NGOs

Before this Haiti trip I kind of had the idealistic perception of most Nongovernmental organizations as an effective serving entity because we’ve learned that they usually provided free or cheap aid and could do so with limited governmental bureaucracy crap interfering.

But now after 2 months here and various visits to diverse NGOs accompanied by dinner conversations with people working there, many of the other complexities involved with these organizations are so readily apparent. Its revealing to hear the employees’ transformations from idealistic beliefs in the great services of NGOs turning into realistic hardened outlooks on the extents of aid once they’ve been working for a couple months or so.

Johanniter delivers free prosthetics to

amputees and offers psychological counseling

It seems like the biggest mistake many NGOs commit is to come in to the country with their own goal in mind and persistently try to implement that without responding to specific community needs. Or coming in with the belief that you can fix all the problems you see. Serena from Johanniter illustrated this perfectly by saying when she first came she saw like 20 large problems, but realistically learned that to accomplish anything effective, she with her NGO would have to be flexible and could really only focus on 2-3 problems and just hope other organizations take care of the rest. Other NGOs are just not understanding of the community culture and values. An example of this deals with a group here (whose name I’ll leave out), whose volunteers apparently showed up at the earthquake anniversary march dressed in old dirty unwashed clothes in an attempt to “be like the people.” This was obviously insulting to most of the Haitians who were clean and dressed up in their best clothes for such an event. MSF, while providing free healthcare, also has some faults of its own. We’ve noticed many times from our surveys that people are becoming impatient and sometimes annoyed with them because of the long lines they must wait in to be seen and then being subjected to very impersonal exchanges with some of the doctors, no doubt due in part to many of the doctors coming from foreign countries.

MSF! they didn't let us take pic of the inside

but it was a huge complex, very well-organized

For some of those reasons I was at first a little skeptical of Family Health Ministries and the new health center they're planning to build. Of course the plans were decided with good intentions, but it has become visibly evident how that is never quite enough. Yet upon further inspection I’ve realized there's more to the FHM plan than I originally thought. For starters they’ve been sending students like us out in to the field to conduct surveys and assessments of the real community needs instead of already assuming what the needs are. FHM is also partnering with Dr. Delson’s ob-gyn clinic here and have established their
cervical cancer program, which shows connection to the local healthcare and working alongside it. FHM is also implementing a policy where the health workers at the new hospital will only be Haitian. I’m not sure how feasible it is to stay faithful to this model in the beginning stages but the commitment to employing only Haitians is commendable and will definitely be favored by the local community.

Gadyen Dlo, an organization that gives out water-containing

buckets engineered to prevent contamination

an NGO called Fish Ministries that raises chickens fish

and goats used to feed schoolchildren in the community

other random pics from visit to the Sri Lankan UN compound

Un de Cha cha cha

Ok I’ve been meaning to share this funny experience but constantly forget to mention it, so now I’ll devote a whole post to the story and the fantastic English club down the road.

There’s this pretty popular bar called Masaje right across the road from us, the furthest we’re allowed to walk to after dark for safety reasons. On Thursdays they hold a special Latino night. So on one of these early in the trip we all decided to head over, and upon entering immediately noticed how underdressed we were; everyone had on pants and a shirt/fancy dress while we all wore flipflops and shorts/skirts. Despite all the looks we received we grabbed a table and sat down while other amazing dancers took the stage. After a while Annie and I, followed by Sedlin and Lisa, decided to go give it a shot, messing around and spinning each other up on the dance floor usually inches from hitting someone. After that song they paused all the music and dancing and made an announcement in Creole followed by in English and flatout said “it doesn’t matter if you’re Haitian or if you’re white but especially if you’re white don’t dance if you don’t know how!" For a second we stared at each other in disbelief and then just burst out laughing, and were eventually kicked out for dress code.

MASAJE!
note the 'classy' Haitian beer Prestige being poured into a wine glass

to the left: dancing during our first latino night


So we all made a pact (and wrote it on our bucket list of things to do in Haiti) that we would somehow learn to properly dance salsa, cha cha, whatever, and make an astonishing debut back at Masaje in a few weeks. Luckily we came across the free English club around the corner and over the weeks it served as a great cultural immersion activity for us and a nice cultural exchange for them. We realized they only actually teach English on Fridays and Saturdays while almost every other afternoon is devoted to dance lessons. Mimi, one of the awesome head teachers, introduced us to cha cha cha, starting with the basics steps and twists and turns. We eventually also learned some rumba, bachata, and salsa. Most of the students there now recognize us by our frequent visits and are all very welcoming, often jumpstarting conversations with whatever simple English they know.

sometimes dancing would just
turn into doing the electric slide

On the days they teach English we’re usually brought up to the front for an introduction and then must answer to an assault of questions, usually about our love life, marital status, if we have kids, and whether or not we would like a boyfriend/girlfriend here in Haiti. Definitely a lot of fun answering some of those. It’s also quite funny seeing their uses of certain English phrases; “that’s ok?” and “that’s alright” spoken almost every other sentence. We’ve helped out on a few days and next Friday and Saturday we’ll be teaching our own organized English lessons and exchanging a few different types of dances we know like the cupid shuffle, cha cha slide, and maybe some Indian dances.

helping teach and pronounce some English

Anyways to complete the story, about two weeks ago we all dressed up as fancy as we could, headed over to Masaje on that Thursday night, danced beautifully (or at least we like to think so) and did not get kicked out! And since then we’ve been going every Thursday introducing whatever new moves we may have learned during the week. Spending time at the English Club has definitely been a highlight of the whole Haiti experience.

all dressed up ready for our Masaje comeback

somewhat successful dancing!

Sak Pase!

pics from past few weeks

walking through the Leogane market on Saturday, the busiest day. bargaining was a complete fail with Sedlin

the food section of the market. almost got lost a few times

saw this sign for a local cinema. they only play jet li movies... haitians apparently love chinese action movies and this also explains why when Haitians see any Asian people they scream out "hiyaaa! kungfu man!"

the cinema

a cockfighting ring. the cruel sport is apparently very big in Haiti used as a means for gambling, and also diversion from life's difficulties

walking through the seemingly endless sugarcane fields to city outskirts communities

a 3 yr old girl very very interested in our cameras. She also spoke extremely slow creole and always repeated herself like 5 times making it actually possible for me understand


we stopped by an orphanage one day where all the kids were dressed in soccer outfits playing one huge game. well actually half the time they were seeing how many kids they could fit in the trashcan goals


this adorable 2 yr old orphan, Israel, ran up to me and wouldn't let go


voodoo temple we walked by. they invited us to come back for a ceremony next week

Hidden Emotions

To date we’ve completed 72 maternal mortality verbal autopsy interviews. 72 interviews... and it wasn’t until a few days ago that we encountered the first respondent to shed tears during the survey. Two things struck me as odd. The first, a bit expected, was why we’ve conducted so many interviews up till now without a single person displaying emotion typically associated with talking about the death of a relative or friend. The second, which I didn’t realize till a bit afterwards, was that we ourselves had somewhat become accustomed to people not showing emotion at all. Here we are surveying people and asking them to recall numerous details about the deceased (often that of an immediate family member), and to see someone cry had become ‘unexpected’. Of course everyone reacts differently and maybe some Haitians just don’t always outwardly display emotions. But it’s also scary to think that for many people here death and other traumatic experiences have become so commonplace to the point where they usually talk or even joke about it as if they’re having any regular conversation. We’ve seen or heard funeral processions down the road quite often, and its evident people are mourning, but it appears as if once the body is laid to rest Haitians go back to their everyday life almost as if nothing happened.

Brain Gain

I had an interesting conversation the other day with Missy Owen, our ‘surrogate grandmother’ who lives across the street, working for FHM as the in-country coordinator. She’s been living in Haiti for about 5 yrs now and has developed a fluent command of the Creole language and a thorough understanding of the Haitian culture and other norms. We were discussing the Haitian health system and why it’s in the state it is today and what other progress it’s been making. So a health ministry exists in Haiti but all of its expenditure are more or less heavily concentrated in Port-au-Prince and rarely make it out to surrounding cities or rural areas, places where the government health infrastructure is usually nonexistent. Here in Leogane, a city of roughly 135000 inhabitants, there's not a single government hospital! The harmful consequences are quite evident when during interviews we hear that people aren’t receiving proper treatment from the existing private hospitals or are unable to even access/afford any treatment. One of our translators Eunide, also contributed her opinion, blaming the Haitian health system on the poor organizational structure and lack of effective government action. She also mentioned that Port-au-Prince contains the only state medical school in the whole country (there are other private ones but these are unaffordable to most)

On top of this are the other unfortunate circumstances of Haiti that have contributed to the problem of a “brain drain,” where professionals may be trained in Haiti but leave once they attain their degree to practice in the US or France or other countries with a higher standard of living. This concept is inherent to many low-income countries and further perpetuates their often already diminished professional force.

However in Haiti, there's been a relatively recent force opposing this brain drain, all thanks to Cuba. Since 1998 Cuba has been assisting Haitian healthcare by sending in doctors and health experts for as long as Haiti needs. In addition the Cuban government has been paying for Haitians to attend medical school in Cuba provided they would later return to Haiti to work, implementing a sort of “brain gain” system. Cuba also supplied most of the initial disaster relief after the 2010 earthquake, and unlike many international relief organizations they have continued to maintain aid, and have made a commitment to helping improve the health system here. When speaking to people here it's clear the Cubans are health heroes, but sadly the US diplomatic relations with Cuba resulted in a very low coverage of Cuban efforts, and their immense aid to Haiti has often gone unnoticed.

Hiking across Haiti

This past week was a short break from our main projects and involved the scheduled hiking trip across Haiti as well as some work with two psychologists from Duke focusing on PTSD and stress relief. The beginning of the week was spent up in the mountains at this amazing mountain villa owned by Jean Marc and his wife Varaina, extraordinarily nice people involved in a pharmaceutical industry and friends of David and Kathy Walmer through their medical clinics. The drive up provided some breathtaking views of the mountains settled under stormy clouds, but none of those sights compared to the views available from the mountain villa itself. Their land was extensive and consisted of so many beautiful stone or rock paths along the mountain side connecting to gorgeous gardens or a gazebo or their cousins magnificent house right next door. We also stumbled across a hot-tub overlooking an edge and a trampoline on the side of the mountain! However it was hard not to be constantly reminded of the stark disparity of wealth when looking down to port-au-prince away from the base of the mountains, but according to Jean Marc it’s a reality you have to live with (not sure to what extent I believe that). Yet spending time there in the cool breezy mountain weather was definitely a great relaxing break to preface the hike.

part of the mountain villa

the garden along the path from his house to cousins

sunset view

trampoline on side of mountain!!

the view from the room Sedlin and I stayed in.

We could just sleep with the doors open and wake up to beautiful sunrise

On Tuesday we completed a strenuous 5 hr or so hike uphill to a mountaintop and then through the pine forests to arrive at a cabin outside of Seguin where we’d spend the night, most of us sleeping in tents. We trekked along dirt paths and broken up roads devoid of cars/trucks and more often populated with farmers and donkeys carrying crop loads. It was our first experience with rural mountainous Haiti and it was so peaceful and serene. The next morning we started a taxing 6 hr hike downhill to Jacmel, with more beautiful sights accompanied unfortunately with a steady increase in temperature. At times it seemed like we could have been in Switzerland with lush green fields, and then at other times in the Amazon jungles with an environment of overgrowing plants and vines and chirping birds, waterfalls and other nature sounds.

group pic!

views along the hike

you can see our group as we struggle up while local farmers carrying huge bags and wearing just flipflops whiz past us

star tripping! I had no idea what this was until we did it but basically we went out at night and one person in the circle would look up at the stars and spin around several times until someone with a flashlight yelled stop and then would shine that light in the spinning persons eyes. And they would immediately just fall over sometimes screaming as they did. Funniest thing ever
we could also just stargaze at the thousands of stars thanks to the complete darkness and zero light pollution

beginning the hike down to Jacmel

Beach at Jacmel. perfect water temp for swimming

Later in the week we were introduced to Ben and Cindy Reese, psychologists from Duke on a short trip here to continue some sessions on PTSD and relaxation that they started last year. We accompanied them on their day trip to the mountain village of Fondwa where they received an attendance of roughly 110 people! To whom they taught understanding of emotions, thoughts and behaviors and techniques to reduce stress. I thought the sessions were great and it was interesting seeing peoples different responses; some full of gratitude and eagerness to learn, while others asking how they can even try to be stress-free when they are without basic amenities such as a house to live in. Just shows how when delivering aid you really have to start from the ground up and ensure most fundamental needs are met before advancing.

Ben and Cindy conducting their stress relief session in Fondwa