Reflection From Dr. Morgan On The Passing of Dr. Paul Farmer

Paul Farmer has died.  And while I certainly was not close to him — we met personally just a few times — his death feels extraordinarily reminiscent to me of that of John Lewis.  I felt personally inspired by their public lives.  Both men changed the trajectory of history, literally.  Lewis did so by standing up to injustices, and above all else, that’s what Farmer did too.   

Farmer was not one to mince words with those whom he thought should know better.  I remember one time at a conference, when he was asked a question about corruption in the developing world, he replied something along the lines of “so by corruption, could I use as an example the Enron Scandal?” (Enron was a huge U.S. corporation that went bankrupt in 2001, whose executives committed massive fraud, leading to the loss of thousands of jobs and the collapse of two major companies.)  Farmer would never let pass a comment that suggested poor countries had intrinsic character flaws which wealthier ones were immune from.  

On the other hand, he was immensely interested in people as persons.  Individual persons.  I recall having a conversation with him following a talk he’d given at Seton Hall Law School.  We were discussing a housecall patient whom I’d just visited, who’d had a stroke and was now completely bedbound.  Dr Farmer was curious about the man’s home, his wife, his heart, his psyche, his bedsores, his challenges.  I recall being bemused that, like a good infectious disease expert, he asked if the stroke was due to a mycotic aneurysm, a type of fungal infection, and not the typical intrinsic vascular disease.   The conversation moved to Haiti, and to Cite Soleil in particular.  He knew already of Lamp’s work, and reaffirmed its importance for the many marginalized who lived there.  He encouraged us to not give up despite the legions who would suggest this in one way or another.  

He also challenged me to not settle for a second rate system for people because they are poor, and often have no voice.  Dr Farmer’s point was that people living on the fringes should not have health care as good as you and me, they should have better care, because the deck was stacked against them already in so many ways, from nutrition to education to housing to access to healthcare.   

To not live one’s life in poverty, and to be impacted by Dr Farmer’s work, as many have been, is to be both inspired and directed.  The first requires a willful allowance on our part, letting his message of healthcare as justice soak in.  As to being directed, Farmer consistently pointed out the obvious in all kinds of disparate situations, so that one couldn’t help but notice that a root cause was there, sometimes hidden, often not.  But being the critic was never his goal; it was solving Gordian knots.  By his writing, by his organization, by his doctoring, he threw the gauntlet, challenging us to creatively solve problems that many thought unsolvable.  Farmer, like John Lewis, refused to accept the status quo when such acceptance led to disparity.  He wanted to be a balm for humankind, and he succeeded.  Let’s be both inspired by that thought, and directed to be a balm for humankind too.  

As always, thanks for being a part of Lamp for Haiti- 

Jim  

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Earthquake Update

September 15, 2021

The magnitude 7.2 earthquake that struck southern Haiti on August 14 claimed approximately 2,200 lives.  It is now estimated that more than 135,000 homes were seriously damaged or destroyed.  Some 200,000 people lost access to safe drinking water, as wells collapsed and water sources were contaminated. The area was already experiencing substantial food insecurity before the quake and this has increased by at least 25%, with a total of perhaps 1 million people facing hunger, primarily due to the rapidly rising cost of food.  Persons needing medical assistance have been assisted and relief agencies, including the government and its partners, have redirected their focus to rebuilding homes and livelihoods.  The re-building phase will continue for many years.

The Lamp for Haiti Health Center is not in the crisis zone, but, as a health-focused agency, we stand ready to contribute to this tragic event in any way that we can.  We feel, however, that our most effective role is to work, ever more diligently, at what we do best.  That is, to continue to provide long term health services to the desperately impoverished residents of Cité Soleil, a shantytown on the outskirts of Port-au-Prince.  The enormity of the crisis in the south will continue to affect all areas of Haitian life for years to come, and this effect will be felt especially strongly by those on the economic margins, such as those in the community we serve.  It can be noted that Cité Soleil is currently experiencing a large increase in population, due to the influx of people from the earthquake zone who have lost their homes.  The Lamp will, in other words, be contributing to the relief effort in this indirect fashion.

The Lamp is also undertaking a modest rebuilding effort in one affected village but we feel that we can best assist in the ongoing relief efforts by channeling any additional funds we receive for this emergency to those partner agencies, such as St. Luke Foundation for Haiti, that are on the front lines of the relief effort.  Our own Lamp for Haiti Health Center remains open in Port-au-Prince and we welcome your contributions to this critical work.

Healthcare, partnership, community.  We stand in solidarity with the people of the region, with our partner organizations, and with all those who find a place in their hearts for the less fortunate.

*** The Lamp welcomes your contributions to our ongoing programs for the underserved in Haiti ***

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Weaver Birds in Haiti

Jim Morgan, April 14, 2021

My Sunday flight to Haiti was canceled due to tornadoes in Florida, near where I was to make a connection. My luggage has been lost by the airline. My phone wouldn’t work, and internet is spotty. I couldn’t find potable water last night. 

But today is a new day. This morning I was waiting for our driver to pick me up to go and work along with our in-country staff at Lamp for Haiti. I could hear a lot of birds chirping overhead. I looked up and saw about 40 of them, building nests in the nearby Merenge tree.  Each was a beautiful golden yellow, finches I think, all working in seeming unison, and all singing their tunes in harmony.  The birds  would fly to a nearby palm, way up high and snatch off a piece of frond, then fly back to the nest, trailing what looked to be a too-long piece of greenery through the air. The first few rounds, I was sure that the bird had taken too much palm, and that should it survive the tree-to-tree flight, it would prove to be too much to handle, and the nesting material would drift to the ground. 

I watched the scene for about 30 minutes, engrossed in their diligence. Not once did I see a bird falter. Not one branch or palm leaf fell to the ground. Each strand, no matter its length, was carefully and skillfully weaved, and slowly the nests began to take shape. Moreover, I could swear the song of the birds seemed to almost be spurring one another on to stay focused on the task at hand. 

Like most proverbs, this Haitian aphorism starts from observations: Piti piti zwazo fe nich li (little by little the bird builds its nest).  True not only for our friends of the air, but for any worthwhile project. To me the important part is what’s not stated – the notion of persistence. Dogged pursuit of a result no matter the circumstances, no matter the fatigue. Using available resources. Community. Allowing oneself to be carried away by the collective energy as a part of a noble goal.

Today I was speaking with Miss Salita, one of our community health workers.  She told me that of all the health centers in Cité Soleil (there are about four other health centers in Cité Soleil), only one is consistently present – Lamp.

 And then she beamed, proud to be a part of this organizational fortitude.  

To put that into context, there are roughly 300,000 residents in Cité Soleil, living in grinding poverty, many in tin shacks with dirt floors. Malnutrition is a big problem –we currently have 100 children in the child nutrition program — as is access to even basic healthcare. Security in the capital has significantly worsened with rampant kidnappings and other violent crimes. Two days ago five priests, two nuns and a doctor were all kidnapped. 

And yet our staff continues to go to work. They put their own safety on the line in doing so, but they believe in the work and so they show up. When they do arrive, they are met with smiles of mothers who know that their children will receive the care that we would want for our own children.  They see patients with illnesses that are routine, but for whom getting them the correct treatment can be challenging.   They see severely undernourished children, they see malaria, and COVID-19 and diabetes and GI illness. And they treat them all. Consistently.

 Other centers are intermittently open, but close frequently due to local circumstances. To be sure, we have had to close from time to time, but far and away we remain the bulwark of healthcare in this zone. 

Because of the pandemic, it’s been over one year since I have traveled back to Haiti, and worked alongside our staff there.  Today showed me once again the mettle that is their constitution. It remains consistent, relentlessly pursuing a noble goal of providing much needed healthcare to some of the world’s poorest. 

…Zwazo fe nich li

Lamp for Haiti is about healthcare, it’s true. But it is also about community, and determination, and showing up, consistently seeking a solution in challenging circumstances. Thanks again for intentionally staying a part of this truly life saving work. 

In friendship to you, and still inspired by the work that’s being done in Cité Soleil —

Jim

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Reflection from Dr. Morgan on the 2010 Earthquake in Haiti

Eleven years ago today, at 4:53 pm, the earth in Haiti shook for 30 seconds.

In its wake, over 200,000 people died.  

Thousands  were left amputees,  hundreds of thousands  homeless. 

All in the aftermath of a cataclysmic thirty seconds.

Why?

It seems so long ago — eleven years. World events  careen along , exhausting us. Political tensions,  global warming, floods, cyclones. In this pandemic that has claimed the lives of nearly 2 million, it’s hard to make sense of the world. 

I find myself asking “Why is this happening now? Why me? Why us?”.

Last week  I came upon some notes from a retreat I’d taken about five years ago.  On one page I’d written “Ask the right question“.  That question ,  we’ve learned again and again as we continue our collective journey, is not the usually unanswerable “why me?”  but instead “How do I find I meaning in the current moment?”.

I believe that that important question is answered every day, all around me, but I need to keep my eyes open.  For example it’s answered when a high school student, Toby Baer, and his mother and father and brother and sister decide that they can do something to make the world better, and they organize a basketball tournament four years in a row to raise funds for Lamp.  It’s answered in an email I received recently from Dr Hyppolite, who told me that while there was a shooting in the zone of our health center one day earlier, the staff is back to work today, unshaken and resolute.  It was answered when we provided emergency care to the homeless and injured following the 2010 magnitude 7.0 earthquake, and it continues to be answered each day when we see, and are moved by  a mother’s warm embrace of her baby, made well because of treatment they’ve received at Lamp. 

We all yearn for meaning in our lives. I am convinced that it’s all around us. Tragic events will continue to befall our world, but when we ask the right question and see such creative and courageous and loving responses, we’ll be strengthened anew.  

Today I’ll invite you to set your alarm on your cellphone for 4:53pm, the exact time at which the earth shook so violently eleven years ago.  Let’s  reflect on that tragic event , but not stop there. Let’s look for meaning in our world and today and let’s  work in some concrete way to reflect that meaning to those around us.

In friendship- 

Jim

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The Meaning of Community by James Morgan

In a recent NY Times article1, columnist David Brooks wrote about the importance of grassroots projects and strong community bonds . On reading it I immediately thought of the Lamp community, among whose members  are residents of Cite Soleil, our intrepid medical staff, as well as the many supporters like you who believe in our mission of working — and being — with and for those on the margin.

In particular Brooks writes  that the “neighborhood is the unit of change.” That is, communities grow  when local people act locally. Affluent communities can raise taxes or issue bonds, and build  places like a vibrant community  health center. But poor areas, which arguably need such places even more, don’t have that option , and thus the  need for  outside assistance. Lamp for Haiti is an example of such a transformative place. We have become a vital link to health and an integral part of the Bwa Nef  section of Cite Soleil . And we have done so not because we gave handouts, but because we have intentionally walked with the poor, and collectively we have grown stronger.

Brooks comments further about  a deep skepticism that permeates communities when locals feel “betrayed again and again by outsiders…” who don’t carry through on pledges to stay involved. Like any strong mature relationship, residents are not looking for handouts. Rather they’re seeking  committed partnerships.

In Cite Soleil, a very poor sprawling slum on the fringe of Haiti’s capital, there are many reminders of groups’ — governmental and otherwise – having left behind some brick and mortar structure, with no plan or funding for its future use, or even its maintenance.  In many cases these ghost remnants make matters worse. Not only are they decrepit eyesores, but they also serve as reminders of the social distrust Brooks writes about.  It’s as if he had   been interviewing area residents in 2005, the year we began our work in Haiti. We faced that same deep skepticism for several years before we would become an intrinsic part of that community.

If, as Brooks asserts, part of the answer to the puzzle of community development lies in  understanding that the “neighborhood is the unit of change”, I would contend further that we need a broader vision of who our neighbors really are.  Are they just those who live close to where I live?  Though Cite Soleil residents live far away, Lamp’s supporters clearly don’t see geography as a limiting factor when considering that question. For almost 15 years Lamp for Haiti has successfully worked   to empower residents in one of the poorest corners of the globe,  helping  foster health and pride in that community.  We don’t give handouts, but we do accompany. Lamp has never wavered in our commitment. We have been there in the wake of an earthquake, monsoons, gang wars, political unrest, and now a global pandemic.  Neighborliness requires consistency — acting in a way that demonstrates a long term commitment in authentic partnership with local people. But it also requires resources, a  hand up when my neighbor is in need.

Thank you for your caring commitment to this important project. Your willingness to stay engaged during this difficult time is a (not surprising ) testament to the generous spirit, so pervasive in the Lamp community.

James Morgan, MD
Co-Founder and Chair of the Board

 (1) https://www.nytimes.com/2020/04/23/opinion/income-inequality.html

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Lamp for Haiti’s COVID-19 Update

Dear Friends-

I am writing to update you about Lamp’s local preparation in Haiti for the COVID-19 outbreak, now an official pandemic. 

I have been in discussions with our in-country medical director, Dr Barrere Hyppolite, who in turn has been in regular contact with Ministry of Health in Haiti (MSPP). As of present, there are no confirmed cases in Haiti. 

However, the  coronavirus infection has been diagnosed in the Dominican Republic, which of course shares the island with Haiti. In addition, the greater New York area seems to be the latest “hotspot” of infection, and with its large Haitian diaspora who travel home regularly, it seems inevitable the infection will spread there. Here is a link to an updated map of areas infected worldwide. 

MSPP has announced their capacity to test for coronavirus. If a patient is suspected of having the virus, our staff will contact Ministry of Health. The patient is sent to a dedicated testing site, and the specimen is processed at the National Laboratory in Port-au-Prince. 

Our staff has been instructed on personal protection and we are in the process of trying to procure more equipment (goggles and gowns) to keep them safe.  Masks are provided to staff and to patients who cough. Hand washing and hygiene education is being given by our nursing staff to patients awaiting care at Lamp. The situation is evolving and under continuous review.

Thanks for reading this update, and for continuing to engage in solidarity with our one human family. 

Please take good care of yourselves and take seriously the need for precautions at this time.

My best to you,
James Morgan, MD
Medical Director/Board President
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Why Remember

Tomorrow, we mark the tenth anniversary of one of the most horrific natural disasters on the planet in the past 100 years. A magnitude 7.0 earthquake, or trembleman té, struck just outside the Haitian capital of Port-au-Prince shortly before 5pm on January 12, 2010. In its wake, the earthquake led to the loss of over 100,000 lives, left about one and a half million people homeless and countless lives shattered. 

I was present soon after that earthquake hit, working closely with our Lamp for Haiti health center staff in the huge shantytown known as Cite Soleil, as well as with partner organizations like St Damien’s Hospital and CMMB (Christian Medical Mission Board). I saw massive destruction throughout the city, and heard the cries of wounded and dying. I heard, too, the similarly pitched wails of those scarred by the tragic loss of someone they dearly loved. I smelled death that week, literally; even today the memory of that smell returns unexpectedly from time to time.

So why remind ourselves of such a terrible day?

Some say that recalling the earthquake is too painful, and we ought not conjure that day again. It’s too much to bear. Others have suggested to me that pain is an inevitable part of being human, and even a major disaster is not completely unexpected. As such it is yet one more valley, albeit a deep one, in the roller-coaster that is life. We just need to keep moving forward. 

I would side with those who posit a third perspective. It is a perspective which looks at the catastrophe as a starting point, almost a chance to reset.

It’s no surprise to anyone who follows Lamp’s work or who follows events in Haiti that both human-incited and natural disasters have made daily life in Haiti a challenge. But that challenge has not gone unanswered by most Haitians, and we at Lamp, have walked in solidarity along with them in formulating a concrete response to extreme adversity. 

When we started Lamp back in 2005, we had one doctor and one manager, working two half-days per week. We hadn’t the resources to support anything more. We had to start somewhere, and with trepidation we began to walk on wobbly legs, confident that the mission of Lamp for Haiti would steady our gait. I recall when we had resolved our first “labor concerns” – staff were uncomfortable taking public transportation into Cite Soleil, as they felt they were targets for thieves; they were right, and we soon purchased our first vehicle — it coincided with the end of a remarkable first year. We knew at the time that once the question shifted from “Do we dare even consider trying such a project?“ to “That we are doing this is a given, now how do we navigate the next obstacle?” it would mark a turning point. Once the project’s existence was seen as more than an experiment, but became part of the fabric of a community, then we were confident we could build local support. 

In the wake of the earthquake ten years ago, Lamp staff came together, supported by generous donors, to expand our work and our footprint in Cite Soleil. Initially we hired trucks to dispense water , for example. Next we repaired a local water station in concert with the Haitian Kwa-Wouj (Red Cross). Today we help to manage three water stations, partnering with a local community leader and DINEPA, the water utility. 

We have continued to walk with the mission in our collective mind’s eye. Our programming has grown substantially. We now have 21 (!) staffers in Haiti, including one part-time and three full-time doctors, expanding the breadth of our primary care impact. We recently were asked by the Ministry of Health (MSPP) to become an official vaccine provider in Cite Soleil. (MSPP does not make such requests unless the organization is very well vetted. ) 

It is fitting for us to remember, then, on this day, not only as a way to honor the fallen, but as impetus for us to recalibrate, and reinvigorate and recommit. 

Thanks for being a part of this day, of this work, and of the movement that is Lamp for Haiti. 

– Dr. James Morgan, Jan. 11, 2020

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