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Archive for June, 2010

By Nayla Khoury*

Rosanna stood in the middle of a circle of benches, outside of Medishare’s compound in Casse; her hands were raised and waving. She was speaking about Jesus and to no one in particular. I asked Wilfred, our newly trained interpreter, to translate for us.

“She is talking about someone who is trying to kill her with a machete,” He told me. “She is praying to Jesus for the sick.”

I asked him to speak in the first person and to try to follow her speech, however rapid and rambling.

“She is not making any sense,” He told me. “She is fou.”

This was my first impression of Rosanna, a small and energetic 74-year-old woman whom we have begun to know over the past two weeks. In our effort to learn about mental illness in rural Haiti, “fou” or “crazy” is a term that we encountered early on.

Some people described fou as someone who does bizarre things, walks around with tattered clothes and talks to him or herself. I had seen quite a few people labeled as “fou,” who even Project Medishare nurses stayed away from, telling me that a “fou” could be dangerous. The western medical student in me wanted to translate this into a term I could understand; “fou” it seemed, referred to someone with severe mental illness, perhaps overt psychosis.

The next week, I accompanied Aimée, a public health student, on a home visit to Rosanna’s house. After the Medishare motorcycle could no longer navigate the rugged terrain, Juno, a local Haitian, led the way to Rosana’s house on foot. The walk to her house was beautiful; from this elevation, we could see the Thomonde River to our left. I saw fields surrounded by mountains to our right. Juno explained that he had worked on these fields in the past and that he knew Rosanna. He described her as a sweet old woman who likes to pray a lot. He denied that she had any mental illness.

After a 30-minute hike in the mountains of “Vingt-Cinc”, we turned right onto a skinny path that crossed a field. I could see Rosanna from afar, her body bouncing up as she walked toward us; she was carrying wooden chairs in her hands. She smiled broadly and kissed Aimée, Ken (our translator) and me on the cheek. Juno enveloped her in a hug, lifting her off the ground and swinging her tiny body. She squealed.

Rosanna introduced us to her son and grandson who lived next door, then took us on a tour of her house. We told her that her place was beautiful. She shook her head, saying, “Not when it rains.” She apologized for not having more to offer us and for the state of her small house.

Her house was certainly small; her bed was within arms’ reach of her kitchen table. Yet it was clearly a home. Outside of her house hung nicely arranged pots of purple plants.  Her belongings were neatly organized:  boxes were stored on wooden planks above her bed, every inch of her space well utilized. She showed us how she lined the walls with decorations, which consisted of many seemingly random magazine pages.

Afterwards, the four of us sat down under the mango tree next to her son’s house. Rosanna talked to us about her life. She explained that her role in the community is to pray for people. She spoke rapidly and with passion; from time to time, Ken was able to put a hand up to pause her in order to translate for us.

Rosanna explained that she first took Jesus into her life when her son was younger and had a sickness. She explained that a Loogau, a person who comes to take babies, caused her son’s sickness. Rosana discovered that she had special powers sent by Jesus that enabled her to detect the Loogau and throw away the bad spirit. She spoke of animals with wings and other stories we could not follow, even with our translator by our side.

Later conversations would reveal that a Loogau is actually commonly understood as a normal person by day that can manifest into any form at night. Our research assistants excitedly explained that one could become a Loogau by going to a Hougan or voodoo priest. It was a way to make money, one research assistant explained, since Hougan’s needed people to be sick to stay in business. Often, however, a person did not even know that he or she was a Loogau because it could be inherited. If one’s grandmother was a Loogau and you were the first to cry after her death, you might become a Loogau. Loogau’s could transform babies into animals that a parent might unknowingly eat.  Our research assistants joked and laughed while sharing these stories, but one explained that he had goosebumps while talking about such a “creepy” subject.

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By Jennifer Browning

In an effort to promote forward giving Chase Community Giving is giving away another $5 million. Project Medishare supporters can vote to help put our organization in the top 200 charities in the running to help us a receive donation from Chase Community Giving.

Join us and Chase Community Giving. Vote and share your decision on your personal Facebook page and then continue to spread the word! Email your friends asking them to vote for Project Medishare on the Chase Community Giving Facebook Page!

Voting ends on July 12! On July 13 Chase Community Giving will announce the winners. First place winning charity will receive $250,000. The four runners-up will receive $100,000, and 195 other top voted charities will receive $20,000.

Here’s how it works:

1.) Log into your Facebook account.

2.) Go to Project Medishare’s Chase Community Giving Page.

3.) You will have to click “like” on the Chase Community Giving Page before you can vote.

4.) VOTE for Project Medishare

5.) Share your vote with friends on your personal Facebook Page encouraging them to cast a vote for Project Medishare.

Want to push the vote further? Message your Facebook friends, asking them to vote for Project Medishare too.

Every day in Port-au-Prince and in the Central Plateau, Project Medishare is working side-by-side with Haitian doctors, nurses, pharmacists and community healthcare workers to empower them to help improve healthcare in Haiti. Voting for Project Medishare through Chase Community Giving on Facebook is a quick, easy, and free way to help Project Medishare receive the much needed funding to continue our important work in Haiti!

There are 17 days left to vote in the Chase Community Giving! Vote today and spread the word!

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By Jennifer Browning

Students from Emory University have been working with Project Medishare staff in Haiti’s Central Plateau this summer trying to understand how mental health is understood in rural Haiti. The students hope that this is the first of many trips to work toward improving psychosocial services in the Central Plateau.

“This summer is the first of hopefully many steps,” Bonnie Fullard said. “Right now we are trying to lay the groundwork for some type of psychosocial support through Project Medishare. We are trying to understand the needs the way mental health is understood and discussed in rural Haiti and the resources that are already in place.”

Fullard who is a second year Masters in Public Health (MPH) student also working toward her doctorate in anthropology is spearheading the focus group discussions on the project while working training the research assistants.

“We are working at mapping these current local resources available, but at the same time we are using resources used in the U.S. and sort of adapting them here,” Fullard said.

Hunter Keys, a first year nursing student at Emory, said one of the major challenges the research group faces is the language. While the group has been taking Creole lessons at the university to prepare them for this project, there is still an issue about how the language translates in regards to mental health.

“I think one of the challenges is getting a sense of the language and an understanding of the language barriers,” Keys said. “We are really trying to get an understanding of the local language and how mental health is expressed here.”

To assist them with this, the research group found four English/French translators who also are serving as research assistants to help them understand the true understanding of mental health in the rural area.

“One of the examples is the concept of emotions, for instance, a word that we use to describe as emotions for example is the French word, sentiment, is feelings,” Keys said, “but we have been told that in Creole sentiment is reserved for amorous relationships, so sitting around in a group talking about sentiment might conjure up the wrong images. “

Keys said that even the Creole word for mental health doesn’t necessarily translate.

“Even the translation for mental health in Creole, santé mentale doesn’t necessarily translate among rural Haitians. Maladie mentale –a mental illness is immediately thought of as being on the extreme end of mental illness and we are trying to take a more global approach to a more encompassing view of mental illness.”

Fullard agreed with Hunter in that in rural Haiti there is not an actual term for mental health.

“In that sense it is something that is not really talked about,” Fullard said. “When it is talked about it is a really stigmatized topic where people here immediately describe it as “fou” or “crazy” so that it is hard to talk about the things we want to get to, which are the more mild to moderate disorders such as depression, anxiety, and post-traumatic stress disorder(PTSD).”
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After vaccinating an infant, a Project Medishare nurse explains to the mother when the child will need further vaccinations. A vaccination chart recording all shots, as well as the child's current height and weight, is handed to each parent. Photo by Jennifer Browning.


By Jennifer Browning

Every first Wednesday of the month Project Medishare employees go to select area schools in Haiti’s Central Plateau to provide medical check-ups for children through the School Health Program.

A Project Medishare nurse organizes medicine for the children being served at Foundation en Chretienne School in the Lahoye area as part of the School Health Program. Photo by Jennifer Browning.

In 2008, Medishare received a grant from Cross International to begin working with primary schools in Thomonde, Marmont and Casse/Lahoye to provide access to age-specific curative and preventive healthcare to over 6,000 students between 5–19 years of age in Thomonde. This program reaches children typically neglected when it comes to access to health care. Additionally, there are certain ailments in children, such as malnutrition and visual problems that can handicap his/her ability to adapt, pay attention, and learn in school. Through the program, a community health nurse and two LPN’s visit these schools on a monthly basis and provide vaccinations, nutritional supplementation, visual screening, deworming, vitamin A and multivitamins, basic medical evaluations and health education. School Health is an important and supplementary aspect to Project Medishare’s Community Health Program. This program has the support of the Haitian Ministries of Health & Education with the goal to replicate it in other schools throughout the country.

In addition to providing medical examinations to the participating school children, it also allows Project Medishare’s staff to set up the vaccination clinic for infants. Here parents in the community bring their babies to check their weight and to get the necessary vaccinations such as polio, diphtheria, and tetanus. An average of 70-80 infants are seen each month during the school year.

Project Medishare nurse Marcel Pascal said the School Health Program helps the staff provide routine medical check-ups so that potential health issues can be combated immediately.

A Project Medishare community health agent measures a child at the Foundation en Chretienne in Cayemite, a village in Lahoye. Photo by Jennifer Browning.

“The School Health Program is important because now, the children don’t have to miss a day of school in order to get a check-up,” he said, “and if the child is having a health issue then it allows us to detect the problem sooner.”

Pascal said that the most typical conditions found in children during the medical examinations are worms and malnutrition. According to the World Health Organization, intestinal parasites eat up to 20 percent of a child’s nutritional intake a day. In most cases, ridding a child of these parasitic worms can mean the difference between life and death. Importantly, worm infections cause anemia, vitamin deficiencies, a weakened immune system, lethargy and poor physical growth, especially in children. Worms also have longer-term economic effects. Anemia results in poor cognitive and intellectual development and impaired cognitive function.

In addition to the opportunity of early detection, the clinics provided through the School Health Program add a convenience for the parent. Before the program, parents had to wait to take their children to a mobile clinic in the area. This meant either and paying to rent a horse or donkey for the transportation, and possibly spend two hours under the sun during their journey to get to the clinic.

“Sometimes the parents don’t have the money, even if they see that their child needs to see a doctor, they can’t afford it,” he said, “so the School Health Program helps make sure these children get the appropriate follow-ups they need.”

Last year Project Medishare worked in 95 schools, and served 17,544 students through the School Health Program.

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Vodpod videos no longer available.

Check out the above video about the Miami Heat in Haiti. Two weeks ago, Alonzo Mourning returned to Haiti with Tim Hardaway and Miami Heat Coach Erik Spoelstra. The team visited Project Medishare’s field hospital as well as Bernard Mevs hospital, where Project Medishare’s trauma and rehabilitation hospital moved.Mourning has been a supporter of Haiti and Project Medishare’s relief and recovery efforts since the January 12 earthquake.

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By Jennifer Browning

After receiving the President’s Emergency Plan For AIDS Relief (PEPFAR) grant, Project Medishare staff started identifying vulnerable children that they could assist along the guidelines of the grant.

As one of five organizations in the Cross Haiti Alliance, Project Medishare received a three-year PEPFAR NPI grant in December 2008. Project Medishare has been focusing activities in the very remote community of Casse/Lahoye located in the commune of Thomonde.

Program objectives are to enable indigenous NGOs to develop their capacity and capability to deliver orphans and vulnerable children (OVC) services at the community level; provide care and support services for HIV/AIDS OVC’s; prevent HIV infection among adolescent and youths; and provide access to palliative care for people living with HIV/AIDS and affected households.

Project Medishare’s local staff has agreed to live in this remote area. The community is also mobilized and participating which has a positive impact on the community.

In July, Rosemerlin Pierre-Louis, a Project Medishare nurse and Coordinator for the PEPFAR program found 16-year-old Ninitte at a town event. She was severely thin, complaining of pain in her chest, and was in need of medical care. Merline decided to take charge and took her to the hospital in Cange where Ninite was diagnosed with tuberculosis.

“Doctor’s at Cange found that she had water in the lungs, and she had pain in her chest so she was really sick and in serious condition,” Rosemerlin said, “but they were able to help her.”

Ninitte improved and was able to leave the hospital seven months later in January.

Ninite (second from the left) with her brothers and sisters at their home in Casse. Photo by Jennifer Browning.

But that wasn’t where Rosemerlin stopped with Ninitte’s care. Rosemerlin, who visited her in the hospital often, knew that Ninitte’s mother had passed away. When Ninette was able to leave the hospital, it would be Ninitte’s sister, Angeline, who would be primarily caring for her. Rosemerlin and her team continued to make sure Ninitte was improving.

“It was team work to work to help Ninitte continue to get better. I worked with the coordinator and the social worker,” Rosemerlin said. “I still come to visit her, and when I do visit I bring food and teach her older sister to cook for her, so that [Ninitte] eats healthy.”

Angeline said she is thankful of all that Rosemerlin has done for her sister and her family.

“It was very helpful to have her training in order to teach me how to cook healthy meals,” Angeline said. “Now I can help take care of my sister to help her continue to get better.”

Rosemerlin said nursing and taking care of others is her mission in life.

“It is a mission for me to find those who have nothing, and are in serious condition,” she said. “Ninitte is one of these people. Doing this work is part of what I believe in”

The Project Medishare nurse attended nursing school in la Cayes, and said helping her patients has always moved her.

“It was important for me to see patients get better and see them get back on their feet again,” Rosemerlin said. “I would do whatever I could to help my patients get better.”

At one point however, Rosemerlin said began to experience burn out, so she left the hospital and went to Port-au-Prince to study community health.

“I thought it would be better to be in an office,” she said, “because at the hospital I got too involved with the patients. “

But Rosemerline couldn’t stay away from the hospital, nor from the patients she cared about. A year ago, she found herself working for Project Medishare in Haiti’s Central Plateau.

“It is a calling for me to care for these patients,” Rosemerlin said.

Ninitte said that Rosemerlin is much more than a nurse to her.

“Rosemerlin today, for me, is like a mom, but even more,” Ninitte said. “Even if my mom was still alive she wouldn’t be able to do the things that Rosemerlin does to help me today. She is very special to me.”

**Laurene Leger contributed to this story.

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Yvens mother comforts him at their home in Casse, Haiti located in the very rural Central Plateau. Plastic surgeons from Miami who were volunteering through Project Medishare's Plastic Surgery Program corrected Yvens cleft lip. Photo by Jennifer Browning.

By Jennifer Browning

Almost three weeks ago, plastic surgeons from University of Miami Department of Plastic Surgery came to Port-au-Prince as part of Project Medishare’s Plastic Surgery program. Eleven-months-old Yvens Olsen was one of their patients.

Today,  Yvens, is already healing well from his cleft lip surgery.

Project Medishare nurse, Rosemerline Pierre-Louis, met Yvens and his mother at the clinic in Casse. Rosemerline informed her that there was a program that could help her son.

For Madame Olsen, she said she mostly worried about Yvens cleft lip, because the child looked different from his twin brother, Yvner.

“It was difficult because I have twin boys, and Yvens had this deformity on his lip, and Yvner looked normal,” she said. “I was sad for him, because if we could not get it fixed, then when they grew up people would see a difference between them.”

Project Medishare provides specialized plastic surgery to individuals living in Port-au-Prince as part of our specialty surgery program.

In addition to providing these surgeries (cleft lip & palates, burns, breast cancer reconstruction) local surgeons are trained on these specialized techniques enabling them to perform these procedures themselves.

Even though he was crying as he was waking up from the anesthesia, Yvens mother said he looked better after the surgery.

“I was so happy when I saw him after he came out of surgery,” she said. “I am happy that Rosemerlin found me and I am thankful to God that the doctors were able to fix Yvens lip.”

Madame Olsen now takes Yvens to the clinic in Casse so that Project Medishare doctors can follow-up on how the child’s lip is healing. The mother said she is so happy that there is a clinic in Casse. A few years ago, that wasn’t the case.

Local staff working with Project Medishare’s Community Health Program in Haiti’s Central Plateau assists in making sure the patients living in this rural area receive proper follow-up appointments after the surgery.

Before the clinic opened in Casse, people like Madame Olsen went to the clinic in Thomonde which not only included a journey, but cost more money for transportation.

“When I had to go to Thomonde to see the doctor, then I had to find money to rent a motorcycle or rent a horse to get there,” she said, “but now I can walk to the clinic and I don’t have to worry about having money for transportation.”

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