In this issue: - From the desk of Christine Hamann
PIH staff based in Boston don't always get to see their colleagues working in the communities PIH serves. Boston-based Christine Hamann shares her experience.
- Add your voice!
Add your name to a statement calling for comprehensive health care for all!
- Love walks in
With the bones of her shin protruding at a 90 degree angle, many thought a young Haitian girl would never walk again, let alone attend school. Read her inspiring story.
- Fixing Haiti's environmental woes
PIH's partner organization in Haiti combats hundreds of years of environmental degradation with several new projects. - Dateline PIH: Project updates from all over
Celebrating community health workers in Peru; fighting gender-based violence in Haiti; and bringing HIV/AIDS testing and education to rural communities in Malawi.
- Plus:not just another death, relief for Haiti, lifting the HIV travel ban, a success story in the fight against HIV, OpenForum blog, and Twittering.
Above photo: Agriculture project in Haiti.
From the desk of Christine Hamann
Dear Friends,
I began working at Partners In Health in the spring of 2007, just after Zanmi Lasante (PIH's partner organization in Haiti) broke ground for the new hospital in Lacolline. Since then, I had heard all about its construction, its opening in early 2008, and the number of patients now treated daily. But it wasn’t until last week that I actually visited the gleaming hospital. And while I have met a number of our wonderful Zanmi Lasante colleagues here in Boston, I had never directly witnessed the level of pride the ZL staff has in our work.
The tone was set by Dr. Milien Christophe, the Clinical Director at Lacolline, who led us on a tour. When asked why he works for ZL/PIH—as a talented clinician, he could earn a higher salary at a private clinic in Port-au-Prince or in the U.S.—his response was quick and very certain.
Dr. Milien grew up in an area as poor as Lacolline, and upon finishing his social service year with ZL/PIH, he realized he could provide his patients with first-rate health care and help lift communities like his own out of poverty. With the host of medical and social services now available at the Lacolline hospital, Dr. Milien has been able to do just that. The staff I met the following day similarly conveyed the dedicated—and infectious—enthusiasm for ZL’s numerous programs, ranging from medical projects to agricultural initiatives, and the pride they take in being able to use their training and expertise to help their communities.
Our last full day in Haiti took us to Petit Riviere and St. Marc, cities in the Artibonite Department. The difference in a community like Cange—where people have had access to health care, clean water, education, food, and jobs for the past twenty years—compared to a community where these services have just started is evident at first sight. We visited two small communities outside of Petit Riviere, communities decimated by the hurricanes in September 2008.
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House destroyed by hurricane floods
in 2008.
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During these storms, waters rose in the middle of the night to submerge entire communities, and while the floods have subsided for now, the families who were already living on the edge now face unimaginable conditions. The hurricanes struck before harvest, robbing farmers of both their crops and their seeds, and leaving them in immeasurable debt. A mother in her late thirties grabbed me by the arm and told Dr. Patrick Ulysee, the clinical director of Petit Riviere, she wanted to make a point to the PIH Boston team—she was so very grateful for the food ZL brought during the hurricanes, the homes ZL built for the families that the community decided needed the most help, and the medical care available in Petit Riviere. "But,” she said, “while that is good, I need you to understand that we are starving. We need so much more." Surrounded by at least 20 children under the age of nine, all who need more food, education, and opportunities to thrive, I felt overwhelmed. I had witnessed just how much work we have left to do.
Driving back into Petit Riviere, Dr. Patrick decided to take a quick detour. We drove past Le Palais Aux 365 Portes (the Palace of the 365 Doors, built by King Henry Christophe in celebration of Haitian independence) and got out of the car at Fort Crète-à-Pierrot (the fort where Jean-Jacques Dessalines led the battle against the French that ultimately decided Haiti’s independence)—two historical monuments symbolizing Haiti’s important past. Dr. Patrick proudly emphasized the need for people to understand the inspiring history of Haiti as the only nation that won independence by a successful slave rebellion. Standing on the wall of the fort where Haiti ensured its independence with a team of extremely talented Haitian colleagues who are incredibly proud of their history, and even more proud to ensure the dignity of the poor in the struggle for human rights and health care, I no longer felt overwhelmed. While ZL/PIH has an incredible amount of work before us, I feel nothing but confidence in our incredible colleagues in Haiti who are so dedicated to serving the poor, and I am energized to do nothing but help them reach our goals.
-Christine Hamann,
PIH Development Assistant, Boston
Add your voice to a movement calling for comprehensive health care for all!
Add your name to a declaration calling for comprehensive health care for all! This statement was drafted following a recent meeting that brought a group of NGOs from around the world together in Stony Point, New York. The meeting was hosted by Partners In Health’s Institute for Health and Social Justice as part of the John M. Lloyd AIDS Project and sponsored by the John M. Lloyd Foundation.
The main purpose of the meeting was to start a discussion and movement leveraging learned successes and failures in global health and to unify voices around the call to provide comprehensive health care for all. While the world’s funders cry poor in the face of the economic crisis, we recognize the need to speak with one voice when it comes to addressing the root causes of poor health around the world.
To join this movement, please review and add your name and/or organization to the statement: http://act.pih.org/page/s/declaration. Please also share it widely with your networks by using the form on the website.
Already, we've received support from 347 people and 86 organizations in 47 countries around the world from all fields in international health. Please consider adding your support as soon as possible.
Thank you and please direct any questions to Donna Barry, Advocacy and Policy Director, at: dbarry@pih.org.
Love walks in
Eleven-year-old Loveline (“Love”) has never attended school. About six years ago, she fell while crossing the rough terrain near her home in rural Haiti. Having been born with congenital pseudarthrosis of tibia, a disease characterized by abnormal bone formation, the fall was very serious. She broke both of the bones in her lower leg. With such a terrible fracture, her family scrambled to collect money for her treatment and set out for the Dominican Republic to have her leg treated. Unfortunately, on the long journey back home, the rough terrain again played a tragic role—her cast broke. Without a functional cast, the bones eventually healed, but at a painful angle, preventing Love from walking. Or going to school.
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Love's fractured bones healed at a painful angle
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And this is how Love remained until November of 2007, when her family saved the money to travel to the hospital in Cange, operated by PIH’s partner organization in Haiti, Zanmi Lasante (ZL). The doctor took one look at her leg and her x-rays, and knew that the expertise required to fix these long-standing fractures did not yet exist in Haiti.
So he and the ZL team turned to Dr. John Birch of the Texas Scottish Rite Hospital for Children in Dallas. Dr. Birch’s team had the medical experience to do the complex orthopedic surgery and rehabilitation that Love would need, and their hospital made the services available to Love for free. A team of PIH supporters and their families in Dallas pooled their time and resources, and opened their homes to Loveline, her mother and a Haitian nurse who traveled along to translate and assist in home care. Although Love's mother was scared at the thought of traveling outside of her hometown for the first time, she said, "I know that Love can't stay in the house forever, and if she would be able to walk she would have all the chances and opportunities in the world."
The surgery took place in September of 2008. Love went from a wheelchair and a cast to a walker and brace, and finally to a small plastic ankle brace. Early in 2009 Love was able to go back to Haiti to a wide-eyed and amazed reception—the little girl who had been immobile and confined to her home was now able to walk alongside friends!
Now with the support of Love's new-found friends in Dallas and the support of ZL, she is finally enrolled to start her first year of school in Haiti this fall. Dr. Birch’s team in Texas and ZL doctors in Haiti will continue to monitor her healing leg.
Fixing Haiti's environmental woes
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Burning wood to create charcoal contributes to the deforestation problem in Haiti.
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Senator Dick Durbin, D-Ill., hasan ambitious plan, outlined in his recently introduced Haiti Reforestation Act of 2009 (Bill S.1183): to end deforestation of Haiti within 5 years and replace, within 30 years, the “extent of tropical forest cover in existence in Haiti in 1990.” This is no small task. Haiti, a country covered in rich rainforest 500 years ago, before the Spanish and French looted the land for valuable wood and cleared forests for plantations, is almost completely without tree cover. The country is 98 percent deforested. The ramifications—soil erosion, unarable land, and an energy crisis—are especially devastating in this hurricane-prone country, where more than 80 percent of people live under the poverty line. But in the past several months Partners In Health, and its partner organization in Haiti, Zanmi Lasante (ZL), has been teaming up with other organizations to help combat Haiti’s environmental degradation on multiple fronts.
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Charcoal press developed by MIT students
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The most common household cooking fuel in Haiti is charbon—charcoal made by cutting down trees and carbonizing their wood. In efforts to provide an alternate energy source, ZL worked with a group of MIT students and professors to develop charcoal presses that can compact carbonized organic waste, including bagasse (the waste product that remains after sugar is extracted from the cane) and corn cobs, into charcoal briquettes. The group worked with the Zanmi Agrikol team in Corporant to make and distribute about fifty presses, and to teach families how to make the charcoal from organic farm waste. The briquettes serve a dual purpose—they stop the cutting down of trees for wood charcoal, and they generate income for families who make and sell the briquettes.
Also on the energy front, ZL, working with SELF, the Solar Electric Light Fund, is installing solar panels in two clinics that currently use fuel-powered generators. When the price of fuel spikes, or when hurricane devastation makes the transport of fuel difficult, the clinics suffer. The panels will either wholly or partially offset energy used by the generator; ZL’s plan is for both clinics to eventually run completely on solar energy.
Deforestation’s most serious effects, especially for sustenance farmers and others living in poverty, include soil erosion and land degradation. ZL is using everything from dry latrines to fruit tree saplings to help stem the tide.
Much of the nutrient-rich top soil in Haiti has been flushed into the ocean during floods (a direct result of bare mountains that cannot hold on to the soil), and in some places, the earth has been eroded down to bedrock. Zanmi Lasante, partnering with SOIL (Sustainable Organic Integrated Livelihoods), a nonprofit committed to preserving soil resources, is fighting the problem with, at first glance, an unlikely resource: human waste.
ZL has constructed 75 dry latrines, also known as composting toilets, in the past year in Cange and Boucan Carre. The latrines, enclosed concrete structures shared by multiple families, have a fiberglass molded plate designed to facilitate the separation of liquids from solids. The urine, collected in a large plastic bucket, can be used to water crops when mixed with the correct amount of rain or river water. The solid waste has a more complicated future.
Two chambers collect the waste. For six months, one side of the latrine is used; the other is covered by a concrete slab. Six months later, ash and sand are added to the chamber filled with solid waste, the chamber is covered with a concrete slab, and the other chamber is used. After six more months, the solid waste mixed with ash and sand can be used to fertilize crops. Then the cycle starts anew.
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Mango saplings grown by ZL's agricultural partner organization, Zanmi Agrikol.
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Finally, to fight deforestation directly with reforestation, ZL distributed more than 20,000 soil conservation and fruit tree saplings in the last year. In 2007, ZL began educating communities about deforestation and distributed tens of thousands of conservation and fruit tree saplings. The fruit tree saplings prove especially useful since the fruit can be sold or consumed.
While reversing hundreds of years of environmental problems cannot be quickly remedied, ZL’s projects, and others, are helping to prevent further destruction, as well as supply jobs and food to the communities served by ZL. The medical clinics at ZL know that environmental degradation contributes to the cycle of poverty and disease; these projects help to weaken those links.
Dateline PIH: Project updates from all over
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Community health worker in Peru
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Peru: On June 4, Socios En Salud observed Peru’s Community Health Worker Day, established in 1999. Many of the CHWs, some of whom are former patients or family members of former patients, have been with the organization for over a decade and been an integral part of SES’ growth. The CHWs play many roles: accompaniment of patients with MDR-TB, HIV, and other illnesses; making childhood nutrition visits; running small health centers in isolated communities; educating patients about their health and their rights; and providing psychosocial and socioeconomic support. And they all provide an essential link between the community and health networks, battling stigma and fears as they advocate for their patients. As one CHW from SES puts it, “One must discover what is behind the illness, listen to the people, and know their problems.”
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Hills surround the rural village of Binje, where APZU recently ran a clinic for HIV testing and educational outreach. Over 97 villagers attended in this community alone.
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Malawi: PIH’s partner organization in Malawi recently launched a new initiative to encourage HIV education and testing in remote villages scattered around the rural southwestern Neno district. “The campaign is part of an effort to encourage those who are very far from the hospitals to be tested,” said Annemarie Ackerman, the program manager for APZU, PIH’s sister organization. So far, over 300 people have been tested at three different villages. About 30 remote communities have been targeted by the initiative. All present geographic challenges to accessing health centers and care.
Haiti: In May, Zanmi Lasante released a declaration against gender-based violence, along with other partner organizations in Haiti. “We know that violence against women comes in many forms, not only in physical abuse, but also in the way we speak, the words we use, and other actions we take, which degrade her and strip her of her dignity,” states the declaration, which goes on to define gender-based violence, as well as ways to prevent and reduce such acts of violence. Read the full declaration.
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