HOPE works in more than 25 countries worldwide. Please enjoy our blog as we document the successes and challenges of our work.
Jim Schermerhorn is a Physician Assistant and HOPE volunteer in Haiti. His work following Hurricane Matthew is Jim’s third medical mission with HOPE this year. He was part of the HOPE team on the hospital ship, the USNS Mercy, for two deployments in 2016. Jim is also a member of the U.S. government’s Disaster Medical Assistance Team (DMAT) that responded to the flooding in Louisiana earlier this year.
This is my third time in Haiti. I was here in 2011 for the first serious cholera outbreak in Haiti and I was also here in 2008. Haiti is a difficult place to work. There are lots of challenges for health care providers and that’s what we’re here to address.
I am part of a team that was deployed two weeks ago to help assess how Project HOPE could best address the possibility of a surge in cholera following Hurricane Matthew. I have been concentrating on working with the St. Therese Hospital in Miragoane in the Nippes region. I’m working with health authorities as part of the Project HOPE team and coordinating with other NGOs that are working in this area. We’re focused on developing an outline of a plan that would address cholera at St. Therese Hospital.
There are ongoing staff shortages and a lack of resources at the hospital and many challenges in the health system as a whole, before you add cholera into the mix. At St. Therese, there are patients that also need regular medical care.
The case definition of cholera is watery diarrhea which is identified in an area or region that has already tested positive for cholera. In this area in Nippes, they have documented cholera. This means that every case of watery diarrhea is considered suspected cholera and we have no way to determine whether it is cholera because the hospital doesn’t have the ability to test for the disease. But what the hospital is doing is separating all of those patients who have the case definition of cholera and they are staying in a separate area in a separate building within the hospital compound and they receive IV medication. But currently, the hospital does not have the medications and the antibiotics and the support services and staff to work both in the hospital and in the separate cholera area.
We have seen several people with watery diarrhea. In fact the two nurse practitioners I am working with referred one case over today for a patient to be moved to the separate area for people with suspected cholera. This is not a high cholera situation right now. What we are concerned about is that it very easily could be. So we have to come up with a plan to address the possible scenario where the hospital could go from the one or two cases of watery diarrhea to 15 or 20 or 50 or 75. If that happens, could the hospital handle it? That’s the challenge that we have and that’s what I’m trying to work on.
I have participated in international humanitarian assistance disaster response work for many years with many different organizations, including Project HOPE. I think the best way that those of us in the United States can help people in developing countries like Haiti is to work in close coordination with the health authorities and other NGOs to build the health infrastructure and capacity of health workers here.
Fresh from hurricane-stricken Haiti, where HOPE volunteers continue to bolster the health system and care for families impacted by the most recent disaster, Andrea Dunne-Sosa, Project HOPE’s Director of Global Volunteer Programs and the Americas Region, reflects on the experience of humanitarian aid workers on the ground immediately following disaster situations.
When the alarm went off at 5:30 this morning, I immediately jumped out of bed. Even though I left Haiti yesterday, I wanted to be in solidarity with our team still on the ground.
I am thrilled and reassured to be home with my beautiful son and family, but it is hard to adjust to the regular pace of routine life after days and weeks in such a high intensity environment. In Haiti, the devastation of the storm in the heavily affected areas is inescapable. Relief workers are constantly thinking about the people, the families, the children who have been impacted by the disaster. At the same time, we also have to constantly be figuring out how to balance the resources and security of the relief team on the ground with all the overwhelming needs of the people. Questions bombard your brain.
Have I read all of the latest reports? Is the security team in place for our volunteers to travel tomorrow? Where should our team be to have the greatest impact? Do we have a plan if one of the vehicles gets a flat tire? Will our satellite phone work in a remote area of the country without communications? How can we coordinate with the government and other teams to get ahead of cholera before the next outbreak? What if it starts raining again when our team is hours from home base and the river crossing is flooded?
Every email you send, every meeting you attend, every communication you make, takes on the highest level of importance. Lifesaving importance. Your brain is on fire 24/7, figuring out what are you going to do, at any given time. You are up at dawn and still working late into the night. The situation can change in an instant, so you have to be flexible, ready, available, professional and thoughtful, all while your heart aches in the face of the humanitarian crisis unfolding minute-by-minute in front of you. Life takes on a greater intensity, a greater sense of purpose.
Then you are home, with regular electricity, mobile service, a safe comfortable bed. An email comes in from the office, about a time card deadline. And you realize you are not in Haiti anymore.
For now, I am back at HOPE headquarters in Millwood, Va., supporting the relief effort from the comfort of my office and at home, surrounded by my family. But half of my heart remains in Haiti with the HOPE team on the ground. The team that doesn’t get to tuck their children into bed at night, doesn’t have regular communications and is still working 24/7 to make sure they do everything possible to help those in Haiti still needing care.
Two of those relief workers are Nurse Practitioners Maya Ginns and Lindsey Martin from Massachusetts General Hospital. Maya and Lindsey began work yesterday at the St. Therese hospital in Miragoane, Nippes. St. Therese is a facility 3 1/2 hours west of Port-au-Prince, where 10 of the 28 health facilities in the region no longer have rooftops due to Hurricane Matthew, stretching too thin an already limited health system. The St. Therese hospital has a severe shortage of health professionals, including no pediatrician on duty and support for the maternity ward only four days per week, despite the nearly 70 babies born there each month. The dedication of the current hospital staff is simply valiant, doing the absolute best they can with limited personnel, limited supplies, and an influx of patients.
When I was there, just a few days ago, I saw a family, smiling and holding their absolutely beautiful newborn baby, waiting for services for their infant that just were not available. It was heartbreaking.
But one of the highlights of my relief work in Haiti was when I was meeting with the Director of the St. Therese Hospital, knowing that I was going to be able to send HOPE volunteers to the facility to support the dedicated existing staff, that continues to work, despite the demanding and stressful environment.
The St. Therese Hospital also has a small cholera unit, but only has room for three or four patients, insufficient supplies, and is in desperate need of upgrading. Around the country, 34 cholera treatment centers were completely destroyed during the hurricane. The threat of a cholera outbreak looms heavy in the hurricane impacted areas. That’s why HOPE volunteer Jim Schermerhorn, a Physician’s Assistant and disaster response expert who was in Haiti during the devastating cholera outbreak after the 2010 earthquake, is working with HOPE and our partners to identify long-term solutions to support the health system in case of another outbreak. HOPE is securing plans and resources to help train health care professionals and rehabilitate cholera treatment centers to diagnose, treat and prevent cholera outbreaks in the coming weeks.
HOPE has been working in Haiti since the mid-1980s and is committed to supporting recovery from Hurricane Matthew and helping to strengthening the health care system in the long run. Whether through our dedicated volunteers, training programs, donated medical supplies and lifesaving medications, programs to support maternal and child health, or rehabilitating cholera treatment centers, HOPE is making a difference.
Your continuing support helps fuel our team on the ground in Haiti. Thank you for all you do.
Haiti is awash with broken buildings. Piles of fallen trees lay on the ground like heaps of huge match sticks. Trauma is palpable everywhere and our disaster relief team has wasted no time building potential partnerships with Haiti’s Ministry of Health to try to find a clear path forward for Haitians. Short and long-term needs of the Haitian people are a priority for those in government because food and water supplies, and homes and health systems were crumbled by the Category 4 storm that swept across the Caribbean.
Our field assessments reveal what many Haitians are experiencing here: The southwestern part of the country has been particularly hard hit and PAHO reports that acute diarrheal diseases including cholera threaten parts of the population, and the majority of cholera treatment facilities in some regions have been destroyed. Even before the hurricane, access to health care, water and sanitation presented challenges for Haiti and cholera was on the rise. Now, hundreds of new cholera cases have been reported and water supply interruptions are certain to make the situation worse.
Nurse practitioner and first-time Project HOPE volunteer, Maya Ginns, from Massachusetts General Hospital is here to begin her two-week rotation at the St. Therese Regional Hospital in Nippes. As soon as she arrived in Haiti, Maya said she quickly sensed the crucial needs that brought her here. “My first impressions are that there is so little infrastructure in place to deal with sanitation and health care delivery so when you think about putting a disaster on top of that which wipes out a lot of physical structures and human resource capacity, I can see how there would be an immediate need for an ongoing capacity,” she said. Maya said she was somewhat prepared for this experience before she arrived. “I was speaking with a Haitian nurse on the airplane and she explained that a lot of the food supply is day-to-day. People farm things and then they eat that food. They don’t have fridges stocked full of food supplies. So when a disaster wipes out the health and agricultural sectors and even the place where you grow your own food gets wiped out, you find yourself in an incredibly dangerous predicament,” Maya said. Maya will work with three other volunteers, including her fellow nurse practitioner from Massachusetts General, Lindsey Martin, in the St. Therese Hospital. “My hope is that we will be able to assimilate into the hospital staff and take care of patients as soon as possible. I am partnered with Lindsey Martin who is also a nurse practitioner and she and I have very complimentary skill sets so she is used to dealing with very acute critical care and I do more of the urgent care and primary care and I think that will be a very good marriage of skills,” said Maya.
Project HOPE's Gifts-in-Kind team is also in Haiti, preparing for a shipment of essential medical supplies to arrive later in the week.
Hurricane Matthew has brought devastation, shock and trauma to Haiti. For some people here, this disaster has stirred up difficult memories of the last major disaster – the earthquake of 2010. Many people here feel that Hurricane Matthew’s destruction has washed away the progress Haiti had made in rebuilding its major sectors, including health, since the earthquake.
The Category 4 storm slammed into Haiti’s southwestern peninsula on October 4, unleashing violent winds of 145 km//hour and torrential rains. Massive flooding has wiped out tens of thousands of homes across the country, forcing many to seek shelter. Buildings have collapsed, schools have closed and people are extremely anxious as efforts continue to bring people to safety and authorities and humanitarian aid agencies assess the damage and crucial needs. Our team travelled to Port-au-Prince to coordinate with the government last week to find out where humanitarian needs are greatest. We met with Haiti’s Interim President, Jocelerme Privert, and the First Lady, Ginette Michaud Privert on Friday. President Privert told me that he has been addressing the immediate need for food, water, shelter and medicines. The nation is in a state of “humanitarian emergency” and in the weeks and months ahead, the President said, he is keen to also focus on rehabilitating systems that were damaged or destroyed by the storm such as the health, agricultural and education sectors. He is extremely grateful for foreign humanitarian aid and stressed the need for all aid to be processed through the government to ensure it is distributed effectively.
The UN says 1.4 million Haitians need help, out of 2.1 million affected by the hurricane. HOPE is deploying medical volunteers to Haiti on Thursday as health concerns deepen throughout the country, especially in the southern region. Cholera cases are increasing and our volunteers have expertise in this area. HOPE has prepared a shipment of supplies, including water hydration tablets, gloves, saline solution, sponges, gauze, water purification units, generators and more. Our team will continue to coordinate with the Ministry of Health to identify areas of greatest need as we respond to this humanitarian crisis.
Labels: Africa , China, Dominican Republic, Europe and Eurasia, Macedonia, Namibia, Poland, Sierra Leone, South Africa , Global Health Expertise, Chronic Disease, Women’s and Children’s Health, Alumni, Infectious Disease, Health Systems Strengthening
In my first 12 months as HOPE’s new President and CEO, I’ve been privileged to visit colleagues in 13 countries in Africa, Asia and Latin America and seen for myself how our programs and professionals are doing vital work in building health capacity that is directly helping patients, doctors and nurses, and others.
In China, a nurse educator praised the volunteer HOPE nurse educator who had transformed her life by equipping her with skills and knowledge to become a more effective and dedicated educator and an example for others to follow. Now she leads a large nursing department in a Beijing hospital – passing on the skills we empowered her to develop for a new generation of Chinese nurses.
At the Shanghai Children’s Medical Center and the University Children’s Hospital in Krakow, which HOPE helped to establish decades ago, I met families whose children are thriving thanks to the expertise and state-of-the-art medical technology on hand to treat a young patient’s special needs and support the family as well.
Post-Ebola Sierra Leone has faced enormous challenges since it suffered from the world’s largest and deadliest outbreaks of the Ebola virus, which claimed the lives of thousands. Project HOPE donated medicines and supplies and the Ministry of Health asked us to stay on in the fight to restore the health care system. We are helping to tackle horrific levels of maternal, newborn, and child mortality, most of which is entirely preventable.
In Namibia, a nurse in an AIDS clinic told me how helpful the Project HOPE field workers had been in tracking down treatment defaulters, thereby preventing drug resistance and transmission to others.
In the Dominican Republic, I spent more than an hour in deep discussions with the Minister of Health, a fellow pediatrician, discussing issues affecting children, especially the Zika virus epidemic and the country’s very high levels of neonatal mortality.
And thanks to the commitment of our many private sector corporate partners, Project HOPE is in close partnership with the governments of China and South Africa to establish appropriate local models of care for diabetes and hypertension. One patient told me how much better he attends follow-up appointments ever since the HOPE Centre in South Africa established an appointment system – a simple step to overcome an important bottleneck.
And in Macedonia, I saw how the Project HOPE team has effectively integrated our support with the Ministry of Health as a true partner to bring much needed health services to thousands of refugees as they cross parts of Europe, fleeing war, poverty, and hopelessness.
In addition to disease-specific programs, I continue to be reminded how crucial it is to invest in the human capital that is needed to drive the delivery of health services and these priority programs. If you ask local health leaders, they will say organizations like Project HOPE should focus on building their local capacity. I couldn’t agree more.
HOPE is fortunate to have a diverse portfolio of programs that it can be proud of, including Health Affairs, the leading journal on health policy to help drive sound decision-making for better health outcomes in the US and around the world. Through partnerships, we will continue to pursue innovative service models that are designed to overcome the many bottlenecks that impede access to health care. And we will continue to pursue opportunities to build capacity of the health workforce to address local health challenges in a sustainable fashion.
Project HOPE has a unique and strong tradition in developing the health workforce, going back to the pioneering days with the SS HOPE, the first ever peacetime hospital ship whose mission was to treat, train, and learn. Moving forward, HOPE is determined to build on this unique legacy of trusting relationships and making a difference through service to others. I’m excited for HOPE’S future.
It’s a future focused on boosting our impact, focusing our efforts, partnerships, and ensuring accountability for results.
It’s a future exemplified in the example of a single Chinese nurse who years ago had an encounter with Project HOPE, and has been changing lives ever since.
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