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When living in Haiti, one quickly realizes that things never happen as expected.  That’s why flexibility is an important personality trait for long-term personnel and visitors alike!  And, it’s why Haitians have adopted a fatalistic world view, feeling that no matter what they may want in life, things happen as God wills and they have no control over it.

We had a taste of the unexpected last Tuesday, as we drove down the mountain after a very busy clinic day.  It was about 5:30pm when we passed through a town called Latiboliere, halfway down the road to Jeremie.  There is a nurse auxiliare who works in a clinic there, who we know well.  As we passed by her house, we saw her head appear over the cement wall, arms waving wildly above her.  We stopped to see what the problem was and she came running out to the truck.  “A man just came to my house on horseback with a huge cut on his leg.  It’s bleeding heavily and I think it’s a case for the hospital,” she said quickly.  I pulled the truck over to the side of the road and Cherlie and I ran over to her house, noting the blood caked on the side of the horse the patient had ridden on to Roseline’s house.  The young man was sitting on a chair with his leg propped up on the porch, a gauze pad soaked with blood covering a large, deep laceration on his lower leg.  But, as I examined the wound, I realized it was not all that bad, similar, in fact, to countless lacerations I had repaired as an ER physician in Milwaukee.  “If you want, I can sew it up here,” I told him and his friend.  “Oh, that would be wonderful,” they said.  “It will save us a trip down to Jeremie.”

Cherlie and I carry a small suitcase containing some of our supplies back and forth to our clinic and included was a “laceration kit” I had made up for just such situations.  It contained everything we needed to suture a laceration, including local anesthetic.  So, I quickly went to work and within a short time, the wound was closed, bleeding controlled and a bandage was applied.  It turned out the patient lived not far from our clinic.  So, we told him to come see us in two days so we could check his progress. And, come back he did, with his laceration looking good and beginning to heal.  We had, obviously, been in the right place at the right time to help this young man and a panic-stricken nurse auxiliare.  A good example of God’s perfect timing and the satisfaction of being prepared for the unexpected!

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Things have been pretty quiet here in Jeremie for the past week.  There have been no further political demonstrations, although people are still unhappy about their dismal economic state and the high price of food.

The big news last week was that we had torrential rain for several days.  On Thursday morning, the 17th, we were packing the car with our medications and supplies when we got a call from a patient who lives near the clinic.  She’s one of the few people up there with a cell phone and she has to go to the top of one of the hills to get reception.  But, she was good enough to call us and let us know that the rain was falling heavily up there and no one was expected to come to the clinic.  Besides which, the roads were very slippery and dangerous and she advised that we not try to make the trip.  This is a frequent occurrence for us during rainy season, where the rains make the rough roads impassable and the muddy footpaths that the patients walk on to get to us become slippery and dangerous.  So, once again we had to cancel clinic and patients who would have come to see us had to either wait or go elsewhere.  How happy they will be when we live up there fulltime and our presence won’t be dependent on the weather or road conditions!

Today, Thursday, we were able to successfully make it up to our clinic in Gatineau without running into any problems or disturbances.  There were about 6-8 places along the road coming out of town where there was black dust on the road and burned steel wires from tires which had been burned there earlier in the week.  These were obviously areas where roadblocks had been created with burning tires and debris, keeping traffic from passing to and from town.  Roadblocks are a common form of demonstration here during periods of political unrest, and something that we’ve seen often over the years.  We’re hoping we won’t see more in the future!

It appears, from reports we’ve gotten from Port-au-Prince, that the demonstrations and violence there has abated as well.  All of this has been due to the rising price of goods and increasing hunger and poverty in the country.  There have been a number of news reports lately about Haitians making and eating mud pies, due to lack of food.  While that hasn’t been typical in our area of the country, there has definitely been a worsening of the economic situation in the country as a whole and an increase in the level of hunger and poverty in the communities around our clinic site.  Every day we hear stories about the scarcity of food, due to poor crops and high prices for seeds, and we often truly wonder how these country people are able to live each day.

With poor nutrition comes worsened health, making people more vulnerable to infections and illness.  We’re seeing increasing numbers of patients in our clinic with high fevers, pneumonia, malaria and typhoid fever and several patients with suspected tuberculosis.  We give vitamins and worm medicine to nearly everyone, to help improve their resistance to infection and fight their illnesses.  We’ve received donations of infant formula and milk, which we give out to our pediatric patients’ mothers.  But, our greatest need at this time is to receive enough funds to be able to begin construction of our clinic facility and living quarters, so that we can live in Gatineau fulltime, provide medical services on a daily basis and begin to help improve the economic status of our neighbors.  We appreciate your continued prayers and would be grateful for any financial support you are able to give us during this difficult time in Haiti.

Hello all,

Just wanted to write a quick note to let you all know that there has been some political unrest here in Haiti this week.  Protests against inflation, the high cost of goods and lack of food were scheduled for yesterday, Monday, all over the country.  Unfortunately, in many areas, the protests became violent and began even over the weekend.  The town of Aux Cayes (which is the area I used to work in) was particularly affected, with several injuries and some reported deaths.  Roadblocks were set up and traffic was unable to pass through town to come out here to Jeremie.

Yesterday there were several protests in Jeremie and all the businesses were closed.  There was some violence reported and several roadblocks were set up with burning tires and burning cars.  We didn’t leave home because we knew there would be demonstrations.  But, this morning, we packed up our supplies and meds as usual and went on into town, expecting to go up to Gatineau to hold clinic.  When we got to town we were told that there were large roadblocks set up on the road we have to take to get out of town and people were throwing rocks and bottles at motorcycles and vehicles.  Several buses tried to get through and had to turn back.  The police and many of our friends recommended that we not try to venture out.  There were a number of random attacks going on in town and down at the wharf yesterday and today.  So, we had to cancel clinic, which we felt very bad about, since there were many patients waiting for us.

We’ve been told that the demonstrations may last all week, and most of the schools are closed at least until Friday.  So, we’re not sure if we’ll get through to go to clinic on Thursday.  In any case, we will try not to take unnecessary chances, since anti-American feelings run high during times of unrest here.

I will try to keep you informed of any other developments.  Appreciate your prayers.

Blessings,

Katie

Medical personnel sometimes wonder what is the difference between medicine and public health? Or, as I like to phrase the question, what is the difference between the medical model of care and the public health model?

  • Physicians are trained according to the medical model, which basically involves looking at an ill patient and deciding how best  to treat their illness, no matter how many resources are required.
  • The public health model looks at populations of ill people, trying to figure out what could have prevented the illness in the first place and improve the health not only of that individual, but of the whole population of which he or she is a part. Another important aspect of the public health model has to do with using limited resources in a way that will help the most numbers of people (this involves cost effectiveness and efficiency) and be equitable to all.

In our work in Haiti, we are operating with both models. We place priority on the public health model, as we care for individual ill patients. We try to prevent similar illnesses in the future, make sure that all people have access to basic medical treatment, and use our resources in the most effective and efficient manner. Our goal is to improve health in entire communities, establishing a model of care that can be replicated elsewhere. Meeting this goal begins with improving access to primary care of illnesses, so that minor illnesses can be treated promptly, thus preventing more serious complications from developing. There are many things that prevent people from getting the medical help they need in Haiti. These include distance (usually people have to travel on foot and the country is very mountainous), expense, fear of doctors and hospitals, and personal beliefs about health and disease. Many times, even when a patient is able to get to a local clinic or dispensary, they don’t find the medications they need, or the staff is not trained adequately totreat their illness. That’s why we place special emphasis on having an adequate supply of essential medications and in providing the highest quality care possible. In future newsletters we will discuss further plans we have for meeting the health care needs of the communities we serve.

Last month I reported on the very dry conditions in the area around Jeremie, where we live.  Crops were being lost due to lack of rain in the past few months.  Well, it seems the Lord heard your prayers, because it began raining last week and has rained almost every day since!  That’s good for the farmers, but makes it difficult for us to get up the mountain to our clinic.  In fact, last week it rained so hard in the mountains, we had to cancel both clinic sessions.  We’re praying for the day when we’ll have a new clinic building and living facilities in Gatineau itself, enabling us to see patients every day and not have to drive back and forth.

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