*Updates* Returning from an extremely rewarding time in Haiti and processing a bit while I write up a presentation and some proposals. We interacted with the communities of Thomonde, Marmont, Savane Moïse, Savane Plate, La Hoye, Casse, Tierramuscady, Ticasse, and Mogè. Our mobile clinics saw 1,000 patients and of these I got to work with around 150 adult and pediatric patients. I was given the opportunity to lead a great group of clinicians as site operations manager in Mogè, and I had the chance to teach some of our Nursing, Medical, Physician Assistant, and Public Health students how to operate Point of Care testing equipment. I'm extremely grateful for the opportunity to work in an area where the need is so pronounced, and to be able to work with such an incredible interdisciplinary team.
I was able to generate a narrative timeline of water quality in the area, and identify some of the barriers the population has regarding improved water sources and sanitation, I was also able to locate key local stakeholders in the field, paving the way for the next phase of my project: Integrating the work of these disparate players toward the common goals of improved Water Sanitation and Hygiene in the region, with an associated decreased burden of disease. My very deep thanks to all of you who have donated to support this project and allow me to recoup some of my out of pocket costs, as well as push this project off of the starting line. ~Jeremy
Hello Colleagues and Friends,
This year I've been accepted to take part in an outreach program to Thomonde, Haiti with Project Medishare and The George Washington University School of Medicine and Health Sciences. I cannot express how excited I am to have been selected for this opportunity to serve abroad in an area that truly defines basic human need in almost every aspect of daily life. I wanted to take this opportunity to share a little bit about what I do, and where I'm headed with it. I began the PA/MPH program at GWU in May 2012, I'm finishing my Master of Public Health, Global Environmental Health this Fall, and will finish my Master of Science in Health Sciences, Physician Assistant Program in May 2015. Those of you who have worked with me in the past are aware that I've purposely chosen places where both need and scope are as broad as possible, and after providing care to underserved communities here in the states and Baja California Sur I see this mission as an opportunity to take my work, and hopefully a community, to the next level.
Where I go: Thomonde is a community in the Hinche Arrondisement of Centre Department in Haiti's Central Plateau, on the border with the Dominican Republic, 3-4 hours by 4x4 from Port-au-Prince. This short reporting series by Pascal Priestley and Guillaume Gouet for TV5Monde gives a recent look at life in the Central Plateau and Thomonde in particular, where subsistence agriculture and abject poverty are a way of life, and development is making slow inroads (in this case literally). Even if you don't speak French, the images speak volumes about the stark realities of life in this region. The father of their interviewee family, Mattéis Calixte, is a 35 year old father of four who is thankful to have found a new construction job that leaves him and his family about $66 at the end of the month. "Me, I hope for change. Today I would like to work, it really doesn't matter what (kind of job), because tomorrow my little ones will live better". http://youtu.be/HJWXfix3H9U
Why I go: In Thomonde and the surrounding countryside, access to regular healthcare and public health infrastructure is non-existent. Over 50% of adults over age 25 have essential hypertension from genetic and environmental factors. Breadwinners like Mattéis are at risk for Cardiac, Cerebrovascular, and Renal complications which place them and their dependents at risk. Women of childbearing age have an average of 7 children to care for (even higher than the already inflated national average) and are at increased risk for Maternal Child Health complications. My primary area of Public Health focus at present is Water, Sanitation, and Hygiene (WaSH) and Indoor Air Quality, and well over a third of our patients will present with active enteric disease, with the remainder dealing with complications of enteric diseases, some of them lifelong. Soil Transmitted Helminths, Cholera, Dysentery, Malaria, Dengue Fever, Leptospirosis, Lymphatic Filariasis, Typhoid, Anthrax, Tetanus, TB, Rabies, and Hepatitis are all endemic to the region, with Diarrheal disease and respiratory infections being the leading causes of death for children under the age of five. Survivors face secondary malnutrition due to poor absorption of nutrients, stunting, wasting, and other developmental deficits. Multivitamins, supplemental nutrition, and antiparasitic medication from the clinic will only help in the extreme short term, until kids become infected again and the cycle repeats itself.
What I do: Like my classmates in the Physician Assistant MSHS program, and our colleagues in the Medical and Nursing programs, the majority of the work I do in Haiti is devoted to direct contact patient care. Our outreach missions with Medishare have a stipulation of taking place a minimum of 3 hours walking distance (30 minutes in our vehicle) away from established free standing clinics, this means that we interact with a population that has no access to medical care outside of what we and other volunteer groups provide on a semiannual basis. We should see between 700-1000 people with a variety of infectious diseases, Neglected Tropical Diseases, and diseases related to poverty, as well as traumatic injuries. In addition to clinical work, I'll also be acting in the role of a Global Environmental Health professional by conducting Public Health field research on the underlying causal links between water, sanitation, and hygiene issues within these communities and the illnesses people present with in clinic. In the long term I'm attempting, and you're attempting along with me, to gather data and bring sustainable improvements to water quality and access, sanitation, and hygiene practice within the region in order to prevent the majority of diseases that patients present with at our clinical sites. Along with the burden of chronic disease comes chronic poverty, if a child is developmentally delayed they may miss out on options later in life. If an adult is chronically ill or cares for chronically ill children, or spends a large portion of their day just to gather necessary water, it also creates a productivity sink of lost time that could have been used in education, farming, job training, and employment. With the frame narrative largely focused around Port-au-Prince and the 2010 Earthquake when people discuss Haiti, it's often surprising to people how abject the situation is farther inland, and how little has been done outside the capital before, during, and after the natural disasters came into the picture.
How you can be a part of it: In order to support Project Medishare's continued presence in the region, we pay for all costs incurred while we are there. Airfare, room & board, ground transportation, even the medicine and clinical supplies our patients receive is paid out of pocket by our volunteers and by you, their individual donors. If you've wanted to participate in an outreach program, global or environmental health, if you're interested in international development, if you care about the sustainable health and quality of life of others, if working overseas isn't feasible for you, or if you've always wanted to say "Yes, I have someone on the ground over there" you can be a part of this ongoing mission by supporting my work. Whatever you feel comfortable contributing will be greatly appreciated by myself, the team I work with, and the communities that we are all serving in this group effort. Any funding above and beyond our goal will be utilized to continue this project through subsequent phases. Feel free to contact me for updates, to access my journal, or just to say hello, I'm always excited to talk with you. My deepest thanks to you all for your time and support in making all of this possible.
Votre Santé, Sante ou, Your Health!