Family Health Ministries and Duke Engage in Leogane, Haiti
June 1 - July 30, 2009

Taller row : Max Kligerman, Hannah Meador, Matt Gay, Kevin Chen, and Johnny Lai
Front row: Laura Ferraro, Sunita Saith, Jackie Ndirangu, and Juyon Kang

Introduction

For the first time in 2009, Duke Engage students are traveling to Leogane, Haiti, with Family Health Ministries. Read the FHM program brief on Duke's website. (Use Ctrl+F to search for "Haiti") The Duke Engage program provides funding for Duke undergraduates who wish to pursue an intensive civic engagement experience anywhere in the world. Through Duke Engage, Duke students address societal issues within the U.S. and abroad.

Who's Involved

Seven students are spending eight weeks on FHM projects that include a follow up on Dr. Rachel Peragallo’s focus groups with Leogane women, GPS mapping of the local healthcare facilities plus completion of a questionnaire on each of the locations, HPV education, and working in the Leogane clinic and lab, helping with the FHM's cervical cancer prevention program. All of these projects relate to FHM's planned construction of the Leogane Family Health & Research Center.

The cervical cancer education team includes Kevin Chen, Matt Gay, and Sunita Saith, coached by Jackie Ndirangu. The GPS health team is Johnny Lai and Max Ligerman, coached by Kathy Walmer, FHM's Executive Director. Juyon Kang and Laura Ferraro are working on the community needs survey, coached by Hannah Meador.

                
FHM's Duke Engage team in Leogane is coordinated by Hannah Meador (left above).
Assisting her is FHM's Research Coordinator, Jackie Ndirangu (right above).

News from Haiti

Link here to read the official weekly blog written by Kevin Chen

Kevin on his first day in Haiti

Another great link is to Sunita Saith's blog with details about the cervical cancer project.

2 June 2009 (one day after arrival)
An exerpt from Kevin Chen's first blog:
From reading about Haiti in the American media, you tend to get the impression that people living in Haiti must be terribly depressed. However, this is quite far from the truth. The locals that we have met so far are very lively and all seem to be living in the moment, not really worrying about things. When Dr. David Walmer, one of our group leaders who has spent many years in Haiti, said that “Americans can’t change Haiti, but Haiti can change Americans,” I didn’t quite understand what he meant. But now I think I am starting to realize his meaning.

8 June 2009 (after one week)
Matt Gay's Reflections:
As we drove through Port-au-Prince and entered the more rural community of Leogane, I remember feeling overwhelmed, but yet at peace. The scenery was gorgeous – tropical vegetation dotted the beautiful landscape towering over the many ‘moto-taxis’ and ‘tap-taps’. I was immediately engulfed into another culture, one where people express joy in light of their circumstances. A place where time is not an issue. A place where the person that you are currently talking to is more important than where you have to go later in the day. A world where everything operates at a much slower pace.

Matt working on the new cervical cancer prevention brochure

Johnny Lai's Reflections
It's been an amazing time so far.  I'm enjoying my project so much because it gives the the ability to collect large amounts of data quickly.  But most importantly, I enjoy it because I actually get to explore the community, while getting mini-lessons in Kreyol from my translator each time we're working together.  5 days in, and I have a decent command over Kreyol greetings and basic sentence structures.  Overall, it's a very dynamic experience, and the job doesn't feel routine at all (which is a plus in my book). 

Haitian translator working with Johnny

16 June 2009 (after two weeks)
Sunita in her blog:
Already, we have seen some benefits of our work. We have also been calling women about their follow-up appointments, and several have returned for treatment. Here is a look at the inside of the brochure!

20 June (after almost 3 weeks)
Max Kligerman's Reflections

This was a great week.  Monday, Tuesday, Wednesday, and Thursday we continued to GPS map Leogane.  Johnny and I have been making a lot of progress.  I am optimistic that we might actually be able to map almost all of Leogane before we have to leave.  The most memorable part of the week, though, occurred on Friday when we went to a health fair organized by the nursing school.   At the fair I gave a 25 minute presentation on oral hygiene.  I though it went really well!  There were probably about 200 people there all watching very attentively.  I had this big model mouth and model toothbrush I used to demonstrate proper brushing technique.  While I was doing that, though, one of the teeth popped out of the mouth and fell on the floor.  Everyone started laughing, it was very funny.  After the presentation several really good insightful questions were asked.  After all the questions, we handed out all of the toothbrushes and toothpaste I brought down with me.  I brought down a whole bag (50 lbs) worth of supplies, and past it all out to the audience to whom I presented.  It was really fantastic.  I could not have asked for a better venue or opportunity to present.  I hope I can present more in the future.  While I don’t have any more oral hygiene supplies, just passing on the knowledge itself is very important. The most challenging part of the week occurred on Thursday.  On Thursday we switched up the groups a little bit, and Matt Gay went GPSing with me.  We were out in a very rural section of Leogane and came across a mission.  The mission supported a school and a church.  It also used to support a clinic, but the clinic had closed down a few years ago.  The school was the only one in a community of about 4,000.  We sat down and had an impromptu hour long meeting with the principle of the school.  He told us that their situation is really desperate.  They do not have enough money to pay the teachers’ salaries and for general operation.  They said that they needed help before the school reopened again in September.  In all likelihood the school would have to close down within the next couple of years if they do not receive any help.  During the meeting he pressed Matt and I to see just what we could do and how we could help.  It was very difficult because I knew there was not too much we could do.  And we had to explain that we were students and we really didn’t have that much power.  We could lobby for them and try to get other NGOs to focus on them, but we really just couldn’t do that much.  So seeing how desperate the situation was, and realizing how little we could do was my biggest obstacle.  When we get back to the states I would really like to organize some sort of fundraiser or charity event, but it seems like it would be so complicated.  Like even if we did raise the money, how would we get it to the school?  And even who would we give it to?  If there is a way to help, I really want to, but I am just at a loss of how? This upcoming week, our plans are the same.  We will continue to map Leogane. The fist two weeks we focused a bit more on the rural areas, and now we will map the city’s center.    Everything is truly wonderful.  I am still loving this experience, loving our group, and loving our GPS project.

30 June 2009 (after one month)
Note: Kathy Walmer, FHM's executive director, recently returned from a two-day hike with the Duke Engage students in Haiti. She filed this story:

TWO DAY HIKE IN THE MOUNTAINS OF HAITI

Seven Duke Engage students spending two months in Leogane this summer with Family Health Ministries took a few days to see the country of Haiti. They started out on Saturday from Leogane and stopped at the Baptist Mission outside Port-au-Prince for lunch. This is the closest to American fast food in Haiti and the students found it a great surprise for the day. After a filling lunch the group went on to visit Fort Jacques. Fort Jacques sits on a mountain overlooking the vast capital city. Here the students heard about the history of the first successful slave revolt and how Haiti achieved independence from France.

That evening the group traveled to “The Lodge” in Furcy where they met Nichole and Stanley who run the hotel. The housing and food were exceptional. The menu had a large selection of French cuisine to pick from and they even had HOT water showers. It was hard to decide which was the first joy…fabulous food or hot showers.

The group got up early the next morning  and traveled by van about an hour south into the Massif De La Selle  mountain range to start the first day of a two day hike. The first day took the group through very rural and rugged mountain terrain including a significant portion of the Parc National La Visite. This national park is home to one of the few still existing pine forests in Haiti. You would have thought the group had landed in the mountains of NC. The six hour hike ended at a rustic lodge in the town of Seguin which sits on top of a mountain range at over 6000 feet. The evening was not just cool, but downright cold!  This did not bother most of the group that were curled up under piles of quilts and asleep by 8pm. Yes, an entire group of Duke students asleep by 8pm!

The next morning the group started out early for their final destination, the town of Peredo on the coast above Jacmel. Needless to say this was a challenging hike which was ALL downhill and took 5 hours. After crossing the river at Peredo, the group was excited to see the four wheel drive truck that would be transportation for the rest of the day. The group drove first to Raymond les Bains where they had grilled fish for a late lunch on the beach and then to Fondwa where they will spend the next couple of days seeing Family Health Ministries project sites and resting prior to their return to Leogane.

Although, tired and sore, the group was thrilled to have had the chance to spend time in rural Haiti. Meeting the friendly smiling people along the trail was all the encouragement the students needed to keep on walking.

15 July (after 6 weeks)
Read the Duke Global Health Institute story about FHM's Duke Engage students.

27 July (with just a few days left in the trip)
Matt Gay's reflections

Second Time a Success
If I were to try and describe the Haitian culture to someone, one of the first things I would say is that the pace of life is slow. This leaves you with the leisure of soaking in events, people, conversations and relationships that you would fail to do otherwise if you were in the States.

As I have recounted before, the person that I am currently talking to is more important than where I am going. However, this phenomenon can come with seemingly negative benefits. For instance, last Friday we had planned to meet with two women’s groups in the rural village of Fondwa to give a cervical cancer presentation.

We had spent quite a bit of time and energy assembling the presentation, not to mention the countless hours of writing, filming and editing the video. Well Friday came around, and after an hour of waiting only 6 women showed up. Honestly, I was a bit disheartened, because we were all under the impression that many women would be there. Instead, in typical Haiti fashion, women had other important duties to attend to, such as working in the market, caring for their children or attending church.

Nonetheless, we enthusiastically gave the presentation to the women, knowing that if only one person listened and decided it was important to get HPV testing, our work would not be in vain. At the end of the presentation as we were answering questions, a woman asked us if we would be willing to come back on Monday to give the same presentation to a larger group of people. She promised that she would make sure that other women would come. Delighted, I accepted.

It turns out, while I was enjoying a bit of rest and relaxation this weekend, these 6 women were hard at work convincing their friends to come and hear a presentation about cervical cancer. This Monday, we were able to give an hour and a half long presentation to 30 women who make up two progressive women’s groups in the rural village of Fondwa.

Preparing the Presentation
It’s exciting to experience the fruits of your labor—to present a finished product and observe the impact it has on a community. Just a couple of months ago, we had an idea, a vision of conveying knowledge of HPV and cervical cancer to the women in Leogane in a unique way. Like any journey, this process has been filled with challenging obstacles and unpredictable circumstances, but rewards those willing to see the whole project through. This presentation felt like a culmination of our work in Leogane.

After explaining that cervical cancer is caused by HPV, which is transmitted through sexual contact, we proceeded to inform the women how to reduce their risk of contracting the cancer by using condoms and remaining faithful to one partner. We also emphasized that the cancer is preventable, thus the importance of getting regular pap tests.
After our presentation, we entered into a discussion and fielded a couple dozen insightful questions. The atmosphere was lively as women began answering other people’s questions and came up with questions of their own.

Wilkins, my good friend/cultural ambassador/mentor/translator has a unique way of making woman feel comfortable and at ease. I admire his soft-spoken, compassionate personality. This is reason why the woman were open, honest and vulnerable, telling us of their personal issues such as the fear of using condoms, fear of husbands not being faithful, fear of contracting vaginal infections. Their vulnerability and confidence in asking questions allowed us to challenge several of the common misconceptions that women hold about cervical cancer.

For example, many women that we have talked to actually think that condoms spread disease, or men are unable transmit HPV. By graciously challenging these beliefs, we were able to convey important information about HPV and cervical cancer. After we discussed for a while, we showed the video. The women were captivated by the video and very thankful for the valuable information as they gave us a round of applause.

After giving the presentation, I talked to the leader of one of the women’s groups for a bit. She assured me that the message was conveyed, that the women were very grateful for this opportunity so much so that they would like for us to come again.

Next Steps Before We Leave
            On Wednesday, we are traveling to Petit Goave to give three presentations, one to a church, and two others to a couple of hospitals there. On Thursday I am teaming up with the nursing students to give one final presentation to a group of women at the local village.

As I wrap up my time here I am left with an appreciative heart of what the Haitian’s have given me – a taste of their simple culture, deep relationships, and a new way of viewing global health.

Dr. David Walmer visits with the Cervical Cancer Education Team at the end of their stay in Haiti. Below - Duke Engage/FHM coordinator Hannah Meador, student Juyon Kang, translator Wilkens Oscar, Dr. Walmer, and student Laura Ferraro.