haiti: can we make a difference?
TRANSCRIPT
http://nwh.awhonn.org © 2007, AWHONN 445
iI’ve always been inspired by the stories of
health care workers who’ve traveled to develop-
ing nations on medical missions and I yearned
to do the same. So when I was invited to be
part of a mission to conduct pediatric clinics
in Haiti, I couldn’t resist. Although I felt some
trepidation and uncertainty, I felt compelled
to follow my dream.
The organization I went with is Forward
in Health, a Gardner, MA–based nonprofit
organization whose mission is “to improve the
health conditions and dignity of the people
in and around Les Cayes, Haiti” (Forward in
Health, 2007). It accomplishes this by sending
caring, well-trained medical and nonmedical
people to set up clinics in several remote areas
in the Les Cayes area. The organization has
been doing this for several years, and because
of the knowledge and experience of the people
at Forward in Health, I felt confident that
I’d made the right decision to go.
Little could prepare me for what I saw.
The extreme poverty, poor living conditions,
lack of resources and unsanitary conditions
were daunting. Homes, which were shacks by
American standards, comprised nothing more
than a concrete shell with a tin roof, open
windows with no screens and doorways that,
in some instances, had nothing more than an
old curtain for privacy. For those who were
fortunate enough to have some property, there
would be chickens, roosters, pigs and goats
scattered throughout their land. But rather
than use livestock as a source of nutrition, these
Little could prepare
me for what I saw.
The extreme poverty,
poor living conditions,
lack of resources and
unsanitary conditions
were daunting.
Haiti:Can We Make a Difference?
Karen Beaton, RNC, BSN, MS
446 Nursing for Women’s Health Volume 11 Issue 5
residents sold the animals as a way to provide
income. It’s not surprising that they choose to
sell their livestock, rather than eat it, as there
is a 50 percent unemployment rate in Haiti
(NgCheong-Lum & Jermyn, 2005), and 85
percent of residents live on the equivalent of
$1 U.S. per day (Human Rights for All, 2006).
Raising livestock for food, rather than for
income, is simply a luxury many Haitians
can’t afford.
Within the city of Les Cayes, there is a
drainage system that directs runoff and raw
sewage into the river—a river strewn with lit-
ter, garbage and old, broken-down vehicles.
Livestock, such as pigs, bathe in the river, as do
the Haitian people, who also fill jugs of water
for drinking and cooking. This regular contact
with polluted water puts them at risk of infec-
tion and disease (NgCheong-Lum & Jermyn,
2005). This was evident at the clinics we held
where more than half of the patients were
treated for worms.
We conducted five clinics in various rural
areas of Haiti where was saw 548 children
and 86 adults. I was struck by the long wait
times—sometimes in excess of six hours—that
these families were willing to endure to have
their children seen and was equally impressed
by how they presented themselves to the clinic.
Each child was dressed in beautiful clothing
that was clean and pressed (notwithstanding
that it was hand washed with water from the
river). Despite their few possessions, limited
education and poor living conditions, the
Haitian people displayed dignity and grace.
They appreciated the service that our clinics
provided. Without our presence, they would be
without medications to treat fever, pain, para-
sites, infections and scabies, which the children
are so often afflicted with.
I remember one boy who presented to the
clinic with a fever of 103°F and severe muscu-
loskeletal pain. He was diagnosed with having
either malaria or some type of unusual virus.
We were able to treat him with ibuprofen
initially and chloroquine on the chance that
the fever was due to malaria. Within an hour
of receiving the ibuprofen, his pain began to
subside. To Americans, taking ibuprofen for
pain seems so simple. But had our clinic not
been there, he would have gone home to suffer.
There would have been no relief, only suffering.
There was no oxygen,
no suction catheters,
no fetal monitor and
no C-section room,
as we’re accustomed
to in North America.
It’s no wonder that
Haiti has the highest
maternal mortality
rate in the Western
Hemisphere.
Karen Beaton, RNC, BSN,
MS, is a certified perinatal
nurse and the director
of maternal/child health
at Heywood Hospital in
Gardner, MA.
DOI: 10.1111/j.1751-486X.2007.00229.x
Box 1.
How to Prepare for a Medical Mission
These are some of the steps involved in preparing for a medical mission:
1. Purchase and/or collect through donations needed materials, including:
Toothbrushes and toothpaste Vitamins
Small plastic bags Ibuprofen
Acetaminophen Antibiotics
Cortisone creams Anti-malarials
Scabies and lice treatments Antihistamines
Cough syrups Antifungals
2. Pack supplies into durable bags (on our mission we used 32 hockey bags).
3. Update your tetanus and hepatitis B immunizations.
4. Take chloraquine prophylactically to prevent malaria.
5. Do background research to discover what the most prevalent medical conditions are in the region you are traveling to.
6. Review the action, dose and special directions for various medications.
October | November 2007 Nursing for Women’s Health 447
Medical facilities are scarce in Haiti
(usually located in the more urban
areas) and are, for the most part, sub-
standard. In a rural town called Port a
Piment, there was an archaic hospital,
reminiscent of what I imagine a U.S.
hospital must have looked like in the
early 1900s. I came upon the room
used for childbirth. Approximately 8
× 12 , it had nothing more than a sink,
small table and an old, broken-down
delivery table. Dots of red were scat-
tered about at its base. I wondered if
these were rust or blood stains. The
small sink held a basin, most likely
used to catch the placenta. There was
a scrub brush and can of Ajax on the
table. Was this scrub brush used repeat-
edly to wash the hands of the care
provider before each delivery? I don’t
know for sure, but I figured it was bet-
ter than nothing at all. There was no
oxygen, no suction catheters, no fetal
monitor and no C-section room, as
we’re accustomed to in North America.
It’s no wonder that Haiti has the high-
est maternal mortality rate in the
Western Hemisphere. Approximately
523 women die for every 100,000
births (Human Rights for All, 2006),
and there is an infant
mortality rate of
71.65 deaths per 1,000
live births (Central
Intelligence Agency,
2006).
I was told that there
was a midwife who was
present for many of the
deliveries at this hospital. I wondered
if there were any obstetricians or other
physicians available to provide backup
when she needed it. I wondered what
kind of training she had and if she also
did home deliveries. These questions
inspire me to return to Haiti, to try to
find the answers, to learn more about
Haitian culture and to continue to help
in whatever way I can.
At a clinic in Port a Piment, a
mother brought her one-month-old
baby with a cleft lip and palate. She’d
been told by the people in her village
that this happened to the baby because
she had fallen into a river while she
was pregnant. Through an interpreter,
we explained that this wasn’t the cause,
but I’m betting she didn’t believe us.
She brought the baby to the clinic
because she was concerned that the
baby wasn’t getting a good seal when
she breastfed. Despite her concerns, her
baby appeared very well-nourished and
had no signs of dehydration. There was
little we could do other than to offer
support and reassurance that she was
doing a good job of feeding the baby.
Still, we told her about a clinic in Les
Cayes that was equipped to do correc-
tive surgery. But in a country with little
infrastructure, getting to such a clinic
is a major challenge for many residents.
The first problem is transportation. Les
Cayes is about a three-hour ride over
dirt roads and riverbeds. If she didn’t
have transportation, she would have to
find someone to bring her. Fortunately,
the parish priest would most likely
offer this service to her, which would
help solve that problem. The next
problem is the availability of the doctor
at the clinic. Apparently, the ear, nose
and throat doctor is only there about
once a month and no one ever really
knows when he’s going to be there. So
although there are health care services
in some areas of Haiti, accessing those
services is enormously difficult for
many Haitian people.
The question I posed in the title of
this article is, Can we make a difference
in Haiti? On the mission I went on,
it felt like we only scratched the sur-
face—placed a Band-Aid, so to speak—
by bringing enough vitamins and
medicines to last the people a month
or so, or until the next goodwill group
came along to offer their services. But
there is hope. Forward in Health has
purchased some land and has plans to
build a clinic where patients can be fol-
lowed on an ongoing basis. Vitamins,
worm medications, acetaminophen,
ibuprofen and antibiotics will be avail-
able all the time, and there will be an
opportunity to provide more education
to these people about sanitation, birth
control and health care—much more
Although it doesn’t always feel like we made
much of a difference by our American standards,
to the people we saw and the people who are so
looking forward to the new clinic, we are making
a world of difference.
448 Nursing for Women’s Health Volume 11 Issue 5
than what we could accomplish in a
one-day clinic.
Although it doesn’t always feel like
we made much of a difference by our
American standards, to the people we
saw and the people who are so look-
ing forward to the new clinic, we are
making a world of difference. As long
as there are people who continue to get
involved and provide access to health
Box 2.
Additional Resources
Cathedral Haiti MissionThe Cathedral of Incarnation2015 West End AvenueNashville, TN 37203615-327-2330
Catholic Medical Mission10 West 17th StreetNew York, NY 10011-5765800-678-5659 or 212-242-7757
Diocese of Milwaukee Haiti Project804 East Juneau AvenueMilwaukee, WI [email protected]
Episcopal Medical Mission Foundation606 Rathervue PlaceAustin, TX [email protected]
Forward in Health190 Lawrence StreetGardner, MA [email protected]
Friends of Haiti312 Victoria StreetGreen Bay, WI 54302920-469-0431http://www.friendsofhaiti-gb.com
Haiti Catholic Diocese of Richmond Outreach811 Cathedral PlaceRichmond, VA [email protected]
Haiti Christian Mission, Inc.P. O. Box 56025Indianapolis, IN [email protected]
Haiti Connection419 Pine StreetBoulder, CO [email protected]
Haiti Medical Missions of Fargo-MoorheadP. O. Box 188Morehead, MN 56561701-235-5760 or 701-241-5317
Haiti Medical Missions of Memphis1779 Kirby Parkway #1PMB 319Memphis, TN [email protected]
Haiti Medical Mission of The First Presbyterian Church1432 Washtenaw AvenueAnn Harbor, MI 48104Hope Alive Clinic MinistriesP. O. Box 964Medford, NJ [email protected]
Living Hope Haiti Christian Mission9200 South Dadeland Boulevard, Suite 103Miami, FL 33156
Lumiere Medical Ministries3816 South New Hope Road, Suite 20Gastonia, NC [email protected]
Maison de Naissance—a birthing home in Haiti6401 Wornall TerraceKansas City, MO [email protected]
Medical Mission to Haiti—St. Joseph Catholic Church87 Lacy StreetMarietta, GA 30060770-422-5633
Mission to HaitiP. O. Box 5231567Miami, FL [email protected]
Partners in Health641 Huntington Avenue, 1st floorBoston, MA [email protected]
The Children’s Medical Missions of Haiti925 Hertzler RoadMechanicsburg, PA 17005717-796-1603
The Haiti Episcopal Learning Project (H.E.L.P.)325 West Touhy AvenuePark Ridge, IL 60068847-692-6378www.haiticonnection.org
services to a population so much in
need, there’s hope and a difference
happening for the people of Haiti (see
Box 1 for how to prepare for a medi-
cal mission and Box 2 for additional
resources). NWH
ReferencesCentral Intelligence Agency. (2006). The
world factbook. Dulles, VA: Potomac Books.
Forward in Health. (2007). Forward in health. Retrieved March 16, 2007, from http://www.forwardinhealth.org
Human Rights For All. (2006). Haiti and human rights. Retrieved March 3, 2007, from http://www.globalissues.org/HumanRights/Abuses/Haiti.asp
NgCheong-Lum, R. & Jermyn, L. (2005). Haiti (cultures of the world). New York: Marshall Cavendish Corporation.