Thoughts on the Passing of Dr. Paul Farmer

When I decided to concentrate on global health in 2011 and started Social Good Moms I learned immediately about Dr. Paul Farmer and the nonprofit he co-founded, Partners in Health. It is absolutely impossible to miss the immense contributions he made to the disciplines of global health, health inequality, and human rights for others to admire and aspire to, including me. He is the reason I decided to go to Haiti on my own to see the work other NGOs and nonprofit hospitals were doing for Haiti’s poor.

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Donate to Help Expecting Mothers in Haiti

It is difficult to believe how much Haiti is suffering. Not only was its president assassinated a little over a month ago, but a 7.2 magnitude earthquake hit last weekend with a death toll now of over 1400. And, if that is not enough, a tropical storm is quickly barreling its way towards the island where mudslides will inevitably cause additional deaths, injuries, and property damage. This is all amid an interim government that has not gotten its bearings after President

I had the privilege of visiting Haiti once. That was five years after the devastating earthquake in 2010 that killed 200,000 and injured 300,000. Even after five years I could clearly see where buildings had not been rebuilt and rubble was still bulldozed into corners across Port-au-Prince, Haiti’s capital.

Then, I went to see the work of Midwives for Haiti whose dedication to quality maternity care in the poorest country in the western hemisphere I admire greatly. While Midwives for Haiti was not immediately affected by the earthquake, there will undoubtedly be an increased need for its help in the region because as its Executive Director, Jane Drichta, said in her most recent newsletter, “Haiti is a small nation and what affects one, affects all.”

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Residents in Southern Haiti Receive New Access to Quality Health Care

Several vistors wait to be seen at new hospital (1)During my visit to Haiti two years ago I had the privilege of visiting two hospitals: L’Hôpital Albert Schweitzer (HAS) in Haiti’s Artibonite Valley and L’Hôpital Sainte-Thérèse in Hinche, Haiti. Many of the patients at both hospitals, I learned, walked or took public transport over long distances for quality hospital care. As the poorest country in the Western Hemisphere, Haitians need many more hospitals and health workers to care after their sick. There are currently only six health workers for every 10,000 Haitians according to USAID. And, Haiti has the highest rate of infant, child, and maternal mortality in the Western Hemisphere. Most Haitians live on less than $1 a day and their life expectancy is only 64 compared to 74 for its neighbor, the Dominican Republic.

Quality health care in Haiti continues to be one of the country’s greatest problems. In fact, Haiti only spends 6 percent of its expenditures on health care and relies heavily on international funding.

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Book Review: To Fool the Rain: Haiti’s Poor and Their Pathway to a Better Life

To Fool the Rain: Haiti's Poor and Their Pathway to a Better LifeTo Fool the Rain: Haiti’s Poor and Their Pathway to a Better Life by Steven Werlin

My rating: 4 of 5 stars

“Helping families lift themselves out of poverty means helping them build income and wealth, but it is a social phenomenon as well,” wrote Steve Werlin, the author of To Fool the Rain: Haiti’s Poor and Their Pathway to a Better Life. “And one of the social change we try to effect involves working on the way members look at themselves.”

It is quite impressive how someone’s mind and attitude can alter and reset the course of one’s life. However, in order to eventually arrive at that mind reset some people require a substantive hand out, constant observation and follow-up; not simply a prescriptive hand up. When looking at the lowest income countries in the world like Haiti a vast array of NGOs work to alleviate some of its inherent problems with programs that address the root of poverty. Some provide work programs, educational programs, health care, or even microloan programs. But some of Haiti’s families are so extremely poor they cannot dream of qualifying for many of these programs because they have virtually nothing. In fact, they live in such cyclical poverty they cannot feed themselves on a daily basis, or even every other day. In Haiti’s deepest far reaches and unfathomable rural areas are families who live in abject poverty far away from roads and towns. They require the most cumulative social programs designed by worldwide NGOs that specialize in the nuances of poverty reduction and eradication.

In Haiti, for example, one of those social programs is called “Chemen lavi miyo (CLM)” in Creole or a Pathway to a Better Life that is run by Fonkoze, Haiti’s largest microfinance organization. Even as a microfinance enterprise Fonkoze realized that to reach the poorest Haitian families means to provide overarching programs that teach rural women who qualify for their CLM program financial and entrepreneurial skills as well as life and relationship skills.

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As the UN finally Admits Role in Haiti Cholera Outbreak – Here is How Victims Must be Compensated

Rosa Freedman, University of Reading and Nicolas Lemay-Hébert, University of Birmingham

The United Nations has, at long last, accepted some responsibility that it played a part in a cholera epidemic that broke out in Haiti in 2010 and has since killed at least 9,200 people and infected nearly a million people.

This is the first time that the UN has acknowledged that it bears a duty towards the victims. It is a significant step forward in the quest for accountability and justice.

Haiti is one of the poorest countries in the world. It is frequently devastated by disasters – both natural and man-made. Yet cholera was not one of its problems before 2010. Then a group of UN peacekeepers was sent to help after an earthquake.

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[Updated] Photographer Captures the Realities of Maternal Health in Haiti

B.D. Colen, a documentary photographer, is currently in Haiti with our partner Midwives for Haiti capturing the realities of maternal health for many Haitian women who live in the country’s poor Central Plateau. The mothers who receive care from Midwives for Haiti are the lucky ones. They have access to prenatal care at mobile clinics in the region as well as in far-off villages with traditional birth attendants or matrones as they are called in Creole. Expectant mothers are also afforded quality labor and delivery as well as postnatal care in the hospital. Midwives for Haiti also teaches matrones how to perform safe, clean births for women who object to delivering in the hospital or for those who want to deliver in the hospital but it’s too far and they cannot afford transport.

As you may recall, I spent a few days in Hinche, Haiti and visited L’Hôpital Sainte-Thérèse earlier this year with Midwives for Haiti. There, I spent time with the visiting certified nurse midwives as they did rounds. Read my piece: Maternity Ward Observations: Midwifery Care in a Haitian Hospital.

Colen is documenting Midwives for Haiti’s work at their mobile clinic as well as at L’Hôpital Sainte-Thérèse. He has also visited mothers’ home.

Below are photos he has posted this week. Follow him @TheBDColen.


8/ 24/ 15: Updated to include additional posted photos from B.D. Colen.

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Cervical Cancer: Haitian Women’s Next Biggest Killer

By Dr. Leslee Jaeger

Mother and Child. HaitiRoseline had delivered her baby during the chaos of our first day at Mama Baby Haiti, a birthing center for women near CapHaitian, Haiti. Mondays are the busiest day at the center, located on a dirt road just off Highway 1, as it is the intake day for expectant mothers that are new to the program. Three of us had arrived the night before from the early spring of Minnesota weather to be greeted by unseasonable warm Haitian weather – 95 degrees and high humidity.

While we were teaching 10 Haitian nurses and physicians asked about cervical cancer screening in a low resource setting and Roseline was laboring with the aide of a Haitian trained nurse midwife to deliver her healthy baby girl. She graciously agreed to be interviewed only hours after the birth of her child and shortly before she was to depart for her home (patients stay at the center for only 4 hours after an uncomplicated birth).

As is true for many of the 30-40 women who deliver at Mama Baby Haiti each month, she had heard of the program through a friend. She lives 20 minutes away and had been seen for five prenatal visits. She was appreciative of the nurse midwives that seemed to listen to her concerns and the cleanliness of the birthing center. This was Roseline’s first child. The father of her baby was sick and unable to work and she supported herself with side jobs and help from her family. The cost of her care at the center was much reduced from what her care would have cost at the local hospital. Without the services of Mama Baby Haiti, she would have had to deliver at home, either by herself or with an unskilled birth attendant.

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Newborn and Child Health Education Through Haitian Art

Inside the child malnutrition unit at Hôpital Albert Schweitzer, the largest regional hospital in Haiti’s Artibonite region, colorful murals have been painted over the beds. They were specifically designed to teach parents, especially mothers, how to keep their newborns and children healthy and well-fed.

In Haiti one in five children suffers from chronic malnutrition and 6.5 percent of Haitian children suffer from acute malnutrition. Chronic malnutrition is described as stunting or shortness. Acute malnutrition is wasting or thinness.

This mural in Hôpital Albert Schweitzer Haiti shows mothers the importance of breastfeeding their newborns as well as the importance of taking their babies to the Centre de Santé (health center).

Health messaging art

Haiti has a 53 percent literacy rate making it imperative that health messaging at the hospital is conveyed through art as well as through color-coded words. For example, the hospital’s social services are all written in red so those who cannot read can easily find that department. Additionally, for those who can read all signs are written in French as well as in Creole as language politics in the region are quite heightened.

Mothers instead of fathers are more likely to tend to their children in the malnutrition unit like the mothers I saw when I visited. Some mothers were feeding their children and others were sitting with their children who were too weak to be awake.

Haitian women have a lower literacy rate than men in Haiti making messaging through art critical to driving home nutrition education in this unit.

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[Photos] Haiti Works Toward Eliminating Maternal Tetanus

Casimer Dieuvela, 24 years old and five months pregnant, lives two to three hours walk from her monthly health post in Deschappelles, Haiti, but she goes despite the distance to receive her tetanus shot. It’s her third time coming to the health post run by health agent Junior Exanthus and arranged by Hôpital Albert Schweitzer (HAS). Dieuvela brings her daughter to receive her full course of vaccinations. HAS also immunizes … Continue reading [Photos] Haiti Works Toward Eliminating Maternal Tetanus

Maternity Ward Observations: Midwifery Care in a Haitian Hospital

The sunny, steaming hot morning when I visited L’Hôpital Sainte-Thérèse in Hinche, Haiti, the maternity unit was overflowing with busy midwives checking charts and administering care, nurses-in-training in white and yellow uniforms obtaining requisite clinical hours, as well as a few obstetricians checking on patients. Of course, there were expectant mothers, mothers who had just given birth, and those who were being prepped to deliver their babies. Husbands and other family members milled about slowly, but deliberately, bringing food and water to their loved ones, or just sat on benches and waited.

In each of the maternity units – antenatal, postpartum, and labor and delivery – there was a bed for every woman. No expectant mother laid on the ground waiting for space. In fact, I even saw some empty beds. That is not always the case I was told. Some times of the month are busier than others, but each mother can be accommodated.

Some expectant mothers – many with swollen feet and ankles – walked around slowly outdoors in the sunlight angling for some type of momentary relief from the constant wave of contractions. Others laid in bed with worried eyes anticipating the incumbent pain they faced. When I visited labor and delivery, one mother’s screams were piercing and she wasn’t even pushing yet. Another woman was calm, smiled, and gave me a quick wave as I walked by despite her contractions. Midwives were attending to their care – calmly and respectfully.

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The Priceless Reaction of a Baby Being Vaccinated #Haiti

As I watched baby after baby receive the pentavalent (5-in-1) vaccine at a mobile health post put on by Hôpital Albert Schweitzer (HAS) in Haiti this week, their reactions were all the same. First, they were oblivious to what was going on. Then, they all felt a momentary prick of pain and the waterworks began.

Vaccinations Vaccinations vaccinations

Even though each of the babies experienced short-lived pain, they are now protected against diphtheria, pertussis and tetanus (thus replacing the former diphtheria, pertussis, and tetanus vaccine), hepatitis B and Haemophilus influenzae type b (Hib), which causes pneumonia and meningitis.

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Health Agent Junior Exantus on Why He Became a Health Worker

Junior Exantus
Junior Exantus prepares the pentavalent vaccine.

Junior Exantus is a health agent for Hôpital Albert Schweitzer in Haiti. He has been a health agent for three years.

“I wanted to enter the field to help the community,” said Exantus through translation. “I saw a lot of illnesses in the community.”

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How Is Haiti Faring Five Years After the Earthquake?

Five years ago today, a magnitude 7.0 earthquake destroyed large regions of Haiti especially Port-au-Prince and Jacmel. For the poorest country in the western hemisphere, the earthquake only exacerbated poverty matters for its citizens and its standing in the world economy. An estimated 230,000 people lost their lives and 1.5 million more were displaced. Since 2010, $13 billion has been raised to aid the small Caribbean island country, but where has the money gone?

By most accounts, Haiti is doing much better than it was five years ago, and yet there is still a long way to go to provide permanent housing for its citizens and finally do away with the tent cities that became ubiquitous with a slow-going recovery effort.

“Haiti’s recovery has not been easy. There have been – and continue to be – setbacks along the way, and there is much work still to be done to ensure political and institutional stability, democratic governance and sustainable development,” said the UN chief, Ban Ki Moon in a statement commemorating the five year anniversary of the earthquake.

While some Haitians have moved into permanent housing outside of Port-au-Prince many complain that the new homes, while much better than living in squalid tent cities, are too far away from Haiti’s capital to work. Jobs were promised near their new homes, but those have not yet materialized. And, there is still a looming question about the 8,000 cholera deaths that occurred after human waste was inadvertently dumped into major waterways by Nepalese UN workers in 2010. 700,000 people were also sickened by the disease and continue to be plagued today. Haitian groups have tried since 2013 to sue the United Nations because of the cholera epidemic, but last week, a judge ruled that the UN could not be sued.

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How PSI Keeps Sex Workers Safe in Haiti

By Ashley Judd, PSI Global Ambassador A woman will do whatever is needed to feed her family. In a brothel in downtown Port Au Prince, you see just that. Twenty women, all of them mothers, were clustered in the front room. The cement walls were sparsely decorated with stenciled yellow stars. With few options but with families counting on them, these women sell their bodies. … Continue reading How PSI Keeps Sex Workers Safe in Haiti

Join Ashley Judd In Supporting Health Workers in Haiti

By Ashley Judd, PSI Global Ambassador Virgila is more charismatic and animated than most actors I know. She’s a PSI-trained health worker on the outskirts of Port Au Prince, Haiti. And she’s passionate about her work. She goes door-to-door educating women about the benefits of reversible contraception like the IUD. Giving birth is dangerous business for Haiti’s poor, who suffer the highest maternal mortality rate … Continue reading Join Ashley Judd In Supporting Health Workers in Haiti