Friday, July 30, 2010

Castro's Reflections on Haiti

Photo by John Carroll
Cite Soleil, Haiti

July 29, 2010
Cuba has not forgotten Haiti

Leticia Martínez Hernández

SIX months have passed, but it seems like yesterday when, on that January 12, the faces of this agitated, forgetful world turned toward Haiti, the poorest nation of the American continent. Then the earth was shaking infernally and the international community lamented the tragedy that had befallen the nation of Toussaint L’Ouverture.

The people who breathed their last breath amounted to hundreds of thousands, and one million lost the roofs of their homes in which they spent their nights and sheltered from the sun and showers… Six months after the earthquake that devastated Port-au-Prince, more than one million people are still sleeping rough in tents and waking up to despair despite the promised aid from many countries. Six months after the earthquake "the dance of the millions" continues without it materializing, and the gestures of goodbye are becoming commonplace.

The Haitian capital is still an immense refugee camp, with more than 1,300 camps that have become ‘stable residencies’ for those who have lost everything, and every morning they go off to find ways of surviving in a country where options of work, apart from the informal markets, are becoming more and more elusive.

Meanwhile, the rubble remains impassable, the dumps constant fixtures, the rainy season is threatening, illnesses are lying in wait, forests are disappearing and uncertainty is overpowering a nation extremely lacerated after so many years of capitalist exploitation.

However, the world has once again turned its back on Haiti. One figure is enough to back up this hypothesis: the country has only received 2% of the close to $10 billion that the international community promised to donate for its reconstruction.

And so the prophetic words of Comandante en Jefe Fidel Castro in his Reflection of January 16 resound with a hard truth: "In Haiti, it will be put to the test how long the spirit of cooperation will endure before egotism, chauvinism, petty interests and contempt for other nations prevail."

While some are turning the page on the tragedy of Haiti, Cuba does not want to forget, it cannot do so, because more than 11 years of work there have made it understand the value of a hand extended in time, like that of the night of January 12 when the first hospital to give help to the wounded of the earthquake was that of the Cubans, or when, in 2008, merciless rain buried the city of Gonaïves in the mire and the corpses reached into the hundreds, and only the Cuban doctors weighed anchor there in order to help save lives and share the same fate as the Haitians. For this reason, it doesn’t seem strange or, even less, an exaggeration that in response to an inquiry about the doings of our doctors, many Haitians will say, totally naturally, "After God come the Cubans."

Thus, another figure is more demonstrative. When the earth shook in Haiti, 331 Cuban doctors were already there, and their numbers now stand at 1,010 between Cubans and graduates of the Latin American School of Medicine, attending to anyone at any hour of the day or night. They are striving to totally reconstruct the collapsed health system which, in a few years, will provide coverage for more than 75% of the population: a dream until yesterday prohibited for those without sufficient gourdes (national currency) to enter health institutions, even for a simple injection.

For that reason little Kevens of Haiti is eternally grateful for the prosthesis that will give him the chance to play Ronaldinho-style football again; and 70-year-old grandfather Paul Benito, whose health has always been neglected, is dumbfounded by the fact that when his high blood pressure took him to the brink of death, the Cuban doctors treated him without asking for anything in exchange.

This is how it has been since 1998, when Hurricane George devastated Haiti and our medics planted their flag for the first time in this much-lashed nation.

From that time, many are the stories recounted about that enduring love, like that of Logista, a beautiful young woman who lost both her legs in the earthquake and arrived at the hospital with a hemoglobin level of two and medical nurse José Enrique gave her a blood donation so that she could smile again.

Today this young woman is more alive than ever and the Cuban doctors are teaching her to walk again with prostheses sent from Cuba. How to forget the joy of Mackende in La Renaissance Hospital in Port-au-Prince, when Nurse Marlene Jorge, "his other mom," visited him every afternoon in the ward where he was awaiting an operation on his leg. The child had lost all of his family in the earthquake and only had the Cuban medics for company.

That simple and sensitive is our aid in Haiti, acts of help forgotten more than once by those who are constantly involved in their Herculean task, even when the total of patients treated after the earthquake is in the vicinity of 500,000; when approximately 180,000 Haitians are finding relief in 30 rehabilitation rooms; when more than 150,000 operations have been performed; when more than 125,000 people have been immunized; when prosthesis and electro-medicine workshops are materializing or when 22 community referral hospitals are functioning thanks to Cuba and the countries of the ALBA (Bolivarian Alliance for the Peoples of Our America).

And as if that was nothing, other groups of Cubans are building houses and setting up fish farms, teaching literacy, or restoring to life an abandoned sugar mill… They are the architects, engineers, teachers, veterinarians, fishers and sugar-cane workers who, alongside the medical brigade, are giving lessons in lasting aid, aid with a view to the future that will end the avalanche of "band aids" which conceal the wounds of Haiti every year.

Six months have gone by, even though it seems like yesterday. Port-au-Prince and its surrounding areas remain the seat of "the inferno of this world," in which so many people are surviving in infrahuman conditions without any idea whatsoever of how long the punishment will last.

Meanwhile, the world continues to suffer from amnesia, and the peoples, as Fidel wrote this past January 16; "will be increasingly harsher and more implacable" in their criticisms. But there are still those who believe in the future of Haiti, of that beloved Haiti captured in a famous song, of that Haiti which is discovering the smiles of its children, perhaps a joyful presage of a future that, of necessity, has to be better.

Wednesday, July 28, 2010

Orphan, Port-au-Prince

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Orphans, Port-au-Prince


The boy on the left was abandonded on Delmas 31.
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Sign Promotes Education above Tent City Near Port-au-Prince International Airport

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Don't Kidnap in Haiti

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Haitian Government Must Lead

Photo by John Carroll
Les Cayes, Haiti
July, 2010

Haitian government must lead recovery, Farmer tells Congress
Posted by Gideon Gil July 27, 2010 05:28 PM
By Stephen Smith, Boston Globe Staff

Dr. Paul Farmer, the charismatic founder of Boston-based Partners in Health, told Congress today the path to recovery in earthquake-shattered Haiti must be charted by that nation's government and not by outside aid agencies, no matter how well-intentioned.

Farmer, who first began working in rural Haiti nearly three decades ago, has long championed the strengthening of the Caribbean nation's government, arguing that is the best hope for bolstering tattered health, education, and social service systems. Too often, Farmer argued, proliferating aid agencies and foreign nations have failed to establish enduring partnerships with Haiti's government.

"Our historical failure to do so is one of the primary reasons that trying to help the public sector now is like trying to transfuse whole blood through a small-gauge needle or, in popular parlance, to drink from a fire hose," Farmer, a UN deputy special envoy for Haiti, said on Capitol Hill.

"How can there be public health and public education without a stronger government at the national and local levels?" Farmer said in prepared remarks.

Farmer testified before the Congressional Black Caucus alongside Loune Viaud, director of operations and strategic planning for Zanmi Lasante, the Haitian sister organization of Partners in Health. They sketched portraits of a nation whose needs remain acute six months after the earthquake that sundered much of the capital city, Port-au-Prince, and laid waste to nearly all federal government buildings.

Partners in Health, which has expanded to Peru, Russia, Rwanda, and beyond, assumed a leading role in the days after the Jan. 12 earthquake in helping provide services and in partnering with the Haitian health ministry. The Partners in Health model empowers local doctors, nurses, and residents; in Haiti, virtually all of the 4,000 staff members are Haitian.

"We need Haitians to lead the reconstruction efforts," Viaud said. "This means supporting the capacity and the leadership of both the Haitian government and Haitian communities; it means deferring to the experiences of Haitians and guaranteeing our participation in the rebuilding of our country."

But that has not happened sufficiently since the earthquake, Farmer said. He cited UN figures showing that while $1.8 billion in earthquake relief has flowed into Haiti, less than 3 percent has gone to the government.

Farmer invoked the strategies used in the United States during the Great Depression as a model for creating jobs in Haiti to clear rubble, rebuild, and expand health services. "Certainly," he said, "Haiti's need is no less great than that faced by the States during the Depression.

Tuesday, July 27, 2010

Bowel Obstruction with Visible Peristalsis


Fifty-six year old Haitian man in clinic today with weight loss and vomiting for three months. Tympanitic percussion and high pitched tinkling bowel sounds.

Bowel loops appeared distended with visible peristalsis.

X-ray machine not working today.
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You Need to Read This

Fate uncertain for 12 Haitian kids airlifted to US

AP National Writer


Six months after a chaotic airlift to the United States, 12 Haitian children remain in a Roman Catholic institution near Pittsburgh, their fate in limbo while U.S. and Haitian authorities struggle to determine which nation should be their future home.

Their case is complicated and politically sensitive, and all parties say they want the best outcome possible for the children. Yet impatience in some quarters is growing.

"It's astounding to me that the bureaucracy can't get this done," said Pennsylvania Gov. Ed Rendell, who took part in the airlift. "It's unfair to these children. Let's get them adopted by loving families."

Unlike some 1,100 other children flown out of Haiti to the U.S. after the Jan. 12 earthquake, the youths at the Holy Family Institute in Emsworth, Pa., were not part of the adoption process prior to the quake and - according to some legal experts - shouldn't have been eligible for the emergency program.

There are American families eager to adopt them now, including some who've been screened and approved by adoption agencies. But there's been little in the way of public updates on the case as federal agencies, the Haitian government and the International Red Cross try to determine whether the 12 should be put up for U.S. adoption or returned to relatives in Haiti.

The State Department, which oversees various aspects of international adoption, is deeply involved in case - but has not issued statements about it. Two staffers - authorized by the department to brief a reporter only if they not be identified - described the case as very complex and said there was no timeframe for resolving it as efforts continue to verify information about the children's families in Haiti.

They said no decisions would be made that were not acceptable to the Haitian government, which has been wary of some post-quake efforts to send children abroad. In May, the leader of an Idaho church group was convicted of arranging illegal travel after the group tried to take children out of Haiti without government approval.

The 12 children at Holy Family were part of an airlift of 54 children from the Bresma orphanage in Haiti's capital, Port-au-Prince, where two Pittsburgh-area sisters, Jamie and Alison McMutrie, had been volunteering for several years. The sisters' urgent post-quake pleas for help were heeded - participants in the Jan. 19 airlift included Rendell, officials from the University of Pittsburgh Medical Center, and a local Democratic congressman, Rep. Jason Altmire.

At Holy Family, the 12 children have been shielded from public view, and from the media, since their arrival, but by all accounts are receiving excellent treatment. They experienced their first snowfall during the winter, made field trips to Pittsburgh's zoo and children's museum, and have enjoyed the swimming pool during recent hot weather.

"The children had typical reactions to being whisked out of their country. ... We had bed-wetting and tantrums," said Sister Linda Yankoski, the institute's president. "We're not seeing that now. ... They appear to be very well-adjusted."

Ranging in age from 15 months to nearly 13, the children have been living together in their own residence, kept apart from the dozens of troubled youths who make up the institute's regular population. The staff has been supplemented with Creole-speaking volunteers.

In hindsight, it's clear that including the 12 children in the airlift has created a long-running dilemma. Yet federal and state officials have defended the decision not to leave them behind in the confusion at the Port-au-Prince airport - saying the alternative would have been to send them back to an understaffed, undersupplied orphanage in a devastated city.

When it became clear that the 12 children were not part of the U.S. adoption process, an adoption service provider affiliated with the Bresma orphanage compiled a list of qualified U.S. families willing to adopt them.

Among them were Chad and Sherry Cluver of Forsyth, Ill., who'd been contemplating adopting from Haiti long before the earthquake. The Cluvers - both high school teachers - flew to Pittsburgh on Jan. 21 to meet briefly with two of the 12 children who, later that day, were moved to the Holy Family Institute.

Since then, according to Sherry Cluver, she and her husband have been prohibited from further visits or any other contact with the children, and the last update they got from any federal official was June 15.

"We're here, praying for you, loving you, and writing and calling important people for help - to bring you home," Culver wrote in a recent blog entry, addressing the children even though they were unlikely to read it. "We pray that your hearts might somehow know that we have not left you behind."

Among those Cluver has contacted is her congressman, Aaron Shock, R-Ill. His spokesman, Dave Natonski, said Shock plans to write to Health and Human Services Secretary Kathleen Sebelius inquiring about the status of the case and the welfare of the 12 children.

Rendell, in a telephone interview, said he already has contacted Sebelius.

"I'm enormously frustrated," he said. "This diplomatic problem has to be worked out."

HHS is the parent agency for the Office of Refugee Resettlement, which is responsible for the children while they are in the U.S. but not up for adoption.

Even while praising the Holy Family Institute for its care of the children, some adoption experts are now insisting it's time they should be released for adoption.

"What's in the best interest of these kids - to stay in an institution or get them into a family?" asked Tom DeFilipo, president of the Joint Council on International Children's Services, which represents many U.S. adoption agencies.

DeFilipo says parents or other relatives of all 12 children have gone on record as relinquishing legal custody of them and endorsing their adoption by U.S. families.

"Six months is long enough," DeFilipo said. "But no one is rallying around this. These kids aren't in anybody's constituency. They've not got adoptive families. They're not citizens. Nobody wants to talk about this."

The State Department is aware of claims that the children's relatives have relinquished them, but wants to verify any such actions and be sure the relatives understand the ramifications of any statements they've made. The department said the children's cases would be decided individually - so there might not be a common outcome for all 12.

Yankoski urges those concerned about the children to be patient, and suggests they are far better off at Holy Family - with nutritious meals, schooling and counseling - than if they'd stayed in Haiti.

"Everyone is trying to make the right decision for these children," Yankoski said. "Until they do that, our job is to care for them as best we can and prepare them for the next step in their lives."

Saturday, July 24, 2010

Preval Leads the Way

Posted on Fri, Jul. 23, 2010
Préval leads the way for a new Haiti


On the sixth month anniversary of the earthquake that devastated Haiti, the Haitian government held a ceremony to give awards to some of the people that symbolized the heroics that took place in the wake of the disaster. Among those present were former president Bill Clinton shown here behind president Rene Preval.

Deep in the ravine amid the narrow corridors and chaotic construction, workers in T-shirts push wheelbarrows up and down a newly carved dirt path as rubble-filled buckets are passed in a human chain.

At the top of the steep hill, a clear view of the crumbled presidential palace and near-collapsed capital emerge as empty lots replace mounds of rubble.

For two months, Haitian President René Préval has been quietly laying the foundation for his quake-wrecked nation's rebuilding, transforming Fort National, a densely populated slum, into ground zero of Haiti's recovery efforts.

Often criticized for inaction, Préval has personally dispatched government top loaders and bulldozers to some of the hardest-hit neighborhoods, asked international aid agencies to send displaced residents to clean up their own streets, and sat with neighborhood leaders and camp dwellers to determine their needs.

``Temporary shelters are not the solution,'' Préval told The Miami Herald this week.

``There just isn't enough space. They are a solution to help people get from underneath tents. But they are not a housing solution. We have to build up.''

A little more than six months after the worst natural disaster in the Western Hemisphere, reconstruction remains slow: Just 275,000 of an estimated 20 million cubic meters of rubble have been removed.

But Préval said he's working on a three-prong reconstruction plan that includes using government heavy equipment to allow many of the estimated 1.5 million displaced quake victims to return to their neighborhoods, and having the government construct affordable multi-story apartments.

At the same time, he's pushing an innovative plan to redevelop downtown from the waterfront to the Champ de Mars with the help of Central Bank financing, and by using rubble to extend the Port-au-Prince harbor.

The Central Bank would use $150 million to build about two dozen modern buildings. The buildings would be leased to the state, and be part of a new administrative and financial district that includes hotels, apartment complexes, 15 government ministries, the palace of justice, and parliament.

The proposals are expected to go before the Interim Haiti Reconstruction Commission when it meets next month.

The initiatives come as many here speculate on who Préval will tap as his successor, Haiti struggles to get the United States and other donors to make good on $5.3 billion in promised aid, and U.S. Sen. Richard Lugar, ranking Republican on the Foreign Relations Committee, once more blasts Préval over his leadership in a report released Thursday.

``I don't have flashy leadership,'' he said. ``I have a leadership that is tranquil.''

For now, the progress of his efforts can be seen in Fort National, where government equipment with the words Ayiti Pap Peri -- Haiti Will Not Die -- emblazoned on the side work alongside residents.

``If someone had never visited Fort National . . . they would think nothing has been done,'' said Jean-Michel Olophene, a resident-turned-leader inside the Champ de Mars camp. ``But if you saw what it looked like before, you would realize that an immense amount of progress has been made.''

Last weekend, Préval made his first foray into the hard-hit community since the 7.0 earthquake.

``Everyone was happy, but I wasn't happy,'' he said. ``I did not see the solution for relocating people.''

So far, the idea of having residents travel several flights of stairs -- as opposed to several miles from the city -- for housing seems to have the support of the co-chairs of the commission, Haitian Prime Minister Jean-Max Bellerive and former President Bill Clinton.

``If we can build multi-story housing, it would make the city less dense even with the same population,'' Clinton said in a meeting with foreign donors this week, adding that any future construction would have to be anti-seismic and meet code.

Préval says Haiti's ongoing challenges -- the lack of temporary shelters, the logistics of removing rubble from densely populated neighborhoods and bringing together different groups, make it clear, ``we have to provide the solutions.''

For instance, while outside government organizations ``worked on their own, did what they wanted, we are working with the people, bringing together leaders of the camps and of the popular neighborhoods and asking them what route should we take.''

So far the path appears to be winning fans among both foreign diplomats who laud the progress, and residents living in other hard-hit communities such as Avenue Poupelard, who recently asked for similar assistance as Fort National.

To cope with the growing demand, a dispatching center was recently set up on the grounds of the palace to field calls. The government also cut a deal with the neighboring Dominican Republic to put 50 additional trucks at its disposal to clear and cart away rubble.

Préval will not say how much the pilot project is costing his cash-strapped government that received $35 million in donations.

Meanwhile, faced with few dump sites for the rubble, Préval has asked one of his chief engineers to order up a study of the soil composition of the Port-au-Prince harbor as he considers using debris to extend the harbor.

The vision of an extended, remodeled waterfront would not just offer unchartered territory for prime development, but also take it back from the anarchist development that has taken over the capital and led to a government-estimated 300,000 dead from the quake.

``While others are talking about recycling the debris for road construction and other things, we'll take it and do this instead,'' Préval said. ``We are better off enlarging the harbor for new development."

Doctor's Office

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How to Write about Haiti by Ansel Herz


Photo by John Carroll
Southern Haiti

See this article from the Huffington Post by Ansel Herz.

Ansel makes many salient tongue-in-cheek observations. And he happens to be right.

Years ago someone wrote that Haiti needs no more books or articles written on it. Instead, Haiti needs action.

Friday, July 23, 2010

Water is Most Important in Haiti

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Abortion in Haiti


Provoked abortion is illegal in Haiti but many women still have abortions.

The mother of this baby came into clinic groaning in pain the other day. She states that she was three months pregnant and took some pills to terminate the pregnancy.

Bimanual exam on the mother revealed a dilated cervix with the baby's head at the cervical os.

The baby slipped out and smelled very "septic".

Mother had a fever of 102 F.

We gave the mother IV antibiotics and performed a D&C.

Mother did fine, her fever disappeared, and she went home in two days.
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Southern Haiti

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Southern Haiti

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Tubeculosis Clinic, Southern Haiti

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Southern Haiti

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Thursday, July 22, 2010

AIDS in Haiti after the Quake

Reprinted from Caribbean Net News

Haitians with AIDS hit by broken promises of aid
Published on Thursday, July 22, 2010

by Sabrina Guillard

VIENNA, Austria (AFP) -- As Haiti struggles to rebuild itself after a devastating earthquake, people with AIDS are still waiting for aid promised to them before the catastrophe, activists here said on Tuesday.

There are some 120,000 people with the human immunodeficiency virus or HIV in Haiti, which was hit by a huge earthquake on January 12, killing 250,000 people and leaving 1.5 million homeless.

An international pledge of 500 million dollars (385 million euros) in reconstruction aid has been slow in materialising, with the World Bank saying last week that the fund was only 20 percent full.

But people with HIV and AIDS are suffering even more as their previously promised aid also continues to trickle in only very slowly or not at all, according to organisations attending the World AIDS Conference this week in Vienna.

"It's very difficult for grassroots organisations to operate since the quake. We simply don't have the means to do so," said Liony Acclus, head of PHAP+, a Haitian coalition of organisations for people with AIDS.

Around 90 percent of all funding for AIDS in Haiti comes from abroad, Acclus said.

"Since the quake, the programmes set up by international organisations to help people with AIDS to earn a living are no longer operating," complained Edner Boucicaut, head of Housing Works, a non-governmental organisation.

It was still common practice that prospective employees had to prove they were HIV negative to get work, Boucicaut said.

"We have to stop helping Haiti on paper and start taking action," said Liony Acclus.

However, there are more optimistic voices.

"We've lost 70 percent of our office space. But that isn't stopping us working," said Jean-William Pape, director of the Haitian NGO Gheskio.

"The situation is not going to deteriorate, because health organisations are well organised."

"What we hear about Haiti is always very negative, but before the earthquake, good things were happening there, in the health sector particularly," said Jonathan Quick, director of Management Sciences for Health (MSH).

The prevalence rate of HIV in Haiti has declined from 6.2 percent in 1993 to 2.2 percent in the middle of this decade, Quick noted.

Free care for people with AIDS, HIV tests and preliminary treatments are still available, Edner Boucicaut of Housing Works conceded.

"But we still don't have second-line antiretrovirals (drugs used when a patient develops a resistance to the first treatment), and even before the quake, 43,000 people were not receiving treatment," he said.

The organisations all share the view that the entire population be integrated into the process of reconstruction.

In a joint statement, NGOs Gheskio, MSH, the Global Health Council and Partners in Health, called on the international community to direct its support to a "'whole of society' integrated approach to strengthening health systems as the best way to sustain HIV/AIDS prevention, care and treatment over the long term".

Edner Boucicaut complained of a lack of coordination in the programmes of the NGOs and the government.

"Integrate us into your programmes," he said.

There is a general scepticism towards the public authorities in Haiti, with organisations saying people expect more of the UN's special envoy Bill Clinton than their own president Rene Preval.

Copyright© 2007-2009 Caribbean Net News at



This is Gedna.

Gedna is 48 years old.

He had mitral valve surgery in the United States in 2002. He also had a permanent pacemaker placed at that time.

I saw Gedna in clinic today. He came in early this morning very sweaty, very short of breath, and he could barely complete a sentence. His body was swollen with fluid and his lungs were wet.

He and his wife gave me his recent and past medical history while I examined him.

Gedna has tried three times in the last eight years to return to the States to have a check up and more surgery if necessary. His pacemaker also needs to be examined by a cardiologist to see if it needs to be replaced.

Unfortunately Gedna has been denied a travel (non immigrant) visa by the American Consulate each time he applied.

Now Gedna is in serious trouble.

I diuresed three liters of fluid off Gedna today and kept him in clinic all day long with an IV. We have no inpatient beds to admit him to the hospital.

As the thunder started late this afternoon, I removed the IV and sent Gedna home on a new regime of medication.

He will show up early tomorrow morning and I will reassess him.

Gedna needs to be evaluated again in the States in a good medical center. And this needs to be done quickly.

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Mountains Behind Mountains, Southern Haiti

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Wednesday, July 21, 2010



This is Vanessa.

Vanessa is 12 years old.

She is from Barradare which is light years from here.

I examined her for the first time today in the clinic in Les Cayes.

Her mother said that for several years Vanessa has been quite short of breath especially "walking up the mountain". And with further questioning mom added "yes Vanessa's left knee DID swell up" and hurt like mad several years ago.

Vanessa had the ubiquitous loud murmur over her mitral valve that always makes my heart sink.

She has the typical history and physical findings of rheumatic fever that we find in so many children in Haiti. Poverty and crowded conditions make this suffering possible.

I told her mother that Vanessa needs heart surgery in the United States and Haitian Hearts gave mom the money to have a formal echocardiogram done in Port-au-Prince.

I also told Vanessa's mother that it is difficult to find medical centers to accept Haitian kids for heart surgery but that we would try.

Mom started to cry, but recovered quickly as poor Haitian women are prone to do.
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This is Christine.

She is 11 years old.

I brought her to OSF in Peoria when she was four months old.

Christine was very sick with a hole in her heart and she had pneumonia.

She had heart surgery and did very well.

Christine lives in Les Cayes with her dad, mom, and two brothers. I ran into her mom coming out of Mass the other morning.

Haiti has many problems but there are good solutions to most of these problems.

Christine is good evidence that little by little the world can change.
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Tuesday, July 20, 2010

This is Rose...Again


From a previous post you know this is Rose who has a heart problem. She was buried for four days in a building that fell and killed her father.

I just HAD to post this picture.

She is in what remains of Port-au-Prince getting an echocardiogram tomorrow morning.

Rose is something else...
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This is Mona.

Mona is 31 years old.

She is very poor and lives in Camp Perrin, Haiti.

Mona has congenital heart disease called Tetralogy de Fallot.

She is in good condition other than her heart.

Mona has an up to date passport and is ready to travel to the US for heart surgery.

Only problem is I have no medical center to accept her.

What to do?
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This is Kerrine.

She is 10 years old.

Kerrine lives in a tent with her mom and dad and brothers and sisters in Port-au-Prince. It is very hot in the tent these days.

Kerrine has a congenital heart defect called Ventricular Septal Defect. It is the most common congenital heart defect and is a small hole that allows the lower chambers of the heart to shunt blood in the wrong direction.

She needs heart surgery.

What to do?
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This is Rose.

Rose is 10 years old and lives in sourthern Haiti with her mother and brothers and sisters. They have nothing except themselves and cousins.

I examined her yesterday and she has a big heart that does not work well due to the fact that one of her valves is damaged.

Rose was in Port-au-Prince with her father on January 12, the day of the earthquake.

The house they were in collapsed and her father was killed. Rose was trapped for four days under the walls and roof until she was pulled out. She wasn't hurt.

But she needs heart surgery now.

Rose has ALOT of spunk and would like to live a long life after surviving the quake.

What to do?
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Monday, July 19, 2010

Bill Clinton's Plan for Haiti

Bill Clinton and the Country That Never Was

While most of the world has stopped paying attention to Haiti, he has become the de facto leader of the effort to rebuild the country after the historic earthquake. The problem is, there wasn't much there to begin with.

By: Tom Chiarella

Published in Esquire's special August 2010 issue on The Impossible.

After five days in Port-au-Prince, I sat at the hotel bar and ordered a Prestige, the beer of Haiti, the beer of preference — a pretty damned good beer, if you ask me. I liked the word, Prestige, which somehow rolled French off my tongue. And I liked the way the bartenders wrapped the fat brown bottle in a white paper napkin, which in the evening heat clung like gauze to a wound. A jazz trio played under the eaves at one end of the courtyard, well enough that I wondered who they'd played with and what they knew. Next to me: a baby-faced accountant, here from Kentucky to audit microcredit payments, Ryan, the only person at the hotel I could stand to drink with.The rest of them were NGO volunteers or medics in for a week, insular, high-minded, and somehow vacant in their mutual moral purpose. Just then, some of them were swimming in the hotel pool, a half dozen American nurses and a pair of Canadian surgeons, playing a game of Marco Polo.

Keep in mind: This is now. A kind of now, anyway. Late spring 2010, just five months past the great earthquake that rocked the already roiling city. To the south was a city lot, half full with a twenty-foot pile of wreckage that once constituted an Italian restaurant. A sweeping pile of rubble projected eight feet into the road, having been carried there, one bucket at a time, by an old guy who worked the lot all day with a worn-down mattock. Rubble dropped there on faith in an unscheduled collection. Traffic bent and slowed around it, a little more each day. In that rubble: a child's sock, half a purse, bloated rolls of toilet paper, a key chain, the wet skin of a grocery bag, and notes regarding inventory off the top of a desk long since splintered, or salvaged, or stolen. Used-up gaskets. Broken bottles. Bits of food, too. Pits. Rinds. That was just what I'd seen that morning, when the guards from the hotel let me step into the street for a look while they stood watch, shotguns cocked.

Around the corner, facing the main entrance of the hotel, stood a tent city — more cardboard than plywood, more plywood than tin, more tin than tent pole, more tied-down blue plastic sheeting than anything else — unspooling itself across the Champs de Mars, the former national plaza, rooting fifty thousand people right up to the ruined national palace. That was west. To the north, more: churches, guts blown outward, still somehow uncollected in the street; collapsed apartments, one cement deck piled upon the other, unexcavated and peopled, everyone supposed, by skeletons. Through these streets walked the Haitian citizenry, scores of them, hundreds, thousands. Haitians selling fruit, selling floor mats, selling chickens, washing windows, cooking corn on rusted hibachis, proffering bags of drinking water.

That night in the hotel, with the jazz throbbing, it started to rain. I pulled out my cell phone and texted the single soul I knew in the city of 2.4 million, Emmanuel Midi, my twenty-five-year-old fixer, who'd dropped me there an hour before. I had no idea where he went at night. I thumbed out my concern: Are you safe in this rain?

I'm ok! he texted back. Thanks for asking! I liked the kid. Everything with him was exclamation points.

I didn't know much about the geography of Haiti, but I had known enough to look for Cité Soleil, the notorious slum, as the plane landed. The district occupied a dark, gray clump of land near the airport, at the water's edge. People had warned me about it. The night before I left, in New York, I had watched half of a documentary about it, Ghosts of Cité Soleil, then nudged around the Internet long enough to find State Department travelers' warnings naming it the most dangerous place in the world. It seemed a place apart, beyond reckoning somehow, a place the Haitian government ignored and the UN struggled with — and one that some part of my most greedy heart wanted to see. Then I got my first up-close look at Port-au-Prince, straining, crumbling, collapsing in every quarter, and Cité Soleil was forgotten again.

In the mornings, I sometimes stood in my T-shirt, hands in pockets, on the steps of the hotel, staring across the street at the wall of the tarpaulin city. The hotel clerks fussed at me about going outside. Even when it was a park, when you could see through the arbors right to the walls of the palace, the Champs was not particularly safe. "You can't see past the tents," one told me. "So there is nothing to see." I persisted until he came out from behind the desk, unlocked the folding gate, then unlocked the front door, then stood watching me watch the camp.

One morning, someone in the camp had a rooster. Three men — one shirtless, one pantless, the other fully dressed for work — rousted by the crowing, prowled the curving exterior of a clutch of tents. Two women stood over a charcoal fire, heating up bread. Even at 5:45, the traffic was sometimes loud enough that the rooster was difficult to track. The men closed in. Then the bird went quiet.

Then, in one moment, all three caught sight of me for the first time. The shirtless one walked straight to the edge of the traffic, intent on me. The pantless one at his heels. They called to me, "Monsieur! Mister!" Not good. I turned, and the door swung open for me — a guard, shotgun crooked in his elbow. He said something I couldn't make out. "Bonjour," I replied. But he stopped me to clarify. They're pimps, he was saying. Pimps who watch the doors. You cannot go out there. After that I didn't.

Sunday, July 18, 2010

Les Cayes, Haiti


This man is 86 years old.

He is in the hospital but is up and about walking up and down the hallway. His doting family is here also.

He tells me that he remembers World War II very well and the atrocities of Adolph Hitler. I told him that my dad was at Hitler's home at the end of the war.

This man has a heart rate of 28 per minute. He is in complete heart block.

He needs a pacemaker which can only be done in Port-au-Prince by a private cardiologist. And he doesn't have the money anyway.

What to do?

Les Cayes, Haiti


I admitted this young mother for fever, anemia, and diarrhea for two weeks.

I started her on cholorquine, ceftriaxone, iron, and vitamins.

She has no fever now and her diarrhea is gone. She has her 5 month old with her. Her family brings her food and changes her bed sheets.
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