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Life in our region continues to be extremely difficult. Recovery from the earthquake is ongoing and many still do not have safe housing.
Update October 2023 - January 2024
Another round of cholera has a grip on the Grand’Anse with many people infected in villages in some of the 12 Counties. Due to few government designated “CTC” Cholera Treatment Centers, rural clinics are left to manage caring for the desperately ill under tarps and tents outside of clinic structures.
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The only early treatment is doxycycline pills and oral rehydration solution by the gallon. Based on our experiences in 2010-2011, untreated cholera can cause death in 6 hours. Burial, then, becomes difficult as contact with contaminated items passes the bacterial infection quickly. The epidemic continues to spread.
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The photo below shows the separate space they created at a clinic in Abricots. MDs and staff receive people suffering from cholera. GAHDA is sending what we can to assist including needles, tubing, disposable gowns, and gloves. AGAPE FLIGHTS has pledged additional supplies.
General Situation
Hunger and housing
Food insecurity continues. There is a shortage of local food supply due to flooding and crop loss and intermittent transportation over the road. Shipping was a major way for goods and vendors to get in and out of the Grand’Anse, but this ended in 2016 after hurricane Matthew. In addition, more people have relocated to this rural area as it is relatively safe.
Many families (average of 6 people in each home) are living in houses damaged by earthquakes in 2021 and 2023. GAHDA has provided cement or tin and nails for repair and rebuilding to 55 families with support from generous donors.
Electrical power and transportation
Jérémie remains without town-generated electricity since January 2022, adding to the unrelenting challenges in the main town of Jeremie.
Buses from the main company serving Jérémie are periodically delayed as part of a protest.
The only scheduled air carrier, Sunrise Air, has flown in and out of Jeremie on an irregular basis, reducing travel to and from Jérémie. Flights in and out of Les Cayes (1 ½ hours away by vehicle) to Port-au-Prince are also variable. MAF (Mission Aviation Fellowship), the only charter air carrier closed services until 2024.
Finding alternatives
GAHDA has been looking for transport alternatives in order to get needed supplies and medications delivered. We applied for approval for GAHDA personnel to travel with the World Food Program helicopter (WFP.org) as a government recognized Haiti organization. This was submitted in June. The trip to Port-au-Prince is on Mondays and Fridays. Follow-up e-mails have been sent but we are still waiting for a decision.
Keeping programs operational
GAHDA has continued its work in breast cancer, supportive health services, development, and relief, despite ongoing obstacles. Our team on the ground has persevered and responded creatively to maintain health and social support to the communities we serve. 3000 gallons of water continues to be delivered weekly to the prison (population 450). We would also like to acknowledge AGAPE FLIGHTS based in Venice, FL and its biweekly cargo drops to Jérémie. GAHDA has been accepted as a member which means we are able to receive medications, supplies and other critically needed donations at a subsidized rate of ($3.75/lb).
Summary of breast cancer program activities
Almost 80% of women diagnosed with breast cancer in the GAHDA breast cancer program have the kind of cancer that is treated with an oral chemotherapy medication called
tamoxifen. To support this long-term treatment, a laminated card explaining common side effects, and written in Kreyol has been discussed and distributed to patients/families and providers. A donor is contributing funds so all women have enough medicine for daily doses. The photo below shows nurse navigator, Leila Casseus giving one -month supply. As of December, 14 women were taking this medication and being monitored for secondary effects.
Community outreach for breast cancer screening and education:
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The activities of 125 Church Volunteers, as well as education in the hospital perinatal clinic have been monitored for quality of services.
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Collaboration with village health workers to teach breast self-exam to women and men in their service areas. Photo below shows man educating men in his church about breast cancer and self-examination for their wives.
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Several trips out of town to rural churches and centers to support breast self-examination education by volunteers and screen for women needing advanced diagnostics.
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Updating the database information for 700 several hundred faith leaders in the Grand’Anse ongoing for completion by June 2024
Clinical services
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Dr. St. Jean is a certified sonographer. He began working as part of the GAHDA CREMED partnership in June and is a welcome addition to the team. He has completed breast ultrasounds at GAHDA for women identified in the screening program. Women needing biopsies stay in town for the consent process and biopsy by Dr. Douge.
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The new ultrasound machine has been purchased and is being shipped to Florida to be hand carried to Haiti.
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GAHDA continues clinics sessions for women with breast cancer to provide follow up and supervision. These are held every 2-3 months.
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The nursing staff suggested opening the GAHDA center every Wednesday morning for screening, patient follow-up, care of women with breast pain, and general questions. These weekly morning clinics began this year.
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Six screening clinics held, two ultrasound and biopsy clinics in October and November.
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Four patients were referred to Hospital St. Francois de Sales Oncology Program in Port au Prince for chemotherapy and mastectomy and their care was ongoing October through December.
Summary of Supportive Health Services, Development and Relief Activities
Development and Relief
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Schools remained open during this period with GAHDA support to a number of families.
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Rural village volunteers continued sharing a baby goat to another woman in the village.
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Lastly a magnitude 4.2 earthquake struck the area around Corail in the Grand’Anse on December 11th with continued aftershocks. No deaths known at this time.
THE GAHDA STAFF
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Bette Gebrian
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DOUGÉ Jean Robert
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Bourdeau Louis Chenet
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Leila Petouchka Casséus
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Jeffson Jean-Pierre
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Elisabeth Daphney Casséus
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Sainte Rose Joseph
DEVELOPMENT AND RELIEF
School funding for 13 children from 7 families (fees, uniforms, books and supplies)
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Began sharing goat offspring from original women recipients to 20 other women in the villages
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Received earthquake relief donation from Presbyterian Disaster Assistance in Kentucky for food and construction materials. Food packages were purchased and delivered to the most vulnerable families. 55 families have been identified to receive construction materials.
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Displacement and mental health needs have been identified for people arriving in Jérémie from Port au Prince and other gang and violence affected areas. A recent national consortium of NGOs meeting minutes included the following statement
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Internal displacement continues to be a major issue in the Grand'Anse as people continue to flee Port au Prince, many have arrived in the Grand'Anse increasing the pressure on an already fragile healthcare system. One facility reported 1,708 new patients seen for mental health services. 176 of those had been victims of sexual assault, 83 of whom were children under the age of 12, 51 of whom were 12-21. The need for mental health services for victims of sexual assault great.
The 7.2 earthquake that struck our area in August 2021 is a disaster we are all still recovering from. Many lost their houses, access to mountain springs, jobs, animals and livelihood. Some people were never found. Urgent medical care in these regions was critical. GAHDA put out the word and many responded immediately to supply needed emergency medicines and wound care supplies.
The political and economic disasters compounded the suffering of families already affected by loss. And it is getting worse.
GAHDA, with the generous donation of many helped us develop a cadre of 5 MD teams that volunteered to travel on foot, by boat, mule, and motorcycle to underserved areas in four counties. They were able to consult over 20,000 people with urgent and chronic conditions. When fuel topped $25/gallon, these efforts stopped. We plan to continue as soon as possible.
