Bonjou tout moun and welcome to our blog!

It's hard to believe, but we have now been in Thomassique for a full month. After a whirlwind orientation from Katie and Kavita, we have quickly assumed our many roles as fellows and already survived a few ti pwoblem along the way, including mechanical difficulties, illnesses, and embarrassing Kreyol misunderstandings. For the next year, we'll use this blog to give updates about our work in the clinic and community, for anyone that is interested! This post is admittedly overdue, but we promise to post more frequently in the future.

Clinic Updates

Our central goals this year focus on improving St. Joseph's Clinic itself, so we'll begin with an update about the happenings in our klinik. For those who don't know, St. Joseph's is a rural clinic that provides primary care, maternity services, lab tests, basic radiology and emergency care to approximately 100,000 people in Thomassique and the surrounding areas.

We have quickly learned that supply management is a significant challenge at St. Joseph's. This is a common problem for clinics in the region, and has been further complicated by the increased medical needs in post-earthquake Port au Prince. So, in an effort to improve our oversight of medications, lab tests, and other supplies, much of our time has been spent organizing and inventorying items in the clinic. After countless hours of moving, sorting and labeling, we finally have three sparkling rooms full of neatly organized boxes: The medications depot (pictured at left, alphabetized and labeled with expiration dates), the orthopedics depot and the storage room which once held the Tuberculosis program. The ER depot will also be completed soon, and after that loom the surgical and pediatrics depots. Though it may not be glamorous work, knowing and tracking what we have in each of these spaces is incredibly important for keeping the clinic consistently stocked. We've already found supplies that clinic staff thought they lacked and have a better concept of what and how much to order in the future.

Another development at the clinic (which is probably more exciting to you than hearing about rooms full of boxes) is the impending reinstatement of a Tuberculosis program! The government will be sending us a nurse specifically to run a TB program starting next month, which we welcome enthusiastically.

Community Health Centers

There are also many promising advances being made outside the clinic. Most notably, three of our new Community Health Centers (CHC- previously known as Satellite Health Centers) are now open in Savann Plat, Dahlegran and Barank. After trainings with Zanmi Lasante and at St. Joseph's, our Community Health Workers (or Ajan Sante) Anya, Mary Madeline and Jude are each busy providing first aid, essential medications, referrals and health education to 35-40 patients daily. Many of these patients (such as those pictured above, waiting to see Jude at Barank) would otherwise be unable to access care due to their remote locations. Additionally, we are incorporating our Bon Sel and Klorfasil projects into the health centers. Each Ajan Sante promotes these items to patients and community members, and is responsible for conducting home-visits to ensure that the Klorfasil systems are being used properly.

We are continually inspired and impressed by the dedication of our Ajan Santes and Health Committees (groups of community members that support and guide each CHC) to improving health in their communities. In fact, it was the Barank Health Committee that first suggested the concept of a CHC and it is a testament to the hard work of many community members this idea has become a reality. In the image to the left, our Klorfasil expert, Shelove, demonstrates how to use Klorfasil systems to the Bouloum Health Committee (which will open a CHC in early August).

Looking Forward

In all, one of the strongest impressions we have gained in our first month is that there is no shortage of incredibly caring and passionate individuals in Thomassique working towards the same goals as us; the Health Committees are only one example of this. We are thankful to the past fellows for cultivating relationships with some truly inspiring organizations and leaders, and are excited to work with these extraordinary people in the coming year.

Thanks for reading; we'll be in touch again soon!

Festive music emanated loudly from large speakers. Crowds of people mingled, greeting one another and chatting. The atmosphere was vibrant and full of energy; this could easily have been a scene out of a wedding reception or town fair. Actually, this was last Saturday’s mobile clinic for the physically disabled people of Thomassique, organized by a community-led organization called ACAHT (Association pour la Canalisation d’aide aux Handicapés de Thomassique). Upon arriving at the event, we realized that this was not merely a mobile clinic, but an opportunity for the community to come together and celebrate the fact that much-needed services are now being provided for handicapped people in this area. The event was an embodiment of all that ACAHT and other local community-led initiatives seek to do – bring people together to effect positive change in Thomassique.

ACAHT is just one of many successful locally led initiatives in Thomassique. Here, we will highlight the work of several other organizations with which we’ve worked this year. This is just a small sample of countless community initiatives that exist here.

ACOSAT
Within our first week in Haiti, we were approached by Jocelia, a woman who runs an organization and school for orphans in Thomassique. The organization, called Association Communautaire Orphelinat secours d'Enfant de Thomassique (ACOSAT), aims to provide services for guardian families taking care of orphaned and abandoned children. While this is a perennial problem in the community, it has been a particularly pressing need in the months following the earthquake. ACOSAT was one of the local organizations (along with ACAHT and the World Vision Earthquake Relief Committee) that we partnered with to distribute the earthquake relief items that were sent to Thomassique from the US in the months following the disaster.

An innovative thinker, Jocelia has also begun a program to fund ACOSAT’s school by starting a business as a seamstress. She plans to teach young women in the school how to use manually-powered sewing machines. They will make and sell uniforms, clothing, and decorative cloths. All profits will benefit the organization and school. In an environment in which external funding is nearly impossible to come by, it is this kind of entrepreneurial spirit that can sustain community initiatives such as ACOSAT.

Lekòl Tèt Ansanm
The lack of an adequate education system is a persisting problem in Thomassique. The government-run school has the capacity to serve only a small fraction of children in the area. For the majority of children who cannot find seats in the government-run school, private school is the only chance at an education. The cost of a private education – tuition fees, books, uniforms, shoes - can be unmanageable, especially for families with multiple school-aged children. In response to this problem, there are several locally run free or low-cost schools that have been introduced in Thomassique. We collaborate with several of them for our School Lunch Program. One of them, Tèt Ansanm, was started by Down Belizaire (our x-ray technician at St. Joseph’s Clinic) and his friend Betony. This free school is open to Thomassique’s poorest children, and the teachers work on a volunteer basis. Other free and low-cost schools in this area include Lekòl Fermi and Lekòl Pòv.

Kay Pòv
Kay Pòv (the Poor House) is a home for the aging and infirm of Thomassique. Managed by Pierre Louis, a local leader who also directs Lekòl Pòv (the Poor School), Kay Pòv exemplifies the social services that are made available to those most in need – not by any governmental or international aid program, but by a neighborhood coming together to support its residents.

Association Femmes de Thomassique (AFDT)
It seems that we are constantly learning of more community initiatives in Thomassique. Just last week, we attended a meeting with the Association Femmes de Thomassique (AFDT), an organization dedicated to the empowerment and mobilization of women as key players in development work. We met with the committee of over 50 women from Thomassique and discussed their needs and ambitions. One of their goals is to begin a loan program for women, using pooled funds to support entrepreneurial ventures. They also expressed interest in collaborating with the clinic to address issues of women’s health in Thomassique. We plan to collaborate with AFDT as we look to expand the outreach services of our maternity department. Furthermore, the board members of AFDT expressed interest in selling Bon Sel as a way of promoting good health practices and fundraising for their organization. AFDT’s salt sales began last week.

The presence of multitudinous community-led initiatives in Thomassique was a surprise to us when we first arrived here. Not knowing much about the area, we had originally anticipated that community-led initiatives would require a certain base level of material resources that were lacking in Thomassique. We were impressed to find that, even with extremely limited resources, several programs have been implemented. This is not to say that resources are not needed. Indeed, money is the limiting factor in every one of these programs. But we were surprised and impressed by the fact that community collaborations such as these exist even in the absence of material resources; such initiatives are fueled by the resourcefulness, determination, and civic-mindedness of the people of Thomassique.

This week marks our one-year anniversary at St. Joseph’s Clinic. One year ago, our friend Rigot Thomas asked us a question that has resonated with us ever since: kijan w wè Ayiti? How do you see Haiti? The answer is complicated, to say the least. Every day in Thomassique, we witness the effects of global injustice: hunger, preventable diseases, lack of access to clean drinking water, and abject poverty. But it is unfair and inaccurate to reduce this country to a poverty-stricken, victimized nation. The people of Haiti are not passive recipients of misfortune or aid; they are active and invaluable players in development work. In the face of a harsh reality, it is they who best understand the needs of this country. Our work in Thomassique this year would not have been possible or effective without our local partnerships. We continue to be inspired and moved by the competency, compassion, and undying commitment that these organizations have to this community.

Imagine finding yourself ill and knowing that the closest health center is two to three hours away by foot. This is a reality that the majority of our patients at St. Joseph's Clinic face whenever they seek care. We are centrally located in Thomassique, but for our patients that live nan deyo (in outlying zones), the clinic is far from accessible. If they get a cut or have a cough, they must walk several hours to access medical care. Unfortunately, this means that many people do not seek care until the last minute- when small cuts have become seriously infected, or minor coughs have progressed to pneumonia.