Above photo: To fight HIV/AIDS in their community in the mountains of Lesotho, a group of men gather to learn more about the disease and how they can protect their families. To commemorate Father's Day, view a slideshow celebrating the contributions of fathers and father figures at our sites around the world.
PIH co-founder Paul Farmer honors our Mamito, Mme. Yolande Lafontant, the "mother" of PIH's Haitian sister organization, Zanmi Lasante.
Dear Friends,
By now the sad news has gone out far and wide that our Mamito, Mme. Yolande Lafontant, succumbed Saturday to a hemorrhagic stroke. She collapsed after a brief bit of exercise and said not another word. Some of us already take heart in the fact that she did not suffer, and, as hard as it is to imagine a world, much less Cange, without Mamito, she has left us clear direction for what she'd like us all to do in the coming years.
For if there was ever a mother more willing to give instructions, I have yet to meet her. Mamito's versions of "wipe your feet" or "clean up your room" were simple, if broader in scope, and equally to the point: "Make this house waterproof for this family; put tin on the roof and cement on the floor." "Pick up trash outside" (we often failed her on this one); "Don't cross the lake in the afternoon when the wind is high" (we took mischievous delight in flaunting that order); "Think of something for these old ladies to do in their retirement; and teach them to read." And of course the more typical maternal fiats: "Wash your shirt," "Shine your shoes," etc. And she did not hesitate to leave scraps of paper with lists and instructions in her schoolmarm hand. She had a regal air about her, a personage from the very beginning, but also a sense of humor. Making fun of her trademark chandelier earrings was sure to get a rise, as was expressing wonder that one might be blessed with such naturally jet-black hair well into one's eighties. "Frekan, you're too fresh," was her response to this teasing, along with a wry smile.
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Mamito (right) with PIH co-founder Paul Farmer (middle) and Father Fritz Lafontant, circa 1984.
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I was lucky enough to be adopted by Fritz and Mamito when I was 23, which meant that whenever I was in Haiti in those early years, I shared a home and broke bread with her. When she was in a good mood--which was often, if you hadn't crossed her--she would bring me a cup of coffee in bed. (She was always up with the dawn and approved of my study habits). My wife, Didi, is another of her adopted children; the list goes on and on. She fussed over guests and set the highest standards for hospitality in central Haiti, receiving, in recent decades, thousands of visitors from around the world. It's not a surprise to me that we have already received letters of sympathy from Russia, Mexico, Peru, France, Rwanda, South Africa, and of course across Haiti (and its diaspora) and the United States. Everyone who was lucky enough to come to Cange got a little dose of Mamito's mothering, and this maternal web will live on and even grow as long as we carry out her instructions.
Let me note that during the past four months Mamito and her close-knit team did an enormous amount of work receiving scores of medical teams from all over, and also thousands of patients injured in the quake. Many times she went to visit in the hospital or in the church, which had become an ersatz trauma ward. Whether she was feeling well or not, she rose every day to give instructions to the rapidly growing hospitality team, knowing, I believe, that she had so inculcated her values in them that things would be done a la Mamito whether or not she had issued specific orders. Now is our chance to see if we can live up to her standards. Or perhaps she is hovering out of sight and not, as usually, just over our shoulders, but still able to push us to behave as we invoke her memories and then smile dutifully and get to work.
We will do her proud by carrying on her work to promote health, education, and a better life for the poor.
Mamito nou p'ap janm bliye-w! Rest in peace, but hover not too far from us, please.
Paul Farmer, PIH Co-founder
Cange, Haiti
Read Paul's full piece. A memorial service for Mamito will be held today in Cange, Haiti.
In this issue:
- PIH clinics in Port-au-Prince log over 100,000 patient visits
Providing access to health care for displaced survivors of the January earthquake.
- Join the PIH online community
What would happen if we provided advocates of social justice with a space to meet and team up with others who share their passion?
- PIH Kazakhstan holds its first training
Kazakh physicians focus on addressing an epidemic of multidrug-resistant tuberculosis.
- Q & A on sociolegal accompaniment in Guatemala
Staff from PIH's supported project in Guatemala discuss one of their core programs.
- A right to health care: Sanley Jean
Anette knew that her daughter, Sanley, was seriously injured. But in the chaos of post-earthquake Port-au-Prince, where would they find the medical care she needed?
- An early harvest
An emergency planting yields a crop to feed 200 families displaced by the earthquake.
- A Father's Day Slideshow
A photo essay celebrating fathers and their contributions at our sites around the world.
- Plus: Fighting hunger in Haiti, Mental health in Haiti's recovery, Revolutionizing medicine, Proving it can be done, Getting her goat, and Tackling TB in Mexico.
PIH clinics in Port-au-Prince log over 100,000 patient visits
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A patient receives care at one of the settlement clinics run by Zanmi Lasante.
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PIH/ZL mobile clinics by the numbers*
- HIV tests performed: 3,358 (149 tested positive)
- Pregnancy tests: 1,026 (453 pregnant)
- Patients diagnosed with malaria: 52
- Patients referred to the psychosocial/mental health program: 1,131
- Patients suffering from acute diarrhea: 1,202
- Patients suffering from urinary tract infections: 2,878
- Patients needing treatment for diabetes: 53
- Patients suffering from abdominal pain: 3,609
- Patients needing treatment for coughing: 2,907
- Patients needing treatment for headaches 4,588
- Malnourished children enrolled in ZL's nutrition program: 697
* Numbers were taken from patients visiting between
April 26 and May 21, 2010.
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Last month, the four health clinics in Port-au-Prince operated by PIH's partner organization, Zanmi Lasante (ZL), reached a milestone in delivering care. Over 100,000 patient encounters have been recorded since the clinics were first established about four months ago. These clinics serve four large settlements of displaced survivors of the January 12 earthquake.
The clinics, which began seeing patients in late January, provide comprehensive primary health care services, including reproductive health care, HIV testing, and malnutrition screening.
During the month of May alone, the clinics logged 36,204 patient visits. Roughly one quarter of these visits were from children under the age of 10.
Headache, cough, and abdominal pain were among the most frequent symptoms seen at the clinics.
Proje Sante Fanm, ZL's women's health project which operates women-focused spaces separate from the general health clinics, saw 1,175 women; 494 received prenatal consultations last month.
The four settlements, Building 2004, Caradeux, Park Jean Marie Vincent, and Dadadou, are all located in or around Haiti's capital city, which was decimated by the earthquake. PIH/ZL began working at these sites in collaboration with Haiti's Ministry of Public Health. During the first 17 weeks of operations, the clinics recorded 107,003 patient visits.
Join the PIH online community
Every day, those of us working at Partners In Health are privileged to meet individuals who share our commitment to providing health equity and ensuring social justice in our own country and around the world. What would happen, we wondered, if we provided these passionate advocates with a space to meet and team up with others who share their passion--be it with a neighbor down the street or activists working in Haiti?
ACT.PIH.ORG is that space.
Integrated right into our new website, act.pih.org is an online community for supporters of PIH and global health equity. It is a place where we can meet, plan, and take action. Organize events, create personal fundraising pages, and mobilize advocacy campaigns: you have the tools to create change. We must work together--we must stand in solidarity. Learn more.
PIH Kazakhstan holds its first training
PIH's project in Kazakhstan held its first training session for Kazakh clinicians last month in Tomsk, Russia.
Initiated earlier this year in partnership with the Kazakh Government, PIH Kazakhstan is focusing on addressing an epidemic of multidrug-resistant tuberculosis (MDR-TB) in two regions of the Central Asian country--Karaganda and Pavlodar oblasts. Training and building capacity of Kazakh tuberculosis specialists is a key component of the project.
"TB is a challenging disease that demands using a variety of strategies to combat the epidemic," said Julia Jezmir, project assistant for PIH Russia and Kazakhstan, who helped organize the training. "Such trainings provide an opportunity for TB medical professionals to learn from other TB experts and walk away with a practical guide of how to follow international standards and evidence-based best practices for combating the disease."
The recent training was based on the best clinical and program practices and lessons learned through established PIH tuberculosis programs--specifically PIH's partner project in Tomsk, Russia, which has a decade of experience combating the disease. From 2000 to 2008, the Tomsk project saw the TB mortality rate in Tomsk drop from 18.6 deaths per 100,000 people to 8.6. In comparison, the TB mortality rate for Russia as a whole was 22.6 per 100,000 people in 2005. Likewise, the case notification rate (the number of new cases per 100,000 people) in Tomsk fell from 114.2 to 101.4 during that same time period. Because of these successes, the project hosts a number of trainings each year for TB specialists throughout Russia and the former Soviet Union. The government of Kazakhstan also requested the partnership with PIH on the basis of these successes.
Twelve Kazakh clinicians--eight from the civilian sector and four from the penitentiary system--took part in the first training. They represented the Pavolodar and Karaganda regions of the country--both which are heavily burdened by the disease.
Read more about this training.
Q & A on sociolegal accompaniment in Guatemala
Equipo Tecnico de Educacion en Salud Comunitaria (ETESC), a supported project of Partners In Health in Guatemala, was founded by refugees of the Guatemalan Civil War who returned to help rebuild their country. One of the ETESC's core programs is sociolegal accompaniment--accompanying the most marginalized populations as they learn and exercise the rights guaranteed to them by the government following the brutal war. These programs include financial restitution as well as the exhumation and dignified burial of loved ones' remains. PIH's Chiapas Project Manager, Lindsay Palazuelos, sat down with ETESC's Coordinator, Santiago Pablo Lucas, and Volunteer Rural Technician, Marciano Felix, to discuss ETESC's sociolegal accompaniment program.
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A woman lays to rest the exhumed remains of a loved one who was killed during the Guatemalan Civil War.
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Part of ETESC's mission is "healing." What does this mean?
Santiago: ETESC supports, accompanies, or assists--together with victims of the armed conflict [the Guatemalan Civil War]--healing of the harms caused by the state. We are looking for solutions.
Marciano: It's an act of orientation, perspective. Many people have been afraid to speak out. They would say that "nothing happened" but inside they were saddened, injured.
A key program of ETESC is sociolegal accompaniment. Why is it necessary?
Santiago: ETESC has converted sociolegal accompaniment into a tool to aid victims of the conflict. This accompaniment is necessary, first, because many don't know how to read or write, second, they don't speak Spanish (but rather indigenous languages), and third, they are blatantly ignored if they are not accompanied by a human rights organization. They are ignored because they are poor, elderly, orphans, or simply because they are women... ETESC orients communities, helps create documents of condemnation including affidavits, helps lead visual inspection of clandestine graves, programs exhumations with forensic anthropologists, and later helps coordinate the dignified return and burial of remains.
Read the full interview.
A right to health care: Sanley Jean
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Sanley with her mother, Anette.
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On January 12, 2010, 19-year-old Sanley Jean found herself suddenly trapped when the walls of her Port-au-Prince house collapsed on her during the massive earthquake. The rubble crushed her leg, breaking and exposing the bone. Such open fractures require immediate medical attention and often complex orthopedic surgery. But the devastating earthquake had left Port-au-Prince's hospitals in ruins.
Sanley's mother, Anette, survived with scrapes and sprains, and knew that getting treatment for her daughter would be difficult. The capital's only public hospital was able to provide only limited services in tents set up on the hospital ground. The facility was overrun by thousands of patients. Many of the Port-au-Prince's residents were forced to seek medical attention outside of the city.
So Anette took her daughter to the Dominican Republic, a multiple-hour journey from their devastated home. Her hope was that once there, Sanley would have a better chance of seeing a doctor.
Meanwhile, Dr. Ralph Ternier of Zanmi Lasante (ZL, PIH's partner organization in Haiti), was in the Dominican Republic assisting patients who had fled to a hospital in San Juan. It was there that Ralph, who heads ZL's hospital in the town of Belladerre, Haiti (which is near the border), found Sanley and Anette. He quickly realized Sanley's open fracture required surgical care not available in his facility, and arranged to have her transferred to PIH's hospital in Cange, Haiti.
Once in Cange, Dr. Chris Sampson met and started treating Sanley. He believed that there was a slim chance that Sanley's leg could be saved--but only by transferring her to a better-equipped hospital. So PIH's Right to Health Care (RTHC) team stepped in.
The first step was to locate a hospital willing and able to take on Sanley's case. With support from Dr. Sampson, the Boston-based Brigham and Women's Hospital (BWH) quickly stepped up to the plate.
PIH and Zanmi Lasante staff then began the task of coordinating Sanley's paperwork, maneuvering through both the U.S. Department of Homeland Security and Haiti's overburdened government offices. With so many moving parts to the equation, some of the staff began to worry that they wouldn't be able to get Sanley to the U.S. for treatment in time. A half hour before the plane was scheduled to take off, Sanley, her mother, and ZL staff were at the airport, but without the needed paperwork.
Find out what happened to Sanley and Anette.
An early harvest
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Harvesting the emergency crop of corn.
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Last month, about 200 earthquake survivors carried home freshly harvested ears of corn to feed their families. Although not the typical corn harvesting season in Haiti, the devastating following the devastating earthquake demanded an emergency planting, which was organized in a collaboration between Zanmi Agrikol (ZA), Partners In Health's agricultural project in Haiti, and local farming families in the Central Plateau.
After the earthquake destroyed much of Port-au-Prince, many survivors poured into the rural Central Plateau and Artibonite regions to find shelter, food, medical care, and safety. With so many displaced people, the ZA team knew that hunger would quickly become a major problem. So they initiated a project that expedited food production by planting an emergency crop of precocious (quick-growing) corn in fallow fields.
The first harvest of this crop yielded enough corn to fill about 200 large bags with roughly 50 ears each. These bags were distributed to families who had been displaced by the earthquake.
Three more fields will be ready for harvesting within the next 2 months.
Read more about ZA's post-earthquake programs.
A Father's Day Slideshow
Sunday, June 20, is Father's Day. In honor of fathers everywhere, we've pulled together a photo essay celebrating the contributions of fathers and father figures at our sites around the world.
Click here to view.
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