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By H.O.P.E. Admin, February 15, 2010 11:49 AM

Bonswa,

Hone`!
Respe`!
Honor!
Respect!

If you happen to walk through rural areas in Haiti, you will certainly come across family compounds called lakou, or yards. There are usually several nuclear units in a yard as members of an extended family build their homes on land the family own in common; ancestors are often buried there also. A lakou is usually fenced in with thorny cactus to keep chicken and goats inside! A visitor should stop at the gate and call out Hone`! then wait to hear Respe`!, the invitation to enter the yard, the private space.

It is in this spirit that I call Hone`! to you, hoping that you will once again let me in for a chat, an update.

We are now a month into the disaster, or as some say, “that thing that happened to us”… avoiding to name the event that destroyed their lives. As we read in the media, and know too well from Borgne, the crisis has entered a new phase… and the depth of the devastation is beginning to sink in! The dead are buried, all 230,000 of them; and the living need to be cared for. They need our full attention—their bodies, their minds, and their souls are in need of tender care. An eerie normalcy, complacency almost, is already replacing the hectic pace of the early search and recovery days in Port-au-Prince. “Bedsheet” cities look more and more like neighborhoods where survivors establish tenuous roots and make new friends, scrape a living, find creative ways to build sturdier shelters out of scavenged wood and tin roofing, and … as usual where kids bring life and force adults to plan for an uncertain future.

In outlying areas like Borgne where displaced persons are rebuilding their lives, we feel the aftershock… the picture is slightly different. People from the region who had migrated to the slums of Port-au-Prince to chache lavi, in search of a better life, are returning to their native villages, having lost the little they had. They come back scarred by the events they lived through, often with infected wounds, malaria, fractures that were not treated, hunger, and emotional trauma… their children showing signs of malnutrition. This group is claiming a lot of our staff’s attention… we receive about 60 per day at the hospital and many more at mobile clinics.

Mike Shields came back from Haiti with an interesting take on how the events surrounding the earthquake will unfold: it’s like watching a snake trying to swallow a big frog. At first it looks like an impossible task. Slowly yet inexorably, the frog makes its way down the snake! Well, the frog is reaching us! I mean that the aftermath of the earthquake is now reaching the rural areas… slowly, yet inexorably! The problems of Port-au-Prince are being felt throughout the country, the scope is not the same but the issues are.
The number of inpatients at our facility is not overwhelming yet but we are bracing for the inevitable. Those who were housed in the high school will have to move when classes start again. So our own tent city is taking shape in a vacant lot adjacent to the hospital. A big hangar is being erected to provide shelter from the sun and the rains (it rains frequently in Borgne) and I hear that it will house 40-50 people in individual tents! Hard for me to imagine but this sounds more and more like a semi permanent encampment. A team from Rochester is heading down in a few days to help finish the hangar, hook up water pipes and electricity, and build a kitchen and sanitary facilities… We are feeding a lot of people and the cost of food has increased dramatically. Staples of Haitian diet, rice, dried beans, vegetable oil, flour, sugar, etc that used to come from Port-au-Prince are hard to find. So, tomorrow our first shipment of food will land in Santiago, DR and be trucked to Borgne. Since the refugees have lost everything, they also need clothes and shoes… another shipment! This evening, they added rain ponchos to the list… The logistics of managing this crisis are mind boggling… we face problems we never dreamed of, are called to find creative ways to answer these needs… But as the Haitian saying goes… Bondye bon! God is good, or things will fall into place!!! We have no alternatives…

Last week I told you about this 16 year old boy who arrived to us from Port-au-Prince after losing all eleven members of his family. His name is Kirby. He is having a really hard time. He was doing OK until he dreamed of his sister who perished in the quake. Now he is despondent and withdrawn. The friend he met during his ordeal who accompanied him to Borgne does not leave his side. Dr. Thony bought them phones hoping they could reach out to people they know. Kirby has not used his; he says that he has no one to call and no one to call him… that the only family he has now is his buddy and the staff at the Borgne hospital. I am confident that Kirby will heal. It will be a long and arduous road but he will make it; he is not alone! He has all of us to root for him and support him. I find his story emblematic of what Haiti is undergoing… we know we have friends and that we don’t have to do it all by ourselves.

Mesi anpil e mwen swete nou bonn nwit! Na we pita…
Thank you very much and I wish you a good night! I will be back soon…

Rose-Marie

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By H.O.P.E. Admin, February 8, 2010 9:37 PM

Mother and baby from Port-au-Prince

Good evening everyone/ Bonswa tout moun!

In the space of a minute, three weeks ago over 150,000 people died in Port-au-Prince and this event changed the “fortunes” of a nation and the lives of countless individuals… in Port-au-Prince, throughout Haiti, in Haitian communities abroad, and in communities across the globe. The tragedy brought so many people together, in ways that those of us who come from Haiti never imagined possible. Your empathy and sympathy ease the suffering and bring hope–hope for healing, recovery, and a better future. Mesi anpil pou sipo nou/thank you so much for your support, it means a lot to so many who need something to hang on to in these difficult times. I hear over and over again how grateful Haitians are knowing that there are friendly hands to help steady them on this journey.

 To paraphrase the psalm, there is a time to mourn and a time to pay attention to the living! So what is happening in Borgne as we speak? When I got off my last phone call of the day this evening, the staff was waiting for five special patients. Dr. Xavier drove to Port-au-Prince to accompany two orphans (one 16 year old boy who lost his whole family and has just begun to talk again), and two very sick adults, the fifth patient was too ill to drive and was flown to Cap Haitian. The roads are atrocious even in good weather and hard on the body even for a healthy person, so I can’t even begin to imagine how these very sick people managed! All I know is that a warm welcome was being prepared for them, especially for the young ones… comfy beds, clean clothes and a warm meal.

 Life is never easy for refugees and displaced persons, regardless of the circumstances that propel them from their home. As my friend and colleague Pierre Minn emphasized in a recent discussion, most people in Haiti depend on their social networks as a basic survival strategy.  So, leaving the familiar and going to a place where one has no relatives and does not know anyone is like adding another layer of anguish to an already painful situation. The silver lining is that those refugees who make their way to Borgne will find plenty of people waiting to ease them into their new lives and shower them with attention and love… I hope they are not smothered; our staff can be very enthusiastic! Dr. Thony told me that the Mayor visits the patients and has gone out of his way to welcome them to the area. On our end though, H.O.P.E. is mindful that our commitment is for the long term… As Mike said, the need is both overwhelming and enduring… There are bodies and minds to heal but also homes to build, gardens to start, kids to send to school, jobs to create!!! This is a collective enterprise. We need help from all kinds of folks: doctors, nurses, therapists, counselors, social workers, builders, teachers, entrepreneurs, agronomists, artists, and many more … people who can envision a different future and help create it!  

 Our priorities in the field are becoming clearer, short and long term. We have made significant inroads in how to care for the health needs of displaced individuals and now must focus our attention to meeting their social needs… how to house them in a way that is both comfortable and safe and put in place social services… Thony told me that some of the refugees are still reluctant to sleep indoors; they fear that the earth will shake again. To accommodate refugees, we still need cots, inflatable mattresses (hopefully manual pump), single size, bedding, powerful flashlights (preferably solar or crank powered), basins, nightgowns/PJ, etc., to get them settled. We also have to confront the fact that we face increasing pressures on our system. Patient loads are increasing daily, we now provide to an average of 50 refugees daily in our out patients clinics (in addition to our regular patient load) and our 18-beds capacity is over its limit. We are housing those refugees who have no relatives or kin in the area in a high school but this is a stop gap measure. Eventually, rather soon actually, classes will resume and the school will reclaim the space. I can envision a “refugee village” sprouting around the hospital but for the long run, we all would prefer something more permanent and livable than tents, especially when the rains come. We will need to work with the community, the newcomers, local authorities and funding agencies to plan how to tackle this problem. H.O.P.E. cannot do this alone and welcomes ideas, suggestions, and donations to meet these challenges. We have always worked in solidarity with grassroots organizations to address the needs that the community presents to us. This should not be any different!

 We are finding out that there are more refugees in the region than we first thought. Remember that Borgne is both the name of a region of 80,000 people dispersed in 250 villages/agglomerations and the name of the main population center, the town of Borgne, where a tenth of the population lives. Many people who had migrated to Port-au-Prince in search of some elusive jobs have rejoined families and native villages. They came back physically and emotionally scarred! We find them in our mobile clinics (a mobile clinic is a team of care providers who walk to outlying villages to bring health care to people who often have never seen a physician)! They come with infected wounds, malaria, typhoid, and emotional problems. Last Saturday, there were 300 patients waiting for the mobile clinic in Bassin Kayiman, the average for that area is 180!!!

 A critical problem is that the hospital needs structural improvements to meet the increased volume, the current as well as the long term needs of patients. A wish list would include an operating room for minor surgery, improved water distribution and sanitation, and additional professional and support staff.  Here again we need funding, technical support, and equipment. Please share this with people in your social and professional networks who might be able to lend a hand, contribute funds, and provide equipment.

 I am confident that we will find the right answers to these problems, the energy to stay the course, the patience to deal with setbacks and challenges, and also the joy of a job well because we are not alone! We invite you to walk the path with us. Kenbe, pa lage! Stay with us, don’t give up!!!

 In solidarity,

Rose-Marie Cassagnol Chierici

Executive Director

Comments (1)

By H.O.P.E. Admin, January 30, 2010 12:39 PM

Bonswa zanmi m yo/ Good evening my friends!

The last two days have seen a flurry of activity in Borgne and here in the US. The most exciting one is that our truck/ambulance is finally on the horizon; thanks to CO Campaign and a private donor! It should be in Borgne around the 10th of February J What a difference this will make! Instead of putting patients on overcrowded public transportation for an excruciating journey to a hospital in Cap Haitian, we will be able to transport them in a more humane and safe way.

Refugees continue to arrive… Ambulatory ones join relatives and friends but are still part of our patient load. Today, 60 refugees came for treatment of a variety of wounds, infections, diarrhea… and all them with symptoms of stress or emotional distress. This was in addition to our usual out-patients load and Mike described the waiting room as a mad house! People everywhere… We are bursting out of our seams! Our in-patient population also increases daily, some stories are sad like that of a woman whose leg was amputated… she wails and cries for her leg and has no idea where her family members are. There are small miracles fortunately to balance the sadness. A pregnant woman arrived from Port-au-Prince in full blown eclampsia (a condition that is no longer seen in the US and industrialized nations), convulsing and unconscious… the stress of the past two weeks exacerbating her condition says Dr. Thony. The delivery room staff successfully delivered the baby who is doing well. The mom will have a long recovery but will survive. What a gift!

This evening I gladly replied to an inquiry from a hospital in Port-au-Prince asking if we could take a 16 year old boy who has lost all eleven members of his family and is suffering from acute emotional distress. There is no doubt in my mind that he will receive good care but more importantly that he will be quickly surrounded by caring people… I am sure that Miss Suze will embrace him… with even more warmth than she gives to anyone she thinks needs a hug. Refugees arrive with gripping stories … They mourn losses even as they deal with physical and emotional turmoil hard to imagine from our vantage point here. They come alone or with family members, some want to go back home as soon as they recover while others will have no one to return to. Those are the ones we have to think most about and plan for. For now we can accommodate them at the high school but after a while we will need to provide better shelter, food, education… It will be a long journey…

The madness was not only at the health center in Borgne but also at today’s mobile clinic where 300 patients crowded in a school yard to be seen by the team. I love going out with a mobile clinic! Put away any idea of a well equipped van which sets up shop in a parking lot! No! A mobile clinic is a team of health care practitioners who set out on foot for one of the remote villages; supplies are carried by mule or motorcycles (if there is a good path). When the team arrives on location they set up shop quickly in a peasant’s home, a school, or church—a makeshift pharmacy and lab (we perform HIV, Syphilis tests right there and even insert Norplant capsules…), a few consultation areas for the doctor and Nurse Practitioners, tables for social workers to provide pre and post test counseling for those who volunteer for HIV testing! It is quite exciting to arrive in a yard full of people waiting to see a doctor or nurse, many for the first time in their lives!! The team does not leave until everyone has been seen… So 300 patients is huge!!

Well… on the home front in Rochester, our army of volunteers is hard at work. THANK YOU ROCHESTER! THANK YOU DC! THANK YOU LA AND SAN FRAN!!!! The first of what will be regular cargo shipments arrived in Santiago, DR yesterday! Thanks to those who made this possible J Meanwhile a plane loaded with cots and generator is “stuck” at the airport in Front Royal, VA because of an ice storm!! What a contrast, sun and heat in Borgne, ice in Front Royal, and below 0 temps in Rochester this morning!!! Just got a call from the field, one of many, many each day… besides cots, we need air mattresses for patients with fractures and back injuries! A “bed” for them is an air mattress on top of a cot! Now to gather air mattresses in time to make that flight which is fortunately delayed… a lucky break!!! An email from my nephew who works in Shanghai just popped up … he is off to a “Drink for Haïti” fund raiser at a bar!!! So even all the way in China people stand in solidarity with Haiti… we are not alone!

I close by trying, once more, to express the depth of our gratitude for your prayers, gifts of time and money, your concern and your warmth! Please stay with us on the journey… a journey is as good as the people you travel with! I will be back later… Na we pita!!

Rose-Marie