Here in Haiti-Short report

Here in Haiti - a short report

Well the news got out fairly quickly that Dr Paul Walsh and I were coming here. Maybe its my accent, but the story was quickly distorted in the rumour mill, and the latest was that we were going to Tahiti!

Anyway we are sitting here in the courtyard of a hostel in Port au Prince, and are pleased to report that we have been quite industrious, we have met many NGO's and some very special people who have been trying to bring us up to speed on the "situation" here.

I suspect we shall unfold the full story for all when we get back, but we thought a quick overview might be courteous for the many people that have expressed so much support to us.

It seemed that immediately on our arrival (without Paul's luggage), we hit the ground running. First on the list was a medical clinic in Cite Soleil, that notorious slum in Port an Prince. We were escorted in by the caretaker, on his motor bike. He seemed to know everyone everywhere, we almost felt "Presidential" and then there was "Mission Ranch" a small medical oasis with an orphange attached. They would love any kind of dental care!

They have a saying here "that one sees from where one looks"............. as Canadians it did not look too good. The only thing in abundance was the smiles.

Then off to the Dental School where we met the Vice Dean Sam Prophete, the Dean and many staff members. The structure of the school itself emerged largely unscathed from the earthquake, the medical school next door was largely destroyed including a full cohort of 150 nurses, in the 33 seconds that so cruelly changed so much for so many. There is great need in the dental school for equipment and supplies.

We met Dr Prophete, a charming man, later for supper. He kindly introduced us to Dr Ariel Henry a minister of health. He "filled us in" of plans for the future, but alas he had to leave early due to an unfolding health crisis in the Central Highlands.

Thursday was a planned trip to the Central Highlands, under the care of Partners in Health (look em up on the Web), escorted by Jon Lascher their "Procurement Officer". Jon is a delightful young man who has more energy that the two of us put together. His finger was very much on the pulse and we were frankly astonished at the work and success of their programmes. They have developed partnerships in Haiti over the last 25 years and their hospitals have been pivotal in the response we have seen since January. We had a lot to learn from him.

The drive to the Central Highlands was both long and painful across roads barely manageable to a four wheel drive, the scenery was stunning. We visited health care facilities in the back of beyond and then a little further. We were asked to consult on a broken jaw and as you may appreciate, you just keep a wet fingered dentist down!

Many will know by now that there is an emerging health crisis with the cholera outbreak in the very region we were visiting, the story was unfolding by the minute as we continued on throughout the day. As procurement officed Jon was responsible for most things associated with containing and treating an epidemic. He operated his I-phone with his right hand and his cell phone with his left, speaking 3 languages as we bounced over dirt tracks in the middle of nowhere.

He apologised profusely as he went, checking on the availability of rehdration packs from Panama, their delivery time, was Cipro available and had the bugs been confirmed and identified yet. The connections of PIH were impressive. The tour still went on......

14 hours later, long after dark, we arrived in the Womens Health compound in La Colline. 4 ragged, past their best, well sweated guys were made warmly welcome, in this bastion of feminine retreat. We behaved well and remembered our manners.

So, Paul and I are back in Port au Prince, our brains are dizzy, bodies tired. Our impressions so far

well the country was dealt a cruel blow Jan 12th, the good news is that it is up and running again, there is a lot going on, sure its going to take time............ I do not know what the dental community can do about 1.2 million people living in tent cities, but we can help in other ways, and I suspect we shall!

The smiles on the faces of the school children walking hand in hand at the side of the road, their uniforms freshly laundered, attest to the resilience of a remarkable people. I have to say that there is much hope for the future.

Anyway more to come when we get home, we wonder that Monday morning at the office might be like wakening up from a dream.......................

More to follow

Medical Officer of Health

We were thrilled to have Dr David Allison come to our meeting last Monday. He had just returned from Haiti where he had just completed a tour with the Canadian Red Cross. He was working in a field hospital which was set up by Germany.

He had much to tell us, about security, health care and much more and I have enclosed some of our minutes of this meeting.

Discussion:

• Dr. Gillies welcomed everyone back and recognized that a number of our members were out of town and unable to attend.
• Dr. Gillies introduced Dr. David Allison Medical Director for Eastern Health. Dr. Allison had just returned from a 7 week tour of duty in Haiti and provided a valued review of issues that we may face as we go forward.

Dr. Allison’s Presentation:

• Dr. Allison had served with the German Red Cross in a field hospital located in a football stadium. He was very clear that what they were dealing is no longer earthquake related but a very inadequate health care system which was there before and still exists.

• The current relief efforts are a short term solution to a long term problem. How does the Red Cross finish up and leave when there is so much that will still need to be done. It is a concern they have and a reality that we need to deal with as we make our plans to provide relief.

• There is a high level of opportunism ongoing in Haiti. The high value of aid, supply and equipment coming into Haiti has developed a side economy based on fees and taxes to the process. An item may take months to clear customs and the fees could be very high. If we bring in donated equipment they will charge us an assessed value.

• There is an issue of competition in providing health care. Down the block from the Field Hospital is a functional Haitian Obstetrics Hospital which is not being fully utilized while the field hospital is treating OB cases. The field hospital provides free drugs and supplies and thereby is more attractive. That is a very significant issue as we would be operating in a fee for service environment.

• Crime and corruption is a real issue and needs to be dealt with on a very serious basis. The field hospital had armed guards at the entrance to the stadium plus inside armed guards at the compound where staff are accommodated. A goodly number of patients brought in are as a result of gun shots and stabbings. The Red Cross have a self imposed curfew of 6:00 just before sundown. Being kidnapped is a real possible thing if you go wander in the wrong place at the wrong time.

• To work in Haiti licensure is not an issue at this time. This is possibly not because they are accommodating but more because they have not thought about the possible cash involved. To hire a local Physician or Surgeon the cost is approx 2,500 Gourdes or $66.00 Canadian. Approx $17,000 per year. A Dentist would be similar in price.

• The actual destruction of building and homes is an issue which will take a long time to fix. There are buildings still standing but unsafe and others which are just a pile of rubble. Who cleans up and knocks down condemned buildings? The Government has not gotten to that level of order yet and that is one of the first things that need to be done.

Outcomes:

1. Mr. Patey and Mr. Winters will meet to set up an operating budget for the Foundation. Such will not just administrative but also projects.

2. Dr. Hiltz will contact Dr. Prophete in Haiti with regard to current needs and process of getting supplies in without the high level of fees, customs duties and theft.

3. The following positions were assigned;

· Dr. Gillies President

· Dr. Paul Walsh Vice-President

· Mr. Peter Winters Treasurer

· Dr. Hiltz Secretary

· Mr. Anthony Patey Executive Director

4. Next meeting September 9^th 2010 7:30 NLDA Offices

After the summer

Well, the summer has come and is fast ending, I have been away on atrip for most of it. Alas all good things come to an end. The good news is that whilst I have been away, the committee has been busy.

The big news is that Ken Templeton has submitted the paperwork to the CRA and Industry Canada, such that we can move towards our charitable status. Thank you so much Ken, it is greatly appreciated, and we are waiting now to see if we are accepted by the authorities.

This will allow us to proceed with our canvassing the Membership for donations, and then we can move along with the aid.

We heard froma journalist, who has been going to Haiti, and who has written some good stuff, I will enclose some of her writing which I feel is worthy of the attention of interested parties.

One of the things she has advised us is that we believe 35 dental offices were lost in the earth quake.

We continue to correspond with Dr Prophete the Vice Dean of the dental school, and we are starting to get some dates together for travel to Haiti.

Thirty-five seconds.

Less time than I spend brushing my teeth in the morning. Or kissing my husband. Tucking my daughter into bed.

That’s how long the earth shook in southern Haiti in the early evening of Jan. 12. It took 35 seconds to crush mothers cooking dinner in their kitchens, smother students at their desks, buck terrified drivers into the air, shove buildings over cliffs onto buses packed with commuters.

In 35 seconds, a country was brought to its knees.

I often think of that. In less than a minute, you can lose everything. That’s one lesson Haiti has taught me.

I have travelled to Haiti four times since the earthquake. It’s been an emotional roller coaster, cranking me up to hope before careening me toward despair.

On my first trip, shortly after the 7.0 magnitude earthquake, I was overwhelmed with sorrow. The rubble I stepped over was decorated with high heel shoes, computer chairs, framed baby pictures — intimate mementoes of all the lives lost. Death was everywhere. I carried toothpaste to smear under my nose when its overripe smell became sickeningly pungent. During an interview down one rubble-choked alley, a woman hobbling past said she’d lost two children and kept going. It was as if she was mentioning a TTC breakdown.

I noticed a sense of optimism almost immediately after arriving the second time. Where a single airport employee had roused to stamp my passport and wave me through a dark, abandoned terminal the first time, I was greeted by a four-man band. A stroll through the country’s biggest refugee camp revealed beauty parlours, restaurants, health clinics, bathroom areas where spigots spurted water from giant bladders. Schools had just reopened under tarps, many at the expense of principals like Marie Florvie Dorestand, who emptied her family’s bank account to remove the rubble. Stepping into her schoolyard, I was greeted by hundreds of little girls, white ribbons in their hair, bouncing and singing. They went on for more than an hour.

The country’s first post-disaster action plan, presented at the international donors conference in New York, painted an idyllic Haiti of the near-future: universal health care, free education, reforested countryside, decent housing for all, a strong economy with dependable clean electricity.

I returned from my most recent visit last month. By then, much of that optimism was gone. You can pee in a bucket in your sweltering shelter at night for fear of being raped enroute to the latrines only for so long before your spirit is crushed. The free bags of rice were long gone; replaced by “cash for work” programs, which pay men and women around $5 (U.S.) a day to throw rubble into dump trucks by hand or, if they’re lucky, shovel.

A doctor pulled me aside at that throbbing refugee camp and whispered, “Want the real story? Write about hunger. People are starving.”

The government hadn’t made good on its promise to pay teachers’ salaries, and many principals were threatening to close their schools.

Some 1.6 million people are still displaced, most crowded into impromptu camps along the sides of the road with no hope of a real home. Landowners squabble over the rubble removal, many demanding to be compensated. So, the roads remain clogged.

The UN estimates 135,000 temporary shelters of wood and metal need to be built to house the homeless. So far, only 5,660 have gone up.

I met a 2-pound baby who was rushed to one of the city’s main for-profit hospitals. The hospital lost $180,000 in the first month after the earthquake, treating patients for free. To survive, it started charging again and the baby’s panicked parents were told to pay $400 for ten days of treatment — more than many Haitians make in a year. We scrambled to find the money — volunteer nurses and pediatricians throwing in $20 each, knowing that otherwise, this baby would die.

All this makes me angry. There are many people to blame: the Haitian government for not taking enough leadership, international aid agencies set on heroism over cooperation, international donors that haven’t delivered on their promises.

I can’t understand why the Interim Reconstruction Committee, headed by former U.S. president Bill Clinton and Haitian Prime Minister Max Bellerive, has managed to meet only once in the months since the earthquake. What is taking them so long?

I concede a few points. Nigel Fisher, the deputy special representative of the UN secretary general in Haiti, who I met in a dusty resettlement camp, told The New York Times: “What hasn’t happened is worth noting. We haven’t had a major outbreak of disease. We haven’t had a major breakdown in security.”

Haitian President Rene Préval was visiting the camp that same day. He pointed out that recovering from natural disasters take rich countries years. Case in Point: Hurricane Katrina, where people were still homeless two years later.

“We are doing our best. You have to understand and be patient,” he said. “It’s not that easy to make good conditions right away.”

He is right. Except, it’s hard to be patient when your 2-pound baby is going to die without care you can’t afford.

Most experts I’ve spoken to predict it will take 10 years for Haiti to get back on its feet. Ten years to recover from 35 seconds.

That is too long. We must all do better.

Catherine Porter’s column usually appears Tuesday, Thursday and Saturday. She can be reached at cporter@thestar.ca.

Where are we now

well, we gently trundle forward hopefully inexorably. The Oral Health Convention has come and gone and Margot Hiltz presented at the business meeting, and she did a fine job. Basically it brought the membership up to speed on the project. She spoke well in the few minutes she had to deliver the goods! Well done Margot and thank you very much.

I also had an opportunity to speak at the Presidents dinner and kept the pot boiling on our project. Many people have offerred their support. Thank You.

We have a meeting tonite with Viola Duff a health care worker who has run projects with CIDA and other organisations as far away as China and also in Central and South America. We look forward to hearing what she has to say, as we are the newbies on this one and her direction would be most valuable.

We have talked before about trying to focus our energies and funds such that we can achieve the max benefit, we have to be realistic in what we might achieve, and I hope that Viola can keep our feet on the ground and help us refine some details.

Mr Ken Templeton a lawyer in town here has also stepped up to assist, and he most graciously has offered to take care of the setting up of a Foundation such that we can then accept so much of the financial assistance that had been extended. We should be moving forward on that very shortly.

Mr Peter Winters an accountant who has some experience with charities and their issues has agreed to come onto the board of the Foundation, both Peter and Ken are very knowledgeable and are most welcome.

We are slowly developing our contacts in Haiti and more information is coming in. It seems that the Dental School in Port au Prince is operational and indeed standing after the quake. It graduates about 22 students a year. Our contact Dr Prophete, is Vice Dean and he has been explaining some of the details of health care, in the country.

Apparently there is enormous need not just in the city but also in the rural areas, where we believe there is no dental care at all.

We have asked the dentists at our Convention whether anyone would like to travel to Haiti for one to two weeks to provide care. It is the intention that both myself and Dr Paul Walsh will travel to Haiti some time in the fall when we can meet with some of the people there to try develop the details of our response. Hurricanes permitting. It will likely be an opprtunity to do a bit of dentstry!

There is a clinic which is Church supported near the airport which has three dental chairs, and only one dentist. One of our colleagues from the States goes down every year for a couple of weeks, and does what he can in that time. He has encouraged others to follow suit, and speaks highly of the clinic. We can asist anyone who would like to do likewise.

Actually I am just off the phone from a discussion with Dr David Allison, our own Medial Officer of Health who will be leaving next week for a six week tour of assistance in Haiti. We will keep in touch and look forwrad to his safe return and advice as the summer proceeds. He is part of a response by the Cnadian Red Cross.

Thats all for now.

Food Aid Ceases

Its now business as usual for the Haitian people, that means that there is much more uncertainty and back to living literally from day to day. Free food handouts have been withdrawn.

Since the last entry we have met a couple of times, and in all honesty we are struggling to come up with the best way of assisting the country. More information has been coming in and we now know that apparently the Dental School is still intact. Indeed we have been in touch with the Vice Dean a Dr Samuel E Prophete.

It seems that before the earthquake they were some progress in Dental Public Health with the coming appointment of a Dental Officer, however we can reasonably assume that any activity has since ceased with the present circumstance.

Dr Prophete has expressed an interest in working with us, and this may well be an avenue to pursue. We are thinking that perhaps we may assist with materials and equipment and also possibly education.

Some of our thoughts are being directed towards the immediate needs of the people of Haiti, we have identified a hospital which is run by a church group which would welcome us. The unit which was donated by Paterson will be in town shortly and will be assembled and checked out fully before we send it down possibly to this clinic.

Our contact there is Dr Jackie Solages who has advised us that there are two free clinics for the public, one at St Damiens (church supported charity) and another in a place called Kenscoff.
I believe they need help both in terms of equipment but also monies for staff, both dentists and assistants.

One thing we are very sure of is that the need is immense, we have to be very selective to see that we not only assist with immediate issues but also be aware that we should allow the people of Haiti to participate and hopefully take ownership. They can then be slowly left with the education, training and tools to move on. We would then reduce their depency on aid.

Discussions have taken place with a view to establishing charitable status and we think we have good news on that effort. We believe that its possible to set this up ourselves and thereby maintain control over our own funds and being able to direct them as we see fit. A meeting is planned shortly to try and put this issue to bed.

A bit a media blitz at the coming Oral Health Convention is planned and we hope we shall have our charitable foundation status at that time so we can canvas our membership. Dr Hiltz is the prime mover on this. We would also like to approach the Dentist to see if anyone would be interested to travel to Haiti to donate their time.

Making contacts

As usual, the word gets around and next thing in Newfoundland one person knows another and then things start.

Well we received a name in the Salvation Army, apparently the SA have a hospital in Haiti, so contact has been made and we are advised that they are sending people down very soon and had lots of good advice as to how to navigate the system. They will be reporting back soon on their return and we anxiously await their news. I believe that they have been working with St Theresa's church to develop a dual response and already have medical equipment to send. One of the interesting bits of information they gave was that nearly all health care/education was pretty organised by the churches.

We shall be shortly be receiving a Dental Unit from Paterson Dental which will stored here in St John's and fully checked out by their representative Mr Dave Badcock, so all will be in good working order before despatch.

The big news was that one of our own, Dr Linda Goodyear made the trip down, and many may have seen her picture on the front page of the Telegram. She tells of a most rewarding experience, the warmth of the people and just how things were going. We have a few more names of contacts on site, one was a hospital administrator who would be delighted to have a dental unit in his hospitall.

So things are moving along, we have a lot of emails out there (yes email is alive and well in Haiti-but can be intermittent). We have asked the locals for input, how should we proceed, what do they need how can we assist them. This is again building on the partnership plan, allowing us to assist them but letting them self-determine and move forward with our assistance.

Next meeting is 7th April (Wed) at the NLDA offices and we hope to have more to report at that time. Dr Angela and Paul Walsh have become involved now and they bring much energy and experience to the table. I shall be a way in late May, however, Dr Margot Hiltz will be making a small presentation at the AGM in May to keep everyone in the picture.

Not much posting but lots happening

We have a few get togethers and time is always the enemy. I apologise for not getting the info out there more quickly however here goes.

Lots of action with many people contacted, lots of good work and as usual the leg work is starting to provide some dividends. So here is the news.

We have talked to the CDA and also Health Canada with really nothing of note to report. Similarly the Dental schools, everybody is happy to talk but really no action at all. The FDI were spearheading some work but we have yet to get a response from Dr Rodriguez.

A logo has been developed and we hope to add it to the blog page when we learn how to do that, (its not easy being old), however I think Leslie Patey will come to the rescue as she did for the logo itself. Gee I guess we are out there now we have an identity, it also will appear on the latest edition of the Newsletter which is just being sent out. Moreover it will have a link from the NLDA website (ah the wonders of the computer age).

Communication with the membership and others has been a problem. It seems that email may be either ignored or disregarded. Anyway we shall try in other ways to keep everyone informed and up to speed. The intention for the AGM of the NLDA is to set up a table next to the registration desk with pictures, and brochures to keep all informed. There will of course be a receipt book handy for any donations.

Talking of which we are still endeavouring to establish our tax deductible status. The General Hospital Foundation has been very supportive but has not given us the go ahead yet. They promise soon.