Spring Campaign for Community Health Workers!

CHW options-081

UPDATE on Spring Campaign: Our goal was $25,000.  The final tally was $27,185!  Thanks to all!!

Community-based health services are what the Lamp is all about. This shows through in all kinds of ways, though most clearly by the fact that our clinic is located right in the middle of the community we serve – not even on a main road, but in amongst the meager slum homes, part and parcel of daily life. We want to be a part of the community, to be part of its progress, to be a catalyst for that positive change. Our all-Haitian staff is a tremendous influence in that way — a glowing example of hard work, integrity and professionalism. But we don’t just want to provide services to the people, we want to involve the community in the ongoing success of the clinic itself. Therefore, all of our construction projects (and many other activities) utilize both community labor and materials from local micro businesses. Our staff includes four people from the local area, including our X-ray technician, who lives right next to the clinic itself.

However, one element of our community building approach is not yet in place — Community Health Workers!  Community Health Workers are local residents that are trained to act as health agents, visiting people in their homes, providing basic services and a vibrant connection between the community and the health center. In a place like Cite Soleil this outreach can save a tremendous number of lives.

Click the link to visit our fundraising page!

https://www.crowdrise.com/communityhealthworkersforhaiti

The campaign has been extended until May 31st.  We need to start this critical program!  Please give generously and pass on the word!

For some instructions on HOW to pass the word, click here!  Help the Spring Campaign!

 

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A Visit to Bwa Nèf

Grace Harrison is a high school senior from Montclair, NJ, who recently visited the Lamp’s clinic.  She wrote this piece as a college entrance essay.

To view the whole newsletter, click here!

I stepped out of the van in Cité Soleil, Haiti. The powerful odors of pigs, dogs, goats and strewn garbage assaulted my senses.  I saw homes created from concrete slabs and children playing with empty bottles tied to strings, others splashing barefoot in filthy puddles. I saw a woman selling mud cookies, which hungry people use to trick their stomachs into feeling full.  Two teenage boys played dominos, one with two guns strapped to his waist.
I followed the footsteps in front of me to the Lamp for Haiti. The safe, clean health clinic was an oasis. Dozens of people waited for care, including pregnant teenagers younger than me, elderly people who have lived a long hard life, and sick people with nowhere else to go. Here I was, a healthy teenager from New Jersey, in an impoverished community in Port-Au-Prince. I expected resentment, and yet a woman who had almost nothing shared her chestnuts with me and another woman reached out to hug me tightly.
The next day I watched two little girls sitting in a pile of indescribable garbage. We stared at each other as people from two different worlds. It felt like there was an unspoken agreement to keep a comfortable distance. And yet, when one of the girls began to cry I broke that distance and walked over to rub her back. She reached her arms around my neck and I lifted her off the ground. As she rested her tiny head on my chest, her tears stopped. Mine began. After a few moments between us I put her bare feet back on the dangerous, debris filled ground. Walking away from her took all my strength. Her face will remain with me for the rest of my life.
That same day I joined nurses, doctors and Lamp supporters for a celebration of fried plantains and grilled goat that followed the annual board meeting. The manager of the Lamp, named Benoit, kissed me and said, “Thank you, Grace. You are helping to save lives. We appreciate all you have done.” I was humbled because nothing I did compares to what the Lamp employees, both Haitian and American, accomplish every day.
I had learned about The Lamp three years ago from Dr. Jim Morgan, a physician in my town. I was moved by his words and knew I had to help. But how could a 16-year-old in New Jersey help people in Haiti?  I felt powerless. Then, one day in chorus class, as I listened to friends belt out high notes, I thought there must be a way to use our love of music to help others. I invited my friends to sing, borrowed microphones and cables, reached out to businesses for donations and sent out invitations to my Backyard Lamp for Haiti Concert.  Dr. Morgan came to speak and told us that Cité Soleil was the only place in the world Mother Theresa called more impoverished than Calcutta. The event raised more than $3000. The next year I organized my second concert, raising total contributions to $7000. Then in October Dr. Morgan invited me to see firsthand how the funds I raised were helping. I got a typhoid shot and used my babysitting money to book a flight.
Can a person’s life change in four days? Mine did. Haiti changed how I see my place in the world. Organizing my backyard concert made me realize I can make a difference and being in Haiti made me realize that I must. After just three and a half hours on the plane, I was back home drinking clean water from the tap. Guilt coated my bones that night as I put the air conditioning on and fell asleep thinking of the girl I had held a world away.

Photo by Grace

Photo by Grace

 

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Solar Powered Lamp – coming soon!

The community of Bwa Nèf, like most other neighborhoods within the larger slum of Cité Soleil, has no electrical infrastructure. Residents pool money to buy a transformer, and then attach a multitude of wires to this transformer – one for each family. The resulting power is very weak. Every so often the overworked transformer explodes and a new one must be purchased. This is the system that the Lamp uses for its clinic – for its lights, fans and computers. Unfortunately, even this power is highly unreliable. Power is available for only a few hours each day, and over the last year the number of hours has been declining.

What this means for the Lamp is that we have been forced to use our generators on a near-constant basis. Generators are fine for back-up power, but they are noisy, polluting, and costly to run and to maintain.

We are thrilled, therefore, to announce that we will soon be “going green”!

Pharmacy 1

The solar panels will go up on the new cement roof

Old picture of pharmacy (as registration room)

The room was previously used for patient registration (and for health education!)  It will soon be our new pharmacy.

Solar battery storage

A new storage room for the solar batteries

 

 

 

 

 

 

 

 

 

 

 

Thanks to the farsightedness and environmental concern of certain of our supporters we will soon be installing solar panels on the roof of the pictured room, with a full complement of batteries next door. In addition to its other advantages, a solar system provides 24 hour power – through the use of the battery system – which will allow us to store medications, such as vaccines, that require refrigeration at the clinic site itself. To say that we are looking forward to this would be a major understatement!

The pictured room, by the way, has recently acquired a new cement roof, to allow the placement of the solar panels and will soon be the new site of our pharmacy.

For more information on the current work of the Lamp, please check out our latest newsletter here!  For updates on our work, including this exciting initiative, check back on this site OR ask to join our mailing list here (please specify print or email!)

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Ready to Learn

The pictures are of a few of the school children that the Lamp sponsors, near to our clinic in Cité Soleil.  Education is not the primary focus of the Lamp but it’s hard to underestimate its value. People in Cité Soleil are well aware that education is the one sure way to give yourself, and your children, a chance at a better life. In response, the Lamp has been supporting children in the local schools of Bwa Nèf ever since our clinic was established here. This year we will be supporting 23 young people.

Schnaida and Djoulie

Schnaida and Djoulie

 

Ideally, one would love to support many more, and above that, the local schools themselves. There are more than 1,000 children in the five schools closest to the Lamp’s clinic. We provide occasional support for the schools – sponsoring the studies of one school’s principal so that his school could be state-approved, providing a tutoring program at another school. But there is always more to do; a program of teacher training which includes a summer camp for kids has long been one of our dreams.

 

Clebert

Clebert

Misterlande

Misterlande

Until that dream is realized, though, it has been very gratifying to realize that our support, small though it is, has been of tremendous importance to the local community. Regular, reliable, fees for 23 children is in fact an enviable source of income for these schools. The large majority of families struggle mightily to provide the necessary fees but are often forced to keep some children at home, or to see their children sent home for lack of payment. Schools are always on the edge of financial collapse.

So it was a pleasant surprise to note that one of the schools, where most of our sponsored children go, was expanding its facilities. The owner, Ms Samson, was clear: it is only because of our regular sponsorship that she could take the risk.

The Lamp’s first priority here in Bwa Nèf is to provide the best health care we can, but we also want to make sure that we are an open and engaged member of the larger community. Our education program is one great way to do that.

Djoulie and dad

Djoulie and her father

 

 

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Taking on the challenge of Electronic Medical Records

Rony Charles

Rony Charles, EMR programmer

Dr Severe, EMR

Dr. Severe at work, using the EMR system

The Lamp for Haiti is first and foremost a community organization. Everything that we do is focused on one thing: improving lives in the community that surrounds our health center in Bwa Nèf, Cité Soleil.  Cité Soleil is a notorious slum; the needs of the community are many. One might wonder then, Are electronic medical records the best way to spend our energy and our limited resources? EMR systems need computers, appropriate software, uninterrupted electricity, trained personnel, maintenance. Very few clinics in Haiti have EMR systems, Should the Lamp be pushing the envelope in this way?

This article is written to say a resounding “Yes!” to those questions! It has, in fact, been a substantial challenge but the end result is something that has justified all of our efforts. Our current EMR system provides our doctors with unparalleled recording of, and access to, a patient’s medical history.  It provides unparalleled efficiency and unparalleled ability to analyze our medical activities. All of these “unparalleled” things mean that we are providing substantially better medical care for our patients, and that was always the main goal. The system also allows much better accountability and reporting so that our administrative tasks are also reduced.

It was not, however, an easy fight. Our initial (two) attempts to use US-based commercial systems were not sustainable. Those systems are extremely complex, demand very substantial resources (even if the software is provided for free!), and include many features that are irrelevant to the needs of a primary health care center.

Our answer, after those two attempts, was to “buy local” — always a good idea in the realm of international work! We opted to customize an open-source EMR, called OpenMRS, that had been developed initially in Haiti by the aggressively progressive Partners in Health, and then rebuilt at MIT. Nick Sahagian, a remarkable young medical student, took this shell and customized it for our clinic. We began to use it immediately. That was in 2013. Now the final piece of the puzzle has fallen into place. We have found, and hired on contract, an excellent Haitian IT programmer, Rony Charles. Amazingly enough, Rony has extensive experience with OpenMRS itself. He is, as we speak, adding new modules to the system and making it even more robust. With Rony available for maintenance and upgrades, we can be confident that our system will always be up-to-date and fully functional. Our EMR system is here to stay.

Like many other things at the Lamp, the move to integrate an electronic medical records system was a risk. Perseverance was our main weapon and this case perseverance won the day.

The real winners? The people of Cité Soleil.

 

The next innovation? A fully solar-powered clinic.

Will it pay off? We will have to wait and see…

 

EMR training

Initial EMR training with Dr James Morgan and Nick Sahagian

Nick at Pharmacy

Nick making sure the system works in place (at the pharmacy)

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Ambassadors for the Lamp

womens and xray launch final   lily event 2015 2

Grace grace event 2015

The feature photo shows the launch of the women’s clinic and x-ray last October. It was a very significant event for the Lamp, but the reason I’m posting the photo now is to highlight that young lady in the middle of our yellow-shirted staff. She is 13 year old Lily Silverman, who visited the clinic with her family in October and then took her enthusiasm a step further. She asked if she could be called an Ambassador for the Lamp (we of course said, “of course!”) and she proceeded to organize a series of events that made her, very clearly, an ambassador for the Lamp! She organized a school supplies drive at her school — for the Lamp’s education program, a yoga fundraiser at a local fitness club — with raffles and T-shirt sales, and then presented Lamp and her fundraising project at a school assembly. I would give her an A+.

The young woman pictured above is Grace Harrison, another amazing ambassador for the Lamp.  Grace is a high school student who just held her second annual fundraiser for the Lamp last weekend!  Grace brought a singing group from her school, provided refreshments, discussed the Lamp’s work and sold Haitian art. All that on her parents’ lawn! She also held an educational event at her school and was the volunteer coordinator for Lamp’s major fundraiser in November.

Not everyone can do as Grace and Lily did (and do) – they are exceptional girls. But when one sees the impact that they have had with simple enthusiasm and creativity it certainly highlights the possible!

If you are interested in organizing a fundraising event for the Lamp, give me (Henry) a call at 267-499-0516 or write me at admin@wordpress-92375-260288.cloudwaysapps.com.

Or, just be inspired by Lily and Grace to throw your support behind any worthy cause (including the Lamp)!

Banish cynicism, celebrate the good!

lily event 2015 1lily event 2015 3

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The Story of Sylvia Blanc

Sometimes it can be difficult to explain the value of the Lamp’s work.  We can say, for example, that our doctors see 60 patients per day, 16,000 per year.  But the statistics don’t reveal the real lives, nor the real activities of the doctors with regards to each patient.  The following letter was written by the Lamp’s In-Country Medical Director, Dr. Barrère Hyppolite. It is an inspiration to us all.

 

Hello guys,

This is a success story about what we do daily in the clinic of LAMP for Haiti. It’s about the caring for a woman named Sylvia Blanc.

Sylvia Blanc is 37 years old, married, a teacher. She has 3 children and lives in the area of Cité Soleil. One day this woman came to the clinic; she had a history of low fever, pain in her chest that made her respiration painful and on some occasions, coughing and discomfort. She had already visited another health center for these symptoms but she was not satisfied with the care of this health center because she continued to suffer and this interfered with her daily work as a teacher. In this health center they did some exams for Tuberculosis and the results were negative. She received some advice from friends who recommended that she visit our clinic in Bois 9. She was desperate when she came to the clinic.

She arrived with a chest X-ray that mentioned a probable problem in the lungs, but the x-ray image was not so convincing. After her clinical examination, we note no fever and nothing special in the lungs and she continues to complain about her thoracic pain. We do some additional exams including an EKG. The EKG result gives the suspicion of a heart problem named pericarditis. Some drugs are prescribed, and after some real discussion with her, we recommend an echocardiography for her heart to have a better idea. She decides to do this because she really wants an answer for her disease. She goes to a private clinic to do this and comes back with the exam results. The exam was negative.

So I decide to start again with the process of the clinical exam and to deepen my searches. With sustained attention I detect a problem in her right lung and decide to recommend a new chest X-ray. This X-ray reveals that there is something abnormal in her right lung, seeming to be a collection of liquid. I decide to send her do a sputum exam for tuberculosis in CHAPI, another health center in Cité Soleil and schedule with her a thoracentesis, a procedure which allows me to withdraw some liquid from the lungs, a procedure perfectly controlled and mastered. When she returns to the clinic she has brought the results of the sputum test: all of the 3 specimens were negative for the evidence of Tuberculosis.

D-day, I do the thoracentesis and withdraw nearly 360 ml of liquid from her right lung. She takes the specimens to the laboratory. The specimen will be studied for tuberculosis and also for cancer. She experiences some relief of her symptoms but continues to have bad feelings about her health. Meanwhile, I have to say, every time she feels something bad she takes her phone and calls me to get my impression and also to know if she must come to the clinic to get a clinical exam from me.

The results from the laboratory come and a particular result stands out: in the liquid there are some cells named lymphocytes present in high levels. These cells are cells of the human immune system and are present in the defense of the organism against some diseases like Cancers but also Tuberculosis. Testing of the sample for Cancer will take nearly one month. However, I still suspect Tuberculosis and this suspicion will lead to the final therapeutic for this woman who is determined to find a solution together with LAMP. Thanks to an advanced workshop on Tuberculosis that I attended at THE RUTGERS GLOBAL TUBERCULOSIS INSTITUTE in New Jersey, with the support of my organization LAMP for Haiti, I have been made aware of a special laboratory test named Gene Expert that can increase the accuracy of Tuberculosis diagnosis, specially a Tuberculosis that can be negative on routine examination of sputum. Not every doctor in Haiti knows this test! Also, only two centers in Haiti have this capacity to do this test: GHESKIO Centers and Zanmi La Sante Center (Partners In Health). I discuss with her the necessity to go to GHESKIO in order to pursue this test. She accepts and I make a complete referral for her to GHESKIO.

After that I did not see her for some time. To my big surprise, during a weekday she then called me to let me know what was going on with her. She began with these words: “Excuse me, Dr. Hyppolite, to disturb you, but you know you are my doctor and I have to inform you about my actual clinical situation. They have put me, at GHESKIO, on anti-Tuberculosis drugs. They have done some tests for me and after these tests they decided to put me on these drugs.” Wow!! Tuberculosis, this big killer was there and it has nearly taken the life of this brave woman and made 3 children orphans very early without their mother!! This was so amazing and I was so proud to have pursued the steps needed in this case. I was also so pleased about the confidence that this woman showed in us and her commitment to her own health. Rather than despair, every time she needed information she called or came to the clinic and we were always responsive to her case and listened carefully.

Now she has completed the 6 month treatment of Tuberculosis (the last test done for her revealed no signs of the disease). And she has returned smiling to her job with this feeling: she has found a great answer about something considered like a curse. She also feels safer because with the treatment she will not spread this contagious disease to her family — her husband and her children – and also her colleagues. She had felt guilty and the treatment gives her the power to smile again, to be more confident in life and to fight for her family. Before the treatment she had lost some pounds but now she eats normally and has found a great appetite. With this big change in her life, she asked me this question: are you a generalist? I answered that I am an internist. And she told me, for her husband and her, I was the greatest doctor they have encountered! It was an honor for me, but I told her that I have only followed the necessary clinical steps and made a good choice in wanting deeply also an answer to her problems. I also thanked her for her patience, for her understanding about the steps necessary to make a clinical decision. Without her also this final diagnosis would not have been possible.

During her treatment, she unfortunately also developed diabetes. She has decided for this she prefers LAMP to evaluate her diabetes and help her to control it. She was very satisfied with the time dedicated by our team to explain her disease and our therapeutic approach to help her. Now she deals with diabetes and she relies on LAMP to walk with her in this great fight, and we give her this assurance that LAMP will be there for her and that our primary priority is to give our best for her and to give her the hope for a good future for her family and also herself.

This a story about the trust of a woman, who felt hopeless in the beginning, fearful of a dark future because of an unknown disease but regaining some confidence in life, believing again that something is possible, giving a great hope to her family, a husband and three children. But also this a story about the passion for health care conveyed by the spirit of LAMP for Haiti: We want to make more and something better for our brothers and sisters in Cité Soleil who are humans like us and who want to build a safe future pursuing dreams with a strong health.

All the best
Barrère Hyppolite, MD

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A Sample of Health Statistics for Haiti

Statistics provide only a very approximate and impersonal view of the impact of ill health on well-being. Often one must die in order to even be counted! And, in many countries, one’s death may only be noticed (officially) if one dies in a health facility. The personal stories of individuals are always more informative about the benefits of health care to human well-being. Still, it is good to be reminded of the scale of the problems that are before us. Statistics can help in this regard.

The following is a sample of recent statistics on Haiti, along with a few comments on interpreting these numbers. A fuller set of information can be found by clicking on Who We Serve on the main menu.

To begin with, one should point out that — somewhat surprisingly — statistical indicators of health in Haiti have been improving steadily for many decades now. Despite an earthquake that closed down 37 out of 48 hospitals in the country in 2010, and despite a tragic cholera epidemic, which peaked in 2011 with 340,000 cases, and despite a desperately struggling health system, these numbers continue to show improvement.

There are, however, a number of things to keep in mind. Firstly, the health status of Haitians, even as recently as 1970, was shockingly poor. Currently, for example, that the under-five mortality rate in Haiti is reported to be 73 out of 1,000. That is 7.3%. In 1970, the rate was 246. That is, 25% of all children died before the age of 5. The difference in these statistics is enormous and very heartening; but it is clear that very much remains to be achieved. Currently, the under-five mortality rate in the US (hardly the healthiest country on the planet) is 7 (or 0.7%).

Secondly, national statistics do not distinguish between the rich and the poor. That is, if one were to collect data from only the residents of Cité Soleil – the slum in which our health center is located – the results would be dramatically different than the statistics for Haiti as a whole. When these statistics are sorted by income, the implications are very clear. For example, the national statistic for “skilled attendant at birth” is 37.3%. One’s initial impression is that this is very low – but this is not the whole story. Actually, for the richest 20% of the population, the true figure is 78.1%. For the poorest, then, the figure is much lower; 9.6%, in fact. That is, for the poorest fifth of the population, less than 10% of births are delivered by a skilled attendant.

With those caveats in mind, here are a few additional statistics on health and well-being in Haiti.

  • Haiti is the 20th poorest country in the world (IMF 2013)
  • 62% of the population is below the international poverty line of $1.25 per day (income)
  • Female education levels are as follows: 35.5% have had no education; 42.2% have had some primary education; 20.4% have had some secondary education; 1.9% have had some education beyond high school
  • One in 80 women will die in childbirth (“lifetime risk of maternal death”). Note, again, that this is a national statistic. The statistic will not be the same for the poor

 

  • Haiti had the most cases of cholera in the world for the years 2010 to 2013, a total of 690,525 cases, and including more than 9,000 deaths
  • Haiti has the highest rates of infant, under-five and maternal mortality in the Western Hemisphere
  • More than 50% of pregnant women are anemic (the latest statistic is from 2006)
  • Children under five, with Acute Respiratory Infection, that were taken to a health facility: 38%

Statistics are, of course, just the surface, just the outcomes of underlying conditions. To change the statistics one must change those underlying conditions.

As the slogan of one of our partner agencies* says: Be the Change!

 

 

For more statistical information, please click on Who We Serve on the home page.

*SAKALA – a program for youth in Cité Soleil.

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It has been 5 years since the quake

January 12th was the 5 year anniversary of the disastrous earthquake that struck Haiti in 2010. It is a good time, then, to pause in remembrance of the hundreds of thousands of people that were killed, and the hardship that was experienced throughout the country. It is also a good time to reflect on the efforts of the intervening years, efforts to restore Port-au-Prince and the rest of the country to something near a pre-quake level of functioning and well-being.

It has been a hard five years for Haiti. After the quake there was a positive international response and a hope that Haiti could “build back better” (in the words of Bill Clinton). That hope did not materialize — the funds that were raised were small in comparison to the scale of the disaster. The quake had leveled, for example, the central headquarters of all of the Haitian Government’s ministries; 37 out of a total of 48 hospitals in the country were put out of service by the earthquake, perhaps 250,000 residences were seriously damaged as well as 30,000 commercial structures. Haiti was the poorest country in the hemisphere before the quake — it was never plausible that it would somehow come out ahead.   Also, unfortunately, the funds that were raised were often not used effectively by the American and international agencies that received them (almost no funds were provided to the Government of Haiti). Around 85,000 people remain in decaying tent cities to this day.

But hope for Haiti was never really in the hands of foreign powers. All across the quake zone, reconstruction has indeed occurred as individual families and business owners rebuild their shattered lives and shattered homes. The cost to these families has been enormous but the recovery has most certainly begun. Also, it must be said, many international agencies did provide effective assistance. Doctors Without Borders were very effective in their role as first responders; Partners in Health has built an excellent teaching hospital and 12 clinics in the area to the north of Port-au-Prince. The government’s ability to rebuild its health system remains extremely limited and these agencies, and others, have filled gaps that desperately needed filling.

As for the Lamp, the five years since the earthquake have been ones of dramatic progress. From a part-time primary care clinic with one doctor, we have grown to become a vital community institution, with a full time staff of 10, with special programs in child nutrition, women’s health, and radiology, providing consultations, testing and medications to approximately 80 persons per day.

For us the quake provided a strong affirmation that our strategy — of direct community engagement, an all-Haitian staff, and a commitment to the most marginalized — was the correct one. Many international agencies had difficulties when they tried to impose their programs on communities that they did not understand.   The most marginalized often got lost in the shuffle. At the Lamp we are present in the community each day, the poorest are our clients, and we will continue to provide services long after the final traces of the earthquake disappear.

The earthquake was a dreadful cataclysm; the answer, we believe, is steady commitment.

 

Before pic 2 - seating areaSeating area construction

seating area near completion

Open campus at Lamp

 Photos: The Lamp’s latest improvement – a new covered seating area

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