Update: HTRIP & Hurricanes

For HAS' service area in the upper communes of the Artibonite Valley, hurricanes most often mean a lot of rain, and this was indeed the case with Tomas, which hit Haiti last weekend. Although Dechapelles did not face the same high winds and destructive storm surge as did the South, our region sustained heavy rainfall, which threatens infrastructure, the environment, and public health. In brief, this kind of heavy rain can cause flash flooding that washes out roads and overburdens dams; it washes barren hillsides down to bedrock, and there have been speculations (as of this entry unsubstantiated, fortunately), that the overflowing of public water sources could prompt a worsening of the recent cholera outbreak.

The mountainous areas where HTRIP is working are particularly susceptible to the immediate and long-term effects of heavy rainfall. With Haiti's current environmental situation at crisis point (98% deforested), there is little forest cover to encourage seepage into steep, denuded hillsides, and valuable topsoil is washed into ravines on its way to the Artibonite River and, eventually, the Caribbean. Our organization’s mission is to plant trees to improve agricultural practices and livelihoods in the mountain communities in HAS' catchment area while fighting environmental degradation. Tree roots are deeper and more extensive than those of annual crops like maize and sorghum, so they are an excellent vehicle for soil retention and rainwater absorption—although HTRIP has previously collaborated on larger anti-erosion projects like the water catchment basins and "ravine correction" walls constructed last summer, planting trees is one of the most basic watershed management strategies available to fight the effects of the heavy rain that comes with a hurricane... and we and our partner communities do a lot of it. A storm like Tomas, simply put, reaffirms the importance of the work we do.

HTRIP's Approach to Reforestation in Haiti

By Dan Langfitt & Ruth Portnoff

Nowhere is the connection between environmental degradation and chronic poverty more clear than in Haiti: centuries of exploitation and political and economic instability transformed the sixteenth-century's "Pearl of the Antilles" into the crumpled landscape of barren mountainsides where families struggle to eke out a living today. Just as overwhelming deforestation led to the soil deterioration that keeps so many Haitians in extreme poverty, impoverished Haitians often have no choice but to cut down trees for wood to cook their food, fueling a cycle of poverty and environmental degradation that is very difficult to break.

Reforestation belongs in any integrated development approach for Haiti. Simply repopulating forests that once existed (or survive only as remnants) would be an enormous boon to Haiti's primarily agricultural economy, restoring soil, increasing water infiltration, and reducing the damage of heavy rains to crop fields. The problem is developing a reforestation approach that can work in Haiti's particular socioeconomic situation. Even a balanced reforestation effort that plans a diversity of native tree species coupled with proper erosion control and watershed management techniques risks failure when desperate locals pasture theirgoats on fields of tree seedlings or cut down young trees for charcoal. Moreover, reforestation can be controversial: if planting trees on potential farmland in a country that suffers such acute malnutrition gives policy-makers qualms, it certainly proves a difficult case to make to the starving people themselves. For all of these reasons, HTRIP has chosen to embrace agroforestry, a land use system that mixes trees with crops for increased productivity and biodiversity.

Specifically, trees have extensive root systems that protect crops from Haiti's tempestuous rainy season. As a mountain farmer's tree plot matures, it becomes unable to sustain certain kinds of crops (like corn and millet), but HTRIP hopes to introduce higher-value shade crops (like yams and even coffee) as this happens. Meanwhile, fast-growing trees can be harvested for timber products that can dramatically increase family income (a single tree may be worth more than US $125, no small figure for a household living on $1/day). If farmers understand that trees are valuable from the beginning (routine pruning can yield substantial cooking fuel starting in the third year), they will keep the trees and "reforestation" will be successfulthanks to the benefits the farmer derives from practicing agroforestry. In HTRIPs model, agroforestry and reforestation are complementary goals.

Since HTRIP has only been working in the mountains of the Artibonite Valley since 2006(currently with forty-two communities and over two thousand farmers, each of whom boasts a tree plot of fifty to one hundred trees), the parcels planted with its program are not yet mature. When they are, HTRIP will be there to see that the trees are harvested and replanted sustainably, and then help market the timber products these parcels yield to ensure that the farmer gets the greatest possible value for his or her lumber.

We have found that some of the most enthusiastic community members working with HTRIP are often the youngest--these boys understand that the economic benefits this mahogany tree will eventually bring will have an impact on their generation.

Development organizations have planted hundreds of millions of trees in Haiti during the past fifty years, and yet over all tree cover still continues to decline (from about 10% in 1960 to less than 1% today). So far, reforestation efforts in Haiti have not overcome the obstacles that the country's society, environment, and history present. HTRIP approaches these challenges by using an agroforestry model designed to reduce poverty and malnutrition, and educate both literate and non-reading Haitians about the economic and environmental value of planting and protecting their trees.* The fact that they can help reforest Haiti in the process is the icing on the cake!






*P.S. HTRIP is unites agricultural education with literacy training--hitting two birds with one stone, so to speak.

Cholera in Haiti: A Message from Ian Rawson

"Last evening, the Center for Disease Control confirmed that the cases of diarrheal illness that HAS Haiti and other hospitals in the Artibonite region have been receiving have been identified as Cholera.

"HAS has instituted the World Health Organization Cholera treatment protocol, and redesigned the hospital's patient flow to keep the cholera patients in a separate area.

"All HAS staff have been provided with training on cholera and its effects, and its treatment.

"HAS remains in close contact with the CDC, whose efforts are now focused on localizing the source of the disease. A CDC team was at the hospital last night to study maps of the region and to review our patient data, especially the localities where the patients have been living during the previous week.

"Most patients appear to have contracted the disease from one or several sites at some distance from the hospital. We have received very few patients from the immediate area.

"Under the able direction of our newly-arived Medical Director, Dr. Silvia Ernst (who was formerly at the Schweitzer hospital in Lambarene), HAS has been able to manage the patient flow without undue stress. All of the staff have served long hours with great professionalism.
To a great extent, cholera is a nursing disease, requiring the establishment and maintenance of IV lines, education to the patients' families to remain hydrated, and the administration of antibiotics as appropriate. Most patients so far have been able to recuperate and return home within several days."

Ian Grant Rawson

Top Image: Dieu Nalio Chery/AP: "Cholera victims in Haiti receive treatment at the St. Nicholas hospital in Saint Marc, Haiti." Source: NPR.ORG
Bottom Image: Source: Doctorswithoutborders.org

Media Links:
ABC
BBC
CNN
Medcins Sans Frontiers
MSNBC
NPR
Salon.com

Courage for the Disabled at HAS Haiti: An audio slide show by Martha Rial

Click the image above to view the audio slideshow!
(FYI::Captions for the images are available by clicking on the word "captions"
in the lower right hand corner of the view box!)

Pulitzer prize-winning photojournalist, Martha Rial, journeyed to Haiti in the summer of 2010 to photograph our work at Hôpital Albert Schweitzer Haiti. This is the first of two audio slide shows that she compiled about two very exciting collaborations that are taking place at the hospital, one with the United Nations, and another with Hanger Orthopedic Group.

This particular video shows images of Haitians who have suffered the loss of a limb, whether as a result of the January 2010 earthquake, motor vehicle accident or illness. Hanger Orthopedic Group is working in collaboration with HAS's revolutionary rehabilitation program to fulfill two major needs in Haiti that were greatly escalated since the earthquake: jobs for unemployed or internally displaced Haitians, and new artificial limbs for amputees.

The young man whose voice is heard in the background of this video is singing a rap song that he wrote called "Kouraj pou handicape," or "Courage for the disabled."

Even before January's devastating earthquake, living with disability in Haiti was often synonymous with a loss of livelihood. Haitians with disabilities often live isolated existences, shut away from much of the outside world, and heavily reliant on friends and family to provide for them. For years now, HAS Haiti and the "Friends" have been trying to change this situation, by integrating rehabilitation services into their vision for improved health care in Haiti.

This new effort in collaboration with Hanger Group, however, brings wholly new meaning to the phrase, "Courage for the disabled." A picture, of course, is worth a thousand words.

Click here or on the photo above to view the audio slideshow.

H'Art Pictures Preview!

Check out some of the first photos from last Friday's ultra-successful H'Art & Soul of Haiti Gala! Thanks for all of you who supported this effort!

"Patients from the Hanger Clinic in Deschapelles, Haiti are the definition of resilience"

The following is a guest blog entry written by HVO Volunteer and physical therapist, Karen Helfrich, who just returned from a session at Hopital Albert Schweitzer Haiti and the new Hanger Clinic in Deschapelles.

Patients from the Hanger Clinic in Deschapelles, Haiti are the definition of resilience. Each person is there because somehow during the course of their life each one has lost part of a limb or multiple limbs from their body. Coming to the Hanger Clinic is a new beginning for each person. At the Clinic, the patients receive a new prosthetic limb of what they previously lost. Each patient has a story to tell, and each has left an impression on me that I will never forget.

We had a young woman come walking into the clinic on her knees with flip-flops protecting her knees from the ground. At the age of five she lost part of both of her legs because of an infection. Now, sixteen years later, she is standing up tall and walking. On the first day that she got her new legs, she spent time learning how to walk again on the parallel bars. Over a period of time, with much hard work and sweat, she said goodbye to those parallel bars and is now able to walk without any assistance. Every day she would come into the clinic and give me a hug around my waist because it was as high as she could reach. I had to return to the United States before she was finished with her therapy, but I hope that some day I can return to Haiti and get a hug from her as she is standing tall.

We had a five-year-old girl who brought laughter and excitement into the clinic. She too had lost one of her legs. She was not able to wear her new prosthetic leg yet, but would walk all around the clinic with her forearm crutches and her one leg. Her favorite pastime while at the clinic was to play soccer with anyone she could rope into it by batting her pretty little eyes, and smiling wide.

The patients all had one thing in common: the loss of a limb. This helped unite them.

As new patients were admitted, and other patients got ready to graduate from therapy, they each helped teach each other what they had previously learned in therapy. As patients were waiting for their therapy time, they wouldn't sit in the halls, but would rather be up walking around, practicing the stairs, and walking on the terrain.

They are all so strong. I worked for a week and a half straight before I had a patient tell me that they were tired and needed to rest. I must admit I was relieved when I heard this because I wasn't sure if I could continue much longer with the activity we were doing, myself!

I have learned so much from my patients by their courage, strength and resilience.

To see more of Karen's photos from her time in Haiti, visit our RTTP Flickr album here.

For more information about the Rehabilitation Technician Training Program, visit the Friends' Projects page here.

Way to go, Denise!

Denise English accepts the first Humanitarian Award from the University of Pittsburgh's School of Health and Rehabilitation Sciences, presented by Dr. Cliff Brubaker (left), dean of the school, and Dr. Kevin Conley, president ofthe SHRS Alumni Society.

Our very own Denise English was honored this week by her alma mater, the University of Pittsburgh. Denise was awarded the Humanitarian Award from the University’s School of Health and Rehabilitation Sciences (SHRS) on the occasion of the school’s 40^th anniversary.

Denise was the first alumna to receive this honor, which was created “to recognize those who are respected by their peers, recognized as leading experts, and are devoted to the promotion of human welfare.”

According to Dr. Clifford E. Brubaker, professor and dean, SHRS, “Mrs. English has gone beyond the call of duty in her humanitarian efforts related to providing rehabilitation training and therapies to the people of Haiti. Her work has spanned more than two decades and we are very proud of her dedication and commitment to others. We boldly count her among our most deserving alumni award recipients.”

The following statement was issued by the University of Pittsburgh on June 16th:

A 1973 graduate of SHRS’s Department of Physical Therapy, English has been the driving force behind the development of the Rehabilitation Technician Training Program at the Hôpital Albert Schweitzer in Deschapelles, Haiti. Having worked on development projects in that country since 1988, English realized the need for training programs that would develop local human resources and enable Haitian rehabilitation workers to serve in their communities. Once envisioned, she, along with a team of volunteer rehabilitation educators and clinicians from U.S. and Canadian universities, set about developing the curriculum and recruiting teachers. English and another instructor were providing student training in Haiti when the devastating earthquake rocked the island in January 2010. They continued the training and demonstrated hands-on skills as they assisted patients pouring into the area for care.

English is a volunteer professional with Health Volunteers Overseas (HVO), Haiti site, where she serves as program director. She also serves as co-coordinator on their Rehabilitation Curriculum Committee, helping to develop a rehabilitation aide curriculum that can be implemented in other underserved areas. English continues to provide PT services in the Pittsburgh area and is actively involved in the American Physical Therapy Association’s Health Policy Administration Section and the Cross Cultural and International Special Interest Group. She is a member of the Pennsylvania Physical Therapy Association (PPTA), the Haiti Solidarity Group of the Thomas Merton Center in Pittsburgh, and Health Volunteers Overseas/Physical Therapy Overseas, a board member of Friends of HAS Haiti, and is active in other Haiti-related organizations.