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

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 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: 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.

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.

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.

Photo by Jason Beaubien/NPR

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.” 

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

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 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.

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.

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.