Friday, January 29, 2010

Haitian Hearts Summary of the Last Two Weeks

Dear Haitian Hearts Friends,

Haitian Hearts thanks you for the tremendous financial support you have given the Haitian people following the earthquake that destroyed Port-au-Prince two weeks ago.

We have made or received hundreds of phone calls and e mails to and from Haitian Hearts patients, their families, and their friends during the last 14 days.

We have heard from Katia, Caleb, Suze, Henri, Mirterlande, Frandy, Jenny, Katina, Marie, Rodolphe, and Nadia. Most of them lost their homes, relatives, and friends, and almost all of their possessions, including their heart medications. But none of them were physically hurt by the quake.

It is very sad and sobering to listen to their desperate voices from the streets of Port-au-Prince. Most are living on the streets. They describe lack of clean water and food. There is no infrastructure that is working well. There is no sewage system in Port-au-Prince.

Katina's father and family fled to the countryside in southern Haiti to live with relatives who have a garden. Katina's father explained to me that he escaped the earthquake "with only his head".

Mirterland's sister Carminne called today and she is living in Liancourt, a village in Haiti's central plateau.

Jenny, a thirty year old girl who needs repeat heart surgery, is living in a car body parked in her yard near her damaged home.

Suze, Henri, Frandy, Marie, and their families are living on the streets of Port-au-Prince.

Maria has been able to wire money via Western Union from Haitian Hearts to almost all of the people mentioned above. Western Union is not charging any fee for our Haitian friends to obtain their money in Haiti.

Haitian Hearts supporters have allowed us to do this and the people and their families mentioned above who lost almost everything are benefiting right now.

Unfortunately, we have lost some Haitian Hearts patients.

We were working on getting Valerie, a six year old girl, accepted to a medical center in the United States for repair of a hole in her heart (atrial septal defect). Valerie, her twin sister, and her mother were all killed in the earthquake. Her recent video echocardiogram sits on the floor of our living room. It is hard to look at it.

Dieula was an eight year old girl that I examined for the first time in 2006. She had a ventricular septal defect and active tuberculosis. We treated the tuberculosis in Haiti and another group was successful getting her accepted into a large pediatric medical center for heart surgery. Dieula had the surgery in 2007 and returned to Haiti.

When the earthquake struck Port-au-Prince, Dieula was killed. Her seven siblings and mother survived.

Several days ago a six year old Haitian Hearts patient that I first examined five years ago was formally accepted for surgery in California. Her name is Widnerlande. She has a ventricular septal defect also. She and her mother Magalene live about three hours by car north of Port-au-Prince. We have been unable to contact Magalene since the earthquake, but we will continue to look for them until we get an answer.

Medjina is the last Haitian Hearts patient that we brought for heart surgery. Medjina arrived in the States in December and is scheduled for mitral valve replacement this spring. Medjina's mother gave the ok for surgery two days before the earthquake and has not been heard from since. If we do find out Medjina's mother status, we will let you know on this site.

As you are following in the news, the majority of search and rescue teams are done with their work. Now Haiti has entered another stage of disaster medicine in Haiti.

This stage will be just as horrific if not more so than the first stage. Infections due to trauma, surgery, and dirty water will be rampant. Haitian mothers will not be able to get their kids medical help quickly due to the Haiti's deficient infrastructure which even became more impossible two weeks ago. Lack of good shelter and sewage systems will cause more morbidity and mortality.

People suffering diseases of tuberculosis and AIDS will go without treatment which will hurt them and possibly others around them.

Many more orphans in Haiti need help right now. And BEFORE the earthquake there was an estimated 300,000 orphans in Haiti.

And what about the psychological help that hundreds of thousands of Haitians need that have survived this disaster? And there will be significant burn out and severe stress for the relief teams that enter Haiti to help out.

Unfortunately both national and international corruption will slow down the aid to the people that need it most. Fuel prices have already been elevated.

The funds that are donated to Haiti need to filter up and not down. There are hundreds of thousands of young men and women that can and would rebuild their country if they were paid fairly and could provide basics for their families. During the last 29 years I have seen Haitians do unbelievable physical labor, and I have no doubt they could rebuild Haiti with their bare hands. The work force is in Haiti right now. Why not use them?

Poor Haitians have had problems for centuries. True justice for the majority of people in Haiti, to enable a basic standard of living, simply does not exist.

Haiti will not be fixed quickly. It will take decades of intense work at every level. But it can improve significantly if the national and international will is there.

Haitian Hearts will do the same work this year that we have been doing for the last 15 years. We will continue to work in hospitals and clinics with Haitian doctors and nurses seeing whoever comes in.

When a young heart patient comes along, we will do our best to examine, diagnose, treat, and determine if the patient is a surgical candidate. And if the patient is operable, we will attempt to find medical centers in the United States or other countries, to accept the child and perform the surgery.

Jenny, Henri, and Rodolphe all had heart surgery about 10 years ago and all three need heart surgery again. We have their exams and echocardiograms done. They sit on our living room floor too, reminding us to work hard. We will continue to search for medical centers to accept them.

In summary, Haitian Hearts work will be challenging in 2010.

The world has now seen the courage of the Haitian people. And from our personal experience we know our Haitian Hearts patients will not give up. And they won't let us give up either.


John and Maria

Wednesday, January 27, 2010

New Civilization Discovered

(Photo by John Carroll)
The Onion reports new civilization discovered.

After reading their report the people in Haiti DO seem human.

I wonder if OSF-SFMC in Peoria is aware of this breaking news?

Madame Mellon of Hoptial Albert Schweitzer

The young girl pictured to the right is Mirterlande. I took this picture in 2006.

Haitian Hearts first examined her during the fall of 2006. She clearly had a damaged mitral valve due to rheumatic fever and was in congestive heart failure.

We were able to bring her to the United States at the end of 2008 where she underwent mitral valve replacement by and excellent surgeon at an excellent medical center. Mirterlande is doing very well today.

Mirterlande is from Haiti's central plateau. She told us that she had been hospitalized as a child at Hopital Albert Schweitzer (HAS) for heart problems.

HAS was founded in the mid 1950's by Dr. Larry Mellon and his wife Gwen Mellon. They built the hospital for approximately 1.5 million dollars with their own money.

I had the opportunity to transport a patient to HAS in 1981. My patient was a little 5 year old boy that had fallen off a donkey, struck his head, and was leaking cerebrospinal fluid from his fractured skull.

HAS accepted the little boy and the pediatrician placed him on antibiotics. I begged this physician to send me follow up. Several months later I received a letter from this Haitian pediatrician who told me that the little boy survived, did well, and was discharged.

In 1987 I was able to work at HAS from July until November. It was the best medical experience of my life. Dr. and Mrs. Mellon were elderly at that time but still lived close to the hospital and were very involved in the daily operation of the hospital.

My friend David Volk and his wife Dr. Lauze Volk worked at HAS ten years ago. David sent me the following post written by Ian Rawson. Mr. Rawson is the son of Gwen Mellon. The lady he refers to in the post is his mother.

Please see article below.

Tuesday, January 26, 2010

Each day I try to go through the hospital several times in the early morning, during the day and in the evening. I try to encourage the people who are waiting for surgery and their families, and then to check on the progress of those who are recovering from their procedures. I have become quite close to several of these strong people, and our visits buoy the spirits of both of us.

We have never asked people about their experiences in the earth quake, but some now want to be able to express themselves about the disaster. One of my special friends is an elderly lady who has required two surgical procedures, with her leg in traction between them. She has endured pain and discomfort with strong perseverance (that's the word she used). She has a beautiful smile, which she usually shares with me each time I visit. If not, I know that she is suffering.

Once, when I went to see her, the bed was gone, but her son, who has not left her side, indicated that he wanted to talk, so we went out the ward door to a breezeway, and sat on a concrete bench. His mother comes from a small community on the north side of the Artibonite River. She had come in to Port Au Prince with her family to prepare for the daughter's wedding. When the quake hit his mother was buried in the rubble of a 3-story apartment building.

Miraculously, her sons found her and carried her to a nearby house. One of the sons drove to three hospitals to seek help for her broken leg, but he only found bodies of people which had been carried there by distraught families. The son returned to report to his mother, who was coming out of the initial shock of the quake. She told her children to take her home. Why? They asked, and she told them about the hospital across the river where she had gone when they were young, to have an operation.

The sons drove around buying gasoline, for which the price had doubled, and started on the road to Deschapelles and Hôpital Albert Schweitzer. On the way, she told them about the hospital and the American woman who visited her every day.

I met her the day after she arrived, when she stopped me to ask me when she would have her operation. We talked a while, and she asked if the American lady was still there and I explained that she was not, but as the American lady was my mother, she had taught me how to care for our patients. That earned me the first of her beatific smiles.

She said that she will be my Mami, and I am honored with the relationship.

Later today, she will have her second operation and will be on her way to recuperation, and I am certain to be graced with another of her smiles.

Ian Rawson

Tuesday, January 26, 2010


(Photo of Dr. Jennifer Carroll examining baby with congenital heart disease in Port-au-Prince, Haiti.)
Hard lessons, humility for big-city doctors in Haiti

By Elizabeth Cohen, CNN Senior Medical Correspondent

Doctors arriving in Haiti learn there is no technology, no basic equipment
Doctors created operating room with no surgical lights, oxygen, blood or ventilators
After witnessing death of children, surgeons quicker to give permission to amputate

Port-au-Prince, Haiti (CNN) -- Dr. Roberto Feliz and Dr. Hiba Georges were quickly jolted from the most modern of medical care in Boston, Massachusetts, to the most rudimentary of care when they flew to Haiti last week to work at a hospital housed in two tents run by the University of Miami.

The doctors, who worked at the Boston Medical Center, quickly learned that when you have no technology -- not even the simplest blood test -- you have to make medical decisions in an entirely different way.

The first death they witnessed taught them a valuable lesson.

The patient was a boy who needed his leg amputated or else he would die of either an infection or rhabdomyolysis, a kidney disease that follows injuries where muscles are crushed.

Find loved ones in Haiti | Share your story

Feliz, Georges and the other doctors had nowhere to take the boy. Their own hospital had yet to open its operating room, so they spent hours trying to find a hospital that could do surgeries. Their search was in vain.

Finally, the doctors decided to do the surgery themselves that night by the moonlight under a mango tree.

"We just sawed his foot off. We didn't have to use anesthesia because he was already unconscious and wasn't feeling a thing," Feliz says.

But they'd waited too long. The boy took his last breath during the surgery.

"Some of the doctors cried," Feliz says. "I told them, 'There is no crying in medicine.'"

As a direct result of the boy's death, a few hours later, at 3 in the morning, the surgeons at the University of Miami hospital decided to build their own operating room. They had no surgical lights, no oxygen, no blood, no ventilators and no monitors. For a tourniquet they used one of the doctor's belts.

"We'd been waiting to build the operating room until we received better equipment, but after that boy's death we became more aggressive. We said let's do it, because they're going to die anyway," Feliz says.

The doctors continued to learn lessons about what one had called "civil war medicine" after the operating room went up.

At one point, a 16-year-old boy needed an amputation, but the surgeons asked Feliz and Georges to make sure the boy's kidneys were working before they put him through surgery. Without any blood tests to assess kidney function, the only thing they could look for was urine as a sign that his kidneys were working.

"We tried to see if we could get some urine going, but there was not a drop. We filled him with fluids and gave him Lasix, a diuretic, to get him to pee, but nothing," Feliz says.

The boy died as the doctors were treating him.

"I saw a lot of deaths there, but this one hit me the hardest," he says. "I texted my wife back at home, 'I've had a bad day.'"

After that boy's death, surgeons were quicker to give permission to amputate, Feliz says.

Feliz says if there's any silver lining to practicing such rudimentary medicine, it's that it made him a more humble doctor.

"Back in Boston, I'm a hot shot. The nurses have to respect me," Feliz says. "Here, I'm just a worker bee. I cleaned the OR floor after surgery. I carried dead bodies down the street. I was in traffic carrying dead bodies. That makes you human. I came here a very fancy doctor, and I'm leaving here as a humble man."

Shameful Medical State

The young lady pictured to the right is Mona. She lives in southern Haiti and has the most common cyanotic congenital heart disease called Tetralogy de Fallot. Most people with heart defect do not make it out of their teenage years. Mona, being Haitian of course, survived. She needs surgery and I am looking for a medical center in the States to accept her.
Please help if you know of a good medical center that would operate adults with congenital heart disease.

Below is a commentary written from the heart by a team of doctors that found the medical situation in Haiti worse than they could imagine.

Doctors: Haiti Medical Situation Shameful

By Drs. Dean Lorich, Soumitra Eachempati and David L. Helfet, Special to CNN

Doctors gathered sophisticated team and equipment for Haiti on private plane.
They found nobody in charge, chaos, hospitals had nothing, not even elementary equipment. Plane sent with equipment; supplies hijacked; resupply plane not allowed in. They say the "lack of support for our operation by the United States is shocking."

Editor's note: Dr. Dean G. Lorich is the associate director of the Orthopaedic Trauma Service at the Hospital for Special Surgery and New York Presbyterian Hospital and teaches orthopedic surgery at the Weill Medical College of Cornell University. Dr. Soumitra Eachempati is a medical researcher with a clinical surgical practice and teaches at Weill Cornell Medical College. Dr. David L. Helfet is professor of orthopedic surgery at Weill Cornell Medical College and director of the Orthopaedic Trauma Service at the Hospital for Special Surgery and New York-Presbyterian Hospital.

New York City (CNN) -- Four years ago, the devastating Hurricane Katrina affected millions in the United States. The initial medical response was ill-equipped, understaffed, poorly coordinated and delayed. Criticism was fierce.

The response to Haiti has been the same. The point no one seems to remember is this: Medical response to these situations cannot be delayed. Immediate access to emergency equipment is also crucial.

Within 24 hours of the earthquake, Dr. David Helfet put together a 13-member team of surgeons, anesthesiologists and operating room nurses, with a massive amount of orthopedic operating room equipment, ready to be flown directly to Port-au-Prince on a private plane.

We also had a plan to replace physicians and equipment -- within 24 hours, we could bring in whatever was necessary on a private jet. We believe we had a reasonably comprehensive orthopedic trauma service; as trauma surgeons, we planned to provide acute care in the midst of an orthopedic disaster.

We expected many amputations. But we thought we could save limbs that were salvageable, particularly those of children. We recognized that in an underdeveloped country, a limb amputation may be a death sentence. It does not have to be so.

We thought our plan was a good one, but we soon learned we were incredibly naive. Disaster management in Haiti was nonexistent.

The difficulties in getting in -- despite the intelligence we had from people on the ground and Dr. Helfet's connections with Partners in Health and Bill and Hillary Clinton -- only hinted at the difficulties we would have once we arrived.

We started out Friday morning and got a slot to get into Port-au-Prince on Friday. That was canceled when we were on the runway and was rescheduled for the next day. We were diverted to the Dominican Republic and planned on arriving in Port-au-Prince on Saturday.

That Saturday morning slot also was canceled and postponed until the afternoon. The airport had one runway and hundreds of planes trying to land. But nobody was prioritizing the flights.

Once we finally landed, we were taken to the General Hospital in Port-au-Prince with our medical supplies. We had been told that this hospital was up and running with two functioning operating rooms.

Once we arrived, we saw a severely damaged hospital with no running water and only limited electrical power, supplied by a generator. Surgeries were being performed in the equivalent of a large storage closet, where amputations were performed with hacksaws.

This facility could not nearly accommodate our equipment nor our expertise to treat the volume of injuries we saw.

We quickly took our second option: Community Hospital of Haiti, about two miles away. There, we found about 750 patients lying on the floor. But the facility had running water, electricity and two functional operating rooms.

We found scores of patients with pus dripping out of open extremity fractures and crush injuries. Some wounds were already ridden with maggots.

About a third of these victims were children. The entire hospital smelled of infected, rotting limbs and death. Later on, we would judge our surgical progress by the diminishment of the stench.

In our naïveté, we didn't expect that the two anesthesia machines would not work; that there would be only one cautery available in the entire hospital to stop bleeding; that an operating room sterilizer fit only instruments the size of a cigar box; that there would be no sterile saline, no functioning fluoroscopy machine, no blood for transfusions, no ability to do lab work; and the only local staff was a ragtag group of voluntary health providers who, like us, had made it there on their own.

As we got up and running and organized the patients for surgery, we told our contacts in the United States what we needed. More supplies were loaded for a second trip. Those included a battery-operated pulse lavage, a huge supply of sterile saline and the soft goods we needed desperately in the operating room.

The plane landed as planned Sunday night, and the new equipment was loaded onto a truck. Then that truck, loaded with life-saving equipment, was hijacked somewhere between the airport and the hospital.

We had planned to run a marathon round-the-clock operation and leave at 11 p.m. Tuesday. We worked for 60-plus hours without stopping. The plane that would take us home would bring with it not only a new medical staff, but also equipment that was nonexistent in the hospital, or even the country.

These pieces of equipment, two of each, were urgently needed: portable anesthesiology machines; electrocautery machines to stop bleeding after amputations; portable monitors for the recovery room; autoclaves to sterilize equipment; and a lot of orthopedic equipment, which we were quickly using up. The other items were those that were on the previous flight and had been hijacked.

Officials at the Port-au-Prince airport canceled that plane's 6 a.m. Tuesday slot, and the plane never made it to us on time.

We had started to see daylight Monday night, having performed about 100 surgeries, which were mainly amputations, fixing broken limbs and soft tissue debridements. Many of the patients were children and babies.

But on Tuesday morning, a huge number of new patients arrived. The Haitians had heard we were trying to save limbs, and families were bringing their injured loved ones to us.

The hospital was forced to lock down, closing its gates to the angry and frustrated crowd outside. On Tuesday morning, we saw that many of the patients we had operated on were becoming septic and would require additional surgeries.

We finished operating at noon Tuesday, our last surgery assisting an obstetrician on a Caesarean section and helping to resuscitate a newborn who was not breathing.

We decided the situation was untenable. Our supplies were running out, our team was past exhaustion, safety was rapidly becoming a concern, and we had no firm plan to leave or resupply.

A hospital benefactor helped us get to the airport. First, Jamaican soldiers with M-16s escorted us out of the building as the crowd outside saw us abandoning the hospital. We made it to the airport on the back of a pickup, got onto the tarmac, hailed a commercial plane that had carried cargo to Haiti and was returning to Montreal, Canada, and had a private jet pick us up from there.

We were unprepared for what we saw in Haiti -- the vast amount of human devastation, the complete lack of medical infrastructure, the lack of support from the Haitian medical community, the lack of organization on the ground.

No one was in charge. We had the first hospital in the Port-au-Prince area with functioning operating rooms, yet no one came to the hospital to assess how we did it or offer help.

The fact that the military could not or would not protect the critical resupply medical equipment on Sunday, or allow the Tuesday flight to come in, is devastating and merits intense investigation.

There was no security at the hospital. We needed a much higher level of security with strong and clear support of the military from the very beginning.

The lack of support for our operation by the United States is shocking and embarrassing and shows how woefully unprepared we are for the realities of disasters. We came to understand that our isolated operation may work in a mission, but not in a disaster.

We first thought we would support those at the helm but soon realized we were almost the only early responders with the critical expertise and equipment to treat an orthopedic disaster such as this.

Still, nobody with a clear plan is in charge, and care is chaotic at best. Doctors are coming into the country with no plan of what they are going to do, and nobody directing them how to do it.

Surgeons who expect to show up and operate will be mistaken. Without a complement of support staff and supplies, they are of limited to no value.

We left feeling as if we abandoned these patients, the country and its people, and we feel terrible.

Our role back in New York is to expose the inadequacies of the system in the hopes of effecting change immediately. Patients who are alive and still have their arms and legs remain in jeopardy unless an urgent response is implemented.

The quickest and most efficient way to really help now and support the medical staff on the ground is to assess needs, provide equipment and personnel in necessary quantities, and bring them safely and expeditiously into the country and to the hospital units caring for patients.

Upon our departure, we witnessed pallets of Cheerios and dry goods sitting on the tarmac helping nobody. Yet our flight of critical medical equipment and personnel had been canceled, and the equipment that did get through was hijacked.

We implore an official organization to step up and take charge of the massive ongoing medical effort that will be necessary to care for the people of Haiti and their children. And to do it now.

The opinions expressed in this commentary are solely those of Drs. Dean Lorich, Soumitra Eachempati and David L. Helfet.

Friday, January 22, 2010

Healing Haiti

(Photo by John Carroll)
January 22, 2010

Op-Ed Contributor
To Heal Haiti, Look to History, Not Nature

HAITI is everybody’s cherished tragedy. Long before the great earthquake struck the country like a vengeful god, the outside world, and Americans especially, described, defined, marked Haiti most of all by its suffering. Epithets of misery clatter after its name like a ball and chain: Poorest country in the Western Hemisphere. One of the poorest on earth. For decades Haiti’s formidable immiseration has made it among outsiders an object of fascination, wonder and awe. Sometimes the pity that is attached to the land — and we see this increasingly in the news coverage this past week — attains a tone almost sacred, as if Haiti has taken its place as a kind of sacrificial victim among nations, nailed in its bloody suffering to the cross of unending destitution.

And yet there is nothing mystical in Haiti’s pain, no inescapable curse that haunts the land. From independence and before, Haiti’s harms have been caused by men, not demons. Act of nature that it was, the earthquake last week was able to kill so many because of the corruption and weakness of the Haitian state, a state built for predation and plunder. Recovery can come only with vital, even heroic, outside help; but such help, no matter how inspiring the generosity it embodies, will do little to restore Haiti unless it addresses, as countless prior interventions built on transports of sympathy have not, the man-made causes that lie beneath the Haitian malady.

In 1804 the free Republic of Haiti was declared in almost unimaginable triumph: hard to exaggerate the glory of that birth. Hundreds of thousands of enslaved Africans had labored to make Saint-Domingue, as Haiti was then known, the richest colony on earth, a vastly productive slave-powered factory producing tons upon tons of sugar cane, the 18th-century’s great cash crop. For pre-Revolutionary France, Haiti was an inexhaustible cash cow, floating much of its economy. Generation after generation, the second sons of the great French families took ship for Saint-Domingue to preside over the sugar plantations, enjoy the favors of enslaved African women and make their fortunes.

Even by the standards of the day, conditions in Saint-Domingue’s cane fields were grisly and brutal; slaves died young, and in droves; they had few children. As exports of sugar and coffee boomed, imports of fresh Africans boomed with them. So by the time the slaves launched their great revolt in 1791, most of those half-million blacks had been born in Africa, spoke African languages, worshipped African gods.

In an immensely complex decade-long conflict, these African slave-soldiers, commanded by legendary leaders like Toussaint Louverture and Jean-Jacques Dessalines, defeated three Western armies, including the unstoppable superpower of the day, Napoleonic France. In an increasingly savage war — “Burn houses! Cut off heads!” was the slogan of Dessalines — the slaves murdered their white masters, or drove them from the land.

On Jan. 1, 1804, when Dessalines created the Haitian flag by tearing the white middle from the French tricolor, he achieved what even Spartacus could not: he had led to triumph the only successful slave revolt in history. Haiti became the world’s first independent black republic and the second independent nation in the Western Hemisphere.

Alas, the first such republic, the United States, despite its revolutionary creed that “all men are created equal,” looked upon these self-freed men with shock, contempt and fear. Indeed, to all the great Western trading powers of the day — much of whose wealth was built on the labor of enslaved Africans — Haiti stood as a frightful example of freedom carried too far. American slaveholders desperately feared that Haiti’s fires of revolt would overleap those few hundred miles of sea and inflame their own human chattel.

For this reason, the United States refused for nearly six decades even to recognize Haiti. (Abraham Lincoln finally did so in 1862.) Along with the great colonial powers, America instead rewarded Haiti’s triumphant slaves with a suffocating trade embargo — and a demand that in exchange for peace the fledgling country pay enormous reparations to its former colonial overseer. Having won their freedom by force of arms, Haiti’s former slaves would be made to purchase it with treasure.

The new nation, its fields burned, its plantation manors pillaged, its towns devastated by apocalyptic war, was crushed by the burden of these astronomical reparations, payments that, in one form or another, strangled its economy for more than a century. It was in this dark aftermath of war, in the shadow of isolation and contempt, that Haiti’s peculiar political system took shape, mirroring in distorted form, like a wax model placed too close to the fire, the slave society of colonial times.

At its apex, the white colonists were supplanted by a new ruling class, made up largely of black and mulatto officers. Though these groups soon became bitter political rivals, they were as one in their determination to maintain in independent Haiti the cardinal principle of governance inherited from Saint-Domingue: the brutal predatory extraction of the country’s wealth by a chosen powerful few.

The whites on their plantations had done this directly, exploiting the land they owned with the forced labor of their slaves. But the slaves had become soldiers in a victorious revolution, and those who survived demanded as their reward a part of the rich land on which they had labored and suffered. Soon after independence most of the great plantations were broken up, given over to the former slaves, establishing Haiti as a nation of small landowners, one whose isolated countryside remained, in language, religion and culture, largely African.

Unable to replace the whites in their plantation manors, Haiti’s new elite moved from owning the land to fighting to control the one institution that could tax its products: the government. While the freed slaves worked their small fields, the powerful drew off the fruits of their labor through taxes. In this disfigured form the colonial philosophy endured: ruling had to do not with building or developing the country but with extracting its wealth. “Pluck the chicken,” proclaimed Dessalines — now Emperor Jacques I — “but don’t make it scream.”

In 1806, two years after independence, the emperor was bayoneted by a mostly mulatto cabal of officers. Haitian history became the immensely complex tale of factional struggles to control the state, with factions often defined by an intricate politics of skin color. There was no method of succession ultimately recognized as legitimate, no tradition of loyal opposition. Politics was murderous, operatic, improvisational. Instability alternated with autocracy. The state was battled over and won; Haiti’s wealth, once seized, purchased allegiance — but only for a time. Fragility of rule and uncertainty of tenure multiplied the imperative to plunder. Unseated rulers were sometimes killed, more often exiled, but always their wealth — that part of it not sent out of the country — was pillaged in its turn.

In 1915 the whites returned: the United States Marines disembarked to enforce continued repayment of the original debt and to put an end to an especially violent struggle for power that, in the shadow of World War I and German machinations in the Caribbean, suddenly seemed to threaten American interests. During their nearly two decades of rule, the Americans built roads and bridges, centralized the Haitian state — setting the stage for the vast conurbation of greater Port-au-Prince that we see today in all its devastation — and sent Haitians abroad to be educated as agronomists and doctors in the hope of building a more stable middle class.

Still, by the time they finally left, little in the original system had fundamentally changed. Haitian nationalism, piqued by the reappearance of white masters who had forced Haitians to work in road gangs, produced the noiriste movement that finally brought to power in 1957 François Duvalier, the most brilliant and bloody of Haiti’s dictators, who murdered tens of thousands while playing adroitly on cold-war America’s fear of communism to win American acceptance.

Duvalier’s epoch, which ended with the overthrow of his son Jean-Claude in 1986, ushered in Haiti’s latest era of instability, which has seen, in barely a quarter-century, several coups and revolutions, a handful of elections (aborted, rigged and, occasionally, fair), a second American occupation (whose accomplishments were even more ephemeral than the first) and, all told, a dozen Haitian rulers. Less and less money now comes from the land, for Haiti’s topsoil has grown enfeebled from overproduction and lack of investment. Aid from foreigners, nations or private organizations, has largely supplanted it: under the Duvaliers Haiti became the great petri dish of foreign aid. A handful of projects have done lasting good; many have been self-serving and even counterproductive. All have helped make it possible, by lifting basic burdens of governance from Haiti’s powerful, for the predatory state to endure.

The struggle for power has not ended. Nor has Haiti’s historic proclivity for drama and disaster. Undertaken in their wake, the world’s interventions — military and civilian, and accompanied as often as not by a grand missionary determination to “rebuild Haiti” — have had as their single unitary principle their failure to alter what is most basic in the country, the reality of a corrupt state and the role, inadvertent or not, of outsiders in collaborating with it.

The sound of Haiti’s suffering is deafening now but behind it one can hear already a familiar music begin to play. Haiti must be made new. This kind of suffering so close to American shores cannot be countenanced. The other evening I watched a television correspondent shake his head over what he movingly described as a “stupid death” — a death that, but for the right medical care, could have been prevented. “It doesn’t have to happen,” he told viewers. “People died today who did not need to die.” He did not say what any Haitian could have told him: that the day before, and the day before that, Haiti had seen hundreds of such “stupid deaths,” and, over the centuries, thousands more. What has changed, once again, and only for a time, is the light shone on them, and the volume of the voices demanding that a “new Haiti” must now be built so they never happen again.

Whether they can read or not, Haiti’s people walk in history, and live in politics. They are independent, proud, fiercely aware of their own singularity. What distinguishes them is a tradition of heroism and a conviction that they are and will remain something distinct, apart — something you can hear in the Creole spoken in the countryside, or the voodoo practiced there, traces of the Africa that the first generation of revolutionaries brought with them on the middle passage.

Haitians have grown up in a certain kind of struggle for individuality and for power, and the country has proved itself able to absorb the ardent attentions of outsiders who, as often as not, remain blissfully unaware of their own contributions to what Haiti is. Like the ruined bridges strewn across the countryside — one of the few traces of the Marines and their occupation nearly a century ago — these attentions tend to begin in evangelical zeal and to leave little lasting behind.

What might, then? America could start by throwing open its markets to Haitian agricultural produce and manufactured goods, broadening and making permanent the provisions of a promising trade bill negotiated in 2008. Such a step would not be glamorous; it would not “remake Haiti.” But it would require a lasting commitment by American farmers and manufacturers and, as the country heals, it would actually bring permanent jobs, investment and income to Haiti.

Second, the United States and other donors could make a formal undertaking to ensure that the vast amounts that will soon pour into the country for reconstruction go not to foreigners but to Haitians — and not only to Haitian contractors and builders but to Haitian workers, at reasonable wages. This would put real money in the hands of many Haitians, not just a few, and begin to shift power away from both the rapacious government and the well-meaning and too often ineffectual charities that seek to circumvent it. The world’s greatest gift would be to make it possible, and necessary, for Haitians — all Haitians — to rebuild Haiti.

Putting money in people’s hands will not make Haiti’s predatory state disappear. But in time, with rising incomes and a concomitant decentralization of power, it might evolve. In coming days much grander ambitions are sure to be declared, just as more scenes of disaster and disorder will transfix us, more stunning and colorful images of irresistible calamity. We will see if the present catastrophe, on a scale that dwarfs all that have come before, can do anything truly to alter the reality of Haiti.

Mark Danner is the author, most recently, of “Stripping Bare the Body: Politics, Violence, War,” which chronicles political conflict in Haiti, the Balkans, Iraq and the United States.

Thursday, January 21, 2010

Better to Light One Candle...

See Elaine Hopkins post regarding local support of Haiti.

Pictured to the right is a small Haitian Hearts patient with her mom.

Also, see Pam Adams article below.

Let's not fail poor Haiti again

Pam Adams

Journal Star
Posted Jan 20, 2010 @ 10:30 PM
Haiti is never far from central Illinois.

No further than right around the corner or just down the block, there's a neighbor who cared for, maybe adopted, a Haitian child brought here for heart surgery through the Haitian Hearts program.

Or a cousin who travels there often on medical mission trips with Friends of the Children of Haiti.

Or a co-worker who's involved with Haiti Mission Connection, another Peoria-based group that organizes medical mission trips to Haiti.

There's a friend who was a foster mom to teenage refugees fleeing Haiti in the 1980s, or a member of one of many area churches that do the trips, raise the money to help feed, house and school Haiti's poorest.

Even before the earthquake, Haiti and its problems had been growing closer to central Illinois. One friend, one church, one co-worker, one cousin, one neighbor is connected to 10, and 10 are connected to hundreds who give time, money or compassion to the island nation best known as one of the poorest countries in the world, the absolute poorest in the western hemisphere.

Poor Haiti. Already doomed to dependence on the kindness of strangers, and now a major earthquake has crushed the country to the bone, leaving much of the capital, Port-au-Prince, in ruin, displacing some 3 million people and who-knows-how-many tens of thousands dead.

To go to Haiti 30 years ago was to return to central Illinois with a sublime appreciation for the marvel of running water and traffic stoplights. To go to Haiti today is to confront wreckage that leads a coordinator of Doctors Without Borders to tell the Associated Press, "We were forced to buy a saw in the market to continue the amputations."

Poor Haiti. With each passing day, the death toll climbs as deaths due to natural disaster give way to deaths due to the man-made disasters that hinder aid to the injured, avoidable deaths brought on by the economic and political poverty that leaves Haiti's social infrastructure virtually paralyzed in the aftermath of a massive earthquake.

Central Illinois and Haiti are close. Haiti and the United States are linked.

The barren land known as Haiti was once a fertile colony of France. It was France's richest colony, producing at various times in its very early history three-fourths of the world's sugar, coffee, rum and cotton.

If the United States was the first independent nation in the Americas, Haiti was the second. Both countries share a history of revolution to overthrow colonial masters. After that, the histories diverge. An independent U.S. feared an independent neighbor where slaves had overthrown slave masters. The U.S. went on to become the richest country in the hemisphere, Haiti the poorest.

As one partial explanation of Haiti's persistent poverty goes, in Haiti, slaves overthrew their masters and Haitians have been paying for it ever since - beginning with billions paid, essentially in reparations to the French, to gain diplomatic recognition from the rest of the world.

Haiti's own legacy of corrupt regimes combined with our own often disastrous political, economic and immigration policies toward Haiti have continued almost to this day.

"For some of us Haiti is a neighbor and, for others of us, it is a place of historic and cultural ties," former President Bill Clinton told the Washington Post. "But for all of us it is now a test of resolve and commitment."

Current President Barack Obama has promised the U.S. will not fail the test.

U.S. policies toward Haiti have not always been as benevolent as the efforts of the friend, the church, the co-worker, the cousin, the neighbor in central Illinois. But if there was ever opportunity in disaster, it's time for this nation's long-term policies toward Haiti to get closer to what Haiti needs rather than what the U.S. wants.

Pam Adams is a columnist with the Journal Star. Her e-mail address is

Copyright 2010 Some rights reserved

Haitian Hearts Patients Still Hungry and Thirsty

We have had contact with many Haitian Hearts patients in the last week who are victims of the Haitian earthquake.

Pictured above is Katia and below is Suze. Both had valve replacements several years ago at Provena St. Joseph's Medical Center in Joliet, Illinois. Both are homeless in Port-au-Prince and without any medication to prevent them from clotting off their artificial valves.

Our patients are contacting us via cell phones, cybercafes, and through friends and relatives in the United States.

Most have lost everything and are living on the streets with their families and neighbors. Our patients are pleading with us for water and food. They repeatedly tell us that international aid has not reached them.

Haitian Hearts has received significant donations from many generous people. These funds will go to our Haitian Hearts patients and families who are homeless and also to the Daughters of Charity Pediatric Clinic in Cite Soleil.

When one leaves Port-au-Prince and travels south and west, there is a huge amount of destruction. Roads and bridges are bad and villages have been leveled.

See Michael Diebert's article below.

One Week in, Haitians Are Still Hungry

By Michael Deibert

Posted Tuesday, Jan. 19, 2010, at 11:34 AM ET

LEOGANE, Haiti—When Elvis Cineus rushed to his home in the town of Leogane, 18 miles west of Port-au-Prince, in the aftermath of Haiti's devastating earthquake, he was not prepared for what awaited him.

Under the remains of his home, smashed flat as if pummeled by a giant fist, lay the bodies of his wife, his nephew, his cousin, and a friend, all dead. His 1-year-old son was dangling from the building's jagged facade, injured but alive.

"It was a miracle," he says of the infant's survival. "But I think there are still survivors in the fallen schools, because we still hear them screaming."
This coastal town, once one of the most pleasant in Haiti, was largely decimated by the quake. The International Federation of Red Cross estimates that as much as 90 percent of the town has been destroyed.

Along Leogane's Grand Rue, once-stately concrete buildings lie in rubble, with only a few structures built in Haiti's distinctive wooden gingerbread style remaining. The putrid smell of death wafts through the lanes, helped along by an ocean breeze.
At a ruined dental clinic, a woman cries when she tells how a neighbor died after her leg was severed by falling debris and how the neighbor's child, a little girl, took off screaming down the street.

"It's beyond chaos, beyond catastrophe," says Michael Moscoso, a local businessman. "The losses cannot be numbered."

One week after the earthquake flattened large swaths of central Port-au-Prince, people beyond the capital and closer to the epicenter have grown ever more desperate as much-promised aid has been slow to trickle in or has failed to materialize altogether.

In the Médecins Sans Frontières hospital in the capital's southern Carrefour neighborhood, several hundred people lay on makeshift surgical tables, on benches, or sprawled on the floor. Half a dozen people groaned with severe suppurating burn wounds caused when a gas cylinder exploded during the great tremor. Nine-year-old Michel St. Franc lay with blood caking his face, his leg in a primitive cast and tears in his eyes.

"This is the worst situation I've ever seen," says Julien Mattar, project coordinator for the hospital. "We have huge needs in terms of human resources, medical supplies, and materials."

Mattar tells me that a supply plane that was unable to land in Port-au-Prince was instead rerouted to the Dominican Republic. From there, the supplies made the seven-hour overland journey to Haiti.

The injured who were able to reach the hospital were the lucky ones. Farther down the road, both the living and the dead waited for respite in the form of assistance from the international community or from the government of Haitian President René Préval, who has faced withering criticism at home for his perceived lax and disorganized response to the disaster.

Along the Route des Rails, almost every home seemed to have been destroyed, and, again, the intense smell of decay intensified under a glaring Caribbean sun. Residents say they feel abandoned.

"No one has ever been here," Vilaire Elise, a 38-year-old Protestant minister, said as he led a visitor and fellow residents to survey homes where his neighbors had died. "We have no water to drink, nor food to eat. We are suffering here."

Though nearly 105,000 food rations and 20,000 tents had been distributed by humanitarian groups on Monday, the effort seemed unable to come to grips with the scale of the disaster. The U.N. World Food Program has said it will need 100 million prepared meals over the next 30 days.

The growing foreign military presence in Haiti, which has played host to a U.N. peacekeeping mission since 2004 and will now house at least 2,000 U.S. troops, also seemed overwhelmed.

Late on Monday, with the sun setting outside Leogane, in a scene reminiscent of others played out in severely war-torn countries such as the Democratic Republic of Congo, at least 1,500 townsfolk rendered homeless by the quake took over a flat patch of grassy land and constructed fragile shelters from logs, twigs, bed sheets, and leaves.

"Since the disaster, everyone here has had nothing," said Innocent Wilson, a 31-year-old who acts as one of the impromptu camp's spokesmen. "No one is here to help us, so we are organizing ourselves."

Michael Deibert is the author of Notes From the Last Testament: The Struggle for Haiti.

Tuesday, January 19, 2010

Sound of a Wooden Bell...Can you Hear us Now?

A Haitian proverb says:

"No one hears the cry of the poor or the sound of a wooden bell."

Haitian Hearts protested when OSF-SFMC was slow to do the heart surgery on a sick Haitian baby boy. After he arrested at home, we asked OSF, why? And when we went to the Catholic Diocese of Peoria to report this incident, we were told by the Vicar General to "let me know if this ever happens again."

Can you hear us now?

Haitian Hearts protested and notified the OSF Pediatric Resource Center when a young Haitian Heart's patient's pre operative work up was cancelled. She was put on the schedule immediately after we notified them of medical abandonment by Children's Hospital of Illinois.

Can you hear us now?

OSF-SFMC told the Journal Star that Haitian Hearts would not change at the end of 2001. We knew better. OSF cut all funding of Haitian Hearts six months later.

Can you hear us now?

Haitian Hearts picketed OSF when the Executive Director of Children's Hospital of Illinois called the American Consulate in PAP and asked the Consulate to deny any visas for children coming to OSF for heart surgery. The Consulate official in Haiti became tearful as she told me this story in Haiti. She knew that this would cost Haitian kids their lives. And it has.

Can you hear us now?

Haitian Hearts picketed OSF when Willie Fortune was denied any care at OSF when full charges were offered to OSF to pay for a new pacemaker after his old pacemaker failed. OSF's CEO Keith Steffen stood behind 88 year old Sr. Canisia while both looked out her administration office window at us. Mr. Steffen smiled as Willie and I stood on the sidewalk. Sister Canisia did not see Mr. Steffen's antics behind her, but Willie did.

Can you hear us now?

Keith Steffen told me that fear amongst empoloyees at OSF is a good thing.

Can you hear us now?

Jackson Jean-Baptiste and Maxime Petion both became ill in Haiti. Both were OSF patients and Haitian Hearts patients. Both needed repeat heart surgery to stay alive. OSF refused to care for either of them and they both died extremely painful deaths. Both are buried outside of Peoria.

Can you hear us now?

Heurese was denied repeat surgery at OSF too. She had heart surgery elsewhere and was denied a post operative outpatient echocardiogram at OSF. And last year OSF's attorney contacted the non immigrant visa section of American Consulate in Port-au-Prince requesting private information on Heurese. For what reason?

Can you hear us now?

And Jenny e mailed me from Haiti last night. She had heart surgery at OSF in 1999. She was on the fourth floor of a building in Port-au-Prince during the earthquake. She escaped with no physical injury. However, she states that she is not good and has lost all of her medication that Haitian Hearts provides her. She needs repeat heart surgery but OSF is denying her any care. Is this not insane?

Can you hear us now?

And Bishop Jenky assumed control of the Haitian Hearts program to cover for OSF's public relations nightmare. However, Bishop Jenky's fear of OSF's money was obvious when he told me that OSF was a "1.6 billion dollar industry" and refused a Catholic Tribunal Court against OSF stating, "I won't rule against OSF."

OSF and The Catholic Diocese of Peoria, can you hear the Haitian people now?

(Maxime Petion photo above, one month before his death.)

Wednesday, January 13, 2010

Haiti's Earthquake...Another Bad Day for Haitians

In the next few weeks and months, Haiti's poverty and lack of functional infrastructure will take the lives of many Haitians that could have been saved after the earthquake yesterday.

I saw a video clip on television last night of a man walking down a street in Port-au-Prince. I recognized the street and location. There were burning piles of garbage in the middle of the street. Frankly, I think this video was shot BEFORE the earthquake hit, but am unable to say for sure. Port-au-Prince, on a good day, looks semi-destroyed.

Haitians cannot get out of the way of natural disasters. Most people can't get out of the way of unpredictable natural disasters.

But the disasters created and exacerbated by man are avoidable. Man-made racism and injustice have put Haiti in a child-like, helpless position for the last 200 years.

This segment of Peoria's Channel 25 covered the local efforts of various aid groups in Haiti.

Friday, January 1, 2010

I Just Don't Understand...

The following paragraphs appeared in The Catholic Post during the summer of 2009:

"Bishop Daniel R. Jenky, CSC, brought good news and bad news with him when he celebrated Mass for respect life coordinators from around the diocese August 29, and he delivered both with the same words.

"The craven politicians, the lapsed Catholics, the death-dealing abortion mills ultimately cannot win," the bishop said during his homily at St. Joseph's Church in Peoria. "Our power, our final victory, is the risen Christ whose body and blood we are privileged to share. So I say to you, "Be Strong. Be confident."

My comments:

I think Bishop Jenky needs to lead not only with his words but with his actions. And his actions need to be strong, confident, and consistently pro life.

OSF acquired another medical facility in Bloomington, Illinois in 2009 and allowed forty new OSF physicians to begin writing prescriptions for oral contraceptives. Similar behavior by OSF has occurred for 15 years with the agreement of the Catholic Diocese of Peoria.

Most Catholics in the Diocese are unaware of OSF's oral contraceptive policy and many Catholic priests in the Diocese were unaware of this policy until this year. The priests that I have spoken with have no idea what to do to change OSF's policy. They fear Bishop Jenky and are obedient to him.

OSF's oral contraceptive policy was created by OSF Corporate Ethicist Joe Piccione and The Catholic Diocese of Peoria in the mid-1990's. Mr. Piccione tried to convince me in 2009 that fewer and fewer OSF physicians are writing prescriptions for contraceptives; however, he provided no data and, at the same time, allowed 4O new OSF physicians in Bloomington to begin writing contraceptive prescriptions.

Bishop Jenky must be in agreement with OSF's anti-life policy because it continues year after year. In fact today the policy started into its third decade.

I just don't understand.

Catholics are being mislead by The Catholic Post, OSF, and The Catholic Diocese of Peoria.