Thursday, March 25, 2010

Huffington Post

Hi out there,

Check out The Huffington Post's new blogger!

Mine is the one directly above Sienna Miller's post...

Friday, March 19, 2010

Another Airlift

Every so often something happens down here that makes you think that some of the coordination effort between the UN, aid organizations, and the government is actually working. The UN has the tremendously difficult task of trying to coordinate and oversee the over 900 foreign NGOs in the area to avoid duplication and ensure that everyone in the earthquake-affected area is receiving aid. As you can imagine, this often looks a lot like herding cats (or maybe even wind).

NGOs are autonomous agencies and have their own ideas on what they want to accomplish and how they want to accomplish it. However, one of the bright spots in this whole effort is the UN logistics cluster that provides supply-chain and transportation support to groups like us who are providing essential medicines and supplies to hospitals and clinics so that patients can receive the kind of care they deserve.

Like many other organizations currently working in Haiti, we are primarily focused on distributing these medical supplies to the earthquake affected areas of Port au Prince and Leogane. However, medical facilities all over the country are now over-burdened by the thousands of Haitians who have relocated from these areas to go live with family and friends.

The effects on the outlying health facilities are intense. They are receiving additional patients into their already tenuous medical system (511,405 people as of February 17th) but generally not receiving any of the aid that the hospitals in affected areas are. Indeed, after meeting with the WHO last week I found out that they too are focusing their medical relief efforts specifically in these few cities.

So we have made a concerted effort to try and get medical relief supplies to hospitals and clinics distributed throughout the rest of the country. However as anyone who has been to Haiti can attest, the roads are in tough shape and the traffic within Port au Prince can turn a one kilometer drive into a two hour sweaty standstill. So when we heard that the UN was offering helicopters to move humanitarian cargo to areas that could not easily be reached by roads, and that the service was actually being underutilized, we thought it was too good to be true.

So after receiving a request of medicine from an organization called the Haiti Hospital Appeal, who are supporting the influx of patients (many of whom are amputees and quadriplegics who have come off the USS Comfort) at the Baptist hospital in Cap Morin, we loaded up a truck with two tons of antibiotics, oral rehydration, and pain medication for children and brought them to the UN airfield to fill up the Mi-8 chopper. The entire flight and unloading time was only two hours (as compared to the roughly 20 it would have taken by road) and before we knew it we were back at the airfield and they were packing it up for the next trip.

After spending six weeks down in Haiti, I’ve realized the most important part of effective aid delivery is planning and coordination. Planning your route so you don’t sit in the traffic. Planning what services you are going to provide so you don’t dump any useless items on the recipients. Coordinating your efforts with other NGOs to ensure that all the facilities here are being looked after. And in this case, utilizing the coordination efforts of others so that the support for Haitian people can stretch far and wide.

Wednesday, March 17, 2010

Support for the locals...

I've been thinking a lot lately about the money that's been pouring into aid groups to support the people in Haiti. Almost 1 billion has been raised in the US alone by private charities. Of course, it's not yet close to the 14 billion the government says it's going to take to rebuild, but it's pretty damn good.

However, as I've mentioned before, I wonder how much of that money will actually be seen or directly contribute to the well-being of the Haitian people? I've read that groups who receive money from USAID to assist in the recovery effort only have to spend 30% of that money within the country they are assisting. The rest can be spent on hiring staff, procuring (American made) equipment, and whatever else they choose to spend it on really. So that's why I'm really glad to be doing the kind of work we are doing here.

Today for example, Scott (a new DRI-Haiti staff member) and I filled up Pino's truck with pallets of medical supplies for four hospitals around Port au Prince. Not only are all of these hospitals providing free services to every patient who comes in, but they are all completely run by Haitian doctors, nurses, and administrators. While they are all currently receiving support from overseas medical personnel, the fact that they have been around since before the quake means that they are not going to be gone in a few weeks or months down the line. And that means that the medical supplies we are providing them directly support their infrastructure and long-term capabilities because they can take the money away from buying costly medicines and use it to rebuild their hospitals.

One of the hospitals we went to today was Grace Children's Hospital. They are a non-profit hospital that before the earthquake was providing free treatment and medications for children with HIV and TB. Before the quake, they had a multi-story facility with multiple wards but now that the their hospital is destroyed the children who stayed there are now sleeping in tents outside. And at this moment, it's pouring down rain. When we went to drop off the medicines today, the medical director thanked us profusely for the supplies, but then proceeded to ask us if we could provide any money so they could start to rebuild the facility and continue to run their generator. Since their is no electricity in PaP without one, it essentially means they need money to keep the hospital open.

And this brings me to the other aspect of our work down here. Direct Relief has decided to fund locally-run organizations so that we can ensure at least some of the money raised for Haitian people is actually getting to them. After hearing this request from the director, I knew exactly why a fund like this is so important. Even if groups like DRI provide them with free medicines and other groups provide them with medical personnel, they cannot continue to run their hospital without raising the money to pay staff, buy diesel fuel, or repair the buildings.

Likewise, yesterday Brett and I met with a woman named Nadege (who is actually a professor at UCSB and was born in Haiti) and her father to discuss the possibility of providing funding for him to rebuild his library and community center in Carrefour-feuilles, a city just outside of PaP. This library served a population of 250,000 people and provided parents with a safe place to send their kids where they could use computers, go swimming, or read one of the 8,000 books from the collection. The library was completely destroyed as a result of the quake so they basically need to start over from scratch.

And while we were there, another group came in to request that we fund them to provide food for the 16,000 residents of this city who haven't gotten any support from any other organizations since the quake. This group had spent the last two months canvassing the city to ascertain who had perished in the quake, what families had moved, and what the immediate needs for people were. Unfortunately, once they had completed the survey, they had no funding to provide the most destitute of these people the food, water, shelter, and medical attention that they so need.

I think we all have to remember that the money raised to help the people of Haiti should go to the people of Haiti. Clearly not every penny is able to make it down here, but I think too often we get bogged down with doing what we think the people need and don't usually take the time to ask them. Or provide them with the resources to do it for themselves.

Monday, March 15, 2010

Highs and Lows, Strikes and Gutters

I've noticed lately that my outlook on things here change by the minute. Every time I think things are going well and some positive may eventually come out of this tragedy, something brings me back down to earth.

A few examples...

On Friday we spent the whole day in the warehouse distributing medicines and supplies to the various hospitals and clinics who we are now working with. Everything they received was specifically requested and can be used to treat the patients in their facilities no matter what their capacities are. These partners vary in the services they provide (one group of doctors from the Tzu Chi Foundation are doing acupuncture in a displaced persons camp) and the numbers of patients they see, but they are all providing their services and the medicines for free. One of these groups was telling us that they are going to ship in these pre-fabricated houses and set them up in a camp so that people will eventually be able to get out of these tent and tarp shelters. People seemed to be doing really good work and at the end of the day, we felt like we had done something to improve the health care of the people being treated by these types of groups. The outlook seemed bright.

Later that night however, we had a long talk with Pino, the owner of the water purification and bottling factory that our warehouse is located in. He has crews in here 24 hours a day, every day except Sunday, making over 10,000 bags of drinking water a day. And in doing so, he directly employs thousands of people. And I had never seen Pino get angry until he heard that overseas groups were going to ship in and build houses for the people in Haiti. What Haiti needs, he said, are jobs. And industry. And investment. And infrastructure. People need to work and they don't need houses built for them. He said when he opened the factory, he had 10,000 people lined up for a job and at the time, only had 500 available.

Hearing this makes me think of the old "give a man a fish" saying. So far, the international community has raised almost $2 billion for Haiti and with that, the immediate needs of shelter, water, food, health, and sanitation are being addressed as best as anyone could have hoped for. But you can see the picture of Haiti in a year from now. That money will be gone and there won't be any more opportunities than there are now except for the few who still have jobs working for the remaining NGOs. If even a fraction of the money raised was spent just to improve the roads (an obviously unglamorous proposition for how to spend aid money) it might be possible for some industry and trade to develop. So needless to say, after the talk with Pino, depression set in...

But alas, today was a new day and we were able to load up a truck with 12 pallets of supplies (mostly Pedialyte for kits who need fluids replaced) to the Petionville Country Club--former golf course and current site of the largest tent city (70,000 people at last count) in PaP. The four medical clinics inside the city see an average of 3,000 patients per day and just as we were walking into one today a baby was being delivered and was eventually named after Alison, the American nurse who delivered her.

When it came time to unload the truck, since there was no forklift we rounded up a team of about 30 people to bucket brigade the supplies into the storage tent. In the line with us, was a guy from the Center for Disease Control who has been studying the health infrastructure in Haiti since April and has now been tasked to study the possibilities for outbreaks in these camps. He said that because of the unsanitary conditions in the camps, they are predicting huge problems of diarrhea and dehydration and the Pedialyte we were unloading would literally serve to "quell the outbreak." It made unloading this truck for four hours in the 90-something degree heat feel pretty good. And afterwords, Sean Penn thanked us for what we are doing because his group is the one running all the medical tents in the city!

But then, just as we were on a high from the day, on the way home we saw a relief truck in front of us carrying boxes of food get hijacked. Basically, a few guys jumped into the back of the truck, opened up the gate, and just started throwing all the boxes out to their buddies waiting on the street. The driver was in the tractor part of the truck and had no idea what was going on. I guess as long as the food is getting to the people it's not a big deal but unfortunately this will probably get sold.

We'll see what happens next...

Thursday, March 11, 2010

Deliveries Begin Again

Hey out there. I have a couple pieces of great news to report.

First, my colleague and good friend Brett came down on Tuesday morning so I'm not flying solo here anymore. I have to say however, that while it's great to have him back, it actually wasn't bad being here alone since I was rarely truly alone. Most days I spent at least 17 hours (or what felt like it) in the car with my boy Pascal (see him and I below at this amazing beach in Jacmel on our Sunday beach day) and the rest of the time I was in meetings, visiting hospitals, or spending time with the doctors in the house. But either way, it's great to have Brett back down here.
The other great news is that we got our own little office and apartment set-up above our warehouse. Now we have a place to work from, we can be here when people come to pick up products, and we have a place to stay that is already set-up whenever we come down. And it's actually turning into a real-life apartment. When we first came in it was totally barren because they had just finished building it when the earthquake hit. But on Tuesday they put in the shower, yesterday we got the stove hooked up, and today we even got a kitchen sink installed! And because this place is actually a water factory, I'm convinced that we have the best bathroom/water pressure in all of Haiti.

And yesterday, after a couple small customs issues, we collected the shipment of 53 pallets from the airport and delivered them securely into our warehouse. (All the cuts are from customs officers inspecting the products to make sure we're actually sending medicines). After spending time today organizing and inventorying the products, we sent out a list of what we have here to the over 30 new hospitals and clinics that we've identified and have already received requests for all of it! These items include everything from standard painkillers, to asthma medicines, to antibiotics, and re-hydration formula for babies.

Tomorrow we'll spend the day distributing these products to the partners and will hopefully collect more info on their specific needs. For example, one of our largest new partners is a group called the Jenkins/Penn Haiti Relief Organization (as in Sean Penn) and they are running the largest tent city in Port-au-Prince where roughly 80,000 people are people living, bathing, receiving medical attention, going to school, and trying to make a new life. Our plan is to continue to support them in the future with hygiene kits that contain basic items like toothpaste, soap, and diapers that are so desperately needed in these camp settings where sanitation and hygiene remain one of the highest priorities.

Tuesday, March 9, 2010

Finding the Cure for What Ails You

A few people have written to me asking about my mental and psychological well-being after seeing the devastation and spending so much time in hospitals here. First, let me say thank you for thinking about that aspect in all this. And second, the only word I can really think of to describe the way I feel every day is overwhelmed; and that doesn't even really do it justice.

But I think those who had been to Haiti before the earthquake would say the same thing. Life here in general, is overwhelming. The anger over government corruption and ineptitude, the absolute poverty (especially on an island where the other half is doing just fine), the crowds, the noise, the constant feeling of claustrophobia, the crappy roads that turn what should be an hour drive into a five hour drive, the number of kids begging on the streets, the lack of any kind of infrastructure to create schools or hospitals, and the general feeling of hopelessness that things will get better soon; it's all overwhelming. And then the earthquake hit.

It's typical to hear stories from people who were walking through the streets minutes after the quake hit and could hear people yelling from underneath the rubble and were not able to do anything about it. Parents with their kids underneath. Brothers with their sisters. And students with their classmates. The far too casual manner in which these stories are told make you think that these people have not fully processed what has happened and I know for sure that there aren't enough therapists in Haiti (read: zero) to deal with these long-term mental health issues.

As for me, I have no doubt that some of these things will stay with me for the long-term, but in hopes of gleaning something positive out it, I'd say that it will help me keep perspective in life. For the time being, the thing that's been beneficial for my own mental health has been staying in this house with people who are working in a medical clinic down here. We are all seeing things that don't leave you very easily and it's been great to come back from the day and discuss the things we went through that day.

That, and the fact that last night a new person came down with a two-day old Dashound/Yorkie puppy and after spending some time with that little guy I was ready to go out and fight the world again. I think you just need to figure out your own cure and last night, this was mine.

Monday, March 8, 2010

You Tube Video

Just noticed a video has been posted on Direct Relief's You Tube page of me updating the situation on the ground. We recorded this when I was back home after the first trip.

Watch it here on: You Tube

Sunday, March 7, 2010

Hello out there?

So I have this Google Tracker device telling me that I have a fair number of people out there in multiple different countries reading this blog. I keep telling myself there must be a glitch, but if not, two things come to mind:
1. I'm stressed to know that there are people out there actually looking at this thing
2. Where are all the questions and comments from the readers? Am I answering everything you want to know about Haiti? I must not be.

So please feel free to write in and ask a question, let me know something you want to hear about, or just tell me a funny story so I can have a laugh when I come home at the end of the day. I'd love to hear from you and I hope you'll continue to follow along with the story.


Saturday, March 6, 2010

Just when I thought I was doing pretty good work...

I'm spending the weekend down in Jacmel; a large city in the south coast that was severely affected by the earthquake. It is the largest city in the region and in the past has served as one of the (few) tourist destinations in the country. The town reminds of me New Orleans or Puerto Rico. It has narrow streets lined with high-walled houses and balconies where people can drink local rum and survey the goings-on in the town below. And the beaches that run along the south coast of the city are as clear and blue as anywhere you'd see in the world.

We have been working on a plan with a few other organizations to start up a medical depot here so that all the medical facilities in the area (from east to the ocean and west t0 the border of the Dominican Republic) could access the medicines and supplies they need. We had a great meeting yesterday with all the organizations involved and I really think that we might be able to supply the medical needs of entire the region. Already, our medicines are reaching over five major hospitals and over 30 clinics and dispensaries in the region.

Today I went to visit some of these sites and became even more pumped about the plan. We first stopped by Bumi Sehat; an organization of nurse midwives from the States who are setting up a birthing clinic in Jacmel that will serve as the only free birthing clinic in the area. (This picture is me with one of the local workers helping to set-up their clinic on newly acquired land.)

Then I went by two of the largest hospitals in the region who have also accessed the medicines in the depot. Being a Saturday, many of the doctors were not around (7th Day Adventists are big in the area) but we were able to see the facilities and the numerous patients staying in tents outside the buildings. As I have mentioned earlier, in addition to the fact that Haitians are extremely scared of earthquakes, the government is also telling people not to sleep indoors so even structures that remain intact after the quake are not being utilized. For example, I'm currently staying in a guesthouse with a few other aid workers and when I asked my driver Pascal to sleep inside the house, he politely refused saying that he's too afraid to sleep under the concrete.

So anyway, I was feeling pretty good about the way things were progressing down here and, given that it was about 5pm on a Saturday, I felt like I might be ready to stop working for the day and have a beer. So me and by buddy Ceasar, another guy I recently met who is working with us on the depot, decided to swing by and pick up his friend Sarah Wallace and go have a beer at a local spot. Since the local beer factory, Prestige, collapsed in the earthquake, you can only find foreign imports now but I was lucky enough to stumble upon a place that was fully stocked with icy-cold Guinness!

As it turned out, Sarah (listed here between Scott Brown, Barack Obama, and Tim Tebow on CNN's most intriguing people for January 2010) is a 24 year-old Canadian midwife who moved down here 18 months ago to start an orphanage completely on her own. After realizing that many of the kids in orphanages down here actually have parents who just can't take care of them, she decided to change courses and open a birthing clinic for pregnant mothers so she could help reduce maternal/infant mortality and educate the moms about the need to keep birth rates in Haiti low. (She's pictured below with two of the kids she's birthed and subsequently named.)

After already being completely blown away by the work she was doing, on the way home we stopped by her house that she has been living in for over a year and saw that she's surviving on $200USD per month in a house with no electricity or running water. Being the founder and CEO of her organization, she decided on her rate of pay and is using these funds to pay local staff as well!

And to top it off, she has begun making micro-loans to local folks who need some money to start a small business of their own. To my great pleasure, the first guy she funded is a sandal maker. After hearing this, I immediately asked to meet this sandal-smith and asked if he would possibly be willing to make a sandal for my (size 16) foot. He said he would gladly do it, but he would need to buy extra material a new wooden mold because he didn't have any that would work for my foot. Sarah tried to convince him that he might not be able to find a mold my size in Haiti and that he might have to just measure my foot free-hand. He eventually relented and measured my foot on a large piece of cardboard (to the great amusement of his parents, sisters, cousins, and children) and agreed to have my new sandals completed within two weeks. I have no idea what they are going to look like, what the price will be, or if they will fit without the mold to guide him, but I'm pretty excited to find out!

Thursday, March 4, 2010

Thoughts on past few days

I think taking a week off to get out of Haiti was a good idea. Without knowing it, I had started to get used to things down here and accepted things that I saw as normal when they really shouldn't be.

Buildings (this one being a school) should not look like this.

People shouldn't be living in the center divider of a major highway in 'houses' like these.

And you should definitely not have to wait in a line like this to see a doctor.

I think that certain things have become accepted here and the problem is so huge that it's hard to focus on anything more than tomorrow. There are naturally so many immediate concerns (food, water, health care, temporary shelter) so the larger issues that have been plaguing the country for years (government corruption, unemployment, lack of infrastructure) are naturally falling by the wayside.

What concerns me is that most of the groups that I got used to seeing during my last three weeks here have now gone home. There was a huge international presence initially and that was incredibly refreshing. But there are very few left. And that leaves the prospects for rebuilding this country and addressing the long-term problems seem incredibly slim.

Today I visited two completely different types of medical facilities but the great thing about both of them is that they are committed to staying in Haiti and figuring out a way to treat the people for the long term. Since the earthquake, Partners in Health (a group started by a Harvard Doctor named Paul Farmer in the 80's) have set up four 'mobile clinics' in different tent cities around PaP. These clinics are set-up in very rough conditions and they are essentially operating out of tents (I was reminded of M.A.S.H) in large fields without any running water, medical equipment aside from stethescopes and blood pressure cuffs, or computerized record system. But they services they provide are absolutely essential. They are doing everything from re hydrating kids to treating STDs to testing pregnant moms for HIV. All of this out of a small army tent. (Incidentally, many of the supplies and medicines they are using to do this came from Direct Relief).

From there I went to the University of Miami field hospital that is set-up in four gigantic tents on the airport grounds. While they are also operating out of tents, they have the most state of the art hospital I've ever seen in a field setting. They have everything from surgical theaters (they have operated and amputated roughly 1,000 people) to a neonatal ICU which held the smallest babies you've ever seen. That being said, this is still Haiti, a country without a single incinerator, so all the hospital waste (think about it) is all dumped 1oo yards away under a mango tree. Yikes.

But at least they're staying...

Monday, March 1, 2010

Back to Haiti for Phase Two

Hey People,
So we've all had a week off. Me from living in Port-au-Prince and you from my incessant blogging. But now I'm back and I hope you'll continue to join me.

I'm kind of thinking as these next three weeks as Phase 2 of the operation. Last time down we did basically what we wanted to do in a hurried frenzy. We got ourselves linked in with the UN, got a warehouse, distributed the first wave of supplies to the roughly 25 new hospitals and clinics we met, and got started thinking about our long-term strategy. Essentially though, we were running around with our heads cut off for 3 weeks trying to get the products out as quickly as possible and didn't have much time for reflection or long-term planning.

This time around I'm hoping to have some time to get out of Port-au-Prince to potentially assist some of the large hospitals around the country that have been inundated with patients who fled from PaP. I'd like to head out on Thursday to visit some of Partner in Health's facilities in and around the central plateau and then head east to visit a hospital called St. Bonifice who are receiving a great deal of post-op patients coming off the USS Comfort (the Navy ship off the coast where they are bringing people who need major operations). From there, I hope to head north, possibly up to Cap Haitian on the far north coast to see some large hospitals in that area. Me and my driver Pascal will bring a tent and some food and have our own little road-trip.

I'm also going to try to connect up with other non-profit groups who are working to provide shelter and water to all the people living in these tent cities all over the capital city. Direct Relief has received a great deal of products like: toothpaste, soap, shampoo, lotion, diapers, sheets, and towels and these items would be perfect for distribution within these camps to people who are literally without any possessions besides their clothes on their backs and tarps over their heads. So we may look to work with groups like Oxfam and Save the Children if to see if we can't assemble and distribute these personal hygiene kits to the hundreds of thousands of people who need these items.

And finally, we've been invited by the government to be a part of their working group to create a strategy for caring for the handicapped and disabled. There were already a large number of handicapped people in Haiti and the earthquake has made amputees out of countless more. This New York Times article spells out the dire situation for these individuals. It is a great honor that they invited us to play a role in the five-year plan and I'm going to represent us at these meetings in the upcoming weeks.

After spending an amazing week back in California splitting time between Tahoe, Sacramento, Santa Barbara, and Ojai, I can't say it's good to be back in Haiti but I'm not bummed about it either. Between the guys at the warehouse, the new office and apartment we are setting up, the house I'm staying at (and the food the women here cook), my awesome driver Pascual, and the variety of interesting people I'm meeting, I'd say that overall it's not that uncomfortable. Of course, every day you get gigantic pangs of sadness and guilt for the absolute poverty and dire conditions that you see. The kids are the hardest to deal with but today I saw a woman on the sidewalk trying to sell her few pieces of fruit and she had her head buried in her arms and you could just understand the hopelessness she was feeling. And when she looked straight at me and held out both her arms with her palms upturned it was all I could do to not give her all that I had on me.

But every so often you feel great about the work people are doing down here and feel hopeful that the conditions might improve. I was looking back at my pictures from last time and remembered this school that had been set up right in the middle of this gigantic tent city. All the kids were uniformed and smiling and there was a huge line of parents trying to sign their kids up. It wasn't much, but it was clearly a beginning.