Saturday, April 4, 2009

Walking the Streets of Les Cayes

Les Cayes is one of the largest cities in Haiti. Located in the southern department (southwestern region) of Haiti, it has been my home for the last year. Though I don't live directly in the city, I am only a 10-minute drive away. I live a mile off the beaten path in a village known as Castel Perre where the houses are made of straw and mud and the roofs covered with palms. I drive to town at least twice a week whether it be to buy groceries or supplies or give out food and toothbrushes to the street children. I remember being scared to walk around town by myself. I don't know what I was afraid of but I felt like a stranger and an intruder. Not knowing the language only made me feel worse.

Things quickly changed. I began learning Haitian Creole. I began meeting people and making friends. The street children learned my name and so did the taxi drivers. Before I knew it, I no longer felt like a trespasser. I felt welcomed. I felt at home.

These streets, which to the visitor, seem so broken, empty and destroyed are exactly the opposite. I admit that when I first came to Haiti, all I saw was pain and anguish in every face and sadness in every set of eyes. I know now that I saw only what I wanted to see. I was taught to see Haiti as a country of absolute devastation, a country that lacked hope and a country destined for suffering. There were smiles. There were people laughing. There were mothers hugging their children and husbands kissing their wives. But I seemed to ignore all of the good things and only believed the bad things that I saw. Now, as I near my exit, I understand more than ever how beautiful of a country this is and how beautiful its people are. This is a country like no other, a country that can be devastated by hurricane after hurricane, flood after flood, diasater after diasaster and still wake up each morning singing and thanking God for what they have. There is no word for suicide in Creole. The people I've met this year are among the most kind, passionate and thankful people that I have ever come across. I will never forget Haiti or the Haitians that changed my life.


Downtown Les Cayes. There is no public waste management in Haiti. For the most part, people burn their own trash. This is one of the many public piles of garbage that builds up until someone decides to burn it or move it to another location.
One of the nicer homes in downtown Les Cayes.

Downtown Les Cayes mid-afternoon.

This is a "tap tap." It's the public means of transportation. For about 5 gourdes ($0.10) you can get a ride across town and get off wherever you'd like. Yes, every tap tap is this full and if you're one of the lucky ones to get on when it's empty, just wait 10 minutes and before you know it, you'll be sitting on someone's lap.

Friday, April 3, 2009

Demonstrating Scabies Treatment

One of the boys volunteers to get scabies treatment while Gedna and I show the PH team how to apply it. (I should be wearing gloves)

With 15 of us working, we treated over 200 children for scabies in just one night! Though there were only 15 children found to have live scabies, over 200 were either living with or in close contact with those 15, so we treated them all.

Thursday, April 2, 2009

Toothbrush Distribution

Every three months, the public health team gathers together to distribute toothbrushes, toothpaste and dental floss. With 15 public health workers, it takes us a little over an hour to distribute the supplies to the 540 children in the area.

This distribution program, is quite possibly the most difficult and serious of all the distributions when it comes to organizing my workers. Toothbrushes and paste are highly valuable down here. There are families in nearby villages who have never owned a toothbrush and 6-year-old children who've never before brushed their teeth. When I load the public health team up with these supplies it's as if I'm filling their backpacks with money. They work in groups and never alone.


Wednesday, April 1, 2009

Distributing TB Meds



Fritz and I, showing the new public health students how to perform directly observed therapy (DOT) for our Tuberculosis treatment program.


Every Monday and Thursday, the PH team travels with cups, water and their Tuberculosis (INH) meds to track down the over 100 children in the area who have tested positive for TB. The directly observed therapy (DOT) program that we use requires the public health workers to hand deliver the meds to the children and watch them take the meds.

Tuesday, March 31, 2009

A Burden of Disease

Waterborne pathogens are microorganisms (bacteria, parasites etc.) living in water capable of causing human disease such as Schistosomiasis, Hookworm and chronic diarrhea. These diseases are the most prevalent infections of poor people, affecting over one billion people living in developing countries. These people, who lack access to affordable clean water and sanitation systems, are disproportionately affected by the burden of diseases related to water. Many of the disease cases lead to chronic and disabling conditions while nearly half result in the death of the infected individual.

There are several ways in which these pathogens make their way into the human body. Human feces, containing a wide range of bacteria, viruses and other microorganisms, pollute water sources used for drinking and washing. Dead animals and debris are other examples of pollutants posing major problems to drinkable water sources. There are also naturally parasitic waters where bacteria and parasites have survived for billions of years. In many instances, these bacteria play a major role in balancing the ecosystem around them but make the water undrinkable for humans. The problem is not whether or not these pathogens can be destroyed, because almost any water can be made drinkable with the proper filtration system. The difficulty lies in determining an ethical approach to combating these existing inequities among the rich and poor while not compromising the ecosystem and the natural state of the earth. Chlorinating the water for example would make it drinkable for humans but would also kill off all of the parasites in the water, disrupting the ecosystem and possibly leading to the death of all the plants and animals that rely on these naturally occurring bacteria in order to survive.

The statistics are shocking as researchers discover that water supply and access to sanitation is the world’s most lethal and least reported humanitarian disaster. These complex issues bring about many ethical questions that have long gone ignored. Should clean water be proclaimed a human right and made accessible and affordable to all humans? Who’s responsibility is it to secure this right? How would the natural environment be affected positively or negatively from eliminating all water pathogens from the Earth in order to make “clean” drinkable water available to humans.

The anthropocentric view point that proclaims water as a human right, places human beings at the center of development. The essence of a human right is to inform people of their entitlements and empower them to achieve those rights. Thus, it is the human that matters and that must be protected first and foremost. The issue of safe water is central to life and a lack of access to it has a major effect on people’s health. However, an animal rights approach may argue that though most waterborne pathogens have no detrimental effects on the health of animals, matters of pollution and waste lead to the unnecessary death of millions of animals a year. Such perspectives can drastically change depending on how one chooses to view the source of the problem.

The declaration of water as a human right brings with it a responsibility to respect, protect and fulfill the full realization of the right to water. In some instances, this may mean a complete reconstruction of a community, a way of life and a people because of the several factors that play an important role in the access to water including the dynamics of poverty. Whether understood as anthropocentrism or animal rights, it is the responsibility of wealthier and thus more developed nations to take the lead in securing the right to water for all who lack access. 500 children die every day from diarrheal diseases resulting from polluted and parasitic water sources. Families in rural areas of Haiti, plan to have several children knowing that half of them will not survive beyond five years. In many cases, families are forced to go without water in order to keep their livestock alive, but the polluted water only kills the animals faster, often times making the carcasses inedible. This persisting cycle of poverty is an issue of human and animal rights.

To view the issue of unclean water from a gaiacentric point of view forces one to acknowledge the Earth as a whole in its natural state of being. Humans are relatively new on this 3.5 billion year old planet, while bacteria and parasites have been here from the very beginning. Bacteria are an extremely important part of the ecosystem and are responsible for important processes such as decomposition, nitrogen fixing in plants, digestion in animals and the production of essential vitamins. The effects of eliminating these bacteria would be detrimental to the planet and all living creatures. However, waterborne pathogens such as parasites and bacteria are killing millions of humans and animals every year. The same bacteria that keep a particular plant alive can result in a deadly disease if ingested by a child. This is not new information. It is the survival of the fittest and though humans stand at the top of the food chain, deadly disease such a hookworm demonstrates that humans are not the fittest. It all began with bacteria and will all end with bacteria. Through an anthropocentric lens, the health and well being of all humans must be attained in order to secure the existence of mankind. This attainment means guaranteeing access to clean water and proper sanitation systems and killing off any harmful parasites through chlorination, fluorination and water filtration.

Ensuring access to sufficient safe water is crucial in securing the right to health guaranteed to all people by the Universal Declaration of Human Rights. Lack of sanitation systems for fecal matter, the inability to bury dead animals leaving them to decompose in water, poor hygiene, malnutrition and the burdening cost of water are the results of broken infrastructures. Humans are responsible for their own survival. If humans were meant to live harmoniously with nature then there wouldn’t be deadly parasites in water, the one resource that is essential to human life. Keeping in mind that bacteria and parasites play several important roles in regulating numerous environmental factors including plant growth and decomposition and digestion in humans and animals, caution should be taken in determining to what extent the elimination of naturally occurring bacteria and parasites would affect the overall bionetwork of the planet. How do we then decide the value of things? Who determines the value of a life whether it be of a plant, a cow or a child? What does it mean to make water a human right, if in doing so; it requires denying it from other creatures? How do we reach out to communities that believe it is normal to lose half of their children to deadly diseases and that the water gods are responsible? How do we mind personal boundaries and respect the cultures, religions and ways of life of the many world communities. Most importantly, how do we save the 14-16 thousand people, mostly young and elderly, who die every day from avoidable water-related diseases?

As part of the hygiene and sanitation program, the four main public water sources at Vilaj Espwa are tested bimonthly by the PH team for any dangerous bacteria, lead, nitrites and nitrates. We treat our water with chlorine weekly to kill off any dangerous bacteria. This doesn't always kill the parasites, especially when the parasite is spread through fecal matter etc outside the water source. This is why we treat all the children at Espwa with deworming meds on a monthly basis. I am struggling to find funding to extend the treatment to local villages who lack any water treatment. Here are some photos teaching the PH team how to perform a water quality test...








Sunday, March 29, 2009

Having the PH boys practice some of their first aid skills...bandaging invisible wounds...treating imaginary burns...

I can't explain my facial expression so please don't ask!

First and most important...clean the wound

Delince applying a bandage

Gedna, treating Jean Roody, one of the public health students


Some PH Photos

Teaching the public health boys how to use a microscope...





Weekly public health meeting...This was the first meeting where all the public health members including the students met together. As part of their graduation requirement, I've decided to have the students join forces with the public health vets in tackling some of the PH programs. We split the 11 students up into four teams, putting the four public health workers in charge of their own team of workers. Three students joined Gedna, who's in charge of scabies and tinea capitis treatment, two joined Webert for TB treatment, two joined Delince in PH lesson designing and four joined Sam in performing home, kitchen and bathroom inspections.




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