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Archive for the ‘Integrated Community Development Program’ Category

By Jennifer Browning

The final pieces are being put in place to finalize the Akamil Production Facility in Thomonde. Ground breaking began June 2007 for the construction of the facility, but construction and final equipment installment was delayed after the January 12 earthquake. When production begins, it will mean so much to rural Haiti and those Project Medishare serves in the commune of Thomonde.

DSM's Marienella Mendez, Project Medishare's Laurene Leger, and CDC's Mike Kaiser in front of the Akamil Production Facility in Thomonde. “ I am really surprised and I am really amazed at the job Project Medishare is doing here. Medishare is motivating Haitians to do things by themselves.With this project you involve the local community, the international community and private industry all together in a project that has sustainability,” Mendez said. “It is difficult to find projects like this that involves the entire community.”

Three years ago Center for Disease Control (CDC) Senior Fellow Mike Kaiser met with then Project Medishare Executive Director Ellen Powers and began brainstorming about producing Akamil, a fortified nutritious supplement created by locally grown ingredients. Since then, with the combined support of Project Medishare President Dr. Barth A. Green, Co-founder Dr. Arthur Fournier, Country Director Marie Chery along with numerous supporters, the production facility became more and more of a viable reality. Today, Kaiser and Chery are putting the final touches to the plan.

The CDC’s role in the project is to research and document whether the Akamil project is successful or not.

Kaiser said the Akamil Production Facility is a great grassroots effort and supports Project Medishare’s mission in the Central Plateau.

“It has the value of creating jobs for the farmers……and you are going to fortify something they like to eat, instead of something you are trying to make them eat,” Kaiser said. “[Akamil] is an indigenous food that [the people] already like and know.”

Akamil when mixed becomes a porridge that people can mix sugar and fruit with in the morning or can mix with salt, vegetables and meat in the evening.

“It becomes a staple food that can be fully nutritious, but the full-circle idea is that you are creating jobs for the farmers to then grow the crops and they now know that someone will purchase the crops if they grow more than what they need for just themselves,” Kaiser said. “The Akamil plant can buy it from them.”

To help make the Akamil project successful, the University of Florida provided technical assistance through Project Medishare’s agriculture extention agents by providing training at Project Medishare’s demonstration farm and local farms around the community.

But Kaiser pointed out that it isn’t just the community farmers who benefit from Akamil. Women in the community, benefit as well.

“The other part is that you are creating jobs in the factory, creating jobs in the sale and distribution of the product,” he said. “We’ve talked about microlending with women—creating opportunities for women, which is a real big deal in Haiti, because right now the women don’t have the rights and the respectability that they deserve.”

Kaiser added not only will Akamil benefit the community Project Medishare serves, but more importantly, that same community fully supports the project.

“The enthusiasm that has been generated locally is incredible,” Kaiser said. “This is all being done locally.”

The sale of Akamil doesn’t stop in the commune of Thomonde.

“The international community has said they will purchase Akamil to use in school feeding programs,” Kaiser said, “and thanks to all the donors who have contributed to this project, there is no overhead and the plant will be able to produce and sell the product at cost as a not-for-profit enterprise.”

One of those contributors is DSM who has donated the vitamin-fortified pre-mix for the Akamil product.

The pre-mix for Akamil contains Vitamin A and B complex (Thiamin B2, b12), Iron and Zinc making it a complete formula that can be consumed by the whole family from children to adults. Iron and zinc helps with anemia as well as the immuno process, and additionally these nutrients help to improve the growth rate in children.

DSM manager Marienella Mendez said her company became involved with Medishare through AzkoNobel, a supplier of iron. AkzoNobel contacted DSM and asked to assist Project Medishare with the vitamin supply and pre-mix.

But DSM not only decided to donate the pre-mix, they wanted to participate further by providing technical assistance.

“We wanted to participate in the complete process to be sure the pre-mix is going to be used in the right way,” Mendez said. “We have a social responsibility with our products. We need to make sure that the people taking these vitamins that their bodies are absorbing them the right way. We have the responsibility to ensure the product is being used correctly. In order to obtain the right product we are helping make sure that the vitamins and minerals are created at the right levels.”

After this Mendez and DSM will join Kaiser and the CDC in formulating a nutrition survey, which will be managed by Project Medishare’s community health agents.

Mendez said the goal is first to give Akamil to 300 families and six month later these same families go in for blood tests to monitor the levels of iron and other nutrients. Community health agents will continue to test the families once a month to monitor nutrition levels. Afterward, Akamil will be offered to the whole community and will also be available for other NGOs to purchase for their programs.

Mendez said the nutritional survey is an important part of the process.

“This kind of test has to be done to sort of close the circle because when the kids or the families eat the Akamil we need to ensure the levels are good for them and will produce positive changes in their body and in their metabolism,” she said. “This helps us continue to make sure the right levels of the vitamins end up in the body and actually helps improve their nutrition.”

The nutritional surveys, according to Kaiser, are an essential part of Akamil’s business plan. And thanks to AutoGov and Motion Computer for donating data software, Blackberry’s and digital tablets, information collected by the community health agents will be available immediately.

“That information is creating electronic medical records which can be communicated to the local doctors, local clinics and it is immediately provided to the Ministry of Health,” Kaiser said. “People don’t have to wait two or three years for the results of a nutrition survey, which is typically how it is done. All of this information will be available immediately thanks to AutoGov and Motion Computing.”

In addition to the local medical community having instant access to information, the Ministry of Health will also receive these electronic medical records.

“[The Ministry of Health] are really excited that they are going to receive electronic medical records and they are going to have this way to collect information,” Kaiser said. “For Medishare, because we have done this nutrition survey, someone else can come in and conduct future health surveys because all to the equipment is there.”

“And now they are collecting their own data, and they don’t have to rely on the Pan American Health Organization (PAHO) to collect it for them, which always takes time,” Kaiser said. “Now [the Haitian people] can do it themselves, if we can teach them….and they can, and this is happening right here. We really are taking this concept of don’t give them a fish, but teach them to fish. That is what we are really doing from the beginning.”

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Project Medishare community health nurse Wiseline Celestine hands a box of oral rehydration packets to a community health agent. Project Medishare's health agents are working feverishly to educate the people in order to prevent cholera in their communities. Photo by Jennifer Browning.

By Jennifer Browning

Forty community health agents gathered at the Project Medishare office in Thomonde today to meet with Country Director Marie Chery, Dr. Serge Pintro, Zanmi Lasante doctors and Project Medishare medical staff. After the meeting the staff handed out water purification tablets and oral rehydration solution to community health agents. The health agents will distribute these items to those in their community reminding them how important it is they follow specific prevention guidelines.

Project Medishare  medical staff reinforced the prevention guidelines.

Federick Fanel, a health agent with Partners In Health’s sister organization, Zanmi Lasante, was also invited to attend to help spread the word in the community. Fanel, who is also a teacher in Thomonde, said he learned much at the meeting.

“They not only reinforced the importance of boiling and treating water, but also how important it is to disinfect the latrines. In rural Haiti, there are many people without latrines, so it is important that we instruct them how to properly build a pit latrine by digging a deep hole, and more importantly covering it properly after use.”

Each community health agent received a large box full of bottles of water purification tablets to distribute in their communities. They also received oral rehydration packets to have on hand in case they encountered anyone with cholera symptoms. Photo by Jennifer Browning.

Fanel said that he also learned how to instruct others on how to make their own oral rehydration solution, if they did not have any of the ready-made packets on hand.

During the meeting Dr. Malou Phanord also stressed to the health agents how important home visits were at this time.

“Home visits are even more important today, because there may be some who have symptoms and stay at home,” she said.

Should a health agent notice a person with cholera symptoms, Project Medishare community health nurse Wiseline Celestine also gave specific instructions on what the health agent should do. Because cholera severely dehydrates its victim, it can kill within hours.

“If someone has diarrhea as a symptom, before you take them to the hospital, it is important to immediately start giving them the rehydration solution,” Celestine told the health agents. “This will help them stay hydrated on their way to the hospital. Many of the deaths in Artibonite were on the way to the hospital, because they were not able to hydrate before leaving for the hospital.”

She then talked about how it was necessary for all the water people used to be purified.

“It is important to tell them to use these purification tablets to not only purify the water they drink, but all water,” she said. “They must treat the water they bathe in, the water where they wash their dishes and their clothes. It is a lot of effort, but it is very necessary!”

Benet Joacime, a supervisor for health agents stationed in very rural Baille Touribe said he appreciates meetings like the one today because it allows for good communication between the Project Medishare medical staff and the health agents.

“When we learned that cholera had started in the Artibonite, we immediately went out to our sections and started educating about preventing cholera,” Joacime said.

For Joacime, he said it was important to make sure all of the community health agents in his area were organized and understood how to educate each area about prevention.

“It is a big responsibility because I have to make sure my community is safe,” he said, “so I have to put more leadership out to my agents, and be really organized to make sure everyone understand how important this is.”

He continued to explain how the health agents are using all of Project Medishare’s resources to spread the word. Health agents who oversee hard to reach areas are given motorcycles and all agents are given megaphones to speak to large groups and community education rallies.

At these community cholera prevention meetings, Benet said people listen closely.

“From what we see, people are very afraid of this disease,” he said. “They listen on the radio and they hear how bad things are in the Artibonite, so they really know how important it is to follow our instructions.”

When we were notified of the outbreak, the purification tablets and disinfectants weren’t available for us to distribute to the communities,” Joacime said. “People were worried. We continually heard ‘how can I protect my family?’ ‘How do we purify the water?’”

Without the purification tablets to distribute, Joacime said that health agents stressed the importance of boiling water, cooking food thoroughly and steering clear of raw fruits and vegetables. However, now they can help the people in their community go one step further in making sure the water they use is clean.

“Now that we have these important items to hand out to the people. We can go back to our communities and as we distribute the purification tablets and rehydration solution, we can reinforce the message,” he said. “We are so grateful that we have these to give to the people in our community to keep them safe.”

*Laurene Leger contributed to this story.

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The final piece of equipment arrived at the Akamil Production Facility in Thomonde. Project Medishare's construction team will soon begin to put all the equipment in place so we can start working towards a production date. Project Medishare is bringing in a technician to provide training. Photo by Jennifer Browning.

By Jennifer Browning

The last piece of equipment required for the Akamil Production Facility arrived in Thomonde last week.

Project Medishare is now in the process of putting all the equipment in place, so that we may start working toward a production start-up date. In the meantime, our staff is arranging for a technician to come to provide training on how to use the equipment properly. Once the technician arrives the facility will be operational and Project Medishare will begin conducting trials on all the equipment.

Soon all the equipment will be put in place and tile layed out along the floors inside the Akamil Production Facility. Photo by Jennifer Browning.

For the past three years Project Medishare has been a part of this hopeful spirit of progress and change in Haiti. Medishare has been working toward a long-term solution regarding hunger and malnutrition in Haiti’s Central Plateau, starting with the community of Thomonde. Project Medishare has been working toward specifically solving the malnutrition problem in Haiti with the construction of the Akamil Production Facility and Nutrition Complex. Construction of the facility began over two years ago and despite severe hurricanes and the recent earthquake, the Akamil Production Facility is finally complete.

Before the earthquake, Project Medishare planned to begin production of Akamil in late-January, however the final piece of equipment was held in customs long after the earthquake. Project Medishare staff for a while feared that the equipment had been damaged in the quake, but it was tucked away safely in the crate and has now arrived in Thomonde.

The Akamil Production Facility will manufacture and distribute AKA1000, often referred to as Akamil (Nutrimil), a mix of locally-grown products such as cereals (rice, corn, millet, wheat) and vegetables (beans) all blended into powder. It is a product of great nutritious value containing building and energetic nutrients, and is affordable to poor families. With the expert consultation of a nutritionist, the finished product will be fortified with a mix of important vitamins and minerals such as iron, zinc, and Vitamin A.

With the recent migration of earthquake victims from Port-au-Prince, Project Medishare’s  population in Thomonde has increased by 29 percent. In Marmont, our population increased by 18 percent. This increases a burden on an already overstressed area when it comes to healthcare and food consumption.

The Akamil Production Facility will not only help battle malnutrition in the Central Plateau, but provide additional jobs for locals in Thomonde and surrounding communities. Project Medishare will also purchase produce from local farmers that will be used as part of the ingredients for Nutrimil (Akamil).

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By Jennifer Browning

Emory Medishare’s Dr. Rick Spurlock recently visited Marmont to check on the Safe Water Project’s sodium hypochlorite production building. Construction is progressing as planned. Dr. Spurlock is hoping to start implementation in the next few months.

Project Medishare's sodium hypochlorite production facility construction is progressing. Photo by Rick Spurlock.

Implementation of the project will include purchasing equipment and supplies for the sodium hypochlorite production facility, as well as hiring and training  local personnel regarding how to make the solution and how to distribute it throughout the communities.

As a part of the Community Health and Development Program, Project Medishare is not only continuing to provide healthcare in Haiti’s Central Plateau, but also develop a sustainable community that will be able to thrive in the future.

Project Medishare and Emory School of Medicine hope to have the program up and running by this summer, however the program still needs financial support and funding. Emory Medishare still needs to raise $20,000 to make this project a reality for the people of Thomonde, Marmont, and Jolivert.

The water project is in line with the Millennium Development Goals (MDGs) set in 2000, which specify eight objectives, including improving health, promoting gender equality, reducing poverty, ensuring environmental sustainability, and enhancing access to education, to be achieved by 2015. Goal 7, “Ensure environmental sustainability” focuses attention on reducing “by half the proportion of people without sustainable access to safe drinking water and basic sanitation.”

Click here to make a donation to Emory Medishare’s Safe Water Project and join in the goal of providing safe drinking water for all in Haiti’s Central Plateau.

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By Jennifer Browning

As a part of the Community Health and Development Program, Project Medishare is not only continuing to provide healthcare in Haiti’s Central Plateau, but also develop a sustainable community that will be able to thrive in the future.

One of these ways is through providing safe drinking water. Currently, Rick Spurlock and Emory Medishare are still working toward the Safe Water Project. Construction on a sodium hypochlorite production building is underway in Marmont. The facility is located next door to the new Maternal Health Center.

Training for the project workers will begin in the next few months with the help of Deep Springs International coordinating these efforts between Thomonde/Marmont and Jolivert.

Project Medishare and Emory University hope to have the program up and running by this summer, however the program still needs financial support and funding. Emory Medishare still needs to raise $20,000 to make this project a reality for the people of Thomonde, Marmont, and Jolivert.

The water project is in line with the Millennium Development Goals (MDGs) set in 2000, which specify eight objectives, including improving health, promoting gender equality, reducing poverty, ensuring environmental sustainability, and enhancing access to education, to be achieved by 2015. Goal 7, “Ensure environmental sustainability” focuses attention on reducing “by half the proportion of people without sustainable access to safe drinking water and basic sanitation.”

Click here to make a donation to Emory Medishare’s Safe Water Project and join in the goal of providing safe drinking water for all in Haiti’s Central Plateau.

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By Jennifer Browning

Two weeks ago Hand in Hand for Haiti traveled to Thomonde to visit Project Medishare’s Community Health and Development program.

The Moodie Report, which documents the organization’s project, reported that while there are no easy solutions to Haiti’s problems, that Haiti needs fighters like Project Medishare’s Country Director Marie Chery and “powerful organizations such as Project Medishare who will battle seemingly insuperable odds to create a better Haiti.”

What Martin Moodie is referring to is Project Medishare’s long-standing work in the Central Plateau.

In 2003, Project Medishare started a process to implement a community

Rosemerline Pierre-Louis, community health nurse and coordinator for Project Medishare's PEPFAR grant, checks vitals of a young patient during a mobile clinic visit in Savanne Perdu. As part of the Community Health Program, Project Medishare staff conduct mobile clinics to hard to reach areas like Savanne Perdu in the Central Plateau two to three times a week. Photo by Jennifer Browning.

health program in Thomonde. This program was financed through a three-year grant from the Green Family Foundation. Today, Project Medishare has over 95 local staff of Haitian doctors, nurses, LPN’s, health agents, and administrative staff to provide this care. It includes managing the Ministry of Health clinic in Casse (Lahoye) and conducting a community health program with rally posts, mobile clinics, home visits, community meetings, vaccinations, nutritional monitoring, and providing oral rehydration solution, vitamin A, iron tablets, and anti-worm medication.

In 2008, Project Medishare began collaborating with the Government of Haiti, The University of Florida Institute for Food & Agriculture Sciences (IFAS) and the

As part of the Integrated Community Development Program, Project Medishare's agricultural team has been successful in working with community farmers to promote sustainable farming practices in the area. Photo by Jennifer Browning.

community of Marmont to undertake an integrated community-driven development program. The activities focus on achieving the Millennium Development Goals (MDG’s), which are aligned with the government of Haiti’s Poverty Reduction Strategy Plan, and promoting human security in impoverished rural areas through community based investment and community based capacity building. The program is in the pre-implementation, scoping stages and activities have focused on health, agriculture and education.

While Project Medishare is continuing to provide medical relief to earthquake victims in Port-au-Prince, it is important that our Community Health and Development Program continues to meet the goals set forth before the January 12 earthquake, especially with the recent exodus of earthquake victims who left to seek refuge with relatives in rural Haiti.

Click here to read the full Moodie Report about Hand in Hand for Haiti’s visit with Project Medishare.

If you would like to assist Project Medishare in Haiti click here to make an online donation.

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By Jennifer Browning

This weekend in the first of a two-part article, the Miami-Herald takes a look at rural Haiti and the government’s intentions to look toward decentralizing the country in order to give more power to the municipalities and provinces.

Rural Haiti has already experienced a mass exodus–over 400,000 people have fled to rural areas to seek shelter with family and other relatives. Later this month, Haitian leaders intend to outline a rebuilding plan during a critical aid conference in New York. The leaders are working toward a plan that will incorporate rural areas into the development of the country.

In addition to providing care for earthquake victims at the Project Medishare and the UM Global Institute Hospital in the capital, Project Medishare continues to provide ongoing support to our existing rural programs like the Community Health Program and our Integrated Community Development Program, which includes helping local farmers with better agriculture practices in the Central Plateau.

As resources in Port-au-Prince continue to dwindle, soon there will be another exodus to the countryside. Schools and health clinics will need to be built and funded to accommodate these urban guests who will more likely become permanent residents.

Click here to read the first of two parts of the Miami-Herald’s story about how rural Haiti is pushing for decentralization of power and resources.

In the coming months, we expect to see a continued growth in our rural communities of Thomonde and Marmont in the Central Plateau. If you would like to help us in continuing our support of our Community Health and Development Programs in Haiti’s Central Plateau click here.

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