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”!

The solar panels will go up on the new cement roof

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

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!)

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

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

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 her father

Rony Charles, EMR programmer

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…

Initial EMR training with Dr James Morgan and Nick Sahagian

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

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!

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!