Cholera outbreak

Hi all!

  I'm not in Haiti now, but I really identified with this article.  Unfortunately, a massive cholera epidemic has been dreaded and 100% anticipated since the earthquake.  Sadly, cholera is a water-borne illness that is completely preventable, so starting with prevention now... it's a little late, but better than never.  Now if only this article went on to talk about teaching people to purify water by putting it in soda bottles and leaving it in the sun for two hours and making oral rehydration solutions with simple water, sugar and salt, so that the mysticism and technologies are removed, making health accessible to all.  

- becky


Haiti cholera hospital is a horror scene
Source: AlertNet
Date: 22 Oct 2010

22 Oct 2010 10:54:00 GMT

Written by: David Darg

Reuters and AlertNet are not responsible for the content of this article or for any external internet sites. The views expressed are the author's alone.

We woke to disturbing news on Thursday. Our friends at Partners in Health told us droves of people were arriving at St Marc, sick with diarrhea, and that they were dying from dehydration at an alarming rate. The question was clear, could we mobilize to provide clean water to an area suspected of having Haiti's first major cholera outbreak in decades?

Our staff immediately began loading our trucks with equipment. As we drove the two hours to St Marc emails on my phone showed the death toll was climbing steadily. Everyone was nervous.

We arrived at St Marc hospital to a horror scene. I had to fight my way through the gate as a huge crowd of worried relatives stood outside, while others screamed for access as they carried dying relatives into the compound. The courtyard was lined with patients hooked up to intravenous (IV) drips. It had just rained and there were people lying on the ground on soggy sheets, half-soaked with feces.

Some children were screaming and writhing in agony, others were motionless with their eyes rolled back into their heads as doctors and nursing staff searched desperately for a vein to give them an IV. The hospital was overwhelmed, apparently caught out suddenly by one of the fastest killers there is.

Our friend, Cate Oswald, from Partners In Health came out from a triage tent clutching a hand-drawn map. It showed the local river and the names of a few communities where the patients had been coming from. Cate and some of her colleagues led us into the countryside to find the source of the epidemic.

Soon we were heading down narrow dirt roads with rice paddies and canals on either side. The crisis had started the day before. Doctors realized it was getting serious during the night. By then the villagers had heard of the deaths and word spread quickly not to drink water from the river.

Most people had gone thirsty for hours. The roads were lined with villagers holding buckets, begging for water. Some larger groups had set up road blocks and our convoy was forced to stop and explain that we didn't have water, only equipment to purify water, and that we were heading to the source of the problem. The villagers reluctantly let us pass.

People were constantly trying to flag us down and pointing to sick friends and relatives. One group forced us to stop - they had a girl close to death. PIH staff started her on an IV and placed her in their vehicle. Her mother, clutching another baby, explained that her husband had died yesterday and asked us to save her daughter.

RISING TOLL

We arrived at the place where many of the patients had originated from, a small dusty community called Babou La Port. Our team set up a water purification system, which filters and chlorinates, ensuring that any bacteria or diseases are killed.

As we worked, sick villagers of all ages congregated under the shade of some large trees. The medical staff placed IVs in some. One, a boy named Frantz, was brought to us by his grandmother. He was weak and vomiting. His grandmother was frail and could only point to the river when we asked her how long Frantz had been ill.

Diarrhea is unfortunately a common problem in this part of the world. A villager with cholera might lie down on feeling ill, expecting to get better, and be dead within hours.

Convoys of trucks plastered with the posters of various presidential candidates drove up and down the dirt roads. Many candidates saw this as an opportunity to campaign. They were tossing out small plastic bags of water to the desperate crowds. There were fights for the water and one man was crushed under a truck in the scuffle.

Our filtration unit fired up and word spread quickly. Soon a sea of multi-colored buckets surrounded us. There were no cheers and little laughter; most of the villagers were stunned, afraid and weak. They were just relieved to have water.

Some of our Haitian staff agreed to stay with the system overnight and keep it operating. It was a daunting challenge, to stay awake surrounded by deadly disease and desperate villagers.

Back at St Marc hospital not much had changed, other than the death toll. As I write, the confirmed toll is 135 and rising with thousands more infected. There are still patients being carried into the hospital close to death.

Now however the cries of the mothers are louder and there are even more people at the gates desperate to hear news of their loved ones. The hospital is struggling to cope with such a sudden influx of patients, especially since it is still trying to recover from the January earthquake.

The scenes at St Marc reminded me of Haiti's capital Port-au-Prince after the quake: patients lying in the streets, doctors struggling to cope, mass hysteria and fatigue.

On Thursday morning, as the scale of the problem began to emerge, my friend Dr Koji from Partners in Health shook my hand and said "Let's stop this". The only way to halt a disease like cholera is to stop people from getting infected. The hardest hit areas now have access to safe water, and thanks to people like Dr Koji the sick are receiving treatment.

Reuters AlertNet is not responsible for the content of external websites.

For more humanitarian news and analysis, please visit www.alertnet.org

--
Posted By poxvox to Haiti Vox at 10/23/2010 12:40:00 PM

A Reflection on Greed and Guns

I’ve been re-reading Tuesdays with Morrie (it was in the guest house book shelf).  For those of you who don’t know the story, Morrie is Mitch Albom’s old sociology professor and together they embark on a project to reflect on the meaning of life, as Morrie slowly dies of ALS (Lou Gehrig’s disease).  What a beautiful story!  And it’s short…  I highly recommend it.

Anyhoo… Morrie said something that made me think of Haiti.

“… if you’re surrounded by people who say, “I want mine now,” you end up with a few people with everything and a military to keep the poor ones from rising up and stealing it.”

It applies to most of the world, but it’s incredibly obvious here in Haiti.  People are materially poor, as they were before the earthquake and continue to be.  The rich are filthy rich and the poor are struggling, and the UN is here, toting their guns around, “keeping the peace.”

Now I recognize that the UN soldiers are here with noble intents.  They’re here to stop riots and protect people.  Riots are stopped with guns, shields and tear gas, right?  But all over Latin America, the poor are oppressed.  They demonstrate to demand their rights.  Food, water shelter, health, and, most importantly, dignity, which are not too much to ask for, and they have very few outlets from which to ask.  For whatever reason, burning tires in roadblocks and assembling in mass numbers are they how they express these needs.  Are foreign guns really necessary when people gather to request respect and support from their own government?

Corinne and I went to the beach this weekend and met some awesome guys from the US Army.  They’re from the National Guard, volunteering their weekends and taking time away from their families to support my country. What a welcoming, enjoyable group of guys!   They’re 18 soldiers, here as a part of the American humanitarian efforts who have come to help with crowd control at the US Air Force’s hospital in Saint Mark.  I’m really curious to hear more about their experiences when they start working. 

I’ve been to many hospitals in Haiti, and I’ve never seen armed forces there.  I’m curious as to why the Air Force is having so much difficulty “controlling” their patients… Or maybe the problem is with the patients’ families?  Why would people be getting unruly in a medical facility?  Are there misunderstandings going on?  Do they need more translators?

Needless to say, I taught them a few Creole phrases, and they promised to keep me posted as to how things go.

But it really brings me back to Mitch’s sentiments.  In a culture of greed, where the rich and powerful need to protect their wealth and uprisings among the poor destabilize their businesses, what else can we do to “keep the peace”?

Interestingly, he talks about creating your own culture, not giving into the materialism and selfishness that mass marketing totes, but rather to cherish family and loved ones and to choose to value more meaningful things.

“Invest in the human family.  Invest in people.  Build a little community of those you love and those who love you.”

            This can be applied to Haiti too.  Invest in human capital.  Empower people to help themselves.  Build relationships and listen to people. 

            Unfortunately all of these take time.  There are no quick fixes.  But I think that people appreciate that I’m taking the time to get to know Haiti and build relationships, before jumping in and trying to “fix them.”  And to think, Morrie Schwartz has probably never been to Haiti! 

Haitian child transporting mud as part of a community pond project

There’s No First Aid for Decapitation

            Haiti definitely has a dark side.  I can honestly say that I have never felt unsafe.  People are always friendly and hospitable toward me, but just like any collection of humans, arguments ensue, people are shot and some people are just bad people. 

            I’m still personally struggling with Terry’s experience.  He is a recovering alcoholic who came to Haiti volunteering as a foreman on a building project.  A few days ago, he was in the car with his crew, the group of Haitians who worked for him, and they passed a freshly beheaded body in the road.  He was traumatized as he looked on, as they casually drove around the body.

            Now I know his Haitian counterparts were affected too.  They told me so.  But what do you do when you see that?  I am so grateful that I was not in that car.  There’s no first aid for that.

            And it struck me.  Initially I thought, I don’t know if that person was Haitian or American.  They may have been in an argument, they could have raped someone’s sister (rapes have increased tremendously since the earthquake, one act of aggression responding to a sense of powerlessness), or maybe they were outright attacked.

            On further reflection, that person was likely not a foreigner.  They didn’t appear in any news, I got no emails from my government warning me of the dangers of Haiti, as someone was beheaded this week.  They had to be just another dead, poor, nameless Haitian… not worthy of news, as it’s sadly too common.

            Needless to say, Terry started drinking again… and he, like Haiti, will likely have a long road to recovery.

Haiti Thru Gary's Lens

Monument by the Airport

Tent City by the Airport

(note the Red Cross latrine tent)

Fun Tap-Taps

(aka local public transportation)

Oxen & Cart

Metal Artist

Lady on Donkey

Another Tent City

Bathing by the River

Man Selling Prescription Medicines

Snow Cones

Gary at a Home for Sick Kids

Hilarious editorial about journalists in Haiti

Hi all!
  I know I've written NOTHING since I left Haiti, but hopefully I'll be getting back into the blogging in the next few weeks, as a warm-up for my trip back in late August.  In the meantime, I just wanted to share this overly cynical editorial by a Mr. Herz... it's, unfortunately, quite accurate.
  Let me know if there's anything else you want me to include in the future.
-becky



*Actor Sean Penn, who is helping manage a camp of displaced earthquake


victims in Haiti, is making pointed criticisms of journalists for dropping

the ball on coverage of Haiti. He's wrong. I've been on the ground in

Port-au-Prince working as an independent journalist for the past ten months.

I'm an earthquake survivor who's seen the big-time reporters come and go.

They're doing such a stellar job and I want to help out, so I've written

this handy guide for when they come back on the one-year anniversary of the

January quake!*



For starters, always use the phrase 'the poorest country in the Western

hemisphere.' Your audience must be reminded again of Haiti's exceptional

poverty. It's doubtful that other articles have mentioned this fact.



You are struck by the 'resilience' of the Haitian people. They will survive

no matter how poor they are. They are stoic, they rarely complain, and so

they are admirable. The best poor person is one who suffers quietly. A

two-sentence quote about their misery fitting neatly into your story is all

that's needed.



On your last visit you became enchanted with Haiti. You are in love with its

colorful culture and feel compelled to return. You care so much about these

hard-working people. You are here to help them. You are their voice. They

cannot speak for themselves.



Don't listen if the Haitians speak loudly or become unruly. You might be in

danger, get out of there. Protests are not to be taken seriously. The

participants were probably all paid to be there. All Haitian politicians are

corrupt or incompetent. Find a foreign authority on Haiti to talk in stern

terms about how they must shape up or cede power to incorruptible outsiders.



The US Embassy and United Nations always issue warnings that demonstrations

are security threats. It is all social unrest. If protesters are beaten,

gassed, or shot at by UN peacekeepers, they probably deserved it for getting

out of control. Do not investigate their constant claims of being abused.



It was so violent right after the January 2010 earthquake. 'Looters' fought

over goods 'stolen' from collapsed stores. Escaped prisoners were causing

mayhem. It wasn't necessary to be clear about how many people were actually

hurt or died in fighting. The point is that it was scary.



Now many of those looters are 'squatters' in 'squalid' camps. Their tent

cities are 'teeming' with people, like anthills. You saw your colleagues use

these words over and over in their reports, so you should too. You do not

have time to check a thesaurus before deadline.



Point out that Port-au-Prince is overcrowded. Do not mention large empty

plots of green land around the city. Of course, it is not possible to

explain that occupying US Marines forcibly initiated Haiti's shift from

distributed, rural growth to centralized governance in the capital city. It

will not fit within your word count. Besides, it is ancient history.



If you must mention Haiti's history, refer vaguely to Haiti's long line of

power-hungry, corrupt rulers. The 'iron-fisted' Duvaliers, for example.

Don't mention 35 years of US support for that dictatorship. The slave revolt

on which Haiti was founded was 'bloody' and 'brutal.' These words do not

apply to modern American offensives in Afghanistan and Iraq.



Today, Cite Soleil is the most dangerous slum in the world. There is no need

to back up this claim with evidence. It is 'sprawling.' Again, there's no

time for the thesaurus. Talk about ruthless gangs, bullet holes, pigs and

trash. Filth everywhere. Desperate people are eating cookies made of dirt

and mud! That always grabs the reader's attention.



Stick close to your hired security or embed yourself with UN troops. You

can't walk out on your own to profile generous, regular folk living in

tight-knit neighborhoods. They are helpless victims, grabbing whatever aid

they can. You haven't seen them calmly dividing food amongst themselves,

even though it's common practice.



Better to report on groups that periodically enter from outside to deliver

food to starving kids (take photos!). Don't talk to the youth of Cite Soleil

about how proud they are of where they come from. Probably gang members.

Almost everyone here supports ex-President Jean-Bertrand Aristide. But their

views aren't relevant. There is no need to bring politics into your story.



You can't forget to do another story about restaveks. Child slaves. It's so

shocking. There is little new information about restaveks, so just recycle

old statistics. Present it as a uniquely Haitian phenomenon. Enslaved

Haitian farmworkers in southern Florida, for example, aren't nearly as

interesting.



When you come back here in six months, there will still be a lot of

desperate poor people who have received little to no help. There are many

big, inefficient foreign NGOs in Haiti. Clearly something is wrong.

Breathless outrage is the appropriate tone.



But do not try to get to the bottom of the issue. Be sure to mention that

aid workers are doing the best they can. Their positive intentions matter

more than the results. Don't name names of individuals or groups who are

performing poorly. Reports about food stocks sitting idly in individual

warehouses are good. Investigations into why NGOs are failing to effect

progress in Haiti are boring and too difficult. Do not explore Haitian-led

alternatives to foreign development schemes. There are none. Basically,

don't do any reporting that could change the system.



On the other hand, everyone here loves Bill Clinton and Wyclef Jean. There

are no dissenting views on this point. Never mind that neither lives here.

Never mind that Clinton admitted to destroying Haiti's domestic rice economy

in the '90s. Never mind that Jean's organization has repeatedly mismanaged

relief funds. That's all in the past. They represent Haiti's best hope for

the future. Their voices matter, which means the media must pay close

attention to them, which means their voices matter, which means the media

must ...



Finally, when you visit Haiti again: Stay in the same expensive hotels.

Don't live close to the people. Produce lots of stories and make money. Pull

up in your rented SUV to a camp of people who lost their homes, still living

under the wind and rain. Step out into the mud with your waterproof boots.

Fresh notepad in hand. That ragged-looking woman is yelling at you that she

needs help, not another foreigner taking her photo. Her 3-year-old boy is

standing there, clinging to her leg. Her arms are raised, mouth agape, and

you can't understand her because you don't speak Haitian Creole.



Remove the lens cap and snap away. And when you've captured enough of

Haiti's drama, fly away back home.

Last night's dinner meeting...

Last night I had my final wrap-up meeting with pcH.  They took me to a cute little seafood restaurant in Petionville to discuss my month.  I was struck by how grateful they are that I am here, and I tried in every way possible to return that gratitude.

As we discussed my upcoming proposal, their wheels started churning.  pcH does not have a health care arm.  At first they suggested that I might be better off partnering with AME-SADA.  When we discussed that SADA does not have any involvement with the community, they agreed that their values are more in line with the type of program that I would like to build.  They then suggested that they might need to review their founding documents.  Their contract with the Haitian government states that they are an NGO that works in cooperatives, agriculture and adult literacy.  First they will speak with their board, then their lawyer, and then they may need to apply to modify their government documents.  They sounded very willing to do so but warned me that it might take some time.  I encouraged them to take as much time as they need, reminded them how impressed I am with their organization, and explained that I hope to work with them for many years to come.  We agreed that if the government won’t let me start a health program by the time I come back in August, then they will help me work on language skills and learning more about Haitian culture (and they might have me teach some English classes).

And then I opened up my line of questioning.  We discussed how health promoters might be selected.  Their communities already have health agents, midwives, and voodoo priests, all of whom practice some form of medicine.  However, I would like to use a term different from health agent, potentially health promoter, but we’ll discuss that with the communities.  Then we will ask the cooperatives.  I’ll explain to them what a health promoter will do, and then their community, through open space dialogue, can come up with their own list of qualities their health promoter should have.  After the list is generated, we will ask them all to vote on whom their promoters will be.

We also clarified that based on Haitian laws health promoters here will never be allowed to prescribe medicines.  Ironically, you can buy antibiotics, antivirals, and birth control pills in any market place, or even on the bus, but they won’t be allowed to write prescriptions… However, I reassured them that there are many many things that they will be able to do without prescribing, such as suturing, teaching how to make oral rehydration solution, and healing without medicines.  They got really excited and LeGran said, “They will save lives!” (His words, not mine J, but that is the idea.)

My language skills also need some help.  We agreed that I should have a helper, who I will call a partner.  I asked them to look for a few smart dynamic villagers who speak both English and Creole, who I can then interview.  I reassured them that they need no health care knowledge and they don’t need to be certified translators.  My ideal partner would be fun, animated, willing to try new things and culturally sensitive.  I explained that I need a local person to help me with Creole, but I also need someone who will elbow me if I say something that’s not culturally appropriate. (They agreed.) My proposal will include a stipend to pay this person, and a similar stipend to pay myself.  (I’ll donate it back, but that way they can financially account for my services.)

We also discussed about when, in the future (when my schedule isn’t based on a residency program), it will be best for me to come back, i.e. one week every two months, two weeks every four months… And they proposed that I come between planting an harvesting.  Ideally 2 weeks in January, 2 weeks in August, and 2 weeks between November and December.  I’m not sure how that spacing will fly with my future employer, but agriculturally, that makes a lot of sense.

Our meeting concluded with another round of appreciation.  They appreciate me, love my ideas, believe that our philosophies are consistent and are honored that I want to know Haiti.  I reiterated why I’m impressed with pcH, thanked them for their hospitality and generosity and told them how excited I am about coming back.

The best part, of the meeting though, was when LeGrand decided that since I keep coming back to see Haiti, Haiti and I have become lovers.  I made them promise not to tell my boyfriend.  J

Animation in Haiti-- a development model

I’ve been reading this paper, Animation in Haiti: MCC Haiti’s Experience with Rural Community Development by Barry C. Bartel, published in February 1989.  Barry lived in Haiti for a few years during the 1980’s as an MCC volunteer (it’s something like JVC, but through the Mennonites), and his writing is eloquent, as I wish mine were.  I’ve transcribed the first section of his paper, as I think it’s brilliant…  It might be a little too philosophical for some of you, but I think it resonates so well with everything I’m trying to do.

(Hopefully he won’t mind… I don’t have any permission to replicate his work, but I hope he’ll see this as a sincere form of flattery.  J )

Animation as a Philosophy of Development

Before describing animation in its specific applications to Haiti, it is important to establish it as an overall approach to or philosophy of development.  The specific applications will then be seen to embody this philosophy.

The term animation is not likely a familiar term in many development circles outside of Haiti.  Other terms, such as consciousness-raising education, participatory development and empowering, may be more familiar in other countries.  The essence of the approach is that it sees development as a long-term process that seems to empower others through encouraging and facilitating their participation and ownership in the development process.  Results are important but are secondary to the process.  Roland Bunch, author of Two Ears of Corn, has identified a key to development not as solving or even helping people solve their problems, but as helping them learn not to solve their problems.  Otherwise, what happens if we help them solve their problem, then we leave, and their problems change?  They are stuck, no better off than before we came.

Haiti is the poorest country in the Western Hemisphere and by some people’s estimates has the highest concentration of foreign missionaries in the world.  Foreigners see needs in Haiti and feel good doing things to solve them.  Haitians thus learn that the only way for their situation to improve is if foreigners come and do something for them.  I call it the Helpless Haitian/ Almighty American syndrome.  As a result one of the biggest tasks for development in Haiti is to help Haitians learn that they can control their situation and solve their problems.  Without a doubt they need technical advice, moral support, and financial assistance, but they need to own the solution.  This takes longer and results may not be as evident, but some of the most significant results (trust, cooperation, a sense of individual and collective self-worth) may be invisiblt or may only be a seed then we see them.

In its orientation sessions for new workers, MCC stresses that new workers will likely enter assignments with high expectation of what they will accomplish.  They desperately want to help those less fortunate than themselves.  But the brief contributions of development workers are often more frustrating than productive, as is seen as a long-term enabling process, the approach is significantly different than when participants try to produce visible results quickly.

This approach takes more time, but hopefully results are more permanent.  Rather than solving someone’s problem, an approach based on animation helps people identify their needs, helps them identify and analyze possible solutions, helps them develop and implement a plan, and only then helps them find necessary financial resources to supplement their own resources and work.  With their own planning, work, and sacrifice, they will own the solution, begin to feel like they can solve their own problems, and work to ensure that the solution lasts.  Without this emphasis on process, we risk showing people that they can’t solve their own problems now or when we leave.  Animation as used in Haiti does an amazing job of bringing primarily illiterate farmers, who have learned by living that life is difficult, that leaders dictate, and that foreigners are needed in order for anything good to happen, to an understanding and implementation of forms of cooperation, solidarity, collective self-worth, and self-determination.  The process is the key.

This is the shortest section of this paper, but I believe is is the most critical.  I articulate it here because I believe it forms the foundation on which specific applications of animation in Haiti are based, not because I expect it will be new or revealing to people reading this paper.  I suspect the above description of philosophy would have been more universal application in development than the specific approaches used in Haiti, though they, too, may have application elsewhere.