Tuesday, December 14, 2010

Incredible Widnerlande

Widnerlande has her appointment with the US Consulate in Port-au-Prince at 7 AM Thursday morning (two days from now)!!

This appointment will determine whether this seven year old little girl is granted a non immigrant visa to fly to the United States on Friday for her heart surgery. Widnerlande's surgery is scheduled for December 23 in California.

Please go to this post by Maria detailing Widnerlande's six year wait for surgery.

Tuesday, December 7, 2010

Renaldo's Obituary


Born April 4, 2010--Died December 6, 2010

Renaldo, eight months old, of Bon Repos, Haiti was pronounced dead at 9:05 AM this morning at a Cholera Treatment Center in Port-au-Prince, Haiti.

Renaldo was the son of his Papa and Mama who were present at his death.

Renaldo was admitted to the Cholera Treatment Center yesterday with his mother who is also a patient there. She witnessed his death lying on a green cholera cot just a few feet away.

Renaldo is survived by his two older siblings and his loving aunt in Bon Repos, Haiti.

The family loved Renaldo. His expressive eyes and smile wrapped everyone up with happiness.

His family would like to thank all who cared for him during the last 24 hours of his life, especially his aunt, who is also the primary caregiver to Renaldo’s mother.

Minutes after Renaldo’s death, oral rehydration solution was used to baptize him on his sweet forehead. His body was wrapped in the usual fashion after a cholera death in Haiti and taken to an undisclosed location.

There will be no memorial services.

Friday, December 3, 2010

Genocide in Haiti

In the mid-90’s I had a chance to meet President Aristide. I was an “added” member of a small delegation of Catholic priests who met with him one afternoon. Mildred, President Aristide’s wife, served us cold, sweet citron in their home in Tabarre.

During the meeting human rights, Haiti’s problems, and other subjects were discussed. President Aristide’s comprehension of our questions and comments in English was excellent but I thought his spoken English was difficult to understand. However, he was patient with us, since I am sure he had heard different variations of our concerns many times.

I remember that my comment to President Aristide was I thought genocide was occurring in Haiti. My work is in “downstream” Haiti and I see the worst nightmares wash down the Haitian river.

Quite honestly, I do not remember President Aristide’s answer to my genocide comment.

Since that time I have read about the derivation of the word genocide and about the man who took much of a lifetime to “create” the word. However, I could not give an exact definition of the word right now. And I didn't even look up genocide on Wikpedia before I posted this. So please forgive me for not doing my homework.

I DO know that my thoughts regarding the plight of most Haitians have not become more cheery in the last 15 years.

My definition of genocide is “to kill a people”. That seems exactly what is happening here....at least to poor people. The official definition probably says much more.

It seems that we are witnessing the slow destruction and death of the Haitian poor. That is what I see every day and one “writes from where one stands”.

A couple of days ago in the pediatric clinic in Soleil, the genocide of the Haitian poor seemed alive and well to me.

The mothers stories of their sick children and their anguished lives were told to me over and over. And the scary part was each mother told me their tragedies in a fairly dispassionate way. Kind of like how a friend at home may say that the “Bulls lost to the Pistons last night”.

For example, a mother brought in her two year old boy named Slovensky. The toddler weighs 17 pounds and he had diarrhea and was coughing up long white worms (twelve to be exact). He had recently been discharged from St. Catherine’s Hospital right next door and was “still sick”.

Slovensky has severe underlying malnutrition. His heart rate was normal and he gazed at me with knowing eyes. He just appeared to be an “acute on chronic”. But he was definitely very sick.

Mother then objectively reported to me that Slovensky’s eleven year old sister died from cholera on the same day she became ill. Mother watched her daughter die at Saint Catherine’s Hospital last week. When she told me, her voice didn’t crack but she may have had a slight facial contortion when she related the story. I was waiting for her to break down, but of course she never did.

When her little girl died, mother was at her bedside at St. Catherine’s and the girl’s body was taken immediately and buried in a mass grave outside of Port-au-Prince. Mother said they did this because they didn’t want her little girl’s body to “contaminiate” anyone.

I told mother that Slovensky needed to be readmitted to Saint Catherine's for fluids and she said “I have no one”. She meant that she had no one to take care of Slovensky’s remaining sibling at home if she was tending to him in the hospital. Mothers are expected to bathe and feed and change the sheets and buy IV tubing for their children. This meant that she was going to refuse admission of pathetic Slovensky.

When I asked where the children’s father was, she said that he was killed on January 12 in the earthquake. He was downtown in Port-au-Prince pulling a cart (bouret).

And she told me all of this fairly matter of fact.

So I enlisted the help of one of my Haitian pediatric colleagues to convince the mother that Slovensky should be admitted. Not surprisingly, the pediatrician listened to the facts, eyed the patient, and then sided with the mother and agreed Slovensky should go home.

I was very frustrated and tried to fight back in defense of Slovensky. But mother wanted nothing to do with my arguments and neither did anyone else. And Slovensky just laid in his mother’s arms silently watching the situation. It appeared that HE didn't even care what happened.

So with a slew of medication, I sent pathetic Slovensky back into the upper part of Soleil with his satisfied mom who could now be at home with both of her children. (Home for them is a falling down shack and tent.)

There were more histories somewhat similar to this the other day. In fact every day has similar stories told by stoic and fatalistic poor people.

The infant mortality rate and the maternal mortality rates are very high in Haiti. And people are dying everywhere in the slum from preventable and treatable diseases...cholera being the most recent killer.

I need to do my homework.

During genocide how many people need to die? Do they all need to die at once and from the same cause? And do people witnessing genocide like family and friends have to get use to it and report the loss of loved ones in an objective fashion? And do other people with means, like me, need to go through stages of "acceptance" of death and destruction before it can be called genocide?

I will look it up on Wikpedia.


Tuesday, November 30, 2010

Update from Haiti

Update from Haiti.

The Hippocratic Oath

I swear by Apollo, the healer, Asclepius, Hygieia, and Panacea, and I take to witness all the gods, all the goddesses, to keep according to my ability and my judgment, the following Oath and agreement:

To consider dear to me, as my parents, him who taught me this art; to live in common with him and, if necessary, to share my goods with him; To look upon his children as my own brothers, to teach them this art.

I will prescribe regimens for the good of my patients according to my ability and my judgment and never do harm to anyone.

I will not give a lethal drug to anyone if I am asked, nor will I advise such a plan; and similarly I will not give a woman a pessary to cause an abortion.

But I will preserve the purity of my life and my arts.

I will not cut for stone, even for patients in whom the disease is manifest; I will leave this operation to be performed by practitioners, specialists in this art.

In every house where I come I will enter only for the good of my patients, keeping myself far from all intentional ill-doing and all seduction and especially from the pleasures of love with women or with men, be they free or slaves.

All that may come to my knowledge in the exercise of my profession or in daily commerce with men, which ought not to be spread abroad, I will keep secret and will never reveal.

If I keep this oath faithfully, may I enjoy my life and practice my art, respected by all men and in all times; but if I swerve from it or violate it, may the reverse be my lot.

Sunday, November 28, 2010

Saturday, October 30, 2010

Do You Know Where This Picture Was Taken?


This picture was taken by me yesterday deep in the back part of Cite Soleil.

Can you believe it?

The "worst slum in the western hemisphere" shouldn't look this way, or should it?

The people in Soleil are even more beautiful than this picture.

The parents that I see really care about their children. They run barefoot through Soleil's hot horrible streets with their dying sick kids.

They have nothing to give them until the child is limp with fever...and then it is time to "scoop and run".

And it is usually too late...

Hundreds of thousands of humans living like rats.

No jobs mean no money.

Not enough food or potable water.

No security from gangs that like to shoot, rob, and rape when the sun goes down.

But this is all man made suffering due to corruption from within and without.

It doesn't need to be this way.
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Friday, October 22, 2010

No Room in the Inn for Haitian Hearts Patients

(Photo of Haitian echocardiograms of Haitian Hearts patients who need heart surgery. These videos sit in my living room in Peoria and haunt me each time I look at them because they represent the beating hearts of people I have examined who have treatable disease. I also know their mothers and families who put so much trust in us to help them. Jenny and Henri's echocardiograms are among the stacks of videos.)

OSF HealthCare System in Peoria is refusing Haitian Hearts patients to return to Peoria for repeat heart surgery. They have been refusing my patients for seven years now.

I am having a very difficult time finding any medical center to accept Jenny and Henri for repeat heart surgery. Other medical centers believe it is OSF’s responsibility to take care of their patients.

In the last few years I have had three Haitian Hearts patients die. All were in their early twenties. All needed repeat heart surgery at OSF. All were refused by OSF.

And this week in the Peoria Journal Star an article reported that OSF just added Ottawa Regional Hospital to the OSF System.

OSF HealthCare System is enormous. The Milestone Project was just completed in Peoria and cost hundreds of millions of dollars. (OSF received 450 million dollars from the Illinois Finance Authority (IFA) several years ago with ex-Governor Rod Blagojevich making the annoncement of the second largest loan in IFA’s history going to OSF...)

The Third Order of St. Francis in Peoria owns and operates OSF HealthCare System but have put control of the day to day operations in the hands of its managers. These managers wear suits, not habits.

The OSF HealthCare System consists of seven acute care facilities (now eight with Ottawa), one nursing home which has not been rated highly, and a couple of nursing schools.

There are 550 physicians in the OSF Medical Group. In other words, OSF signs the paychecks of these physicians and essentially owns the hearts and souls of these physicians.

Peoria’s OSF Saint Francis Medical Center and Children’s Hospital of Illinois are two of the largest facilities in Illinois with 616 beds. (That doesn’t mean OSF has the staff to safely take care of all of these patients, but they do have the space and a shining new medical building.)

Yet, OSF has no room for my very sick Haitian Hearts patients who received care from OSF and Peoria physicians in the past. And since the earthquake in Haiti, Jenny and Henri have been homeless much of the last nine months in Port-au-Prince.

How sad for the Peoria medical community and for these Haitians who are really suffering. And how pathetic this is for the silent Catholic Diocese of Peoria and Bishop Jenky whose “headquarters” sit six blocks from OSF.

From a text book on Tuberculosis by Simon Schaaf:

“The wealthy nations have a moral duty to press for the creation of a more just, equitable, and healthy global society. We are reminded of the words of King Solomon--”Along the way of justice there is life.”

Friday, October 15, 2010

DuSable Bridge in Chicago

Photo by John Carroll

Michigan Avenue bridge officially renamed DuSable Bridge

By Alejandra Cancino, Tribune reporter

3:57 PM CDT, October 15, 2010

Alice J. Neal devoted her life to having a street in downtown Chicago named after Jean Baptiste Pointe DuSable, a black man known as the city's first non-native settler. But she died before DuSable had a citywide recognition.

On Friday, her daughter-in-law, Bessie Neal stood before politicians and leaders of various organizations at the ceremony to officially rename the Michigan Avenue Bridge as the DuSable Bridge. It isn't a street, but it is a Chicago landmark.

"Anything that is no trouble to you is no good to you," said Neal, who celebrated her 90th birthday in February. "You are going to have to have some ups and downs, I don't care what it is. And I believe that we had some ups and downs before we got this, but we are proud that we got it."

Historians debate DuSable's early years, but it has become widely accepted that he was a free, black man born in Haiti in the mid-1700s. He was the son of a African slave mother and French mariner.

In the late 1700s, DuSable moved to Chicago, a zone of trade for the Potawatomi, Ojibwe and Lakota tribes, said Joseph Podlasek, president of the American Indian Center. DuSable married a Potawatomi woman named Kittihawa and had two children, Susanne and Jean.

DuSable and his family settled near the Chicago River, where DuSable built a home, and later, a trading post, with a mill, a bake house and a barn, among other small buildings. Kittihawa was instrumental in DuSable's career as a businessman, Podlasek said.

On May 7, 1800, DuSable sold his properties in Chicago. Soon after, he moved to St. Charles, Mo., , where he lived until he died in 1818.

Through the years, many fought to erase DuSable's tale from Chicago's official history, but it was never forgotten.

In the 1930s, Alice J. Neal helped form the National DuSable Memorial Society, which set up an exhibit at the 1933 Chicago World's Fair to educate people about him. As the years passed, the society began to fade. So in 1966, Neal organized the Chicago DuSable League, through which she pushed for a street and a statue named after him. She died in 1981, before achieving those goals.

Through the years, a public high school, museum, harbor, marina and an undeveloped lakefront park have been named after DuSable in the city. Until Friday, a variety of more prominent proposals, from renaming City Hall to Lake Shore Drive after him, either failed or stalled in the City Council.

"Many times we have introduced ordinances in the City Council, some of them have passed and some of them just sat on the table, but we've come a long way," said Ald. Walter Burnett at Friday's ceremony.

In 2000, Haroon Rashid formed Friends of DuSable and pushed for the renaming of the bridge. Bessie Neal, president of the DuSable League, was there to help him. Neal said she has spent many sleepless nights and a lot of money "to try to get this going."

"I can't tell you what this means to me," Neal said. "It means so much."


Copyright © 2010, Chicago Tribune

Thursday, October 14, 2010

OSF Tries to Quell Rumors

Peoria Journal Star's Catherine Schaidle wrote a good article regarding OSF.

OSF employees are told one thing by OSF management that makes them worry about losing their jobs. And then an article like this comes out with OSF management's confusing statements like "job restructuring" and notes Mr. Steffen's "bewildered" appearance when questioned.

How could OSF's employees be anything but "bewildered" and afraid? Mr. Steffen told me that fear is a good thing amongst employees at OSF.

Many of the comments that follow on the Journal Star website clearly show that many people no longer trust OSF and believe that the Sisters have lost control of their medical center.

Monday, October 4, 2010

OSF's New Building and Shoddy Care

This forum article appeared yesterday in the Peoria Journal Star.

I will add more soon.

Keith Steffen told me that it was OK with him if OSF nurses left for Methodist. I think quite a few have.

Who will take care of sick patients at OSF?

Tuesday, September 28, 2010

Catholic Bishops and Mandated Contraception

Here is a link from NPR.

This interview was done yesterday.

The Catholic Diocese of Peoria and OSF created their own ethical loopholes 15 years ago which allows OSF physicians to prescribe oral contraceptives. And OSF's health care plan at the time offered a wide array of contraceptives.

It seems that OSF in Peoria does not have to worry much about contraception being pushed on the them by the federal government. OSF made it easy for patients to obtain contraceptives...no federal mandate was needed.

Thursday, September 23, 2010

Peoria's EMS Not the Same as Miami's


This Emergency vehicle was sitting in front of the Miami International Airport the other day.

The Miami-Dade fire officials have told me that for a firefighter to advance in the Miami-Dade fire department they must advance their skills to Paramedic level.

(Paramedics give advanced life support versus basic life support.)

This of course is not what the Peoria powers have wanted for the Peoria Fire Department (PFD) over the past two decades. Peoria City Council meetings were filled with local hospital administrators and physicians who wanted to keep the PFD at a basic level.

Up until a couple of years ago, the PFD was not allowed to provide ANY paramedic support to people who called them for medical emergerncies. All the PFD could do was provide basic life support and wait until Advanced Medical Transport arrived. And the patient waited too...

In the last 18 months Fire Station 12 in Peoria was designated Paramedic by the powers that be. This change was not announced or covered by the local media. So the average Peorian did not know the change had been made or even that their was a NEED for change.

During a 12 month interval Fire Station 12 gave Paramedic care to 89 victims. And that is just Fire Station 12 during its first year providing Paramedic service.

If one extrapolated to the entire city of Peoria with 12 Fire Stations, how much Paramedic care would the PFD have provided for the citizens of Peoria with all Fire Stations providing Paramedic care? How much good would they have all done for people who called 911 for a medical emergency?

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Saturday, August 28, 2010

Haitian Hearts has 141st Patient Accepted in to the USA

When I was working in Haiti in July a very sick man came to clinic early one morning. He was in terrible congestive heart failure and arrived on the back of a little motor scooter.

He has been accepted into a medical center in the USA and will be arriving soon.

See Maria's blog for further details.

Tuesday, August 24, 2010

Long Waits in the Emergency Room

In today's Journal Star there is an article on long waits in the nation's emergency rooms.

Dr. Nick Jouriles, emergency medicine chief at Akron General Hospital in Ohio was quoted in the article:

"The longer people stay in the emergency department, the more likely they're going to have complications, deaths. If they are elderly, they're more likely to end up in the nursing home."

In 2001 I wrote Keith Steffen, CEO at OSF-SFMC in Peoria this letter.

The next day I was put on probation for six months and Keith referred to me as "a malignancy in the emergency department."

I think OSF-SFMC was keeping the hospital full of elective surgical cases to the detriment of my Emergency Room patients.

A few months later Mr. Streffen fired me, and in July, 2002 he cut all OSF funding of Haitian Hearts patients.

Tuesday, August 17, 2010

Will Saint Francis Really do this?

Will OSF allow Jenny to die?

How could OSF do this?

OSF has a shining brand new 300 million dollar medical building. But was this building worth it if the life of one Haitian is ignored?

If Jenny were in Peoria, we wouldn’t keep her invisible. If she asked for medical help, the Peoria community would try and help her. Jenny lives 90 minutes from Miami.

The best medical technology in Peoria should not be used in a discriminatory fashion. Will OSF allow Jenny to die in Haiti with no medical technology at all?


Photo by John Carroll

Examining patients in Haiti is a very humbling experience for me.

When I look at the patient sitting on the examination table in front of me I realize there is no difference between the two of us. We are the same being. He just happens to be in a worse way that particular day than I am. And deep inside I realize some day I will be in his position one way or another.

When one is strong and seemingly in control one can be mistaken and think that he will always be in control of himself and his environment. But that is just not true.

Someday we will all be Haitian-like. We will be looking into someone's eyes pleading for help for ourselves. Will the other person be kind and at least try and help some? When our day comes hopefully we will have some of the dignity that Hatiians display during their dark hours.

John A. Carroll, MD

See the abstract below about humility in medicine.

"The new professionalism movement in medical education takes seriously the old medical virtues. Perhaps the most difficult virtue to understand and practice is humility, which seems out of place in a medical culture characterized by arrogance, assertiveness, and a sense of entitlement. Counter cultural though it is, humility need not suggest weakness or lack of self confidence. On the contrary, humility requires toughness and emotional resilience. Humility in medicine manifests itself as unflinching self-awareness; empathic openness to others; and a keen appreciation of, and gratitude for, the privilege of caring for sick persons. Justified pride in medicine’s accomplishments should neither rule out nor diminish our humility as healers."

Jack Coulehan, MD, MPH
Annals of Internal Medicine Vol. 153 Number 3
August 3, 2010

Monday, August 9, 2010

Keith Steffen and the (Revised) OSF Mission Statement

A recent Journal Star article referred to OSF's new Milestone Project as "monolithic".

The article quoted OSF Keith Steffen extensively. Several of Keith's quotes made me laugh...this one in particular:

"I've never seen the sisters back away from risk, back away from being first or back away from this value proposition of market differentiation. We're different...."

If anyone understands where Saint Francis of Assisi factors in to the "value proposition of market differentiation", let me know.

Wednesday, August 4, 2010

Catholic Health Care Demise...Article and Comments from One Year Ago


There was a time when institutions bearing a Catholic identity, such as hospitals and clinics, would never have agreed to even the slightest hint of deviating from the Catholic Church’s teachings. That was, I am sad to say, a very long time ago.

Today, there appears to be a slow deterioration in the Catholic identity of Catholic health-care institutions. I started to become aware of this over 10 years ago, when the Peoria Protocol first came to my attention. For those unfamiliar with it, the Peoria Protocol, first developed in 1995, was put in place at Saint Francis Medical Center in Peoria, Illinois. The Protocol defines permissible approaches to medical care following a sexual assault. Following are two of its four possible courses of action:

* The woman is determined to be past the early post-ovulatory phase of her cycle if the LH urine test is negative and her progesterone level is greater than or equal to 6 ng/mL. In this situation, the timing of the sexual assault could not have coincided with the presence of an ovum. Hence, it is morally permissible to administer an emergency contraceptive for the victim's psychological benefit.

* Finally, the woman is determined to be in the late post-ovulatory phase if the LH urine test is negative, her progesterone level is less than 6 ng/mL, and she anticipates menstruation in less than seven days. Here, too, it is morally permissible to administer a contraceptive medication.

These two statements, while approved by many Catholic medical ethicists, represent a fundamental moral problem. If the Catholic Church does not condone the use of contraception as medical treatment in any case other than a situation involving a serious medical condition and in which the female abstains from sexual relations during such treatment, how can it be permissible to administer a powerful chemical compound that is known to abort, when there is no serious medical condition and alternative therapies exist?

Neither of the above scenarios described in the Peoria Protocol provide a 100-percent guarantee that a child has not been conceived. Moreover, these statements are nuanced and do not provide adequate safeguards to protect the child, should his conception have occurred as a result of the rape.

One has to wonder why a Catholic hospital would even consider this treatment option.

Saint Francis Medical Center is also involved in dispensing oral contraceptives. The news media reports that its involvement in the distribution of birth control pills is the direct result of a “middle ground” decision:

[W]hen OSF Saint Francis began hiring primary care physicians in the 1990s as part of OSF Medical Group, many of the physicians wanted to prescribe oral contraceptives. Much anguished discussion ensued, said Joseph Piccione, corporate ethicist for OSF Healthcare System.

Yet a middle ground was found. No contraception of any kind would be distributed within the four walls of the hospital itself, Piccione said.

Regardless of walls, there is no Catholic doctrine that would sanction an arm’s-length agreement that the birth control pill can be dispensed under the aegis of the Church.

Then there’s the California case involving known abortionists serving as staff physicians for Catholic hospitals. When Wynette Sills first brought this to our attention earlier this year, we investigated, only to find—to our dismay—that, in fact, the situation is as she originally described it. As Bud Reeves reports,
We want our readers to know that we are continuing with our investigation as well as with our direct action activities regarding Mercy San Juan Hospital (MSJH) and Catholic Healthcare West’s (CHW) practice of allowing identified abortion doctors to practice at MSJH and even be promoted on their webpage. CHW originally excused their promotion and use of three identified abortion doctors as a matter of an insurance requirement. Following my (Bud) efforts to get clarification from Mr. Gardner, last week he sent me a one sentence email which now claims that federal law requires CHW hospitals to allow the abortion doctors to practice in their hospitals. I wrote back to Mr. Gardner and asking him for a meeting or at least giving us the citations for the laws he refers to. So far nothing but silence from Mr. Gardner. Keep this in prayer.
It is probably no accident that about a year ago, Catholic Healthcare West entered into an alliance with human cloning practitioner Advanced Cell Technology, Inc. While it is reported that Catholic Healthcare West will be conducting clinical trials of adult stem cell treatment for heart disease, this alliance raises serious ethical questions, due to the fact that “ACT has previously promoted research that contradicts Catholic principles regarding respect for the rights of the human embryo.”

The problematic nature of such agreements, arrangements and alliances is not by any means limited to Illinois and California. It is a nationwide epidemic, rooted in the age-old dilemma of choosing between God and money. This becomes very clear when revisiting the complexities of the Boston archdiocese’s Caritas Christi mess. You may recall that American Life League was quick to commend Cardinal Sean O’Malley when the archdiocese made this announcement on June 26:

Caritas Christi Health Care, the financially challenged Catholic hospital system founded by the Archdiocese of Boston, is abruptly ending its joint venture with a Missouri-based health insurer at the insistence of Cardinal Sean P. O'Malley, who has decided that the relationship represented too much of an entanglement between Catholic hospitals and abortion providers.

But, within days, we received a telephone call informing us that the agreement had actually not been cancelled. Carol McKinley reported this on her blog, which has thus far not been refuted: “Nobody (including other bishops and cardinals) is able to get details out of the cardinal about what it is he has approved. I think our Catholic pro-life force deserves to know what the actual arrangement is.”

But we do have an inkling when we consider the statement Cardinal O’Malley made, as quoted in the Boston Globe: “By withdrawing from the joint venture and serving the poor as a provider... upholding Catholic moral teaching at all times, they are able to carry forward the critical mission of Catholic health care.’’ The newspaper’s analysis: “Because Caritas will no longer be a joint owner of the insurance venture, the archdiocese is hoping that there will no longer be any question that Caritas will not financially profit from abortions, sterilizations, or other services provided by non-Catholic hospitals.”

A Caritas spokeswoman told the Globe, “This is the right way to move the distraction of the debate of ownership and allow us to be a provider.’’ Here is noted Catholic commentator Phil Lawler’s response: “A debate over involvement in killing unborn babies is a ‘distraction’ from the business of saving lives. A debate over mutilating people to make them infertile is a ‘distraction’ from the distinctive mission of Catholic health care.”

So we are left to wonder if all this means is that Caritas Christi is no longer an official business partner of abortion providers, but still connected with them in some way. Does it mean that Catholic hospitals will continue to refer for abortion, use the morning-after pill to treat rape victims and so forth? Nobody knows!

As I write this, similar problems are developing in New Hampshire, where the pressure is on Catholic hospitals to bend to the will of the state. New Hampshire Right to Life has prepared a set of three videos dealing with the challenges they face at this time. As was the case in Massachusetts, the cause of concern is a merger.

Wisconsin’s Catholic hospitals are also under the gun. Just last year, they were forced to dispense emergency contraception and did not sue, or in any other way, act to protect their Catholic identity. So what will happen now?

Well, the answer, which is frightening to say the least, may be contained in a short commentary written by Catholic Health Association’s president and CEO, Sister Carol Keehan, DC, who attended the March 5 Obama White House Health Reform Summit. She tells us, President Obama also was clear that we will have to spend more money in the immediate future to build the infrastructure to lower health care costs in order to achieve the kind of savings and affordability in the future. He pointed out that this is politically one of the hardest kinds of decisions to make.

It occurs to me that the various pressure tactics already being used by state governments to pressure Catholic hospitals into doing the unthinkable are but one way to tighten the noose as “Obama-care” becomes a reality, if, in fact, it does.

What also occurs to me is that our bishops must speak with a unified voice, without any dissent and without any bureaucratic mumbo jumbo. They must set forth authentically Catholic medical ethics as the only medical ethics that will be followed in a Catholic setting—with or without mergers, alliances or “common-ground” shenanigans. Until that happens, Catholic health care, as we once knew it, will continue to deteriorate and, at some point, will crumble.


I honesty cannot belive that a woman would consider rape to be a gift from God. Maybe you, julie, need to get out in the real world for a while. You will be not be winning anyone's heart and mind by acting like a fanatic

July 22, 2009

It must be that bishops are unable, or unwilling, to teach Catholic beliefs, and so instead appease the culture.

For example, the Peoria Protocol "administer an emergency contraceptive for the victim's psychological benefit" when no physical purpose exists.

And OSF allowing employee physicians to prescribe oral contraceptives because they the doctors wanted to. Teaching employee physician the truth as set forth in Humanae Vitae would have fulfilled the Bishop's and OSF's responsibility, instead!

If Catholic teachers and institutions are not going to stand up and answer the challenges in the hard cases, then what do they understand Catholicism to mean? When do people get the teaching? When does the light shine? When does the Light shine?

If bishops want to restrict themselves to espousing pious practices - which the secular culture may ridicule but nonetheless tolerate, and avoid teaching us how to address the difficult decisions in our lives, then they lead us towards sentimental religiosity and away from truth and heroic living.

David Volk
July 22, 2009

Catholic health care has been sliding down the moral slippery slope ever since it permitted replacement of the demoniacal possession theory of disease with heretical scientific theories of disease.

July 22, 2009

The Massachusetts law requiring that emergency contraception be provided at hospitals to rape victims went into effect in late 2005. There is no exception for Catholic hospitals and none are known to have refused to comply with the law. One of the ways the medication works is by preventing the implantation of a newly conceived human being in its mother's uterus. This is an abortion. Governor Romney vetoed the legislation, and the Catholic hierarchy made no effort to round up the votes (one-third from either house of the legislature) needed to sustain the veto. Never mind that about 70 percent of the members were Catholic! Apparently diocesan leaders decided it would not be worthwhile to risk antagonizing the heavily Democratic legislature by working to sustain a Republican governor's veto.

Charles O. Coudert
July 22, 2009

John Carroll to Webmaster
Submitted Comment

One has to know Peoria’s local politics to really understand what is happening at OSF- Saint Francis Medical Center regarding Catholics and contraception. What has happened is quite complex and not transparent.

OSF hired Catholic ethicist Joe Piccione in the early 90s and made him OSF Corporate Ethicist. According to the Peoria Journal Star articles from that time, one of Mr. Piccione’s main goals was to work with the Catholic Diocese of Peoria and make an ethical loophole which would allow OSF to be in the contraceptive business. The rationale was that this would help OSF stay competitive in the Peoria medical marketplace.

OSF’s Mr. Piccione and Bishop John Myers of the Catholic Diocese of Peoria were able to establish a policy which allowed OSF physicians to write for contraceptives ('limited private practice'). At the same time, OSF HealthPlans insurance provided a wide array of oral contraceptives and sterilization methods.

These policies were implemented, as explained to me by Mr. Piccione, using ethical firewalls to separate the evil act (contraception) from OSF. The “limited private practice” policy and third party payers supposedly provided the firewalls.

However, when interviewed by the Peoria Journal Star 15 years ago, Mr. Piccione, stated that their hands would be dirty with this policy.

And just recently, OSF purchased Carle Clinic in Bloomington, Illinois. Carle serves over 37,000 patients. Carle Clinic representatives have told me that their physicians will soon become OSF employees and will write prescriptions for oral contraceptives in this newly purchased OSF facility.

Unfortunately, these Peoria policies and practices are in opposition to the fundamental teachings of Humanae Vitae. However, as pointed out in Judie’s commentary, the Catholic Diocese of Peoria is not alone in succumbing to the forces of the medical marketplace.

John A. Carroll, MD
Peoria, Illinois

Tuesday, August 3, 2010

Haitian Adoptions

Photo by John Carroll/July 28, 2010
Beautiful Haitian orphan...one of thirty seven babies, toddlers, and children in an orphanage in the capital going nowhere quickly. How sad and how bad.

My wife Maria and I adopted a Haitian toddler several years ago. It took 20 months of agonizing paperwork (done by Maria). The bureaucracy on both sides of the water was terrible. (We had to be fingerprinted three times by the US government. And our adoption documents sat in various Haitian ministries for months at a time...just needing one director's signature.)

It has not been uncommon during the past twenty years to walk down the street in Port-au-Prince and be offered a baby/child to adopt by a desperate adult caregiver. In fact that happened frequently. And still does post earthquake. (We were offered a baby who was born in July by the parents...but the offer was made to us in May.)

Haitian parents love their kids, they just can't feed and educate them. So there are hundreds of thousands of orphans in Haiti.

Haiti just went through the biggest natural disaster ever recorded. In history. Ever.

Were mistakes made with hustling over 1,100 kids out of Haiti to be adopted AFTER the earthquake? Probably.

But are mistakes being made now by slowing Haitian adoptions? Yes, definitely, with many Haitian kids suffering in every fashion you can imagine.

See article below.

August 3, 2010

After Haiti Quake, Adoption Chaos

BAXTER, Minn. — Beechestore and Rosecarline, two Haitian teenagers in the throes of puberty, were not supposed to be adopted.

At the end of last year, American authorities denied the petition of a couple here, Marc and Teresa Stroot, to adopt the brother and sister after their biological father opposed relinquishing custody.

Reluctantly, Mr. and Mrs. Stroot, a special-needs teaching assistant and a sales executive with four children of their own, decided to move on.

Then on Jan. 12, a devastating earthquake toppled Haiti’s capital and set off an international adoption bonanza in which some safeguards meant to protect children were ignored.

Leading the way was the Obama administration, which responded to the crisis, and to the pleas of prospective adoptive parents and the lawmakers assisting them, by lifting visa requirements for children in the process of being adopted by Americans.

Although initially planned as a short-term, small-scale evacuation, the rescue effort quickly evolved into a baby lift unlike anything since the Vietnam War. It went on for months; fell briefly under the cloud of scandal involving 10 Baptist missionaries who improperly took custody of 33 children; ignited tensions between the United States and child protection organizations; and swept up about 1,150 Haitian children, more than were adopted by American families in the previous three years, according to interviews with government officials, adoption agencies and child advocacy groups.

Among the first to get out of Haiti were Beechestore and Rosecarline. “It’s definitely a miracle,” Mrs. Stroot said of their arrival here, “because this wasn’t going to happen.”

Under a sparingly used immigration program, called humanitarian parole, adoptions were expedited regardless of whether children were in peril, and without the screening required to make sure they had not been improperly separated from their relatives or placed in homes that could not adequately care for them.

Some Haitian orphanages were nearly emptied, even though they had not been affected by the quake or licensed to handle adoptions. Children were released without legal documents showing they were orphans and without regard for evidence suggesting fraud. In at least one case, two siblings were evacuated even though American authorities had determined through DNA tests that the man who had given them to an orphanage was not a relative.

“I feel a weird sense of survivor’s guilt,” said Dawn Shelton of Minnesota, who hopes to adopt the siblings. “So many people died in Haiti, and I was able to get the life I’ve wanted.”

In other cases, children were given to families who had not been screened or to families who no longer wanted them.

The results are playing out across the country. At least 12 children, brought here without being formally matched with new families, have spent months in a Pennsylvania juvenile care center while Red Cross officials try to determine their fate. An unknown number of children whose prospective parents have backed out of their adoptions are in foster care. While the authorities said they knew of only a handful of such cases, adoption agents said they had heard about as many as 20, including that of an 8-year-old girl who was bounced from an orphanage in Haiti to a home in Ithaca, N.Y., to a juvenile care center in Queens after the psychologist who had petitioned to adopt her decided she could not raise a young child.

Dozens of children, approaching the age of 16 or older, are too old to win legal permanent status as adoptees, prompting lawmakers in Congress to consider raising the age limit to 18.

Meanwhile, other children face years of legal limbo because they have arrived with so little proof of who they are, how they got here and why they have been placed for adoption that state courts are balking at completing their adoptions.

One Kansas lawyer said he satisfied a judge’s questions about whether the Haitian boy his clients had adopted was an orphan by broadcasting announcements on Haitian radio stations over two days, urging any relatives of the child to come forward if they wanted to claim him.

Another couple seeking to adopt, Daniel and Jess McKee of Mansfield, Pa., said Owen, 3, who can dribble a basketball better than children twice his age, arrived from Haiti with an invalid birth certificate — it shows him as 4 — a letter in French signed by a Haitian mayor that declared him an orphan, and stacks of handwritten medical records from his time in a Haitian orphanage.

Their prospective daughter, Emersyn, also 3, came with no documents at all.

“As things stand,” Mrs. McKee said, “I’m basically going to show up in court and tell a judge, ‘These kids are who I say they are,’ and hope that he takes my word for it, because if he asks me to prove it, I can’t.”

Later, she added, “I guess the government said, ‘Let’s just get the kids out of Haiti, and we’ll worry about the details later.’ ”

Decisions Made in Haste

Administration officials defended the humanitarian parole program, saying it had strict limits and several levels of scrutiny, including reviews of adoption petitions by the State Department and the Department of Homeland Security in Washington and Port-au-Prince, the Haitian capital.

But they also acknowledged that the administration’s priority was getting children out of harm’s way, not the safeguards the United States is obligated to enforce under international law.

Matt Chandler, a spokesman at the Department of Homeland Security, said the evacuations were done in the best interests of children who faced “an uncertain and likely dangerous situation that could worsen by the day, if not by the hour.”

Whitney Reitz, who oversaw the parole program at the Department of Homeland Security, acknowledged that the decisions were hastily made.

“We did something so fast,” Ms. Reitz said at a conference in New York in March. “We did something that normally takes a couple of years and that we normally do with excruciating care and delay. There’s so much time for deliberation in the way the program normally goes, and we condensed all that into a matter of days.”

There is no evidence to suggest that the evacuations were driven by anything other than the best of intentions. And with untold numbers of unaccompanied children in Haiti, the hemisphere’s poorest country, left fending for themselves or languishing in institutions, it is not hard to make the case that those who were evacuated are better off than they would have been in the hemisphere’s poorest country.

Many now live in the kind of quiet, scenic towns depicted in Norman Rockwell paintings. They are enrolled in school for the first time. They have grown inches, gotten eyeglasses and had their cavities filled.

And they are learning what it feels like to have a mother and father wake them up every morning and tuck them into bed every night.

But child protection advocates like Marlène Hofstetter at Terre des Hommes, an international child advocacy organization, contend that those ends do not justify the means. Rushing children out of familiar environments in a crisis can worsen their trauma, she said. Expediting adoptions in countries like Haiti — where it is not uncommon for people to turn children over to orphanages for money — violates children’s rights and leaves them at risk of trafficking, she added.

“I’m certain that one day these children are going to ask questions about what happened to them,” Ms. Hofstetter said. “I’m not sure that telling them their lifestyles were better in the United States is going to be a satisfactory answer.”

Even though the humanitarian parole program has officially ended, it remains a source of tensions between American-run orphanages in Haiti and international child protection organizations.

The advocates, led by Unicef, have refused to place children who have lost their parents or been separated from them in some foreign-run orphanages, fearing they would be improperly put into the adoption pipeline before they had the chance to be reunited with surviving relatives.

And the pro-adoption groups, led by the Joint Council on International Children’s Services, accuse the advocates of using endless, often unsuccessful, attempts to locate the children’s biological relatives to deny tens of thousands of needy Haitian orphans the opportunity to be placed in loving homes.

“Unicef’s idea is to house children in tents, and tell them that maybe in five years their relatives will be found,” said Dixie Bickel, who has run a Haitian orphanage called God’s Littlest Angels for more than two decades. “What kind of plan is that?”

Washington Feels Pressure

Concerns about child trafficking led China, after its 2008 earthquake, and Indonesia, after the 2004 tsunami, to suspend all international adoptions, despite intense pressure by pro-adoption groups in the United States, according to Chuck Johnson at the National Council for Adoption.

After January’s quake, Haiti, though, was hardly able to stand on its own feet, much less push back, Haitian officials acknowledged. Orphanage directors with political connections in Washington said they saw an opportunity to turn the tragedy into a miracle. Some issued urgent pleas, saying that the children in their care had had been left without shelter, and that the orphanages’ limited stocks of food and water made them prime targets for looting.

In the United States, adoptive parents contacted anyone they knew who might have money, private planes and political connections to help them get children out of Haiti. Evangelical Christian churches, which have increasingly taken up orphan care as a tenet of their faith, were also mobilized. Before long, legislators and administration officials were getting calls from constituents.

Senator Mary L. Landrieu, a Louisiana Democrat and adoptive mother, has been a champion of the cause and pushed administration officials to help bring Haitian children here after the quake. “I wouldn’t be the least bit surprised if there are some errors that were made,” Senator Landrieu said in an interview about the rescue effort, “but you want to err on the side of keeping children safe.”

On Jan. 18, less than a week after the earthquake hit, the secretary of homeland security, Janet Napolitano, announced that the United States would lift visa requirements for those orphans whose adoptions had already been approved by Haitian authorities and those who had been matched with prospective parents in the United States.

The requirements were written so broadly, adoption experts said, that almost any child in an orphanage could qualify as long as there were e-mails, letters or photographs showing that the child had some connection to a family in the United States. And by the time Ms. Napolitano announced the program, military flights filled with children were already in the air.

“The standard of proof was very low,” said Kathleen Strottman, executive director of the Congressional Coalition on Adoption Institute, a nonprofit group that is a leading voice on American adoption policy. “That’s why the administration ended the program as quickly as they did,” she added, “because they worried the longer it was open, the more opportunities they would give people to manufacture evidence.”

Obstacles to Adoption Vanish

Over the next several weeks, orphanages big and small were nearly emptied, whether or not they had been affected by the earthquake.

The staff at Children of the Promise, about 90 miles from Haiti’s capital, barely felt the temblor. But 39 of the 50 children there were approved for humanitarian parole, even though none of them had been affected by the disaster and the orphanage had not yet received the proper license to place children.

Rosemika, 2; Alex, 1; and Roselinda, 1, offer a look at the typical humanitarian parole case. Rosemika’s mother died before the quake. The other two children were given up for adoption because their parents could not provide for them.

Jenny and Jamie Groen, a missionary couple from Minnesota who were volunteering at the orphanage, had fallen in love with the children and decided to adopt them.

Under normal circumstances the couple would have had to get special permission from Haiti’s president to adopt because they are both 28, and the government requires at least one of the prospective parents to be older than 35.

After the quake, Prime Minister Jean-Max Bellerive summarily signed off on their adoption — as he did with all humanitarian parole petitions submitted to him by the United States — without checking the Groens’ qualifications.

Meanwhile, the couple rushed back to the United States for the background checks and home study their own country required for them to take children into their care. And they submitted e-mails, photographs and a Dec. 2 newspaper clipping to prove that their commitment to adopt the children predated the earthquake.

During a recent visit to the orphanage in Haiti, surrounded by peasant hovels and sugar-cane fields, Ms. Groen, now pregnant, said she and her husband were still trying to absorb how quickly they were going from an empty nest to a full one.

It has been a whirlwind for the children’s biological relatives as well. The girls’ relatives still regularly visit the orphanage. “That’s the thing that’s so different about Haiti,” Ms. Groen said. “It’s not full of unwanted children. It’s full of children whose families are too poor to provide for them.”

That appeared to be the predicament shared by Beechestore, 14, and Rosecarline, 13, who are going through all the turmoil of adolescence, exacerbated by a confusing legal tug of war.

In the spring of 2008, their biological father had told the American authorities that he had placed the children for adoption only because he thought they would be educated in the United States and then returned to Haiti. Once he understood the implications of adoption, he refused to give them up.

In November 2009, American authorities formally notified the Stroots that their adoption petition had been denied.

By then, the Stroots were spent — emotionally and financially. The effort to adopt the children had taken four years and $40,000. Rather than appeal, the Minnesota couple decided it would be best for everyone to end their efforts.

Then the earthquake hit. Homeland Security, which earlier had denied visas to the children, reversed course without consulting the children’s biological father or the Stroots. “One day, we’re being told we can’t have the kids,” Mrs. Stroot said. “The next minute, we’re getting a call telling us we need to get them winter coats. It was crazy.”

In late July, a Minnesota judge awarded the Stroots legal custody of the children. Neither the previous denial nor the views of the children’s biological father were mentioned during the proceeding, the Stroots said.

Since then, the newly expanded family has moved on to more mundane matters, like dentist appointments, vaccinations and back-to-school shopping.

“God got done in 10 days,” Mr. Stroot said, “something human beings couldn’t do in years.”

Erin Siegal contributed reporting from Oakland, Calif. Barclay Walsh contributed research from Washington.

Catholics and Fear of Church Hierarchy in Peoria

Peoria Journal Star

Forum: Catholics shouldn't be afraid to challenge church hierarchy

Posted Jul 31, 2010 @ 10:45 PM

With the sale of Resurrection Church in LaSalle, plus the demolition of St. Benedict's in Ladd and the loss of attendance in the four suspended churches in our area, it is time to challenge the church's hierarchy.

We have little authority in church governance. We must challenge this clerical pyramid that is secretive and above scrutiny. We must take a stand for accountability in overseeing the complexities of church finances and all church functions.

We want a diocese, monastery or abbey to be like that of a poor workman who is not sure if tomorrow he will find work or bread. We want them to be filled with those who with all their being share their suffering with those they preach to.

We no longer want a diocese, monastery or abbey whose leaders concern themselves with their own survival and security, free from fear, care or anxiety, while the parishioners are uneasy about what the future holds in their Catholic community. It is easy to speak of spiritual poverty, to fill one's mouth with pious words based on scriptural readings, and yet lack for nothing.

It is time, the parishioners take back the churches they paid for, furnished and repaired. It is time for the laity to handle church operations and let the priests be responsible only for what is sacred.

We have too many priests who live comfortably while parishioners struggle for their church's survival. This has to stop. There are few priests who emulate the poor Nazarene and the humble Jesus.

We need a crusade to recover "Christianity" from the clerical elite. This must come about in order to ensure our Catholic faith.

Carlo Olivero


Monday, August 2, 2010

A Lesson for U.S. Health Care

Photo by John Carroll
Les Cayes, Haiti
July, 2010

In Haiti, a Lesson for U.S. Health Care


In February, a month after Haiti’s earthquake, I went down to Port-au-Prince as part of a team that was helping to reactivate cardiac care in the city’s public hospital. For several months since, I have observed how the earthquake and its aftermath profoundly changed Haiti’s health care system. Over that time, I have come to the unorthodox conclusion that Haiti’s tragic experience may show us a way to improve health care in the United States.

Let me explain. The sudden availability in Haiti of free high-quality care from foreign doctors put enormous competitive pressure on the private local doctors, who had already been working under difficult conditions. Watching this situation unfold, I found myself wondering if the same would happen to private medical services back in the United States were our government to suddenly provide high-quality, low-cost health care.

Haiti, with the worst health care record in the Western Hemisphere — the infant mortality rate is nine times that of the United States and the maternal mortality rate is 50 times as high — was ill prepared to help disaster victims. For the public hospital in Port-au-Prince, earthquake damage only made things worse. Into this vacuum surged hundreds of international doctors and nongovernmental health care organizations.

In the beginning, of course, those with immediate injuries were treated first. But even after the earthquake victims had been taken care of, lines more than a quarter-mile long still formed at the hospital entrance. There were mothers carrying babies with swollen bellies, prematurely old men and women with waterlogged legs and labored breathing, people with painful sores and lots of people coughing. These were Haitians who’d had no access to medical care in a long time and who suddenly saw hope in a hospital full of foreign doctors eager to help at no charge.

This humanitarian aid came with a downside though: it caused many of Haiti’s local private clinics to lose business. One such clinic is Michel Théard’s cardiac practice, near the public hospital where I worked. Before the earthquake and during the immediate aftermath, Dr. Théard did echocardiograms (ultrasound images of the beating heart) for cardiac patients, because the public hospital lacks the equipment to do them. His ultrasound pictures, and those done by other private Haitian cardiologists, often at charity rates, enabled us to diagnose many conditions for patients in the public hospital.

But because Dr. Théard, and the private hospital with which he is affiliated, cannot compete with free foreign doctors, there is a danger that he will no longer be able to stay in business and provide echocardiograms for the poor.

There are many other services that only private doctors provide in Haiti, because the public hospitals are so poorly financed. The rudimentary intensive care unit at the public hospital has no heart monitors, oxygen sensors or any other kind of modern medical equipment. The only thing “intensive” about the I.C.U. is that a health care worker (doctor, nurse or nurse-anesthetist) is present at all times. A CT scanner donated to the hospital in the early ’90s lies rusting outside one of the buildings, sad evidence of the public medical system’s failure to provide adequate care.

Patients who can afford it get specialized procedures like CT scans and echocardiograms at private clinics and then return to the public hospitals for free care. This is also the case for many medicines: family members buy them at a pharmacy and bring them back to be kept under the patient’s hospital pillow for dispensing at the prescribed times.

Perversely, by shoring up the capacity of the normally dysfunctional public health system during this crisis, the foreign doctors may be further damaging Haiti’s fragile medical sector. Once they leave, who will be left with the will and the capital to adequately care for Haitians?

What may be needed, some have suggested, is for key nongovernmental organizations now offering health care in Haiti to work alongside the government’s Ministry of Health to rebuild destroyed facilities and to better train Haitian doctors and other providers. If the organizations could also cooperate financially by directing some of their budget into accounts run jointly with Haiti’s Ministry of Health, the government could reimburse providers like Dr. Théard for their work, thus removing competition between the foreign doctors and local private doctors. In time, as the Haitian government took control of health care delivery and education, the nongovernmental organizations would fade from the scene.

HAITI’S crisis — and its possible solution — provides a mirror for understanding our own difficulties delivering good health care in the United States. After all, it was a similar tension between private and public medical care that made it impossible for Congress, in passing reform legislation this year, to create a single-payer public health system. Many private health-care organizations — primarily for-profit insurance companies — strenuously resisted it, fearing that if the government suddenly provided high-quality, low-cost care for a significant part of the population, they would lose profits or go out of business. Worries about competition between public and private medicine, in other words, are universal.

It is clear that the American health care system functions at a much higher level than its Haitian counterpart does, but that’s mostly a matter of national wealth. Our healthier economy has allowed us to have a relatively viable private-sector health care system, though there remains tremendous disparity from one economic class to another in infant and maternal mortality and access to basic care. And now, because the growing cost of our health care system is unsustainable, we are faced with the need to consider an alternative.

The Haitian situation also suggests a solution — a way to provide health care for all in the United States without destroying our private medical sector. (This, by the way, was always President Obama’s goal, no matter how the right tried to defame his proposals.)

A public-private partnership like the one contemplated for Haiti could be created here. The government, through the Centers for Medicare and Medicaid Services, could team up with health care systems that provide high-quality care to people of all income levels — Kaiser-Permanente, in California, comes to mind, as does the Mayo Clinic network; the Geisinger Health System, in Pennsylvania; Partners HealthCare, in Boston; and Intermountain Healthcare, in Utah — to provide a public option. Private doctors could be paid for the work they did for the new public entity. People who did not want to join such a health plan could remain with their current private insurers.

Health care systems wishing to be part of the new partnership would have to demonstrate competence as well as fiscal responsibility. Those that did not provide good care at a reasonable price might fail, but in the long run the system could serve the broadest cross section of America, and it could do so without undermining private doctors — or at least not those who are motivated by care itself rather than by mere profit.

Although it is unrealistic to expect Congress to rewrite the health care law to allow for this proposal, there is room within the law for a state or regional pilot project to experiment with public-private medical partnerships.

Dr. Théard’s clinic in Port-au-Prince has not yet closed, but he tells me it is now fighting for its life, with little or no money for salaries, equipment or rent. “We are still open but without any help from any sector,” he said in an e-mail last week. “Equipment needs repair, buildings need repair and we are doing the best we can.”

Haiti’s need to fix its health care system is, if anything, more urgent than ours. But its best solution, a public-private partnership, is one that could easily work for America, too.

James Wilentz is a cardiologist at the Lenox Hill Heart and Vascular Institute.

Monday, July 19, 2010

Les Cayes, Haiti


This man is 86 years old.

He is in the hospital but is up and about walking up and down the hallway. His doting family is here also.

He tells me that he remembers World War II very well and the atrocities of Adolph Hitler. I told him that my dad was at Hitler's home at the end of the war.

This man has a heart rate of 28 per minute. He is in complete heart block.

He needs a pacemaker which can only be done in Port-au-Prince by a private cardiologist. And he doesn't have the money anyway.

What to do?

Sunday, July 18, 2010

Yarnie (1985-2010)

Photo by John Carroll
Southern Haiti
July, 2010

In the late 90's Haitian Hearts brought Yarnie to the United States for heart surgery.

Yarnie was about 13 years old at the time and she had valvular heart disease caused by rheumatic fever.

She survived surgery at OSF in Peoria and became much healthier and stronger. Yarnie returned to her home town in southern Haiti which is called Dame Marie. This little village is the home of the famous Haitian-American author Edwidge Danticat.

Yarnie survived the next 12 years in rural Haiti and had she had a two year old baby.

Yarnie was in Port-au-Prince on the afternoon of the earthquake in January and survived. However, shortly after the earthquake she became ill.

Yarnie was evaluated by Cuban doctors in southern Haiti.

An echocardiogram was performed which indicated she needed heart surgery. However, OSF in Peoria refused her repeat heart surgery because she is a Haitian Hearts patient. And another hospital could not be found in time to transport her to the US.

Yarnie died several weeks ago.

Her child is now an orphan in Haiti, one of the very most difficult countries to grow up in the world.

Maria, my wife, wrote a poem about Yarnie in 2002.

It is printed below.


Chosen For

Little did I know
25 years ago when I said,
"Sure, I'll go to Haiti with you,"
that half an island would claim me.

In my work, I am faced
with the limits of what I can do
in the land of limitless heart patients.
Not patients with great hearts, that don't work quite right.

They all know me, Dr. Blan,
who can whisk them
to the magic land, the heaven
up north where hearts
can be synchronized.

The Haitians wouldn't put it that way.
They would say they no longer feel
th ocean rising in their chest
and maybe they won't drown.

Thousands need help.
Who to choose?

A priest tells me of
a sick girl in Dame Marie.
Yarnie, the best student
in her class and maybe the cousin
of Edwidge Danticat, who wrote
Breath, Eys, Memory.

I'm sure she is lovely and deserving,
and her weak breath concerns,
but five kids on the list are coming back.
Perhaps next time.

The next morning I scale an
eight-foot airport fence
and drop to my knees.
The priest arranged
for a Haitian Pilot Man
to fly me to Yarnie.
If I can take five, what's six?

Why is the pilot tasting the gasoline?
Because it's mostly water?
We lift off while the sun peeps
innocently over mountains.

Heading west, preparing to land,
the guilty sun blinds the cockpit,
and the pilot confirms,
"I cannot see anything."
Whack! Whack! Whack!
We hit the treetops and prepare
to die in Dame Marie's red clay.

But instead we land in mud.
Haitian Pilot Man boasts,
"I use only one half of runway and am only pilot,
in Haiti who will land here,"
and then warns me not
track mud in his plane when I reenter.

A group walks toward us.
Yarnie and others.
A runway examination reveals
tachypnea and a heart rate of 140,
the beautiful girl, a stick figure.

The brave fool pilot says he will
fly lower than the mountains for Yarnie's breath.
What choice do I have?
Yarnie's mother cries for
her daughter who she
will lose to find.

Back in Port-au-Prince,
I must get yarnie a visa.
If she falls asleep,
she stops breathing, a deadly cardiac slumber.
I tell another cardiac kid, Nadia, to shake
Yarnie if she doesn't breathe after 15 seconds.

I am gone three hours.
Will there be a girl for this visa?
Rushing in the door,
Yarnie standing and smiling,
"Sure had a good nap. Made a new friend who
kept shaking me for some reason."

Maria King Carroll
Cri de Coeur, 2002

Friday, July 16, 2010

OSF's New Children's Hospital Blessed

Bishop Jenky and the other "Catholic prelates" in attendance have to be embarrassed with OSF because of OSF's abandonment of the Ethical and Religious Directives for Catholic Health Care written by the United States Conference of Catholic Bishops.

A prominent Catholic Monsignor in Peoria described to me the "corporate malaise" at OSF. And the good Catholic priests in parishes of The Catholic Diocese of Peoria are frequently uninformed about huge moral issues at OSF. One priest explained to me how he didn't want to make Bishop Jenky angry regarding a serious "Catholic problem" at OSF and did not want to even talk to Bishop Jenky about it.

And Bishop Jenky and The Catholic Diocese of Peoria are afraid of OSF's power and money and have given in to OSF on very crucial Catholic issues. And the priests and laity in the Diocese--we just follow along with our heads in the sand.

It's all about money, power, and instilling fear in people so they remain quiet.

Too bad.

Below is the Journal Star article regarding the blessing of the new Children's Hospital at OSF today.

OSF's new Children's Hospital blessed

By CATHARINE SCHAIDLE (cschaidle@pjstar.com)
Journal Star

Posted Jul 16, 2010 @ 03:04 PM

“This is the day the Lord has made; let us be glad and rejoice,” U.S. Secretary of Transportation Ray LaHood quoted from Psalm 118: 24 at the dedication ceremony Friday morning of the new Children’s Hospital of Illinois and OSF Saint Francis Medical Center.

Indeed there were hundreds of reasons for rejoicing. Speaker after speaker related various stories, of the long and arduous path to the shining new hospital that was blessed by Bishop Daniel Jenky and a host of other Catholic prelates before a contingent of Peoria dignitaries and well-wishers.

Scriptural verses and symbolisms abound at the brand new building which is being celebrated on the 133rd anniversary of its founders, the Sisters of the Third Order of St. Francis.

Despite his pious opening, LaHood couldn’t let a cheeky observation pass. He was among many who believed it was necessary for the children’s section of the hospital to have its own unit. In those early days, LaHood said, “We fought just to get one sign up.”

Today, the $280 million “sign” is a shining light giving witness to the state-of-the-art facility dedicated to the care of children.

With this project, the Sisters of the Third Order of St. Francis re-affirmed their original mission when they arrived in Peoria on May 22, 1876, and opened a new orphanage and school called “Mount Mary.”

It was while begging on behalf of their wards, that they met the pastor of St. Joseph Church, Rev. Bernard Baak, who asked them to set up a hospital in Peoria.

In October 1876, six nuns led by Sister M. Frances Krasse, set up a make-shift hospital in a rented three-story house on Adams Street. They named it St. Francis Hospital.

And the rest, as they say, is history.

Check out the new hospital for yourself this weekend. Two public open houses are scheduled for 10 a.m. to 4 p.m. Saturday and Sunday.

OSF in Peoria Denying Care to their Haitian Patients

See this Forum article I wrote and the Peoria Journal Star printed today.

Forum: OSF failing patients from Haiti with urgent needs.

Posted Jul 15, 2010 @ 11:00 PM
Re. July 5 article: "Children's Hospital tours scheduled":

I am sure the brand new, $290 million OSF Children's Hospital and Emergency Department is beautiful and will be loaded with technology. People from central Illinois deserve this structure, along with competent medical personnel inside to deliver high-quality care.

However, every society around the world deserves the same chance at cutting-edge medicine.

During the last seven years Haitian Hearts patients who have returned to Haiti after heart surgery at OSF have been categorically denied follow-up surgery at OSF. Several weeks ago, a young girl operated on 13 years ago at OSF died in Haiti. She needed repeat heart surgery.

It's difficult to find other medical centers in the U.S. to take OSF's Haitian patients. They believe Haitian patients cared for in Peoria are OSF's medical and ethical responsibility.

Two more Haitian patients operated on at OSF need heart surgery again. They survived the devastating January earthquake and both have been homeless in Port-au-Prince. Last month I examined them. Both will die without heart surgery soon.

Haitian Hearts donated over $1.1 million to Children's Hospital of Illinois earlier this decade to help build this new OSF medical complex. We would pay for both of these patients, as well.

Over 130 years ago, OSF's founding Sisters said they would turn no one away. The current OSF Sisters say the same, but unfortunately Haitian Hearts patients have been excluded from their mission.

The new OSF medical complex needs to show how "beautiful and uplifting" it really could be. OSF could really shine if they would accept back their Haitian patients and give them another chance at life.

John A. Carroll, M.D.

Haitian Hearts Medical Director

West Peoria

Copyright 2010 pjstar.com.

I am quite sure OSF is mounting a rebuttal to my opinion written above.

OSF's usual modus operandi is to recruit a well known Peoria person to write an article stating why I am all wrong. Who would want this job to defend OSF's neglect of Haitian kids who are dying as a result of OSF's neglect?

Someone will run with the ball for OSF and I will post their article when it appears.

The host families for these Haitian kids in the Peoria area are very afraid of OSF...and for good reason. Much of the Peoria community is afraid of OSF...even big donors to OSF would like to see Mr. Steffen replaced, but their own medical problems make them think twice about going public.

In the meantime, I need to find medical centers to accept Jenny and Henri. They don't have the same time or resources as does OSF.

Tuesday, July 6, 2010

"Affluence is a Funny Thing"

Photo by John Carroll
Cite Soleil, Haiti

"Affluence is a funny thing. Once so many millions of people have so many millions of dollars at stake, even life-and-death issues are resolved on the basis of what protects my money, right now--not the general good or the planet's health. Money and fear will choke even the strongest to death...unless they take that step back, take that breath, and see what money and fear are doing to them."

Gary Smith
Sports Illustrated, July 5, 2010

(Smith wrote an article on the gulf oil spill. This paragraph is relevant for all areas of life. Money and fear do bad things to people and fear of losing money hushes them up, even when they know they should speak up and act.)

Friday, July 2, 2010

On the Ground in Haiti

On the Ground in Haiti
John A. Carroll, M.D.
June, 2010

My wife Maria and I worked in Haiti during part of the months of May and June. We stayed in a guesthouse-orphanage just outside of Port-au-Prince.

A lady named Yolande lived right across the street from us.

Yolande is 78 years old and lives under a blue tarpaulin which encloses a small pup tent inside.

During the earthquake on January 12 her shack, which was located several miles away, was so damaged that she had to move out. Yolande suffered some leg injuries at the time of the quake and still has one lower leg wrapped in a rag. But Yolande smiled and told me that her legs were "much better".

One afternoon shortly after we arrived, I entered an opening in Yolande's blue tarp. The stifling heat, humidity, mosquitoes, and flies were overwhelming.

The tarp was fastened to thin wooden poles and tied above with shoe laces and other fragments of cloth.

Yolande's family brings her rice and vegetables when they can and she cooks in a metal bowl over pieces of charcoal.

I found Yolande to be a practical and pleasant woman. She did not complain about her living arrangements and even said that Americans are the most charitable people in the world. I sure did not feel that way right then as I hurried out from under the tarp so I could get a breath of cooler air in the street.

During this time of the year in Haiti, the rain comes in torrents in the late afternoon or evening, and now this rain seeps through Yolande's tarp and leaks into her tent. So on top of roasting, Yolande and her family are wet much of the time too.

These hardships are not isolated to Yolande.

Haiti has an estimated 9 million people with one third of the population living in the capital, Port-au-Prince. In this city there are over one thousand tent cities, and an estimated 1.5 million people are still homeless five months after the quake. Many people told me that they are simply too afraid to move back inside of their houses. If their houses are still standing, the walls may have been fissure (cracked) and people fear they will collapse on top of them.

Several miles from us downtown Port-au-Prince looks like a nuclear bomb struck it. The once beautiful Haitian National Palace is collapsed and the majority of nearby Haitian government ministry buildings downtown were destroyed in the 47 second earthquake. Haiti's tax building is pancaked just across from the Palace with its director's body and many employees still inside under tons of concrete.

A densely populated tent city now sits in front of the vacant Palace in Port-au-Prince's largest square called Champs de Mars. A young man who identified himself as Carlos told me some of their problems after I walked through his section of the tent city. Carlos seemed fatalistic and did not see any end in sight to their misery.

Rape is common in Port-au-Prince's tent cities and seldom gets reported. Poor women in tent cities have no rights.

Fountains and small decorative pools in Champs de Mar have turned into large toilets filled with stagnant sewage. Kids play nearby with their family's tent abutting these toxic cesspools. Sewage drainage and treatment facilities are more or less nonexistent.

In the chaotic months following the quake, millions of dollars flowed into Haiti from generous people all over the world. (One out of two American households gave to the Haitian relief efforts.)

And five billion more dollars from the international community has been pledged to Haiti over the next two years. Bill Clinton who is UN Special Envoy to Haiti. Recently Mr. Clinton along with Haitian officials have been in charge of the Interim Haiti Reconstruction Commission. One of the objectives of this Commission is to allocate these funds to ensure that the money is used in a transparent fashion for Haiti's post earthquake reconstruction.

Mr. Clinton and Haiti's Prime Minister Bellerive announced the Commission's first approved spending projects:

- $45 million from Brazil and Norway in direct funds for the Haitian government, closing a quarter of its estimated $170 million budget shortfall.

- $1 million from the Clinton Foundation for buildings that can be used as storm shelters in the quake-ravaged towns of Leogane and Jacmel, which are often in the path of Atlantic hurricanes.

- A $20 million fund to provide loans to small- and medium-sized Haitian businesses.

But despite international pledges of some $5 billion over two years at the United Nations donors' conference for Haiti in March, only a fraction has actually been delivered - just $40 million from Brazil.

Even though other pledges are supposed to be delivered soon, I spoke to no Haitians during our entire time in Haiti who trusts that the money will be spent properly. People that I spoke with don't really trust Mr. Clinton any more than they do their own fragmented and dysfunctional government. Many are very angry with Haitian President Preval for his perceived lack of leadership and poor communication through Haiti's largest crisis in its history. They also feel he is cuddling up to international powers for business interests that will exclude the majority of poor Haitians.

And why should 9 million poor Haitians trust any one? They and their ancestors have been on the short end of the stick since Haiti was founded as a Republic more than 200 years ago. The corrupt Haitian state is considered to be a fact of life... not unlike corrupt Illinois politics.

So what do "we" do with hundreds of thousands of displaced and homeless Haitian people? Although Haitians are a tough lot, they are not as resilient as our defense mechanisms would like us to believe. And on top of this earthquake which was "biblical" in size, the U.S. National Oceanic and Atmospheric Administration has predicted a terrible tropical storm season coming Haiti's way in several months.

But so far (as of this writing) the Haitian government has relocated only about 7,000vulnerable people to two safer camps. The relocation is slow because the crippled government doesn't have enough money to complete a job that includes not just setting up new tents, but providing work, schools and services.

First of all, should the tent cities continue to exist? Are they good enough?

No. These places are inhuman and horrible. Lack of food and water, lack of security, and the rain are a few reasons.

And the rain is quickly bringing more problems.

Malaria and typhoid fever were everyday occurrences in the area of the city where I was working. Stagnant dirty puddles of water are everywhere and are good breeding grounds for mosquitoes who will carry disease. I saw a teen-aged boy scooping up water in his hands drinking from a puddle in the road. Medical and public health interventions will not help the majority of Haitians unless their dangerous living environment is changed.

Also, heavy rains tempt unstable hillsides to unleash their mud. And serious flooding and mudslides could endanger not only Haitians but relief workers also.

Port-au-Prince, before the earthquake could have accommodated 300,000 people, not three million people. There has been decades of urban decay. This city is doomed right now unless a paradigm shift in thinking takes place.

We need to be honest and understand that many people are dying now and are still going to die no matter what is done. I saw children starving in front of me. I often wondered what good was my stethoscope in times like this.

So what needs to happen? What interventions will minimize the final death count? How can Haiti's problems be prioritized and triaged appropriately? What can be done to give some dignity to the life of over one million displaced Haitians? How do we stop the violence aimed at Haitian society's unfortunate losers?

Haitians tell me they want jobs. Who would have thought?

Jobs earn them money to repair their lives and their family's lives. Jobs allow one parent to stay at home during the day and take care of their babies and toddlers. Kids suffer alot mentally and physically when they are alone or being watched by a neighbor who is already swamped with problems. Children are literally down in the dirt and sewage and their chances for survival diminish without a parent home.

Mother's can breastfeed if they are home. And when mother's breastfeed, they save money because they do not need to purchase milk. And if they purchase powdered milk, they may accidentally prepare it with dirty water which can sicken their children.

With the billions of dollars that hopefully will come to Haiti, big firms with heavy equipment should be hired. Skillful urban planners from all over the world need to work with the Haitian government.

And most importantly poor Haitians need to be hired.

Hundreds of thousands of young, strong Haitian men and women that live in the capital would jump at the chance for a job. Hire them and pay them fairly so they can feed their families while they make a new and better Haiti. The billions of dollars of international pledges need to go for displaced Haitians while they perform the back breaking reconstruction of Haiti.

Pay Haitians in tent cities to repair or rebuild their own homes--the structures where they were living pre earthquake. Or pay the man that rents the home to these people. And these homes need to be earthquake proof homes using Western building codes. Earthquakes don't kill people, bad buildings do.

The huge mounds of rubble on the Port-au-Prince streets needs to be cleared so the streets can be navigated by cars and big equipment.
The traffic jams in the capital now slow progress for everyone.

Many people have returned to their neighborhoods after inspections found their homes safe, but often return to the tent camps when word of aid distribution spreads. So food and water distribution needs to be local--- brought to people in their neighborhoods as their homes are rebuilt.

Port-au-Prince needs to be decentralized. The earthquake negatively influenced 80% of Haiti's economy because PAP was and is the hub of the country. Now the hub is critically ill. The capital is built over fault lines and this all could happen again. Three million miserable people living on top of each other need to be spread back out to Haiti's provinces.

But for people to move to the Haitian countryside or smaller cities outside of PAP, there has to be jobs, family members with adequate housing that can accept their homeless relatives, and some basic services like schools, roads, water, electricity, and medical care.

Trees need to be planted and gardens started in these communities. Listening to Haitian grass roots organizations and the Haitian farmer is very important. These people know what they need to stay alive.

The local Haitian community in the province needs to be involved in all decision points.

For­eign aid that flowed into Haiti after the quake has hurt the Haitian farmers. Most of the peo­ple in Haiti's central plateau (L'Artibonite) earn their liv­ing by grow­ing and sell­ing rice, Haiti’s sta­ple food. But the influx of for­eign food aid has meant that many Haitians can now get rice for free. As a result, the price of rice grown in Haiti has plummeted and the Haitian farmer finds himself in more trouble.

Several months ago even Mr. Clinton was quoted as saying, "...we made a devil's bargain" when he was President. He publicly apologized for forcing Haiti to drop tariffs on imported, subsidized US rice. His policy hurt Haitian rice farming and, as reported by Kim Ives, "seriously damaged Haiti's ability to be self sufficient".

And let us not forget that Haiti, believe it or not, is in the digital age. The Haitian people in the countryside have cell phones and access to the Internet. Many Haitians are adept at using both. This means that they still communicate with Haitian relatives, the diaspora, overseas.

Haiti's diaspora has sent back billions of dollars over the past few decades to needy Haitian relatives, but this obviously has not been enough. The diaspora need to physically come back to Haiti and revitalize Haiti's industrial sector. But they won't come back and invest in Haiti unless than can do so safely. Most diaspora tell me they fear for their personal safety in Haiti. Security everywhere needs to be improved. And the economic climate for joint business ventures, to stimulate Haiti's diaspora to invest in Haiti, has to be improved by the Haitian government.

In conclusion, Haiti was a severely damaged country before the January earthquake and is even more damaged now.

Haitians are a beautiful and wonderful people, but they are not as "resilient" as we would like to believe.

Yolande, the little old tent lady who lived near us, should not be living like this. If Yolande were your grandmother, you wouldn't refer to her as "resilient" as she suffers the Haitian heat and mosquitoes, would you?

The huge international monetary pledges need to be allocated in a transparent fashion to help these neediest Haitians.

Keith Steffen, OSF in Peoria

In September, 2001 I wrote this letter to Keith Steffen, CEO of Saint Francis Medical Center (SFMC) in Peoria.

I was concerned about the safety of the patients in the ER at OSF because of ER overcrowding. This medical negligence put the central Illinois community at risk if ambulances went on diversion from OSF and pre hospital patients needed to wait even longer for medical care.

ER overcrowding is caused by many reasons that have been documented in the medical literature during the last decade. Greed and poor hospital administration rank high on the list.

In the July, 2010 issue of InterBusiness Issues, a free publication in Peoria, Mr. Steffen is quoted regarding the new $280 million dollar Milestone Project at OSF which is about ready to open for "business".

Mr. Steffen states that the present ER at OSF was built to see 33,000 patients per year. He states that the OSF ER is currently seeing 74,000 patients each year.

When I wrote the letter above to Mr. Steffen, we were seeing about 60,000 patients each year in the very crowded OSF ER. And with the inefficient hospital management of inpatient beds, ER patients were dangerously waiting too long.

I asked Mr. Steffen at the time if OSF-SFMC was guilty of "institutional malpractice". He asked me what that was. I was surprised at his answer and told him that I thought he could answer that question much better than I could.

Now, nine years later after I spoke with Mr. Steffen regarding the above, the numbers he quotes speak for themselves.

The Milestone Project at OSF will be feted this month as it opens its doors. (Whether the building will have adequate numbers of nurses and employees is a different issue.)

And while Peoria celebrates the new medical center technology, OSF will continue letting their Haitian Hearts patients die unseen and homeless, living in the rubble of post-earthquake Port-au-Prince.

Many people in central Illinois are covering for OSF right now. They don't want the public to know how OSF has banned dying Haitian Hearts patients that were operated at OSF in the past from returning to OSF. And people are very afraid of OSF...so afraid they won't even approach OSF's Mr. Steffen to plead for the young Haitian life. (Mr. Steffen told me that fear is good thing among OSF employees.)

But OSF's patient negligence and lies will be exposed. And we will all be shaking our heads and wonder how this was ever allowed to happen.