I just finished a 12 hour day here in Haiti, up on the Central Plateau in Thomonde. Near Hinche, a regional city of 100,000, Thomonde is a rural community of several thousand. Our headquarters for two days, we are escorted around by two exceedingly dedicated, talented, brave, and smart representatives of Project Medishare, Marie and Laurene. One is lucky to have such partners that instill hope in every breath despite hardships that make most of us tremble. When 2-3% of Haiti’s population was killed by the earthquake (and everyone in the whole country was affected), and society could have crumbled like concrete buildings, the only way visitors, like the doctors with me from Jewish Healthcare International, avoid despair is to surround ourselves with talented Haitian community health workers and expose ourselves to native hospitality.
Today’s lessons, like the school we saw at a health clinic in one of the more remote areas of Haiti, called Boucantiste, come from what we clinicians learned long ago: poverty breeds disease. HIV disease, TB, cholera, malaria, malnutrition, etc., cannot be solved without profound economic development and support. That is why it was so heartening to see Medishares working to build an Akimil plant (a bean/rice food supplement with fortified vitamins) about to be finished next to a new rural training center. Throw in sustainable farming on site, and we truly have a yummy long-term mix. I hope some of you who gave me money to give out will like the small amount I am leaving for this purpose.
Next up, on the way to Boucantiste, you learn the meaning of the word “rural”, people living in the country. A 75 minute convoy of two vehicles, the mobile health van and the personnel, over small canyons, rivers, up and over and across and down pretty steep cliffs, feeling bumps and cracks in the road with every four wheel drive spin, with scenery as beautiful as any found anywhere, but almost no people or homes visible, arriving suddenly at a one room church and an open air covering for the school, where the monthly health clinic is held. Monthly, except for the four months of rainy season, when no cars can pass, and of course no people can get to the city. All is still except for the 100 schoolchildren singing “Maria, Maria” to the instructions of their two teachers.
Inside the church, at least 150 people are lined up on three walls to see providers: a wall for pregnant and breastfeeding women, a wall for the dozens of children, and a wall for adult males and females. Dividing up quickly and taking our cue from the one Haitian nurse practitioner and intern on-site for the day, we dive right in, with interpreters, and a mobile pharmacy with a fairly effective though limited formulary. Several thousand dollars of samples we brought do prove helpful in some cases. Severe hypertension, severe arthritis, reflux and ulcers, iron deficiency, worms, urinary tract infection, eye infections, hernia, headaches, rashes and contusions, from those who had traveled 1-2 hours on foot to the church. Two cases of goiter and hyperthyroidism, one almost certain congenital heart disease in a 5 month old not thriving. We help, reassure, treat, and recognize that a paved road to these rural areas is more potent a pill than any we can deliver.
On to Hinche to see regional hospital, over 100 beds, orderly treatment of multidrug resistant TB (must stay at site for a year), HIV, peds, ob, post-partum, surgery, and unfortunately, cholera. Another make-shift cholera camp set up at the front entrance. Yesterday, all had hope the disease might wane. Today, 50 new cases on top of 50 in treatment. 100 now in a tent hospital. Several died again because they got there too late. Heroic Ministry of Health administration and Partners in Health clinicians making a difference. Medishare, our host, providing supplies, training, and additional personnel.
Riding back to Thomonde, the conversation turns to happiness and hope. What does it take to be happy in the world? Certainly food, housing and health at a minimum. What about hope? Marie tells us that Haitians are hopeful–they believe that tomorrow will be better, that they can’t complain about themselves if others are worse. Hope from Haiti is a blessing for all of us, despite the overwhelming suffering.
Tomorrow, I will blog about several ideas our group has to support the amazing, sophisticated and remarkably successful partnerships that have existed for many years on the ground but can always benefit from additional resources.