Education is Essential

One of the ways that we are improving overall health is through education programs for the community.  Here is a photo of Dr. JF and some of the attendees of a recent seminar titled "Diabetiis and Your Feet".  The presentation used our new vidoe projector and a powerpoint presentation in Creole.  According to our administrator Killy, the presentations gave pointers on how to care for feet and toes, how walk with care, what kind of shoes to wear and so forth.  Of the twenty attendees, fifteen were diabetic patients.

Visitation Clinic subject of recent news article.

Three-year-old rural clinic focuses on compassion in care
 
By Dennis Sadowski Catholic News Service

PETITE-RIVIERE-DE-NIPPES, Haiti (CNS) -- Beyond a few hospitals, quality health care facilities in Haiti are scarce. It's the clinics -- some big, some small -- that provide the bulk of health care Haitians receive.

One such clinic is located 70 miles west of the capital, Port-au-Prince, in the rural community of Petite-Riviere-de-Nippes. The three-year-old Visitation Clinic -- a project of the Visitation Hospital Foundation in Nashville, Tenn. -- sees about 70 patients a day. Most have common illnesses -- gastro-intestinal ailments, urinary tract infections or a slight infection, all typically caused by ingesting contaminated water.

In a country where access to health care is limited, having a clinic nearby can mean the difference between a mild illness or something more serious.

Many patients are children whose parents are glad the clinic opened in their seafront town because it saves them from making the 45-minute, 10-mile trip over sometimes rocky unpaved roads to St. Therese Hospital in Miragoane.

Dr. Rony Jean-Francois has worked at the clinic since it opened in 2008. He left a hospital in Port-au-Prince to work among people who have few other alternatives for care.

"I'm proud of my work because I'm giving service. It's a gift to be part of it. I can bring my competence to a community that is by itself without help," the 43-year-old physician said.

Since January, the clinic has housed a cholera treatment unit on its grounds. At the peak of the epidemic in December and January, the unit's 30 beds were nearly full for days on end.

Jean-Francois and the clinic's administrator, Riphard "Killy" Serent, made the rounds to the 30,000 residents in town and the surrounding rural area for weeks, talking about cholera prevention techniques: proper hygiene, including regular hand washing, and drinking only safe water. Serent said the effort likely prevented the clinic from being overwhelmed with cholera cases.

Through April 19, more than 200 people had been treated at the clinic and in the special unit opened by Doctors of the World, a French medical aid agency, on the clinic grounds.

Haiti's health care system was severely tested with the cholera outbreak. Through April 12, Haiti's Ministry of Health and Population reported more than 283,000 cholera cases with more than 4,800 deaths.

Until October, Haiti had not seen a reported case of cholera for 50 years. The disease unexpectedly reappeared in rural Artibonite department in the center of the country, and the strain was traced to South Asia.

At Visitation Clinic, while cholera was not as serious a challenge as elsewhere, Jean-Francois and Serent still face daily challenges because of the deep poverty in which people live. Most patients arrive on foot, some leaving home before dawn so that they arrive for the clinic's early morning opening.

Numerous patients over two days said they found the staff helped them feel respected and comfortable.

That falls in line with the clinic's mission to provide "competent and compassionate health care."

Jean-Francois sees the clinic's work simply.

"The foundation of the clinic is love," he said. "Everybody is involved in it."

Klinik Vizitasyon Video - Petite Riviere de Nippes, Haiti

Don't know how they did it

Our first pediactric dental mission was an unqualified success.  Somehow, nearly everyday Betsy and Stacy worked, they were able to see more patients than the previous day.   In eight working days, they treated 154 patients - 29 children under 7 yrs, 117 children from 7 to 18 yrs, and even eight adults.  To accomplish this they worked from the clinic's opening  until well after dark.  They even arranged for hourly announcements on the local radio station so that parents would know this service was available. 

One would think they would be exhausted.  But Betsy emailed this morning.  She is trying to figure out how to add a second dental chair to speed things up.   She's getting estimates to fully equip a dental clinic.  She's even trying to figure out how to rewire the clinic so that the lights don't dim when the compressor comes on.  She's hoping to return soon.

Our gratitude to Betsy, Stacy and Johnson is immense.  And we all now realize the tremendous need for dental healthcare and education for the chilcren in rural Haiti.

Watchin'

Our dental team has treated 121 patients as of yesterday, and somehow they are able to see more each day.  Yesterday they saw 30 children, nine of whom were under six years old.  As seen here, there is often an audience of very interested children at the window who seem riveted by watching our dental team at work.  Dr. Betsy encourages this.  She hopes the onlookers today will become the future dentists of Haiti.  We also want to note that the newest member of the Unit is Mr. Johnson (left).  He is an interpreter who lives in Petite Riviere when he is not in school.  He has become our dental health advocate who explains to the children the technique and importance of taking care of their teeth.

Waitin'

 

Waiting for the dentist

 

Waiting some more



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Still waiting



Redemption songs

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Rural Haitians have little exposure to video media.   Televisions are scarce, theatres are rare, and even the viewing of DVDs is limited.  What takes their place are the churches.  Even a small town like Petite Riviere can have a grand church that holds a large congregation, some of whom will walk considerable distances to attend.  Non-Haitian visitors to rural churches are infrequent, but those few who are fortunate to attend will invariably experience an unforgettable celebration.  Perhaps most striking is the music.  Even on Sundays in ordinary time, the celebrations will seldom last less than two hours and the musical bounty that enfolds a visitor seems to endure and refresh for days.  The entire congregation is the choir and all will sway and pray, both individually and communally in harmony to the music.  The instrumental accompaniment is just as diverse and infectious.  Drums, of course, are prominent and essential.   

This past Sunday was Easter and the ceremony was undoubtedly the most spectacular of the year.  But even the days preceding Easter have their own beauty.  For instance, the music and lower photo here came from the more reflective celebration on Holy Thursday. 

This past year, the world has noted the tremendous resilience and hope that Haitians retain, even in the most trying of times.  One cannot help but wonder if it is Haiti's music and celebrations that nourish this most precious of virtues. 

The Unit

There is a television series called "The Unit" which is about a team of specially recruited, highly trained, disciplined and dedicated soldiers who work in difficult circumstances to accomplish their mission.  I dream that the producers will travel to rural Haiti someday and see the real thing at work.  We have a number of Units at Visitation Clinic.  Our newest one is lead by Dr. Betsy Barcroft from Memphis who is an accomplished pediatric dentist and spends her free time treating disadvantaged children to places like Alaska, Hopi Indian reservations, rural Arkansas and now Haiti.  She and her incredibly efficient assistant Stacy have volunteered for ten days to work at our clinic with the goal of seeing every child they possibly can.  Each day, they start early, don't want to take lunch breaks and work until the last child is seen.  They spent weeks preparing for the trip, acquiring all the equipment, supplies and instruments, which they squeezed into their checked baggage.  Betsy even did her own fundraising for the project.  

It is unfortunate that our Unit's members share a major flaw which will keep them from becoming television action heroes.  They are just too darn nice to be believable and the children actually like them.

The worst of times, the best of times

Imagine for a moment that you are a child in rural Haiti and your tooth hurts.  Next thing you know your parents are taking you to a big white building where maybe you can hear some kid crying through one of the windows.  Then after waiting for a long time, your mom takes you to a  room filled with scary stuff, where these pale strangers put you into a weird chair that nearly turns you upside down, then they get out the biggest needle you've ever seen, even though they try to hide it, and then it feels like a couple stings and your mouth feels thick and funny.  Next thing they are cramming  weird gadgets that look like scissors into your mouth, then a loud machine makes this noise and there is a whining sound on that tooth that you don't want anyone touching.  And you can't even holler to your mom who is sitting next you looking worried.  Finally after a fistful of forevers they are taking the stuff out of your mouth and you can't stop shaking and you want to cry except it seems too late.  But then the strangest thing happens.  You get this little car like you've never seen before with wheels that actually turn and it's the most wonderful thing and you can't wait to get outside to play with it.  And somehow you can't quite remember how the worst day of your life turned into one of the best.

Click here and you help change a child's day at Visitation Clinic in Haiti.

Dental screening

This week we are bringing a new program to Petite Riviere - pediatric denistry.  We have two dedicated volunteers with years of experience in chilren's denistry.  Today they were screening children in a nearby school.  The video shows how this was done.  Unfortunately our team found that nearly all of the older children had untreated cavities and other dental problems.  In fact, it looked like most of children had no prior dental care.  Over the next ten days, our team will be treating these children and, we hope, many others too.  Our team won't be pulling many teeth.  They have come with all the equipment and materials to do high quality restorative dentistry.

If you are very observant, you can see on the blackboard a table showing the size of the class.  For those of you who can't quite make it out, the sign shows that there are 83 children in this modest sized class room. 

Market

In rural Haiti there are no supermarkets, convenience stores, or Walmarts.  Shopping and trading is done in an open market that lines the main street of Petite Riviere every Wednesday. 

The daily diet of most rural Haitians consists of rice, beans, fruit and grain products.  With no electricity, there are few refrigerators and ice is a rarity.  So storing meats and fish is a challenge. 

The lack of refrigerators also impacts the healthcare that Visitation Clinic provides.  We can't dispense pharmauciticals that require temperature controls.  And patients with trauma injuries can't apply ice to reduce swelling.

Education

One of VHF's core missions is to provide health education to the general populace.  We do this in a variety of ways, including radio talk shows, large public gatherings and, every morning, a meeting with the patients.  These photos show typcial morning meetings.  The patients have gathered in the clinic's shaded portico and are waiting for the clinic to open.  Each day, one of our medical staff has been assigned the task of preparing a short talk on some public health issue.  This can range from basic hygiene, to child nuitrition, to the need to take medicines in the proper manner.  When Dr. JF is the presenter, there is often much humor in the presentation and much laughter and smiles in the audience.  Programs like this can be one of the most effective ways to improve overall health, as well as to quickly get on top of outbreaks of diseases like cholera.

Artists

One wonders at times if there is a more naturally artistic people than Haitians.  From the infectious music, to the elaborate painting of the private buses or "tap-taps" one can hardly avoid encountering artisans.  Even in rural areas like Petite Riviere, one can encounter art in surprising ways, including the elaborate embroidery of children's homemade dresses and the painting of fishing boats. 

Still, we were surprised on our recent trip to find this elaborate mural on the walls of a new gathering-spot that is being built.  The artist is a local resident who appears to have not just exceptional skill but a great deal of practice and training.   

Homes of Petite Riviere

People wonder about where our patients live and what a typical home looks like.  Here are two that sit on the beach.  Houses are made of either wood or cement block with a metal roof.  They are about the size of the utility sheds that are sold at places like Home Depot or Lowes.  If the family is very poor, the floor will be dirt and the roof might be banana fronds.  More common will be a concrete floor.  Cooking is done outside the house, usually on the ground and over charcoal.  Indoor plumbing is very rare.  There is no electricity, of course.  Glass windows are only for the rich.  As are window screens.

 

These homes sit right at the sea's edge and in good weather the view is very beautiful.  But, as everyone knows too well, Haiti is prone to earthquakes, tropical storms and huricanes.  Houses like these are not where you would want to be in any of these. 

Smiles

Kids in Petite Riviere don't get their pictures taken very often.  When you attempt this, they are usually so puzzled that it's hard to get them to smile. You can say "souri" (Kreole for "smile") but this normally results in a look of Mona-Lisa bemusement.  For example, check out the photo in the "Shared Bond" blog below. 

But here is a trick that works every time.  You show them their picture on your digital camera. Giggles of delight are always forthcoming.  Of course that doesn't help you get a picture of them smiling, unless there happens to be a real photographer nearby who can capture the moment.

Such is the case here.  Bob Roller of CNS was visiting our clinic when these girls saw, perhaps for the first time, their digital images.  Everyone was delighted. 

You can share in this wonder very easily.  Just click here to donate.

Laundry

Sometimes photos of kids from Petite Rivierre can be misleading.  Like this little girl, they usually are well dressed, clean and cared for.  But close-up photos like this don't show the context of their lives and don't convey the reality of the poverty that many families live in.  For example, very few rural Haitian families have homes with running water, electricity, kitchens or any of the features that many consider essential.  Consequently, many ordinary chores require more work than most of us imagine.  For example, the picture below shows how this mother washes clothers. 

Our clients live in a poverty that one just doesn't see anymore in the US.  This is why our clinic only charges a token amount for the healthcare we provide.  We don't charge for lab tests.  Prescriptions are also free.  So we have to raise well over 90% of the cost of providing this care.  We get help of course.  Groups like Direct Relief International provide us with many of the common pharmauciticals that we dispense.  This helps keep our cost below $20 per patient.  But we treat over 1000 patients per month, so groups like ours are constantly in a fund-raising mode.  Our biggest expense is just paying our Haitian staff's salaries.  We have over 30 employees which makes us the biggest employer in the region.  And even though Haitian medical profesionals make far less than their US peers, their combined cost is substantial.

You can help us sustain this by clicking here.

A shared bond

Friends in need

These are two of three little girls whose mothers brought them some distance to be treated at the clinic.  All three have cardiac problems and their mothers by-pass other healthcare facilities for the care and compassion of our staff.  They probably need heart surgery, but this is not something that is obtainable in Haiti. So for now we are treating them with the drug Enalapril, which allows the heart to work more efficiently.  Dr. JF is encouraged by their response to this medicine, and they are doing reasonably well.

Obtaining modern medicines like this is one of the challenges that the clinic continuously faces. At times our administrator spends hours going to various distributors to find the right meds for patients like this.

Typically, children are about one third of our patients.  And typical of most of our children patients, these girls are wearing their very best clothes to come to the clinic.

Roads



Arrived in Haiti yesterday.  On drive from the airport we stopped at the Haytrac - Haiti's large Caterpillar dealership.  There we met the owner, Mr. Reymond, who has offered to help us fix our washed-out 1/4 mile access road.  He was most enthusiastic and he re-affirmed his generous offer to help get our road graded and compacted, with a drainage ditch on either side.  It is this drainage that will be the major issue, for without it any improvements will be washed away quickly.  Next we spoke by cellphone (which are transforming the ability to work in rural Haiti) to our Haitian civil engineer and clinic-builder who also offered his help.  He too underscored the need for drainage control, but soberly estimated that it should be lined with cemented-rocks which could cost around $20,000!  Still, we remain hopeful that through the help of these freinds the job will get done.

Work on main road.





The good news is this.  The government work on the main coastal road is progressing nicely.  It is only a mile or so to the point where our access road connects.  When completed this road will improve the access to the clinic enormously.

 





Suffer not the children

How does a group know if their efforts are making a difference in Haiti?  Here is one example.  Recently we had an inquiry about setting up a malnutrition program at our clinic.  So we were challenged to estimate the degree of the problem.  Fortunately (and unusually) this is the kind of question we can actually answer rather quickly.  Our clinic has a computer based record system in which we can search patient records and look for diagnoses such as "MALNUTRITION".  We saw that the number of cases had dropped wonderfully in 2010.  Seven cases in the first quarter of the year, three the second quarter, none at all for the rest of the year.  This was a most encouraging result to see, even while granting the seasonal nature of such afflictions.  It challenges us to keep working.  And to even dream of a Haiti where all the children grow up healthy and well.

Dine out for Haiti

A few weeks ago our clinic staff celebrated the third anniversary of  our clinic's opening.  It was a festive affair with an elaborate spread of Haitian country cooking. 

Here is your chance to do something similar.  On April 4, Nashville's Amerigo Restaurant is sponsoring a three-course Italian feast, complete with wine, all for the benefit of Visitation Hospital Association.  For just $100 per person you can enjoy a evening of fine dining while knowing that half the proceeds will be going to support healthcare in Haiti,. 

For Reservations, call:

Fran Rajotte

615-673-3501

 

or register online at

www.Visitationhospital.