Archive for November, 2008


Photo by François Rollin

By Jennifer Browning

Doctors and medical students from Emory University School of Medicine are spending their Thanksgiving break in Haiti’s Central Plateau. The group has been traveling around the plateau this week assisting Project Medishare’s mobile clinic team and working with the school health program providing vaccinations for children in the area. Click here to check out images from Emory Medishare’s trip this week.

Check out photos from other medical trips on Project Medishare’s Flickr site here.

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By Dr. Joyee Goswami

We are on day three of our five day trip to Haiti, and it’s been a crazy mix of emotions. As a pediatric hospitalist with an interest in global health and have been on a few global health trips in the past so I thought I’d be prepared for the amazing chaos that is Haiti. I have to say I grossly overestimated myself.

Before, when I traveled to countries doing global health work, I was very idealistic about how our work was changing the world. These days I find myself having more questions than answers. Am I disturbing the local infrastructure that already works for this society? How can I truly make a difference?

Ethical dilemmas plague my mind. If only I had this newer, better drug. If only I could run this lab test. If only, if only… This then leads me to wonder if am I truly wanting a more scientifically sound technique or instead if I am needing objective data for a personal sense comfort on patients with whom I have no follow-up.

I suppose all global health workers battle with their inner selves at some point or another and so it’s my turn. I only hope that I do more good than harm, that I can augment existing programs without disrupting the local culture and society, that I am able to make a difference.

Perhaps it is because my role has now changed from medical student or resident to attending that I feel a greater – the ultimate – responsibility to provide the best healthcare possible to my patients.

Haiti has already changed me. My perspective on global healthcare is clearer; understanding my role is unfolding. Gandhi said, “Be the change you want to see in the world,” and that is what I intend to do.

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By Jessica Cohen

I’m back in Thomonde for the second time. It’s familiar and cozy—I know the town, one of our drivers remembered my name, and the taste of beans, rice, and chicken at the end of the day is as delicious as I remember it. That said, the familiarity of the situation does not, in any way, assuage the overwhelming feelings that come over me and the intensity of the time that we spend in Haiti. I thought I would be more efficient and more helpful this year because I have another year of medical education under my belt and I’ve been here before. That was not the case.

I spent the day in the Pediatric clinic. In the morning I helped one of our doctors examine patients and listen to their chief complaints. In the afternoon, I worked on our anthropometry measurements and on our survey. The two small rooms were constantly full of children—babies crawling on the floor, five year olds holding their baby siblings, toddlers waddling in and out, moms breastfeeding and all ages crying out of fear of our stethoscopes and strange measuring tools. Most of the moms complained of fevers, colds, rashes, loss of appetite, and diarrhea. I took the history of one 17 month old girl. She was beautiful and smiley and seemed quite healthy. Her mom started describing fevers that came at night. The fevers were accompanied by sweats and the baby wasn’t sleeping very well. Immediately my mind jumped to Malaria. Malaria it could be, but it could also be a number of other things. No one else in the house or neighbourhood was sick, the baby appeared healthier than many we saw, and she was one of the few we saw who wasn’t anemic.

The doctor and I pondered what to do. We couldn’t order a smear or a test of any kind so confirmation was out. Should we treat under the assumption that it is Malaria? Should we send the mom to a hospital hours away to get a confirmation? Or should we giver her paracetamol for the fever and our standard de-worming? What ever option we were going to choose it was going to have to be a guess. As we were guessing we had to weigh what would be best for the child, most convenient and plausible for the mother, and the best choice from a public health point of view. The bottom line is that we didn’t know the right answer.

There is always uncertainty in medicine. Even in the US where we have tests and imaging and cohort studies to help us decide what to do, sometimes we just have to make a best guess. In Haiti the sense of uncertainty is exponentially higher. We have fewer choices on every front: fewer medicines, fewer tests, fewer doctors, and fewer opportunities to get to know our patients. Not knowing can be uncomfortable. Today I realized that even our doctors, who have been practicing medicine for years, feel inefficient and overwhelmed.

We saw over one hundred children today. We saw some very sick kids and some pretty healthy kids. Most of the time we had a pretty good idea of what to do for them, but sometimes we didn’t know. As we drove away from the clinic site the sun was setting  and rain clouds were threatening us with their ominous greys and a yellow-tinged sky. We had been driving for about fifteen minutes when we passed a woman I had seen in clinic walking with her two children on the side of the dusty road. She was walking a few miles home in the dark and the drizzle because coming to see us was worth her time and effort. I realized then that though we may not always know exactly what to do, the patients know that Project Medishare is there for them if they ever need medical care. I don’t mind the uncertainty if I can give the people of Haiti some more certainty and security about their health and well-being.

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By Jamie Sodikoff

After giving out hygiene packs of toothbrushes, toothpaste, and soap to the charming and gracious kids of the Thomonde public school, we packed into the van and headed to Marmont.  Although somewhat acclimated, at this point, to riding on the rough, stone-laden roads of rural Haiti, I couldn’t help but hold my breath as we approached a slippery, muddy patch of road that smelled of trouble (and manure).  Franc, our skilled driver, jammed on the gas, hoping the momentum would get us past the ditch.  His skilled maneuvering, however, was to no avail, and we were stuck.  Determined not to be a collective stick in the mud, our group banded together and used our combined strength and wit to push the car out and continue on.

We arrived mid-morning in Marmont and began visiting homes to get an idea of the day-to-day lives of the people we will be seeing in clinic, to talk to families about what obstacles they face (health and otherwise), and to see their living environments.  We met one family who had taken into their home two small boys who were recently orphaned when their mother died during childbirth.  This same family relayed to us that they had lost two of their own children at infancy to asthma. Asthma, such a treatable illness and so heartbreaking to hear that it had cost two young lives.

Many of the homes we visited housed one mattress for the whole family, causing us to wonder how everyone could fit.  The answer was that they didn’t; many slept on the floor.  Each family welcomed us with open arms and generously responded to our many inquiries.  It was a great day and a great learning experience overall to gain a window into the lives of the people who live here.  I’m so grateful to be here and excited to start clinics tomorrow!

Jamie Sodikoff is a medical intern student at Emory University School of Medicine

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Returning to Haiti

By Nickisha Naulie Berlus

Externat St. Joseph was the first school I attended in Aux Cayes, Haiti. I had gotten as far as Preparatoire II, equivalent to the second grade, when my family and I moved to Brooklyn, New York, where we’ve resided for the past 15 years.

Travelling to Thomonde as a translator for Emory Medishare was the first time I had returned to Haiti. So when I saw the Haitian children in their light and dark blue uniforms and the girls with their hair fully adorned by blue ribbons at the Ecole Nationale Mixte de Marmont-I most definitely had a flashback. We must have driven for approximately half an hour before we arrived at the school.

I imagine that some of those kids had to walk for at least an hour to get to school because I remember spotting those same uniforms earlier in the morning walking past Project Medishare’s headquarters. Many of the students seemed very excited at the sight of foreign faces and many of them were kind of caught off guard when I greeted and conversed with them in Kreyol. Why? Did I not blend in? Maybe it was the scrubs…

Almost in every classroom I noticed at least one face not appearing as enthused as the rest no matter how hard I smiled or how friendly I was. Those same faces also tended to be fairly emaciated, with protruding bony cheeks screaming for coverage, and bulging whites of eyes juxtaposed on dark complexions. For a while I wondered, how anyone can care or even manage to focus on reading, writing, and doing math when he/she is hungry and malnourished. I also noticed a group of older women getting the cooking grill, called recho, started behind the school and wondered how that could be serving as a greater incentive for hungry students to attend school daily. Some classes were filled with as many as fifty-five students per teacher. Classes contained a variety of ages.

That day we handed out brown paper goodie bags filled with hygienic products (toothbrush, toothpaste and a bar of soap) one per student- which we had prepared the night before. Teachers received family packs filled with four toothbrushes, a large toothpaste, and four bars of soap. Everyone showed sincere gratitude for our visit bearing gifts. The school principal personally thanked the team with moving words. Students at the pre-school harmoniously repeated “Mesi Medishare” after their teachers and maintained their well-behaved composures just until we walked out after which they immediately tore through their bags to see what it contained.

Maybe, I’m romanticizing this part of the day a little bit too much because there’s a whole reality of socio-economic and political issues as to why Haiti’s situation does not have to be the way it is. But as a medical student interested in international health, and strongly considering returning to Haiti to work, I’m so glad I heard about this trip and acted quickly to accompany Emory Medishare. This trip has re-introduced me to the Haiti I knew and remember. The hospitable, witty, carefree yet hardworking kind of Haiti I don’t ever get to see on the front page of The New York Times or some PBS documentary on violence and political turmoil, or something on the Discovery Channel regarding the exoticism of voodoo in Haiti.  Each day I spend in Thomonde, I see the average Haitian working, laughing or smiling, playing, dancing, singing, planting, living/surviving throughout their daily lives declaring normalcy in the face of extreme poverty and pride despite severe stigma from the international sector.

I see the Haiti I love, filled with hope and potential. What I see here in the high peaks of Thomonde is confirming my desire to return after obtaining my MD and establish that change I want to see. Although I miss not being able to see my family in Les Cayes, I couldn’t think of a better way to make a comeback to Haiti.

Nickisha Naulie Berlus is a medical student at Robert Wood Johnson Medical School

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By Ira Lee
Photo by François Rollin

Thomonde, HAITI – Whew! We finally made it. Our trip together started at 4 a.m. this morning as we gathered at the American Airlines ticketing desk at Atlanta’s Hartsfield-Jackson International Airport. From there, we traveled by air to Port-au-Prince, Haiti via Miami. The view on the final approach to Port-au-Prince was absolutely breathtaking. Although Haiti has seen its ups and downs for much of the last century, there is no denying the intrinsic beauty of the place. From the air, the country almost takes on a storybook appearance with tall and steep ridge lines crisscrossing much of the country. As one nears Port-au-Prince, the mountains abruptly end at a flat flood plain that demarcates the physical border of Haiti’s capital city.

Disembarking from the airplane, we soon met up with Project Medishare’s local staff who quickly whisked us away by 4×4 caravan. By this time it was already 1pm, and we needed to reach the Medishare compound in Thomonde by dark. Although Thomonde is only 60 miles away from Port-au-Prince as the crow flies, Haiti’s road infrastructure has been left to deteriorate through much of its recent turbulent past. The four-hour trip brought us up from sea-level to Haiti’s Plateau Central through a series of windy roads with more back-breaking boulders than true asphalt.

The visuals along the trip to Thomonde ranged from quintessential signs of abject poverty to some of the most beautiful natural vistas I have ever seen. One of the most notable points was our trip around the ring road that runs along Haiti’s Lac Peligre, an artificial lake created by a large dam that provides much of the electricity to Haiti’s urban areas. While the natural beauty of the lake drew everyone’s admiration, it was difficult reconciling the wonder of such a place with the exploitative past
dsc_0040for those affected by the dam’s construction. Many have noted that construction of the dam irrevocably disrupted the lives of thousands of Haitians who lived in the now submerged valley. During our trip to Thomonde, we saw evidence that many of these residents had re-established homes on the banks of the lake only to be told that they would have to move again with the expansion of the lake’s ring road.

Finally, we made it Thomonde! After quickly storing away our gear, we were treated to a wonderful buffet of Haitian-inspired cuisine that was immensely satisfying after such a long day. We also were quickly introduced to members of Project Medishare’s local team and given a rough schedule for the week. The plan we have for the week sounds exhilarating. Because of Emory Medishare’s past experiences, they’ve stretched us a little thinner than usual to have us reach the most people. At some points, we’ll be sending different groups on two or three different activities, ranging from mobile clinic sites to well-child, school-based checkups and health education.

I can’t wait for what’s to come.

Ira Leeds is a Medical Intern Student at Emory University School of Medicine.

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By Jennifer Browning

Vibrant steel drum music played in the background last Friday at the Rebuild Haiti: Mission Possible silent auction event hosted by the Coral Gables Congregational Church. Project Medishare worked in collaboration with the Florida Association of Volunteer Action in the Caribbean and the Americas (FAVACA) and the Lambi Fund of Haiti.

After introductions by Project Medishare founders Dr. Barth Green and Dr. Arthur Fournier, CBS News Miami Anchorman Calvin Hughes shared with the more than 200 attendees his experiences covering Haiti. Hughes recalled his first story about Haiti when a boat full of refugees washed ashore in Miami Beach in 2004. Deeply moved by the event Hughes began writing a proposal requesting to cover a story from the streets of Port-au-Prince about the situation in Haiti. In 2008 his request was granted, and Hughes arrived in Haiti with many surprises. The Miami reporter discovered most of the reports from the tiny Caribbean country were negative, so Hughes began searching to break new ground in how Haiti is portrayed.

Growing up poor in St. Louis with his single mother, he found much in common with the people of Haiti. He saw that despite their economical struggles, the people in Haiti had not given up hope. Hughes intended to do a story on the Haitian prison system but his focus changed when one night he found students in Champs du Mars, a nearby park, studying while huddled outside under street lights. Hughes met and interviewed Joana St. Paul, 15, who told him that she often spent four hours an evening studying by these lights because of the lack of electricity in Haiti. Touched by St. Paul’s story, he soon turned his focus from the prison system to the park and students outside, giving him a way to report the positive sides, showing the resilience and the strength of the Haitian people.

“Be ye transformed by the renewing of your mind,” Hughes told the crowd.

Even after the recent destruction from storms in Haiti, Hughes still sees hope and believes Haiti has a bright future with the new Prime Minister Michele Pierre-Louis.

“Where there is crisis, there is opportunity,” he said, “and with dedication, commitment and money, Haiti can make a turn around.”

Hughes ended his speech with his commitment to show the positive images and stories of Haiti on Miami’s Channel 10 News.

Auction items ranged in a variety of Haitian art and hand made crafts including paintings, metal art, sequined beaded flags. Other items auctioned were services such as chiropractic visits, spa visits, concert tickets, sporting event tickets, a cruise for two on Royal Caribbean, a week retreat in Montana, and a bongo drum signed by Gloria Estefan. Dr.s Fournier and Green attended and gave the introductory speech for Project Medishare.

Dr. Fournier brought copies of his book, “The Zombie Curse” and autographed the books sold. All proceeds went to the fundraiser.

The silent and live auction proceeds are currently being counted. All proceeds will be split between the three hosting organizations.

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By Jennifer Browning

Musical entertainment provided an opportunity to create awareness about Project Medishare and Haitian healthcare Wednesday, November 5 at Smiths Olde Bar in Atlanta. The event was hosted by Emory Medishare, Morehouse University, and Partners In Health. The money raised will help fund Emory Medishare’s medical trip with Project Medishare November 23-29.

The event which offered a combination of a concert and a silent auction raised $2234.

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In a collaborative effort to raise funds to rebuild Haiti after the devastating storms, Coral Gables Congregational Church, the Florida Association of Volunteer Action in the Caribbean and the Americas (FAVACA), the Lambi Fund of Haiti and Project Medishare are teaming together on Friday, November 14 at 6:30 p.m. to host a silent auction to continue efforts to support Haiti’s recovery. The event will be at the Coral Gables Congregational Church.

The evening will begin with moving words from keynote speaker, WPLG mroning news anchor Calvin Hughes. Afterwards guests will enjoy steel drums while participating in the silent auction.

Please call 305-448-7421 to RSVP by November 11.

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