Monday, December 31, 2007

Wise Men in Soleil

A couple of weeks ago, before Christmas, my father-in-law and I spent some time working in Cite Soleil.

One day we were at a medical clinic/school and witnessed the following scene:

About 50 uniformed kindergarten aged children were at the end of a courtyard and huddled around three other children. One of the three children was a little boy lying motionless on a dirty piece of cardboard. His face appeared quite serious as he stared ahead. He obviously had wet his pants but it sure didn’t seem to bother him.

Kneeling next to him was one boy and one girl.

The teachers were coaxing three little boys as they ambled towards the child on the cardboard.

These Soleil kids were obviously practicing for a Christmas play regarding the Nativity and the wise mens' visit to the newborn Messiah.

Was Jesus birth manger 2000 years ago as horrible as this fetid corner of Soleil?

Most likely none of these children received any toys for Christmas. However, Christmas for these children in Soleil occurs every day when they come to school because they get a big hot metal plate of rice, covered by red bean sauce, meat, and vegetables. This is their only nutritious meal of the day.

Most Soleil children have no Christmas all year long for many reasons. And most children are not in school. Conditions in Soleil should be an aberration and not the rule. All children everywhere deserve to eat every day.

Soleil needs many more wise men (and women) to work out the problems. The best gift for Soleil is justice.

Will OSF Let Katina Die?

Two Haitian Hearts Patients

The last two Haitian Hearts patients for 2007 arrived in the United States for heart surgery two weeks ago.

Pictured above is Jhiny holding her little sister. Pictured below is Christelle in the arms of her father.

OSF, the Media, and the Carroll Family

The media in Peoria make sure that OSF looks good.

The Peoria Journal Star supports OSF and their 500 million dollar Milestone project. This project has been covered extensively in the newspaper. However, much of OSF’s immoral behavior never reaches the pages of the Journal.

OSF does a good job in many areas. But they should. That is the function of a not-for-profit Catholic medical center. However, the Carroll family knows they could and should do much better and we intimately know how OSF works behind the scenes. Most people do not have our perspective, and the people that do know what has happened are shocked.

However, OSF may not want to admit this, but many people speak in hushed voices in disdain of OSF's actions. People are very fearful of the power of OSF...and they should be. They don’t know where to turn. Many know their jobs (and health insurance) are most likely linked in some fashion to pleasing OSF and so they are quiet.

The Ethics Committees at OSF have no real teeth and neither does Bishop Jenky regarding key Catholic OSF policies. This is a problem. The Diocesan Ethics Committee regarding health care will not address OSF's medical negligence of Haitian children.

Respect for life should include Haitian lives. Early in 2007, Haitian Hearts’ Maxime Petion died. He was not accepted back at OSF for medical care even though he had been operated at OSF-SFMC in the 90’s.

OSF continues to deny former Haitian Hearts’ patients medical care. Other medical centers around the United States do not want OSF’s “problems” and are concerned about OSF’s negligence. As OSF ignores their own mission philosophy and the Catholic Ethical and Religious Directives regarding health care, more young Haitians will likely die.

The Carroll family was treated poorly by OSF in multiple ways. Medical care was obstructed and unethical things were said and done to us by the largest downstate medical center in Illinois. Why would OSF have this intense reaction against a small family who only wants honesty, accountability and transparency by the Catholic medical center that states they embody these qualities?

Keith Steffen is responsible for what happens at OSF-SFMC. I am sure he has been scolded by OSF Corporate and other people when he and his robotic staff have gone over the edge, but OSF will allow him to continue his ways until they are done with him. He is carrying out the dirty work for OSF. He knows it as do the Sisters and Catholic Diocese of Peoria.

Even though it is not politically correct in Peoria to scrutinize the Sisters, it is up to them to make sure that their philosophy is practiced and not scandalized. They have surrounded themselves with people that do not have the OSF mission philosophy at heart. As a result, all people that OSF should serve in central Illinois and in Haiti are not being treated in a consistent Catholic fashion.

OSF will change for the better. It probably won’t be soon, but it will happen.

Wednesday, December 26, 2007

Maxime's Anniversary

One year ago Maxime was fighting for his life.

Maxime now rests over the Illinois River from his vantage point that watches OSF's new 500 million dollar expansion.

The world's best medical technology did not help Maxime. The human heart in Peoria that controls the lives of Maxime and many others simply does not care.

Thursday, December 20, 2007

People in the Pictures

A photoessay of Port-au-Prince is in the works on this web log. But will it do any good or is it just some evidence of "what I did on my summer vacation"? Will it help the people that live here? Or is it more of our technology that is "cool" but doesn't enhance the lives of the people trapped in the pictures?

Wednesday, December 19, 2007

Leaving Soleil

The International Herald reports that Doctors Without Borders (MSF) are leaving Cite Soleil at the end of December.

Because "violence" is down and the need for trauma surgery has decreased, MSF is leaving the one and only functional hospital in Soleil. The hospital is tiny, pathetic Saint Catherine Laboure.

However, structural violence is still at an all time high in Soleil. The children are literally starving to death and their immune systems are rendered impotent. Diseases such as pneumonia and meningitis fill the overcrowed pediatric hospital wards.

Newborn premature babies lie in over-sized metal cribs up stairs. A few of these babies have tiny IV's placed by the excellent Haitian nurses. Antibiotics slowly drip in. No ventilators are present to help the newborns' immature lungs search for oxygen. The babies grandmothers gently coax the babies to take a few drops of powdered milk, and when their tiny grandchildren decide to sleep, the grandmothers lie on the floor under their cribs and sleep too.

Numerous children are abandoned in the hospital. They are too much of a financial burden for their famlies. A doctor visit at Saint Catherine's costs 75 cents and admission to the hospital costs a grand total of a couple of dollars US.

The beautiful baby girl pictured above is one of the abandoned. The nurses plead for help for her. All the mothers in the ward care about this little one, but they have their own problems. All eyes are on the blan...but they shouldn't be.

Saint Catherine's patients need Doctors Without Borders. Saint Catherine's needs very active participation from the State of Haiti and the world needs to know that the population of Soleil should not be treated in this despicable fashion.

The "violence" in Haiti is alive and well at the end of 2007. The war in Soleil continues.

Tuesday, December 18, 2007

Displaced in Soleil

The young mom's mother-in-law beats her up and throws her in the street of Soleil.

The baby's father has another girlfriend.

This baby girl is swollen from head to toe lacking protein in her diet. She is the picture of kwashiorkor...a displaced child.

The young mother sobs, but the Brazilian Sister stops the tears quickly and gives her hope.

The baby sips fortified milk and quietly joins the malnutrition club in the back of the slum...

Thursday, December 13, 2007

Father Jean-Juste

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South Florida

Baseless Arrests Continue
December 9, 2007
By Brian Concannon, Jr.

Rev. Gérard Jean-Juste's struggles with Haiti's criminal justice system have been a good gauge of the system's health for the last three years. The latest episode, last month, showed that rule of law is alive in Haiti — if not exactly kicking.

"Fr. Gerry," a Catholic priest well-known as an advocate for South Florida's immigrants and Haiti's poor, has fought charges of murder, treason, weapons possession, disturbing the peace and criminal conspiracy since Haiti's interim government first arrested him in October 2004. No one has produced any evidence of criminal activity, but that has not stopped Haitian authorities from arresting Jean-Juste three times and jailing him for seven months.

Gérard Latortue, who headed the interim government (March 2004-May 2006) that arrested Jean-Juste, has returned home to Boca Raton, replaced by an elected government led by President René Préval. Jean-Juste has been out of prison since January 2006, when he was released provisionally to seek treatment for leukemia at Jackson Memorial Hospital.

But he still faces charges of illegal gun possession — even though there is no proof he ever possessed any weapons — and criminal conspiracy — even though there is no allegation that he conspired with anyone or planned any crime. There are no witnesses against Fr. Gerry.

When Jean-Juste languished in Haiti's prisons, his plight was widely condemned by human rights groups and members of Congress as political persecution by an undemocratic regime. When he was released a week before the long-delayed elections that brought President Préval to power, many saw the promise of the return of the rule of law to Haiti.

That promise has been only partially fulfilled. Last month's hearing of Jean-Juste's challenge to the charges, before the Appeals Court of Port-au-Prince, had many auspicious signs. Jean-Juste and his lawyers made their case freely. Hundreds of supporters turned out without incident. The hearing was orderly. And the prosecutor formally recognized the absence of evidence against Jean-Juste and recommended dismissing all charges.

But the judges declined to dismiss the case, claiming they needed more time to review the file. The Appeals Court has already had 22 months since Jean-Juste filed his appeal, and seven months since a previous appeals hearing in April. That is plenty of time to review almost any file, and more than enough for a file that the prosecutor concedes contains no evidence of wrongdoing.

Jean-Juste has now faced charges under the Préval administration for as long as he did under the Latortue regime. Although Fr. Gerry is not in jail, thousands of other men and women arrested by the interim government are stuck in the democratic government's prisons, including perhaps a hundred or more political dissidents.

Over 90 percent of Haiti's prisoners have never been tried; most were arrested without a warrant and have no evidence against them in their files. Most are poor, and unlike Fr. Gerry, don't have access to lawyers or supporters to come to court for them.

The cases of Fr. Gerry and others arrested by the Latortue regime are not President Préval's fault, but they are now his problem. Although comprehensive reform of Haiti's justice system is complex, dismissing baseless cases is not.

Haiti's government can advance the cause of justice, bring hundreds of people home to their families, and save money in the prison budget by simply reviewing case files and seeking dismissals unless the files show a good, legal reason to continue. Ending Fr. Gerry's battle would be an opportune place to start.

Brian Concannon Jr., Esq. directs the Institute for Justice & Democracy in Haiti,
Copyright © 2007, South Florida Sun-Sentinel

Brian Concannon Jr.
Director, Institute for Justice & Democracy in Haiti
PO Box 745
Joseph, Oregon, 97846
Skype: Brian.Concannon

Disturbing the Peace

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by Brian Concannon Jr.
December 11, 2007

Fr. Gerard Jean-Juste, a Catholic priest from Haiti, just does not know when to shut up. In the 1970’s he saw his people starved and persecuted while Jean-Claude “Baby Doc” Duvalier lived in opulence, so he organized for change. The Duvalier regime responded as dictatorships do, and kicked him out of the country. When he reached Miami, Fr. Gerry saw that the safety he found there did not extend to immigrants locked up in detention centers or sent back to face torture or worse in Haiti and countries like it. So he organized there for change. He founded Florida’s Haitian Refugee Center to bring the struggle for justice to the U.S. courts, and coordinated demonstrations to bring the struggle to the streets.

The United States responded as democracies should: it let Fr. Gerry do his work, as long as he did not break the law. He did not win all the battles here that he should have- our laws and our courts are not perfect. But he was at least able to criticize and mobilize without fear of persecution, and sometimes even win.

Bill Quigley, a Catholic law professor from New Orleans, cannot stop helping people organizing for change. He has been a leading advocate for the victims of Katrina since he weathered the storm in a New Orleans hospital where his wife Debbie, a nurse, works, trying to help. The hospital patients did not need a lawyer then, but the families still without homes and the kids still without good schools need one now, so Bill is busy. In 30 years of public interest lawyering, Bill has stood up for a whole spectrum of people fighting for social justice, including peace protestors, death-row inmates and advocates for fair education, healthcare and housing.

Fr. Gerry brought the lessons he learned in the U.S. about non-violent organizing for social change back to Haiti. In early 2004, when the brutal, unconstitutional and U.S.-supported interim regime took over from Haiti’s elected government, Fr. Jean-Juste became the most prominent and respected political dissident. He denounced the killing of political opponents, the political arrests, the looting of public coffers and the tax breaks lavished on the wealthy while the poor starved. People listened, so the regime responded as dictatorships do, and arrested Fr. Gerry on trumped up charges, jailing him for over seven months. The authorities accused him of many things over the next two years- three murders, treason, gun possession, plotting against the state and criminal conspiracy, all without a shred of evidence or a single witness.

There was one charge — made by the police at one of Fr. Gerry’s arrests, but never in court — that might have stuck: disturbing public order. Where public order meant poor kids dying of hunger and young men massacred for living in a politically-active neighborhood, Fr. Gerry disturbed the order. He fed hundreds of children at his church to show that it could be done. He used his pulpit, the radio waves and the streets to denounce the repression, and remind people that there was a better way.

When Professor Quigley found out about Fr. Gerry’s first arrest, he could not help but go down to Haiti to help. Bill appeared in court alongside Fr. Gerry’s Haitian lawyer, Mario Joseph, and stood at Fr. Gerry’s side during particularly dangerous times. Bill was roughed up once trying to shield Fr. Gerry from a crowd before his second arrest, which he recounted in a July 2005 Common Dreams article. But the police and the courts always treated him with respect, always allowed him to do his job.

The American professor’s presence in court and at the police station was a potent reminder of how a government should respond to its critics. The police, prosecutors, judges, lawyers and even the defendant saw Bill as representing a justice system that rejected punishing people for their political opinions, tolerated dissent as long as it was expressed legally, and respected the right of lawyers to assist their clients.

Bill’s presence had a tangible impact. It helped give one judge the courage to release Fr. Gerry provisionally (the judge was forced off the bench the next month; Fr. Gerry was re-arrested eight months later). It helped bolster Attorney Joseph, who managed to obtain another provisional release, which is still in effect, in January 2006.

But despite Bill’s efforts, Fr. Gerry’s legal struggle continued, even after the restoration of democracy to Haiti in 2006. The latest chapter was an appeals court hearing on November 26, to decide Fr. Gerry’s challenge to his indictment. Bill had planned to go to Port-au-Prince for the hearing, but a few days before, he cancelled. He was needed even more in New Orleans, to represent public housing tenants in their struggle against the Bush Administration’s plan to destroy 4,500 units of desperately-needed housing (see HUD Sends New Orleans Bulldozers and $400,000 Apartments for the Holidays, December 3).

In Haiti, Fr. Gerry’s hearing went fairly well. The judges allowed him and his lawyers ample time to make their case, and appeared to be under no inappropriate pressure. Hundreds of Fr. Gerry’s supporters packed the courtroom for the hearing or protested outside, but there were no incidents, and no one was arrested (see My Rosary Is My Only Weapon, Fr. Jean-Juste Goes To Court, Again, San Francisco Bayview, December 5, 2007). The court has not yet issued its decision, but the fact that a politically-charged hearing was held fairly and peacefully was a welcome sign of Haiti’s increasing democratization.

In New Orleans, Bill’s work went less well. He was brutally arrested by a New Orleans deputy sheriff. The arrest was caught on video, which shows Bill quietly standing by as his clients explain why they should be allowed to enter a public New Orleans City Council meeting. Suddenly a deputy grabs Bill from behind, slams him against the wall and roughly handcuffs him. The charge: disturbing the peace. The fact that the lawyer whose protests had been tolerated by Haiti’s dictatorship was brutally arrested for standing outside a hearing room in Louisiana is an unwelcome sign of America’s decreasing democratization.

After the arrest, Bill tried to deflect attention from his experience to the persecution of his clients. He noted that “we live in a system where if you cheer or chant in a city council, you get arrested. But you can demolish 4,500 people’s apartments, and everybody is supposed to go along with that. That’s not going to happen.” He added that “there’s going to be a lot more disturbing the peace before this is all over, I am afraid.”

Although the video footage of Bill’s arrest is disturbing, the meager press coverage of it is even more so. If a nationally-known professor having his head slammed against a wall on film for peacefully helping the victims of the most notorious natural disaster of our times ask their City Council for help defending their homes against a discredited Bush Administration does not generate outrage, what will?

The attack on Bill was clearly designed to intimidate New Orleans’ political dissidents. The attack itself, and the lack of an outcry about it, will encourage more attacks. Even more people will hesitate before standing up to the Bush Administration and its local allies.

But the attack will not stop the New Orleans tenants, or their lawyer. Today, International Human Rights Day, they went before the city’s Historic Conservation District Review Committee, bringing over 100 protestors to the meeting. They won one: the Committee agreed to stop the demolition of one of the three developments. The tenants will keep fighting the other demolitions, and they will keep exercising their Constitutional rights to speak, to cheer and to chant, to disturb a peace that tolerates the destruction of public housing during a housing crisis. Let’s hope that New Orleans can treat its dissidents and their defenders at least as well as Haiti now would.

Human rights lawyer Brian Concannon Jr. directs the Institute for Justice & Democracy in Haiti,

Monday, December 03, 2007

Haitian Hearts 2007

Revolution of the Heart

"The greatest challenge of the day is: how to bring about a revolution of the heart, a revolution which has to start with each one of us?"

Dorothy Day

Tuesday, November 27, 2007

"My Rosary..."

(Photo by EVENS SANON)
“My Rosary Is My Only Weapon”- Fr. Jean-Juste goes to Court in Haiti, Again

By Pooja Bhatia, Esq.

Port-au-Prince, 26 November 2007— Hundreds of supporters of Father Gérard Jean-Juste crammed into the courtroom of the Palais de Justice today to attend his long-awaited hearing before the Cour d’Appel (Court of Appeals). Dozens demonstrated outside. Although the court did not dismiss the charges against Jean-Juste—as many of his supporters had hoped and cautiously predicted—the hearing gave them reason to believe that the charges will eventually be dropped.

The Commissaire du Gouvernement, or the prosecutor, officially recommended that the charges against Jean-Juste be dropped. Moreover, the judges gave their legal imprimatur to Jean-Juste’s provisional freedom. As Jean-Juste’s release, on medical grounds in January 2006, was ordered by the government rather than the proper judicial authorities, he was still vulnerable to arrest and detention. As of today, Father Jean-Juste is free to move about.

The judges will now review Jean-Juste’s file and issue their decision on Fr. Jean-Juste’s appeal. He has asked the court to dismiss the charges as unfounded in both law and in fact. Although it is difficult to predict when the decision will finally come down, Jean-Juste’s attorney, Mario Joseph of the Bureau des Avocats Internationaux, believes it will be within one or two weeks.

“I am very pleased that Père Jean-Juste has his freedom, and that the prosecutor recommended dropping the charges,” Mr. Joseph said after the hearing. “I believe that after a short period of time, the Cour d’Appel will issue its ruling.”

If the Cour d’Appel rules against Jean-Juste, Mr. Joseph said, his legal team would file an appeal to the Cour de Cassation, Haiti’s highest tribunal.

Father Jean-Juste was imprisoned twice during the regime of Haiti’s Interim Government (2004-2006). In October 2004, he was arrested for plotting against the security of the state and later accused of murder. There was never any evidence presented for those charges. Fr. Jean-Juste was released provisionally after seven weeks in jail, and the charges were eventually dismissed.

In July 2005, Jean-Juste was taken into custody by MINUSTAH troops, and handed over to the police—at first, purportedly for his own protection. He was later accused of kidnapping and murdering journalist Jacques Roche. No evidence was ever presented to back up the murder allegations, and those charges were eventually dismissed. But in the meantime the interim government charged Jean-Juste with possession of illegal weapons and “association de malfaiteurs”—a vague conspiracy charge that had proven malleable enough to justify the detention of hundreds of Lavalas activists. Although no evidence was presented that Fr. Jean-Juste possessed any weapons, or that there was a criminal conspiracy, he was held in jail for five months.

The arrest was widely understood as an attempt to silence Jean-Juste. International human rights organizations denounced the charges as politically motivated, and Amnesty International promptly declared Jean-Juste a prisoner of conscience. Like former President Jean-Bertrand Aristide, Jean-Juste has an ardent following among the masses, and was, for many, the presumptive heir to Aristide’s mantle. At the time of his arrest, he was a leading critic of the interim government’s human rights policies, and Haiti’s most effective advocate for non-violent social change.

Jean-Juste languished at the National Penitentiary from July 2005 until January 2006, the eve of elections. There, he contracted pneumonia, which was apparently brought on by prison conditions. In December 2005, two United States doctors, including the prominent Harvard physician Paul Farmer, diagnosed him with leukemia. Amid heavy international pressure, Jean-Juste was granted a humanitarian release to seek medical treatment in Miami, on the condition that he would return to Haiti to face the charges against him. A week before Haiti’s presidential elections, Jean-Juste went to Miami to begin chemotherapy.

This April, while Jean-Juste was being treated in Miami, Mr. Joseph argued his appeal, contending that the ordonnance, or charging document, had several legal flaws, and did not contain any evidence of illegal activity by Fr. Jean-Juste. He noted that there was no evidence that Fr. Jean-Juste had ever possessed the guns in question, which the government had given to Fr. Jean-Juste’s security detail before the February 2004 coup d’état. Attorney Joseph also presented certifications that the guns had been returned to the government, and noted that there was no allegation of underlying crime on which a conspiracy charge could be based. At the April hearing, the Commissaire du Gouvernment agreed with Mr. Joseph and recommended dropping all the charges against Jean-Juste. However, the Cour d’Appel held that Father Jean-Juste must be present for the charges to be dropped.

Today’s hearing consisted of a two-hour-long interrogation of Jean-Juste, in a stuffy courtroom made sweltering by the presence of hundreds of supporters, a dozen international observers, and at least 30 journalists. For much of the time, Jean-Juste, who had been battling leukemia, was standing on his feet. When asked to respond to the illegal weapons charge, Jean-Juste pulled out his rosary and said it was the only weapon he had. The crowd erupted in cheers. Later, when asked about the association de malfaiteurs charge, Jean-Juste, a Roman Catholic priest, explained that his only associations were with Jesus, the Pope, bishops and the people he works with and feeds at his rectory in Port-au-Prince. The crowd roared again.

Pooja Bhatia is a lawyer and Harvard Law School Satter Human Rights Fellow who is spending the year working for the Bureau des Avocats Internationaux in Port-au-Prince. She can be reached at or + 509-658-9845 . Haitian journalist Wadner Pierre took the photographs that accompany this article. For more information about Fr. Jean-Juste’s legal battles, see Fr. Jean-Juste Harassed Again on the website of the Institute for Justice & Democracy in Haiti.

Brian Concannon Jr., Esq.
Institute for Justice & Democracy in Haiti
PO Box 745
Joseph, OR 97846
Skype: Brian.Concannon

(Photo by a good friend, Joe Zelenka)

Wednesday, October 31, 2007

Tropical Storm Noel

In the 90’s a hurricane hit Haiti. The wind blew non stop for 24 hours in the mountains on Haiti’s southern peninsula and the palm trees swayed surrounding the little hospital where I was working. Performing an appendectomy during the hurricane was an interesting experience.

Because of the storm, the patient population visiting the clinic slowed for many days. The roads were not passable. And patients became sicker because they could not access any health care facilities.

What is not understood by many is the horrible aftermath of hurricanes and tropical storms in the developing world. Life is not back to normal for a long time in Haiti due to the infrastructure damage. Haiti’s dirt mountain roads can’t take much.

During the last few days, Tropical Storm Noel recently caused severe damage in Haiti and the Dominican Republic. Dozens of people have been killed, hundreds are missing, and thousands have been evacuated from their homes.

Haiti faces regular flash flooding during the rainy season. Deforestation heightens the risk of flooding as people and their homes are washed down the mountain sides. Parents need to decide which children to attempt to save from the water.

Crops are destroyed by the flood and stagnant water is a home for breeding mosquitoes that spread malaria and other diseases.

With Tropical Storm Noel, Cite Soleil has also been damaged with dirty water and filthy debris. Soleil sits on the edge of the ocean and water runs downhill from the mountainous Port-au-Prince. The medical clinic in Soleil closes during heavy rains and storms because employees of the clinic need to clean the dirty water out of their homes. Mothers don’t bring their children to the clinic for the same reason.

Makeshift shelters are set up but are seriously under equipped. So time passes and the kids become sicker and many die. Their deaths are never reported.

(Photos by the Associated Press)

To read about the chaos in Soleil due to Noel see this AP article.

Social Teaching Must be Lived

The Catholic Post from the Diocese of Peoria ran an article on October 28, 2007-- Church’s Social Teaching Must be Lived.

The Catholic Diocese of Peoria had their first Institute for Catholic Social Ministry last weekend. Father Larry Snyder, executive director of Catholic Charities USA was the keynote speaker for the two-day event.

“Father Snyder set the tone Saturday by outlining several themes of Catholic social teaching, beginning with the fundamental principle that every human person has inherent, God-given dignity.

“If we could just get this one right, all the others would follow,” said Father Snyder. “We have to recognize that within every person we come into contact with is the image and likeness of God,” he added, no matter how scruffy or smelly that person is, rich or poor, young or old, sick or healthy.

The problem according to Father Snyder is that “Catholics remain unfamiliar with or unmoved by these teachings.”

Another speaker at the Institute said that the Gospel’s social demands are “very hard teachings we would like to gloss over.” Father Snyder added, “…if you take this seriously, you’re ruined for life.”

Bishop Daniel Jenky is the publisher of the Catholic Post.

Saturday, October 20, 2007


The Peoria Journal Star had an article this morning about silence from the Catholic Diocese of Peoria.

Too bad it is true.

Monday, October 15, 2007

Mauricio Survives!

Mauricio was operated in the United States and survived a complex heart surgery.

He is with his fantastic host family and doing very well. He is crawling everywhere.

Saving Mauricio will not save Haiti. But we all know that all of Haiti's babies deserve medical care whether it is basic or complex.

If Mauricio can be helped with a serious congenital heart defect, we should be able to help thousands of Haitian babies that are dying from medical problems that are preventable and much less "complex" to treat.

The collective will has to be there to do as much good as can be done.

Sunday, October 07, 2007

Dogs, Haitians, and Heart Valves

In 1960 in the United States, prosthetic heart valves were being placed in dogs in the mitral position. The dogs woke from surgery, recovered, and barked and ran around. They felt much better with their new heart valve.

The first prosthetic valve was placed in a human being the same year by Dr. Albert Starr.

Heart valve replacement is commonplace in the resource-rich world in 2007.

However, Haitians and most of the people in the resource-poor world, don't get new heart valves when their native valves fail. Technology that has been available in the United States for almost 50 years is still not available in Haiti.

Saturday, October 06, 2007

What of Haitian Children?

The Peoria Journal Star published this forum article several days ago. It will not remain on their site for long, so it is copied below.

What of Haitian Children?

Friday, October 5, 2007

Re. Sept. 21 story, "Surgery center very kid friendly":

Contrary to what the article states, not every child is welcome at OSF-Children's Hospital of Illinois (CHOI).

Haitian Hearts' children who have been operated on at OSF-CHOI in the past, and who presently need additional cardiac surgery, are being refused further care at OSF-CHOI. The Journal Star does not report that these Haitian children are suffering and dying.

OSF-CHOI's International Committee is ignoring Haitian Hearts' children. This is medical negligence and reveals a blatant disregard for Haitian children's lives. This policy by CHOI is anything but "friendly."

Where are the OSF sisters and their mission philosophy, which turns no child away?

John A. Carroll, M.D.


Currently in Port-au-Prince, Haiti

Tuesday, October 02, 2007

Thirst for Profit

Heureuse is the young Haitian lady who was operated at OSF several years ago. She needs further surgery and is being refused care at OSF.

One of her two children, Kenley, is pictured to the right. Kenley is two years old and his father has abandoned the family. Heureuse lives with Kenley and his older sister in a slum in Port-au-Prince.

The Catholic Post in Peoria recently published an article--"Pope Contrasts Thirst for Profit, Logic of Sharing".

Pope Benedict spoke about the demands of economic justice during a Sunday blessing September 23.

Benedict said:

"The hunger and ecological emergencies point to growing evidence that the logic of profit, if dominant, increases the disproportion between the rich and the poor and brings a ruinous expoitation of the planet."

"...when the logic of sharing and solidarity prevail, it is possible to correct the route and orient it toward an equitable and sustainable development", he said.

The article also stated that "the Pope emphasized that economic justice was a matter of balance. Making a profit is not in contradiction with justice, he said, but the church teaches that a fair distribution of good takes priority".

When Heureuse dies in the slum for lack of heart surgery, who will take care of Kenley and his sister? Will three people actually die due to "thirst for profit" in Peoria?

I wonder what Pope Benedict's advice to OSF regarding operating Heureuse would be?

Wednesday, September 26, 2007

The Catholic Diocese of Peoria and Social Doctrine

The two girls pictured to the right had surgery at OSF in Peoria several years ago. Both are 27 years old now and are in Haiti.

One girl is Jenny and the other is Heureuse.

Jenny teaches at a school for children that are deaf. Heureuse lives in a slum with her children aged two and four years.

I have written about both girls in the past.

I examined both of them last week in Haiti and both need heart surgery. OSF is refusing them care. Written communication several years ago from OSF’s lawyer, Doug Marshall, stated that OSF would no longer care for Haitian Hearts patients. Thus, Jenny and Heuruese will not receive the care they need and deserve from OSF. Their chances at long term survival are minimal.

We have buried a couple of young Haitian Hearts patients in the last couple of years and most likely will bury more.

When I talked with Bishop Daniel Jenky about Haitian Hearts several years ago, he was very afraid to support the Haitian kids and go against OSF. Simply put, I believe that Bishop Jenky was concerned about alienating the Peoria area business community and did not want to hurt his Diocesan Capital Campaign in any way. He did not want to embarrass OSF.

The Ethical and Religious Directives for Catholic Health Care Services did not seem important to Bishop Jenky or to OSF. The Directives state that collaboration amongst Catholic health care providers is very important for the good of the patient.

Neither the Catholic Diocese of Peoria or OSF offered the Haitian patients any alternative. Haitian kids would have to suffer more.

I was totally astounded by the actions of OSF and the Catholic Diocese of Peoria and I still am in disbelief that their respect for children lives in the Haitian Hearts program seems to be nonexistent.

The Catholic Post is the paper of the Peoria Diocese. Bishop Jenky is the publisher. The September 23, 2007 issue has an article entitled: Educators Urged to Teach Social Doctrine.

A speaker named Jan Rosenhauer spoke to principals of Catholic schools in the Diocese of Peoria at King’s House. She made some very dramatic statements about the church’s social doctrine.

Some excerpts from the article:

“In her address, Rosenhauer described the roots and foundation of the church’s social doctrine, including Scripture and the teachings of popes.

“Among the key Scripture passages is the parable of the Last Judgment in the 25th chapter of the Gospel of St. Matthew. In that parable, Jesus says we will be judged based on how we responded to the poor, needy, and suffering in our midst.

“It’s clearly a profound message about what it means to be a disciple of Jesus Christ. There aren’t a lot of other places where Jesus is so explicit about how we are going to be judged.”

“The Eucharist commits us to the poor,” she said, quoting the Catechism of the Catholic Church.

“As we receive the Eucharist and become more and more connected to Christ, we become more and more conformed to Christ’s life and how He associated himself so closely with the poor in so many ways in his life,” said Rosenhauer.

“The first and most fundamental theme, said Rosenhauer, is the life and dignity of the human person.

“This idea of the dignity of the human person changes everything—it’s a whole different world view,” she said.

“When teaching social doctrine, Catholic educators need to connect the “tradition of action” with the “tradition of thought”, said Rosenhauer.

“Within the social doctrine’s “tradition of action” there are two kinds of good work: the works of charity or service, and the works of justice.

“Charity addresses immediate needs, but working for justice means striving to address the underlying causes that create the needs that charity addresses…”

Bishop Jenky, OSF, and the OSF legal team in Peoria need to read this article in the Catholic Post and put the “tradition of thought” regarding sick and dying Haitian kids into the “tradition of action”.

Tuesday, September 25, 2007

Mauricio Arrives!

Many people have wondered about Mauricio.

Mauricio is a 10 month old baby boy from Port-au-Prince who weighs 14 pounds and suffers from a severe congenital heart disease.

He arrived in the United States on Saturday night and is scheduled for surgery this Friday.

Please keep him in your prayers.

Pharmacy Window in Soleil

Thursday, September 20, 2007


This is an eight day old baby from Soleil who is perfect. He may have a big head, but he is still perfect in my book.

His name is Bernardin.

His mother, who wears layers of cotton flannel shirts, is unable to give their address in Soleil. They live somewhere near a church. They also live somewhere near 200,000 other people in the slum of Soleil.

Tears run down mother’s face as she states that Bernardin’s father forced her to take medicine while she was pregnant to abort Bernardin. His father has another woman and did not want another baby to take care of in Soleil.

However, the home made Soleil abortion medicine didn’t work. Bernardin was born and is fine…except for a big head. He has hydrocephalus.

Bernardin most likely needs a shunt. His mother has no money, and more importantly, if Bernardin had a shunt placed, who will be responsible for following him? When shunts go bad in Haiti, the baby goes bad.

Bernardin needs to be adopted out of Soleil where he can receive proper medical care and follow up.

He survived an attempted chemical abortion. He lives in horrid Soleil with an abused penniless mother.

He is eight days old.

Will anyone out there give Bernardin a chance?

Don't Let This Baby Fool You

Don’t let this Soleil baby fool you.

He may appear unhappy, but a bath with decent water is everybody’s dream in Soleil.

As we all know most of Haiti’s trees have been cut down. The trees are turned into charcoal to provide a fuel source.

When the trees are gone, and most are gone in Haiti, the topsoil is thin and the rain water is not absorbed into the under ground aquifers. An aquifer is an underground water source that supplies water for wells and springs.

Haiti ranked last in the world in the International Water Poverty Index. That doesn’t sound good.

Greater than 60% of Haitians have no access to clean water. That number is probably higher in Cite Soleil where people have to run between bullets to obtain a gallon of water.

Water borne diseases kill many people in Soleil. Especially babies.

Don’t let this baby fool you.

Wednesday, September 19, 2007

Haitians and Mannequins

Medical schools in the United States purchase expensive mannequins so medical students and resident physicians can examine them.

The mannequin is programmed so that the student or resident can hear different heart sounds and attempt to learn their significance.

One hundred years ago in the United States, rheumatic fever was a disease that destroyed many people’s lives because it destroyed their heart valves. Now rheumatic fever is almost gone due to our standard of living and the availability of antibiotics in our resource rich country.

However in Haiti, rheumatic fever is common place and destroys many young lives. Unfortunately, Haiti is a good “laboratory” to study rheumatic heart disease. Haiti doesn’t have mannequins with funny sounding hearts…it has real people with funny sounding hearts.

Erline, pictured above, is a patient of mine in Haiti. She is 39 years old and has multiple valves destroyed from rheumatic fever. She is in chronic congestive heart failure.

Erline is not a mannequin that can be folded up and put back in the closet after you listen to her abnormal heart. She is a human.

For example, Erline has a very loud systolic murmur over her right upper sternal border. The murmur originates from aortic valve which is calcified, stenotic, and destroyed. Also, her heart is very irregular and after a compensatory pause, her systolic murmur becomes louder. This gives even more evidence that her pathology lies in her aortic valve (and not in her mitral valve because of unequal pressure gradients).

Interestingly for all of us except Erline, she has a diastolic murmur down the left sternal border which means that her aortic valve is leaky and insufficient also. She has the “diastolic blow” of aortic insufficiency which is consistent with her blood pressure of 160/60.

What mannequin in the States could teach us so much?

Problem is, what do we tell Erline? How do we help her? Do we tell her that we give better exams and care to our mannequins than we do to most Haitians?

Erline has a lot more to teach us than just her heart exam. We just are not listening closely enough.

February 22, 2008--

Erline died at the end of 2007.


Malnourished in Soleil...Why?

Pediatric Clinic in Cite Soleil

Tuesday, September 18, 2007

Hope in Soleil

Babies and Bullets in Soleil

This baby is in the malnutrition clinic in Cite Soleil. He is doing well.

On December 29, 2006 many MINUSTAH bullets missed him as they were shot from the white tanks on the main road near his home in Soleil. His family's two room flat was riddled with bullets as MINUSTAH's tanks fired indiscrimately at the "bandits".

Mother and Baby in Soleil...They Sure Look Human

Twins in Soleil

Monday, September 17, 2007

Cite Soleil Baby


Heureuse came and visited today in Port-au-Prince. She brought her three year old daughter Nehemie with her. Nehemie’s father is dead.

Heureuse has a younger sister named Elsa. Elsa has allowed Heureuse, Nehemie, and Heureuse’s baby boy to move in with her in a slum in Port-au-Prince called Carrefour.

She normally doesn’t complain of anything, but today Heureuse broke down and cried and said that she cannot take care of her daughter and needs her adopted by a blan (foreigner). Heureuse has no money, of course, and doesn’t know where to turn.

Also, Heureuse had heart surgery at OSF in Peoria several years ago and needs repeat valve surgery. OSF is refusing her further care.

When Heureuse dies from medical negligence and poverty, that will leave Nehemie and her little brother buried in the Carrefour slum with Elsa.

Thursday, September 06, 2007

Saint Jude and Father Jean-Juste

He lived for many years in exile as a street priest in Miami. Father Jean-Juste had fled Baby Doc’s henchmen to stay alive.

In the early 90’s after he returned to Haiti and was living underground, I briefly talked to Father. His hair was black then but his thoughts about Haiti were the same as they are today.

Over the years my wife and I became good friends with Father Jean-Juste as we attended mass at his parish—-St. Clare’s in Port-au-Prince. St. Clare’s is located on top of a hill looking out over a huge plain with the mountains in the distance.

Father Jean-Juste’s mass was a dynamic process. He worked hard during the mass. He needed to. Sweat broke out on his temples and forehead as he begged, pleaded, and invoked God’s good will for Haiti. He prayed with fervor. His homilies were broadcast on the radio for the entire country of Haiti to hear. Nothing was hidden from anyone.

During mass Father Jean-Juste pointed to the saint’s picture above the altar and beseeched Saint Jude Thaddeus in his baritone voice, begging the saint of desperate, forgotten, and lost causes to give Haiti some respite and some justice.

At the conclusion of a mass several years ago, Father brought a seven year old girl named Raphaella to the altar. Raphaella had been badly burned by a propane gas explosion that left her grossly scarred and disfigured from the flames. Her face, chest, and arm were involved. Raphaella sang a song in a quiet shy voice into the microphone held by Father as she pleaded for medical help from the poor parishioners.

We watched the faces of the people in the pews…they were calm and full of respect for their priest who has no fear in asking that just and deserving options should be offered to those who need it...even in Haiti.

When each mass was over, Father seemed emotionally and physically spent. But he was still relentless in his push for his people. Five to ten people would be waiting in the front pews after mass to ask Father for some kind of help. They needed "aid" to bury their relative who had been murdered in the slum or they needed some other type of help. He listened patiently, putting his ear close to them as they quietly spoke to him. This gesture offered them some privacy while they talked. It also showed his attention to detail and to the fact that "tout moun se moun".

Night and day he worked both upstream and downstream in Haiti’s river of injustice.

All this occurred while his feeding programs, set up close to the church, were feeding thousands of happy children each week. It was startling to walk to the feeding area down the path from the church and see the window that was smashed as Father was drug out of it during one of his arrests by the Haitian police several years ago. Glass was still on the ground and we had to wonder about the shots that rang out and the pandemonium that must have existed as three children in the neighborhood were hit by police bullets while father was being arrested.

After interacting with the kids in the feeding program and returning to church, Father’s fatigue was again evident as we climbed the narrow twisting metal steps from the area behind the altar to his little ante room in which he received people on the second floor of the church. I am sure many important discussions regarding the future of Haiti occurred in this small area right outside his tiny bedroom.

I always wondered where his security detail was. Of course, he had no security detail except a few elderly church ladies and some young men that helped him with St. Clare’s and the feeding program.

Father’s courage and honesty were obvious and contagious. So was his perseverance. But he always had to be careful what he said and where he went and how he documented everything. He took nothing for granted. He knew he was a marked man.

Finally, as the world knows, he was thrown in prison again in 2005 on trumped up charges. Would he have run for president of Haiti? Who knows. But the big guys were not going to wait to find out. Father needed to be in prison.

The United Nations and the Haitian National Police (HNP) guarded the prison. The church ladies brought him food. For some reason we worried less about Father in prison than in his little room at Saint Clare’s.

While incarcerated Father became ill. Most of the Haitian State and Church leaders stayed away from him. Cancer in his blood began to consume him. The Haitian State doctor said he was fine… but he wasn’t. The world and main stream media tends to forget about the sick Jean-Juste’s when they are hidden away in a deplorable jail in a dilapidated neighborhood in a country that doesn’t mean much to anyone...unless you are Haitian.

Eventually Father made it out of prison and received proper medical care.

Who can anyone really dispute what Father Jean-Juste does or says? Where is he wrong? He only wants the best for Haiti and its people. He should be in the Haitian picture as much as anyone. He should not be drug through sharp glass windows, thrown in prison, and given medical treatment not suitable for animals. The anxiety of his poor parishioners at Saint Clare’s was high because the only priest they really trusted was taken from them.

Recently Father returned to Haiti. The people of Saint Clare's are happy again. The HNP have shaken his hand and said they will protect him.

So what will happen? Will anyone listen to this priest? Will Haiti’s Catholic Church allow him to function as a priest and sweat again during his honest homilies? Will his opponents stop injuring and harassing him? Will his cancer give him many more years to plead to St. Jude for the good of all of Haiti?

Just because Father is back, the slum violence has calmed, and President Preval’s government seems to be somewhat functional, this doesn’t mean that the Haitian people are not starving. Babies are dying everyday of preventable illnesses. The slums and rural areas are miserable. The roads and other parts of the Haiti’s infrastructure have crumbled. The water is dirty. Men and women sit around the country unemployed but are more than willing to work, even back breaking work, if offered a just salary.

It would be wonderful if Haiti’s rich and powerful citizens at home and abroad, and the Bishops and Monsignors of the Catholic Church in Haiti and the Americas, would embrace Father Jean-Juste and what he espouses. Respect for the dignity of all Haitians needs to be given by the international community.

Simply put, would more Haitian babies live or die if Father and his passionate cry for justice were listened to and his fervent prayers to Saint Jude answered?

(To see an excellent account of Father Jean-Juste's return to Haiti see Bill Quigley’s article published on IJDH.)

(Picture of Father Jean-Juste by Joe Zelenka.)

Thursday, August 30, 2007

Pity and Compassion are not Enough

Paul Farmer gave a talk recently at the University of Utah as part of Tanner Lectures on Human Values.

Paul talked about the fact that more than 80 million Africans might die from AIDS by 2025 with a similar toll on that continent by tuberculosis and malaria. He states that “these numbers have lost their ability to shock or even move us”.

Paul goes on to ask, “What sort of human values might be necessary to save a young man’s life (someone dying from AIDS, for example). Compassion, pity, mercy solidarity and empathy come immediately to mind. But we also must have hope and imagination in order to make sure that proper medical care reaches the destitute sick.

“Are the human values of compassion, pity, mercy, solidarity, and empathy all there is to it? How might the notion of rights reframe a question often put as a matter of charity or compassion?

“Do the destitute sick of Haiti or Kenya ask for our pity and compassion? Often they do. But can’t we offer something better? The human values required to save one person’s life, or to prevent children in a single family from losing their parents, surely include pity and compassion and those sentiments are not to be scorned. Often it is possible to save a life, to save a family. But “scaling up” such efforts requires a modicum of stability and the cooperation of policy makers and funders, themselves unlikely to suffer the indignities of structural violence.

“To move from pity and compassion for a the values inherent in notions of human rights is along leap. For many, especially those far removed from conditions such as those faced in rural Haiti, the struggle for basic rights lacks immediacy. But sometimes we can entrap ourselves into becoming decent and humane people by advancing sound policies and laws. The road from unstable emotions to genuine entitlements is one we must travel if we are to transform human values into meaningful and effective programs that will serve precisely those who need our empathy and solidarity most. In other words, we are not opposed to pity, but we’re anxious to press for policies that would protect vulnerable populations from structural violence and advance the cause of social and economic rights.”

Paul finishes with the following:

“The language of political rights has become meaningless to many people living in the world’s unimaginable poverty. Conversely, the language of economic rights is sometimes viewed as excessive, menacing, and irresponsible in the eyes of people living in the midst of plenty. This growing rift, I would argue is the most pressing human rights problem of our times.”

Kindred Spirit

“Freedom had been hunted around the globe; reason was considered as rebellion; and the slavery of fear had made men afraid to think. But such is the irresistible nature of truth that all it asks, and all it wants, is the liberty of appearing...In such a situation, man becomes what he ought. He sees his species, not with the inhuman idea of a natural enemy, but as a kindred.”

Thomas Paine, 1791

Wednesday, August 01, 2007

Peoria's Catholic Post

The Catholic Post in Peoria can leave one confused.

The July 29, 2007 issue had an article about OSF’s groundbreaking ceremonies immediately followed by an article on the legacy of Dorothy Day.

What is the reader to believe? Mixed messages are being sent.

The article regarding OSF’s $234 million dollar Milestone project was replete with statements that the Sisters started from humble beginnings 130 years ago in Peoria. Sister JudithAnn, president of OSF Healthcare System stated, “We have placed these resources into the hands of the most caring physicians, nurses and technicians so that all who come to us in need of health care can be received with open hands and hearts. The true joy of this day is to realize that in serving those in need we serve Christ Himself.”

But OSF is not doing what Sister JudithAnn told the crowd at the ceremony. What about the Haitian Hearts patients that are being turned away at OSF and are dying? Would the pioneer Sisters that started with "humble beginnings" in Peoria 130 years ago be proud of OSF's immoral behavior now? I don’t think so especially with the amount of money available for medical care.

Multiple dignitaries spoke of the Sisters great work in Peoria over the last century, and I agree it has been great work. However, the dignitaries are hiding behind the Sisters now as OSF ignores the sick and dying Haitian kids.

Bishop Jenky "prayed that God would bless the builders, benefactors, physicians, nurses, employees, and all those cared for by OSF Saint Francis and Children’s Hospital, especially “the little ones”". I completely agree with this also. But it seems to me that Bishop Jenky forgot Haiti’s “little ones” when he abandoned the Haitian Hearts program in Peoria several years ago. His Chancellor, Monsignor Rohlfs, called a picture of a Haitian child with heart disease an “advertisement”, rather than a “little one” during a Haitian Hearts committee meeting.

What is one to believe from the Diocese and OSF?

Dr. Kay Saving, the medical director of Children’s Hospital, personally turned away a Haitian child from receiving care at Children’s Hospital several years ago. However, at the groundbreaking ceremony the Post reported that Dr. Saving stated that the guiding principal of the new facility is “the patient will be first”. Amazingly this statement meant that the new $234 million dollar Children’s Hospital will “feature private rooms that include comfortable beds for a parent that may wish to stay the night.”

What about the Haitian kids who live in small stifling rooms with 10 other family members who have no options for medical treatment? What would the OSF founding Sisters say about that? Contrary to Dr. Saving's declaration, the sick Haitian child is definitely not coming first.

And the article on the legacy of Dorothy Day described a lady who “handed herself over totally to the humble and courageous service of the poorest of the poor" by fighting for their causes in her newspaper, “The Catholic Worker”.

Bishop Jenky is the Publisher of The Catholic Post, the newspaper of the Diocese of Peoria. Too bad he and the Post send mixed messages to all of us regarding care of the Haitian poor. I bet Dorothy Day would have been honest regarding this issue and would not have hid behind the OSF Sisters as did the groundbreaking dignitaries.

(Pictured at the top of this post is my niece standing in front of a tiny hospital in a slum in Port-au-Prince, Haiti. The slum is home to 400,000 people and this is the only hospital that is functioning. Below is OSF, the largest medical center in downstate Illinois.)

Does Cite Soleil Deserve Simple Technology?

Since 1995, Haitian Hearts has helped bring approximately 150 infants, children, and young adults to the United States for medical treatment unavailable in Haiti. The vast majority of these kids have suffered congenital heart disease or rheumatic heart disease.

Congenital heart disease means the patient was born with an abnormally formed heart. Rheumatic heart disease is an acquired heart problem due to Group A beta hemolytic streptococcus infection. The streptococcus infection is usually a pharyngitis that goes untreated in resource poor settings.

The teenagers in Haiti with rheumatic heart disease break our hearts when we examine their broken hearts. These patients usually have valves that have been injured and do not work well. They are leaky or calcified and tight and won’t open like they should. Many times the valve is leaky and tight at the same time.

These teenagers are in a constant state of congestive heart failure. They have missed much school over the years and can’t contribute much to the family because they can’t physically exert themselves. Their hearts are just too weak from rheumatic heart disease.

Many of these kids die in Haiti before we can find an accepting hospital in the States to operate them. The children and teenagers that have made it to the States and have their valve repaired or replaced have a new lease on life. But surgery is very difficult, being placed on a blood thinner can be problematic, and sometimes more surgery is needed if the valve fails again or another episode of rheumatic fever occurs.

The New England Journal of Medicine has two excellent articles on rheumatic fever this week (August 2, 2007).

Important points made in the two articles:

1. Rheumatic fever is a disease of poverty. Overcrowding and poor hygiene allow the easy transmission of streptococcus. Malaria, tuberculosis, and AIDS are bad diseases and are very prevalent...but so is rheumatic heart disease.

2. In the mid-20th century, children with rheumatic fever occupied many of the beds in pediatric wards in industrialized countries---some hospitals were totally dedicated to the treatment and rehabilitation from rheumatic fever.

3. In the later half of the 20th century, rheumatic fever receded as an important health problem in almost all wealthy countries because the standard of living is so high and because penicillin is available.

4. For the resource poor world, rheumatic fever and rheumatic heart disease are huge problems right now.

5. It was recently estimated that worldwide 15.6 million people have rheumatic heart disease. These are conservative estimates. A walk through Port-au-Prince and Cite Soleil would prove that to you. And almost all of these cases and deaths that occur happen in the resource poor world like Haiti.

6. An unfortunate consequence of the decline in rheumatic fever in industrialized countries has been a parallel reduction in related research. In other words, if we in our well-to-do world don’t get this disease, why do much research?

7. Most resource poor countries do not have effective primary or secondary preventative measures and higher degrees of treatment such as medication for heart surgery, valve surgery, and anticoagulation are not found in places like Cite Soleil.

8. The authors of one of the articles studied kids in high risk settings in Cambodia and Mozambique, and found that echocardiographic screening found many subclinical cases of rheumatic heart disease that could be treated to prevent further valve destruction. Echocardiography picked up many more cases than did the stethoscope and clinical exam.

9. The authors concluded that it is not acceptable to leave these cases undiagnosed and these children at risk for recurrence of rheumatic fever simply because echocardiographic screening is seen as an inappropriate use of modern technology in developing countries. Instead, further research is needed to define models of echocardiographic screening that are practical, affordable, and widely applicable.

10. Portable on site echocardiograms are not difficult, the machines are small and give very good images, and should be done in research poor settings. That would include Cite Soleil.

Monday, July 30, 2007

Cost Effective to Treat the World's Poor?

A great article was written by Darshak Sanghavi this month--Wrong Number. It is a must read.

Take home messages from this article:

1. Don't pit the poor against the poor.

2. QALY's dont count if YOU are sick. (Read the article to find out what QALY's really are.)

3. Farmer proved that treating poor Haitians with AIDS is reasonable, rational, and the right thing to do.

4. One's economic paradigm powerfully influences what can be done locally.

5. Haitian Hearts met with Dr. Aldo Castaneda several years ago in Guatamala. He was considered the best pediatric heart surgeon in the world. Dr. Castaneda accepted a Haitian child for cardiac surgery in Guatamala and will accept more. Dr. Castaneda and the Haitian child's mom don't care about QALY's either.