Tuesday, November 29, 2011

Tuesday, November 15, 2011

Haitian Kids in the Dominican Republic for Heart Surgery (Updated November 29, 2011)

This is Charles.

And this is Naika.

I examined both of them at Hopital Lumiere in Bon Fin, Haiti in 2010.

Both are having surgery this week in Santiago, Dominican Republic.

Thank you, Chadasha.

(Photos provided by Chadasha.)

Update November 16, 2011:

Last night Naika was operated for her patent ductus arteriosus. She did not need to go on bypass. The operative procedure was done through an intercostal incision and her ductus was successfully tied off. She is doing well.

Update November 29, 2011:

Charles did well also. Thank you everyone.


Monday, November 14, 2011

No Haitian Army, Please

Photo by John Carroll

Posted on Mon, Nov. 14, 2011
No new army for Haiti

The Miami Herald Editorial

The list of urgent needs in Haiti is extensive, from housing to a thorough clean-up of its streets and refugee camps to better sanitation and medical treatment. Not on this list: a new army.
Yet even so, President Michel Martelly has told supporters he is going to announce some kind of “public security force” later this week, thus fulfilling a promise to some of his most ardent backers in the campaign that brought him to the presidency earlier this year. If Mr. Martelly had bothered to consult the Haitian people, it’s doubtful they would have endorsed this wrong-headed action.

Mr. Martelly reportedly justifies his actions by summoning the brave role played by the indigenous fighting force that led the successful war of independence from France. The historical reference may be good politics in the narrowest sense. Haiti’s people are justly proud of becoming the first black republic to declare independence back in 1804 under the heroic banner of Toussaint L’Ouverture.

But playing the patriot card in order to reward former army members in his retinue and bringing back the very institution that trampled on the human and political rights of Haitians before and after the coup that brought down the dreaded Duvalier regime is an insult to the people of that nation. They’ve had enough of military strongmen and their abuses over the last few decades to justify their fears for a better future if Mr. Martelly goes through with this plan.

This is both dangerous and reckless, particularly in light of the desperate situation that faces most of Haiti’s people every day. Squalid camps dotting the capital and its environs still house more than 500,000. Conditions are miserable and most people have become disconsolate because they see no progress. Electricity remains a sometime thing, cholera still rages throughout the country and the educational system is rudimentary, at best.

Knowing that the international community, without whose support Haiti would collapse entirely, is opposed to his action, Mr. Martelly says he will raise about $95 million to support the army from donors other than Haiti’s institutional supporters. Even if he succeeds, which is doubtful, his priorities are completely misplaced.

How about an army of street-sweepers to remove the remaining debris and give the capital and other earthquake-ravaged cities a cleaner look and, not incidentally, improve santitation? As a writer on the facing page recently suggested, a brigade of construction workers would do far more good than bringing back the army that was disbanded by former President Jean-Bertrand Aristide 16 years ago.

Someday, the international security force guarding Haiti will be disbanded and leave the country, but there is no need for an army to replace it. The U.N.’s MINUSTAH peacekeeping mission has worked with international donors and others to build up the police force. That is where Mr. Martelly should focus his efforts if security is his genuine concern.

By and large, the international community has been reluctant to play the heavy in obliging the Haitian government to do its will. The cooperative approach remains the best way. But given that external aid remains a vital lifeline for Haiti, its friends must exert leverage on Mr. Martelly to persuade him to put his energies elsewhere.

This may cause hard feelings between donors and Haiti’s proud president, but the desperate needs of the Haitian people should be placed above any individual’s political interests.

Thursday, November 10, 2011

Father Andre Pleading for an "Abandoned Population"

Photo by John Carroll

Here are two more posts tonight (November 10, 2011) from Father Andre Sylvestre who is pastor of a Catholic church in Robillard, Haiti.

Post Number One:

Hi, all!

I had short meeting with my medical staff this morning. They shared their concerns with me. They reported that they realized that several of the family members of the cholera inpatients of the CTC of Robillard have TB symptoms. My staff is worried for themselves and for all the people who are in CTC of Robillard.

The situation of Robilllard is definitely becoming chaotic. I called someone from the Mininstry of Health in Cap Haitian to talk about the new development in the CTC of Robillard. I do not know yet what they are going to do and the situation is urgent. We
cannot expose an entire population to some TB people.

Please be the voices of the people of Robillard. Please share this email with those who can help. I am tired to have to share all the bad news with you, but I have no choice. The population of Robillard is like an abandoned population.


Post Number 2:

Hi, all!

There is one year since the cholera disease was brought to Haiti in Haiti. I had a stressful experience about its consequence in Robillard last Sunday.

I had to celebrate two masses last Sunday. I was on my way to celebrate the first one when one of our nurses said to me that there was no enough IV fluid for the day. It was 7: 50 when she told me that. She even said that there was enough for half day. Imagine that there were 22 patients at the CTC. I know that all those cholera inpatients would die without IV fluid. I called someone from Cap Health and someone from Ministry of Health in Cap Haitien. Fortunately, they both were ready to help us get some IV. Thanks to a parishioner who is a driver, we were able to pick IV and other supplies from Cap Haitien and save the life of 22 people. We were fortunate that the driver showed up at mass that Sunday, because most of the people cannot drive (they do not have a car).

The municipality of Plaine du Nord and Grison-Garde, La Bruyere and La Souffriere (the areas of the municipality of Acul du Nord) continue to send cholera patients to the CTC of Robillard. I do not see anything done yet to improve the situation of Robillard that is becoming chaotic. I do not want to have to experience such a stressful experience like the one of last Sunday. Cholera is an issue of public health. I do not understand the reason why the cholera patients of the CTC of Robillard are treated the way they are treated. Who has the financial means to help the cholera patients in Haiti? Can you help me know who received financial assistance to help them? Forgive my complaints, because I am tired to have to carry the burden of the cholera patients while the are people who have the responsibility to do that. I have to reapeat that the situation of Robilard is urgent. Those who have to improve that situation, what are they waiting for? Are they waiting for an human disaster to move quickly? I would appreciate that all of those who receive the current email become the voices of the people of Robillard. Thank you in advance for your cooperation.

Father Andre Sylvestre
Pastor the Parish of Robillard

Damages Sought for Haitian Cholera Victims

Posted on Wed, Nov. 09, 2011
Damages sought from the UN for Haitian cholera victims


More than 5,000 victims of Haiti’s deadly cholera outbreak or relatives of those who died have submitted claims to the United Nations for hundreds of millions of dollars in damages related to the introduction of the disease into Haiti a year ago.
A study published in a journal of the U.S. Centers for Disease Control last summer “strongly suggests’’ that a U.N. peacekeeping mission brought the cholera strain to Haiti, but the U.N. has never admitted its peacekeepers were responsible for the ongoing epidemic. To date, it has killed more than 6,600 Haitians and sickened in excess of 475,000 people.

Attorneys delivered the petitions for damages Thursday to both the United Nations and the U.N. Stabilization Mission in Haiti, which is known as MINUSTAH.

“I cannot comment more on the petition as, of course, the mission must study it in detail,’’ Kieran Dwyer, a spokesman for the U.N. Department of Peacekeeping Operations, said Tuesday.

Ira Kurzban, a Miami lawyer who is working on the case, said attorneys are seeking damages of $50,000 per victim and $100,000 for each family of a Haitian who died from cholera — a water-borne disease.

When peacekeepers enter a country they sign a special-forces agreement that grants immunity for most contingencies, Kurzban said. But he added: “It doesn’t grant immunity for introduction of a disease into a country.’’

In addition to damages, lawyers for the victims want a public apology from the United Nations and a nationwide response that includes medical treatment for current and future victims and a program to provide clean water and sanitation.

“Ultimately, the sewage at the peacekeepers’ camp overflowed into a tributary of the major river in Haiti and that is why the cholera spread so quickly,’’ Kurzban said.

The study by an independent team of epidemiologists and physicians that was published in the CDC journal found an exact correlation in time and place between the arrival of a battalion of peacekeepers from Nepal in the remote Artibonite region of Haiti last October and the first cases of cholera along the Meille River a few days later. The same cholera strain was present in the peacekeepers’ South Asian homeland.

“The Secretary General has taken this matter very seriously,” said Dwyer. An independent scientific panel appointed in January by the United Nations, he said, reported in May “that it was not possible to be conclusive about how cholera was introduced into Haiti. We do not know that it was U.N. peacekeepers who brought cholera to Haiti.’’

Kurzban said the U.N. entities are liable because they failed to adequately screen and rescreen peacekeepers coming from a country experiencing a cholera outbreak, dumped waste into a tributary of Haiti’s most important river and failed to respond adequately to the outbreak.

Also working on the case are the Institute for Justice & Democracy in Haiti and the Bureau des Avocats Internationaux, a group of human rights lawyers in Haiti.

“This is an opportunity for the United Nations to demonstrate that its stated ideals of eliminating disease and encouraging respect for rights are not just empty promises,” said Mario Joseph, managing attorney for the bureau.

Kurzban said the lawyers hope to negotiate with the U.N. entities to reach a satisfactory solution.

Special correspondent Stewart Stogel at the United Nations contributed to this report

Wednesday, November 09, 2011

Questions in Haitian Cholera Campaign

See this article regarding the fight against cholera in Haiti.

There are pro-cholera vaccine people and anti-cholera vaccine people. And they both have their reasons.

I don't think it is an either/or proposition. Vaccines should be given and water sanitation should be improved to prevent cholera in Haiti. That only makes sense.

According to this article it would cost 40 million dollars to vaccinate everyone in Haiti against cholera. That seems like a good deal. We need to remember that the UN costs 60 million dollars per MONTH to keep them in Haiti. Which do you think is more important?

Tuesday, November 08, 2011

Cuban Doctors Fight Haitian Cholera

Photo by John Carroll
Cholera Treatment Unit

Great article in the Times.

Our Neighbor is Sick

See my post in the Peoria Journal Star.

Mobility in Society

Time magazine (November 14, 2011) has a good article on social mobility in society. They site education, technology, health care, and the market as some of the factors playing important roles.

Time concludes:

"A large body of academic research shows that inequality and lack of social mobility hurt not just those at the bottom, they hurt everyone. Unequal societies have lower levels of trust, higher levels of anxiety and more illness. They have arguably less stable economies: International Monetary Fund research shows that countries like the U.S. and the U.K. are more prone to boom-and-bust cycles. And they are ultimately at risk for social instability."

Saturday, November 05, 2011


A decade ago I started thinking that OSF in Peoria had lost its way.

I thought that money had become more important to the hospital than patients.

I was afraid that they would let my Haitian patients die, and they have. And I thought that the ambulance monopoly in Peoria served the high end CEO's, not the people of central Illinois.

Leslie Moore of Metamora, Illinois wrote this in the Forum of the Peoria Journal Star on November 5, 2011:

"Early criticism of the corporate business structure have been offered by prominent persons this way: Peorian Robert Ingersoll said, "Every man is dishonest who lives upon the labor of others, no matter if he occupies a throne." "

Today's New York Times columnist David Krugman writes on the difference between those who have and those who don't in our society. Krugman feels that this difference is very dangerous to our society.

Please see the following few paragraphs from Krugman:

The budget office report tells us that essentially all of the upward redistribution of income away from the bottom 80 percent has gone to the highest-income 1 percent of Americans. That is, the protesters who portray themselves as representing the interests of the 99 percent have it basically right, and the pundits solemnly assuring them that it’s really about education, not the gains of a small elite, have it completely wrong.

If anything, the protesters are setting the cutoff too low. The recent budget office report doesn’t look inside the top 1 percent, but an earlier report, which only went up to 2005, found that almost two-thirds of the rising share of the top percentile in income actually went to the top 0.1 percent — the richest thousandth of Americans, who saw their real incomes rise more than 400 percent over the period from 1979 to 2005.

Who’s in that top 0.1 percent? Are they heroic entrepreneurs creating jobs? No, for the most part, they’re corporate executives. Recent research shows that around 60 percent of the top 0.1 percent either are executives in nonfinancial companies or make their money in finance, i.e., Wall Street broadly defined. Add in lawyers and people in real estate, and we’re talking about more than 70 percent of the lucky one-thousandth.

But why does this growing concentration of income and wealth in a few hands matter? Part of the answer is that rising inequality has meant a nation in which most families don’t share fully in economic growth. Another part of the answer is that once you realize just how much richer the rich have become, the argument that higher taxes on high incomes should be part of any long-run budget deal becomes a lot more compelling.

The larger answer, however, is that extreme concentration of income is incompatible with real democracy. Can anyone seriously deny that our political system is being warped by the influence of big money, and that the warping is getting worse as the wealth of a few grows ever larger?

Some pundits are still trying to dismiss concerns about rising inequality as somehow foolish. But the truth is that the whole nature of our society is at stake.

Wednesday, November 02, 2011

Two More Haitian Hearts Patients to the Dominican Republic

Last year, while working at Hopital Lumiere in Bon Fin, I examined a number of patients with heart problems.

One of the heart patients was three year old Charles. He had a loud systolic murmur over his upper left sternal border and he was anemic.

I sent Charles and his mother to Port-au-Prince with a check from Haitian Hearts to obtain a formal echocardiogram.

Charles echo showed that he has severe pulmonary stenosis with a gradient across the valve of 80 mm Hg. This was putting to much pressure on the right side of his heart. This valve could be opened in the cath lab with a balloon or, if necessary, by an open surgical procedure to expand the valve area.

The second patient was seven year old Naika. She weighed 33 pounds.

Naika had a loud "wash machine" type murmur all over her chest. Her chest x-ray revealed a large heart due to too much blood circulating through a large congenital heart defect called "patent ductus arteriosus".

Haitian Hearts sent Naika to the capital too and her echocardiogram confirmed this diagnosis. Her lesion could possibly be closed in the cath lab as well, or she could have an open procedure without needing bypass. But she definitely needed a procedure because she is in volume overloaded heart failure.

So now what was I supposed to do?

Both of these kids are good surgical candidates and both deserve surgery. But they live deep in rural Haiti, have no money, and OSF administration in Peoria definitely will not accept these kids from Haitian Hearts. Charles and Naika are not covered by OSF's Catholic Mission Philosophy which states that OSF will turn no one away regardless of race, religion, or ability to pay. (Haitian Hearts would pay $10,000 for each child.)

So I wrote their names down on my Haitian Hearts "master list", brought their echocardiograms and chest x-rays back to Peoria with me, and kept my eyes and ears open for any medical centers that would accept these kids.

Amazingly, this spring, Chadasha Foundation contacted Haitian Hearts and asked if we had any Haitian kids that needed heart surgery! We always have a "bunch" of babies, toddlers, kids, teenagers, and young adults who need surgery.

Well, Charles and Naika, are on their way this week to the Dominican Republic for heart surgery.

Many thanks to Angela, Chris, Clint, Judy, Gettie, and Miss Beth for helping make this happen.

Exterior Authority

"From the day when the first members of councils placed exterior authority higher than interior, that is to say, recognized the decisions of men united in councils as more important and more sacred than reason and conscience; on that day began lies that caused the loss of millions of human beings and which continue their unhappy work to the present day."

Leo Tolstoy