In Haiti, earthquake shocks give way to chronic disease, malnutrition…and heroism

Nearly six months after the 7.2-magnitude earthquake in southern Haiti, killing more than 2,000 people, many NGOs have returned home and displacement camps have disintegrated. But according to organizations still working on the ground in communities around the hard-hit Les Cayes region, the problems haven’t gone away – they have simply developed.

“What we’re really facing right now are the ongoing effects of the earthquake,” said Conor Shapiro, president and CEO of the nonprofit Health Equity International, which provides health care and other vital services in Haiti.

Shapiro explained that while the camps have disappeared and people are returning to their homes, it would be a mistake to think that life is in any way returning to normal. Wounds and other trauma from the earthquake have been replaced by unmanaged chronic disease and malnutrition – and this continues, particularly in children. The damage or destruction of the clinics has resulted in many people losing their health care resources. Families whose homes were damaged live under tarpaulins.

“A lot of these towns are completely flattened, and that is housing and physical infrastructure like schools, clinics and markets,” Shapiro said.

Many people have been walking miles before to a nearby clinic, said Gina Green, director of development for the Medishare Project for Haiti, which continues to work on the ground in the wake of the Haiti earthquake. “Now, if you wanted to walk an hour to get to the nearest health facility, it’s totally over…People might be six hours away” from a clinic or other health care provider.

More recently, on January 24, a smaller earthquake of magnitude 5.3 struck southwest Haiti, killing two people and causing more damage, causing people to fear going home, The Independent reported.

face obstacles

Ongoing turmoil, hard-to-cross roads and other issues have also disrupted the recovery. “We’ve had so many problems and it’s hard to know where to start,” said Father Rick Frechette, founder of St. Luke’s Foundation for Haiti and a priest and physician at St. Luke’s Hospital.

Late last year, Haiti was hit by a fuel shortage that made headlines. Although the fuel is now widely available, Frechette said it’s twice the price it once was — devastating for a country where the electric grid is unreliable and many utilities, including hospitals, depend on diesel generators. .

A child fills water containers at the Medishare Project clinic. (Image credits to the Medishare project)

Frechette described closing the hospital lab and some departments, cutting lights and turning off aid air conditioners “to try to reduce pressure on the grid” during a fuel shortage.

Omicron also appears to overrun primarily unvaccinated populations; “Labs here can’t tell ” Frechette said [variants of Covid-19], but Delta is finally gone, and we are a month or two behind what is happening in the United States.” At the same time, he explained, throngs of doctors and nurses are leaving the country.

Frechette and other sources said the road to the south is controlled by gangs in Martissant, a huge neighborhood south of Port-au-Prince, making it difficult to get supplies and relief workers to the southern half of the earthquake that struck the region. Island.

This block in Martissante runs in both directions, preventing southern Haitians from accessing help in the capital.

The sources described a weak international response to the August 2021 earthquake, further impeding the long-term recovery.

“Many organizations came in and did what they wanted and then went home,” Green said, rather than focusing on increasing resilience in southern Haiti.

Shapiro worries that Covid-19 is distracting people from thinking about international needs. Additionally, “Haiti has experienced many disasters, from the 2010 earthquake to Hurricane Matthew,” he said. “I’m concerned that people didn’t pay attention to the extent of the devastation…because it was a disaster in Haiti again.”

work on the ground

Health Equity International provides daily mobile clinics in remote communities in southern Haiti, where access to care is difficult. When they come to a village or town, they will usually stay at a school, church, or other public facility and work with community leaders to make sure people know their services are on offer.

Nurse Alexander reviews information with a mother and her baby during an examination in a mobile clinic. (Image credits to Health Equity International)

“They cross rivers and dirt roads to make sure they get to people,” Shapiro said. Asked what providers treat most often, he explained, “These are a group of patients who have no other access to care, so it could be a variety of things: infectious diseases, chronic diseases, malnutrition.”

For Dr Einaubert-Pierre, Director-General of the World Health Organization and its Saint Boniface Hospital, the lack of access to health care has led to an alarming deterioration in patients’ health. “A lot of these people don’t see a doctor on a regular basis, so our team sees a lot of them in really bad shape,” he said.

This also includes an increase in mental health issues. Mobile teams have a cyclical psychology that moves from community to community to meet people.

In addition to medical care, the team provides food, multivitamins, and access to nutrition services for malnourished patients. They provide clinics with medical support. Patients who require intensive treatment are referred to Saint Boniface Hospital.

And despite widespread hesitation about a Covid-19 vaccine in Haiti, Pierre said they had good luck getting people to get vaccinated, thanks to close relationships with community leaders and the work of trusted community health workers.

The Medishare project also provides mobile clinics, emergency food and hygiene supplies, and delivery kits that contain clean and safe supplies for the care of pregnant women.

In addition, they offer training modules for local health workers to help them take care of patients’ needs. One training module for community health workers; The other is for midwives and nurses – midwives from Haiti – to care for pregnant women who would otherwise not have access to a skilled midwife.

“The goal is to strengthen this community, and to enable them to continue to provide that care,” Green said.

To get medical and other supplies to the south, the Project Medishare driver continues to make the journey through Martissant—and so far, he’s done it safely. When asked how the organization manages such a feat, Green explained that they keep close tabs on local logistics and gang activities and never make the trip at night. “It’s a miracle,” she said, to keep working.

To support Health Equity International, St. Luke’s Hospital and the Medishare Project in their vital work, Direct Relief is providing $200,000 in emergency grants to each organization.

For Frechette, the funding means there is enough fuel to care for Covid-19 and other patients. He explained: “We have budgeted the price of gas, but it is weak.”

For Shapiro and Green, the primary advantage is the flexibility of funding, allowing them to meet needs when faced in ways that best serve their patients. “To get this scholarship now… It’s really great that we can continue to help,” Green said.

A child is weighed in a Medishare project clinic. (Image credits to the Medishare project)

Those interviewed said that the resilience and work of the people affected should not be overlooked.

“People are very resilient, and all they want to do is have jobs and opportunities, and take care of their families,” Green said.

“Poverty in the countryside is very abject poverty, because there is nothing to hold on to,” Frechette said. However, “we always see heroism: people who carry their children … they face thieves to get here with their children when they are sick.”

Dan Hovey contributed to this story.

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