The 2021 Earthquake: Dispatches from Jérémie

On August 17th, 4 year-old Robeson's condition worsened rapidly and he was evacuated by helicopter to Bernard Mevs Hospital in Port au Prince for further treatment. He was accompanied by his father. We are currently in communication with the mother and other children and plan to provide food support.

Interview with a Mother at St. Antoine Hospital

The setting is a hospital triage ward at St. Antoine Hospital, where there are many beds with wounded children rescued from the fallen debris during the earthquake. In the days after the earthquake, Bette Gebrian, Executive Director of GAHDA, spent several hours at St. Antoine Hospital speaking with doctors, administrators, and patients, including this mother and her son.

Thank you to Leslie G. Desmangles, PhD, for translation of the interview.

Even though we have been focusing on earthquake relief, our breast cancer work continues. We continue to support 19 women in treatment, 1 woman died and one is living her last days at home. Our volunteers are still working with the women and families in their churches. At least 4 new women have been identified in need of further examination for breast issues and one has a confirmed case of breast cancer. Here is the story of the confirmed case.

Mme A., Pointe Sable

Mme A. is from Pointe Sable on the island of Grand Cayemite. She is 51 years old and sells in the market. She has 5 children. She was referred to GAHDA after the earthquake.

She was first identified by the nurse at ESPWA clinic, Vedette Bazile. Vedette was trained in the first group of church volunteers in December 2019. She is a GAHDA Parish Volunteer for Mont Carmel Catholic Church in Pointe Sable. She has a mirror and BP cuff, and is active with breast cancer education in her parish.

Mme A. came to Vedette after discovering a lump in her breast in early March. Vedette referred her to Port au Prince for a mammogram and then sonogram. Mme A. then returned to Pointe Sable because she did not have enough money to stay in Port au Prince for treatment.

Father Bazile is the priest at Mont Carmel Catholic Church. He was in Jérémie after the earthquake and told me about her. We received the documentation from the mammogram and sonogram and have arranged for her treatment at Innovating Health International (IHI) in Port au Prince. Father Bazile will arrange for her transportation to Port au Prince, and GAHDA and the church community will support her children while she is receiving treatment.

Getting to Port au Prince from Pointe Sable is quite a journey, requiring a boat to Petit Trou de Nippes and then a bus.

Pointe Sable After the Earthquake

Pointe Sable experienced extensive damage from the earthquake: 215 houses destroyed, 375 families without a safe place to sleep. Helicopters came to evacuate the injured. GAHDA is now facilitating connections with other organizations to provide medical supplies, food, water and housing.

Mme A.'s house collapsed after the earthquake. She received money to feed her children, blankets and tarps as they are sleeping outside, 2 cases of manna packs (72 packets that feed 4 each), and money for her travel to Port au Prince and taxi to IHI, $75 for a biopsy and our phone numbers. She has a referral letter to Carl, the guide at IHI, to get her into the clinic for consultation.

We will keep you posted about her progress in treatment.

Hi Everyone,

Sorry for the delay in writing up our recent activities, but we were very busy these past couple of weeks as I prepared to leave Haiti for some family events. This will be the only post until I return October 15.

All of our donated medical supplies are now out in the field. It is encouraging that young docs and nurses are walking in what feels like 104 degrees to work under mango and breadfruit trees to keep cool while serving those in need.

It is a good thing that the supplies were distributed because there is now a fuel shortage. Town power is limited to 4-5 hours a day. The shortage is due to the complete blockage of transport by gangs in Martissant. It is unclear when there might be some relief.

Our partners are continuing to raise funds and purchase medical supplies — now it is important to address chronic health conditions that have been neglected during the emergency response. People lost their regular medications in the earthquake and these have been hard to replace, so the doctors say they have been seeing many patients with very high blood pressures.

Food, Water and Schools

Food and water are still of great concern. A collaborator from Maine came with a team and traveled by boat to Pointe Sable to assess the damage and what they could do. One of the team members stayed for a week and was impressed with the sole nurse in the clinic there, serving as many as she can. This nurse is one of our breast cancer volunteers. We are still hoping to receive solar water purification systems from a consortium called "Palm Beach County Cares". We just learned today that a smaller unit has been donated for use in the Jérémie area. We will be following up on that in the next few weeks.

Though 175 schools were completely destroyed in this region, children are hoping to get back to school and some normalcy at the beginning of October. GAHDA is supporting as many children as possible with uniforms and shoes, books and administrative fees.

The Mobile Clinic

Over 200 people received consultation at the mobile clinic held on Sept 16, 2021. The pharmacy was supported through donations from Project Medishare, Cross Catholic Outreach and Cashman Family Foundation. While many rural people are in need, GAHDA prioritized pregnant women to receive buckets of food or hygiene kits from Project Medishare and blankets from Cross Catholic Outreach in addition to prenatal care and vitamins.

One of the women with breast cancer just returned from Port-au-Prince after months of chemotherapy, mastectomy, and more chemotherapy. She received support for her 2 children to go to school. She also was given one of our plastic 55-gallon drums that had been used to ship medical and educational supplies to GAHDA in the past year. She is happy to be home in Jérémie again.

Hi Everyone,

Since returning to Haiti in late October, we have been very busy dealing with the fuel shortages, lack of food and medical supplies, and ongoing problems with water. While the medical teams can't go out to the mountains because there is no fuel, we were able to plan and complete a successful training on November 2, 2021 despite the fuel problems. We contacted 50 health providers, and almost half (3 doctors and 21 nurses) were able to attend. They all completed a certification training in Clinical Breast Examination. The furthest distance represented was the medical director of the hospital in Anse d'Hainault, a 5-hour drive from Jérémie, followed by another from Abricots, a 2-hour drive.

Our next blog will describe this and other activities of the breast cancer program in more detail.

Living With the Fuel Crisis

Because there is such limited fuel, we are rationing our diesel and hoping for a few hours of local EDH power every day or two. We are fortunate to have solar panels on each guest house and we are using charcoal (made from our own fallen trees and branches) and propane to cook. Gasoline sells for as much as $30 a gallon or more when it can be found. Demonstrators had been stopping motorcycles to take the gas to burn tires so that depleted all local supplies. This has stopped in the last week.

Most people are on foot this week. And, since mules were replaced by thousands of motorcycles, young men who earned their way as taxi men are in big trouble. Our volunteers continue to discreetly bring food to elders, but the young people are desperately hungry. There are so many road blocks that the only transport in town is motorcycle.

How People Are Getting By

Harvesting the glass eels (called elvers in the United States) is a major source of income. These are early juvenile eels which are caught and shipped to Asia for aquaculture to become adult eels, a major source of food in Japan and other Asian countries. We see the lights of the fishers in the ocean at night as they camp on the shore and net the eels. This is the only source of income for about a thousand people living along the shore here and in other places, too. Planes still fly in and buy these live baby eels to ship overseas. The major money goes to the exporters with a small portion going to the fisher people.

I hope there are still mules out in the villages, since this is a well-established way to get goods to and from remote places. It used to be the only way, and I remember many trips on them to do rural clinics. There are no busses, no trucks with goods, and no boats. The only bridge into town is broken so that only foot traffic is possible. While it is sometimes possible to cross the Grand'Anse River by vehicle at ford points, the heavy rains have prevented even this means of getting goods and supplies across the river for many days. Only large MAC trucks can pass through. The main market in Jérémie was closed, so other small markets are timidly appearing on the outskirts to help folks survive. As of November 4th, the markets and banks are open.

In terms of food, avocadoes are being harvested now and there has been rain so there are greens to forage. Fishermen are out doing their best but there is no movement to other coastal towns.

We have been fortunate that internet and phones have been relatively stable. The internet cables were cut in several places a couple of days and long strips of the wiring were stolen, but Natcom has been trying to keep up with it. So far, we haven't lost phone communication, even though there have been many demonstrations against Digicel company.

We can't start rebuilding because there is no way to get cement and the sand is on the other side of the bridge. But we have created several cash for work projects including men making charcoal, young women sewing knitted knockers with fiberfill and beads, and other small jobs so we can get money into the economy.

A Treatment We Cannot Get

The immediate treatment for a dirty machete wound, or lash from rusty tin roofing, or a crush injury is tetanus immune globulin, an injection. Shortly after the earthquake, I went to the ER at St. Antoine Hospital and asked what they needed. They said, SAT (serum anti tetanique). They had none. After contacting many in international and national disaster work, it became clear that there was none for Haiti. The price is $500 per dose and it needs to be kept at a cool temperature and shipped into the country. We never did get any vials. The severely wounded needing advanced care after the earthquake were evacuated by the US Coast Guard helicopters and HERO medical personnel. We heard that there were deaths from tetanus in Port-au-Prince but we do not have details.

In general, we feel safe, although it is still difficult to get money from the banks to get other things done.

We are still preparing for medical teams who will return to rural villages.

Somehow the work does not stop…

Hi Everyone,

As the holidays approach, we are feeling blessed to be with our daughters and family in Florida. I would like to take this opportunity to thank all of you who have been so generous in donating to our work, especially in response to the August earthquake. It is hard to believe it has been four months. The response has been difficult and complex and is ongoing.

The situation in Haiti continues to be extremely challenging. I wanted to let you know how our activities have continued in spite of the difficulties. We are certainly hoping for a better 2022. We were all heartened to hear that soup joumou has been named a cultural heritage dish by UNESCO. It was the first time Haiti has been honored this way. We will certainly be enjoying it New Year's Day 2022!

Power, Bridges and Food

In Jérémie, there was no diesel fuel for the local EDH generator for some time, so no power for the town until just now. Townspeople have power from 6pm to midnight, though we don't know how long this will last. The pontoon bridge is onsite at the river but there has been no activity to install it. This will provide passage over the Grand'Anse River since the damage to the old bridge does not seem to be reparable. We hope that the installation of the pontoon bridge will begin in January.

Food continues to be a major issue. GAHDA is distributing 131 more food kits of rice, beans, oil and spaghetti to families. An additional 40 families who are most in need received 5-gallon buckets filled with food and personal care items, with buckets and some items from Project Medishare. Food is also being given to cancer patients in the Grand'Anse. One of the patients we support received a family ration of food and taxi money.

Breast Cancer Education & Training

Community education for breast self-exam is currently focused on the outpatient clinic at St. Antoine Hospital in Jérémie due to fuel limitations. Four are planned for December by Leila Casseus, the nurse educator/navigator.

Breast cancer training for health professionals continued. There was a training on breast cancer identification and treatment November 2 with 12 doctors and 12 nurses. They all received certificates and 9 received mirrors for breast self-exam teaching in their churches or clinics. December 4 was another training for 27 parish and church volunteers, including voudou-based congregants.

We continue to find more women with breast problems, 12 since the earthquake. Several have cancer and GAHDA supports their diagnostic and treatment care if they can get to Port-au-Prince. There are 18 women with breast cancer who are in a long-term relationship with GAHDA and we provide follow up medical care in Jérémie, oral medicine, vitamins and food. This is one spot of light in an otherwise dark time in Haiti. GAHDA has also supported schooling for some of the children of the families living with breast cancer. We will do more in January.

Aftershocks and Mobile Clinics

Earthquakes continue, sometimes 3 or 4 a day. There have been 150 earthquakes in the Jérémie region since August. The highest magnitude has been 4.2, off the coast of Corail a few days ago, but even 3 is enough to get folks out of their houses. Many of the quakes are off the coast. It seems these are likely to continue, and our home (400 ft above sea level) will become a tsunami detection site in January.

Mobile clinics have slowed because of the lack of fuel for transport. However, there have been a few initiatives. One was a volunteer MD/nurse team from Port au Prince who came for a week in November; Dr. Delzor, the team leader, was born in Jérémie. Dr. Dougé led a group of volunteers. Jocelyn Boyer, GAHDA part-time administrator, was working with HEKS/EPER in rural Beaumont, about a 4 hour walk into the mountains. Just yesterday, Fr. Iraglio and a team of Haitian providers consulted over 200 people despite the pouring rain. GAHDA provided the medicines.

There is still so much to be done.

Wishing you and your loved ones a blessed holiday season and a healthy and happy 2022!