Sunday, March 12, 2017

Night Opera

OUR CLINIC: for the people, by the people     photo by Patricia Borns
please donate to hispanolahealthpartners.org


Haitian spirits in the darkness

March 2nd, 2017 Marjofre, Commune de Grand Gosier, SE Haiti:
For years now I have had a box seat at the night opera every time I sleep over in Marjofre. Well, honestly to be more comfortable I retreat a row back into the dress circle, to my mosquito-netted bed just inside the open balcony door which overlooks the wout prensipal, or main drag of rock and dirt. The evening starts with a punishing mix of burnt out speakers blasting kompa or reggaeton backed up by the high pitched squeal of the generator that powers them. This is usually coming from directly under my bed, where sits the courtyard of the "Love People Bar Resto." The racket is often punctuated with black-outs due to the blessed malfunction of the power source. By 9:30 the gasoline has run out and all that remains is the trilling laughter of a few drunk tenors as they inch their way off stage. I can hear silence for the first time in hours. Footfalls on the road below, sometimes just two - scrape, scrape on its surface, other times a shuffling lilt of hooves, a 3 against 4 rhythm, donkey or horse. More silence. I hear a truck coming from way in the distance and above the baritone of the engine a choir of voices sings as they ride atop the load - hymns in brilliant harmony rising from peaks of charcoal and plantains. It reaches its climax as they approach my balcony and then fades rapidly, before I can get out of bed to see what passed. More silence, maybe I fall asleep. Dogs begin to take the stage, one at a time, then in duets, trios, full chorus. Howling glissando, yappy staccoto. Their pauses give way to some distant drumming - I check the time, its after midnight, and the houngan, the clergyman of the Vodou psyche, has begun to sing in the breath of the gods somewhere near here. Drums' deep voices. Soft call and response crescendoing and decrescendoing, carried capriciously to me by the wind. This goes on for hours as I deliciously drift in and out of consciousness. The cock's aria is always the first to waken me - one shrill joker decides to disturb the peace with his hoarse solo that is then answered by a resounding chorus of atonal wannabes. The pigs' snorts, the donkeys' toothy gasps, the choking gurgle of a motorcycle trying to start, bring this fine performance to a close as dawn arrives.


Admin Asst Mr Bulgué on clinic roof
Little tyke with raging fever and marasmus
I found the Centre de Sante Communautaire Mare-Joffrey, (CSCM) now the official name of our community-shared clinic in Marjofre, in fine shape when I arrived on February 22nd. Better than fine in fact, when I saw everyone's phones plugged into the sockets and realized that WE HAVE ELECTRICITY!!A beautiful solar system has been installed and is fully functional as of a few weeks ago, thanks to the generosity of our donors.  As there is no electricity in town, this is a big deal for us.  This month marks one year of full-time operation of the clinic, and since the beginning of 2017 our providers have seen over 450 people.  This visit was an affirmation of the work we are doing; 5 days a week clinic consults, mobile clinics to more distant communities, cervical cancer screening and training, partnering with other regional non-profits to improve the health of the local population - the list goes on. Shocking and heartbreaking are the challenges we have in front of us; a 3 year old child in heart failure due to end stage sickle cell anemia who died as I sent her to the hospital by motorcycle; the malnourished 18 month old pictured here who arrived on our doorstep with raging ear infections and abscesses, a 2 year old blind in one eye from vitamin A deficiency.  Our staff is working hard to partner with the Ministry of Health to help address the chronic diseases of poverty, as we can not and should not do this alone.  But we have done much to provide the community of over 25,000 folks living in extreme poverty an oasis of hope.  We have you to thank.....


Anatomy refresher at HHP training


With funding assistance provided by Women International Leaders of Greater Philadelphia, HHP organized 3 days of training at the clinic in the procedure of VIA/cryo; a method of screening for and treating cervical changes that can lead to cancer.  Haiti has the highest rate of cervical cancer in the world, according to some sources.  We trained 12 doctors and nurses in the procedure, all from Ministry of Health clinics that we have equipped with training and tools over the past 3 years.  Some have already been trained by me in the past and needed a refresher course, others were new to the technique.   We screened 131 women and treated a few for positive findings; it was stimulating to share so much collective knowledge with so many experienced providers in the house. This is our first training held at the CSCM, which will become a regional center for cervical cancer screening.  I thank my fellow NP Erin Quinn and Dr. Marc Debay who helped me enormously.




Patricia filming surgeon and HHP Medical Director Roberto Peigne, outside his OR at the large Port-au-Prince public hospital "La Paix," which has been shuttered by a strike for almost a year now. 

Another exciting endeavor this time around is the making of a short documentary about the impact of HHP by brilliant filmmaker, Patricia Borns.  Patricia has worked in Haiti before and has a few documentaries out on Haiti - Madam Sara, Women of the Mountains, Women of the Border, which you can find here:  https://vimeo.com/search?q=patricia+borns
Nurse Musac and health agent Jean Robert, crucial to the project's success

We are honored to have Patricia's donated time and talent and anticipate a beautiful piece that helps describe the work we are doing and the land where we do it.   Travels with Patricia also brought us back to Pak Kado,  a community of cardboard shacks constructed by deported Haitians, booted across the border by 
their Dominican neighbors.  We squeezed into this tiny house, generously donated by its owner to do cervical screenings - we have done close to 200 there already since the camp opened in 2015.
photo by Patricia Borns
I leave you with a few tidbits - first, a photo of me and my beloved travel companion HHP treasurer, Peter Halle, here at the "Hotel Snobisme" in Port-au-Prince.  I thank him from the bottom of my heart for his patience and dedication to the cause, and for his love of Haiti, despite its "idiosycrasies."

We were in the thick of carnival celebrations this time around, and I filmed a little bit of rara or Haitian carnival music and dance that happened right outside our clinic gate.  I felt like I was back in West Africa...


video

Sunday, November 13, 2016

Silver Linings Social Aid and Pleasure Club


Dear Readers:  I came home last Tuesday full of the promise of silver linings in Haiti.  A month after Hurricane Matthew chewed up Haiti and spat it out, this natural disaster is giving birth to a new spirit of independence in the first black republic of the New World.  There is a growing generation of Haitians helping Haitians - not patronizing mega-NGOS or world powers manipulating puppet governments.  Examples include:

--Local fishermen banding together to carry their mammoth boats out of harm's way before the high tides struck

--Our community leaders distributing hygiene kits to 200 families, working daily against the threat of cholera

--Our staff keeping our clinic well protected and open as a service center during and after the storm, providing hundreds of neighbors with primary care

Belle Anse clinic
Peritoneal tap in our Marjofre clinic 
--The medical personnel of the Ministry of Health clinic in hard-hit Belle Anse working without pay to care for the rush of cholera patients.

--Our network of doctors, some of whom are from the worst hit Les Cayes region, organizing mobile clinics back home

Les Cayes
--A group of Haitian graduate students in the DR sending money to students who need uniforms, shoes and backpacks lost in the storm so they can go back to school

Hispañola Health Partners is doing what its mission directs - strengthening existing structures from the bottom up.  In the wake of Hurricane Matthew we have invested more than $5000 in Haitian-designed relief efforts.

More silver linings: The rains have also left our less devastated side of the country flush with green, happy corn and bean crops growing out of the usually dispirited rocky terrain.  And the vibrance of the people is very much alive and well. Take these kids playing a beat up drum kit at a Sunday service in Marjofre, or this lady selling chickens in a Port-au-Prince market.
A budding Tony Williams
Stop and Shop




Behold this brand new entrance of a local Catholic church with its simple honesty.

Haitian metal work of Grand Gosier Catholic Church
Charcoal powered ironing









Hope on wheels; we traveled 6 hours with this steel belted radial

Social aid and pleasure clubs are a New Orleans tradition mixing philanthropy with festivity, having roots in the island of Hispañola. So welcome to our Silver Linings Social Aid and Pleasure Club and thanks for the generosity you have extended to HHP.   
Please visit us at hispañolahealthpartners.org.  Our hurricane relief effort is ongoing.  We are responding carefully to ongoing requests from partners on the ground in Haiti to make sure we are using your funds to their utmost potential.  We are also making improvements at our community health center in Majofre so that we will soon have lab facilities and a solar power system to help serve our population better.  But it is not all hard work and dire straights. The pleasure part of the Silver Linings wraps us in the joy of the Haitian experience.  A la bon ou bon!  "Wow, you are good!"

Keep the faith, Louise

Louise Lindenmeyr APRN, FNP-BC
Executive Director
Hispañola Health Partners


PS: Every time you buy something at Amazon, go to smile.amazon.com (no need to reregister your information) and sign up  Hispañola Health Partners as your designated charity.  We will receive .5% of the purchase price. Thanks!
Michele Marie, 35, feels the love




Tuesday, July 12, 2016

Piece of Cake

Birthday cake delivery boy in matching Tee
Dear readers:
I am already digressing to the delightful minutiae of my travels.  But I think if you were there with me, you would do the same.  And in that vein, I will turn over the recall of our recent visit to my companion for the week, Peter Halle:
Community ambulance and the crew ready to start mobile clinics - left to right, outgoing administrator Cleeford Pierre, AMBUF member Jean Baptiste Altès, HHP Medical Director Dr. Roberto Peigne, Marjofre Clinic doctor Dr. Daniel Antoine, me, Peter Halle, clinic nurse/new administrator, Miss Florette


Travels with Louise

Louise and I flew into Port-au-Prince near the end of June, with four duffle bags filled with 200 lbs of free medicines, courtesy of AmeriCares.  The meds were destined for the burgeoning, but needy Centre de Santé Communautaire de Marre-Joffrey, a health clinic located deep in the Southeast.

Louise Lindenmeyr is a nurse practitioner and the executive director of Hispañola Health Partners, the NGO that helps support the Marre-Joffrey clinic.  You may know her as the mandolin-playing band member of the Joint Chiefs, along with her husband Eliot Osborn.  She is multi-talented and a force of nature.  I am a retired Wall Street finance guy who can build Excel spreadsheets, speak French, and withstand hours on bumpy jeep roads.

Hispañola Health Partners (HHP) was incorporated in 2013.  With the generous support of St. John’s Episcopal Church, the Salisbury Congregational Church, as well as private donors in our community, HHP has begun to realize its mission to provide integrative primary health care to rural Haiti.

After our first day in the capital converting currency and making arrangements, we headed to the bus terminal, a beaten down gas station, where we were packed like sardines into a rugged and worn 4WD bus for the five-hour drive up 3000 feet.  Now nighttime, we transferred to motorcycles for the remaining roller coaster ride down to Marre-Joffrey.

The Marre-Joffrey clinic opened for patients six months ago, amid local fanfare. The handful of Haitian nurses and doctors serve a surrounding population of 25,000.  The clinic struggles with neither electricity nor proper running water – both solvable problems in time.  But the staff is well trained and motivated to care for their community.  The clinic is dependent on the NGO’s expertise and money, and the plan is for it to become self-sustaining.

Beginning just a few miles outside Port-au-Prince, the road was unpaved with sharp scree, deeply rutted, crossing streams and flocks of goats and chickens.   It was the main highway.  But the crude roads are also a place for social interaction.  The people we met, and there were hundreds due to the mobile clinics, were friendly and, for the most part, content if not happy (after all, they were seeing a doctor).  The mobile clinics, a new initiative of the Marre-Joffrey clinic, consisted of hiring a stripped down 4WD “ambulance” to take us further into the hinterland to treat patients who could not easily get to the clinic.  While Louise and the other professionals saw to patient care, I acted as novice “farmasyen” counting pills, distributing meds, and fitting the far-sighted with free magnifier spectacles. 

Back at the clinic, the doctors and nurses tended to a regular stream of patients, organizing the inventory of drugs, and planning the necessary building improvements.  I trained the new nurse/administrator in Excel and how to track   the clinic’s finances.  But it was not all work.      

The rough and tumble roads were central to our adventures, providing a window into the dramatic landscapes and to the gorgeous unspoiled seashore.  Due to Haiti’s appalling infrastructure (water, sewage, electricity, roads), some of the most pristine beaches are unknown to all but a few.   Grand-Gosier on the southern coast possesses such a beach, where we swam one afternoon in the clear aquamarine waters.

From Marre-Joffrey we traveled six hours through the Belle-Anse arrondissement and over switchback roads to Jacmel, the regional capital, for a meeting with the health minister.   The politics of running a health clinic are every bit as important as the economics.  Jacmel has its charms, including a lovely waterfront and an old town with 19th century colonial architecture.

Our final leg was back to Port-au-Prince during rush hour.  Traffic lights have not functioned since the earthquake in 2010, and traffic rules are, well, flexible.  Coming from the ease and prosperity of our lovely corner of the state and the world, it is jarring to see the plight of Haiti.  But it is not depressing.  These are a people who have withstood the hardest knocks, and have kept their dignity and good humor.  With a little help, they may yet prosper.

Ribbon cutting of clinic on inauguration day, February 21st, 2016
We began full time clinic operations in January, providing primary care to a community that had poor or no access to services in the past.  However, it is not easy in a culture of poverty and deprivation to convince people to take care of themselves regularly.  When you are poor, I theorize, you are so consumed with fighting the enormous challenges of food, water, safety and shelter, that taking care of yourself only becomes necessary when the salivating jaws of the monster of death are about to devour you.
This woman delayed treatment for a deep neck ulcer, showing up on our doorstep with her problem hidden under a scarf

Our mobile clinics, which take place once a week, are designed to reach people who have not heard of our services, living farther than a long walk or an affordable moto ride.   For 50 goude, less than one dollar, they receive a registration card for our clinic, a consultation and free medication, appropriate for their problem.  We have started a Go Fund Me campaign to help cover the costs of the ambulance, driver, and medication.  PLEASE MAKE A TAX-DEDUCTIBLE DONATION TO HHP AT:  gofundme.com/25rbfe8e 

Baron Samedi, a raunchy bad boy, usually seen with cigar in mouth and rum in hand, imposes his diabolical power at the crossroads between the worlds of the living and the dead.

Despite Baron Samedi's taunting presence in Haiti, we carry on with the youthful optimism of these delightful carnival sprites.  Please help us win the battle at: hispanolahealthpartners.org or send a donation to HHP  374 Taconic Rd. Salisbury, CT 06068


Carnival sprites

In the loving memory of Joe Rinaldi, our dedicated board member who suddenly passed away on May 6th of this year, I lay down these words and continue the struggle.  Joe, a financial wizard with a generous heart and many years of NGO chops, helped us develop into a better board of directors over the last year of his involvement with HHP.  He visited Marre Joffrey for the first time in February for the inauguration and with a little touch of the Baron in him, he handed out cigars and Barboncourt (great Haitian rum) to the local committee.  Cheers, Joe!


Many thanks and stay tuned for more about our cervical screening program next time, Louise






Friday, December 11, 2015

Talkin 'bout good news

 December 11th, 2015
home sweet ougan
Hello friends and comrades - I have been in Haiti for the last 2 weeks but, unplugged, unintentionally "off the grid." It's hard to even keep a charge on your cell phone.  Lots of fine things have happened in this land of the unexpected which included today, while riding on a motorcycle taxi, when my driver decided to take a shortcut to the border and drove right though a little vodou compound as they were in the midst of a ceremony.  The dark hut was warbling with their prayers and intermittent taps of a tamborine.  My driver was embarrassed when I asked him to stop, with a warning chuckle of "ougan," or vodou priest.  This is what had caught my eye, as we buzzed by.
An image to Erzulie Freda, the goddess of femininity and compassion, not without her darker side
I started with a journey back to Belle Anse, a coastal town where I had come 6 months ago to begin teaching cervical cancer screening.  This is the third location where Hispañola Health Partners helps train and equip Haitian government clinics in the Arrondissement de Belle Anse, a neglected corner in the southeast of the country.  Every woman we screen here has never had a pap test, as there has never been the capability.  “See and treat” is a simple procedure using white vinegar and the naked eye with a good headlamp to detect changes that indicate pre-cancer.  The affected area can be treated on the spot by freezing with a cryo gun attached to a small tank of CO2.  Everything has to come by motorcycle, over crazy rocky roads.  


This time I was accompanied by Anne Griffin, an ER nurse from Lewisburg, PA who I hadn't spent time with since we worked together in a Cambodian refugee camp more than 30 years ago. 
She makes the perfect companion for the job. She has lived in the desert of Niger, worked in refugee camps in Sudan, projects in Malawi, and jumped out of a tuk-tuk in Thailand to escape being kidnapped.  We trained a doctor and a nurse to become proficient in the "see and treat" procedure, screening 100 women.  The greatest news is that our efforts are finally being recognized, after seeing and treating 1500 women in the last two + years, one of our participating doctors presented the project to the Haitian Ministry of Health and they are finally developing a way to incorporate this into their routine services.  Ah, the sweet breeze of victory!!


Me at 63 on a pile of conch shells while Anne trolls for her favorite
I spent my birthday in the little fishing village of Cap Pierre. Banging down the mountain in a pick-up to eat conch, crab and snapper in the rocks by the shore, grilled by the guys who caught it. Plenty of Prestige beer, bobbing in the waves and taking a few spins on the rustic dance floor made a perfect celebration of time passed on the planet.


one of my birthday guests
I also came to Haiti this time to check out the finishing touches on the clinic we are building with the locals in Marre-Joffrey, located in the same Belle Anse region.  Not without its challenges, we are poised to open for daily services with a doctor and administrator by the beginning of the new year. This week, Hispañola Health Partners hosted a Haitian team of 3 dentists, 1 ophthalmologist,  a surgeon and a family med doctor, accompanied by me doing gyn, HHP board member Dr. Hank Schmidt assisting in everything, and Anne playing pharmacist. We saw about 500 people in 3 days.


HHP Medical Director Dr. Roberto Peigne distributing toothbrushes while the dentist does fluoride treatments with school kids in the clinic dooryard


*******CONSIDER GIVING US A TAX-DEDUCTIBLE DONATION!!!  VISIT hispanolahealthpartners.org OR SEND A CHECK TO Hispañola Health Partners, 374 Taconic Rd, Salisbury CT 06068  THANK-YOU !!!!!!!!!

Cholera is back due to the flow of refugees crossing the border in Anse-a-Pitres to escape persecution from the Dominicans they have lived with for decades.  Hispañola Health Partners just donated money for IVs and bleach which was desperately needed at our sister clinic in Anse-a-Pitres. Hundreds of them are living in raggle-taggle camps just outside of town. For more information, read recent article from another aid organization:  http://www.hearttoheart.org/refugee-crisis-builds-in-haiti/   Here's a few images shot today from the back of the bike.  


Thanks to all and goodnight, Louise