Friday, October 29, 2010

Haitian mothers cared for in Dominican Republic

Haitian Mothers Find Care in Dominican Republic, but Future Is Bleak

Elizabeth Eames Roebling

SANTO DOMINGO, Dominican Republic, Oct 29 (IPS) - In the spacious lobby of the Nuestra SeƱora de Altagracia maternity hospital, more than a hundred people wait quietly in chairs, overlooked by a 20-foot-high coloured mosaic inset portraying the patron saint of the Dominican Republic.

One of three public maternity hospitals in the capital, with 270 beds, 300 attending physicians and 100 residents, it is the best-equipped in the country and the birthplace of over 12 percent of all babies born in the Dominican Republic. It receives referrals of mothers at risk from all regional hospitals.

The Department of Public Health reports that of the 36,606 babies born in the country during the first half of this year, 16 percent were born to Haitian mothers. The catastrophic earthquake that devastated Haiti's infrastructure in January has not only driven expectant mothers across the border, but doctors say many of those births are riskier due to trauma and a lack of prenatal care.

Charlyn Misdave, holding her baby of a month old, speaks only Kreyole, like many of the Haitian women who come here. This presents a grave problem for the doctors at the hospital.

"I lost everything," she told IPS. "That is why I came here after the earthquake. My baby is a month old. I paid 500 pesos ($13) for the delivery. I can bring him in for check- ups but they do not give me any medicine or any supplies for him."

The Dominican Republic usually spends the equivalent of $10 million a year on health services for Haitians here, the bulk of it on maternity care. This year, the department estimates that the health services delivered to Haitians will be closer to $27 million.

Dressed in a crisp white coat, Dr. Veronica de la Rosa, assistant director of the hospital, told IPS, "We ask for a token payment of 700 pesos ($19) for a normal delivery and 1,000 pesos ($27) for a caesarian birth. If it is a normal delivery, a woman stays here a day or less. But if there are complications, it can be five days or more."

"Since the earthquake, we have more mothers who are staying longer since they are coming with pathologies," she said. "This is using up a larger portion of our budget since we generally have to use our social services budget for these patients as they come with nothing."

Just under a third of the hospital's beds are occupied by Haitian mothers, she said.

"With these patients, we are also managing cases with a much higher degree of risk. Here [in the Dominican Republic] we have prenatal care and some control over the poorest sectors of our population. We do not have this control over foreigners as they come over here directly," De la Rosa explained.

Of every six patients in intensive care, four of them are Haitian, she said.

"From 32 to 37 percent of our births here are delivered by Caesarian," De la Rosa added. "This depends on the number of patients who are HIV-positive. For these women, caesarians are used to prevent the vertical transmission of the virus [to the infant] during birth."

While many of the Haitian mothers are long-time residents of the Dominican Republic, others cross the border specifically to give birth and are referred here from regional hospitals in the border areas of Elias Pina, Bani and Barahona. Cases from the northern border region are referred to hospitals in Santiago.

"We can tell the difference between Haitians who live here in the country and those who come directly over the border as residents usually have an address and a better command of Spanish. Also they usually come with a family member," De la Rosa said.

Upstairs, in the recovery rooms of 20 beds each, Haitian and Dominican mothers lie in neighbouring beds with their newborns. Some have intravenous drips attached to their arms. Teams of residents sweep through each ward, filling out charts and instructing medical students.

The only difference between the mothers is the colour of the birth registration document that is sent to the Dominican government. Several years ago, the Dominican Republic introduced a separate birth registry for children of foreigners and for those who are considered to be here "in transit", which includes the majority of Haitians.

Dr. De La Rosa explained the process. "All births are registered with the Junta Electoral of the Dominican government. Foreigners who give birth here are registered in a special book, called the Libra Rosada. The mothers are given a copy of these papers, but it is up to them to go there and register their babies with their own governments to get their proper papers."

"This book is for all foreigners, not just Haitians, but it is true that about 98 percent of the foreigners who give birth here are Haitians," she noted.

Citizenship rights, particularly for Haitian migrants, have been the subject of ongoing international controversy. The new constitution approved a year ago maintained the wording barring automatic citizenship for those born here of parents of foreign diplomats or "in transit", and added the words "or those who are in this country illegally".

However, it did extend citizenship to those born here who do not have the rights of citizenship in any other nation, clearing up a matter of statelessness for many grandchildren of Haitians. Under the Haitian constitution, one may only claim citizenship if one's parents are born in Haiti.

The Dominican Republic is no longer giving direct assistance to Haiti, but Deputy Rafaela Albuquerque, a former Speaker of the Chamber of Deputies, says that public health expenditures have become a form of de facto aid to the stricken neighbour.

"We do not actually have a budget line for helping Haiti. There was discretionary spending for the disaster which President Leonel Fernandez requested and the Congress approved," she said. "Our president speaks of Haiti in all his international encounters, particularly in front of the U.N. He recently spoke there of the rains and how the people are living in tents and are suffering greatly."

"Our general budget has a line item for public health which is distributed among all the public hospitals. This budget was not designed to aid any other country," she said. "It is a form of humanitarian aid that the Dominican Republic helps Haiti in this way. The Dominican Republic has never asked for reimbursement for this money."

Monday, October 25, 2010

Cholera update

24 Oct 2010 00:05:42 GMT

* Five sick in capital came from infected central zone

* Capital's slums, earthquake survivor camps vulnerable

* Aid agencies increase prevention, surveillance steps

* Biggest medical crisis in Haiti since Jan. 12 quake (Recasts with
confirmation of cases found in the capital)

By Joseph Guyler Delva

PORT-AU-PRINCE, Oct 23 (Reuters) - The death toll from a cholera
epidemic in Haiti topped 200 on Saturday and fears of it propagating in
the crowded, earthquake-ravaged capital increased after five cases were
detected in the city.

U.N. officials stressed that the five cases, the first confirmed in the
capital since the epidemic started, were people who had become infected
in the main outbreak zone of Artibonite north of Port-au-Prince and had
subsequently traveled to the city where they fell sick.

"They were very quickly diagnosed and isolated," U.N. humanitarian
spokeswoman Imogen Wall told Reuters, citing information from Haitian
health authorities. "This is not a new location of infection."

But prevention measures and surveillance were being increased in
Port-au-Prince, with its squalid sprawling slums and about 1.3 million
survivors of the Jan. 12 earthquake packed into tent and tarpaulin
camps. All are highly vulnerable to a virulent diarrheal disease like

With more than 2,600 cholera cases reported and experts predicting the
numbers will rise, Haitian and international medical teams are working
desperately to isolate and contain the epidemic in the Artibonite and
Central Plateau regions, north of the rubble-strewn capital.

It is the worst medical emergency to strike the poor, disaster-prone
Caribbean nation since the earthquake killed up to 300,000 people and
is also the first cholera epidemic in Haiti in a century.

Haitian health officials told a news conference on Saturday that 194
people had died from cholera in the Artibonite region, the main
outbreak zone, with 14 other deaths in neighboring Central Plateau,
where a prison was among places affected.

The total number of cases had reached 2,674.

Cholera, transmitted by contaminated water and food, can kill in hours
if left untreated, through dehydration. But it can be treated easily
with oral rehydration salts or just a simple mix of water, sugar and
salt. TV and radio adds in Creole recommended that treatment to the

Besides rushing doctors, medicine and water supplies to the affected
areas, Wall said the U.N. and aid agencies were identifying sites in
Port-au-Prince where any cholera patients could be treated in tent
clinics, separate from hospitals.

"If we have cases in Port-au-Prince, the only way to contain them is to
isolate them," Wall said.

"Obviously, preventing the disease spreading to the city is an
absolutely paramount concern right now," she said.


Daniel Rouzier, chairman of the Board of Trustees of U.S.-based charity
Food for the Poor, earlier told Reuters he had learned of the five
cholera cases at private clinics in the capital. "It was not originally
in the geographical area of the camps. Now it is," he said.

Rouzier, whose charity has sent water purification units to the
cholera-infected central zones, faulted the Haitian government and its
aid partners for not moving quickly and effectively enough to contain
and isolate the epidemic.

"Right now, it's been over 72 hours. There is no safety cordon," he
said. "If the sick had the proper healthcare where they were, they
wouldn't have come to this chaotic city."

Aid workers in the town of Saint-Marc, in the heart of the Artibonite
outbreak zone, have reported the main local hospital overflowing with
patients, many lying outside in the compound hooked up to intravenous

Haiti is due to hold presidential and legislative elections on Nov. 28
but it is not clear whether the epidemic could threaten the
organization of the vote.

In the crowded camps that fill squares, streets, parks and even a golf
course in Port-au-Prince, fears of contracting the disease are running

"All we can do is pray to God because if we catch this disease in these
camps, it will be a real disaster," said Helen Numa, 35. "You can see
for yourself how people are living here, packed in like sardines."

Haitian Health Minister Alex Larsen has urged people to wash their
hands with soap, not eat raw vegetables, boil all food and drinking
water and avoid bathing in and drinking from rivers. The Artibonite
River, which irrigates all of central Haiti, is believed to be

But many in the capital's camps said they did not have money to buy
soap and chlorine to apply hygiene measures.

"We don't have anything, not even one dollar, because we don't have
jobs," said Marjorie Lebrun, 45. "I'm afraid if I and my five children
get sick, we could die."

Wall said the relief effort in Haiti had enough antibiotics to treat
100,000 cases of cholera and intravenous fluids to treat 30,000. But
those would need replenishing. (Additional reporting by Pascal Fletcher
in Miami; Writing by Pascal Fletcher; Editing by Peter Cooney)

For more humanitarian news and analysis, please visit


Saturday, October 23, 2010

Report from St Marc

Note to Haiti Vox readers: Yesterday evening I learned that a
colleague, Nancy Dorsinville, was headed to St. Marc. She works with
Partners in Health and with Clinton team. The report below summarizes
what they encountered yesterday. More news later today, Check out the
UN Relief Web and Alert Net ( for more updates - AC

Haiti cholera hospital is a horror scene
Source: AlertNet
Date: 22 Oct 2010

22 Oct 2010 10:54:00 GMT

Written by: David Darg

Reuters and AlertNet are not responsible for the content of this
article or for any external internet sites. The views expressed are the
author's alone.

We woke to disturbing news on Thursday. Our friends at Partners in
Health told us droves of people were arriving at St Marc, sick with
diarrhea, and that they were dying from dehydration at an alarming
rate. The question was clear, could we mobilize to provide clean water
to an area suspected of having Haiti's first major cholera outbreak in

Our staff immediately began loading our trucks with equipment. As we
drove the two hours to St Marc emails on my phone showed the death toll
was climbing steadily. Everyone was nervous.

We arrived at St Marc hospital to a horror scene. I had to fight my way
through the gate as a huge crowd of worried relatives stood outside,
while others screamed for access as they carried dying relatives into
the compound. The courtyard was lined with patients hooked up to
intravenous (IV) drips. It had just rained and there were people lying
on the ground on soggy sheets, half-soaked with feces.

Some children were screaming and writhing in agony, others were
motionless with their eyes rolled back into their heads as doctors and
nursing staff searched desperately for a vein to give them an IV. The
hospital was overwhelmed, apparently caught out suddenly by one of the
fastest killers there is.

Our friend, Cate Oswald, from Partners In Health came out from a triage
tent clutching a hand-drawn map. It showed the local river and the
names of a few communities where the patients had been coming from.
Cate and some of her colleagues led us into the countryside to find the
source of the epidemic.

Soon we were heading down narrow dirt roads with rice paddies and
canals on either side. The crisis had started the day before. Doctors
realized it was getting serious during the night. By then the villagers
had heard of the deaths and word spread quickly not to drink water from
the river.

Most people had gone thirsty for hours. The roads were lined with
villagers holding buckets, begging for water. Some larger groups had
set up road blocks and our convoy was forced to stop and explain that
we didn't have water, only equipment to purify water, and that we were
heading to the source of the problem. The villagers reluctantly let us

People were constantly trying to flag us down and pointing to sick
friends and relatives. One group forced us to stop - they had a girl
close to death. PIH staff started her on an IV and placed her in their
vehicle. Her mother, clutching another baby, explained that her husband
had died yesterday and asked us to save her daughter.


We arrived at the place where many of the patients had originated from,
a small dusty community called Babou La Port. Our team set up a water
purification system, which filters and chlorinates, ensuring that any
bacteria or diseases are killed.

As we worked, sick villagers of all ages congregated under the shade of
some large trees. The medical staff placed IVs in some. One, a boy
named Frantz, was brought to us by his grandmother. He was weak and
vomiting. His grandmother was frail and could only point to the river
when we asked her how long Frantz had been ill.

Diarrhea is unfortunately a common problem in this part of the world. A
villager with cholera might lie down on feeling ill, expecting to get
better, and be dead within hours.

Convoys of trucks plastered with the posters of various presidential
candidates drove up and down the dirt roads. Many candidates saw this
as an opportunity to campaign. They were tossing out small plastic bags
of water to the desperate crowds. There were fights for the water and
one man was crushed under a truck in the scuffle.

Our filtration unit fired up and word spread quickly. Soon a sea of
multi-colored buckets surrounded us. There were no cheers and little
laughter; most of the villagers were stunned, afraid and weak. They
were just relieved to have water.

Some of our Haitian staff agreed to stay with the system overnight and
keep it operating. It was a daunting challenge, to stay awake
surrounded by deadly disease and desperate villagers.

Back at St Marc hospital not much had changed, other than the death
toll. As I write, the confirmed toll is 135 and rising with thousands
more infected. There are still patients being carried into the hospital
close to death.

Now however the cries of the mothers are louder and there are even more
people at the gates desperate to hear news of their loved ones. The
hospital is struggling to cope with such a sudden influx of patients,
especially since it is still trying to recover from the January

The scenes at St Marc reminded me of Haiti's capital Port-au-Prince
after the quake: patients lying in the streets, doctors struggling to
cope, mass hysteria and fatigue.

On Thursday morning, as the scale of the problem began to emerge, my
friend Dr Koji from Partners in Health shook my hand and said "Let's
stop this". The only way to halt a disease like cholera is to stop
people from getting infected. The hardest hit areas now have access to
safe water, and thanks to people like Dr Koji the sick are receiving

Reuters AlertNet is not responsible for the content of external

For more humanitarian news and analysis, please visit

Posted By poxvox to Haiti Vox at 10/23/2010 12:40:00 PM

Cholera in Haiti

- 200 people have died so far
- Almost 2,500 people have been affected by the epidemic
- The areas most affected are: Marchand Dessalines, Douin, areas
surrounding Saint Marc, Archahaie, and the Bas Plateau Central
- The Antibonite river is the source of the epidemic
- The Ministry of Heath and the Direction of Potable Water (DINEPA)
assure that the response is being coordinated
- They need water, chlorine, hygienic kits, and portable beds for the
health centers and clinics which have exceeded their capacity
- It seems the contamination originated in three turbines at the Peligre
hydroelectric station.
- It appears as if the equivalent of seven drums of contaminated liquid
per day have poured into the Antibonite River between Mirebalais and
- To request assistance, please see:
- For information about cholera, click here:
Cholera - Wikipedia, the free encyclopedia
- For the reaction from the US Department of State, click here:
- For Haitian OAS Ambassador Dully Brutus’ and PAHO’s press conference,
click here: YouTube - Press Conference, Cholera situation in Haiti
- For the latest reporting on the situation, click here:
YouTube - Haiti struggles to contain cholera!

Thursday, October 21, 2010

Advice for missionaries

This was recently posted to the Corbett Haiti list by a missionary in Haiti, Corrigan Clay, who works with this interesting project / The Apparent Project

I repost it with his permission.

In my experience, the "short term missions team" is no homogenous
species, but a wide variety of people from various demographics with
very unique objectives and strategies for accomplishing those
objectives. In my limited time in Haiti (I've lived here since 2008
with previous visits in 2007), I have seen short term projects that
have destroyed years of labor that had been done by faithful, long
term, in-country missionaries & NGOs, and I have seen projects that
quickly and successfully overcame socio-economic barriers that seem to
have been around for years. There have been teams that come with
minds full of preconceptions about the Haitian people that leave with
the same opinions and self-congratulatory expertise about a culture
whose language they haven't even learned. There have been teams that
have left with more friends than they came with, that have learned
Creole before coming, and have gone home humbled and challenged by the
joy, faith, and hope of their new found Haitian friends. Service
groups are a mixed bag... like a trail mix... their contents are
sometimes sweet, sometimes salty, and occasionally a little rotten.

Our mission ( has shifted over the years,
beginning with the intention to start an orphanage to address the
needs of a special handful of Haiti's "500,000 orphans". After living
in an orphanage for a year we learned the grim truth that the vast
majority of Haiti's so-called "orphans" were actually children with
living parents that loved them but just struggled to provide for their
basic needs. We saw that the cost of one adoption could have provided
enough seed money to start sustainable businesses for ALL of the
parents of the 24 children in the orphanage we worked at.
This gave us pause about the ethics of the adoption/creche industry in
Haiti, and as we sought to obey the Biblical mandate to care for
orphans and widows, we shuddered at the thought that the system of
orphan care so advocated by most Christians was not only not
stewarding resources well to address the orphan crisis, but was likely
causing the abandonment of countless children by creating an orphan

This is why we made a drastic shift towards job creation, home
building and empowerment of Haitian families. Instead of a colonial
paradigm (seize, commodify, consume, and justify) we took on Jesus'
way of doing business: living amongst those we hoped to help, knowing
their stories, affirming their worth, tending to their felt needs,
depending on them as much as they depend on us, and giving out our
power and resources so that they could begin to find some equality.
The effect is a congenial plundering of the colonizers. We play
polite Robin Hood... By selling recycled paper jewelry to North
Americans we are effectively selling Haiti's "fatra" to Americans who
have a "disposable" income. It's working quite well. We continue to
have less supply than demand, and we will likely be situated to
employ many more people very soon.

Long story short, it was a short term team that really kick-started
our artisan program. A few college students from the States came to
teach 3 or 4 women how to make jewelry according to an internationally
marketable standard. This short term initiative has blossomed into a
program that provides employment, education, and housing for more than
50 families who were previously at risk for relinquishing their

We have had other short term projects that have also provided long
term benefits, like the team that built a chicken roost for us that
now provides our artisans and hungry people in our neighborhood with
eggs and some young men with the opportunity to learn sustainable
urban agro-business. Other teams have taught other marketable skills
such as sewing, carpentry, teacher-training, and computer literacy.
These short intensive trainings have provided long term employment in
some cases.

The teams that we have hosted that have been more of a burden are
those that come with more interest in being served than serving, or
who have come with an attitude of superiority. The latter is
especially evident in groups bent on delivering "the Gospel" to a
people "bound in spiritual darkness". These are often groups that have
no Haitian friends, speak no Creole, and have likely never been to
Haiti for an extended period of time. They don't know that many of
our Haitian friends own only one book (Bib La) and they read it quite
often. They don't know that many Haitians worship in their churches
twice a day every day of the week. They often don't know what it is
like to give up food so that their neighbor can eat, or to pray for
somebody's healing long BEFORE calling a doctor. They have never
lived in a country where the president calls for 3 days of prayer,
fasting, and public repentance. They haven't experienced a spiritual
life that is enriched by vivid visions or powerful encounters with
spiritual forces. They haven't stopped to think that when Jesus said
he came to "announce Good News to the Poor" that that may have meant
that the poor might have a better grip of His message than the
over-resourced. They weren't here to hear the echoes of "adore'"
resounding in the hills as Haitians who had just lost homes and family
members thanked Bon Dye for his mercy and confessed their enduing love
for Him.

Haitians, no matter their faith, have lived in an environment and
context much closer to that of the first audience of the Biblical
text. That alone should cause Christian mission groups to come with
an objective of mutual exchange and dialogue or sharing , rather than
an attitude of conquest. Don't get me wrong, If I were a Haitian
citizen, I'd be voting Jesus for president, he's the only worthy
candidate. But he's not American, and his Kingdom comes through the
meek, not through the gregarious flash of 35 Neon T-shirts proclaiming
that Haiti's messianic service team has just arrived to save the day.
A friend of mine saw a group in the airport that had shirts that
said, "Jesus came to earth to save me, We're coming to Haiti to save
you." I can't even write that without a little bit of puke coming up
into my throat. it's that kind of service group that makes me... a
long term Christian missionary and somebody who is eternally thankful
for Jesus coming to save me... embarrassed and nervous. And to those
of you who are Haitians who don't share my faith, it also makes me

As somebody who regularly hosts short term missions teams in our guest
house in Port Au Prince, I hope that more people respond to Mr.
Durban's question. We encourage visiting teams to focus on training
and equipping, providing Haitians lasting employment, and building
intercultural relationships. I share the concern with a previous
poster who noted that many teams are taking away potential jobs from
Haitians (esp.. the thousands of Boss Masons), but I also see a steady
stream of resources into the nation which might not otherwise come.
For example, the house building teams are far more likely to pay for a
home that they are coming to build than to send an equivalent
donation... and they are much more likely to advocate for Haiti after
visiting in person than if they just sent a check to an organization.

The other unfortunate hang up I see is that because of the culture of
corruption (which I observe not only in the elite ruling class, but
amongst the poor as well) there are many people who will not donate
money to an organization without the kind of accountability that only
comes through a personal visit or a hands on project. That is
ultimately why we have such disunity and slowness to act in the
reconstruction effort, with everybody making strong arguments about
who should be in control of reconstruction resources, etc. Until there
is a much higher threshold of trust, I don't think the inefficiency of
outsiders coming with their own projects and agendas will yield to a
more efficient, straight donation of resources.

Friday, October 8, 2010

The Sad News

Report: 1 million Haitians in 1,300 squalid camps
(AP) ­ October 7, 2010

UNITED NATIONS ‹ A report says more than one million people are still living
in 1,300 mostly unmanaged camps nine months after Haiti's devastating
earthquake. Sexual violence is rampant and gangs often roam freely, it says.

Refugees International, a Washington-based nonprofit organization that
advocates to end refugee crises, says its investigators found during a
recent visit to Haiti that less than 30 percent of the camps have managers.
That means more than 70 percent of the camps are unable to communicate or
coordinate with the international humanitarian community.

The report, released Thursday, said the humanitarian response "appears
paralyzed" and called for urgent action to protect the basic human rights of
quake victims living in the squalid overcrowded camps.