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 20^th 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.

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.

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

The 6th annual Concert for Haiti took place on February 7th.  It was a marvelous event with a huge range of musical styles on display, including an intense (and long!) set by Steve Forbert.    All proceeds went directly to Haiti via the educational organizations Edeyo and HELP, and of course the Lamp for Haiti (health care).   Thanks to everyone that participated!

The holiday season is a good time to remind ourselves that

other members of our family are not as fortunate as we are.

Spread the good cheer, and happy holidays!

Today, October 1, 2014, is a momentous day in the history of the Lamp! A great deal of truly inspiring work and generosity has combined to produce this marvelous outcome: the opening of our radiology unit.

We have benefited immensely from the support of so many individuals and partner agencies, from the selection of the equipment, its purchase, shipping and passage through customs, training of our x-ray technician, and installation that we can only celebrate the generosity of the human heart.  It has been an uplifting experience, to say the least!

The unit will greatly increase our ability to diagnose a great range of serious illnesses. Previously we were forced to ask patients to obtain x-rays elsewhere, at great cost to themselves. But, in fact, patients were not able to pay this cost: they simply came back empty-handed and Lamp physicians were forced to diagnose and attempt effective treatment without adequate information.

The x-ray machine itself is digital, which is a great boon, and not only because it is so much simpler to operate. Images can easily be sent by email, allowing collaboration between Haitian and US physicians or between health agencies in Haiti itself. It allows the residents of Bwa Nèf — and especially those with atypical conditions — access to a much wider range of expertise — entrance to a world beyond Bwa Nèf.

The young man pictured above, by the way, is Dénold Joseph, a resident of Bwa Néf itself — the community in which our clinic is located. For the past five months he has been taking hands-on radiography training at the St. Luke’s Foundation for Haiti hospital, in preparation for this day. He is very much ready to take on the role of primary x-ray technician for the Lamp. It will be great to have him at the clinic on a daily basis.

And, speaking of our staff, it is very satisfying to realize that our excellent physicians will have one more tool in their kit — allowing them to more fully use their existing skills, allowing their skills and knowledge to blossom. The people of Bwa Nèf can only benefit!

At one time, the Lamp was considering the construction of a whole new clinic building. The converted residences in which our clinic was located seemed less than ideal for the expanded services we wanted to offer. But financial constraints kept that idea on the sidelines. Strangely enough, the result has been something quite wonderful: an organically growing institution in the heart of the neighborhood.

This last year has seen a lot of construction, a very tangible message to the community that we are here to stay. The pictures above shows the covered seating area that is now nearing completion. Fifteen locally made metal benches will soon complete the scene.  We will be able to provide health education sessions to patients and other groups much more easily with this addition.

Some months ago we completed a small building with two additional exam rooms.

We have, in fact, reconfigured the entire clinic. Previously our main clinic building had sturdy walls around it but other buildings were outside that zone of safety. Now we have joined all four of of our buildings with a number of short walls, giving us a much larger “campus”. This has allowed us to pull down the large walls around the main clinic, making the whole area more open and welcoming.   A month ago a wall would have made these views impossible.

Our goal is to become a trusted community institution, an oasis of security, caring and professionalism, and a model for innovative social action. It is somewhat surprising, but it does seem that simple and modest physical changes may have moved us closer to that goal.

Leisa Faulkner and Paul Burke are the leading lights of Children’s Hope, a small California non-profit with a special interest in Haiti.  One of the goals of Children’s Hope is to inspire in young Americans a lifelong passion to understand, engage with, and assist the poorest of the poor.  It is one thing to talk about poverty in the abstract and another to experience first-hand the vast differences — in wealth, living conditions and opportunity — that are revealed by a 90 minute flight from the US mainland.  So, Leisa and Paul brought 15 young people to the Lamp clinic where they painted walls, picked up garbage and assisted the clinical staff.  They brought a burst of energy and enthusiasm to the clinic and the community.  (Thanks guys!)  Each of these young people also contributed a significant amount of cash which was converted into medical supplies and donated to the Lamp.  They have already made a difference in our world.

Children’s Hope has been assisting the Lamp for many years now.  Here’s wishing Leisa (on the ladder) and Paul (behind the tree) many inspiring, engaging years to come.

The building site; taking down the wall next to the main clinic

After: Manager Benoit Florestal in the new building

The Lamp is very pleased to announce the completion of a new two-room addition to our mini campus in Bwa Nèf, Cité Soleil.  It is a great step forward in more ways than one.  To begin with, the building has tremendous symbolic value — it represents our whole-hearted commitment to this community in a way that words cannot.  The building was constructed entirely with local labor and even local materials to the extent possible.  The beautiful logo was designed and completed by a local artist, using the hammered oil drums that Haiti’s artists are so famous for.  The community has participated in this expansion very directly.

The building also allows us to provide new and enhanced services.  Starting this month, the room on the left will be the new home for our women’s clinic.  Check this website in a few weeks for photos of the launch!  The room on the right will house our radiology facility.  The new digital x-ray machine has just arrived in Haiti this week.   It will be at the clinic very soon.

The construction of the building has also allowed us to create a little island of security for our patients and staff.  As the picture shows, we have created a walled courtyard that now contains the new building, our lab and the main clinic.  Bwa Nèf is often beset by episodes of violence or unrest.   This new arrangement allows all of our work to take place in an atmosphere of calm and security.

But we have more to do!  We are currently hiring local labor once again, to build a large roofed structure that will serve as the primary seating area for our patients.  We are also, once again, stretching our budget as far as it will go, but we have faith that our well-wishers will rally to the cause.  This is ground level work and we need to press forward.

[Photo: In the rainy season, standing water is everywhere.  Mosquito control is very difficult.]

Haiti, and at least 16 other Caribbean countries have been hit with a mosquito borne virus with the odd name of chikungunya.  It appeared first on the island of St Martin in December.   At this point suspected cases of the illness surpass 100,000 in number and there is no reason to think that the infection rate will subside any time soon.  The Lamp clinic is right in the middle of the outbreak.

Photo (CDC): aedes aegypti and aedes albopictus mosquitoes.  Aedes mosquitoes are the main transmission route for the disease.  This type of mosquito usually bites during the day.  They are found all over the world.

In Haiti, Port-au-Prince is the center of the outbreak with thousands of people infected.  Although the infection is rarely fatal it is very debilitating.  Chikungunya is an African word that means “contorted with pain” — a reference to the fact that a primary symptom is extreme joint pain.  Fever and joint pain are the most common symptoms but headache, muscle pain, joint swelling and rash may also occur.  It can be life threatening to newborns, elderly persons, and those with existing conditions such as diabetes, heart disease and high blood pressure.   There is no treatment for the disease, but drugs such as acetaminophen help to reduce the pain and discomfort.  The price of these drugs has skyrocketed over the last two months.

The area surrounding the Lamp clinic is a low-lying mosquito-ridden area.  The Bwa Nèf neighborhood is closed off, on two sides, by a huge tract of swampy land.  The new disease has hit Bwa Nèf hard.  These days, when our staff arrive at the clinic in the morning there are people lying on the ground, groaning from the pain of this ugly addition to the regular health menaces.  And our staff have not avoided the pain either: all of our staff (excepting only one doctor, so far) have already experienced the disease first-hand.  It has been a harsh month for our staff but we are not working in Bwa Nèf to avoid challenges.  The community of Bwa Nèf needs our commitment (contorted in pain, or not!)

One of the key principles of the Lamp is to build our organization — and the wider Haitian health system — by hiring and developing talented and committed Haitian professionals.

The unemployment rate in Haiti is murderously high, estimated at 41% for 2013.  Of persons who are employed, only one third have formal jobs.  Underemployment  — where a worker is  unable to earn a living wage, unable to  provide for the basic needs of their families — affects a huge proportion of those who are considered employed.

Given the scarcity of jobs on one hand, and the overabundance of medical needs on the other, it gives us great satisfaction to provide our services with a fully Haitian staff.

The benefits of this philosophy, for the Lamp and the people of Cité Soleil, are also clear to see on the ground: staff with an intimate knowledge of local culture, language and the intricacies of the Haitian health system.

Denold (future x-ray tech) and manager Benoit discuss some construction issues

Of course, our focus is not only on the wider health system.  We also wish to build capacity, whenever possible, right here in the community in which we find ourselves.   We engage with community groups, provide community services, and assist with community improvements.  We provide jobs wherever possible.   It is very thrilling, therefore, to be able to announce that we have hired our first ever medical staff member (and third staffer overall) from Bwa Nèf itself.

Dénold has long proved his commitment to the Lamp’s cause and his genuine concern for his neighbors by volunteering selflessly at the clinic.  With the launch of our radiology facilities on the horizon, Dénold has taken up training as an x-ray technician at St. Luke’s Hospital, a generous and collaborative partner agency.  St. Luke’s uses x-ray equipment that is very similar to the equipment we will soon be installing.  When Dénold returns he will take full responsibility for the operation of the x-ray unit .

Although we could have chosen to hire one of St. Luke’s own technicians, we could not pass up this opportunity to build capacity in Bwa Nèf.  Dénold Joseph is an extraordinary young man, smart and compassionate; he will make a terrific addition to our team.