This is a blog for anyone interested in telling others of their time in Haiti. It's meant more for us to share stories, and please make any comments you'd like in the box below the posts (no need to sign in). Contact Julian if you would like to post on the blog--we welcome anyone doing health-related work in northern Haiti.

While we welcome discussion on this blog, issues meant for feedback from the Network should be posted on the discussion board by emailing

Tuesday, November 30, 2010

Soap, Chlorox, Aquatabs for people in St-Suzanne

Dear All,

Good evening to you all. Hope this finds you well, thanks to God.

I wanted to share those pictures with you, taken by Juline (therefore not pictured) who helped me. I was able to help
people in St-Suzanne with some soap, Chlorox and Aquatabs to purify the
drinking water. You may know that there had been 5 deaths due to
Cholera there.

My thanks to everyone for helping fight the cholera.

Blessing to all involved!

Eugene Maklin MD

For The Haiti Mission of PUMC

For Cap Haitian Health care Network

Consultant Medical for Hospital St Francois, Vaudreuil.


Thursday, November 25, 2010

Initial Visit to Organisation des Handicapes de Fourgerolle

Greg, Juline and I visited Organisation des Handicapes de Fourgerolle, in Fort Saint Michel this afternoon.  They provide a day centre once a week for 103 people with disabilities.  They have a volunteer physiotherapist (outreaching from Action Sanitaire) who visits to provide some therapy input.
Their vision is to extend the day centre to five days a week to provide people with disabilities with:
- Psychological and peer support and are keen on addressing the barriers of stigma with disabilities in the community
- Education to help with employment options
- Input from doctors and nurses
- Food during the day
With regards to cholera
They are NOT providing treatment for cholera and they are NOT a medical centre/clinic.  however, they are finding many of their 'patients' are coming to them for help with cholera symptoms as many taptap/taxi drivers will not take them to the CTCs.  The facility are therefore helping families with payment for transport to local CTC (currently gymnasium).
- Educated the whole team (6 staff) on WASH principles
- Emphasised importance of early treatment
- Informed them of the new ORP opening up in FSM (5 min drive away) (should be opening in 2-3 days) and showed them site
- Investigested together the new Oxfam/Konbite Sante WASH point 100m from their site - providing hand washing training, ORS (1 box daily at each point) and as from tomorrow treated water from communal tank. 

- Gave them the contact number of Action Sainitaire to link with their psych team
- Contacted Oxfam to ask them to provide further WASH training so they can provide it to their clients.
- Contacted CBM to consider applyication of funding for Day Centre Project

Tuesday, November 16, 2010

Riots in Cap Haitien

As many of you are aware, there were some very violent demonstrations and riots in Cap Haitien yesterday.

Cacooned inside my downtown apartment I had a very acute awareness of what was going on.  By 10am the streets were crowded.  People running in hoards through the nearby square towards the MINUSTAH.  Shouting was constant, chanting and gunfire every few minutes throughout the day until about 10pm.

When the odd mob would pass my apartment  I would see my curious Haitien neighbours quickly close their doors and  return inside for safety.

Vehicles would occasionally charge up the road, must have been about 40-50mph: very fast given the state of the roads and the amount of people on the streets.

There were many reports of rocks and other missiles being thrown with no specific target.  Barricades have been put up all over the town, with no access to enter or leave the town other than by foot up until recently.  I was also informed that the MINUSTAH eventually made the decision to evacuate themselves from town last night.

Reports by Al Jazeera and BBC Latin America say that at least one man was shot dead as an act of defense by the UN.  At least 10 others were injured and are being treated at Justinien Hospital, as was reported on the local news last night.

Today everything seems to be much quieter.  There was an eerie atmosphere driving around Cap Haitien this morning.  The streets were almost empty except for a few passersby.  A dead body half wrapped in a sheet had been abandoned near the town square in direct sunlight.  Tires have been left burning in the middle of the roads and barricades are still in place all over the town.

As the day draws on the streets seems a little busier.  I can hear more gunfire every couple of minutes, but nothing too violent has passed close to me.

This situation is obviously having a detrimental effect to what can be provided to the Cholera victims.  MSF have been unable to receive their latest supplies or reach out to those clinics in the rest of the region so desperately needing support.  With one truck and a warehouse looted, many supplies are being wasted.  The network is still waiting on deliveries, but with the situation as it is, it poses many security concerns with regards to storing and distributing supplies.

Sunday, November 14, 2010

Update on Cholera Treatment Planning

Summary of today's events:

1. Meeting with Fiona Stephenson (RN, representing HHA); Dr. Toussaint (MD, HHA) and myself as representative from CHHN and affiliated physio of HHA.

// Discussion of implementation of how to deal with current caseload with reference to MSF and WHO guidelines.

2. Meeting with Fiona Stephenson and Helmi (MSF Co-ordinator) and myself


a)  Discussion of feasibility of using HHA site as CTC // MSF have resources, but no land secured.  Looking for land to accommodate >1000 patients in total, using as few sites as possible.  HHA have land in appropriate location.

b) Discussion of ability for MSF to provide resources to sites other than the 6 they are supporting currently. // Are happy to do this but do not have the resources currently - hopefully within the next few days.  They need list of sites currently requesting support so MSF can map them.

c) Discussion of human resources // because the North region is the last to be supported by MSF there are relatively fewer supplies and HR here.  Although more on the way it is important we recruit local staff to help at the sites, mainly as auxillary staff.  MSF have the capacity to provide wages.

3. Trip to HHA to gauge potential of opening as CTC


Enough land to accomodate at least 200 patients.  Will be useful if difficulty finding larger expanses of land.  Helmi and HHA to continue planning.

4. Visit to CTC in Quatier Morin with MSF


Currently 80 patients.  2 deaths today.  Supported by MSF - supplies brought in yesterday.  Staffed well, but needs to improve on cleaning techniques and use of IVs (overused).

Minutes from Health and Water and Sanitization Meeting 13/11/10

Attendees: Dr. Jasmin Ministry of Health, Axnick Woody Paul, Ministry of Planification, UN, Oxfam, MSF, WHO, UNICEF, Cap Haitien Health Network

 Two teams: planning and prevention

Update from Dr Jasmin re current situation with cholera epidemic

840 cases, 57 deaths in Limbe, Cap Haitien, Plaisance, Bornge, Portmago

46 cases in Milot

?data for Quatier Morin

A lot of problems with treatment in Cap Haitien, Limbe – with regards to capacity because all surrounding communes bring their cases to Cap and Limbe.

There are increasing deaths in these communities –entire families are being wiped out.

Problem with lack of transportation and security at night

Two main issues: treatment and awareness

Issues re corpses

Important to discuss the issues: no plan, no contact

MSPP and WHO training has focused on health so it’s important to make an integrated plan to ensure the training is carried out in rural communities and with other partners.  WHO don’t have enough capacity to cover all the areas, therefore they aim to focus on the health human resources. So they need other partners to duplicate the training to others rein schools and churches.

It’s very important to determine the area where the departments are going to be deployed.  E.g. Oxfam have the training tools for cholera, but cannot cover all areas.


Have two teams on the field: to make intervention in different areas of Cap.  E.g. Shada to implement chorination of water.  Oxfam team begin to treat water with SNEP (gov. recommendation for water treatment).  Gov and Oxfam working together to treat the water and implement training, once the needs assessment has been completed (tomorrow).

Comment: important to integrate all the actions of all the partners.

Smaller organisations are providing training and education in schools, churches etc but we have little information about their roles and therefore leads to difficulties integrating work.

No one is taking whole responsibility to train those in churches, schools.  Difficult to remove staff away from clinical areas to provide training.

Other areas of concern is the potential increase of cases in private clinics.  It’s very important to stop the rapidity of the epidemic, therefore it is very important to make plans and support the hospitals/health services that are accepting these patients.

We need to know which players will do something re sanitization so we can plan for those areas not already covered.

Next week the Ministry of National Education are planning some training with school teachers around Cap Haitien.  We need to know exactly which schools this training will happen in.

MoP: health NGOs can help with sanitizationn e.g. education, transportation, logistics – want training to be completed by creole-speaking trainers only – not through translators as risk of poor accuracy of message.

Plan for communication in the mass media:

MoH has produced a series of educational promotion in TV, local radio, but many people don’t have access to these media. Starting megaphone campaign.

Mr Woody Paul (MoP) is planning to meet with the pastors in the region re education through churches

WHO: emphasizes again the importance of managing the deceased as they are also a risk of infection for others. Scouts cover the whole of the country.  They can be used to continue the messages re sanitization.

Suggestion: to ask the community leaders and pastors to take control of their own communities re organizing appropriate sanitization

Oxfam: important to make sure training is effective to allow for continuity and accurate dissemination of information.  Would like to provide ‘train the trainer’ programs.  For this need no. to target, training tools, enough fliers.  Suggest 30 persons for this role.

Training for: The scouts, the schools, the churches


Normally private organisation that provide this, although they are reluctant to receive cholera contaminated corpses.  Therefore it is important to work with government, mayor etc to ensure this issue is dealt with.

For meeting with all organizations with this problem.  At present, to use the religious leaders to give the message that dead bodies are very contagious.

Important to set up cholera centre: possible near airport (as well as gymnasium).  Many other services are now being stopped e.g. maternity to meet the demand of the cholera.


Oxfam and Scouts to meet re training

Mayors of the north will be meeting on Monday at Delegation du Nord – to disseminate information to their own communities

IOM to meet with community workers on Tuesday

10-2 tomorrow – meeting of all international radio stations with Ministry of Health

Two cluster groups formed:

Health – WHO, MSF, Dept of Health

Water and sanitation – OXFAM and UNICEF

Saturday, November 13, 2010

Shada disability clinic continues

Juline and I returned to visit two of the housebound individuals we saw last week in Shada.  One major acomplishment was, with a lot of man power, we completely changed the layout of one of the ladies rooms so that she was able to sleep on her newly lowered bed without getting flooded.  It was wonderful to see her beaming smile when she lay on the bed - the first time she has managed this independently in 7 years.

We visited another patient who also has significant weakness and poor sensation in both his legs.  He is normally carried in and out of his house and placed in a wheelchair by his brother everyday.  I advised him and his brother about starting a stretching and standing program to help maintain the lengh of his muscles and keep his bones strong.  He also walked a few steps using a pair of crutches, which he managed reasonably well.  With some practice, and a step to be made by his family, he should have the potential to mobilise around his home and out to the street.

Friday, November 12, 2010

Haiti Hospital Appeal – response to requirement of medical aid

Over the last three days the clinic at Haiti Hospital Appeal of l’Hopital Convention Baptiste d’Haiti in Quatier Morin have started receiving their first cases of cholera.  Equipped only to deal with day and limited overnight cases, they are currently acting as an interim centre to provide immediate rehydration before transporting the patients to Justinien Hospital.

The support team distributed some requested aid to them this morning.  They have reported 9 suspected cases so far.  The network will continue to provide support with the likely influx of cases.

visit to the Orphanage of Notre Dame De La Medaille Miraculeuse

Accompanied by another network support team member, I visited the Notre Dame de la Medaille Miraculeuse orphanage, which has been operating for four years.  We had the opportunity of taking a tour of the entire compound with the assistance of the orphanage Director Mrs. Claudette Leconte, and Laurence Desvignes who supports the Haitian-run service.  At this present moment the orphanage has 104 children to care for, from the new born baby to sixteen year olds.


The main discussion points and outcomes of our visit:

We discussed their need of supplies and promoted the use of the Citizen Action Team Relief Database.

They currently have volunteer Medical Doctor that provides input once a fortnight.  She reported it would be benificial to have more medical input.

They discovered through a test a couple of months ago that the water being used at the orphanage is not very clean, and with the rapid spread of Cholerea it has made them increasingly concerned about their water supply.  Hannah agreed to provide a water purification kit as a trial.

They also reported they would be more than happy to have volunteers to help provide activities for the children, if they are able to provide their own accomadation and transport.

It was nice to see how happy the children were:  They gave me the impression they felt at home, they all had good manners, they would all be playing with their age rank, not so much running around and only would speak french to you not creole.

Thursday, November 11, 2010

First visit to Action Sanitaire

Action Sanitaire is a Haitian NGO that is newly known to the network.  Hannah and I visited them today to find out more about their work and introduce them to the network. The doctors, who also work at  Justinian set up the project after the earthquake.  They were driven to help the earthquake victims and started a clinic, rehab center and mobile clinic.  Since then they have continued to provide services to the communities of Cap-Haitien, with a team of 4 doctors, 1 physiotherapist and a support team.

It was fantastic to find out there is free access to rehab in Cap-Haitien. We observed the physiotherapist name  Anne-Vierge Compere working. We saw children and adults with a variety of conditions and Hannah worked with the physiotherapist to provide some advice and education.  They have agree to set up a training program to further develop Anne-Vierge.  It would also be beneficial to explore ways in which the centre could incresae their capacity to provide rehab, given the overwhelming lack of these services in Cap Hatien.

We also made a contact with a man that works with SEIPH who co-ordinates all the centers in the north region that work with children who have disabilities.

[caption id="attachment_311" align="alignnone" width="300" caption="lab room"][/caption]


[caption id="attachment_316" align="alignnone" width="300" caption="pharmacy"][/caption]

[caption id="attachment_314" align="alignnone" width="300" caption="Therapy Gym"][/caption]

Minutes from Ministry of Health and Planification Meeting: action towards Cholera Epidemic in the North Region 11/11/10

Statements in bold indicate either problems identified with no fixed solution or action plans.


22nd October – first case in north – Ba Mer Limbe

After two weeks, we started receiving patients from Concorde in Cap.

90% of patients received at the gymnasium have been from outside Cap Haitien.

Youngest death: age 3

The 2 hospitals in Limbe are both at maximum capacity.  There is a lack of medication.

The gymnasium in Cap is full (852 people diagnosed; 70 deaths to date) (next to Justinien Hospital)

Main problems identified within community:

  • Not enough clean water – people forced to drink infected water.  MSPP trying to instigate system to treat this water.  Are looking at creating a chlorine-treated reservoir (300 gallons)

  • Canals are full after heavy rainfall therefore nowhere for dirty water to drain to

  • People are afraid to help each other as they are afraid of it spreading

Using TV, schools, church as means to educate and advise the communities, but feel this is not enough as not enough people are accessing these services.  Would like to action a megaphone campaign on the streets.

We need to come together as one so we can make a difference in fighting the cholera.  We will have to fight many battles and will lose people along the way.  But we should come together to find a solution.

Comment: Water has become expensive and difficult to find.  People are anxious. 

If the spread continues at this rate, it is estimated that 10,000 people in the north will be affected within the next few months.

The Mayor’s comment : understands the problems.  Gave example of patient with hypertension treated for cholera but was negative – later died.

Need more tents to be able to treat more people.  Difficulty in getting hold of more tents – Haiti cannot provide them themselves.  The UN have money reserved for the Director of Healthcare/MSPP but have not received it yet.

Discussion on where to accommodate patients: tents, rooms for temporary use – no decision made

There are 300 water systems ready to go – costing HT$2,500

Trying to get more trucks of treated water but cost HT$600 per truck (some HT$300)

What can we all provide to help?

List to be sent round by email this afternoon so all organisations can state how they can help.

Please contact the network if you would like access to this list.

Wednesday, November 10, 2010

Disabilities in Shada

Hannah and I went to Shada to visit a few people who have disabilities. We visited two people in their own homes because they are unable leave their house due to the disabilities. The first lady we met has weakness on one side of her body since March 8th 2008. Considering she had not left her house in two years we were very surprised to see her manage to work a block away from her own home just by using an old 2x4 wooden stick. Hannah has given her some advice on how to move her body and encourage her to use her weaker side more.


The second lady was not able to stand own her two feet without someone being there. She is living by herself and therefore she is reliant on her neighbours to provide her with food,wash her clothes, bring her water to wash herself with. Her bed is too high for her get on and off so she has been sleeping on the floor for 7 years. She explained to us that she became disabled whilst at work running a small market stall. She  stepped on a battery which she believed had a voodoo curse on it. Hannah has asked  some people to lower her bed and we will return to see her on Saturday with some equipment for her and to start a therapy program.

We have arranged with mme Bwa for a disability clinic to be held on Saturday to continue this work.

We also met a wonderful guy name Simeus who is currently a student living in Shada and has a severe foot deformity. I could see he is a strong man that has a lot of courage because he plays soccer and it does not brother him what other people think of his disability. We talked to him about what he thinks of helping others with their disabilities and he was more then happy to help provide peer support.

Tuesday, November 2, 2010

Cholera Cases at Bord De Mer Limbe

For the past two days the Network Support Team has been working with a group of visiting medical professionals at the Haiti Village Health clinic in Bord De Mer Limbe. Throughout the two days of clinic we had several patients present with severe dehydration and excessive diarrhea. After seeing multiple separate cases like this our team became concerned about the possibility that the cases could be linked to the wave of Cholera being seen in Haiti. Through our good relationship with the health ministry (MSPP) we were able to contact Dr. Jasmin, MSPP Director for the North, who immediately dispatched his staff to investigate our concerns.

His staff performed an initial rapid Cholera test for one of our patients, which was positive. The MSPP representatives then transported this individual and another whom we were concerned about to Cap Haitien. The other patients who had presented with similar symptoms had all responded well to oral rehydration methods and antibiotic treatments. In order to serve the patients that arrived with these severe symptoms our team established an impromptu inpatient ward which also helped to separate patients from the general population. We monitored these patients throughout the two days we spent at the HVH clinic, including administering IV rehydration when necessary.

While the the cases we saw were either transferred or stable, the HVH clinic is now faced with the prospect of other possible cases that could arise in their area. They have several visiting volunteer physicians as well as their usual Haitian staff to handle the situation. In the meantime the MSPP continues to work on their plan to provide treatment and combat the spread of Cholera as the situation progresses.

Please keep the people here in Haiti in your thoughts as they deal with this issue and the possibility of a severe storm later this week. We will continue to work to provide care for those we see at our clinics throughout the week and also work with our many partners to help address the issue of Cholera. For those who can provide assistance or are looking for ways that they can help please feel free to contact our Team. We are trying to stay abreast of the situation and work with other organizations and the local authorities to help them manage the response in any way we can.