Monday, June 11, 2018

Heroes and Saints

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June 12, 2018 Over the years working internationally, I have met a lot of heroic characters doing spectacular things but nothing lights me up like the legacy of Larry and Gwen Mellon. Last week I had the privilege of teaching cervical cancer screening and treatment to Haitian doctors, nurses, and midwives at the Hôpital Albert Schweitzer(HAS), on the grounds of the Mellon's famous facility.

Charming stone buildings dot the HAS grounds under massive shade trees

 3rd world vegetation laps up to midcentury modern at Mellon House
William Larimer "Larry" Mellon, son of Gulf Oil founder and CEO, established HAS with Gwen in 1956. A sensitive misfit from the huge Mellon empire, Larry split the gilded life and his studies at Princeton to turn cowboy in the late 1930s, starting a simple ranch in Pecos County, Arizona. The war soon followed and he served the Office of Strategic Services in counter-intelligence. He returned to branding and roping in '45 and married Gwen, another renegade who escaped the routine of rich housewife, supporting 3 kids by working at a dude ranch. The couple was settled into a comfortable routine when Larry read an article about Dr. Albert Schweitzer in LIFE magazine in 1947. The work of this Renaissance man who established a hospital in the jungle of Gabon, West Africa, impressed him so intensely that two weeks later he decided to head for medical school, at age 39. He and Gwen started a master plan for opening a hospital modeled after Schweitzer's and settled on Haiti. She agreed, "we don't want to sit around looking at the damn cows for the rest of our lives."

I worked here with H3 Missions; the project involved 17 volunteers from the US who trained 10 members of HAS's team in pap smear, visual inspection with acetic acid, cryotherapy, colposcopy and LEEP over a two-week period, screening and treating 900 women. Funding was by Rotary International. All equipment to continue the work was left behind for a regular screening program.
GYN Dr.Petisoeur demonstrates female anatomy in my class

HAS is a 131-bed hospital that serves the people of the Artibonite Valley, an area of about 600 square miles. When Dr. Mellon got there the Valley was rife with the diseases of poverty: tetanus, TB, malaria, malnutrition and a dismal infant mortality rate. Mellon and his wife, now gone for several decades, have left the hospital and large network of preventive and outreach services to a team that is 98% Haitian. It is a jewel to behold, particularly for folks like me who hold a fascination for success stories when it comes to long term health care solutions in low resource settings. 

HHP's Centre de Sante Union de Grande-Gosier (CSUG)
But allow me to be a proud parent and brag about another functional health care system, that of HHP, whose growth many of you have witnessed since birth. I am happy to announce that since the beginning of 2018 we have been awarded several grants for new programs in the community. 
The hypertension team and me at CSUG
High blood pressure is the most common diagnosis at our clinic in SE Haiti and threatens the entire family structure with the real possibility of death or debilitation of the family's primary wage-earner/caregiver. Responding to the lack of community understanding about hypertension and its impact, HHP proposed a six month pilot project.Using our well-established network of community health workers,1800 members of extremely remote communities around our region will be educated and screened about this disease and its impact. With the support of our staff and resources, assessment and treatment will be initiated for those at risk. The results of this project will be used to create an efficient model for reaching rural people with hypertension nationwide. We are thrilled that the Harney family of Salisbury, CT supported this program with a $7000 gift. Americares and a local pharmacy in Sharon, CT helped provide medicines for this project. We are also proud that the program proposal was penned by one of our Haitian doctors, as we encourage our staff to sharpen their skills in capacity building as they move towards self-sustainability.

HHP was given a $27,000 grant from Conservation, Food and Health Foundation and $1500 from Women International Leaders of Greater Philadelphia to continue our fight against female cancers in southeastern Haiti. This project, Ede Tèt Nou, or “Helping Ourselves,” will bring an innovative method of self-testing for cervical cancer to women in the far corners of the countryside. Again, a network of community health workers will be central in advancing this project, which also includes awareness raising and screening for breast cancer. Collaboration with some key organizations in Haiti helps shape the circle.

"I don't ever really get discouraged-I have a way around it," Larry Mellon said. "We came here to give what we could, what we have, and that's all we can do. Gwen and I both want to be buried where we drop, and that is not important except that it means we stay until the end of our time. We want to finish up as best we can."
You could join St Pierre in holding the key to our future by owning this antique vodou flag ($750)

Friday, November 10, 2017

Haiti Haute Couture

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November 10, 2017

Shop in Thiotte
Esteemed Followers:  A recent NY Times article investigating the negative impact of donated clothes from the West on the market for locally sewn clothes got me thinking about Haiti's couture (see article below). Haiti's affair with the used clothes market started in the early 60s; the identifying term then used was Kennedys.  The present day term for piles and piles of bound up duds from our ubiquitous charity dumpsters is pepe, which signifies anything imported which otherwise could be created here, hence pepe rice,  pepe chicken.  Now Haitian women wear pepe t-shirts from Canyon Ranch or Pine Woods Christian Camp with pink leggings or denim minis rather than the common homemade garb of the pre-Kennedys era.  However, almost every day my eye catches a few homegrown dresses as they pass on the street or up close as someone sits in the clinic for a consult - their hand sewn buttonholes and delicate needle work call my attention as if it were the latest issue from a Paris fashion house.   I decided to dedicate this edition to the home-sewn dress of the Haitian woman.  May it survive pepe, Kennedys and beyond!

"East Africa Curbs Imports on America's Hand-Me-Downs" by Kimiko de Freytas-Tamura

photo by Patricia Borns*
I am no expert on the topic - my data is purely observational over my last 6 years in Haiti. The women who wear these dresses are generally post childbearing age but still contributing to family and society - selling goods, keeping animals, cooking meals.  It appears there are 2 styles - a shirtwaist style with a large collar in generally bright colors, and a style in navy blue which is reminiscent of a sailor suit.

Sailor style

traditional homemade shirtwaist

incorporating a hint of sailor suit

I grew up in a seamstress-managed household.  Our kitchen, where the 40's era Singer sat, was a domain for measuring tape, tracing wheels, tailor's chalk, tiny pieces of pattern tissues. My mom was magic at making Vogue fashions of the day; suits made from elegant fabrics with bound buttonholes and silk linings with a perfect fit.  Under her supervision I cranked out a few prom dresses, dozens of a-line mini skirts and even a surfer girl 2 piece with lacing up the back side.  Hence my nostalgia every time I see a treadle sewing machine on someone's porch in Haiti.  How pleased I was to meet Nadège, a teacher and seamstress who lives close by in Marjofre.  She sewed up for me a kostim devosyon, or devotional dress, in time to wear to the fet Gede, which is the November 1st vodou celebration of Papa Gede.  He is the beloved and feared traffic cop who directs the coming and going at the crossroads of life and death.  We had been invited to a local party and I wanted to fit in!

Me and Nadège showing off the kostim devosyon

Calling Papa Gede later that evening
           some portraits of what's going on in the world of HHP
Our new clinic sign with all services offered; hundreds of patients seen every month
clinic ruff back in 2013
Lab services started in September '17 *
we've gone green in '17
Visiting Univ of Colorado epidemiologist Alice White working with Dr. Antoine on a study of hypertension in the region 11/17

Ongoing cervical cancer screening in 4 health centers in the Arrondissment of Belle Anse sponsored by Hispañola Health Partners
Cervical cancer screening supervision in action *
Every clinic needs a chicken *

Fet Gede with kostim in action *

* Photos/video by Patricia Borns  Thanks for your interest in this blog; for appreciating the inside view of Haiti and supporting the growing impact that HHP creates in the SE department.  Come visit us sometime!!  All my best, Louise
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Sunday, March 12, 2017

Night Opera

OUR CLINIC: for the people, by the people     photo by Patricia Borns
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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:
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...

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 hispañ  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 (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