Dateline ACT

Haiti 02/04

By Paul Jeffrey, ACT International

"We scramble all the time to find medicines, which have grown much more expensive since the crisis early this year. But the children and adults who come here are hungry and malnourished. The best thing for their health would be some food," says Pauline Jean-Gilles, director of the medical clinic in this dust-covered rural community an hour north of the nation's capital.

Addressing immediate food needs during this emergency is a priority for members of Action by Churches Together (ACT) International, a global alliance of churches and their related agencies, but medical needs are sometimes just as urgent, and ACT members are addressing those needs as well.

As the political crisis swirling around President Jean-Bertrand Aristide accelerated last year, Jean-Gilles and her staff wisely hid away some medicines. When the conflict worsened in the days leading up to Aristide's departure in February, those supplies came in handy as poor mothers with sick children continued to line up every day even as fighting closed the roads leading out of the village.

In addition to medical care, the clinic, run by a Haitian organization called Haiti Med, also sponsors a comprehensive educational program focussed on literacy, parenting skills, job training, and hygiene. It's one of two Haiti Med clinics that are supported by the Lutheran World Federation (LWF), an ACT member. In late March, ACT issued an appeal for $782,031 to support LWF's relief work in this Caribbean nation, as well as the emergency work of Christian Aid, another ACT member.

With the installation of an internationally backed interim government that will lead the country until new elections next year, the situation here hasn't markedly improved. Food prices remain elevated, as does the cost of water, which is trucked into this village; families pay upward of 40 percent of their meager income just for water. Few people have regular jobs. No one can afford to get sick, as prices for medicines remain inflated by the political unrest. With no nationwide distribution system for pharmaceutical products, health workers are forced to beg for money for fuel to drive to Port-au-Prince. And the lingering lack of electricity in most parts of the country leaves lab technicians adapting their equipment to run off car batteries.

According to Raymond Decimus, director of the LWF/ACT-supported Pierre Payen clinic near Saint-Marc, a facility where victims of the gun battles that raged in the days before Aristide's departure were treated, patients continue to die needlessly. These days, however, it's not from gun shots, but rather from the delays in transporting the sick to appropriate medical facilities.

The few government services that are provided in Haiti, including health care, are generally centralized in the nation's capital, what some cynically refer to as "the Republic of Port-au-Prince."

"To get medicines you have to travel one long day to the capital, then spend two days there going around looking for what you need, then one long day to travel back. The churches simply don't have the resources to do that, and as a result the people continue to suffer and die needlessly," says Burnet Cherisol, executive director of Child Care Haiti, a community-based health program in the country's remote northwest province supported by Christian Aid/ACT.

"For Haitians, health care is a luxury commodity. In the countryside, the peasants don't have the same rights to health care as those in the cities. If there are some government efforts in health care, the people in the cities are going to grab them first. So there's nothing left for the peasants," says Cherisol, who also serves as rector of the Episcopal University of Haiti.

As a result, his program focuses on preventative health programs, but Cherisol says it's always short of resources. One particular challenge it faces, in a region where some 13 percent of the population is HIV-positive, is educating youth about reproductive health and the dangers of AIDS. Cherisol's program works in area schools, but he says it's an uphill battle with few educational materials at hand.

Child Care Haiti began when Cherisol, a former Catholic priest, and several university students came to the aid of a local woman they found walking weakly along a road, trying to reach a hospital in Gonaives because of pregnancy complications. They got the woman to Gonaives, but she died giving birth. "We asked ourselves how it was possible for this woman to die in the 20th century," Cherisol recalls. "But there was no physician here, and there was no clinic to help her. The government was doing nothing."

Cherisol and the students decided to start their own health program with help from churches and non-governmental organizations. "Our idea was to start a clinic and then turn it over to the government after three or four years. That way the government wouldn't have to start from scratch. Yet that was more than 15 years ago. The state has never done anything. It has never even agreed to pay for a doctor here," he says. Of the 20 people working in the clinic, the government pays the salary of only one auxiliary nurse, and the rest of its support comes from Christian Aid and the community, Cherisol says.

Child Care Haiti did manage to get some Cuban health professionals assigned to the area, and a Cuban physician, nurse, and lab technician work with the group in Mare Rouge. Although the interim government of Prime Minister Gerard Latortue, under pressure from the U.S., has promised to rethink the presence of some 525 Cuban health professionals in Haiti, Cherisol says many rural residents would feel abandoned if the Cubans were sent home. "In many areas the only care available is from the Cuban doctors, even though the current Haitian government doesn't support them. Few Haitian physicians are willing to venture out this far, where there's no electricity, no hotel. For them, the good life stops down the road."

Cherisol says that providing health care has always been a challenging task in Haiti, and the crisis provoked by the ouster of Aristide only deepens the permanent crisis. "All the existing problems we had before simply grew worse during this crisis," he says.

Yet Cherisol is not without hope. "My hope comes from the youth in Haiti who have grown very organized, and who were instrumental in getting rid of Aristide. They want change, and are demanding that with this change of government there will be food for the poor, health care and education for all. And they are ready to die to achieve these demands," he says.

Cherisol said that the new protagonism of Haitian women is also hopeful. "Women are waking up all over and speaking out. They want to participate in the political discussion in our country. This is new, and it's a also source of great hope."

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