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.

A Few Things

This is a photo of me with Choupi, one of the painters at Espwa. He's the one who painted the 4' x 4' family portrait for me back in September. In this picture, we're holding up some of his abstract pieces. Choupi is 18 years-old and is employed by Espwa as one of the child monitors who organizes trash pick-up and leads are youngest children (under 7yrs-old) to school in the morning. He is extremely talented and one of the hardest and most dedicated workers I've come across.

He comes from a very poor family, deep in rural Haiti where everyone is a farmer, makes under $1/day and lives completely off the land. His family's home was destroyed twice last year during the hurricane season. The second time, there was nothing left standing but a single stick that was used to support one of the corners of the house. It is rare for a family to be homeless in rural Haiti. The bond among neighbors is great and this case was no different. Choupi's neighbors took his family under their roofs. There's an understanding that it could've been any one of their houses to be destroyed and that they were lucky enough to still have their homes. It's only right to reach out to those who weren't so lucky.

I am constantly reminded of the kindheartedness and compassion that the Haitian people show towards each other. Roberson, a 5 year-old boy with cerebral palsy is another example. After hearing about him being left at home alone while his mother would leave him to go to work for the day, I decided to visit him one day on my morning run. When I found him, he was sitting in the corner of the mud shack, dirty, covered in drool and bugs and unable to shoo them away because of his condition and being unable to move. Even in this case, where it seemed so obvious that this boy had been forgotten about and abandoned each day without a person in the world, I witnessed a caring and kindness we don't often see in a country like ours. Roberson's mother had no choice but to leave him each day in order to work the rice fields and put food on the table. While Roberson had appeared alone to me, he wasn't. His mother would make the 3-mile walk back to her home to bring him food during the day, while two of her neighbors, both over 80 years-old and unable to work themselves, would visit Roberson to bathe him and clean up any stool.

It has taken me some effort to realize and understand that what happened to the boy who was murdered a week ago, is not at all a fair representation of the Haitian people who are not an angry people but instead quite the opposite. The men who took action into their own hands that afternoon claim to be vigilantes and no longer wanted to fear this boy who had according to them, robbed dozens of people and caused much anguish for many civilians over the last few months. How true this is, I can't say. I can say however, that an incident such as this is not common and while I'll never be able to forget what happened that day, this experience does not change at all the love I feel for this country and its people.

Seeing patients

A Boy Murdered

I can't get the image out of my head. His face before and after. I have a photo of him sitting in his cell, curled up in the corner with a sling around his left arm and bleeding, the result of what other inmates had done to him after he had been placed there for robbing a boy at gunpoint for a telephone and 100 gourdes (US$2.50). The gun was fake and no one was hurt. Haitians don't take kindly to thieves and depending on the gravity of the crime, stealing is usually punishable by death. I don't know his name. I don't know how old he was or where he came from or why he needed that money. I don't know his story. I wasn't there, but the boy who was robbed was there and he was borrowing my camera.

The other photo that I have of him is after he was released from the prison and attacked by the mob of men with machetes. This photo, which is forever burned into my memory, is of a boy not yet 18 years-old, outstretched on the ground with one arm across his chest and the other, bent up towards his face. His head is tilted back and his eyes are open. There are sneaker prints on his face, hands and feet. His jeans are soaked in blood. There are three pools of blood that surround him. To his right, is the fake gun that he had used, laying in one of the pools of blood. To his left, is a metal pole, covered in blood, that had been used to beat him to the ground. Next to the pole are two sets of feet, one with blue plastic sandals and the other with brown flip-flops. These are the feet of two of the people who helped kill this boy. When he was knocked to the ground, bludgeoned, stepped on and kicked, the men with machetes began to swing at him. Helpless and unable to defend himself, the machete hit his face, removing his right cheek in a single swing. Another swing cut into his achille's heel and another the top of his foot and then his thigh. The swings kept coming until he no longer moaned.

I have tried to delete these photos, but for some reason that I don't understand, I can't. I feel as though these photos are the only thing keeping the memory of this boy alive. The police released this boy to the mob. He was a lone the entire time with not a person in the world at his side, to help him, to defend him. This boy, who I never knew, who I wish I could have helped, will always be with me. I will never forget him. Here is one of his photos. I ask that you never forget him either.

Working 'Round The Clock

We've had great electricity for the last two days and almost nonstop internet access. It has been such a treat that I find it difficult to sleep knowing that I could be online researching, writing and answering the load of emails that await me. Thanks to the insanely strong Haitian coffee, staying awake hasn't been an issue. There is so much happening that if it wasn't for writing it down on this blog, I'd forget half the things that I've done or am doing.

Dictionaries etc.

I've made a simplified Microsoft Word version of the dictionaries that would allow me to email copies to anyone interested. You can just print them out and get started! I've finished the second, more advanced version of the general dictionary. Shoot me an email if you'd like a copy. I've distributed over 150 copies to the children at Espwa but will be postponing further distribution until I can get some money for printing costs (about $0.25/copy).

Edy Aunon

Edy, 12 years-old and a child living on the Espwa campus scared all of us when he suddenly fell to the ground while in school and had a seizure. When he was brought over to the clinic, he was light-headed and had slurred speech. We decided to watch him for a while. He was placed on an examining table and suddenly we heard a moan and he fell off the table while undergoing a grand mal seizure. We sent him to be evaluated at the hospital where he spent two days and had another seizure. The doctors at the hospital said that there was nothing they could do for him. Donated by Mother Theresa's organization, we obtained two weeks' worth of anti-seizure meds and started Edy on them immediately. Later that night, Edy had another seizure and was this time found lying unconscious and flaccid. Soon after, he started showing opisthotonus, arching his back and stiffening of the extremities, followed by turning his head to the left with flexion of the left upper extremity and up going toes. Each of 3 or 4 of these episodes lasted about 2 minutes. He was transferred to City Med where he was admitted at 9:30pm administered IV Valium Saturday and on Monday, Fritzner boarded a flight with Edy to Port-au-Prince. The result of the CAT scan is inconclusive. We do not know why a seemingly healthy boy like Edy would suddenly begin having seizures but we are determined to help him as much as we can. Mother Theresa's organization can no longer supply us with enough meds for Edy but with the generosity of a few donors and Medical Missions of South Haiti, we will be receiving enough meds to last Edy for a while.

Scabies and Tinea Treatment

The last monthly home inspection showed that 66 children of the 489 living in the south village, have tinea capitis. These children were either overlooked the first time or the fungus had not developed to a point of noticeability. The children were all weighed this evening and will begin the 5-week treatment program tomorrow. Of the nearly 500 children, only 15 were found to have scabies. This is a huge positive. In order to prevent further spread, however, all 200 children who live with/near the children with scabies, were treated.

The Rainy Season Has Begun

For the last 5 nights, we've had rainstorms. It's like clockwork, when the sun goes down, out comes the rain. The dirt roads turn to giant mud puddles as the rock roads form rivers and sometimes lakes, making it impossible to pass. For this reason, a rainy day in Haiti is much like a snow day up north. School is off, people can't make it to work, crops are flooded and most are afraid to leave their homes if there's not someone staying behind who can catch the water from the dripping ceiling to protect their belongings from getting drenched. I'll never forget last hurricane season when I saw a woman and two children sitting on the roof of their flooded house with everything they own in their laps. It's rare for there to be a gentle drizzle. Instead, it's almost always a heavy rain...a downpour...a flood.

On the bright side, the ground is no longer cracking from thirst, the crops are watered and the grass is greener.

A Big Update!

A lot happened in the last five weeks. I will be splitting it up into several sections to make it more manageable.

New Espwa Medical Center Design

After being approved by the Espwa Medical Director, reviewed by the Espwa’s founder, director and several visiting doctors, including the founding director of non-profit Medical Missions of South Haiti, the medical center that I designed for Espwa and all neighboring villages, is on its way to Washington DC where a group of volunteer architects will convert my ideas into a working 3D model and computer animated design. This recent advancement is due to the kindness and generosity of Donald Stevens, founder of Reach For Children. The funding for the medical center is roughly estimated to be in the range of $250,000. A woman by the name of Susan Midgett has committed herself to raising the $100,000 needed to begin immediate construction of the medical center. You can read more about her efforts and fundraising on her blog sosforhaiti.blogspot.com She’ll be participating in the Shark Swim off the coast of San Francisco to Alcatraz!

Public Health Office Plan Drafted

With only two and a half months left in Haiti, the pressure to ensure the sustainability of the 14 public health programs and the public health department that I’ve initiated is greater than ever. After speaking with Fr. Marc, the founder of Espwa and Peter Faford, the projects manager, the plan to build a public health office on the property has been approved. This office space will only be temporary until the new medical center is constructed but will nonetheless add a sense of professionalism to the public health department by giving the assistant public health officer, four public health workers and eleven public health students a common space to work, research, educate and execute public health presentations. This is a big step forward. After donating my computer and printer, I will still need to fundraise for a desk, chairs, book shelf and filing cabinet. If you can help with any of these please let me know.

New Food Depot Finished

After receiving a large grant from USAID/CRS (Catholic Relief Services), a 60’x60’ food depot has just been built to house all of the food used at Espwa (3,000 meals/day) along with food donated by CRS for 800 families in neighboring villages to be distributed monthly. Due to the importance of ensuring proper storage and upkeep, the public health team has taken on the responsibility of performing bimonthly inspections of the building which will include everything from hygiene, sanitation, safety, maintenance and pest/insect control.

Medical Dictionaries For Sale

Not really. They’re actually free. But donations are always welcomed! With the help of several Creole/English dictionaries, I’ve put together a 5-page, 400 word medical dictionary and phrase book for English-speaking and non- Creole speaking doctors and medical staff that visit. The book holds hundreds of vocabulary words and need-to-know phrases when working in a clinic environment. The book is broken up into several sections including, Emergencies, First Aid, The Body, Personal Hygiene, Symptoms and Injuries, Common Illnesses, Medical Conditions and Serious Illnesses, General Health Care, Medical Clinic, Dental Clinic, Hospital Staff/Equipment/Materials, Feelings and Emotions and Age and Physical Descriptions. It can be used by both people trying to learn Haitian Creole and those trying to learn English. I’ve also put together another 5-page, 800 word quick reference dictionary and phrasebook for beginning Creole/English. It covers Basic Expressions, Conversation, Personal Information, Nationality, Occupation, and Food and Drink. Seeing as how the most asked for thing besides for a soccer ball is a dictionary, I’m going to make a few hundred copies of this abridged version and give them out at the schools for anyone interested.

Toothbrush/Toothpaste/Floss Distribution

Last week marked our second mass distribution of toothbrushes, toothpaste and dental floss for all 520 children/monitors at Vilaj Espwa. Along with each distribution (every 3 months) comes a refresher course on how to properly brush your teeth. Seeing as how toothpaste is usually our limiting factor, the public health team emphasized the importance of brushing even if you don’t have any paste. They teach about plaque buildup and the importance of our fluoride treatments. The limited floss that we have is distributed only to the teenagers and young adults along with a demonstration on how to use it properly. Thanks to Medical Missions of South Haiti, we have received enough supplies for a third distribution in May.

Interested Pre-Medical/Medical Students/General Volunteers

Over the last few weeks, I have received several emails regarding students interested in coming to Haiti to volunteer, primarily in the medical field. If your interest is strong and you can dedicate a minimum of 3 months to living here and working, I urge you to contact me regarding a position working within the public health department here at Espwa. With 14 programs running, there is a constant need for man/woman power to ensure sustainability. If you are unable to dedicate a full three months, we may be able to find another way for you to help! On the same note, if your skills are in grant writing, intervention proposal writing, fundraising and or public speaking and you would like to help support the public health work happening here, you will be greeted with MUCH excitement and gratitude! Just shoot me an email at willinhaiti@gmail.com

March Medical Mission Group

Comprised of Dr. and Mrs. Blood, Jay Prosner-jack of all trades, and 10 engineering and media students from Valparaiso University, the group of 13, constructed playground equipment and installed it in the South Village where the younger children live, installed float valves in all of the water tanks, and completed several plumbing and electrical jobs, sponsored an activity for the kids on most nights, including making jump ropes, popsicle stick buildings and towers, making silly putty out of water and corn starch, and distributing yo-yos, played soccer and basketball with the kids. Dr. Blood and his Haitian student doctors Vladimyr, Merline, Francise, and Jacob, along with myself, saw patients at Espwa, Charlette, and Cotes de Fer. We saw a wide range of conditions, including thyroid goiters, testicular cancer, breast cancer, Parkinson's disease, new cases of HIV, leprosy, cerebral palsy, malaria, fungal infections, parasitic infections, juvenile rheumatoid arthritis, nephrotic syndrome, third degree burns on the buttocks from a mosquito netting fire, and more everyday problems such as diabetes, hypertension, respiratory infections, and lacerations. We performed several minor surgeries, including lipomas (fatty tumors), cysts, biopsies, and injection of keloid scars with cortisone. Jay Prosser held a food distribution at Charlette. Each family received enough food for a month, including rice, beans, oil, corn flour, and other items. While at Charlette, the Sante Piblik (Public Health) team from Espwa instructed each patient in proper toothbrushing technique, distributed toothbrushes and toothpaste (Colgate in Creole), and did fluoride rinse treatments. The Valparaiso students measured patient's feet and distributed shoes and sandals. (summary courtesy of Dr. Blood)

2nd Public Health Class Nearing Graduation

After nearly 2 ½ months of lectures, presentations, exams, papers and forcing themselves to endure an extra 1 ½ hours of class 5 days/week on top of their regular school work, the second generation of public health workers are just a few weeks shy of graduating. Upon graduation, each is awarded with a monetary award, a certificate of completion, a uniform complete with a lab coat, hat, collared shirt, back pack, and watch. It costs roughly $150 from start to finish, to train one of the boys to become a public health worker. This cost includes the course material, teacher salary and graduation costs. If you would like to help sponsor one of our boys please let me know.

Tinea Capitis Mass Treatment Complete!

Tinea Capitis (ringworm of the scalp), is on its way out after a 5-week mass treatment program undertaken by the public health team. 64 children were treated and cured. The second phase of the program is to target any children who were overlooked the first time and to begin them on treatment. Along with treatment, the house monitors are taught a basic understanding about tinea capitis and how it is spread, along with how to prevent it. The spread can largely be avoided by washing the scalp with soap, not sharing combs, brushes etc and washing clothing and sheets on a regular basis. After seeing the effects of our bed bug and scabies interventions, the monitors have agreed to help us rid their homes of tinea also.

Tuberculosis INH Treatment Program 2/3 Complete

After nearly 6 months of biweekly treatment, over 100 children/young adults are nearly finished with their INH treatment to prevent TB infection. With a compliance of just 42% in previous years, this year, under the auspices of the public health team and institution of DOT, the percentage of compliance has more than doubled to 86%. This is quite the feat that couldn’t have been made possible without the dedication and diligence put forth by the PH team.

On A Personal Note:

I can’t believe my time is winding down so quickly. After returning from the Dominican Republic for a nine-day getaway at Carnaval, I returned to Haiti refreshed and with a new perspective on the world and where I see myself in it. This has led to a mountain of self reflection and the reason for me not having posted on the blog in so long. The days are becoming longer, the work heavier and the nights shorter. In preparing for med school in August, I’ve been reviewing Anatomy and Physiology, Biochemistry and Genetics for at least an hour each morning right before my daily run. I’m in week 5 of my training for my next marathon in Duluth, MN on June 20th. This time, I’m running for me. It’s not a fundraiser but rather a personal goal I have set for myself. This week begins the stress of applying for medical school financial aid so please keep me in your prayers as I work to convince my school how much I am in need. Looking forward to your comments—Will P.