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

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

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 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.

Thursday, July 1, 2010

OSF Does Commercials While Haitian Hearts Patient Dies

Another Haitian Hearts patient died while this commercial was being made for OSF's Milestone Project.

More later.

This is sad not only for the Haitian family and the victim's two year old orphan, but also for OSF-SFMC. The OSF founding sisters in Heaven have to be shaking their heads "no" in disbelief.

Good Words to Live By

War, want and concentration camps, exile from home and homeland, these have made me hate strife among men, but they have not made me lose faith in the future of mankind.

Personal experience, including my own unsteady progress through life, has taught me to beware of man’s capacity for plain stupid, irrational, as well as consciously evil, behavior, but it has also taught me that man has an even greater capacity for recovery from lapses. In a short thrust of planned, wisely guided activity, he is able to climb to higher levels of material and intellectual achievement than he ever reached before.

In short, I remain a rationalist and an optimist at a time when the prophets of doom have the floor. My query is: if man has been able to create the arts, the sciences, and the material civilization we know in America, why should he be judged powerless to create justice, fraternity and peace?

Ladis Kristof