Making the Rounds: Hôpital Universitaire de la Paix

By Conner Gorry in Haiti

It’s not even 7:30 and already it’s hot and close as we board the bus for the circuitous, rubble-pocked ride to Hôpital Universitaire de la Paix. As the crow flies, it’s probably less than a mile from our tent camp to Port-au-Prince’s university teaching hospital, but weaving between vendors and tents pitched in the street, and then caught behind a tractor or backhoe, means it takes almost an hour to get to the front gate.

Canadian surgeon Dr Arthur Porte explains surgical techniques to Dr Valverde (ELAM) and Haitian medical student Xavier Kernizan.

I’m traveling with the Cuban medical team that will staff the ER for the next 24 hours, relieving other members of the Henry Reeve Contingent. My fellow passengers include nurses, lab technicians, family physicians and a few other specialists, like Dr Douglas

Valverde, an energetic orthopedic surgical resident who received his training at Cuba’s Latin American Medical School (ELAM). Costa Rican by birth, Dr Valverde is one of the more than 700 ELAM-trained health professionals making up the Cuban-led international team.

Haitians of all ages are waiting their turn at medical tents pitched in the courtyard when we arrive. Things are fairly well organized, which is a dramatic improvement over the situation in the days following January 12. Hôpital Universitaire de la Paix was at or near capacity when the earthquake struck; it was quickly overwhelmed as the tremors subsided and new patients made their way in droves to the facility.

“The courtyard was filled with wounded people. To cross it we had to step over and around them saying ‘excuse me, excuse me, excuse me’ the whole time,” Dr Wilsos Canton, a Haitian graduate of the ELAM told me. “The building was in decent condition, but there was no light and no water. We delivered babies using the lights on our cell phones. There were patients everywhere,” he tells me in that stoic, but compassionate way Haitians have. This image of the aftermath settles over our conversation.

In the Post Op, Post-Quake

I’m sure what I’ll see today at Hôpital de la Paix won’t compare to those first days and even weeks after the earthquake. Still, coming into the post operative ward where orthopedic resident Dr Valverde and  Cuban colleagues Dr Mariela Rodríguez and Dr Rafael Roque visit with patients, I’m rocked back on my heels.

Dr Rafael Roque of Havana cleans one of many wounds during his shift at the Hopital Universitaire de la Paix.

The heat in the 14-bed unit hovers over amputees of all ages, some moaning in what I imagine is pain mixed with frustration (and undoubtedly fear). This guttural chorus is joined by a clutch of women in the center of the room chanting and undulating, lost in energetic prayer. Daughters, girlfriends, nephews and neighbors wave kerchiefs and swaths of cardboard over their loved ones to keep the flies away. A piercing odor of human waste permeates the scene as an older woman, both legs cut off at the knee, talks to herself in a loud, stricken voice.

The first bed is occupied by one of Dr Valverde’s patients: a beautiful 18-year old who was hit by a car several days ago and presented with a broken femur. Although some of the 84 members of the Henry Reeve team working at this hospital speak Creole, Dr Valverde enlists translating help from one of the women who comes to pray for patients in this hospital several times a week. “She’s in pain and wants to know when you’ll operate,” the woman translates for us. Dr Valverde explains that they can’t operate until her femur is correctly re-aligned, something that without the proper traction equipment, will take a week—or more. The girl lets out a loud wail when this news is translated. Dr Valverde looks at me with wrinkled brow: “We rigged up this manual weight with a cinder block to help the healing process, but she’s obviously in a lot of pain.” He shifts her body a bit and adjusts the height of the block, asking via the translator if that felt better. It did.

We pass along the other beds, occupied by soft-eyed gentlemen

Surgeon Mariela Rodriguez of Holguín lends a hand in the Universitaire de la Paix ER.

paralyzed the instant their houses fell on them in the quake, and young laborers hit by trucks in the disorder that has gripped the Haitian capital since January 12. Trailing behind the trio of surgeons, I learn about complications seen in their daily work here, including infections, phantom limbs (patients feeling pain in their amputated limbs) and depression. Shortages of even basic supplies, despite international donations that continue to roll in, are also a challenge.

A Haitian surgeon and nurse team consults with Dr Rodríguez about another case. Once they’re out of ear shot, I ask about her experience as a female surgeon in this very masculine of settings. She tells me about her two years working in Cap-Haïtien in Cuba’s Comprehensive Health Program—the international program which has bolstered public health systems around the world since 1998, including Haiti’s.

“The hospital I worked in was founded in 1812. In nearly 200 years, I was the first female surgeon they’d ever had,” she explains to me in the laidback manner common to Cubans from the eastern provinces. “It wasn’t a problem that I was a woman, but I had to prove myself in the operating room. Once I did, we got busy.”

Emergency Room Snapshot

With the morning hours dwindling, Rodríguez, Roque, and Valverde shift their attention from the post-op recovery rooms to the hospital’s emergency area. They join colleagues from Nicaragua, Panama, and Cuba’s Villa Clara and Pinar del Río provinces, (all Henry Reeve members), to attend arrivals in the partially screened area with four metal beds. Haitian nurses and medical students lend a hand translating, among their other duties.

There is a steady stream of patients. As in most emergency rooms, (especially post-disaster in the Global South), most patients are extremely sick, including some who won’t see tomorrow. This is the prognosis for the emaciated anemic grandfather and the young woman in a pretty pink dress who has had a high fever for two weeks. Malaria will soon consume her. It’s not only the severity of the conditions these doctors see day after day that is disconcerting; it’s that many of them are preventable. That anguish is written on Dr Adac Mendoza’s face, the ELAM doctor attending the young woman.

Dr Adac Mendoza (ELAM) attends a young patient in the emergency "room" of Hopital Universitaire de la Paix

Accident victims and chronic disease are common in this ER, and between stitching a child’s split chin and taking the blood pressure of Haitian matrons, the doctors treat the aftershocks of natural disaster. A barefoot young boy hops over to the doctors with a badly infected wound on his left calf. Tears stream down his face as the gash is cleaned of dirt, stones, unidentifiable objects (glass? bread crusts? I can’t tell and neither can the attending physician), and finally necrotic tissue. He’s given a shot of antibiotics and told to come back in the evening for another injection, though the doctors admit they probably won’t see him again: transport is too scarce and life too precarious here in post-quake Haiti for many patients to pursue follow-up. Just then, an 18-year old girl staggers in and collapses on one of the metal beds. “She tried to poison herself,” her escort tells me in English. When I ask why, his response is as disturbing as it is vague: “she was sad.”

Improving Health is Collaborative

Like in all disaster response efforts, medical teams from around the world collaborate both formally and informally in Haiti. I’m not surprised then as a blond-haired, blue-eyed woman in hospital scrubs turns up in the emergency area asking to consult on a patient with Dr Valverde. Janice Centurione is a physiotherapist from St Joseph’s Hospital in Ontario, Canada. ‘St Jo’s’, she tells me, has been “sister hospitals” with the Hôpital de la Paix for the past 20 years in a pairing intended to “train Haitians to offer a standard of care.” This extends to specialty services and after examining Janice’s patient, Dr Valverde consults with Dr Arthur Porte, an orthopedic surgeon also from St Jo’s.

“This is my third time in Haiti, but I have no previous disaster response experience, so I was reluctant to come at first,” Dr Porte tells me while looking at an X-ray of the chronically dislocated finger he is about to correct surgically. Dr Valverde, Dr Porte, and Xavier Kernizan, a sixth-year medical student training in Haiti , discuss the incisions to be made and the aluminum finger splint they’ll use to immobilize it following surgery. It’s fascinating to watch the three—from different countries and cultures—collaborate.

“The circumstances are so difficult here in Haiti. Normally I can’t do the operation you’re proposing because we don’t have that type of splint,” Kernizan says to the Canadian surgeon. “Sure you can,” offers Dr Valverde. “You can use anything—sticks, tongue depressors, whatever—to immobilize it.” Dr Porte (who brought the splints, along with other higher-tech tools and materials from Canada) concurs. A Canadian OR nurse enters the anteroom, cutting the conversation short: “We’re ready to go doctor.” And with that, the trio vanishes into the operating theater.

Douglas Valverde prepares to operate.

Following the quick, successful surgery, Dr Valverde tells me: “Working with the international teams here is a great learning experience. I can bounce ideas off the surgeons and they explain their techniques.” Heading back to the ER, Dr Valverde has a near skip in his step. “I love waking up and going to work in the morning.”

We’re met by a boy needing many stitches, including a severed vein that needs sewing, and Dr Valverde sets to work. Night is already falling, but the patients keep coming. “Another one?!” he asks when a young boy hops into the ER. But it’s his young patient from earlier with the infected wound, returning for his second antibiotic shot. The young surgeon compliments the boy for coming back as he finishes mending the vein of his current patient. “This was my most satisfying work in Haiti to date.”

---

Read Full Post »

Interview with Dr. Patrick Dely: Part II

By Conner Gorry in Port-au-Prince

“My future is to see my country transformed, a different country, where Haitians feel happy and proud to be in their country. Where they don’t need to emigrate, where Haitian children have access to education… I see myself working to make this Haiti a reality. My future is to work towards change.”

Dr Patrick Dely spent his early childhood in St Michel L´Attalaye, a town in the central department of Artibonite where the environment was nearly exhausted and educational opportunities limited (to say the least). He attended Haitian public schools – where up to 150 students crowd into a classroom, oftentimes without a teacher – and always dreamed of becoming a doctor. But until a friend alerted him to the possibility of a scholarship to study medicine in Cuba, his future practicing medicine remained just that: a dream. Over ten years later, Dr Dely is a family doctor who was a few weeks short of obtaining his second specialty in epidemiology in Cuba when his country was devastated by the January earthquake. In Part II of this interview, Dr Dely talks with me in Port-au-Prince about difficulties facing the Haitian public health system, what challenges that system presents to Haitian doctors trained in Cuba, and his future plans for his hometown and beyond. To learn more about this remarkable young man, see Part I of this interview.

The Latin American Medical School (ELAM) trains doctors for public service, to work in underserved areas. In your view, what are some of the difficulties faced by these doctors when they return to Haiti?

 

Haiti is extraordinarily complex, in every sense, and there are many factors impeding the insertion of these doctors into the public health system. First, there’s the question of political will. We began studying in Cuba over ten years ago, in 1999. But during the six years that we were studying, there was no structure or strategic plan for how to absorb and place these doctors in the Haitian public health system. No one was asking: ‘How are we going to receive these doctors?’ ‘How are we going to distribute them in the health system?’ So we faced a bitter and troubling situation when we arrived.

Then there’s the economic problem. The government just doesn’t have the budget to employ all these graduates. [Since the first commencement in 2005, the ELAM has graduated 550 Haitian doctors. Eds]. For those it does employ, the salary is so low, doctors can’t make ends meet, even their most basic needs can’t be met on this salary. Remember, also, that Haiti is a capitalist country and this combination has created a vicious cycle: A doctor, although he or she works in the public health system, has their private

Dr Dely with members of St Michel community project

practice on the side to earn a living and really the state has no recourse because they don’t provide a living wage.

So doctors hold down two jobs essentially?

 

Here’s how it plays out: let’s say there’s a surgeon who is the director of a public hospital. As director of that hospital, the surgeon earns $US600 a month. It’s very difficult to live on 600 dollars in Haiti, so this hospital director maintains a private clinic. He might work an hour or two at the hospital and then he goes to his private clinic. At his clinic, he charges $20, $30, $50 to whoever walks in the door for a consultation. This is how he makes a living. Meanwhile, the services in his hospital suffer or don’t function at all because he’s not there.

That’s how it plays out for the hospital director. How does it play out for patients?

 

In the public hospitals, the patient has to buy everything – cotton, syringes – all the supplies needed for their treatment. And there are few doctors, so even those patients who have money to buy the supplies might wait five hours for the doctor or maybe the doctor doesn’t show up that day. So most people prefer to scrape together the money to go to a private clinic. Even if they have to sell something, even if they can only go once and will have no follow up, they prefer to go to a private clinic. If the patient is poor, too bad. They have to find some money, somehow, to pay for care. Until the patient demonstrates that they have the money to pay, the doctor won’t even touch them. If there isn’t someone to assume the payment for them, they go without treatment, suffer, and may even die.

Returning to our hypothetical surgeon and hospital director, his way of life depends on what he charges his patients, which means this doctor sees his patients as clients. Essentially, in Haiti, health and medicine isn’t seen as health and medicine, but has been converted into a business. The state, without the ability to budget for a health system, has entered this vicious cycle.

How do graduates of the Latin American Medical School reconcile this conflict between private and public care, given that the school is designed to train doctors for public service?

The ELAM trains doctors to treat patients. When a person arrives bleeding, the ELAM doctor isn’t going to ask to see their ATM card before providing treatment. They may hope for a little something afterwards, but they know they probably won’t get anything since these are poor people with nothing to give! They try to help out the neediest cases when they can, but still, many resolve it exactly how I’m describing it to you. They work with a clear conscience in a public hospital and in their free time they work in a private clinic or hold private consultations. This is the vicious cycle I was talking about. It’s very difficult.

 

Over 500 Haitian doctors have graduated from the ELAM so far, with around 100 more graduating every year. What impact are these new doctors having on this private/public care dichotomy?

 

It’s problematic. Let’s take for example a Haitian gynecologist who is having car trouble. She’s waiting for a patient needing a cesarean section to resolve the problem with her car. It is that calculated: this doctor is waiting for a C-section patient to walk in the door and pay to fix her car. And I arrive from Cuba, extraordinarily enthusiastic to work anywhere I’m needed, to go to the most remote corner and serve in whatever conditions. This means I’m taking money directly from the pocket of this gynecologist. So we are seen as a threat and that’s the first problem.

Dr Patrick Dely

The second problem is that practicing medicine has always been viewed in Haiti as a luxury, something elite. Something noble and elite – not just anyone can be a doctor. Then all of a sudden there are these masses of humble young people returning as doctors, proving they can be doctors too. And this has effects here like in any market economy: if something is in short supply but high demand, suppliers set the price. But once there is a larger supply, (in this case doctors), it shifts the dynamic. We’re a threat to that dynamic.

ELAM doctors are trained entirely in Spanish. In your experience, is language an issue for you and your colleagues once you return to Haiti?

 

It’s really important to find books in French, if not to study, at least to familiarize yourself with the language. I learned terminology in Cuba that I didn’t know before, so I can explain things to you in Spanish but I have no idea what words to use in French or Creole!

And another thing – you can’t even write a patient’s clinical history in Creole here. It must be in French. Even in the countryside. Everyone here speaks Creole, but when you have to write something, it has got to be in French. During patient consultations for example, you ask questions in Creole, but record the responses in French. And when you have to refer someone to the hospital, you do it in French. If you sent someone to a hospital with a referral in Creole, the receiving doctor would say: who is this doctor who is writing in Creole?!

Creole is an official language here but isn’t accepted as such. I was on the bus one day and a woman said: ´I’m not going to that doctor anymore. He speaks to me in Creole!´ She was judging him on his language, saying – this doctor doesn’t know anything, he speaks Creole. She was actually offended. It’s very, very difficult. But little by little we’re going to break through these prejudices and myths.

How do you see your future?

 

My future? My future isn’t to have a big house or a new car. You know what I did before studying medicine, when I was a professor and received my first paychecks? I went and bought a car. I had been walking to class and I saw my students arriving in cars, which gave me a huge complex, so I went and bought a used car. But today, I’m a doctor, I’ve nearly attained my second specialty and I can walk to meet with the President, I can walk to meet the director of the UN. It means nothing to me to have a car! It’s a tool, sure, but this isn’t what I consider a future.

My future is to see my country transformed, a different country, where Haitians feel happy and proud to be in their country. Where they don’t need to emigrate, where Haitian children have access to education and our youth has access to sports and recreation. I see myself working to make this Haiti a reality. My future is to work towards change.

 

That future also involves your project in your hometown of St Michel. Tell me a little about that.

 

I was born in St Michel, but I had to leave for the capital when I was eight years old because there was no middle or high school. So what options does a young person from St Michel have once they finish primary school? They have to work in the fields or emigrate. Sometimes it makes me cry to go back there…I used to dive from rocks in the river, but now you can cross that river without getting your pants wet. They’ve cut so many trees, the rivers are dry, there’s no wild game anymore, it’s so deforested. This is a region where there was never hunger – there were a lot of mangoes, avocadoes, people grew corn. But people have abandoned agriculture because agriculture doesn’t provide a living. So what do they do? Kids of 10 or 11 go to Santo Domingo to work, to cut cane, and come back with nothing. This always alarmed me and is painful still.

So I started thinking. What can I do? How can I help my people? I’ve got the education, now what about the vision? And I started envisioning a comprehensive project where a poor child who doesn’t have the opportunity for even a grade school education can enroll as a small child and leave as a skilled, useful member of society. A place where a child receives a primary, secondary and technical education based on love of country and work. This child can study music for example, receiving training that could transform him into a famous musician. Or maybe the child will opt for alternative agriculture, using different techniques than his father used, learning and developing techniques to make that same plot flourish and profitable. Or we’ll teach this kid to be a carpenter, plumber or electrician – even though in the St Michel area there are places that still don’t have electricity! – but we have to think of a better future.

With such a comprehensive education, with solid technical skills, this child can graduate as a plumber and I don’t have to worry that he or she will emigrate to Santo Domingo. Or maybe that child will become a carpenter and even though the government can’t assure him a job, he can open a workshop in his yard and work and earn money to support his family, and lead a dignified life.

St Michel school project

Meanwhile, this project will guarantee this child’s food in a community garden and there will be a hospital to attend to the sick, so they don’t have to leave St Michel and travel long distances looking for health care. Right now there’s a health post in St Michel with three doctors. One is the director and the other two are doing their required year of social service. After that they leave. We’re talking three doctors and 10 nurses for 140,000 people. But these are the official statistics; they don’t reflect the reality of absenteeism and the like.

What stage is the project in now?

Well, I wasn’t really sure how to get started and it took me a while since I didn’t have anything… but I was convinced I had to lead by example. So I did what I would like other Haitians to do: start with what you have, even if what you have is very little. My father had this little piece of land and he said: ‘it’s all I’ve got, but if you’re serious and are going to do something useful, I’ll give it to you.’ So I decided to start the project with the school, with one class and one teacher, on that land. That was in 2007; we started with 30 students. Today we have four times that. When I move up there, I think I’m going to be one of the professors – at least when I’m not working as one of the doctors!

Is that your dream? To work in St Michel and grow this project?

My dream is that these kids receive some of the best education in the country, so I can enter St Michel one day and see a child playing an instrument or creating something great. To see those children, happy and learning, that’s the St Michel project. And beyond St Michel, Haiti. With the desire, faith, and perseverance to succeed I believe we can make it happen. If I can see this throughout my whole country, I will be the happiest man alive.

Read Full Post »

Two of the 170,000+ “Cases”

By Conner Gorry in Haiti

I do a lot of listening here, asking far fewer questions than I usually would and I never inquire about family…

Case I

There’s a light drizzle falling as the busload of doctors, nurses, and 5th year medical students head out for the  morning’s work in the Cuban health posts known as Belair I and Belair II. Stuttering through the clogged, rubble-strewn streets of Port-au-Prince, the bus is a veritable United Nations of medical personnel: there are Cuban doctors of course, but also Colombian, Brazilian and Panamanian physicians, plus Cuban nurses and Haitian medical students from the Latin American Medical School (ELAM) – all trained in Cuba. Ironically, as we inch past elders selling charcoal from reed baskets and young toughs peddling black market antibiotics, an armored vehicle full of UN blue bonnets chugs past.

Belair I and Belair II are misnomers – these are not pretty places and the air is anything but. The camps are sprawling, muddy settlements with shelters made from plastic sheets and sticks, cardboard and corrugated metal packed cheek by jowl. Small children, barefoot and bare-bottomed often, beautiful and innocent always, suck their thumbs and watch as we walk past. In the middle of this stark reality stand the health posts: simple tents with a couple of rough-hewn benches and chairs where patients wait to be seen and treated for free by the Henry Reeve Emergency Medical Contingent.

“We were told this was a very rough area, with a lot of crime when we learned where we would be working,” said Arnaldo Santa Cruz, a physical therapist from Havana. But with over 6 weeks in operation, the Cubans are respected and protected by Belair’s community. Today, like every day, women with babies and their young children, grandmothers and the odd man, wait patiently to see one of the “Cuban doctors” as the entire group is known.  At the end of a long morning diagnosing and treating acute respiratory infections, scabies, and other common conditions plaguing Port-au-Prince’s population, a young girl arrives with a too-small bundle swaddled in a towel.

The girl is eight, her baby brother, the swaddled bundle, is just 4 months old. Dr. Yahimely Pezcalderón, a family doctor from Cuba’s Cienfuegos province, lays the infant gently on the table. He’s clearly malnourished and is running a fever of 103°.  With Jude Celerin, a 5th year Haitian ELAM student translating, Dr Pezcalderón learns that this 8-year-old girl has been taking care of her baby brother and little sister since the earthquake. Their mother is in the hospital and the prognosis isn’t good. Dr Pezcalderón prescribes the medicines the baby needs to control the fever, but she is doubtful. “I don’t like seeing children come to the health posts alone. They

Yahimely Pezcalderón with 4-month-old and his sister.

usually don’t read and it’s hard for them to understand the dosage and how to take the medicine. I’ll make sure they come back tomorrow and follow up, but…” We haven’t seen them since, but it has been raining, and patients typically stay away in the rain.

Case II

Son Son, as he is known among us, is a beautiful young man who makes friends easily. His full name is Mickelson Brun and he’s just 13 years old, though responsibilities assumed by him since the earthquake have forced Son Son to grow up fast.

His home was destroyed in the quake and with nowhere to go, the Brun family – Son Son, his mother, father, and 4-year old sister – erected a sheet-and-stick shelter in the park facing the crumbling presidential palace. This is a pestilent, infernal place swirling with dust when the sun is out, and a pestilent, infernal place thick with mud when it rains. Son Son’s mom, Myrlande, escaped from the earthquake unscathed, but was already in poor health, which conditions in the tent city exacerbated. Looking for a solution to her multiple health problems, Son Son sought out the free services of the Cuban team when he met one of the Haitian ELAM graduates working with them.

Myrlande is a typical survivor’s case, of which the Cubans have seen thousands: anemic and malnourished, running a fever and with a tentative diagnosis of more serious infectious disease that only laboratory tests can nail down. In short, she is in very bad shape. The doctors treating Myrlande don’t need a translator – the Bruns spent nearly a decade living in the Dominican Republic trying to eke out a living and Son Son speaks Spanish well. The doctors remit her for a blood work-up and X-rays in Port-au-Prince’s Renaissance Hospital, a public hospital staffed by Cubans, and prescribe fever reducers in the meantime. They bid the duo goodbye.

But the next day, Son Son is back. And the next and the next. He hangs around with his winning smile and quick intelligence, translating for the Cuban doctors and ELAM graduates from other countries working at the health post at Carre Four Feuilles. He is an asset, a tremendous help in times of tremendous need. Soon, Son Son is accompanying the doctors six days a week, volunteering his translating services and making fast friends with everyone on the team – Cubans, Hondurans, Uruguayans, Mexicans, and Brazilians. He learns to recognize symptoms and perfects his health vocabulary.

Son Son

On workdays, he rides back to the Cuban camp with the doctors to eat lunch, learn about different countries represented on the team, and watch TV. Son Son’s life regains rhythm and purpose. He is given a child-sized uniform of the Henry Reeve International Contingent – shirts of green surgery scrub material printed with the Cuban and Haitian flags. When members of the Contingent learn the Bruns have no roof for their shelter, they find him one of the blue plastic tarps you’ve seen in every post-disaster report on CNN. He becomes part of an international family hailing from all over the world.

“I’ve lost all my friends, Conny,” he tells me one day as we walk to the bus that will take us to the health post. I say nothing, waiting for him to elaborate about his friends that perished in the quake. I do a lot of listening here, asking far fewer questions than I usually would and I never inquire about family, waiting for folks to broach personal subjects. “They all left to work in different parts of the country.” It takes me a moment to realize Son Son is referring to the scores of ELAM doctors who have now been posted to health centers and hospitals throughout Haiti. I hope my sigh of relief isn’t audible – departing doctors is much easier to address than dead classmates. “Oh, Son Son. I know you miss them, but don’t worry. There are more arriving tomorrow and I know you’ll make a lot of new friends.”

But the prognosis for Son Son’s mom is another thing: it is not good. Her immune system is extraordinarily weak and may not be able to resist the multiple ongoing assaults on it in today’s Haiti. “She’s very good,” he tells me when I ask after her. The Haitians are incredibly gracious and stronger still; of course he tells me she’s doing well. Still, I go to sleep thinking of Myrlande and pray to whoever will listen that it doesn’t rain tonight – just one more night without rain, please. Son Son still comes to work every day, with his gorgeous smile, giving everyone a hug in turn. Whether he dreams of becoming a doctor, nurse, health technician, engineer, or teacher, everyone is pulling for a scholarship in Cuba for young Son Son. Sí, se puede.

Read Full Post »

A Day at the Leogâne Field Hospital

By Conner Gorry in Haiti

Leogâne, Haiti–Leaving Port-au-Prince is an exercise in self-defense: the assault of sights, sounds, smells, and emotions requires closing your eyes, covering your nose, and shielding your heart from Haiti´s brutal realities.

Haitian drivers – jumping dividers on their motorcycles into oncoming traffic or taking blind curves at high speed in colorful, emblematic taptaps - are additional hazards. On the map, Leogâne is only 20 miles west of Port-au-Prince, but pedestrian congestion and car traffic combine with the earthquake-buckled road to make it an hour-long trip. The city of 16,000 isn’t far from the epicenter and according to some estimates, 90% of the homes here were damaged in the quake. The widespread destruction caused by the disaster, compounded by the pre-quake health picture has manifested in a wide array of health problems, making it a logical location for a Henry Reeve Emergency Medical Contingent field hospital.

Staffed by Cuban doctors and graduates of Havana’s Latin American Medical School (ELAM) from eight countries, plus five Haitian ELAM students who serve as translators and health promoters, the hospital in Leogâne offers free pediatric, OB-GYN, internal medicine and other services in individual tents divided by specialty; the most serious cases are referred to the hospital in nearby Saint Croix, while others are admitted to the limited-capacity tent wards on site.

“We had to adjust our strategy to reach more people,” says Dr Wilbert Barral from Potosí, Bolivia (ELAM 2007) who heads up the ELAM component of the Leogâne team. “Many Haitians haven’t seen a doctor before or aren’t sure how our services work. They think we may charge them, for instance, so we began going into the communities to provide consultations and tell people about the field hospital, explain the services, and that they’re free.” With this new strategy, the previous daily average of 500 patient visits has increased to 800. Dr Barral told me that pregnant women and children are the priority since they are the ones at highest risk in post-disaster situations. Patients with chronic disease are also a priority. “We’re seeing a lot of hyperthyroidism, but not one case of leptospirosis, which is surprising since it’s endemic in Haiti,” explained Dr María Esther from Nicaragua (ELAM 2005).

The doctors at Leogâne emphasize that the emergency health phase has passed–the challenge now is to provide public health

Childhood post quake.

services that emphasize disease prevention and health promotion, including vaccination campaigns. Unfortunately, the emergency phase has also passed for the owners of the land where the Henry Reeve field hospital is located. The team has been given 14 days to vacate the grounds to make way for an internationally funded orphanage which has agreed to pay rent. The team of 60 (53 doctors, 5 Haitian ELAM students, 2 support staff) will be distributed throughout the system of 39 health centers, including hospitals, which will be established or rehabilitated in the next phase of the team’s commitment to rebuilding the Haitian health system.

But today, the current Leogâne hospital was full of song and dance, thanks to the voices, drums, and infectious energy of Agrupación Vocal Desandann, a musical group of Cubans of Haitian descent. Hailing from Cuba’s Camagüey province, the group is part of the

A day of song and dance at the Leogâne hospital.

Henry Reeve’s mental health project, and came to Leogâne to sing traditional Creole songs, accompanied by dancing and lots of audience participation. The group first visited Haiti in 1996 and has been back over half a dozen times since to perform and deepen their ties with their ancestral roots. Many members speak Creole, including Director Amelia Díaz and composer Marcel Andrés whose 50^th birthday is today. Slowly but surely, as the melodic strains came floating over the camp, community members began gathering. Before long, children were clapping, teens were dancing, and a terribly shy grandmother broke into a gap-toothed ear-to-ear grin. March 4^th is the 16-year anniversary of Agrupación Vocal Desandann and what a way to celebrate – in Haiti, bringing smiles and laughter to Haitians.

Read Full Post »