in my office in NY when Dinia popped her head in and said, “Dr. Platt, I am going back to Haiti with you next year! I have to see that baby (Celestine) again… she will be big and strong!” I sighed and nodded, not having as much optimism as Dinia, but reminding myself of all the children who had graduated successfully from our program. We need to help these children sooner and continue to work towards our goal of preventing malnutrition in the first instance so it does not rob them of a chance for a healthy future. I am hopeful.
AP

 

If you would like to help us help these children and others like them, please click here for information on how to donate.


HUFH Wins Henry Schein Cares Medal for Excellence in Expanding Access to Medical Care

We are proud to announce that Hands Up for Haiti was awarded the inaugural Henry Schein Cares Medal for medical health, an annual award given to an organization that demonstrates excellence in expanding access to medical care for the underserved. Stanley M. Bergman, Chairman of the Board and Chief Executive Officer of Henry Schein, Inc., the world’s largest provider of health care products and services to office-based dental, animal health and medical practitioners, presented the medal to Dr. Mary Ann LoFrumento, President, Hands Up for Haiti, and to Karen Akst Schecter, HUFH Director of Programs and Operations, at Henry Schein’s national medical sales meeting in Dallas last week.

Hands Up for Haiti was selected by an independent panel of judges for the Henry Schein Cares Medal from a field of three finalists. “Our Company has embraced the concept of ‘doing well by doing good’ since its founding, and we created the Henry Schein Cares Medal to recognize organizations and practitioners that share our commitment to ‘helping health happen’ for underserved and vulnerable populations throughout the world,” Mr. Bergman said. “We at Henry Schein are pleased to award the inaugural Henry Schein Cares Medal for medical health to Hands Up for Haiti, an organization committed to supporting the health needs of the Haitian people and enhancing their medical community’s ability to provide quality care.”

“It is an honor to be recognized and supported by Henry Schein, a company whose commitment to expanding access to care for underserved and vulnerable populations so closely mirrors our own,” said Dr. LoFrumento. “This award will help us continue to work with the incredible people of Haiti to help build their medical community’s capacity to provide quality, sustained treatment and services. Through these efforts, we are able to make a positive impact that lasts long after our missions have ended.”

As the winner, HUFH will receive $15,000 in cash from the Henry Schein Cares Foundation, Inc. to support its work and $10,000 worth of product from Henry Schein, Inc.


A Glimpse at Conducting Public Health Research in Haiti

by Margaret Keneman

At HUFH we know that healthcare is not just about treating medical problems; it is about identifying the source of the problem so that we can teach our patients how to prevent illness in the future. We also know that we have to be mindful, respectful, and culturally sensitive in our teachings. In other words, we cannot go into a clinic and preach about the importance of healthy gums if our patients have no access to dental floss. We have a responsibility to teach in a way that considers their resources, their abilities, their prior knowledge, and their socioeconomic status. Finally, as we identify areas where we can perhaps contribute aid, we have to maintain open lines of communication with the locals so that our contributions actually help in a way that is meaningful (to the people of Haiti) and sustainable (thanks to their involvement in a particular project).

HUFH pharmacist Thermitus deep in thought

HUFH pharmacist Thermitus deep in thought

As part of our public health initiative on the July trip, we conducted this kind of research in order to evaluate our impact in the communities we serve and to find out what we can do to improve our efforts. We met with groups of locals to learn about their personal experiences with our current program on malnutrition, and two other areas where we might be able to contribute: (1) access to clean water and (2) safe cooking stoves. In this blog, we will discuss some of our initial findings from the focus groups on access to clean water and safe cooking stoves.

HUFH volunteer epidemiologist Lisa and translator Franz leading a focus group on nutrition in Bod me Limbe

HUFH volunteer epidemiologist Lisa and translator Franz leading a focus group on nutrition in Bod me Limbe

Prior to the trip, we developed several questions to initiate our focus group discussions. Some of the questions that we asked were:

  • “Where do you usually get water?”
  • “What are the different solutions for cleaning water?”
  • “Where do people in the community go to the bathroom?”
  • “Do people get hurt when using cooking with fire?”
  • “What can HUFH do better when working with your community?”

However, these questions were only meant to frame the discussions around the topics of water and cooking. More importantly, we were prepared to have honest conversations about the locals’ experiences and we were open to hearing their suggestions, ideas, and questions.

Cooking in Haiti

Cooking in Haiti

We conducted our focus groups at our four established HUFH locations: Shada, Bod me Limbe, Bois de Lance, and Jolitrou. In case you do not already know, Shada is a resource limited community in the heart of Cap Haitien, Bod me Limbe is a fishing village in the Bas Limbe area (west of Cap Haitien), Bois de Lance is a farming community just east of Limonade, and Joulitrou is a rural farming community (north of the city of Grande Riviere). While the locals from each community shared similar experiences, concerns, and ideas, there were some differences in their responses that perhaps reflected the particular region where they lived.

We do not have the time and space to discuss all of the findings from our focus group discussions in this blog, but we want to share some of our initial thoughts and interpretations. First of all, one of the biggest issues, which was expressed by participants at all four locations, is the confusion about how to treat water. There was no consistent understanding even within each group about water treatment options. Few participants seemed clear on how to use products such as bleach, aquatabs, and/or chlorine. More than anything else, they seemed fearful of these chemicals, and perhaps rightfully so. Although HUFH is not involved in the distribution of water treatment products, it might be valuable to hear that many local community members are interested in learning about the use of filters and/or the building of more wells.

Water well in Haiti

Water well in Haiti

The participants at all four locations also expressed, at one point in time or another, the tensions caused by the implementation of “community-use” resources such as wells, toilets, or cooking stoves to be shared by everyone in the community. On the one hand, they were open to the idea if only out of sheer necessity for the particular resource. But, being very perceptive, they discussed the frustration that comes along with having to share with other community members who may not take care of these resources or who may abuse their privileges.

Margaret analyzes focus group data as volunteers debrief about the day

Margaret analyzes focus group data as volunteers debrief about the day

As the conversations became more engaged, the locals alluded to their desire not to necessarily get things but to learn things. Instead of a community well financed and built by a group of volunteers, for example, they would like to learn how to build their own wells. Their desire to learn was not limited to our chosen topics of water and cooking. Participants expressed interest in learning how to cultivate their farms, grow different crops, prevent deforestation, design crafts and artwork, and even start small businesses.

Dr. Mary Ann listening in as HUFH volunteer Jenn leads a focus group in Shada

Dr. Mary Ann listening in as HUFH volunteer Jenn leads a focus group in Shada

Probably one of the most important issues to highlight from our focus groups was how vocal participants were about their contempt for empty promises made by foreign organizations. Madame Bwa, a respected health care worker in Shada, said that she would like to see volunteer groups build more toilets in her community, but she was skeptical that this would happen, since other organizations have entertained the idea but never followed through. This is a critical consideration at HUFH, which explains why we made every effort to be transparent with our focus group participants about the nature of our research. We will use our research to inform the commitments that we choose to make in the future, and we will continue our collaboration with locals so that we can uphold these commitments.

In the meantime, the detailed report of our findings, as well as the evaluation of our malnutrition program, will be available through the HUFH board members and management team in the upcoming weeks. Please contact Dr. Mary Ann LoFrumento, Dr. Jill Ratner, or Karen Akst Schecter if you would like to learn more about our research.

Finally, we would like to extend a HUGE THANK YOU – MESI AMPIL!!! – to all of the local translators and staff members that made our focus group sessions SO SUCCESSFUL. Conducting focus groups in more than one language is not an easy task, and our multilingual colleagues were critical team players throughout the entire process. We hope to continue to develop the language methodology we use during our discussions with the locals in Haiti so that our interactions can be as fruitful as possible. We have no doubt that our Haitian translators and staff members will continue to be vital contributors to this process, and we are very grateful that they are a part of our team.

Volunteers Rosenie and Gayrleen with Dr. Manol and some of our wonderful translators

Volunteers Rosenie and Gayrleen with Dr. Manol and some of our wonderful translators

 

 


Teaching and Learning in Haiti: Making Connections with Haitian Youth

by Margaret Keneman

Bonjou! Kommon ou ye? “Bonjou!,” which means “Hello!” in Haitian Creole, and “Kommon ou ye?,” meaning “How are you?,” are just a few of the expressions that our team practiced before meeting the Haitian youth groups that we would be teaching throughout the week.

As part of the public health initiative on this trip, our team worked with youth groups at three locations in Haiti – Shada, Bod me Limbe, and Open Door – to teach young people how to stay healthy and be safe. After all, we want the response to our question “Kommon ou ye?” to be “Mwen byen!” (“I’m doing well!”). In particular, the nursing students and the certified EMT students developed lessons prior to the trip related to topics such as safe sex, the causes and prevention of common cancers, nutritional practices to stay healthy, and CPR and first-aid.

Nursing Student Katherine Stoesser Teaching - and Learning!

Nursing Student Katherine Stoesser Teaching – and Learning!

Developing these lessons was a unique task for our “student-teachers,” as they had to consider a learning environment very different from what they were accustomed to in the U.S. or Canada. Technically speaking, they could not rely on presentational tools such as computer projectors and PowerPoint software to present information. From a cultural perspective, they had to prepare to be sensitive to differences between themselves and the young Haitians.

In parts of the U.S., for example, we may assume that everyone knows about and has access to contraceptives such as condoms and the pill, but in parts of Haiti, it is not uncommon to use a necklace with 28 beads to keep track of the 28 days of a menstrual cycle. While this may seem strange to people in North America and may even be less effective from our point of view, our volunteers came to Haiti not only to teach but also to engage in conversations that shed light on and respected the cultural practices, local traditions, and religious values of each community in which we work.

These conversations in the classroom were successful thanks in large part to a very positive collaboration between our volunteers and the Haitians on staff at each location. Each lesson was taught by one or two volunteers and was facilitated by a Haitian staff member.

Our Translators Hard at Work

Our Translator Sonel Eugene Hard at Work with volunteers Alex Sudyn, Dr. Jill, Margaret Keneman, and Denise DeLorme

Working Together

Working Together: Nurse Gayrleen Blemur and EMT Joe Israeli

It is not easy (and not necessarily realistic) to translate these medical and lifestyle concepts word for word, and it was often a combination of gestures, pictures, and props that got the point across.

Needless to say there was often a lot of laughter, not in a mocking or disrespectful way, but as a common, cross-cultural reaction to something funny, thus bridging the language barriers between our volunteers, the local staff, and the young Haitians in the classroom.

It is through these kinds of lighthearted interactions that our volunteers were able to connect with the young people in Haiti, both in and out of the classroom. In his reflections about the trip, Joe Israeli, a certified EMT from the University of Miami, explained how impacted he was by the connections he made with the young people. In particular, he shared a memorable moment that he had on the beach in Bod me Limbe: “There was a plethora of kids, and all they wanted to do was talk to me and socialize. The way that they played with me, looked up to me, and sought my approval was very touching. I will never forget all the kids there, since their joy was so sincere and infectious.”

Volunteer & EMT Joe Israeli With Some Local Children

Volunteer & EMT Joe Israeli With Some Local Children

The deep connection that Joe made with the locals really influenced the way he approached his teaching. He went on to say: “I thought that I was going to come into Haiti and just do some teaching and that would be the end of it. However, this trip really taught me the joy of teaching healthcare. The way that the students paid attention and took notes spoke to me on a subliminal level.”

Katherine Stoesser, a Canadian nursing student, shared how meaningful it felt to earn the respect of the young Haitians while teaching them about nutrition. She explained: “It was amazing for me to see how engaged they were in our discussion. They asked many questions and took thorough notes throughout my presentation. It meant so much to me to be able to work with my translators so that I could interact with the youth and discuss with them ways to incorporate healthier foods into their daily lifestyles. I was very touched by their sincerity as the students thanked me for the lesson. It was evident to me that they truly appreciated the opportunity to learn from us that day.”

Studying Hard

Studying Hard

Making Sure to Get it All

Making Sure to Get it All as Denise DeLorme Looks On

At each location, the Haitian students completed lessons on all four heath and safety related topics being taught by our volunteers that day. The Haitian students worked hard, listened carefully, asked thoughtful questions, and we hope they learned a lot. At the end of the day upon completion of the lessons of that day, the students earned certificates. The ceremony of presenting these certificates, while quick and relatively informal, was meant to represent a passing of the torch so our students could share the information they learned with their community members.

Students Proudly Showing Off Certificates at the End of a Day of Study

Students Proudly Showing Off Certificates at the End of a Day of Study

Katherine remembered feeling quite emotional as the Haitian youth accepted their certificates of completion at Open Door. She said: “It was an incredible feeling to help partake in their accomplishment that day and it is a memory from my first trip to Haiti that I will always cherish.”

Lots of Students Able to Share Information With Their Communities

These Students, All Able to Share Information With Their Communities, together with our volunteer teachers

The educational activist Paolo Freire said that education should be the means by which people learn how to participate in the transformation of their world. We hope that our educational efforts in Haiti in July empowered Haitian young people to make a positive change in their communities.

Stay tuned for more reflections about our experiences in July, and an initial report of some of the findings from our research.