Hôpital Albert Schweitzer Haiti

Saving Lives, Changing Lives

Saturday, July 24, 2010

Measuring the Flood Impact in Deschapelles

In the days after the Sunday flood of the Ca Charles watershed, volunteers and part-time workers with the UN project went to all of the affected homes and assisted in clearing away mud, rocks, trees, and trash, helping the residents to gain some sense of order, and to cope with their losses.

Many of us joined the volunteers, and we were shocked by the extent of the damage to the homes and the crops. In a team meeting of the staff of Integrated Community Services (all of HAS’ activities outside the hospital), it was suggested that we would conduct a survey of homes which were in the flood cone, to determine the extent of the damage, and to identify priority families for assistance in rebuilding. We had hoped to immunize 3,000-4,000 people in the area of worst flooding against typhoid. Sadly the vaccines were not available in our area, so instead our health workers provided education about typhoid prevention.

We activated the animatrices, community volunteers who work with HAS as contacts with the community, reporting on births and deaths, finding cases of illness and referring them to the dispensary or hospital, and providing health education. Most of the women (and a few men) had previously participated in the survey of risk factors for malnutrition, so we used the same concept of a graphic survey, so that the mostly-illiterate women could mark the objects which they saw.

Today, most of the surveys have come into the office, and we are compiling them to cluster by sub-zones within the immediate hospital area. Over the weekend, we will compile the results and identify the highest-priority households to be visited and support with whatever resources we can find. We appreciate the responses which have come in after the first blogs in this series, and we have already seen that the needs are greater than we had imagined.

Ian and the Integrated Community Services team.

Tuesday, July 20, 2010

In the Aftermath of the Flood

On Monday morning following the rains and the flood, the HAS managers of the UN Cash-for-Work project allocated more than 100 workers, who had been cleaning local canals or fixing roads, to the flooded areas. Using wheelbarrows, shovels, and other tools from the project, they joined the people in the mud filled courtyards to clear out the piles of trees and branches, and to clear the mud from the house floors.

Some of the women collected the clothes from the houses and washed them, putting them out to dry on fence lines and bushes. By the end of the day, most of the large debris had been cleared, and the houses had been emptied of the furniture to be assessed for future use. Many households had mattresses, but few had bed frames, and thus were soaked with muddy water. When they are dry, most of them will be burned.

The physical, visible, effects of the flood have started to disappear, but the sense of loss and having been invaded by a powerful force will remain for a long time. The HAS team of psychologists, who have been supporting the needs of the earthquake victims who live in this region, will go to the flood areas tomorrow to conduct group therapy sessions, and to try to help them to deal with the sense of insecurity which comes from such a powerful event and it losses.

While the force of the flood was greatest as it passed by the narrow channel behind the market, it gained strength from a web of small watersheds, each of which contributed a rapid flow of water, mud and debris into the main channel. This morning, one of our security guards, who had volunteered to help other families the day before, shared with me that he cannot get into or out of his house, because one of the upstream feeder channels, which is usually a small stream, had flooded and swerved, washing away the gentle slope to his front door. Now there is a steep ravine in front of his gate. Later today he will cut a new gate in the back fence, and negotiate with his neighbor the rights to pass through his courtyard to get to his house."

As always in Haiti, volunteers came from all over the community, to assist the people in the flooded zones, and to show solidarity with them, in the face of a tragedy which might have affected any of them.

Weather forecasters have been predicting for months that a punishing hurricane season is on the horizon. We are watchful and hoping for the best for all of the people of Haiti.

Ian Rawson
Managing Director

Monday, July 19, 2010

Torrential Downpours Flood Artibonite Valley

Five years ago on this date, a short but powerful rain created a flood which rushed down the Les Forges ravine and washed out the Deschapelles market and most of the houses below the bridge which leads to L'Escale, a residential village belonging to HAS.

On Sunday, in the late afternoon, a similar rain created a flood of the same magnitude. Trees are piled up around the houses below the canal, cars and motorcycles are covered with mud, and the interiors of many houses are flooded to a height of about 3-4 feet.

By Sunday evening, it was still raining, and the floods had receded, but it was impossible to walk very far without slipping in the mud and tripping over trees and branches. Thus far, there are no reports of physical injuries or losses, but we can see a substantial impact on the residences, courtyards and fields of food crops. Also, we have not heard from the upland communities, which will have endured the same rains.

Our extended family here at HAS has suffered losses. Manite, employed at HAS since the very early days, found her house was flooded to the height of her waist, washing away many of her treasured herbal plants. Another long-time HAS employee, Tyranie, also lives in that lacour, a small cluster of homes, and her house was flooded as well. The children from that lacour were brought over here to my house, and we had a bit of a camp party there with hot chocolate and blankets.... Fortunately, guests left yesterday, so we have space for the temporary visitors.

In Haiti, we live very close to nature, and its vagaries impose themselves without warning or selection. But the poor suffer more, because they are less well protected, and the margins on which their lives are led are so narrow. The miracle is the resilience of Haitian people, and their ability to carry on in the face of disaster, and to be able to visualize a better situation even in the face of disaster.

Our role is clear; to be considerate and concerned, to share resources as they may be available, but to share with them the experience of loss and also of recovery, hand in hand and shoulder to shoulder.

This incident may not be carried on your national or regional TV shows; the media who were here last week to mark the 6-month anniversary of the earthquake left before this new challenge emerged. Our son Edward came back from Port au Prince yesterday evening along the coastal road, and he reports that the devastation is remarkable all along the road, with flooded rivers and mudslides down from the steep mountains, and people wandering out to and into the road in a state of shock. Today will bring a broader perspective, one of loss and disaster, but ultimately of perseverance and hope.

Ian Rawson
Managing Director

Monday, July 12, 2010

HAS 6 Months After the Quake

Six months ago, a powerful earthquake shook Haiti’s capital city and other crowded residential areas to the south west. Only estimates are available of the number killed or injured, who have endured life in tarp cities, or who have migrated to rural areas.

HAS, unscathed by the tremblors, accepted over one thousand patients, most of whom were admitted to the hospital and received advanced care, most frequently orthopedic interventions. With time, most of the patients were discharged, some to an uncertain future, and HAS began to return to a semblance of its former status as a regional referral center.

However, the earthquake has changed everything in Haiti. The country’s healthcare infrastructure has been severely disrupted, and leaving a significant shortage in surgical and specialty services in the main city. Almost a million refugees are estimated to have left the capital to stay with relatives or acquaintances in rural areas, and approximately half of them came to the Department of the Artibonite, where HAS is located. Many of the refugees in the Artibonite have located in the major towns, but we estimate that our population in the HAS district has increased by 15%, with many of these residents needing primary health care and immunizations.\

The earthquake has also changed everything at HAS. The hospital, normally a 80-bed facility, now has more than half again as many inpatients. Most of the added inpatients are scheduled for surgery, and many of these are orthopedics cases who have been injured in motorbike accidents. The pediatrics ward has also expanded, with children with gastrointestinal and respiratory diseases, often complicated with malnutrition. As the patient population expands, so do the diagnostic services in the laboratory and radiology.

The prosthetics services, provided by the Hanger Corporation and Foundation, is racing to keep pace with the demand for new limbs for amputees. Over 400 patients have received prostheses, and more are on the waiting list. Today, there were more than 40 patients at the clinic; some are living at l’Escale, a temporary residential space just off the campus, and the others were brought up from Port au Prince by bus.

HAS, which prior to the earthquake, was a regional referral hospital for the 300,000 residents of three communes, now serves as a vital resource for the population of the destroyed capital as well, with patients coming from that area for surgery and diagnostic services. The national plan for prosthestics calls for the establishment of 8 laboratories, with four in the capital and four in the periphery. Not all of these services have yet come on line, and HAS appears to be one of the major provider for the entire country of Haiti. HAS now has a new, expanded role in the total scope of health services in Haiti.

The malnutrition ward always expands during the rainy season, while crops are growing and there is little food in the house. Almost half of the patients in the ward today are from two mountain communities, and we are making plans to develop nutrition rehabilitation units at these two dispensaries, to be more convenient for the mothers. In the long run, it is our hope to be able to substantially eliminate malnutrition in the mountain region through preventive intervention, especially among the most vulnerable children, those who are going through weaning to a transitional diet, and those who live in resource-poor mountain communities during the rainy season.

Just as more international aid agencies arrive in Haiti to set up long-term recovery projects, there appears to be a sense of malaise and frustration among many young Haitian professionals about the slow pace of change and the lack of a coherent recovery model. HAS, along with other healthcare organizations, has noted the departure of physicians to Canada and Europe, probably on a permanent basis. Several of our all-Haitian permanent staff positions are vacant, and will have to be filled by short-term clinical volunteers.

HAS was very fortunate to have been generously supported in the weeks following the earthquake, and the funds which were sent to assist HAS in that crisis have been expended in addressing the need for resupplying the hospital, accommodating volunteers, Now, the increased demand for our services, and the resource-intensive nature of the surgical and other services, have placed pressures on the planned expense budget for 2010. While cost reductions have been instituted, the redefined mission of HAS represents a challenge for the organization.

We appreciate the concern and support for HAS and for Haiti which our supporters have expressed in so many ways, and we look forward to our new challenges with confidence, and with appreciation.

As we sit together today in Haiti, making plans for the near term and longer term at HAS, we appreciate the concern and support for HAS and for Haiti which have been expressed in so many ways, by so many people. Some have known HAS for a half century, but countless others are new friends. We look forward to our new challenges with confidence, and with appreciation.

Ian Rawson, Managing Director & John Walton, Board Chair

Thursday, July 1, 2010

This year marks a centennial of a sort for HAS; it is the 100th birthday of Larry Mellon, and it was observed here in Deschapelles with several days of celebration, along with the 54th anniversary of the hospital.

In the past several years, the locus of the HAS birthday events has shifted from being held inside the hospital to out in the community, in order to ensure that both employees and local residents can share in the reflections about the hospital’s achievements. Our closest partners at the community level, the Organization for Economic and Social Development (ODES) has served as the official host and coordinator of the events, with the active support each year by Mme LeGrand Mellon, the widow of Billy Mellon.
The day-long celebration on the 26th was preceded by a week of evening musical events in the outdoor pavilion of the Belizaire-Mellon boutique, which exhibited models of new products emerging from the crafts shops in ceramics (brilliant new colors), cotton rugs, and furniture (new, contemporary designs, along with the antique reproductions).

On the day of the birthday, a large crowd convened in the Catholic Church at the end of the corridor, in a ceremony which was led by the lay pastor, Vanes Dutreuil, who is also our surveyor. This was followed by a parade up the corridor, led by the Fanfare brass band, and the brightly-uniformed young coordinated marchers. After circling the hospital, the crowd returned to the ODES site, where they were welcomed with a prayer from Pastor Sonnal (returning from New York for the event), and several musical selections interspersed with reflections from the oldest HAS alumnus, a community leader, Mme Billy (LeGrand, in her Deschapelles persona), and your Managing Director.

Special guests of the day’s celebrations were a large number of people who were in the process of receiving and using new limbs from the Hanger Clinic. Many of them walked down the road from their residence in l’Escale, on their new prostheses or crutches. This is almost the half-year marker since the January earthquake, which caused the injuries suffered by many of the patients. The day, however, was a day of celebration and liberation, led at the end of the program by a rap which was written and performed by two of the patients.

In observing the 100th birthday of Larry Mellon, the point was made that when he was young, his mother always read to him from the Bible at night, and one of the passages which she frequently chose was the one which notes that it is easier for a camel to pass through the eye of a needle than it is for a rich man to enter Heaven. Larry recalled those verses when, later in life, he was presented with the opportunity to establish a hospital in Haiti.

The formal events were followed by several popular soccer matches on the HAS field; in the first one, an inexperienced but disciplined team of girls from Deschapelles beat a well-equipped team from Petite Riviere, and the under-13 boys from Deschapelles battled an older-looking team from Verettes to a 1-1 tie. The large screen TV on the basketball court which was showing World Cup games went virtually ignored as the feisty locals were cheered on by their neighbors.

A long day came to an end, having covered the gamut of emotions from celebration, thoughtful reflection on the losses which have been sustained recently, and the joy which comes with a return to mobility.

If the hospital and the community can pause at the half-way marker of the Year of the Earthquake with such grace and humor, it bodes well for many joyful celebrations to come.