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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 July - September 2023
General Situation
Jérémie continues to be without any town generated electricity since January 2022. The temporary bridge was not damaged by the flooding in June, and until recently buses were transporting people and goods. However, in September, 7 buses from the main company serving Jérémie were delayed vandalized as part of a protest against Prime Minister Ariel Henry’s visit to the Grand’Anse temporarily reducing travel to Jérémie. Food is so expensive that people can’t afford to buy at the market. There is a shortage of local food supply due to flooding and crop loss and many are still living in damaged housing.
GAHDA has continued its work in breast cancer, supportive health services, development and relief despite the ongoing obstacles. Our team on the ground has persevered and responded creatively to maintain health and social support to the communities we serve. We would also like to acknowledge AGAPE FLIGHTS based in Venice, FL and its cargo flights 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). This is even more important because commercial flights from the Jérémie airport were suspended in July.
Summary of Breast Cancer Program Activities
Nurse counseling and consent prior to biopsy
Demonstration of breast self-exam by Vodou practitioners
Biopsy needles, lidocaine, exam gowns and drapes were purchased for the coming year for screening /biopsy clinics in Jérémie at the GAHDA Center.
Laminated tamoxifen medication education cards for patients and another for clinicians have been developed and are being prepared for distribution
Community Outreach for Breast Cancer Screening and Education:
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Review of activities of Church Volunteers
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Update of database information for 700 faith leaders in the Grand’Anse
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Meeting of 25 rural village health workers from several organizations at the GAHDA Center about breast cancer education, screening and referral
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First meeting with 20 local Vodou practitioners (Vodouyizan) at GAHDA Center to discuss breast cancer screening, treatment and referral; GAHDA staff also attended the annual rural Vodouyizan congress with 150 participants to present breast cancer information and develop relationships with these important community health practitioners.
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GAHDA staff made 4 monitoring visits to rural area to check quality of education by Church Volunteers and village health workers
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Work to update 4-minute breast cancer education video in Haitian Kreyol.
Clinical Services
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Dr. St. Jean began working as part of the GAHDA CREMED partnership in June. He is an obstetrician gynecologist who is certified in conducting breast ultrasounds. He is available to conduct breast ultrasounds at GAHDA for women identified in the screening program.
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Funds have been secured to purchase a new portable ultrasound machine for the program and this will be purchased in October. Thank you to our donors!
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GAHDA began clinical sessions for women with breast cancer to provide follow up and supervision. These will be held every 2-3 months.
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Three screening clinics were held averaging 70 patients per session
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Two ultrasound and biopsy clinics resulted in 12 biopsy specimens
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Of the 9 results (the most recent were just submitted to pathology) 3 were positive and one woman was only 25 years old.
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Four patients were referred to St. Francoise de Salle Hospital in Port au Prince for chemotherapy and mastectomy
Summary of Supportive Health Services, Development and Relief Activities
Development and Relief
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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
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.
Supportive Health Services
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Cholera persists and has been found in the prison and a few other areas. GAHDA has been able to provide doxycycline for these situations. A rural area had a cholera outbreak for a few weeks. This was resolved because of our previous experience dealing with cholera, and GAHDA donated required supplies and materials to a local priest to treat and support cholera patients (doxycycline, serum oral ingredients, clothes, funds for food/supplies)
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Four mobile medical clinics were held in remote rural villages staffed by 17 volunteer doctors and nurses who treated nearly 1700 patients.
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Helped CREMED obtain a microscope for their practice.
Transportation continues to be problematic, often interrupted by insecurity at the airports and on the roads, flooding, petrol shortages and overall unreliability of services.
Compounding existing troubles, the Grand’Anse region experienced another earthquake on June 5th. This caused already fragile infrastructure to collapse, blocked roads, and the many casualties overwhelmed hospitals. GAHDA was able to supply medical centers with supplies, help housing insecure families with tarps and other essentials.
Presbyterian Disaster Assistance provided an emergency grant of $10,000 to support GAHDA with relief supplies including tarps and MREs to meet this latest catastrophe.
The breast cancer program continued despite all the challenges. The Digicel Foundation, funded by a local phone company, paid to advertise via SMS messages dates for GAHDA breast cancer screening clinics. One was held in May and one in June. This helped us greatly expand our reach and resulted in over 100 women coming to the clinics.
We have successfully raised sufficient funds to purchase a badly needed sonogram machine!
We also received a donation of a one year supply of the essential breast cancer medicine, Tamoxifen.
Our “Hand Up” project continued and expanded support to the most vulnerable in Jérémie. This included:
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personal supplies for victims of rape given to GYN department of the hospital
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monetary gifts to support viability of small businesses during economic hardship
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480 Buckets of food/supplies distributed by GAHDA on behalf of Project Medicare
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45 families received food rations purchased in local markets
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GAHDA continues to provide humanitarian support to those incarcerated at the local prison, providing essential access to potable water, personal hygiene supplies and food rations.
Disaster Response and Recovery:
Disaster Recovery continues to meet the needs of those affected by the Aug 14, 2021, magnitude 7.2 earthquake. GAHDA coordinates supplies for the PT needs of those still recovering from injuries as well as medical supplies for long-term care of the injured.
GAHDA is supporting the rehabilitation of a Baptist Church in coastal Pestel town. Funds from Asylum Hill Congregational Church in Hartford, CT matched by GAHDA resources have made this possible. This building will be used as a community center, emergency shelter and educational site in addition to church services.
Presbyterian Disaster Assistance (PDA) hosted a disaster training conference in Grenada. Dr. Douge, GAHDA Medical Director, represented GAHDA at the meeting further strengthening the partnership between PDA and GAHDA.
News from Haiti: (April- June 2023)
2023 International Women’s Day
GAHDA provided special training of 30 nursing students in breast cancer and teaching techniques of breast self-examination as part of Women and Health Together for the Future (WHTF) International Women’s Day activities. (photo of banner) (photo of training)
Dealing with Extreme Hunger
We are experiencing a 4 1/2 month drought. Water scarcity made winter planting season nearly impossible.
Food security efforts through goat distribution to women-headed households is temporarily on hold. 456 goats were already distributed in 4 counties between February and December 2022. (photo of women and their 2 new goats in rural Jeremie)
The challenge to transport goods in and out of the region continues. Food and fuel are extremely expensive. According to the World Food Program nearly 1.8 million people are in emergency phase of food insecurity (IPC4). The entire Grand’Anse department is in this category. (WFP Haiti Country Brief January 2023). Two hundred families have received food rations.
Dollar to gourde value $1.00 =163 gourdes in March 2023 up from 102 gourdes in December 2021.
Breast Cancer Care: Screening for women with breast lumps continued through the efforts of parish volunteers, nurse led education in the hospital and at a yearly conference for members of a Protestant church network. Referrals to the physicians at CREMED continue and 3 breast biopsies were completed and sent for pathology in the USA.
Cholera: Between September 2022 and January 2023 more than 20,000 people had suspected cholera infection, most in Port-au-Prince but all of Haiti was affected.
Mobile Medical Clinics: Since the earthquake in Aug 2021, over 20,000 people in 8 counties received health care consultation, medication and referral through volunteer physicians, nurses, health workers and support personnel. Teams walked, took boats, motorcycles, mules and trucks carrying supplies with them for 1-4 days. Distant clinics have recently been suspended for security reasons. (photo 1: volunteers walking 1-4 hours to rural site, photo 2 families waiting for medical consultation, photo 3 physician consulting patient and pharmacy)
Earthquake Recovery
Church construction: A special grant for rehabilitation of a Church in the coastal city of Pestel is nearing completion. The building will also be used for health education and screening.
Since July 2021, when president Jovenel Moise was assassinated, the country has been in a downward spiral. In all these years since I moved to Haiti in 1987, I have never witnessed widespread hunger like this, lack of power, fuel, food and transportation and access to health care. 60% of Port-au-Prince is controlled by scores of gangs. Rape is rampant and kidnapping continues. Gang members demand up to $1000 for vehicles to pass controlled areas. The US Embassy urged people not to come to Haiti, or, to leave a soon as possible. We are grateful to be hours away from unrelenting fear and uncertainty in the capital.
The BBC posted this report earlier this month. (107) Port-au-Prince: Haiti's capital city taken hostage by brutal gangs - BBC News - YouTube
What to do?
We are a small organization but remain a conduit of support from generous donors and partner organizations to continue our mission to “Meet the needs of Grand’Anse individuals and families seeking healthcare and livelihood support not being met by existing services. Contribute to skills development of Haitian health professionals. Provide community education”
We have been on the ground for hurricanes (category 5 Hurricane Matthew), earthquakes (2010 and August 2021 in our area, cholera (2010 and now again) and other infectious diseases, political unrest and …. We have nurtured trust and community networks that reach all corners of this region of 500,000 people.
Haitian health providers and religious leaders are engaged to teach people about breast cancer. Since July, we have established a diagnostic service site for people with breast problems. We are all grateful for pathology services not otherwise available. All this with the support of materials, medicines, expertise, and funds. Despite the hardships, GAHDA provides care to women diagnosed with breast cancer.
Photo of woman 40 year old cancer survivor
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.
Photos of trips by medical team and MD consultation in rural area
People are near starvation and eat what is currently being harvested. GAHDA distributed 18,000 rapid cooking rice/soy packets and locally purchased food to elder headed households
Photo of elder with food
We need your help to continue this work. Please donate through the PayPal link on this website or send a check made to the Grand’Anse Health & Development Association.
Photo of woman with two goats
Despite the risks, five hundred female goats were given to women headed households in 4 counties, most recently, this month. When offspring are ready, one will be shared with another woman in the village.
GAHDA provides essential healthcare and a range of supportive services to the Grand’Anse Community. This remote corner of southwest Haiti struggles to meet the needs of over 400,000 people. At GAHDA, we seek to meet the needs of the people where they are, causing less hardship, financial strain, and disruption to their already challenging day-to-day lives.
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Health
GAHDA believes that healthcare is a human right, one that is often inaccessible to people with extremely limited resources. Access is also compromised by a public health care system that is resource poor.
While Haiti continues to make great strides at harnessing local talent and training medical professionals, there is still a long way to go for the system to meet the needs of all people. We are committed to helping fill that gap while also contributing to strengthening local systems through mentoring, training, tools, and materials.
