|July 2017 – First Cohort of 200
It was a long time coming. The idea. The concept. The fundraising. The launch last week. And now, finally, to meet all these women and their families. We have the privilege to get to know ALL of the participants in the Mercy-Focus on Haiti CLM Project.
We, as a team, had traveled from all over the US to finally meet in Haiti and begin our journey of discovery. We gathered, introduced, bonded and counted pills together that first day. It was and is always a great team building event – to sort pills into manageable packets to provide medications for the patients. It was a shared effort for the common good.
We then traveled that long bus ride – 5 hours in a school bus – now with our name on it and driven by our protector, Papa. The last one hour is hellish as the paved road disappears and we bump along on hard gravel, ruts, and gullies. Gros Morne is finally at the end of our journey.
After a ‘settling in period’ at the Kay Visite, we visit some of the new CLM members in their homes. Packed in a pickup truck, some of us in the back trying to hold on, others in the cab, we began a trans area trip through the brush, along dirt roads, and up steep paths to be greeted by women eager to share their new journey with us. They proudly show us the packets they got last week at the ‘launch’ with a numbered ticket for their medical visit within the next few days. This packet also contains a membership card with their picture on it (perhaps the first picture they have ever had taken) and their ‘visit book’ which will contain observations by their case workers, any assets they may be given and a description of what is expected of them.
At the first house we visited, we walked along a dusty, rutted path to the back of a compound of houses, each set in the middle of a small patch of land barely capable of growing produce. The house is made of vertical sticks woven together with vine roughly in the shape of an oval, covered with thatch made from palm fronds. The threshold is raised, I’m told, to prevent the rain from flowing through the house when it runs high. The floor inside is dirt, pounded flat by many feet over many years. There is no visible furniture or bedding. Cooking is done outdoors.
Already there is the beginning of a goat enclosure – this woman shows us in her book that she is going to receive two goats and a pig. She is preparing for their arrival.
Her children gather around us, touching the ‘blancs’ to see how our skin feels, and some of the neighbors come over to be part of this celebration. Life can be different for her because of her enrollment, and they all are aware.
The second home is a short drive away and up a steep, rain rutted path, again to a stick house in a small area of land possibly suited for growing. Here there are no other nearby houses. Sitting on a crudely made bench under a mango tree is an old man who hears us coming and rises with difficulty. It is evident that he is blind. But he is ready to greet us with a broad toothless grin. He is the husband of the new CLM member and part of this interesting household.
The CLM member is a woman of about 45, she says but she is not sure, and she is caring for this older man and her three grandchildren. Her daughter, their mother, has returned periodically on at least three occasions from Port au Prince with a new baby and left them with her to raise. The girls are about 11, 8 and 6, all looking healthy except for the ‘redness’ of their otherwise black hair, a sign of micronutrient deficiency.
Again, the beginning of a new goat enclosure awaiting the arrival of her new animals.
They are pleased to meet us and ready to start their 18-month journey to a better life.
We saw these same women and their families again in the medical clinic over the next few days. As the medical screening team, we were going to personally interview ALL the CLM members, their families, and all their children. What a privilege.
Each day starts slow for the clinicians because we wait for the patients as they are registered, triaged, weighed, measured, and questioned about living situations. When we finally see them as a family, all of us with interpreters since none of us speaks Creole, we interview each one individually, trying to assess if a problem exists that needs immediate intervention, timely medication, referral for another level of care, or follow-up later. All patients are given vitamins, and many need Iron replacement for anemia.
And the day progresses, one family at a time. Some families are small, only two people. Others are large, very large, with 12 people. And we continue.
How telling is all this?
Diseases hide, only manifest by a blood pressure measurement or an HIV test. Others are easily manifest by their appearance; a child with a horrendous rash, a middle age woman pleasant in every way except for this large mass growing under her right ear that has been there for years. Sometimes we have solutions, referral sources, alternative care. Many times, we do not have the answer and must rely on the helpful CLM staff that accompany us and in whose hands we work.
As the day progresses, a rhythm develops. Ask questions, get answers, offer advice and redirect the family to the pediatrician for the care of the children. Since most of the adults cannot read, it is important that all instructions be given clearly, repeated for clarity and repeated back to us to assure understanding.
After a few days of explaining to each patient how to take their vitamins, (Monday and Thursday) and Iron (Tuesday and Friday), it became apparent why we were there and why all the families were there. As we explained the medication regimen to one family a young boy pipes up from the back of the family unit, points to the label and says to his mother, ‘It’s written there.” She proudly says, “That’s why we send him to school.”
This boy is the future. He and all the other children who will be educated because of the strength and resilience of these women ‘members’ are the future of Haiti. And we have done our small part in the change.
Kathleen Roeder M.D.
|Kathleen Roeder M.D.
Medical Mission, July 2017