Monday, December 21, 2009


"...few of us feel as though we’re going to be perpetrators; and most of us hope we’re never going to be victims... most of us live in the space not between perpetrators and victims but between bystander and, potentially, ‘upstander,’ to coin a term. The question of how we relate to this history that goes on around us, or to matters of injustice."

Samantha Power

Tuesday, December 15, 2009

Not all Bad Behavior is Actionable

Peoria's OSF/SFMC behavior towards their Haitian Hearts patients was again abysmal in 2009.

OSF/SFMC is denying medical care to two patients, Jenny and Henri, both who had heart surgery at OSF/SFMC ten years ago. They both need repeat heart surgery. Both are in Haiti and both receive medications and exams from Haitian Hearts year after year.

They both have hope to stay alive. But where is the hospital in Peoria that "turns no patients away"?


A couple of days ago I received a comment on this blog.

The commenter was a local Peoria blogger who actually signed his name.

The fact that the blogger/commenter signed his name was unusual...most comments are made anonymously because people fear OSF.

What even made this more unusual was that the blogger/commenter wrote that OSF/SFMC was indeed sliding downwards with regard to quality of care. The blogger/commenter had been a patient at OSF/SFMC recently and wrote that OSF/SFMC ignored and laughed at his requests for pain meds.

Who knows if that was true or not, but that was the comment.

I was really surprised that this person actually signed their name.

However, by the next morning, the blogger/commenter had removed the portion of their comment which regarded OSF's poor care.

Thus, another blogger/commenter thought twice about going after OSF with their name attached. Fear of OSF had won out again.

In this blog I have documented how Keith Steffen, OSF's Administrator, told me that fear is a good thing among OSF employees. I clearly documented how he intimidated two of his nurses in his office at OSF.

I have spoken with many people in the Peoria community during the last decade who genuinely fear OSF and Mr. Steffen. Even a huge benefactor to OSF won't come out against Mr. Steffen in attempts to have him replaced because she fears for her own medical care at OSF/SFMC.

Is this the way a Catholic hospital (or ANY hospital) should act?

Numerous members of the Peoria community fear losing their job and their health insurance if they go after OSF. Our business boards are related and when you go after one business you go after all of them.

And to make matters even worse for OSF/SFMC, this year their legal counsel Douglass Marshall contacted the US Consulate in Haiti regarding a Haitian Hearts patient receiving medical care in Peoria. Many people knew about Marshall's action, but they did nothing.

For good reason they fear OSF.

The seven remaining OSF Sisters that live in the massive convent near the hospital don't walk with a bounce in their step. They know all this is happening, but have lost their mission and their spirit and their will to stop the fear engendered by OSF's secular leaders.

How sad for OSF and for Peorians.

Web Album of One Day in Haiti, 2009

Please go to this album and view as a slideshow.

This was July 1, 2009 in Cite Soleil.

Friday, December 11, 2009

The World's One Hope

"When a child steps out in front of a moving car, someone will snatch the child back to the sidewalk. It's not only a kind person who'd do that, not only the kind of person they honor with statues, and memorial plaques. Anyone would pull a child out of the path of the car. But here, many people have been run down, and many pass by, doing nothing. Is that because there are so many suffering people? Shouldn't there be more help when there's more suffering? There's less help. Even kind people walk past, doing nothing, and they're just as kind as they were before."

--from The World's One Hope, a poem fby Bertolt Brecht translated by Tony Kushner
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Wednesday, December 09, 2009

Neglected Diseases Amid Wealth

Slaves who survived the Middle Passage, "the largest forced migration in recorded history," were forced to live in filthy and unsanitary conditions that facilitated the introduction of parasites from west Africa to the New World. These included hookworms, whipworms and amebae, as well as parasites causing malaria, yellow fever, and schistosomiasis. Today the major tropical diseases introduced into the Americas during the slave trade remain endemic among the people living in Latin America and the Caribbean.

Neglected tropical diseaes are not exclusive to low-income countries. These diseases include ascariasis, dengue fever, congenital cytomegalovirus, and others. Such infections account for a sizable but largely hidden disease burden among minority populations living in poverty in the United States..particularly people of African American descent.

(Health Affairs, November/December 2009, Peter Hotez)

Photo by John A. Carroll, M.D.

Monday, December 07, 2009


Modjina got her visa today to travel to the US for heart surgery!

Keeping her supplied with medication for her heart failure, obtaining her Haitian echocardiogram, finding a children's medical center with an excellent pediatric heart surgeon, obtaining her Haitian passport and her non-immigrant visa, acquiring notarized statements from the Haitian government, purchasing her roundtrip airfare to and from the US took 13 months. (I examined Modjina for the first time in November, 2008.)

Children in the developing world just don't count much...except to their mothers.

But Modjina is on her way....
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A Christmas Carroll

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Sunday, November 08, 2009

Found this Poster Yesterday

Yesterday, while cleaning, I found this poster.

Haitian Hearts and Peoria Area Peace Network carried this poster in 2005 in front of OSF-SFMC as we protested OSF's discriminatory and dangerous policy against Haitian Hearts patients.

OSF refuses to operate on any Haitian Hearts patients even if OSF operated on them initially. In other words, OSF is refusing to give medical care to their own patients even after Haitian Hearts has offered full or partial charges for their medical care.

My wife and I took care of both of these young people in our room in Haiti. Jackson was with us for one month in cardiogenic shock and heart failure. Faustina had severe heart failure.

OSF did not answer repeated requests to save their lives.

Haitian Hearts was able eventually to get both Jackson and Faustina accepted into other medical centers in the United States.

However, it was too late for Jackson. Jackson Jean-Baptiste died a slow and very painful death in January, 2006. He is buried in Goodfield, Illinois.

However, Faustina was operated and did very well. She is a happy thriving teenager today.

Other OSF patients are sick in Haiti. I examine them and we provide them with their heart medication. They need surgery and will die without it.

OSF does not answer when contacted about their current sick Haitian patients. The Ethics Department does nothing. And The Catholic Diocese of Peoria remains silent.

As OSF continues to expand with their one-half million dollar Milestone Project, OSF continues their deadly policy against innocent Haitian Hearts patients as 2009 comes to a close.

Monday, August 24, 2009

Urbanization...A Humanitarian Disaster


New England Journal of Medicine

Volume 361:741-743 August 20, 2009 Number 8

Urbanization — An Emerging Humanitarian Disaster

Ronak B. Patel, M.D., M.P.H., and Thomas F. Burke, M.D.

In 2008, the proportion of the world's population living in urban areas crossed the 50% mark. The current rates of urbanization suggest that in China, 870 million people — more than half the population — will be living in cities within less than a decade, and the capital of Botswana, Gaborone, will grow from 186,000 to 500,000 inhabitants by 2020.1 Most observers believe that essentially all population growth from now on will be in cities: the urban population is projected to grow to 4.9 billion by 2030, increasing by 1.6 billion while the rural population shrinks by 28 million.1

This transition is happening chaotically, resulting in a disorganized urban landscape. Although many expect urbanization to mean an improved quality of life, this rising tide does not lift all boats, and many poor people are rapidly being absorbed into urban slums. Urbanization, in fact, is a health hazard for certain vulnerable populations, and this demographic shift threatens to create a humanitarian disaster. The threat comes both in the form of rising rates of endemic disease and a greater potential for epidemics and even pandemics. To protect global health, governments and international agencies need to make commensurate shifts in planning and programs, basing all changes on solid epidemiologic and operational research.

Although natural disasters and armed conflicts cause migration into urban centers, most people relocate to cities in search of employment. When they arrive, many find only one affordable housing option: illegal and unplanned dense settlements lacking basic public infrastructure, where they must live in lodgings made from tenuous materials, such as used plastic sheets, discarded scrap metal, and mud. The United Nations Human Settlements Program (UN-Habitat) reports that 43% of urban residents in developing countries such as Kenya, Brazil, and India and 78% of those in the least-developed countries such as Bangladesh, Haiti, and Ethiopia live in such slums.2 These slums, which are making up an increasing proportion of growing cities, lack not only most basic government services but also political recognition; as a result, so do their inhabitants. These residents are usually tolerated and their presence tacitly accepted, but the local government generally ignores them, accepting no responsibility for accounting for them in planning or the provision of services.

The current public health paradigm delineates urban health hazards as comprising injuries, pollution, and chronic diseases, such as diabetes and hypertension. Although these hazards are indeed more specific to urban than to rural areas, urbanization also exacerbates long-standing hazards specific to populations that have not undergone the epidemiologic transition from a predominance of infectious diseases. Increasing the population density in cities without proper water supplies and sanitation increases the risk of transmission of communicable diseases. Mortality among children under 5 years of age and among infants is higher in urban slums than in rural settings (see table).3

Though in most countries health care is more limited in rural than in urban areas, the urban environment may lack health support often provided in rural settings while also posing new risks. For example, for women and children, the rural environment provides a community of kinship that often ensures physical safety, food security, and the availability of child care. Without these safeguards, many women's mobility is limited in urban areas. Mobility and child care assistance from more experienced women allow mothers to perform two of the three steps that are theoretically fundamental to health care utilization: identifying illness and seeking care (the third being delivering care). Differential rates of death reflect this effect of urbanization, but we require more data in order to assess the true extent of this problem and other urban health risks. Currently, collected data are rarely disaggregated down to the level of individual city neighborhoods, and slum populations are generally not included when health statistics are reported.

Improved systems for collecting data in slums are urgently needed for the planning of infrastructure construction, programs, and resource allocation. Precise data that distinguish among types of residence, locations, and socioeconomic strata would reveal the varied effects of urbanization on health indicators, allowing for focused interventions.

We believe that the world's wealthier countries need to invest in capturing these data and improving public health systems. Doing so is not purely altruistic; it serves the self-interest of all countries, because poor urban areas can easily become a breeding ground for emerging infections and potential pandemics. The outbreak of severe acute respiratory syndrome (SARS) in Hong Kong in 2002 and 2003, which was believed to have originated in rural China, demonstrated how dense urban living could ignite a global health crisis. In a slum, the lack of surveillance and adequate health care might well result in more rapid spread of undetected diseases; without the necessary resources, it is difficult to implement any kind of preventive, containment, or treatment measures. Developed countries also have a financial stake in the requisite surveillance and health care systems: even conservative estimates of the cost of SARS to the economies of Europe and North America run to billions of dollars.

Understanding health-related behavior and the logistics of the health care environment of urban areas can also aid in the design of appropriate interventions. All three factors necessary to the effective utilization of health care — illness identification, care seeking, and care delivery — vary within urban settings. Although slum residents often live close to many health care providers, they generally have little access to high-quality care. Care-seeking patterns show that although less expensive, higher-quality government clinics are often available, slum residents who do seek care tend to choose more expensive private providers — for a multitude of reasons, from perceived quality to ease of access.4 Studies show that the care received by the urban poor is often of low quality. One study examining the care provided by 100 private practitioners in an urban slum in Mumbai, India, found 80 different treatment regimens being used for tuberculosis, only 4 of which met the guidelines of the World Health Organization.5

In some cases, new interventions are required for this population, but in others, interventions that are known to be effective simply need to be translated into effective programs. Fundamental public health services, such as vaccination, a safe water supply and sanitation, and oral rehydration therapy, remain important, and operational research is required in order to implement them effectively. Adapting interventions for implementation by community health workers or trained midwives has shown benefit, and we believe that a cadre of health care workers practicing in slums must be trained in order to reach this population.

Our knowledge base also needs to be supplemented through dedicated research. Epidemiologists must develop methods for collecting precise and accurate data and surveillance on the health of urban populations. Research must be conducted on the design of interventions and approaches to using proven public health tools that exploit the advantages conferred by urban settings, such as the concentration of target populations and better communication and transportation infrastructures for delivery of care and health education. And governments, nongovernmental organizations, and private providers must commit themselves to implementing new policies and programs. Many projects and field research efforts fall by the wayside when no governing or implementing agency "scales up" initial results. Governments need to determine the structure of health care provision, administration, and regulation, and nongovernmental organizations should aid in promoting good governance, increasing capacity, and ensuring access to care.

As the world becomes increasingly urban, the health of the urban poor may suffer. Decades of progress in public health could be erased, and the stage could be set for devastating pandemics of infectious disease. Action is needed now to avert such a disaster.

No potential conflict of interest relevant to this article was reported.

Source Information

From the Harvard Affiliated Emergency Medicine Residency based at Brigham and Women's Hospital and Massachusetts General Hospital (R.B.P.), and the Division of Global Health and Human Rights, Department of Emergency Medicine, and the Department of Pediatrics, Massachusetts General Hospital, and Harvard Medical School (T.F.B.) — all in Boston.

Thursday, August 13, 2009

Makes Sense to Me....

From: Bob Corbett
Date: Thu, Aug 13, 2009 at 1:58 PM
Subject: 35006: Morse (comment) Rules of Engagement (fwd)
To: Bob Corbett's Haiti list

Photo by John Carroll

I'm trying to get a better understanding of why the United Nations could keep so silent about the fraud during Haiti's April Senatorial elections and the June runoffs and my mind keeps drifting back to Rwanda and the genocide which saw the killing of 1,000,000 people, all under the watchful eye of the UN. That's right the UN witnessed the killing of one million people and yet, did nothing. Why? It's a standard phrase that comes up during interventions and occupations: "Rules of Engagement". The UN is invited by a host country and the "rules of engagement" are determined with the host country. In Rwanda the genocide was seen as an "internal political conflict" and under the "Rules Of Engagement", the UN was not permitted to "Engage". One million people died and the UN did nothing. I can't stress this enough.

I don't want to put the deaths of one million people on the same scale as senatorial election fraud but perhaps these failures by the UN have similar starting points. Perhaps there is an intrinsic weakness in the UN intervention process that leads to failure.

In Haiti there are a couple of things to consider:

1) The UN is here at the "invitation" of the Haitian government, so the UN doesn't want to embarrass "the hand that invites them".

A successful UN mission may mean
Brazil's becoming a part of the UN Security Council. The Brazilians may not want to open a can of worms by criticizing the hand that is so tied to their future; the "hand" that could potentially get them membership to the UN Security Council.

A conflict with the Haitian government could mean the end of the UN mission. If the invitation to the UN is withdrawn, a lot of UN jobs and careers will be sidetracked; the UN mission will be seen as a failure. What will happen to all those resumes (curriculum viteas)? What will happen to Brazil's standing with the UN Security Council and with the international community?

2) If things are perceived as "moving along nicely", then the UN, the UN Special Envoy along with all UN employees will be seen as having had a successful diplomatic intervention; more jobs for all. A "cover up" or "spin" is not the same as making things better but some at the UN may see spin and cover up as necessary evils; an alternate political truth or reality at the expense of the Haitian people.

Unfortunately, the UN seems to have become blinded by some of it's earlier successes. Overseeing the 2006 Presidential elections and the ensuing political calm has given the UN in Haiti the false impression that they can do no wrong in this impoverished nation. The impression that the UN is "so smart, they can get away with anything" is not the impression
to have when dealing with a country like Haiti. Haiti's population is so politically astute that in the long run, they'll make the UN pay for it's miscalculations.

The very thing wanted by ruling authorities in Haiti (factory investment), will be the very thing they're not going to get. Who wants to invest in a volatile country where workers are demonstrating in front of factories; where factory owners are going to embassies for protection; where the very family visited by the US Secretary of State was seen going to the Spanish embassy for protection after a particularly aggressive demonstration? A US embassy car was even attacked last week.

This isn't an investment climate. It could be an investment climate, but the current decision making process is leading us away from political calm.

Issues that have to be addressed and investigated for Haiti to get on track:

1) The election fraud of April and June. When I say the election fraud has to be addressed, I mean those implicated in the execution of the fraud as well as those involved in the cover up. Haitian Presidential elections are coming up next year and if this election process isn't put back on track immediately, we're all in for a long bumpy ride.

2) Economic development for the rural sector has to be initiated rather than si
mply bringing more factories to Port au Prince. Haiti's cities cannot support an influx of people coming in from the provinces looking for work. The infrastructure in Haiti's cities cannot absorb the people already living there; why attract tens of thousands more people now?

3) Why do St Mark and Gonaives still have sub human living conditions? What happened to all the money that has been allocated to these regions since 2004? Since 2004 at least five hurricanes (four in one month) have decimated the region.
We have to find out what's happening to the aid and why the intended recipients aren't getting it. Is it "local politics" or is it "corruption" that keeps these cities in their current states.

I've recently been to Gonaives and St Mark and I don't see how the UN can keep quiet about the current living conditions.

In conclusion, I have to say that things are deteriorating in Haiti right now and the signs tell us that they're going to get worse before they get better and the reason for this is not the Haitian people but the collective leadership of local decision makers along with the international community. It's time to make some significant changes; now.

Richard Morse

Port-au-Prince, Haiti

Wednesday, August 05, 2009

Minimum Wage Increased in Haiti

Haiti lawmakers OK minimum wage hike after clashes

By JONATHAN M. KATZ (AP) – Tuesday, August 4

PORT-AU-PRINCE, Haiti — Lawmakers voted to more than double Haiti's minimum wage Tuesday night after long hours of debate and clashes between police and protesters, who complained they can't feed and shelter their families on the current pay of about $1.75 a day.

The plan adopted fell short of the $5 wage demanded by the demonstrators, although it would more than double the minimum pay to about $3.75 a day.

The raise would include workers at factories producing clothes for export, an idea that President Rene Preval opposed. After refusing to publish into law a plan passed by Parliament in May to nearly triple the minimum wage, Preval proposed giving the garment factory workers an increase to about $3.

Given the lateness of Parliament's 55-6 vote to adopt the new raise, there was no immediate reaction from the president or from the protesters.

Earlier in the day, police fired tear gas at some 2,000 protesters who gathered outside Parliament to demand a big increase in the minimum wage. As legislators prepared to meet on the issue, some of the protesters threw rocks at police and began ripping down flags of U.N. member countries near the building.

Most of the crowd dispersed before the Parliament session began, with no arrests and only two reported injuries, including a cameraman who was hit in the head with a rock.

Many of the protesters were minimum-wage factory workers, such as Banel Jeune, a 29-year-old father who sews sleeves on shirts.

"Seventy gourdes, that doesn't do anything for me," he said, referring to his current minimum wage. "I can't feed my kids, and I can't send them to school."

The issue has been inflammatory in Haiti, which is the Western Hemisphere's poorest nation. But despite the heated debate and occasional violence, few people would be affected by the wage increase.

Most of Haiti's 9 million Haitians who are employed work on small farms or sell basic goods on the street. Only some 250,000 people have jobs covered by the minimum salary law, said lawmaker Steven Benoit, who sponsored the bill.

Still, some development experts argue that a pay increase would hurt plans for fighting Haiti's widespread unemployment by creating more jobs in the factories that produce clothing for export to the United States.

With new trade advantages that allow for duty-free exports of clothing to the U.S., such factories could provide "several hundred thousand jobs to Haitians ... over a period of just a few years," according to a report submitted to the U.N. in January. But it said that plan requires costs be kept down.

The report had been requested by Secretary-General Ban Ki-Moon and prepared by Oxford University professor Paul Collier. It is now being promoted by former U.S. President Bill Clinton, the new U.N. envoy for Haiti.

Friday, July 31, 2009

Heurese Survives Port-au-Prince and Peoria

Heurese went back to Haiti yesterday.

She is back in her one room shack with her two kids and her brother in a massive slum named Carefour.

You may remember Heurese.

During the last 12 months Heurese survived:

Four tropical storms that devastated Haiti last year;

Congestive heart failure;

Extreme poverty with very little food and water for herself and her kids;

UN soldiers who prey on Haitian women;

Haitian gangs who prey on Haitian women;

Peoria's OSF refusal to accept her back for heart surgery;

The silence of The Catholic Diocese of Peoria, the OSF Sisters and OSF Administration, and the Children's Hospital of Illinois Advisory Board who were notified last year that Heurese would die without surgery;

The Haitian government that provides next to nothing for sick people like Heurese;

Giving her children away while she waited to die in the Haitian slum;

Major heart surgery at the top rated heart surgery medical center in the United States;

OSF's Charity Assistance program who refused to do a post operative outpatient echocardiogram for her, but instead had OSF's attorney Douglass Marshall contact the Amercian Embassy in Haiti and request classified information on her visa status;

The pleas of her family in Haiti who told her NOT to return to Haiti now because life is almost impossible.

And to make things even worse for the hypocrisy in Peoria, the July 7 issue of The Catholic Post in Peoria had articles on Pope Benedict's encyclical "Caritas in Veritate" (Charity in Truth).

The pope's main concern in his encyclical is the dignity of the human person.

My family and I have never seen anyone with more dignity than Heurese....a dignity that was totally ignored by Peoria's spiritual and secular leaders.

Joe Piccione, OSF's Corporate Ethicist, who turned his back on Haitian Hearts patients too, called the encyclical "beautiful".

From The Catholic Post in Peoria:

"The new encyclical states that ethical values are needed to overcome the current global economic crisis as well as to eradicate hunger and promote the real development of all the world's peoples.

"The truth that God is the creator of human life, that every life is sacred, that the earth was given to humanity to use and protect and that God has a plan for each person must be respected in development programs and in economic recovery efforts if they are to have real and lasting benefits, the pope said.

"Charity or love is not an option for Christians, he said, and "practicing charity in truth helps people understand that adhering too the values of Christianity is not merely useful, but essential for building a good society and for true integral development.

"In addressing the global economic crisis and the ending poverty of the world's poorest countries, he said, "the primary capital to be safeguarded and valued is man, the human person in his or her integrity".

"The global dimension of the financial crisis is an expression of the moral failure of greedy financiers and investors, of the lack of oversight by national governments and of a lack of understanding that the global economy required internationally recognized global control, Pope Benedict said.

"The pope also said that "more economically developed nations should do all they can to allocate larger portions of their gross domestic product to development aid," respecting the obligations they made to the U.N. Millennium Development Goals aimed at significantly reducing poverty by 2015.

"Pope Benedict said food and water are the "universal rights of all human beings without distinction or discrimination" and are part of the basic right to life.

"He also said that being pro-life means being pro-development, especially given the connection between poverty and infant mortality, and that the only way to promote the true development of people is to promote a culture in which every human life is welcomed and valued."

It seems to me that the OSF and The Catholic Diocese of Peoria are not promoting a culture where "every human life is welcomed and valued".

As mentioned above, OSF's Coroporate Ethicist Joe Piccione commented on the "beauty" of this encyclical in another article in the same issue of The Catholic Post.

"He (Pope Benedict) is speaking to the conscience of the world. What is possible when human persons interact for the common good."

I spoke to Joe on the phone recently about OSF's abandonment of their Haitian Hearts patients. I asked Joe what Pope Benedict would say about this abandonment.

Joe's response was that he thought that Benedict would say that barriers need to be broken down to allow these Haitian kids to return to OSF.

I reminded Joe that OSF and their attorney Douglass Marshall had banned all Haitian Hearts patients from returning to OSF. (Joe told me that he was unaware of this.) I also reminded Joe again that my Haitian patients were suffering and dying with this policy of patient abandonment.

Therefore, it seems like the first barrier to be broken down at OSF would OSF's embargo against my Haitian kids.

Another barrier that could be broken down would be the "fear barrier". Mr. Steffen, OSF's Administrator, told me that fear at OSF is a "good thing" among OSF employees. If this barrier were broken down, the OSF International Committee could speak up for the Haitian Hearts patients like Heurese that need to come back to OSF and OSF's ethicists could act in the Haitian patients' best interests. (The OSF-SFMC ethicist has not responded to three different requests for help with Haitian Hearts patients.) This barrier of fear working against Haitian kids is significant.

So I do agree with OSF Corporate Ethicist Joe Piccione that Pope Benedict's encyclical is beautiful and that barriers do need to be lifted at OSF in Peoria to prevent Haitian kids from dying.

Thursday, July 30, 2009


When the shooting started during the funeral procession, somehow I was not surprised.

I asked myself: Who is shooting? But there was not much time to think much about anything. Mayhem ensued.

Father Jean-Juste's funeral procession had been peaceful up until then.

Only later was I able to document that the horrible shooting was done by MINUSTAH and a young Haitian man had died immediately. His head and face were almost ripped off by a bullet. His body lay near the side door of the cathedral that we had just exited.

He had committed no crime.

See Kim Ives article here.

This is all so sickening.

(Photo by John Carroll about 1 minute after the shooting.)

Tuesday, July 21, 2009


This is Elizabeth.

Elizabeth is a young Haitian woman who is a university student and was the second Haitian Hearts patient who had heart surgery at OSF in Peoria.

She was operated in 1996.

Why did OSF Administration stop Haitian Hearts patients from coming to OSF?

Look at the results with Elizabeth. Isn't she the real mission of OSF?

Sunday, July 19, 2009

Calm Brings Optimism to "Failed" Haiti

Tentative Calm Brings Optimism to a 'Failed' Haiti

Michael Deibert
(Photos by John Carroll)


PORT-AU-PRINCE, Haiti | The dark afternoon clouds that gradually roll over Haiti's capital herald the beginning of the rainy season, but the early-morning bursts of sunshine might more accurately capture the national mood these days.

While the country remains desperately poor, it is more peaceful than it has been in years - no small feat in a place with a volatile political history. Some of the credit goes to the United Nations and President Rene Preval.

A few years ago, the authority of the state did not extend much beyond Port-au-Prince, where armed gangs controlled neighborhoods. Since the inauguration of Mr. Preval in May 2006, however, a fragile calm has prevailed.

The capital's boisterous population again feels safe enough to patronize downtown bars and kerosine-lit roadside stands late into the evening. Billboards that once extolled the infallibility of a succession of "maximum leaders" now carry messages about the importance of respect between the population and the police as well as decry discrimination against the disabled.

Ruled by priest-turned-president Jean-Bertrand Aristide twice in the 1990s and from 2001 until his ouster in February 2004, Haiti saw violent urban warfare between heavily armed Aristide partisans and security forces, who inflicted collective punishment under an interim government in power from 2004 until Mr. Preval's inauguration.

Working with a 9,000-member U.N. peacekeeping mission, known by the acronym MINUSTAH, Haiti's government has made great strides in recent months in professionalizing security forces that were historically brutal and corrupt.

"The capacity of the police has improved quite significantly ... and the image of the police has begun to change within the society," says Hedi Annabi, a Tunisian diplomat who heads MINUSTAH.

"The level of respect for basic freedoms, such as freedom of the press, is at a historically remarkable level," he said.

In addition, according to MINUSTAH, the number of kidnappings has fallen dramatically, from more than 500 in 2006 to about 50 during the first six months of this year.

A projected five-year U.N.-supported police-reform program is in its third year of implementation, providing Haiti with 9,200 police officers - a number projected to grow to 10,000 by the end of this year and to 14,000 by the end of 2011.

The force began with only 3,500, of whom more than 1,500 had to be dismissed for poor conduct.

The surge in police recruits is a far cry from the situation that existed between September 2004 and June 2005, during which a police officer was killed every five days, according to U.N. statistics.

Some observers here credit the leadership of Michele Duvivier Pierre-Louis, a respected civil society activist, who was appointed prime minister in September 2008.

Ms. Pierre-Louis lauds the U.N. mission, which is heavily Latin American, for helping to stabilize the country.

"It's a new paradigm for regional cooperation," she told The Washington Times. "They have their own interests, of course, but let's make the best of the opportunities that are offered to us."

In a country where voting has sometimes boded ill for civil order, midterm elections in April, with a runoff in June, for Haiti's Senate were poorly attended but largely peaceful, with poll workers and observers directing voters and tabulating votes in a professional fashion. The desultory participation, however, led Mr. Preval to warn that Haiti's "political class should wonder about this abstention" as he cast his own ballot at a Port-au-Prince school.

Haiti still faces massive challenges. Largely deforested, the country was battered by Hurricanes Hanna and Ike in 2008, which collectively killed at least 600 people.

Beyond the capital, after the shabby-chic resorts on the Cote des Arcadins, Haiti's Route Nationale 1 is a pot-holed, crumbling wreck long before it reaches the northern cities of Gonaives and Cap-Haitien.

Poverty and the scramble to find basic necessities remain a constant fact of life for the majority of the 8.5 million population. The social peace that has been restored is fragile and could easily fray if tangible gains are not seen in the day-to-day lives of Haitians.

One exception to the national calm are noisy and occasionally violent demonstrations by university students and other political pressure groups in the capital.

Haiti's Senate voted in May to support a law raising the minimum wage to about $4.90 per day, a 300 percent increase. Mr. Preval has not signed the measure, citing his fear that it would jeopardize Haiti's already fragile employment sector. In response, students have held regular protests, during which dozens of cars have been burned and protesters have squared off against U.N. troops and Haitian security forces. Two demonstrators have been killed.

"They chose not to listen to us, and we were obligated to peacefully mobilize about our concerns and the question about the minimum salary," said Beneche Martial, a student at the state university's medical school.

Nevertheless, there is a tenuous hopefulness here for the first time in many years.

In June, the Inter-American Development Bank approved $120 million in grants for 2010 to help Haiti improve infrastructure, basic services and disaster prevention.

Also last month, the World Bank, the International Monetary Fund and the Inter-American Development Bank collectively canceled $1.2 billion owed to them by Haiti, erasing almost two-thirds of the country's outstanding debt.

The scourge of HIV/AIDS is also diminishing, with the rate of infection among pregnant women halved from 6.2 percent in 1993 to 3.1 percent, according to the U.N.

A U.N. report in December suggested that revived garment production might point the way for economic revival, saying that "it is striking how modest are the impediments to competitiveness, relative to the huge opportunities offered by the fundamentals" in the country.

For a nation viewed as a potential "failed state" not long ago, such news cannot help but be encouraging.

Saturday, July 18, 2009

Pulling Teeth in Haiti

I have worked with dentists in Haiti and extracted many teeth.

This is another "slap in the face" to Haitians who have to have their teeth pulled rather than repaired.

See this happy and sad article below from Catholic News Agency:

Lincoln, Neb., Jul 18, 2009 / 01:47 pm (CNA).- Living on a diet of mostly sugar cane, with no money to spare for toothbrushes, the children of Kobano Mission in Haiti suffer serious dental problems. In response, the Faith In Action Team (FIAT) at one parish arranged a special mission trip last spring in which four dentists and four dental assistants, accompanied by FIAT co-founder Don Killeen, journeyed to Haiti to serve hundreds of patients.

Kobano Mission is a "sister parish" for St. Joseph Church in Lincoln, Nebraska. The parish has held various drives to collect peanut butter, shoes, school supplies, etc. and various members of the parish have traveled to Haiti to help with the work.

Established by Louisiana native Father Glenn Meaux, S.O.L.T., the mission serves "the poorest of the poor." It’s situated in a rural area in the mountains about 20 miles from the centrally-located city of Hinche. There is no electricity, running water, paved roads or any sort of shops or stores.

Father Meaux relies heavily on the financial and practical support of U.S. parishes like St. Joseph Church to help. He provides food and clothing distribution, water stations that pipe clean water down from a mountain spring, a school, a housing program, solar-generated electricity and even a small economy that provides jobs and trade opportunities.

Getting medical and dental care to the community is always a challenge. Killeen visited the mission several times and worked with his son, pediatric dentist Dr. Martin Killeen to arrange this special dental mission.

It wasn’t difficult for Dr. Killeen to recruit volunteers. He started with his younger brother, Addison, who is currently studying dentistry and can work as a dental assistant. One of the professors of the University of Nebraska dental college, Dr. Jim Jenkins, also volunteered.

Two more dentists, Jeff Villafane and Shawn Whitney signed on, as did dental assistants Cody Christline, Aaron Larson and Danny Tylka.

None of them knew quite what to expect.

"We prepared for the worst," Dr. Killeen said.

Fortunately, they had been able to ship down a pair of dental chairs in advance. The chairs were donated by a dentist who was remodeling.

Various dental supply companies also donated supplies, such as fluoride treatments, Novocain, toothbrushes, and chemicals that could be used for "cold" sterilization of the instruments.

All of these went down to Haiti in a huge shipping container, paid for by banker Tom Johnson of Brainerd, Minn. Mr. Johnson has also adopted Kobano Mission as a special project, and has generously sponsored shipping numerous times over the years.

Dr. Killeen searched for dental instruments on eBay to pack into his suitcase. He was able to purchase enough equipment for the team at a reasonable cost.

When the dental team arrived, it was a quick set-up, and they were ready to go. A room with a tiled floor, formerly used as a chapel, but now a sewing room most of the time, held the two dental chairs and two wooden benches. The sewing machines were put to use as makeshift instrument tables, and each dental and dental assistant pair manned a station.

"Most of the people we treated had never seen a dentist," Dr. Killeen said, noting that it had been around 15 years since a dentist last visited the community.

They started with kids who were around 9-11 years of age. The state of the children’s teeth was sobering, and it’s all due to poverty.

"It’s just so severe," Dr. Killeen stressed. "It dawned on me when you see what people are eating down there. They’ll mix dirt into their food so they have more food to eat."

Haiti’s abundant sugar cane makes up a large part of the local diet. It wasn’t unusual for the dentists to encounter very painful teeth that were rotting right down to the gum line.

Since electricity in the mission is solar powered and not particularly reliable, the dental crew decided it would be a mistake to count on having enough power for drilling. It was more practical to focus on extracting infected teeth… as well as teeth so badly damaged by cavities, infection was imminent.

"At first, you would hesitate about taking out a permanent tooth, especially in front," Dr. Killeen acknowledged. "But they’d rather have an eyesore in the front than a facial infection or holes in their mouths."

The patients were grateful to just be out of pain from the severe cavities and infections.

"The kids were super tough. Didn’t complain a bit," Dr. Killeen related.

Each patient received a free toothbrush and some instruction about how to care for their teeth from now on. The dentists also taught the mission staff how to apply fluoride treatments, so that even without a dentist on hand, the mission can help improve dental health in the community.

Besides treating hundreds of school children, the dental team also assisted many adults. All told, they saw more than 400 patients and extracted somewhere around 820 teeth in the short week they were in Haiti.

The teams worked basically from sun up until sun down, appreciating the excellent organizing efforts of Father Meaux and his staff.

On the plane home, they were exhausted but invigorated by the whole experience.

"Everybody said, ‘Count me in for next year,’" Dr. Killeen said.

Printed with permission from the Southern Nebraska Register.

Friday, July 10, 2009

Haiti's Debt "Forgiven"...

Now that Haiti's debt has been forgiven by the international community, I assume that money which flows into Haiti will go to the people that need it most.

U.N. Envoy Bill Clinton was not happy with the lack of communication inside Haiti. Mr. Clinton is right...this is a huge problem. The organizations that can put Haiti back on her feet need to communicate with each other.

Haiti needs to do the basics well before it can progress. It is not doing the basics well at all right now. And one reason basics are not done well is lack of communication.

See article below:

Posted on Tue, Jul. 07, 2009
Bill Clinton: Aid coordination needed to fix Haiti
Associated Press Writer

A lack of coordination among aid groups and Haitian leaders is hurting efforts to ease poverty in the Caribbean nation, Bill Clinton said Wednesday as he wrapped up his first trip here as a special U.N. envoy.
The former U.S. president, who was named to the new post in May, said during the three-day tour that some of his chief goals as envoy are attracting investment and making existing aid more effective.

After closed-door meetings with nongovernmental organizations and business owners, Clinton said the country would benefit from more communication among key players as it tries to overcome some of the worst poverty in the Western Hemisphere.

"A big challenge is how little the investor community, all the elements of the government including the legislative branch, and the NGO community seem to have talked and absorbed each other's lessons," Clinton told reporters as he left for the airport and Washington.

In a reflection of the depth and variety of emergencies challenging Haiti, organizations on hand for Wednesday's meeting ranged from advocates trying to improve a fee-based hospital system that leaves millions without care, to small environmental NGOS, the Inter-American Development Bank and a U.S.-funded bank that gives microfinance loans.

Participants told Clinton their needs were not being met despite millions of aid dollars pledged by the international community. Some called for an NGO registry so that organizations can avoid overlapping tasks.

"All these people have a piece of the truth, a piece of the vision for Haiti's future," said Clinton, who was named envoy to Haiti by U.N. Secretary-General Ban Ki-moon two months after the pair toured the capital, Port-au-Prince.

While frustrations run high, many at the meetings said they are encouraged by Clinton's presence.

"His commitment is a personal one, it's from the heart," said Gregory Mevs, a Haitian shipping magnate. "He gets the country."

Clinton's visit included meetings with President Rene Preval and stops in the hurricane-ravaged city of Gonaives. He said he is encouraged by the disaster-prevention and job-creation efforts he saw but added that Haiti needs more money and coordination among aid groups and the government to spur development.

Also Wednesday, the Paris Club of creditor nations said it has canceled $62.73 million of debt and that members had reached bilateral agreements with Haiti to cancel the remaining $152 million of debt Haiti owes.

This follows the cancellation of $1.2 billion in debt last month by the World Bank, International Monetary Fund and Inter-American Development Bank.


© 2009 Miami Herald Media Company. All Rights Reserved.

Friday, July 03, 2009

A Working Mom in Soleil and Pope Benedict (Revised)


This mom and her baby showed up in clinic the other day.

Both have orange hair and the baby has the typical malnourished "look".

I asked the mother if she would like me to admit her baby to our Nutrition Clinic. Mother politely replied "no".

She and her baby plus the baby's two young siblings live in Soleil. Mom explained to me that she has a "factory job" ironing clothes. She works in a factory on "airport road" and makes 30 Haitian dollars per day. This is equivalent to about $3.75 US per day. And mom cannot give up this job.

To admit her child into our Nutrition Clinic Mom would need to bring the child to the clinic each morning (M-F) at 7 AM. For the next six hours the baby would be given two hot meals, vitamins and iron, a bath, and a nap. And mother would be given some crackers, and be put in a sewing class or reading class.

However, this mother had to weigh out the pros and cons of this situation, and so she decided the way she did. She has a "godmother" watching her children during the day when she is at work, but as mentioned above, mother did not think that she could give up her job for the Nutrition Clinic for her baby.

I sent the baby home on some fortified powdered milk, additional vitamins and iron, worm medicine, and asked mom to return with the baby in one week.

Pope Benedict came out with this statement about poverty in Haiti.

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ZENIT, The world seen from Rome
News Agency

Pontiff Asks Haiti for More Support of Families

Urges Getting to Roots of Poverty

VATICAN CITY, JULY 6, 2009 ( Benedict XVI is asking Haitian authorities to give more support to poor families who find themselves forced to emigrate in search of better situations.The Pope made this appeal today in his French-language address to the new Haitian ambassador to the Holy See, Carl-Henry Guiteau.

The Holy Father lamented how recent natural disasters in Haiti have "worsened the already difficult situation for many families." This has caused "many Haitians to leave their country in search of other sources of support to maintain their families."

The Pontiff called for "quick solutions to allow these families to reunite," though he acknowledged "sometimes problematic administrative situations." Renewed support from the international community, is key in this regard, he added.

On the other hand, the Pontiff insisted that it is necessary to "get to the roots of the poverty problem." He affirmed that "the education of youth is a priority for the future of the nation."

"This task is important and urgent to better the quality of life, as much at the individual level as the social one," Benedict XVI declared. "In this context, the Catholic Church offers a significant contribution, both through its numerous educational institutions with its presence in remote and rural regions, and in the quality of the education and formation given in Catholic schools.

"I am happy to note that these institutions are valued both by the authorities and the people."

The Holy Father also considered the issue of protecting the planet, observing that the natural disasters in Haiti have brought attention to this problem.

"There is a type of kinship between man and creation, which should lead to respecting both realities," he said. "The protection of the environment is a challenge for everyone, because it is a matter of the defense and promotion of a collective good, designed for everyone, a responsibility that should move current generations to watch out for future ones."

"Imprudent exploitation of creation's resources and its consequences, which tends to seriously affect the life of the poorest, cannot be effectively confronted without political and economic decisions conforming with human dignity, as well as effective international cooperation," he added.

Looking up

Benedict XVI affirmed that there are also signs of hope in Haiti, despite its extreme poverty: Hope "founded particularly in the human and Christian values in Haitian society, such as respect for life, close-knit families, a sense of responsibility, and above all, faith in God, who does not abandon those who trust in him."

"Commitment to these values enables avoiding the evils that threaten social and family life," he continued. "Thus, I heartily encourage the efforts of all those who in your country contribute to bringing forward the protection of life and returning importance to the institution of the family."

In this sense, the Holy Father highlighted the importance of the testimony offered by the Catholic community: "I encourage you to continue your service to Haitian society, being attentive to the needs of the poor and seeking the unity of the nation in fraternity and solidarity. In this way you will be an authentic sign of hope for all Haitians."


All Tied up in Soleil

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Jimi and Papa, Soleil

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Malaria in Soleil

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Rehydration Clinic, Cite Soleil

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Brave in Soleil

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King of Soleil

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Baby Davison Survived Soleil

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Another Princess of Soleil

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Princess of Soleil

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