A HAM team returned to Haiti for a third time since the
devastating earthquake on January 12th with a different focus for
this mission. Long time HAM supporter, Keith Hare of
Granville, and his brother Bruce joined Paul and Dr. Tracee on
this trip to install a new solar power system, providing much needed
electricity to the clinic. Keith designed a system of solar power
generation so the clinic will have consistent and sustainable electrical
power. To download a PDF file of Keith’s solar system design, click here. The team relied
heavily on using local Haitian welders, masons and electricians to build steel
racks to hold 12 solar panels, securely install the racks on the roof of the
clinic, install a battery system to store electricity, and wire the entire
system with appropriate safeguards. HAM recognizes the importance of employing
local workers whenever possible given the even higher rate of unemployment than
before the earthquake. During this trip, Dr. Tracee also focused on finding
primary resources for medications in Haiti, as major pharmaceutical
distributors were largely wiped out in the earthquake.
The clinic in Dumay is not located near the Haitian power
grid, unreliable as it may be, therefore electrical generation on-site
is
required. The previous occupants relied on a diesel-powered generator
that no
longer exists. The decision to use solar power generation means that
powering
the clinic will be clean and sustainable, independent from the high cost
and
fluctuating availability of fuel. Having reliable electricity at the
clinic now allows us to address the next set of important goals;
creating a lab to do
a variety of tests on-site and having a refrigerator to store vaccines
and
medications that require refrigeration. Electricity will also enable us
to
install an internet connection so that the staff can easily communicate
with
us. With electricity, we will be eventually be able to equip the clinic
with a
variety of medical tools and equipment that will improve our ability to
effectively serve the community.
The posts below were been sent from the team as
their mission progresses.
Saturday, April 24th: We fly back to Ohio today after a productive week. Looking back over the past three months since the earthquake on January 12th, it feels good knowing how much HAM has been able to accomplish in a relatively short time. Just driving to the airport today, the challenges of recovery the Haitian people face are obvious with rubble and tent camps everywhere. Yet, we we take some small comfort knowing that in the community of Dumay, people can count on access to basic health care five days a week thanks to our efforts and the generosity of HAM supporters.
The significance of the recent efforts of Keith Hare in designing to solar power generation and storage system, and along with his brother Bruce flew with us to Haiti to install the system, can not be over stated. Extensively researching resources, equipment, and existing systems in remote locations, Keith crafted a system that would most effectively meet the long term needs of the Dumay clinic with minimal maintenance and maximizing the productivity and lifespan of the components. The system and installation follows the US electrical code, avoiding the usual lure of cutting corners and costs so often found in Haiti. Watching Keith and Bruce work with the many local community members involved in installing the system was a true delight. They worked with the crew both as collaborators and teachers, involving the Haitians in every step and explaining the purpose and function of the process and components. Bruce commented that by the third day, he could barely start a job when one of the crew would simply take the tool out of his hand taking over the task. Hearing the laugher of the crew, at times we wondered how Keith's pension for puns translated so well to Creole. Keith and Bruce departed the project having made many friends and with full confidence that the system was left in good hands. At the airport, making our way through the many security lines, we overheard Keith talking with an American pastor who was inquiring why he was in Haiti. The pastor and his group had been working with a school, orphanage and clinic north of Port au Prince and he was lamenting that they had been charged over $5000 US for just the past two months by the Haitian electrical utility for electricity, sporadic as the delivery was. It wasn't long before the pastor was asking Keith if might be able to help their group design and install a solar system at their facilities. HAM is most fortunate, and even more grateful, for both Keith and Bruce's generosity and hard work in providing electricity at the Dumay clinic.
Solar crew laughing at one of Keith's puns?
Having achieved the milestone of electricity at the clinic this week, we now look to the next steps forward. First, there is the need to provide an appropriate security for our investment in electricity. We have the support of the Fondation committee to build a security wall around the clinic with gates which can be locked at the end of the work day. Currently, members of the community take turns at sleeping at the clinic to make sure thieves can not pillage our investment, a temporarily situation until the security wall is built. Secondly, we feel it is most important that future HAM teams are able to stay in Dumay at the clinic, be even more a part of the community. To that end, we are transforming the two end rooms on the east side of the clinic into guesthouse quarters, and building a secure 10'x35' sleeping porch. These include an existing private bathroom with shower and we shall add a kitchen, and will comfortable accommodate 6 team members. Living and working within the Dumay community will only strengthen our relations with the community, as well as provide the team with a more rural and relaxed environment than Port au Prince. We are awaiting bids from local contractors for both projects and expect to begin construction in early May. Equally as important, we must procure lab equipment and eventually hire a lab technician, so that we are able to support testing on-site and more effectively treat our patients. We are currently searching for donations of equipment such as microscopes, a centrifuge, and an autoclave which we can set up at the clinic as soon as our next trip to Haiti. We have much to look forward when we return next.
Etienne and Edwique's gate design
Friday, April 23: Our last day of work and while the week has been most productive, there is still much to be done. We started in Dumay meeting with the Foundation committee, the group of community leaders that represents the three zones of Dumay: Campeche, Gallette and Pont. We have set up the Dumay clinic, Centre de Santé Communitaire de Dumay, as partnership between HAM and the entire community of Dumay with the Foundation committee functioning as their voice. Formal meeting in Haiti are long affairs requiring much patience and reasonable diplomatic skills. Translation slows the process and there are occasional issues from past discussions that return as topics because the interpretation was not so clear. Today the meeting went on for close to two hours but ultimately concluded with agreements for our future direction and we shall be able to begin the next phases of the clinic development immediately.
After the meeting, Paul and Tracee headed into Croix des Bouquet to purchase metal artwork for the upcoming Art from the Heart auction. Fortunately, that area was further away from the epicenter of the earthquake that damage was less severe and we discovered the artists we work with have started producing again. We found some lovely pieces to bring back. Then it was off to Tabarre where Tracee was dropped off at the U.S. Embassy. Carolyn, our fabulous friend who we are staying with, works at the Embassy and had invited Tracee to attend a art and craft fair being held there. While the volume of art we have been able to procure on this trip is fairly minimal, we are pleased with the quality and look forward to sharing our discoveries at the upcoming event in Granville. Leaving Tracee at the Embassy, Paul went to check another Internet provider to see if Dumay was within their coverage area. They said to check back in three months. It looks like our hope of having the clinic hooked up with an Internet connection will have to wait a little longer.
Keith and Bruce spent the day wrapping up their installation, labeling the various panels and breakers, measuring specific gravity on the batteries, and going through the dos and don't of the system with the individuals who will be responsible for it upon our departure tomorrow. Keith's design and the teams installation seems to have the system performing beyond even Keith's expectations, and we should have more than adequate power at the clinic for all the foreseeable equipment requirements.
The HAM departed the clinic in the late afternoon knowing we had accomplished a great deal with our Haitian partners, and excited about what the electricity at the clinic means for its future.
Thursday, April 22: We seem to have dodged the bullet on rain this week, being able to cross the river to Dumay without problem each morning and copious sunscreen needed for the solar panel installation on the roof. Days have been mostly sunny with high humidity.
Our team camped out in Dumay for the day and accomplished a great deal. Dr. Tracee got back to medical business and saw patients for most of the day. She saw several very sick patients with high fevers, headaches, stomachache aches, myalgia, and suspects increased rates of typhoid and malaria. Unfortunately, we don't have lab facilities as yet so there is no way to be certain. The good news is, now that we will have electricity a lab at the clinic is in the foreseeable future.
Paul worked with Wilberne on administrative procedures and then measured and drew up the plans for a new security wall around the clinic. Half of the walls around the six acre property the clinic is within fell during the earthquake and the clinic is completely accessible and therefore vulnerable. With a significant investment in the solar system and plans for lab equipment and other major purchases in the near future, we have determined it is essential that we build a new security wall around the clinic. Additionally, we will be using one end of the clinic as guest quarters for our volunteer teams and we will be building a small porch area in support of that, and Paul is working with local contractors on that project as well.
Dr. Tracee with patient Laurensley, named
at birth after the doctor's own daughter.
Keith and Bruce cracked the whip and with their crew managed to get all the solar panels up on the roof safely and installed. Much of the rest of the day was spent finishing the wiring of the panels and affixing the entire rack to the roof. By the end of the day, the system had drawn 1.6 kilowatt hours and seemed to be working above expectations.
Our evening was spent back at the house in meetings with Dr. Joey and Dr. Jacques. HAM has been funding an Eldercare program at Dr. Joey's hospital, though since the earthquake is has morphed into a chronic care program focusing primarily on hypertension and diabetes, given the earthquake didn't bias a specific age group. Dr. Jacques, the medical director of the Dumay clinic, has been away from the clinic all week working with Doctors Without Borders on a major surgical project and this evening was the only time we were able to meet with him. A long day and evening, but most productive.
Wednesday, April 21, 2010: Halfway through our week and we seem to have hit our stride. Keith, Bruce and the crew jumped right into wiring and installing the solar panels on the roof while Paul and Dr. Tracee had another full shopping day, including a stab at procuring the remaining 50% of the meds needed at the clinic. Our workday was slightly truncated as we had an important dinner engagement to make and need to leave the clinic by 3:30.
The shopping adventure began with returning the faulty truck battery under warranty, and amazingly it was replaced without argument. Score! At Maxime's, the hardware store, we successfully returned a major item we didn't need and found all the parts Keith and Bruce requested. Second score! Next we visited 4C, a Haitian wholesale pharmaceutical company, to see if we could obtain the meds we could not get at Promess. It took a while, but we got everything but Cloxacilline and Promethazine, which brought us up to over 90% of what the clinic needed for the next four months. Third score! We were getting kind of cocky at this point and went for four out of four, the internet provider Access Haiti to see if their coverage area included Dumay. Well, three out of four isn't bad.
First of three sets of solar panels being installed on the roof of the Dumay clinic.
Keith, Bruce, and their crew definitely scored big time, as, by the time we arrived back in Dumay at 3:00pm they had one third of the panels on the roof and working, with the batteries charging and the clinic powered up. We have all been most impressed with the entirety of our Haitian crew working on the solar project, all local members of the community. Our hope has been that with this project, we could demonstrate to the community our serious level of commitment. By the reaction to it so far, it is certainly proving to be successful.
The crack solar team from Ohio and Dumay.
The important dinner engagement mentioned earlier was a lovely way to end the successful workday. We were hosted at the home of a pair of U.S. Embassy diplomats, Paul and Susan, who served a wonderful dinner and entertained with sparkling conversation. They had just started their service in Haiti last November and their timing couldn't have been more challenging, given the earthquake. We had a delicious meal and a wonderful time, and while we hope to see them socially in the future, we hope not to need their services any time soon.
Tuesday, April 20: Another long but productive day, the team stayed together at the clinic. On the way there we stopped at the welders shop to inspect the work so far and make sure our communication had been clear. The welder, Etienne, is actually Edwique's, the electrician, business partner. Paul checked the specs of the work in progress and talked through the base support structure so that fabrication could proceed.
Paul checking out the solar panel racks with Etienne, Edwique and Charles.
When we arrived at the clinic, the trench we had requested be dug for the ground rods and wire was already complete. In fact, all of our Haitian crew have proven to be hard workers; industrious, inventive, and happy to be involved. They all seem eager to learn and the language divide seems minimal with the commonality of tradesman work. By the end of the day, the American/Haitian solar team had the ground wires planted, batteries installed and fused, conduit run and wired to the Lab where the vaccine refrigerator will be located, and the 24 volt system up and running. Tomorrow, their attention will be turned to configuring and wiring the solar panels.
Dr. Tracee worked in the clinic seeing patients and working with the pharmacy and nursing staff. As it rained heavily in Dumay in the early morning, patient flow was lower than usual allowing for a staff meeting to talk about the current operation of the clinic and the expected changes in the near future. With electricity in the building, we shall be able to start building up the lab and expanding our services. It was actually nice to have a day with fewer patients, which allowed us to work directly with the staff to address some of the operating issues which have come up since the clinic began full operation just 12 weeks ago.
Our biggest challenge so far seems to be the gas shortage in Port au Prince. On the way to Dumay this morning we had to buy a gallon of gas on the street (black market) for about $10 US, just to be sure we had enough to get us there and for Joel, our driver, to look for a gas station with fuel for sale. Joel spent much of the day locating an open gas station and waiting in line. The gas price at stations is over $5US a gallon, but we have a full tank and can breath easier for a few more days.
Monday, April 19:
Crossing the muddy River Gris to Dumay
The rain fell hard last night and it was a very muggy night. The day started out overcast and the river ran brown, but not nearly high enough to cause us to circumvent it. Upon our arrival at the clinic at 7:30 am, Keith and Edwigue, our Haitian electrician, got off to a good start on the solar installation and Bruce was to join them upon his return from Papay. Paul and Tracee met with the clinic staff and then headed off to Promess for another stab at procuring medications. This was our fourth try at this venture since late January and after more than 3 hours of waiting we emerged successfully…well, we were able to get almost 50% of the medications we had ordered. We were then off to Maxime's hardware to pick up the remaining supplies needed by Keith and Bruce. This adventure took us a brief 2 hours. Add in the hour plus each way from and to Dumay, it was a close to 4pm. Fortunately, Keith, Bruce and Edwigue were much more productive and by the time we departed the clinic at 5:30 pm, they had all the holes drilled through the concrete for the conduit runs and the inverter panel wired up and on the wall.
A word about shopping in Haiti: whether it be at Promisse or Maxime's or Epidor for dinner, the system is the same. After waiting your turn in the first line, you place your order with someone who writes it up and then checks inventory to see if the items you want are actually available. Once It is determined what is available and the final order is written up, you stand in another line to pay the cashier. If you are using a credit card for payment, then you usually have to stand in a separate line to have the card processed before moving to the cashier's line. Once the cashier has processed your cash, check, or already processed credit card payment, and stamped the multiple copies of the receipt several times, you are handed back a copy of the receipt and move to yet another line where you give the receipt to the person who collects your order for you. In the case of Epidor, you have to stand in different lines to collect your drink, or sandwich, or french fries, or crepes, or desert. Tonight it took us no less than 45 minutes to collect everyone's food and beverage items from the various lines. This typical practice of purchase-process-segregation in Haiti is stunningly inefficient. I suppose in a country where labor is the least expensive production/service component, time is also of least importance.
Fortunately, our evening ended on a lovely note as we celebrated Bruce's birthday with a cute teddy-bear cake. Once the sugar rush wears off, we should all sleep like babies!
Happy Birthday Bruce (left)...cut the cake, baby!
Sunday, April 18: No rain last night and we were able to easily cross the River Gris to reach Dumay. We were warmly greeted at the clinic by Wilberne, the clinic administrator, Remy, a couple of the committee members, and our Haitian electrician. After a quick tour we put Keith right to work with a number of eager, though non-English speaking, assistants. Bruce was not with us today as he was off visiting another brother, Mark, who works with a Haitian NGO, MPP, in Papay. As Keith had designed the system without having seen the clinic, his goal today was simply to inventory all the parts brought from the US and purchased in Haiti and plan out his approach to working through the installation. Paul worked with the welder to design the racks to be mounted on the roof to hold the solar panels and sent him of to work on getting the materials so construction can begin first thing Monday. Dr. Tracee did a complete pharmacy inventory and reorganized all the medicines at the clinic. Not the most exciting of days, but necessary.
Still life: solar parts
Our friend Stephen came to visit in the afternoon and it was nice to catch up with him and hear of his current projects. Stephen, who is originally from Great Briton, works with a community group in Cite Soliele, the most notorious slum in the Western Hemisphere, teaching English and has been working on ideas for income generation within the poorest of economic communities. He lives with a Haitian family just outside of Cite Soliele in a most interesting community called Villa Renaissance, which we visited when we took him home. The housing project was started earlier this decade by ousted-president Jean-Bertrand Aristide with the intention of moving poor families out of the poverty of Cite Soliele into an improved housing community. The community has been built in four stages, the final stage being under construction. The first two stages were multi-story apartment buildings, all built well enough to hold up to the earthquake. The third stage, where Stephen"s "family" lives, are small single family residences lumped together. As we drove by the final stage under construction, the project seems to have morphed into a full fledged housing tract. An interesting factoid is that this project is being funded by Hugo Chavez, Venezuela's socialist president. There's always something new to discover in Haiti.
Villa Renaissance, stage four. We wondered if Hugo picked the colors?
Saturday, April 17: One is all too often reminded when preparing for a mission to Haiti, that the best laid plans are simply not enough to ensure a smooth path forward. The primary goal of the April trip has been to install a solar power system at the Dumay clinic and we have been working towards this since our previous time here last month. On that trip we had purchased the major items in Port au Prince, including solar panels, batteries and the inverter, paying with a U.S. check written and deposited on March 11th. When I contacted the distributor on Wednesday of this week, the check had still not cleared. Additionally, the money we had wired a week ago to our Haitian bank account for payroll had also not yet appeared in that account, triggering daily phone calls of concern from Haiti. Checking the weather forecast for Port au Prince for the upcoming week, it looks likely we'll be installing the system in the rain. Yesterday, Friday, we heard that there was no gasoline to be found in Port au Prince, gas needed to transport us and run the generator. Needless to say, things were not lining up as well as one would hope.
The four of us met up at the Miami Airport late this morning, and after a forty-minute delay we finally took off and landed in Port au Prince about 4:15pm. We are happy to report a major improvement at the airport as they have now installed baggage carousel in the warehouse and bags are no longer being thrown into an enormous pile in the middle of the room for travelers to wrestle over. It was still a madhouse but we were able to find all the bags and were on the street not much after 5:00. As usual, we were met by Charles and Joel and whisked off Eagle Market for grocery shopping and onto Carolyn’s, where we are once again being graciously hosted.
We have 6 days for our small team of Keith Hare, who designed the system, his brother Bruce, an electrical contractor, Paul, and Dr. Tracee to work with Haitian electricians, welders and masons to build racks for the solar panels, cement the racks to the roof for security, assemble and wire the entire system in hopes of departing on the 24th leaving the clinic with electricity. Fortunately, the check for the equipment cleared on Friday and the equipment was picked up this morning, the account confusion at the bank was sorted out and payroll has been distributed, and Charles was able to find enough gas to last us a couple of days; all in all, a successful day. Tonight it looks like rain. We’ll just have to wait and see what tomorrow brings.
discovered the artists we work with have started producing again. We found some lovely pieces to bring back. Then it was off to Tabarre where Tracee was dropped off at the U.S. Embassy. Carolyn, our fabulous friend who we are staying with, works at the Embassy and had invited Tracee to attend a art and craft fair being held there. While the volume of art we have been able to procure on this trip is fairly minimal, we are pleased with the quality and look forward to sharing our discoveries at the upcoming event in Granville. Leaving Tracee at the Embassy, Paul went to check another Internet provider to see if Dumay was within their coverage area. They said to check back in three months. It looks like our hope of having the clinic hooked up with an Internet connection will have to wait a little longer.
Keith and Bruce spent the day wrapping up their installation, labeling the various panels and breakers, measuring specific gravity on the batteries, and going through the dos and don't of the system with the individuals who will be responsible for it upon our departure tomorrow. Keith's design and the teams installation seems to have the system performing beyond even Keith's expectations, and we should have more than adequate power at the clinic for all the foreseeable equipment requirements. 
