This Old Haitian House

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Fretwork frenzy at Playa Grande Beach Club

March 11th, 2023 - I returned from the isle of Hispañola a few days ago after traversing from the eastern edge of the DR to our home base in southeast Haiti. I have been a fan of older architecture in Haiti for years, but it wasn't until I visited Elric Endersby's magnificent designs in Cabrera, DR (see left and visit https://www.playagrandebeachclub.com/design) that I realized the depth of what I'd been looking at. The tragaluz, or decorative vents at the tops of windows and doors, high ceilings and shutters help ventilate these old buildings, gracefully inviting the breeze inside.  Fretwork inside imitates this lacey art form. "Gingerbread" houses built in the early 20th century were so well built that only 5% suffered damage from the huge earthquake in 2010. One quintessential sample of this style is the Hotel Oloffson in Port-au-Prince, a favorite of ours back in better days.

The Oloffson

      A commercial building near us                                       

                                                                                                                                                    

A fixer-upper, good health care nearby

I'm partial to the funky ones in our region of Haiti that pop out like petunias from the dull norm of cinder block and cement. The tragaluz shown below imitates vodou designs, vèvè, that honor individual gods and are etched on the ground in cornmeal during religious ceremonies. 

Vèvè, Grand Gosier!!

Pink patina to die for with vèvè in neighboring Thiotte

Pardon my digression, but I love a little break from the flying bullets and burning tires, cholera, malnutrition, and gang saturation of our failed state. The reality of living in a war zone has now settled deep in our fabric: we have learned to work around it and with it, at the same time join forces with other NGOs to find solutions to help release Haiti from its death grip. We in the Southeast are fortunate that gang violence does not hit us directly, however, the effect of the paralysis of Haiti's commerce and its people is widespread. Transporting goods to the clinic is now costing double - we have to send items purchased in Port-au-Prince nine hours overland instead of the usual four. And pay the gangs their "fee." And risk kidnapping. Our community can not visit family or continue with their studies outside of our zone without risking their lives.

Dr. Peigne, our inspiration

We have also experienced a terrible and ironic loss. On July 13, 2022, our dear friend, board member, the original HHP medical director, and early visionary who helped me start on-the-ground operations in Haiti, surgeon-dad-native of southeastern Haiti, was senselessly murdered in Florida. After escaping the violence of Port-au-Prince to reunite with his family in the US, he was a victim of our own gun violence. Our strength prevails, thanks to Dr. Peigne's leadership and belief in improving the lives of his people.

Despite the sorrows, dangers, and chaos surrounding HHP and our partner clinic and birth center, our impact is greater than ever. Thanks to generous support from Americares and our private donors, our outreach programs that help the poorest of the poor, are thriving. A cholera prevention project, a traditional birth attendant program, cervical cancer screening and treatment for HIV-positive women, and mobile clinics all boost the delivery of quality health care to those most in need. Our clinic's lab, pharmacy, emergency room and birth center are seeing 50% more patients than last year.

Matwòn Toussaint with baby she delivered

Mobile clinic with Dr. Jean Pierre

I hope these words and images help you palpate the delight it has been to work in Haiti for over the past 10 years. As always, I wish I could bring every one of you here to savor a few seconds of this unplugged world that tweaks the senses. I am confident that better days await the Haitian people, who are tattered but tenacious. HHP will be by their side until that new dawn.  

All my best and avek lanmou, 

Louise

                                                  

Please visit us and donate at: Hispañola Health Partners

 

Back in the Saddle

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Sandy, my chofê in Haiti has upgraded his ride

January 18, 2022 - Last week when I got back to Southeastern Haiti after being absent since May, I had a lot of ground to cover. As the director of Hispañola Health Partners, a US-based NGO that helps design and support health programs that benefit the rural Haitian community, I had reasons to visit the remote corners of our 300 square mile region. 

Loose rock and powder-fine dust rule the steep roads, but with Sandy's driving prowess, complete with a sound system that blasts Haitian kompa, as we bump across the countryside I feel as secure and happy as a kid on a rocking horse. With the new addition of the aerodynamic parasol, the ride is cooler than ever.

Kompa, the national dance and sound obsession is sampled here by JBeatz:

The first few visits I made were to women who had recently given birth at home. Our program, Ann Bay Lavi Jaret, or "give life a helping hand," was designed by the staff of our partner clinic in SE Haiti, Centre de Santé Union de Grand-Gosier (CSUG). This program helps sharpen the skills of the 18 traditional birth attendants or matwòn who attend the vast majority of the births in our area. Trusted neighbors, matwòn use folk medicine, prayer, and a little Vodou to help women who live in remote mountainous areas with conditions too harsh to reach a health center in the throes of labor. This program fills the gap between the innate skills that the matwòn have and the safe birth practices that our midwife presents in the 5-month course. 

Matwòn Cherinor Gustave , 42, received his calling through a dream when he was 18

To visit this 3-generation family, Cherinor, I, and the midwife traveled 45 minutes by motorcycle and 2 hours by foot up a steep mountain path. Our midwife spends a lot of time in the field, making an average of two prenatal and one postnatal visit for every patient the matwòn care for. 15 births/month!

Weighing babies that are born at home help us get baseline data to use for improving outcomes. This is a hammock my kids used for their stuffed animals years ago, attached to a hanging scale used for weighing fish. We also include age at birth, length, hemoglobin and head circumference as criteria. 

Mezon Nesans Fanmi, our new birth center, was built by the community, HHP and Women International Leaders https://www.wil-gp.org/

 

On January 12th, 18  matwòn received diplomas for completing the Ann Bay Lavi Jaret course. They are in front of our new birth center at CSUG,  along with clinic staff.

Another program I needed to visit serves more than 200 HIV+ women in our region. Fanm Vanyan, or "Valiant Women," is an extension of the cervical cancer screening and treatment HHP has been providing women in the region since 2013.  Women living with HIV are almost 5x more vulnerable to invasive cervical cancer. Community health workers who distribute the women's medications house to house recruit and educate them about the dangers of cervical cancer and arrange a meeting spot for the testing. I went on a 4-hour ride to find one of these women who did not have the money to pay for transportation. We arrived at her humble home where she lives alone with her 4-year-old son. She was young, shy, and scared but we held her hand and gently coached her while we did the test and treatment right there on her bed. 67% of the HIV+ women we test need treatment.  

Last May we didn't think things could get much worse in Haiti as we dodged roadblocks and heard about more and more kidnappings. Then came the presidential assassination and earthquake in the Southwest Department. The misery of poverty, lawlessness, political turmoil, a fuel crisis, and natural disaster, all wrapped up and dished out to the struggling, honest, hard-working people of Haiti just seemed too much to bear.  However, 2021 was a stellar year for HHP and our partner clinic, CSUG. We constructed a birth center, Mezon Nesans Fanmi, in 9 months, which now shines like a jewel for everyone to enjoy. The first baby born there (above) was one of our own, his mom is our nurse/pharmacist. There is room at the birth center for medical personnel so Haitian doctors and nurses doing their "social service" can come and work with us for a year, no charge! 

Let's hope we can find the joy and inspiration to meet each day of the year ahead. I'm stunned by the beauty of our world when I walk 5 miles down the hill from our clinic to the edge of this mystery.

I wish you could join me, Louise

Lavi se Dwol

Please visit us and donate at: Hispañola Health Partners

Lavi Se Dwol ," Life is funny,"  is one of the thousands of phrases seen painted on the colorful trucks that crawl over the impossible roads of Haiti. This one stuck out for me, because unlike the usual appeal to Jesus to spare the driver, this admitted to the ridiculous roulette of existence here. Rereading Graham Greene's The Comedians, he too endorsed a sense of humor in this land some 55 years ago. This "beautiful and bedeviled country," he wrote," is a dark blend of terror and farce."

It wasn’t quite what we intended, to walk 26 miles over the mountains behind Port-au-Prince to Jacmel alone. We meant to bring curious friends of HHP for a funky donor tour over the backbone of Haiti, reaching an elevation of 5000 feet, then a descent to the sea on the other side. But due to the chaos here over the past year - frequent protests involving huge crowd manifestations, tire burning roadblocks, flying bullets fighting the corrupt government - our friends opted to try it another time when the situation is a bit more placid. We understand, lavi se dwol.

Kay Ronald's garden

Optimistic nonetheless, we figured we needed to try out the path ourselves if we were ever going to bring along paying guests. Peter Halle, Hispañola Health Partner’s board president, Dr. Daniel Antoine, our resident doctor in our clinic in SE Haiti, and I agreed to this journey together. We started in Kenskoff, a region above Petionville, at the crest of the peak from which all of Port-au-Prince pours downward.

We stayed our first night at Kay Ronald, (see Airbnb addresses below) a lovely and fascinating architectural whimsy that twists around the terrain of the mountaintop, created by Haitian architect Ronald Blain. We took off after a breakfast of herring and eggs…..up the hill further by motorcycle. We walked a gentle ascent for a few miles in the midmorning sun, but with the unfortunate burden of 20-pound backpacks (we were going to be in transit for 5 days), we realized we would need a little assistance.  

The Haitian Alps

We climbed and sweated, straddled motorcycles and slid in the mud and rocks along the Haitian national route 101. No truck or car could ever traverse these narrow peaks, we left them behind in Kenskoff. We felt humbled by people walking along with us who do this every day with burdens much heavier than ours on their heads and backs, I also sympathized with the donkeys, who occupy the lowest rung of the hauling hierarchy. 

Don't Wanna Be Your Beast of Burden

 

 

We staggered to the top of Tet Kay Jak, the highest altitude on the national highway and then continued on for a few blessedly flat kilometers through Parc National La Visite. One of two national parks in Haiti, it is covered with Hispaniolan Pine, and is so cool and misty you need a jacket in mid-afternoon. We arrived at Kay Winny in time for a big thermos of mint tea. Unoccupied for 7 months because of the national crisis, we were the first guests to open a new chapter for the place. This is rugged tourism at its best, I thought, as I wrapped my weary muscles in a duvet. The candlelight cradled me after a goat stew dinner and a warm beer. 

Kay Winny 

A rapid descent the next morning to the sea on Haiti's southern side by foot and moto, then fast forward to our arrival by skiff to Belle Anse where I was meeting our supervising nurse for Ede Tèt Nou, our female cancer program. We were scheduled to see a few women who had been treated for positive HPV (precancer of the cervix) and needed follow up. This program screens and treats 1600 women in the rural and remote Arrondissement de Belle Anse for breast and cervical cancer. 

Training session for Ede Tèt Nou for community health workers at our health center

On the beach in Belle Anse

Crumbling, hot and slightly decadent is Belle Anse, a great place for a stranger to gently perish of solitude. The sound of the relentless surf heaves a billion loose stones at every sigh. On the beach, trudging through drifts of slippery stones, my sole companion amidst the piles of plastic bottles mixed with seaweed and the resident swine, is a ten-year-old boy who watches me stumble, mockingly. Life here is not easy but neither is death. I knew a fellow whose coffin split in two while banging in the waves in the boat that was bringing him to his proper funeral miles down the coast.

The "Jel"

As I lie inside the balcony of the Jel Hotel, I wonder if anyone should feel compelled to advance this place, or is it better to leave it to decay respectfully without outside tampering? 

As a wild, endangered specimen of postcolonial Caribbean life, hard looks of manual labor is on every face, child to crone. Muscles of the arms and backs peek through clothing while I watch the beach-launching of boats, the hauling of 5-foot bags of charcoal, the shoveling of stone and sand. This prototype of the working man has been virtually lost in other Caribbean nations, replaced by the soft labor of tourism. At least this place belongs to them.

When I eventually got to our clinic in Marjofre (CSUG), I arrived on time to help usher this baby into the world. Will he know a better Haiti or is misery as imprinted here as his DNA? 

born yesterday

open wide

 HHP/CSUG has just entered into a new chapter with the hiring of a skilled birth attendant and the drawing of plans to develop the second story of the clinic into a birth center and residence for staff. This will move us into a 24-hour care center. Thanks to the generosity of our donors, we were able to provide 3 days of dental care to the community for a modest price of $1.62/visit. This was the first time in 3 years that dental care has been accessible to our population. 

It's kanaval time in Haiti but the president called off celebrations in Port-au-Prince for the threat of violence. Yet here in our gentle corner of the country, we enjoyed some traditional music and dance with our neighbors. They remember you, the people who give their support from so far away, on this day of grace and simple beauty. We thank you deeply, Louise

Please visit us and donate at: Hispañola Health Partners

Twobadou music

Calibrian dance and song, Marjofre


Kay Ronald https://www.airbnb.com/rooms/18395646. 
Kay Winny https://www.airbnb.com/rooms/25476515

Haiti, Cherie

Balboa was one of the first Europeans to see Les Cayes in 1504, a Haitian port town in the south that exports coffee, sugar and vertiver. Homemade cargo ships with no motors dot the coastline. Read more about Haiti sailboats here:
https://www.passagemaker.com/destinations/history-of-haitian-sloop

On May 16, 2019 we hit the tarmack of Toussaint Louverture International, Port-au-Prince, with a different plan in mind. I usually head for our clinic in the southeastern mountains as soon as I can, escaping the suffocating grip of the capital. This time I, board member Peter Halle and our resident doctor Daniel Antoine were heading out in the other direction in order to visit a well respected birth center near the southern city of Les Cayes (Okay in kreole, from Aux Cayes). HHP is helping to create a birth center at our clinic, plans are to hire a midwife and be in full swing by the fall. It was Friday of a holiday weekend and we had a 2 pm appointment for a grand tour at Maison de Naissance in Torbeck. Half way through the 5 hour trip from Port-au-Prince our bus refused to move and we spent 3 hours sitting by the side of the road with a blown clutch. We finally arrived there at dusk for just a cursory look. Maison de Naissance is one of a mere handful of midwifery centers in Haiti, providing the hospitality of a home rather than the impersonal feel of a medical center.  

Maison de Naissance Torbeck
 http://globalbirthinghomefoundation.org/

Presently 95% of our mothers give birth at home because there is no other logical alternative if your baby decides to come after clinic hours. The situation contributes to several negative outcomes - infection, hemorrhage, prematurity, infant mortality. The birth center will provide support for moms with family planning, prenatal visits, 24/7 on-call service and a training program for the traditional birth attendants who have been the only support system for pregnant women until now. 

Young hopefuls demonstrate with T-shirts saying "Under our flag,
 let's have a dialogue about change in Haiti"

Bumping across Okay on foot the morning of Haitian Flag Day, we had to skirt around a manifestasyon in the city center; there have been demonstrations against the government since last summer when a corruption scandal was exposed concerning government confiscation of funds meant for social programs. The country has been paralyzed by patchy violence which has caused the nascent tourist industry to tank as the US State Dept ordered the departure of non-emergency personnel and ranks it a "Level 4: Do not travel."

Knowing all this, I left for Haiti this time with a twinge of fatalistic dread. Yet besides a few roadblocks, police in balaclavas with rifles and remains of burning tires in the street, I never felt unsafe. It helps to weave into the Haitian fabric, using public transport and traveling with Haitians instead of inside an NGO's SUV with tinted glass. In fact, I was delighted by the funky surprises of Okay like this old drug store.

old apothecary shop

the facade - a future look for CVS?

While in Okay we stayed at the guesthouse of the Business Technological Institute, or BTI, Haiti's first community college. Opened in 2004 by the Episcopalian Church of Haiti, BTI had 140 students in the first graduating class. This year 1200 students will graduate and 70% of them will find jobs in their field. A big chapeau to its intrepid leader, Dr. Ajax, both a visionary and a really nice guy. Oh yeah, the food at the guesthouse is AMAZING and there are cases of wine in the dining room...love those Episcopalians!
https://www.bti-haiti.org/

Dr. Kesner Ajax, an Okay treasure

Okay's architectural je ne sais quoi

Another Haitian seaside attraction

Getting back to what I came here for: Centre de Santé Commune de Grand-Gosier, the clinic in the remote corner of southeast Haiti that HHP has been partnering with since 2013, is thriving. With programs in hypertension, cervical cancer screening, children's vaccinations, family planning, prenatal care and soon-to-be a midwife-centered mezon nesans, we are on fire. Attracting more support from the Haitian Ministry of Health, foundations and the private sector, we are grateful for the energy fueled by your sustained belief in this little miracle.  Thanks so much, Louise

A recent grad from our hypertension project - her bp dropped from 224/150 to 130/84

Please visit us and donate at: Hispañola Health Partners

thanks so much 

HAITI, CHERIE 

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 www.Facebook.com/H3Missions; 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)

 All the best, Louise

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