A Conversation with Dr. Jean Fritz Jacques

“The poor people are stuck with the Haitian government. The government doesn’t care if they have healthcare, food, water, or education—they just don’t care.”

This is a direct quote from Dr. Jean Fritz Jacques, Healing Art Missions’ Medical Director in Haiti. He recently met with the HAM Leadership Team via Zoom to share his thoughts about the increasing lawlessness in parts of Haiti and an update on how the HAM medical team is working to continue to provide services and hope. A summary of that conversation follows.

What is the current situation like for medical providers in Haiti?

Dr. Jacques: The situation is getting worse in many places in Haiti, particularly in Port-au-Prince and the Artibonite region. There are many regions where you simply don’t want to go and, particularly, don’t want to go to at night.

A major healthcare provider in Port-au-Prince, GHESKIO, recently closed its doors in protest of the kidnapping of two members of its medical team and a large rural hospital, Hospital Albert Schweitzer, in the Artibonite region has closed its doors to everything but the most critical of cases due to instability.

The general hospital in Port-au-Prince has been closed since December and, in January, a Medicines Sans Frontiers- supported hospital in Carrefour closed after armed gunmen killed a patient.

So, the situation is dangerous in some regions of the country. Unfortunately, the primary area of trouble is Port-au-Prince, which is the main port, so this impacts the rest of Haiti.

What about the rest of Haiti? What is it like elsewhere?

Many regions of Haiti are safe and just want to live in peace. I think, sometimes, people hear about what is going on Port-au-Prince and assume the whole country is overrun by violence, but it’s mostly just the capital region and a few other small areas across the country. The vast majority of Haiti is not like that. When our team is working in the Nippes region, for example, at the hospital in Miragoâne, there is no gang activity. People are out at all times of day and night just living their lives. The same is true when we are working in Port-Salut—it is very peaceful.

But, due to the unrest in Port-au-Prince, the whole country is suffering from a shortage of food and necessary supplies. Port-au-Prince is the main port for the whole country, and Haiti relies on imports for most of its goods. This situation is very serious and continues to get worse.

Can you describe what it is like to get food and supplies?

It’s bad all over Haiti and people everywhere are struggling to find food. Just recently I noticed a chicken product that I used to purchase for 3000 Haitian gourdes ($20.54) now costs 20000 ($136.98). I don’t know how people are going to continue like this or where they will find the money to feed themselves and their families.

Getting supplies is also getting increasingly difficult. It’s not just HAM—all medical providers are struggling to find basic supplies like wound wraps, surgical draping, and even some important medications.

I think the international community is starting to understand that the Haitian government is not going to step in to help with these problems. I hope there are good people who are willing to intervene on behalf of the everyday Haitian people.

Why do you stay?

Lots of people have left or are trying to get out of Haiti. The people who are leaving are the ones who can afford to leave—the professional class. Haiti is at risk of losing its entire professional class due to the instability.

The poor can’t leave. They are stuck here and are at the mercy of a government that does not care about them. I want to stay because it gives them hope.

When Healing Art Missions’ medical team goes into Miragoâne, people seek us out. We are providing 100% of orthopedic care for that region, so if someone has an accident or a fracture, they need us to be there. We are also bringing 100% of the anesthesiology drugs to that region for people who need surgery.

The director of Hôpital Ste. Therese de Miragoâne told me that they would have closed their doors if it wasn’t for us. If this happens, there is no healthcare for the people of Nippes.

This is why I stay—the worse things get in Haiti, the more responsibility organizations like HAM have to the poor. We are the only ones helping them.

We can’t save the whole country, but we need to play the part that we can.

What does the future hold?

No one knows what is going to happen in Haiti, but we do know that we are going to have a problem if medical professionals keep leaving the country. That is why we are working to help develop the pipeline for the next generation of healthcare providers in Haiti.

Since the General Hospital in Port-au-Prince closed in December, I have been bringing medical residents out into the field with us to Nippes and Port Salut. Each month we bring a different resident to give them real-world experience. We currently have surgery, orthopedic, and anesthesiology residents working side-by-side with our team.

We may not be able to stop people from leaving Haiti, but hopefully we can help develop the talent that will fill their shoes when they are gone.

Any concluding thoughts?

I wish I could show HAM supporters the look on patients’ faces when our team arrives in their area. They know they are going to get quality medical services from people who care about them. We have a good reputation and when we arrive in an area it gives people hope.

I want to thank everyone for making that possible with their donations and support.

Haiti’s Death Spiral: How Much Worse Does it Have to Get?

The following is a message from Haiti Health Network, an organized group of Haitian healthcare providers who are committed to strengthening the overall healthcare delivery system in Haiti. Healing Art Missions is a member.  

What is the breaking point before something is done? Should we accept daily kidnapping and murder as a normal fact of life? Should we accept Haitians dying every day of starvation and Cholera? 

For over a year, the Haiti Health Network (HHN) has been sounding the alarm that healthcare is on the verge of collapse in Haiti, and that we were witnessing a humanitarian crisis unfolding. NYT: “Horror on the Streets of Haiti. Haiti’s crisis has unfolded, and the deaths are spiraling out of control. Hospitals are unable to access medicines, medical supplies, fuel which are key to their functioning. Most HHN members are operating at a drastic reduction in services that are offered, including nutrition programs, emergency child and maternal services, and HIV, malaria and cholera prevention and treatment. There isn’t a member of HHN, staff, or patients that hasn’t been impacted by the horrific situation in Haiti. It is imperative that these healthcare organizations remain open and operate as close to normal as possible, as quickly as possible. This document addresses the situation from three points: (1) the current situation in Haiti, (2) the regional impact of the situation, and (3) the way forward. 

The current situation in Haiti has gotten much worse than even four months ago, and the evidence is overwhelming. Haiti's capital taken hostage by brutal gangs. The social and health conditions are rapidly deteriorating throughout Port au Prince, and many other areas of the country, where gangs are committing horrific acts of violence, causing thousands to flee their homes, including the revictimization of many. Haiti: People face cholera and famine-BBC. Furthermore, according to the U.N. humanitarian chief in the Caribbean nation, it is estimated that the gangs are controlling about 60% of Port au Prince, including access to major roads thus crippling transportation/distribution services for the entire country. The following video was created by an HHN member who was forced to relocate a clinic in Croix Des Bouquets due to gang activity. He gives a detailed report of the location of gangs and their respective areas of control. Nov 2022 Gang Update. Also, in the fall of 2022, gangs seized the main fuel import terminal, blocking the delivery of diesel across the country, thus placing the delivery of healthcare, food, medicine, and emergency supplies at greater risk. Key fuel depot in Haiti reopens. Nothing has changed to prevent such an event from reoccurrence. 

A further complication is the cholera outbreak, which was left unaddressed for several weeks due to the fuel blockade, with no access to clean water or proper sanitation. In October 2022, during his visit to Haiti, Brian Nichols stated that, “this outbreak puts 1.2 million Haitians at direct risk of infection and death.” https://youtu.be/o9OzS-bN5Do. Critical to this is that healthcare facilities lack IV fluids, catheters, tubing, and PPE to battle this epidemic safely and effectively. Even after the fuel was released, the health facilities have not been able to regain access to supplies needed to control this outbreak. Cholera- Haiti (who.int). 

Of enormous concern is the current food security situation “with armed gangs in charge of key transport routes in Haiti, the country could see famine conditions, unless a robust humanitarian aid plan is put in place,” as Jean-Martin Bauer, from WFP, has warned. For the first time in the western hemisphere, parts of Haiti are considered at Level 5 (“catastrophic”) for hunger and death from starvation and 48% of the country is at Level 3 or above for food insecurity. 

https://www.fao.org/newsroom/detail/catastrophic-hunger-levels-recorded-for-the-first-time-in-haiti/en 

The reality is that humanitarian organizations continue to come under attack. For staff in most areas of the country, daily work means navigating roadblocks, with threats of violence (including possible death) and kidnapping. While HHN members are ready to assist with the many health challenges facing Haiti at this moment, including the cholera outbreak, a humanitarian corridor enabling safe passage is essential. Such a corridor does not exist, and all healthcare services remain in daily danger of disappearing due to increasing gang control.

The regional impact of the situation as described above will be felt throughout all neighboring countries. As the current trend continues, a ground intervention will become inevitable to salvage the deteriorating infrastructure and remaining resources of the Haitian nation. 

Violence and instability continue spreading to the neighboring Dominican Republic where the military has mobilized at the border due to gang activity, including robbery, hijacking, kidnapping, arson, and murder. The Bahamas and Florida are already receiving large quantities of irregular migration. Turks and Caicos is under strain after 300 Haitian migrants were recently detained. Turks and Caicos | The Guardian. Without intervention things will continue to worsen, and we will continue to witness Haitians dying inside of Haiti as well as out to sea, as they desperately seek safety anywhere outside of their native home. 

In October 2022, Ariel Henry, Haiti’s interim prime minister, called for an international military force to come to Haiti and deal with the armed gangs terrorizing the country. Thus far, it does not appear that any member of the international community has stepped up to lead such an effort but rather discussions persist about the historical nature of interventions in Haiti–all while Haitians continue to die daily. In the meantime, the current Haiti administration has been unable to provide the security and stability of a functioning society. It is true that Haiti has struggled for many years, and there are endless books and articles around this topic, what most (outside of Haiti) remain unaware of is the multi-layered fallout possible from a “failed state”, under the control of well-armed gangs, less than 100 miles from the coast of Florida. 

The way forward needs to address a terrible situation that continues to deteriorate which may cause more and more healthcare organizations and others to withdraw from working in Haiti. 

The UN’s Deputy Secretary-General urged every country “with capacity” to urgently consider the Haitian government’s request for an international armed force to help restore security and alleviate a humanitarian crisis, which is in “a deepening crisis of unprecedented scale and complexity that is cause for serious alarm.” This request has caused numerous articles and forums highlighting the historical failures by the international community, and yet all these observations and opinions have had no impact on the actual security situation in Haiti. What we see is continued gang mobilization–with increasing acquisition of political, financial, territorial, and military control of large areas of the country–perpetuating a life of violence, illness, malnutrition, and where many people are dying every day. 

We agree that a military intervention ought to be approached carefully, but the current situation cannot wait for long-term solutions to emerge from within Haiti. A Haitian-led solution ought to involve a national dialogue that addresses the freedoms Haitians should be enjoying in their country: political, economic, social, and personal security. It is possible that there are ideas circulating about ways to restore security that are different from those tried previously. We need to listen to all ideas and insist on immediate solutions to the lack of security we are all experiencing in Haiti, as current conditions are unacceptable and inhumane. What many HHN members witness first-hand is the impact that inaction is having on the personal security of Haitians, thus preventing all other freedoms from materializing. 

We all want the same thing – A peaceful Haiti, led by Haitians – yet this is not possible given the current realities. Among us, there are many leaders that are in the position to address these challenges and alleviate the immense suffering and incredible danger people are facing in Haiti. We are asking for your help in sharing this communication with as many people as possible in your network – family, friends, neighbors, volunteers, donors, religious leaders, political leaders, and your local media.

Healing Art Missions and its partners at the Haiti Health Network are working together to address these challenges. Your continued support makes it possible for us to provide essential services and to bring hope to our partner communities. Thank you for helping us spread the word about this situation and for standing in solidarity with the people of Haiti.

Start of School

School is in session in Port-de-Paix! After many months of delay, we are pleased to share that the Charles Salomon Primary School has resumed classes for all students as of January 9, 2023.

As we have shared previously, classes were originally scheduled to begin in October of 2022, however, Haiti’s Ministry of Education had delayed the start of school due to economic and safety concerns for all schools in the country.

Although Haitian schools were officially reopened on November 5, 2022, most schools did not resume operations until December or January. In some red-zone communities, such as Croix-des-Bouquets, schools remain closed due to the ongoing threat of violence.

Parents and families in Port-de-Paix were heavily involved in the decision-making process for the start of school in the community. Jean Herard Charles held several parent meetings to allow parents to express their opinions and concerns about the school year. The community decided to resume classes in January and we are so thrilled to see these smiling faces back in class!

The Charles Salomon Primary School is supported through the generosity of donors to Healing Art Missions. Thank you for your continued support for this community.

Vaccination Clinic in Demier is a Success

Thanks to the hard work of Ferdinand Louis Juste, a trained community health worker, and his brother, Calixte, the isolated mountain community of Demier continues to do well. Demier is home to hundreds of people but lacks formal infrastructure other than walking paths up and down the mountains connecting homes, church, and one school. Accessing Demier requires a 3-hour hike up a mountain from a trailhead that is only accessible after a 45-minute motorbike ride from the closest city, Leogane. As one might imagine, these circumstances make it nearly impossible for residents of Demier to have access to regular healthcare.

Thankfully, Ferdinand and Calixte help fill the gap. For 23 years, Healing Art Missions has worked with them to provide vaccines, basic public health, and first aid for the community.

Ferdinand sent photos of a recent vaccination clinic that we’d like to share with you. (Ferdinand is pictured in the blue shirt and with the vaccine cooler in the photos.)

Healing Art Missions remains committed to being a partner to the people of Demier and is grateful to Ferdinand and Calixte for the dedication and care they bring to their work.

A Letter from Dr. Jacques

Dear Friends,  

The Healing Art Missions team in Haiti is thankful for the continued support of our U.S.-based partners as we continue to provide needed healthcare in Haitian communities. Last year was particularly difficult as we faced numerous challenges due to the gang fighting, risk of kidnapping, political instability, supply shortages, food scarcity, and cholera. Unfortunately, these difficulties continue to plague Haiti, however, Healing Art Missions is part of the solution and, together, we are making a positive difference for many people.   

As you know, late last year we had to leave our clinic in Dumay due to the dangerous conditions. Although this was very difficult and terrible news, it has actually offered Healing Art Missions the opportunity to put down roots in the Nippes Department, which is a safer, more stable community and will be better for our operations in the long run.  

The local government in the Nippes Department has welcomed the Healing Art Missions team with enthusiasm and we are currently supporting a local hospital, Ste. Thérèse de Mirogoâne, which would struggle to remain open and to provide many needed services without our help. Since August of 2021, we have been providing 100% of orthopedic surgery and consultations, and during the recent lock down, due to the fuel and political crisis, we provided 100% of anesthesiologist care and 100% of anesthesiology drugs as well. Additionally, we are supporting more than two-thirds of the surgical activity in the Nippes region and each month I travel to Port-Salut in Cayes to perform surgery on children, which would not be possible without Healing Art Missions surgical missions there. 

It is our great hope to build a clinic in this region in the coming year. There is a tremendous gap in basic healthcare that Healing Art Missions could fill for the people in the area.  

Our intervention in the south regions aligns with the 2015 Lancet Commission vision of “universal access to safe and affordable surgical and anesthetic care when needed, as surgery is an indivisible and indispensable part of healthcare to prevent that easily treatable conditions do not become diseases with high mortality rates and to protect the underserved from the impoverishment or catastrophic expense of full direct payment for surgical and anesthesia care’’. The Lancet Published: April 28, 2015. 

As an old Haitian adage says, ‘it is in difficult times that we recognize true friends’ while many big NGOs have closed their doors and left the country, Healing Art Missions as a strong small NGO has survived and adapted and continues to be held up as the gold standard for NGOs in Haiti by the Haitian authorities and by the medical community. With your continued support we will be able to make a positive difference in the lives of many Haitians in the coming year.  

Once again on behalf of Haitian people and Healing Art Missions family, thank you for your crucial support and I wish you a blessed 2023— 

Dr Jean Fritz Jacques, MD, MBA, CEO Medical Director, HAM 

Update on Clinic in Dumay

There has been an interesting turn of events pertaining to the clinic in Dumay. As you know, we had to shutter the clinic late last year due to the gang violence in the area where the clinic was located and because many people were moving out of that area.  

For many months, we did not have any news about the clinic and we were wondering what had happened to it. We assumed it had potentially been occupied as a gang headquarters, looted, or even destroyed. This weighed heavily on us as the building was an important community resource for many years.  

This changed in late November, however, when we were contacted by a friend, Father Rick Frechette, and Médecins Sans Frontiers (MSF) who asked our permission to visit the property to determine its usability for a potential cholera clinic and we, of course, agreed.  

We were pleased to learn that, despite armed groups in power in Dumay, the clinic’s equipment property remain intact, indicating a great need for health services in this community. 

Since that visit, MSF has taken over the space (with our full blessing) and is operating a cholera treatment center at the site.  

Since MSF is a much larger organization with a culture and long experience of working in red areas under pressure and threats from armed groups, police, and local authorities, we are delighted that our previous investments in building renovations, construction of new infrastructure, and our purchased equipment for the clinic can continue to be used for the community of Dumay. We hope that MSF will work with the local community leaders and the Haitian government to be able to expand their offerings and provide even more services to the region in the near future.  

We should note, that even in light of this news, Healing Art Missions will not be returning to Dumay. The security situation and violence in metropolitan areas are becoming increasingly worse. According to the International Organization for Migration “more than 96,000 people have left the capital for insecurity and gang violence during the last 5 months’’ and, although, MSF may be able to operate safely in the region due to their size and clout, but we could not ask any HAM staff to work in conditions that could jeopardize their safety or well-being. The areas of Dumay, Pernier, Tabare and the roads leading to Dumay are becoming increasingly dangerous and the majority of businesses have closed and a large part of the residents of these neighborhoods have moved away. 

While the country is facing crisis period with an inflation rate of 47.2% We remain committed to supporting the rural Haitian population, and to continuing our own work in the southern region of Haiti specially in Nippes, which offers much safer working conditions for our team and where there is a significant lack of healthcare services available, and in Port-Salut in Cayes, where there is a dire need for surgery for children due to lack of qualified surgeons and anesthesiologists . 

State of Schools in Haiti

It has been four months since the official start of the school year, but like many Haitian schools, the Charles Salomon Primary School has not been able to fully open. The Ministry of Education delayed the start of the school year this fall due to economic and safety concerns, and at this time, 47% of schools in Haiti are still closed.  

Since the start of the school year, the country has experienced fuel shortages, food insecurity, violent protests, and cholera. All of these have had a direct impact on Haitian schoolchildren. In December, Unicef reported that “three in five schools assessed have been attacked or pillaged, leaving half a million children aged 5-19 years at risk of losing learning opportunities.”  

Jean Herard Charles, head of the Charles Salomon School, has been monitoring the situation closely and has convened regular meetings with parents to get their input. During the most recent meeting in late November, parents expressed anxiety due to a school in a nearby town having recently been burned down by vandals and due to their continued struggles to find affordable food.  

Access to affordable food continues to be an issue throughout Haiti. Charles reports that in Port-de-Paix, a small bag of rice that would typically cost $13 USD now costs $49.  Healing Art Missions continues to financially support the school community, including paying the salaries of the teachers and staff, during these difficult times.  

At the parents’ request, the school has been open for grades 6 and 9 only since November, to ensure these grades are prepared for upcoming tests. However, now that there is access to fuel and fewer demonstrations in the country, the school will open fully on January 9 for all grades once again. We look forward to sharing photos of the start of school with you in the February newsletter!  

2022 Year End Letter From Tracee Laing, M.D. Founding Director

This is a particularly difficult letter to write this year. Last year at this time when I wrote to you, I was optimistic that we would be able to return to Haiti and to our beloved clinic to resume our work since the end of the pandemic seemed to be in sight. However, this was not to be. 

Instead, this past year has been the most difficult year for Haitians that I have witnessed in my 25 years of working in the country. The details of this situation are far too much to explain in this brief letter, but just in the past few months Haitians have had to endure gang battles in their streets, children being recruited into gangs, the risk of kidnapping, difficulty finding food, limited access to clean water, fuel at up to $50/gallon (if they can find it at all), soaring unemployment rates, the return of cholera, nationwide lockdowns, closed hospitals, closed banks, and closed schools. 

What’s left of the Haitian government is doing very little to remedy this situation. The everyday Haitian is on their own. 

The worst moment of this year for Healing Art Missions was shuttering our clinic in Dumay due to escalating gang activity and the fact that our patients were moving away in droves to flee the violence. This was devastating to me, personally, and to the many HAM volunteers and donors who have put so much of their time, resources, and love into helping us build that clinic over the past 20 years. 

The situation in Haiti feels very hopeless at the moment, but this is precisely why we cannot give up. So many organizations are pulling out of Haiti now because of the instability, but there is no one to fill the gap. The government will not do it. The international aid community is scrambling, but many of these organizations are big bureaucratic machines and their aid will take time. 

This is where groups like Healing Art Missions come in. We are small and nimble enough to adapt programming to help a targeted community. So, we are adapting!  

Since the earthquake of August, 2021, HAM has been working in the Nippes Department, a rural district in the southern peninsula that has not experienced gang violence or the turmoil that has plagued the rest of the country. What the region is experiencing, however, is a concerning lack of access to basic healthcare. 

For the past year, HAM has helped to fill that gap and we have developed a reputation as a reliable partner. Incredibly, we are currently providing 100% of all orthopedic care in the region. We are also providing safe birthing services, hiring anesthesiologists and nurses, and performing additional surgical procedures at the region’s hospital, Hôpital Ste. Therese de Miragoâne.  Thanks to HAM’s reputation as a trusted NGO in Haiti and to Dr. Jacques’ reputation as a top surgeon, we have been able to seamlessly transition our operations to this new area. 

Dr. Jacques’ steady leadership is to be credited for our success in keeping HAM operational. Many of our partner NGOs in the country have had to cease operations during the recent turmoil. We are fortunate to have Dr. Jacques at the helm in Haiti.  

We are also fortunate to have you in our corner. HAM truly could not have made it through this year without your support—both financially and emotionally! Truth be told, there were moments when all seemed lost, but the thought of turning away from the people of Haiti now, when they perhaps need support from the outside world more than ever, also seemed unfathomable. Knowing that we could count on the HAM community’s support made it possible for us to envision a path forward and to seize opportunities that came our way. Thank you. 

As 2022 comes to a close and we look toward the New Year, I can only imagine that the turmoil gripping Haiti must somehow come to an end. What that future looks like, though, I do not know.
I do know, however, that the people of Haiti are going to need us—potentially even more than they have ever needed us in the past. 

Most sincerely yours, 

Tracee Laing, M.D. Founding Director

Note from the Executive Director

Friends, I am so honored to work with all of you as we aspire to help our partner communities in Haiti. Thank you for your support as we work to meet the healthcare, clean water, and educational needs in three rural Haitian communities.

With all that is happening in Haiti, it is the everyday Haitian who is struggling the most. Your generous donations are put immediately to work employing Haitian people, supporting Haitian merchants, and changing lives for the better. Thank you for sticking with us during this challenging moment in the country’s history. We are truly grateful for your partnership and trust.

Connie Skingel, Executive Director

2021/2022 Supporting/Collaborating organizations:

So Hum Foundation, Portland, OR; First Community Church, Columbus, OH; Larson Legacy Fund, Portland, OR; Children’s Practicing Pediatricians, Columbus, OH; John & Susan Dewan Foundation, Chicago, IL; First Congregational Church , Hudson, OH; Rotary Club of South Sacramento, Sacramento, CA; Rotary Club of Snoqualmie Valley, North Bend, WA; Community Foundation of Anne Arundel County, Annapolis, MD; Lighthouse Christian Church, Drummond Island, MI; United Way of Central Ohio, Columbus, OH; David’s United Church of Christ, Canal Winchester, OH; United Church of Granville, Granville, OH; Whitaker Foundation, Snoqualmie, WA; First Presbyterian Church, Granville, OH; Hare Electric Inc., Rocky River, OH; Lions Club, Heath, Newark, OH; Calvary United Methodist Church, Lakewood, OH; Haitian Ministry of Public Health, Port-au-Prince, Haiti; Together Rising, Falls Church, VA; St. Luke Foundation for Haiti, Port-au-Prince, Haiti; Hernia Repair for the Underserved, Omaha, NE; Direct Relief International, Santa Barbara, CA; Hernia Help, Port-au-Prince, Haiti

Profile: Joël Saint-Cyr

Joël Saint Cyr, a licensed nurse specialized in midwifery, has worked with HAM since 2018. Joël appreciates the opportunity to work in Nippes because he is the only permanent midwife serving 11 communes.  

Joël shares, “HAM’s work in Nippes is important because there are many people who do not come to the hospital due to lack of funds and many pregnant women still lose their lives by staying at home to give birth.” He believes all women deserve quality care during this important milestone in their life.  

Joël has assisted in over 200 deliveries and  helped many women safely bring their baby into the world. However, the stories of women who do not survive stay with him and inspire him to continue his important work. He tells of one woman who presented with eclampsia after having a seizure while laboring at home. Although he medicated her and helped her through a difficult delivery, she did not make it through the night. The baby, a little girl, did survive thanks to Joël’s interventions after her birth.   

Joël Saint Cyr is an integral part of HAM’s medical team and we are grateful for his skill and compassion. He fills an important gap in maternal care in the Nippes region.