DukeEngage: Haiti

It's a wrap!

2009-07-31T14:11:00.001-04:00

Our projects are now coming to a close, and it’s amazing to think about how much we’ve accomplished in only 2 months. To summarize, we have:
• Written and translated a Creole brochure about cervical cancer
• Distributed 1,000 copies of the brochure to women in the Leogane marketplace, Fondwa, and Petit Guave
• Contacted 81 HPV positive women to remind them about their follow-up appointment for treatment, as well as to survey about barriers preventing them from returning to the clinic
• Surveyed 136 women about their current knowledge of cervical cancer for future education programs
• Written and produced an education sketch film about cervical cancer with several local nursing students
• Gave 4 presentations about cervical cancer to women in Fondwa, Petit Goave, and Leogane.

Bassin Bleu

2009-07-28T17:49:00.001-04:00

To wrap our 2 month stay in Haiti, we took a trip to Bassin Bleu over the weekend. We started out in Jacmel, and we rode horses up a mountain to Bassin Bleu. There were some gorgeous views of the ocean and the plants on the way up the mountain. Bassin Bleu has 3 “basins”, and the last basin has a huge waterfall. Matt, Hannah, Max, and I all climbed up the waterfall and jumped off into the water!

Fondwa Presentations

2009-07-27T17:11:00.000-04:00

We had the opportunity last Friday as well as today to present an education program to a group of women in Fondwa. On Friday, we presented to 6 women. Today, we had 29 women at our presentation! We told them about the disease, how it is transmitted, and how to reduce the risk of contracting to disease. We also addressed some common misconceptions that some women have about cervical cancer, such as the belief that it is caused by voodoo. The women really enjoyed learning about cervical cancer, and I was very impressed with their insightful questions at the end. The experience also shed light unto some of the cultural differences between Haiti and the United States. For example, we told the women that it is important to limit the number of sexual partners, and to make sure that their partners also limit their sexual partners. The women replied that, “There are no faithful men in Leogane.” They said that their husbands have multiple partners, and it was out of their control. This shows the importance of knowing the social context and way of life of the audience that is being addressed. We replied that although they do not have control over their husbands, they do have control over their own bodies and they can still be responsible for their health. At the end of our presentation, we showed them the 10-minute film about cervical cancer that we made with the local nursing students.

On Wednesday, we are going to give a few more presentations in Petit Guave.

Global Health Article

2009-07-20T11:34:00.002-04:00

Here is a link to an article about our projects from the Duke Global Health Institute: http://globalhealth.duke.edu/news-events/stories-from-the-field/women-and-prevention-are-priorities-for-fieldwork-projects-in

Education in the Market

2009-07-10T12:56:00.003-04:00

We’ve finally had a chance to begin educating women in the Leogane area about cervical cancer! The brochures that we designed a few weeks ago were printed in the U.S. and brought to Haiti by one of the Family Health Ministries teams. On Wednesday and Thursday, we began by going to the marketplace and finding women to educate as well as survey about their current knowledge of cervical cancer. Hopefully, future DukeEngage students will be able to use information from the survey to design more health education programs. I thought that we would have difficulty finding women that were willing to talk to us, but within minutes, we had a huge crowd of women as well as men who wanted to do the survey and get a brochure. Perhaps they were curious to see what we “blancs” were doing in the marketplace! We surveyed women from as young as 14 years old to as old as 56 years. The women were very eager to learn about cervical cancer, and I was surprised to learn how many of them personally knew someone who suffered or died from cervical cancer. Many of the women didn’t know much about cervical cancer – some thought that the only way to treat it was through a voodoo priest. I am also not sure if our brochures will helpful for all, as some are illiterate(one man was reading the brochure upside down). However, our translator, Wilkins, said that most people were able to understand it. Overall, I think our presence was well-received, and I am excited to continue our education program!

Health Fair

2009-07-06T11:34:00.000-04:00

Matt and I spent Saturday at a health fair put on by the nursing students. The health fair took place about 20 minutes away in a rural part of the Leogane community. There were several nursing students from Minnesota at the fair as well, and they let us “shadow” them for the day. I observed the patient consultations throughout the day, and the nursing students were eager to teach me various things such as taking blood pressure and pulse measurements. The severity of some of the health problems was disconcerting, and left me wondering what these patients would have done if the health fair did not take place. This was probably the only form of health care that people in these rural areas receive, and it was only possible because the nursing students were willing to spend their weekends organizing it. I found their passion for making health care accessible to all quite inspiring, but even so, these “mobile medical clinics” are far from being adequate for addressing their problems. For example, many diagnostic tests are not possible in such a setting, and the treatments and medications offered are extremely limited. There is no opportunity for follow-up care, and so the patients do not have any means of receiving alternate treatments if their problems do not improve. The limitations and shortcomings of the health care system in Haiti were made very clear through this experience. Even so, “mobile medical clinics” seem to be the most prevalent avenue of aid for many Americans travelling to Haiti on mission trips. The health care problems need to be addressed in a different manner in order to provide more sustainable and effective care.

Mountain Hike

2009-07-02T10:14:00.007-04:00

We took a break from our work at the Leogane clinic to travel to Kenscoff, Jacmel and Fondwa. We left Saturday morning and traveled to Kenscoff to see the Baptist Mission and Fort Jacques. After spending the night at a lodge, we woke up early on Sunday to begin our 2-day hike through the mountains. The hike was about 30 miles long, and it was extremely rough, especially since several of our group members weren’t feeling well. However, the views were spectacular, and we saw a very different part of Haiti compared to where we’ve been living. In fact, part of trail went through a forest that almost looked like northern Michigan. We also passed several waterfalls and really pretty tropical plants. Our hike finished at the beach in Jacmel, which was a nice ending. We spent Tuesday in Fondwa, another community in the mountains. Family Health Ministries, the organization with which we are working, sponsors an orphanage in Fondwa. We visited the orphanage and played some games with the children.

The website for Family Health Ministries has some pictures and stories from our hike: http://familyhm.org/dukengageandfamilyhealthministries.htm

Cervical Cancer Brochure

2009-06-16T12:58:00.002-04:00

We have finished translating our brochure about cervical cancer into Creole! 20% of the patients at the Leogane clinic have been tested positive for the HPV virus, so we will be handing out these brochures as part of our cervical cancer education program.

There were several challenges in making cervical cancer education culturally relevant. For example, in the United States, the HPV vaccine is often recommended to prevent cervical cancer. That isn't an option in Haiti with such limited resources, so we had to focus on other prevention recommendations such as limiting the number of sexual partners. Additionally, there are several widespread misconceptions about sexual health in Haiti. Some women do not use contraceptive barriers because they believe that it will spread disease.

Already, we have seen some benefits of our work. We have also been calling women about their follow-up appointments, and several have returned for treatment. Here is a look at the inside of the brochure!

Beach!

2009-06-06T18:00:00.002-04:00

We decided to spend our Saturday afternoon at the beach today. We arranged for a driver and eagerly waited for him to arrive after lunch. A few hours later, he arrived - a perfect example of how the Caribbean culture runs on a much looser schedule (which I should know from how late my mother always is). He also arrived with a 5 person car, and we needed space for 11 people. Instead of making 2 trips, we decided to cram all 11 of us in the car…2 people in the front seat, 5 people in the backseat, and 3 in the trunk space. I don’t know how we all fit or managed the half hour ride, but soon enough, we were standing on a beautiful beach with mountains in the distance. We took a “boat” to a little island a few hundred meters from the coast. The boat was literally carved out of the trunk of a tree, and it was extremely unsteady. It also started filling up with water and sinking, so I was given a bowl and instructed to scoop out water. I was so afraid that it would capsize and ruin my camera (I wasn’t really afraid of drowning…). Luckily, we made it to the other side, where we ate conch shells, drank coconut juice, and relaxed in the waters. We also saw a giant red starfish!

Haitian Funeral

2009-06-05T16:30:00.006-04:00

After returning from the clinic in the torrential downpour, I began relaxing in my room with a book. All of a sudden, I hear band music coming from outside. I thought it was some sort of parade. When Laura ran in the room and got her camera, I asked her what was going on outside. Much to my surprise, she said that it was a funeral. I went on the porch, and I saw a slow procession of people dressed in black walking alongside a hearse. It was interesting to see how a different culture mourns. The music was the most distinctive discrepancy. It didn’t sound somber or mournful, but more like a big band. I recorded some of procession…

A Typical Haitian Meal

2009-06-04T12:53:00.002-04:00

Breakfast
• Oatmeal
• Bread and peanut butter
• Bananas
Lunch
• Pasta or noodles
Dinner
• Rice
• Some sort of meat (meatballs, fish, stew, etc.)
• Plantain
Based on what we have been eating thus far, I can see why malnutrition is such a big problem. We definitely do not eat enough fruits, vegetables, or dairy products. Even so, our diet is probably considered more ample than what most Haitians eat on a daily basis.

This picture is a banana tree that I saw at the side of the road!

Lymphatic filariasis

2009-06-03T22:05:00.005-04:00

This afternoon, we visited a nursing school in Leogane. It is the only nursing school in Haiti, and it graduates about 20 nurses a year. We had the chance to attend a lecture done by some CDC representatives on lymphatic filariasis. Lymphatic filariasis is one of the many diseases, along with malaria and dengue fever, which you can get from mosquitoes in Haiti. It is transmitted by tiny worm larvae carried by mosquitoes. The worms enter your body, nest in lymph nodes, and prevent proper drainage of lymph fluids. Therefore, the fluids collect in your legs and causes “elephant legs.” In men, it can cause the scrotum to swell up immensely. The condition is caused by hundreds of mosquito bites, so hopefully we won’t contract it! Since Leogane is a hot spot for lymphatic filariasis, the CDC is distributing drugs to prevent transmission. The representative said that if 80% of the population complied for 5 years, the disease would essentially be eliminated. Unfortunately, this is the 7th cycle in which the CDC has undergone in attempts to get sufficient compliance.

Here is a link to a 2006 NY Times article about lymphatic filariasis in Leogane: http://www.nytimes.com/2006/04/09/world/americas/09lymph.html

First Day on the Job

2009-06-02T12:58:00.003-04:00

I awoke at 6:30 am this morning, with bright sunlight streaming through the windows, roosters crowing, and loud horns from the "water truck" blaring. The electricity had already been turned off for the daytime, so alas, we no longer had our fan to keep our room cool. Despite applying copious amounts of bug spray, I still managed to get several mosquito bites during the night. Maybe we'll get mosquito nets later! We ate breakfast and then began working on our projects. I am working with Matt and Kevin on a cervical cancer education program. First, we are going to survey women who have not returned to the clinic for followups after HPV screening. We will also survey women in the community to see how much they already know about cervical cancer. Hopefully, these surveys will give us insight into women's perception of cervical cancer and why many of them do not get screened. Additionally, we are planning to develop a skit, or maybe a radio announcement, to educate women.

After discussing our projects, we walked to the clinic. It took about 45 minutes to get there, but it seemed especially longer in the heat! We toured the clinic, which is mostly empty at the moment. And we finally got internet access here!

First Impressions

2009-06-01T19:25:00.001-04:00

After a 4 am wake-up call and 3 flights, I have finally arrived in Leogane! I met up with the rest of the group in Miami, and we all flew in to Haiti together. As we flew in to Haiti, I could already see that it was far different from the United States. There weren’t any big buildings or developed areas visible from the sky, but there was a beautiful coastline with mountains in the backdrop. Driving through Port au Prince, I discovered that Haiti was far different from what I expected. I figured that it would be similar to Trinidad, where my family is from, but it is much poorer. When the van stopped, children came up and put their hands through the windows, begging for money. The streets were lined with overflowing garbage, and the ditches were piled even higher with trash. There were stray dogs, cows, goats, pigs, and chickens, especially in the garbage dumps looking for food. We passed several shantytowns with makeshifts houses of pieced together metal sheets. I loved the colorfully decorated taptaps, or “taxis." Many Haitians looked curiously into our van, wondering who we were. I heard them call us “blahs,” which translates to “white people.” After about an hour of driving, we arrived at our guest house in Leogane. We have now settled in, and we’re gearing up for tomorrow’s work!

Preparing for Haiti

2009-05-22T00:52:00.000-04:00

In approximately 10 days, I will be on a plane heading over to Haiti for a 2 month long service project. I am traveling with 6 other Duke students as part of the DukeEngage program. According to DukeEngage, the mission of the program is as follows:

DukeEngage empowers students to address critical human needs through immersive service, in the process transforming students, advancing the University’s educational mission, and providing meaningful assistance to communities in the U.S. and abroad.

Specifically, our project involves helping out at a health clinic in Leogane, Haiti, which is 30 kilometers west of Port-au-Prince. We will conducting health surveys, creating health education programs, and so forth. Our preparation for this adventure began in March, with several meetings to plan projects, learn Creole, and get to know each other. Now, in the final days before my departure, I am reading over manuscripts and other material to get a better sense of the needs in the Leogane community. I am nervous to be spending 2 months in a country so different from my own, but I hope that this experience will help me gain insight about myself, as well as giving me a chance to change the lives of others.