March 3, 2010

Quake spotlights nation's distress, nonprofit's resolve


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John Patriquin /Staff Photographer; Friday. 01/15/2010 Matt Wickenheiser studio photo.

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Gordon Chibroski

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Nickerson has been talking with officials, trying to gently get them to prepare for an influx of refugees from Port-au-Prince. With the collapse of the capital, the centralized government has been wiped out. Regional officials who have never made decisions -- or had resources to do so -- now find themselves forced into that role.

Many don't believe there will be a surge in victims and refugees, as Nickerson does. Part of that may be the unprecedented scope of damage from the earthquake; it's hard to fathom.

And part of it may be the cultural split between northern and southern Haiti. Many believe that refugees from the south would resettle in that part of the country, rather than come north.

Nickerson has come to Cap about 35 times in the last decade, and every time he learns something new, like peeling back the layers of an onion.

''The thing of it is, I have no idea how big an onion it is,'' said Nickerson.


Konbit Sante has worked to help Cap Haitien's health officials strengthen its public medical system, through Justinian Hospital and a clinic at Fort Saint Michel, one of the city's poorest neighborhoods.

The nonprofit funds 26 jobs at the Justinian and the clinic. Via the clinic, it provides outreach workers who make their way through neighborhoods carved out among garbage dumps to help mothers of young babies. Amid the refuse, they vaccinate children and teach mothers about breastfeeding.

It also helps identify and fill specific needs.

Konbit Sante built a pediatric outpatient clinic at the hospital, for instance. Maine electricians have upgraded parts of the wiring system to maintain critical operations, even during blackouts. Konbit Sante secured donations from Maine Medical Center in Portland to equip a neonatal intensive care unit.

The general model of doing this type of work in Haiti involves foreign groups ignoring government officials and essentially setting up operations and running them with foreigners.

Konbit Sante takes a different approach, by partnering with hospital and health ministry officials, asking them what help they need and then coordinating efforts stateside to meet those needs. It has offices right on the grounds of Justinian and is seen as part of the system.

''When tough things happen and you have a depth of relationship and a depth of experience, it allows you to sit as people together to try to solve what can start to be viewed as a common problem,'' said Nickerson.

Local officials appreciate that difference in approach because it shows respect for Haitians, said Dr. Jean-Gracia Coq, medical director at Justinian.

The hospital has received help in the past from numerous NGOs, said Dr. Marie-Carmelle Leconte, who is in charge of the hospital's operating room and of anesthesiology.

The NGOs would do a short-term pilot program and then would be gone, she explained.

''With Konbit Sante, this is a permanent relationship,'' said Leconte.

The model brings to mind the old saying about giving a man a fish or teaching him to fish, but Nickerson discounts that as arrogant. It assumes, in this case, that the Haitians don't know anything about health care.

''It's more like, 'I know about fishing, and you know about fishing, and this is a really tough pond to fish, so let's work together,''' said Nickerson.

There are several initiatives at the Justinian that will move forward, though the earthquake has likely delayed one of them.

The U.N. has approved funding of an expansion of the Justinian's emergency room, which has been a priority of Coq's since he arrived here in 2007. Konbit Sante worked to find funding and secured it through the U.N., Coq said.

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Additional Photos

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Gregory Rec/Staff Photographer: People wait in front of the maternity unit at the Justinian Hospital on Tuesday, January 19, 2010. Konbit Sante pays for an OB/GYN doctor who works in the maternity unit and the clinic in Fort St. Michel.

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Gregory Rec/Staff Photographer: An earthquake victim sleeps in a wheelchair outside the entrance to the emergency room at the Justinian Hospital in Cap Haitien on Wednesday, January 20, 2010. The steady flow of earthquake victims has taxed the hospital's already meager resources and, because the government in Port au Prince is in disarray and banks are closed, the hospital staff are not getting paid.

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Gregory Rec/Staff Photographer: A boy asks for money as foreigners walk past him on a street in Cap Haitien on Tuesday.

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Gregory Rec/Staff Photographer: A boy asks for money as foreigners walk past him on a street in Cap Haitien on Tuesday.


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