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Volunteers supporting health and education in Haiti

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July 2008 Trip

As a result of the difficulties we faced during the food riots of the April trip, I decided to go to Haiti alone this trip. Sat., July 12th I arrived in Haiti and stayed for 2 days with my good friend Carolyn. Dr Serant (our Bethel Clinic Ob/Gyn) and his wife invited us to a wonderful dinner on Sunday the 13th - felt like a mini-vacation.

Monday morning, while Carolyn was dropping me off at St. Joseph’s, I received a call from Charles “we have a problem Dr. Tracee,” he said. “Jn. Marc is hurt bad. We called the police, and they said we have to wait for them to arrive.”

I said, “no, don’t wait for anyone, just get him to the closest hospital ASAP if he’s hurt bad.” Then Charles said, “no, we have to wait, he’s dead. His girlfriend stabbed him.”

Jn. Marc, who always had a smile in any situation, the “Haitian Sensation,” my interpreter and our friend of many years is dead, stabbed in the early morning hours by a woman he was trying to help out by giving her a place to stay until she could save enough money to get her own place…..His body was taken to the General hospital and she was taken to jail.

A patient being treated for AIDS started sobbing when she heard of his death. She said “he was the one who encouraged me to always take my medicine. He gave me hope.” Working in the clinic will never be the same without his compassion and joy. We miss you Marc!

After returning from Haiti I learned that another interpreter who often worked in the clinic with volunteers died. Benjy “like the dog” he used to say, suffered from sickle cell disease. He grew up in Dumay and was attending University. He will also be missed

Throughout the week, we concentrated on improving services, procuring supplies and laying the ground work for continuing to work in Dumay without the partnership of the Bethel Foundation we had come to rely on. Without Nathan’s presence in Haiti, many things have changed, and we have been forced to do a lot of restructuring. We were lucky enough to be able to “coordinate running into” Phil Warwick of Gift of Water, the clean water project in Dumay, at the Sister’s of Charity orphanage. We discussed problems and possible solutions in the hallway of the orphanage (not an ideal meeting place, but you take what you can get). From there, we went to the “Planification office” to see what needed to be done to get our latest order of medication out of customs. It has been increasingly difficult to get orders released from customs. This is partially due to the chronic problems of doing anything through the government in Haiti, but it is also due to problems with the Bethel Foundation paperwork. If we can find a source for HIV supplies in country, we will be able stop ordering from the International Dispensary Association. Their prices are great, but if you can’t get the supplies out of customs, even “free” is not helpful. The best resource for HIV care in Haiti is PEPFAR, and we were finally able to meet up with the PEPFAR, USAID, CDC people at the US Embassy in Tabarre this trip. The new Embassy in Haiti is a huge new complex, not at all what you would expect in a country the size of Haiti, makes you wonder…. I first met with Chandra, who works for PEPFAR, Haiti. She introduced me to CDC director Ives Marie, who makes the decisions about which clinics and locations could be part of the PEPFAR program. He made it very clear that there was little chance we would be able to be part of the program and that they would not pay for staff or facilities. The good news is, he did call Dr. Romain and arrange to come to the clinic the following week. We have been given a list of requirements we need to meet to become a part of the PEPFAR program in 2009.

• We need to expand clinic physician hours, which we did this trip by hiring a surgeon and increase general practice physician coverage by 2 physician days a week. Of course that led to increasing staff salary costs of Approx. $1,700/mo.

• We need to expand the physical space, which we have started by constructing a pharmacy and storage building. The building is only ½ completed. We ran out of funds because the price of gas for the generator ($100/wk) forced us to immediately install a solar power system on the roof of the clinic. We calculated it will pay for itself in 17 months. It also allowed for us to install a refrigerator in the lab, which we have needed to store vaccines and HIV test kits.

• We need to improve staff education. This is one of the things we specifically asked PEPFAR to help us with and they do offer the education programs we need.

• We need computers and Electronic Medical Records. JCC, inc. has supplied us with computers and they have been working on an EMR system for us. So, we are on track with this requirement.

If we meet the requirements, we will be offered some supplies and educational opportunities.

We saw patients 2 days in the clinic in Dumay. The days were very organized and the patients were very well mannered, but there was a sadness due to the absence of Jn. Marc. One of our community health workers, was diagnosed with a 20cm ovarian mass. Dr. Serant said he could operate and remove it for a global fee of $700. I gave him the money trusting I could plead her case at our next “Womenade” fundraiser later that month. At the Womenade meeting, a regular who happened to have the same name as the community health worker pledged the entire cost of the surgery! I will update this letter when we know the outcome of the surgery.

Transportation continues to be a huge problem. Due to the skyrocketing cost of gas $7+/gal, fewer TapTap’s are going to Dumay, and our physician staff is having trouble getting to work. When we have a truck of our own (we’re looking for one), staff will be able to wait in Croix-des-bouquets for a ride to the clinic in our truck. Currently we are scrambling for often unreliable transportation every day.

At St. Joe’s guest house we were able to see some children who are possible candidates to travel to the USA for healthcare via Angel Missions Haiti (Vanessa Carpenter). Most were too ill to be helped even in the USA. It’s very hard to talk to the parents who are so hopeful we will be able to cure their children. We were lucky to be staying at St. Joe's while Francisco, the Regional Manager of Smile Train was investigating setting up a program to eradicate clef palates in Haiti. We were able to introduce him to Father Rick's facility in Tabarre, and he told us about facilities in Haiti that may be able to help our patients in the future. A reporter, staying at St. Joe’s, was doing a story on Voudou. He interviewed me about our HIV patient who wanted to go to the Voudou doctor because the our patient was told the Voudou doctor could cure him, and then was dragged back to see us by his mother. He started taking the prescribed HIV medication and quickly improved, regaining 20 lbs as well as his strength, but refused to take his medicine when his community health worker died suddenly. Our patient decided the HIV treatment program had been cursed. He was dead within 2 months. If the interview is ever aired, it will be on the Discovery Channel. Let me know if you see it.

On Friday, nurse Carmel arranged a meeting with PAM, the United Nations feeding program. We are hoping will help with feeding the HIV patients and their families. We opened a bank account with the non-profit bank Fonkoze, so we would be able to manage funds without the Bethel Foundation if needed. We also met with the director of FCMS, Haiti, who is in charge of organizing and distributing all the supplies for PEPFAR programs. I thought it would be good for him to know us, so we could get supplies quickly once we are approved.

After trying to arrange to purchase a casket for Jn. Marc, we were told no one knows where the body is. The owner of the casket factory actually made phone calls for us trying to track down the body. It was taken from the hospital by a man who refused to let anyone arrange the funeral but himself, at of course extravagant prices. Jn. Marc was basically being held for ransom in death. We refused to pay ransom for a body, and gave his mother our standard death benefit for clinic employees. I have since heard his body resurfaced and there was a funeral but don’t know any details. St. Joe’s held a wonderful memorial service for Jn. Marc with a portrait surrounded by flowers.

Tracee Karaffa