It was another proud day for our Lamp community.  

Yesterday I worked with our medical staff in Port-au-Prince at our newly refurbished, freshly painted, ancillary health center in a zone just outside Cité Soleil, an area called Klèsin (CLARE-seen).  

On our way to clinic, the normally ebullient and cheerful commute with our Lamp staff, a commute that often finds me laughing after just a few short blocks, one marked by nurses ribbing doctors for this or that, people scrunching together to see the latest Tik-Tok video, or bragging about their children and sharing photos on their phone – that commute was instead subdued, anxious even. As our driver pulled out into the street, I saw two young men on the sidewalk ahead of us look in our direction, then head into an alley. I was sure that they were going to jump on a motorcycle, and pull up alongside us to force a ransom. In my brain, truck drivers and taxi drivers became stooges for street gangs. Women selling clothing or vegetables or soap or phone chargers, or anything else, were surely spies for gangs, phoning them of our whereabouts.    

But such was not the case. Despite traffic patterns that make Grand Central Station at rush hour look calm and orderly, thanks to our driver Anglanès, a sturdy brick wall of a man with great street knowledge and some of the fastest reflexes I’ve ever seen, and who has never had an accident with our van in his more than 10 years of navigating the daily commute, we arrived without any incident.  

I inspected our spruced-up spaces, and chatted with Damas, a community health worker whose smile never leaves his face for long, save times for serious talking. This was such a time. Damas thanked me for coming, and said that he was grateful that Henry and I had made it there, despite what he knows are particularly risky times for foreigners and nationals alike. He knew that the other staff were grateful too, and that they were aware of the risk. He said that they understood why we choose to continue with this work.

Too, Damas said that we needed to pay attention to outside friends, who would warn us if we needed to pack up and leave abruptly.  

Patients, already lined up to be seen, were from Cité Soleil, and another area known as “Maïs Gaté”, a very densely populated (think not quite, but approaching, Tokyo subway cars at rush hour) area not far away. Uniformly the patients were effusive in telling us how glad they were to have a place to go for care. And provide care we did. Three doctors working in sync, our nurse midwife seeing pregnant patients, nutrition counseling and treatment underway, and our pharmacy and labs running smoothly. One such woman, 69 years old with a bad heart condition, reported that it had been a year since she was able to access any care at all. I treated another very thin and ill appearing young man for

pneumonia, who told me that he had no money and nowhere else to go.  

With the hot sun just past its peak in the sky, Dr. Metellus came into my exam room to announce that we needed to leave, quickly. “The streets aren’t safe anymore today” he said. I finished with the patient I was seeing, and along with the others, helped to shutter our clinic in a matter of minutes.  

Riding in the van was a replay of our earlier trip. Anglanès, his eyes darting everywhere, his mind anticipating, his brow furrowed pensively, skillfully navigated the streets, always leaving space to maneuver the van, somehow avoiding traffic jams, and depositing each of us safely home. The day, a single day for me, but a way of life for our patients and staff, has left me on edge.  

“This place has blessed me” the young man with pneumonia, looking weak but bolstered, told me as he was leaving our site, a week’s supply of medication in hand and a cure for his malady in clear sight.

I know how he feels.  

And I hope that you do too. Despite these ongoing and often immense challenges, we continue to walk alongside, and we ourselves feel bolstered. We continue to ride in the van with, and somehow feel calmer through that community that rides beside us. We continue to care for, to talk with, to share cellphone photos with, to smile with those whom we see as our extended family, and gradually that vision of extended family becomes real.

Thanks as always, for joining us on this journey.

In friendship- 

Jim 

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

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.  

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.

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  

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 ***