Tropical Storm Noel

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

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

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

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

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

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

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

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

(Photos by the Associated Press)

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

Social Teaching Must be Lived

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

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

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

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

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

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

Bishop Daniel Jenky is the publisher of the Catholic Post.

Silence

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

Too bad it is true.

Mauricio Survives!

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

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

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

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

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

Dogs, Haitians, and Heart Valves

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

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

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

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

What of Haitian Children?

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


What of Haitian Children?

Friday, October 5, 2007

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

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

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

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

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

John A. Carroll, M.D.

Peoria

Currently in Port-au-Prince, Haiti

Thirst for Profit

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

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

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

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

Benedict said:

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

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

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

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

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

The Catholic Diocese of Peoria and Social Doctrine

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

One girl is Jenny and the other is Heureuse.

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

I have written about both girls in the past.

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

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

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

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

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

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

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

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

Some excerpts from the article:

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

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

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

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

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

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

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

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

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

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

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

Mauricio Arrives!

Many people have wondered about Mauricio.

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

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

Please keep him in your prayers.

Pharmacy Window in Soleil

Bernardin

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

His name is Bernardin.

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

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

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

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

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

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

He is eight days old.

Will anyone out there give Bernardin a chance?

Don't Let This Baby Fool You

Don’t let this Soleil baby fool you.

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

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

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

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

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

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

Don’t let this baby fool you.

Haitians and Mannequins

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

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

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

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

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

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

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

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

What mannequin in the States could teach us so much?

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

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

February 22, 2008--

Erline died at the end of 2007.

JC

Malnourished in Soleil...Why?

Pediatric Clinic in Cite Soleil

Hope in Soleil

Babies and Bullets in Soleil

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

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

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

Twins in Soleil

Cite Soleil Baby