Hand in Hand for Haiti – a Green field hospital of hope

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Martin Moodie
Martin Moodie is the Founder & Chairman of The Moodie Report.

Our journey around Haiti is nearing its end.

After our epic drive to and from Les Abricots, Saturday night is spent back at the Auberge Inn in Jérémie where our host Juliette Nicolas Tardieu produces a splendid meal. Again there’s rice, chicken, goat and plantain with plenty of the excellent Barbancourt rum (tonight we drink the fine Reserve Spéciale 8 year old) to which we’ve all taken a liking.

We’ve been hard at it all day since our 6.30a.m. visit to the Cite Soleil shanty town but tonight’s not an off-duty dinner. We’re meeting with local leaders again, including the Mayor of Jérémie Pierre Ronald Etienne (below with Debbie Brennan) and his two deputes plus Jules Emmanuel Bellerice, Director of the Alliance Française of Jérémie.

We’re anxious to build on an initially difficult but ultimately rewarding meeting this morning with several of the town’s top academic and community figures.

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It proves to be another stimulating encounter. All of us are deeply impressed by the spirit and intellectual insight of Jérémie’s leaders. One of their party makes the telling point that education without any jobs to graduate into is a sure incentive for Haitians to leave the country. Practical, vocational training is critical, he argues. So is job creation.

Ed Brennan, Chairman of Hand in Hand for Haiti (and DFS) agrees, and notes: “Business will follow if we can show that we have a skilled workforce.” He draws a direct link between education (from primary school up), work skills and attracting business investment. It’s a simple, perhaps obvious chain that has been sadly lacking in Haiti.

“We could become a training ground… a model, a case study,” says Ed, warming to his subject.

It’s been good to watch him and Olivier Bottrie at work this week, dovetailing perfectly as a leadership team. Olivier is all passion, energy and sharp insight; Ed brings a reassuring calm and strategic oversight to proceedings and it’s easy to see why both have got to the top of their respective businesses.

Complemented by a strong alliance of Haitians – including Port-au-Prince based Peter and Fafie Frisch, Alex Carias and Michel Apollon, as well as Haiti-born, US-based beauty industry executives Harvey Gedeon and Caroline Sada (both from The Estée Lauder Companies)– our group has just the right balance of business acumen and local insight, underpinned by an absolute dedication to the cause.

Tonight, both sides of the table are equally committed to Haiti’s future. We are from very different worlds but our agendas have converged. We drink rum together and say our fond farewells. There’s no question that Jérémie looms large as a possible location for the Hand in Hand for Haiti school. We’ve been challenged, even provoked but we are parting as close friends.

For the first time on the trip we’re set for more than five hours sleep. My bed, under a mushroom cloud-like mosquito net, feels sweet. But having got up in the night, I’m not as swift as I should be in re-fastening the net and at around 4 in the morning I wake to the unmistakable, high-pitched dive bombing siren of a mosquito, a miniature kamikaze pilot, whose sole target is any exposed skin it can find. I slap myself in Deet and put my head under the pillow so I don’t hear the aerial attacks.

In the morning we’re set up for the day with a hearty breakfast comprising steaming hot bowls of ‘Giromou’ – a delicious squash-based soup. Some of our new friends from yesterday have come to farewell us, including 89 year-old football coach Maurice (pictured left) who shows us a series of moves that he can still do with the ball.

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A step over, a feint, they’re all still in the repertoire – I would have loved to see him 29 years ago when (in the words of veteran singer Leonard Cohen), “I was 60 years old – just a crazy kid with a dream”. Maybe it’s the football, maybe the diet of Giromou, but Maurice has still got more twinkle in his feet and his eyes than most people of 50. I vow when I return to get out on a football pitch with him and some of the kids.

Jérémie on a Sunday morning is a gorgeous place. Young children in immaculately pressed shirts and dresses make their way to church with their parents. Religion is an all-encompassing way of life here. According to most statistics, 85% of Haitians are Christians, dominated by Catholicism (often mixed with the Afro-diasporic religion of Vodou).

We take the short ten-minute drive down the red dirt road to the airport. We pass a number of teenage girls carrying baskets of bananas on their heads for sale in the town. With the lush greenness and coastal beauty around us, it seems like a semi-rural idyll. Of course it’s not – there is much poverty here and widespread malnutrition (many children lack sufficient calories to survive in rural Haiti with 15% dying before their fifth birthday) and the health services are chronically lacking.

The average income is just US$90-$300 per year, according to official statistics. But the quality of life (and certainly of air) is a million times better than the slums of Port-au-Prince. If only you could attract investment and therefore jobs to this beautiful region…

Back at Jérémie Airport, women are selling bananas, plantain and other local fruit from small adjacent tables by the tiny terminal building. It looks like they’re all together but when I walk over I realise there’s three competing businesses. I guess in industry speak these are landside retail concessions and they’re about to hit their peak trading period as the 16-seater daily flight to Port-au-Prince departs.

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I offer one woman a US Dollar and she puts enough bananas in a bag to last me for the next fortnight. I say I’ll take just the one. But then the next woman urges me to buy hers (“sweet… much sweeter”, she says) so I buy one of her tiny, and indeed sweeter, fruit. And of course I buy again from the third.

On the road outside the airport a group of young children are making their way to Sunday school. One, aged around seven, is even carrying a plastic chair. They’re walking from a poor rural hamlet but I’m struck again by how beautifully they are dressed and the pride their parents obviously take in their appearance.

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Back at the terminal building we meet the latest in a string of amazing women that we’ve encountered this week. Bette Gebrian Magloire (below with Ed Brennan) is a no-nonsense, fast-talking and street-savvy American woman. She’s Public Health Director of The Haitian Health Foundation, described as ‘A Charitable Outreach to Neighbors in Need’ (www.haitianhealthfoundation.org).

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The Haitian Health Foundation aims to create a stable and loving preventive and curative health and development programme in what it says is the poorest area of the poorest country in the Western Hemisphere. In addition to Jérémie, it provides support to over 100 rural mountain villages.

I quote from its website: “Our mission is to improve the health and well-being of the poor, the sick, and the infirm of Jérémie and to break the bonds of poverty, which tie so many Haitians to a life of great deprivation.”

Bette’s organization places a particular emphasis on women’s health. The maternal mortality rate (death of a woman during or shortly after a pregnancy) is appallingly high in this isolated region. It’s a shocking, shocking statistic that over 90% of maternal deaths occur in developing countries and Haiti is among the worst affected. Many of these women will die agonizing and totally needless deaths.

The Haitian Health Foundation’s Maternal Waiting Home aims to change that by providing residential care for women in high-risk pregnancies. Village women previously had to walk for hours to receive treatment, travel in a ‘rickshaw’ ambulance, or on the back of a motorcycle, often losing both their new born children and their lives. All this an hour or so away from Miami.

The Foundation’s health care programmes also include an outpatient clinic (with eye care), a public health outreach to over 100 mountain villages, and the residential Center of Hope for malnourished children and at-risk pregnant women.

Bette encourages our Hand in Hand for Haiti project and says it’s just what’s needed. We find much common ground in this chance meeting. “We should have started with education, whereas we started with health,” she says. “But of course we cannot educate unless there are jobs.” Vocational training and business investment are crucial to this region, she says.

And there you have it – Haiti’s perennial cycle that links poverty and unemployment, sub-standard and insufficient education and medical care, lack of investment and shortage of jobs. It’s a vicious, multi-pronged trap.

There’s another link between Bette and us. The Haitian Health Foundation was begun in the 1980s by Dr. Jeremiah J. Lowney, a Connecticut orthodontist, who travelled to Haiti to provide free dental care to the poor. Dr Lowney worked for three years with Mother Teresa and the Missionaries of Charity before, at her request, moving his outreach to the rural outpost of Jérémie.

Earlier this week, by complete chance, we met Mother Teresa’s successor Sister Mary Prema, when we offered her and her colleagues a ride on our plane. Sister Mary Prema told us that a sign from God would tell us when we had found the right location for our school. Is our chance meeting with Bette that sign?

The Haitian Health Foundation has also started down the education road. In 2001 it constructed the St. Pierre School in downtown Jérémie, attended by 400 of the poorest children. Importantly (and fundamental to our own project), St Pierre also provides a free lunch to the students, often their only meal of the day.

Bette’s example, sense of purpose and good humour lifts us and we fly back to Port-au-Prince in great heart.

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There, we experience perhaps the most moving moments of an emotion-filled week. After landing at the airport we’re taken just a few hundred metres away to a makeshift hospital at the airport, created by the Americans in the immediate aftermath of the 12 January earthquake. It’s a poignant, humbling but ultimately uplifting place.

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The hospital is being driven by Project Medishare for Haiti, a 501(C) (3) non-profit organization (as Hand in Hand for Haiti will be) registered in Florida and founded in 1994 by Doctors Barth Green and Arthur Fournier from the University of Miami School of Medicine.

Project Medishare for Haiti is dedicated to sharing its human and technical resources with its Haitian partners to achieve quality healthcare and development services for all. That mission is accomplished through community health and integrated community development programmes.

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Dr Green is a legend in Haiti and within the wider medical community. His plane lands just after ours at Port-au-Prince and there’s a clamour of activity around him.

Project Medishare has been on the ground here since 13 January, just a day after the quake. We’ve been granted a meeting with Dr Green later but first we are given a tour of the hospital, including both the main adult ward and the children’s unit, both housed in giant tents.

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This is, effectively, a war zone hospital, set up within hours of catastrophe, and coping amid the most difficult circumstances and lack of infrastructure. But much has happened since 12 January and there is evidence of a fantastically efficient and motivated medical and support team here.

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Inside the children’s unit, drawings done by children in Miami schools hang from the top of the tent, adding colour and humanity to the place. Our guide, a neurosurgeon called Catherine Murphy, points out to me a little boy, no older than three. “This little fellow was found in the trash,” she says.

It may be a war unit, but it’s also a place of hope, a place of wonder. Olivier speaks to a young mother – surely no older than 14 or 15 – who sits proudly alongside her new-born baby. I’m the only one who notices as Olivier discreetly slips the young mum some much-needed money. Everywhere there are donated soft toys, drawings and paintings to try to give the children and their parents some sense of normality and humanity.

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We’re ushered into an administrative tent where we meet the wonderful Dr Barth Green (below with Olivier Bottrie). He’s viewed like a saint around here but he’s actually a straight-talking, compassionate medical professional who just gets on with business. He knows we’re here to talk to his Medishare colleagues about a potential educational alliance and he gives generously of his time.

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“The tremendous carnage is a tremendous opportunity to build a different new Haiti,” he begins “What you’re standing in now is one of the largest active hospitals in Haiti. It’s a field hospital that came out of the dust the first day after the earthquake.

“The terrible tragedy of this means we are all committed to leaving something different – as they say in the north, ‘snow that sticks to the ground’. We plan to leave something with infrastructure, that is sustainable and something that will change the [medical] opportunity for everybody here.”

Step one has already been taken with the creation of a CPR [Cardiopulmonary resuscitation] unit. The week after our visit, either here or on a new site, Project Medishare will establish the “first real critical care hospital in Haiti – a temporary facility – and rehabilitation hospital,” Dr Green says. “These hospitals will be large and sophisticated but they will be temporary [though given subsequently to the Haitian government and people as permanent facilities].

“We’re flying in sterile operating rooms which are very scarce in Haiti – if there are any at all. We have ICU [intensive care unit] beds which are going to be notched up a step. These are currently the only ICU beds in Haiti, for newborns, children and adults.

“We’re also going to open up a very large rehabilitation centre, where we’re going to be putting on thousands of artificial legs and rehabilitating paralysis victims, spinal cord and head injuries – people with severe catastrophic injuries.”

Project Medishare places an acute emphasis on teaching local doctors, leaving a legacy of expertise that will serve the country for many years to come. It’s the ‘teach a man to fish’ principle favoured by another great US organisation, cleft charity (also active in Haiti for many years) The Smile Train. “We will teach the teachers,” says Dr Green. [To listen to his full address, click here on The Moodie Podcast].

“We already have ordered 500 artificial legs and the first ones will be coming in quickly but we need thousands – maybe between 10,000 and 12,000. We’ve got hundreds of medical experts from all over the world who are queued up just waiting to work here with us.”

Then Dr Green makes a critical point that should be ingrained in the minds of every NGO, every UN or military official, and every well-meaning new organisation such as ours.

“We’re not trying to invade. We want to train and turn over everything that we have. So that every day that we do an operation we’ll have a Haitian doctor being taught the operation. And they’ll be teaching us about the special issues that they face in medicine, the cultural sensitivities. So it’s a mutually win-win-win situation.

“So these hospitals will [ultimately] be run by Haitian doctors, nurses, administrators and therapists. We need to train up this critical mass of people to provide this care. It’s going to be sustainable because the whole thing is going to be run by a public private partnership [PPP] – a Foundation that’s already been established called United for Haiti.”

This will be run as a Public Health Trust, making it independent from the government.

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How will it all be paid for? Simple, says Dr Green. “It will be run as a business. And the way we are going to sustain it is to ask people who work in Haiti to pay a small amount – maybe US$25 every year – for catastrophic insurance. There’s 650,000 people who come off cruise-ships [in the northern resort area of Labadie –Ed] … maybe they’ll each donate US$10. But while they’re here they’ll be in a safety net. If they have a heart attack or a stroke, a trauma, a burn or a maternal emergency, they’ll be in world-class facilities.”

Dr Green’s phone rings. He has to go. There are patients, far too many patients, to take care of. Soon afterwards we meet his delightful daughter Jenna (pictured below with Harvey Gedeon to the left and Michel Apollon), adorned in medical uniform and also working here. Compassion runs through the blood of this remarkable family.

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Outside there are adults and children in wheelchairs, many kids on crutches. I start up an impromptu football kick-around with a boy of about seven with an injured foot. He’s got great skills.

But it’s time to go. I wish my new-found friend luck. He will need it. Meanwhile we’re bound for Haiti’s vast Central Plateaux. Another long drive awaits.

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