Healthcare

Dear Friends –

I’m writing our Annual Spring Appeal letter from Port au Prince, Haiti, a place of 3 million people, most of whom are quite poor by any international standard.  In Cité Soleil, where Lamp for Haiti has its health center, a sprawling and dangerous ghetto, absent reliable clean water or electricity, the situation is even more stressed.

Consider some of these staggering facts: In the arena of healthcare, Haiti spends about 57 dollars per capita annually. In all the Americas the next lowest spending country, Nicaragua, commits over three times that amount per person, while the US rate is about $13,000 (data.worldbank.org — 2019).  There are about 25 physicians per 100,000 persons in Haiti, compared to 278 in the US.  Infant mortality in Haiti is 59 per 100,000 live births, compared to the US rate of 5 per 100,000.

Gangs today control large swaths of the capital, and surrounding areas too. There were over 1,200 reported kidnappings in Haiti last year alone, more than twice that of the previous year.

Given these hard to fathom numbers, aren’t further efforts in Haiti just pouring the proverbial water on sand? Isn’t that country too far gone? Oughtn’t we work in another place?  It’s helpful to answer with a bit more data.  In the past twenty years in Haiti…

-Adolescent fertility rates are down over 30%, a cause for optimism since delayed childbearing beyond adolescence is associated with more years in school, higher future earnings, and more stable households.

-Life expectancy has risen by almost five years, to 63. Still low, but progress nevertheless.

-The infant mortality rate mentioned above is actually decreased by over 25%, as numbers of “attended” births by skilled personnel increased from about 25% to nearly 68% of all births in Haiti.

-Overall age adjusted mortality rate in Haiti is down by over 20%.

I have no doubt that this progress has regressed in the past two years, given the overall state of affairs in Haiti.  But progress can and has been made, even in places of extreme poverty.  And while I personally believe that prayer helps, even St Augustine said that God will provide the wind, but we must raise the sails. In this case, the sails are an organized and integrated health system, with well trained committed staff, outfitted with the right equipment and medications.

 To answer my own question, then, a resounding NO, we oughtn’t give up. Life is harsh, at times brutally challenging, in Haiti right now, most especially in Cité Soleil. But for 17 years Lamp for Haiti has not wavered. We remain committed to our mission to provide quality, well-discerned community development, based on the cornerstone of our work — effective healthcare. We will continue to treat the sick, to mend wounds, to feed the malnourished. We will continue to do so not just with kindness but with organized systems.

I hope that you’ll consider supporting our Spring drive this year.  Working together,  we’re  saving lives. On behalf of our Board, staff, and of course our patients, thanks for choosing to stay a part of Lamp for Haiti.

My best to you and your family at this beautiful time of year.

– Jim

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Community

As we move through this year, we continue to explore the layers of Lamp for Haiti’s tagline: Healthcare, Partnership, Community.  For me, Community is really what it’s all about.

Our tagline is not just a series of three nouns, catchy terms akin to Xerox’s “work can work better”, or Guinness Beer’s “Guinness is good for you”. Those don’t really tell you much about their objectives, their values or aspirations. One only knows that those companies are trying to sell you something.

I like to think of our tagline as a continuum, a cyclical process whose momentum is keeping us rolling forward, in both historic and contemporary terms. It’s a process that started almost two decades ago,  with a few of us deciding that we would provide basic healthcare to a forgotten place.  After speaking about our work with friends, family and colleagues, we realized that we needed partners whom we could rely upon, and who felt in turn that we would be reliable too. Out of that partnering has come community.

Going back to those early days, we identified community almost solely in geographic terms; community referred to those residents living in Cité Soleil, in particular those in our Bwa Nèf zone, not far from Lamp Health Center. It was they whom we wanted to reach, and we did.  But our early success in delivering basic healthcare was revelatory, as we quickly and clearly saw the extreme lack of access to quality care for so many of our patients.  With intentionality, we expanded our healthcare services to include pediatrics, women’s health and adult medicine. We added needed equipment, labs, drugs and social outreach.  We began actively seeking out partners on another level -- individuals like you, who wanted to participate and assist in our work, as well other like-minded organizations working in Haiti.

Today, however, a much-expanded understanding of community is the outgrowth of such efforts. We have seen the impact of Lamp spread to encompass a broader geographic catchment area in and around Cité Soleil. (This is even more acutely the case as we have been forced to work at more mobile sites bordering Cité Soleil, given the frequent security troubles in the capital today.) Moreover, community is seen in Lamp’s staff in Haiti, whose families and neighbors are impacted by our economic impact related to their wages, as well as by the positive effects that gratifying employment brings. Community is seen when we talk with a parent of a sick child who has been treated at Lamp health center in the past, and now comes back to request (and expect) more of that same approach to quality care. Community was seen at our latest event in New Jersey, the Montclair Charity Ball, which introduced many new people to Lamp, people who had not previously heard of our work but who nonetheless were inspired as they learned about our work, and wanted to know about ways they might deepen an involvement and become a part of something bigger.

It’s clear to me that the cyclic momentum of our triad tagline will -- if we remain open to it -- continue to push us to think about and to implement new and better ways to deliver quality healthcare to as many as possible. It’s a positive momentum. It’s a great community. Thanks for being a part of it.

- Jim

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Partnership

This year, we continue to reflect on the importance of Lamp for Haiti’s tagline: Healthcare, Partnership, Community. Last month we offered a perspective on Lamp’s delivery of Healthcare, viewed through the lens of Martin Luther King’s lasting impact on our world.

One striking lesson the pandemic has taught us is that going it alone leads to more of the same – going it alone. In other words, connections make us stronger. Connections help as confidante and counselor when we come to life’s crossroads. Connections encourage us to model right behavior, and follow the straight path as we watch others who, in turn, are often looking to us for the same.

Bill Withers’ classic song has resonated profoundly for so many not just because of its lyrical melody, but because of the wisdom of its lyrics – “… You just call on me brother when you need a hand, we all need somebody to lean on.”

This truism applies not just to us as individuals navigating our own personal journeys, but to organizations, and to nonprofits in particular. Given our limited resources, and overall emphasis on keeping a low reserve so that funds raised are spent wisely in a mission oriented manner, we cannot afford to make mistakes. Having a brother, as Withers suggests, allows us to share learned experiences, and information, and sometimes resources.

One such brother, or partner, for Lamp has been St. Luke Foundation for Haiti (www.stlukehaiti.org), a great organization that works to provide healthcare and community support in the capital of Port-au-Prince as well as in the South of Haiti.  They save lives not just by providing proper medication and great medical care, but also by providing education, job training, employment, and hands on, roll-up-your-sleeves-and-pantlegs-and-wade-in-the-waters-to-get-the-job-done approach to problem solving.

Partnerships are relationships, and they work best when both parties experience mutual growth. Again, Withers is helpful in singing the truism “I just might have a problem that you’ll understand, we all need somebody to lean on.” For example, recently we spoke to a donor who wanted to provide assistance in the wake of the most recent earthquake in the South of Haiti. We told that donor that while we were not explicitly working in the South, we would help to find a reputable partner in Haiti who was already working there, and we then connected St. Luke Haiti with that U.S. donor. 

In turn, St Luke has been for us like a trusted older sibling, assisting us in concrete ways like the implementation of our digital x-ray system. They trained our radiographer, Denold, a local resident of Cité Soleil; today he is a skilled x-ray technician, still working at Lamp. They have advised us on topics like how best to procure pediatric drugs in Haiti, or manage our medical waste, or grow our solar power system.

Partnering with other like-minded organizations has been a key part of Lamp’s success, just as partnering with others is for most individuals. Partnering requires the right combination of leadership and humility. Illegitimate organizations tend not to partner, because they don’t want others to scrutinize their processes. On the other hand strong organizations actively look for ways to integrate into a shared mission, not duplicating services but instead complementing, filling in gaps and furthering the work.

We are proud of our emphasis on seeking out and working with great partners like St. Luke Haiti, and you, our Lamp for Haiti family. Together we comprise a part of a greater world community. It’s a community that shares an emphasis on working with and for local Haitian residents, understanding that in doing so we also strengthen ourselves. It’s a community that sings out “Lean on me, when you’re not strong, and I’ll be your friend, I’ll help you carry on… For it won’t be long, till I’m gonna need somebody to lean on.”

St. Luke's Hospital
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Reflecting on Martin Luther King Day

Health, Partnership and Community

A Message from Dr. James Morgan

It seems appropriate to send this first message of the year on this January day, a day that we mark the birth of surely one of the world’s most influential figures of the past century, Martin Luther King, Jr.. King didn’t start wars, or invent any new technology. Instead he responded to an age old yet still burning issue of his day, inequality, and that response continues to resonate. King asked difficult questions to colleagues and friends, politicians and ordinary people. He organized, he marched, he stuck to his conscience, he never gave up.

In his speech in Memphis, the day before he was murdered, King spoke movingly about the crucial need to stay together with an organized plan in order to effect change.

Further, in recounting the biblical parable of the “Good Samaritan”, King notes that the Samaritan intentionally left himself vulnerable to attack by robbers, or even worse because of the question that he asked himself. While others posited “what will happen to me if I help this poor man?”, the Samaritan instead asked the inverted question of “If I do not stop to help this man, what will happen to him?” and he then acted on his conclusion.  King next extends that same inverted question to the plight of the sanitation workers of Memphis, on whose behalf he was lobbying. 

Our staff at Lamp ask a similar question when they enter Cité Soleil each day. You see, to many of their friends and colleagues, they themselves are “inverted” or “tet anba”. Others are clearly puzzled when they see our staff willfully going into a potentially dangerous place to care for the sick and the injured. The question “what will happen to this community if we don’t participate?” is answered resoundingly with action itself. It is an action borne out of the tagline of Lamp for Haiti: Healthcare, Partnership, Community.

This year, in our communications with you each month, we’d like to highlight examples of these basic tenets of our work.

In the arena of healthcare, the country has seen a continued “brain drain” of doctors and nurses leaving Haiti, trying to escape unsafe living conditions, especially in and around Port-au-Prince. (The Lamp for Haiti health center is on the margin of the capital.) All health facilities have been impacted, including Lamp.  In the past three weeks we have interviewed three very qualified doctors to fill one of our empty positions, and we continue to work to get us back to full staffing soon.

For now, we continue to provide quality care. We have been able to return to Cité Soleil, and have been seeing patients there.  We will continue to organize, to work , side by side with the marginalized in the direction of, and at times explicitly manifesting King’s notion of, the Beloved Community.

We at Lamp remain grateful for your decision to stay engaged in this work. Both your work and your friendship is life sustaining for so many.

My very best to you and your family in this new year-

JM

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December 20, 2022 — Haiti Update

2022 was a difficult year in Haiti.  The government was unable to restrain the activities and conflicts of various gangs so that security issues became paramount for ordinary citizens, especially in the capital city of Port-au-Prince, where the Lamp Health Center is located.  In September, gang control of the fuel supply, and their decision to cut off access to this fuel, caused a crisis across Haiti.  Transportation of goods ceased, electricity was unavailable, and economic activity of all sorts came to a standstill. 

Happily enough, the situation was partially resolved in November, and fuel became available for general use.  At the same time, due to political interventions, gang conflicts were very much reduced. 

The reduction of gang activity was critical for the Lamp, since our health center is located in an area that was directly affected by those conflicts.  Since the beginning of December, we have been able to provide services at the Health Center without disruption, and the long term prospects are relatively good.  

Our advantage, as an organization, is that we are intimately acquainted with the day-to-day reality of life in Haiti.  It is a very unsettled period in Haitian history, but, because of this knowledge and the trust of the community, we are able to provide desperately needed health services in a timely and straightforward way. 

The constancy of our supporters is, as always, the key.

[The photo shows one of the mobile clinics that the Lamp was able to operate during the lock-down period.]

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October 20, 2022 – Haiti Update

The situation in Haiti has become very grave.  For approximately three weeks now there has been a complete lack of fuel available due to the fact that a powerful gang controls the main fuel terminal at the docks in Port-au-Prince.  This follows a year and a half of fuel shortages, so that any stockpiles have been exhausted.   Lack of fuel means that food cannot be transported from the countryside to the city, it means that water cannot be trucked to the many communities that rely on this method of distribution.  It means that electricity has become a precious commodity since all of Haiti’s electricity is generated by fuel-burning plants. 

Aside from the fuel issue, the majority of Port-au-Prince is also controlled by various gangs that have greatly expanded their territories since the assassination of President Moise in July of last year.    The result is that the country, and especially Port-au-Prince, is in a state of lock-down.  Institutions of all sorts, including Lamp’s Health Center, are temporarily closed.  

For ordinary people it is a terrible time.  We will only discover the consequences to health and life when the fuel supply is restored. 

At Lamp, we are organized to take any opportunity to return to Bwa Nef (the portion of Cite Soleil where the Health Center is located) and to provide mobile clinics to the many groupings of people displaced by gang violence.  We are discussing our response to the resurgent cholera with several partners.  We are very well placed to take action as soon as it is possible, so that our presence will soon be very critical indeed.  

Hopefully, the fuel issue will soon be resolved, without bloodshed, so that we can resume our normal services and respond to the enormous need that has been created by this crisis.  The goal of Lamp’s work is to assist the most impoverished, so that we can only affirm that we are in the right place.  The situation in Haiti is dire, but turning away does not help anyone.  

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School Sponsorship Program

Ms. Samson is the indefatigable
head of the Enfant Jesus school
in Bwa Nèf. An educator with
a heart of gold.

The 2021-2022 school year has come and gone. Across Haiti, kids celebrate their achievements and look forward to next year. For most, school is a blessing – a safe place where order reigns, where efforts are rewarded. Parents are ever-eager to have their children attend – these school-going children are the hope of the family, and the kids know it. The attractions of education are heightened by the fact that so many cannot attend. The result for many will be illiteracy – an inability to read a newspaper, a government form, the instructions on a medicine bottle. An inability to determine the correct change for a purchase. The benefits are very real.

The Lamp began its school sponsorship program in 2010. Watching these successive groups of children navigate the challenges of school, their potential fully engaged, has been one of the great pleasures of my work at the Lamp. To date, the Lamp – through the very direct support of our education sponsors – has provided 57 children with a total of 208 years of schooling. Huge thanks to those sponsors! It is a small program but a very powerful one and we would like to make it grow.

The basics of the program are this: children are selected from local families by our Community Health Workers and assigned to specific sponsors. Sponsors receive a brief bio with photo, updates on the child’s progress, and occasional messages from the children. The children must succeed to continue but tutoring is provided for any that are falling behind. An annual sponsorship of $415 pays for tuition, uniforms and shoes, textbooks and school supplies for one child. There is a standardized state exam at the end of grade 9 and success in this exam – which earns a formal certificate – is the primary goal of our program. Sponsors may continue to support their charges but generally speaking, the sponsorship ends and a new young person from Bwa Nèf is chosen to enter school.

The program has value beyond price for the children and their families; it is also critical for its support of local schools – institutions that are vital to positive communal life.

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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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