Helping in Haiti: Avera nurse practitioner offers medical assistance in island nation
WORTHINGTON -- For Greta Martin, traveling to Haiti this past September was an experience she can’t wait to repeat next spring.
She has just one regret. After what transpired in that nation shortly after she left, she only wishes she could have stayed longer.
Martin, a family nurse practitioner with Avera Medical Group Worthington, helped provide medical care in Haiti during her eight-day visit. She arrived in Port-au-Prince, the capital, on Sept. 17 and returned Sept. 24.
“Avera sponsors a trip to Haiti twice a year normally,” Martin explained Thursday. “This is part of Avera’s mission, and they have been involved in Haiti since 2002. Avera also donates medical equipment, medicine and supplies. The organization that’s behind Le Gatineau Clinic is Friends for Health in Haiti. Catherine Wolf, M.D. founded the non-profit organization, which has helped raise funds to build the new clinic, supply it and pay staff salaries.
Dr. Wolf, first traveled to Haiti as part of a Christian ministry group in the 1980’s, Martin said. She received her medical degree in the U.S.with the intention of ultimately opening a clinic in Haiti. Between her first visit in the 80’s and 2002 she returned numerous times for short periods to provide health care and to begin executing her plan to build a permanent clinic in Haiti. She has lived there permanently since 2002.
On her first visit there, Dr. Wolf met native Haitian Cherlie Severe, RN. Cherlie, as everyone calls her, shared Dr. Wolf’s dream.
“They made the perfect team,” Martin said. “Dr. Wolf had the ability to raise funds in the U.S., while Ms. Severe, a native of Jeremie, had immediate credibility with residents. Also, Ms. Severe owned land in the mountains south southeast of Jeremie. One of the two buildings on the land became the first clinic.
Both have been in Haiti permanently since 2002.Time at the clinic
The clinic, known locally as The Centre de Sante de Gatineau, was completed in 2014, and that’s where Martin spent the bulk of her time during her September visit. It’s location isn’t exactly in the most urban of environments.
“The clinic is up in the mountains and located about 16 miles from Jeremie (a city of about 35,000 people), Martin said. “From there, you’re driving through ruts and ravines and over small boulders. … If you ask Dr. Wolf, she’ll say the clinic is only about an hour’s drive from Jeremie. It took us an hour and a half to two hours to make the drive!”
Martin was part of an Avera contingent that made the trip to Haiti. She was visiting the country for the first time.
“The group that went this time included two nurse practitioners, two ultrasound techs, an ER nurse, a respiratory therapist and two guys for ‘general maintenance,’” she explained. Both of the guys offered more than general maintenance, with one being a computer wizard and the being an electrical wizard. “The group leader, Kathy English, RN, has been leading the Avera groups down there for the last 10 years or so. She did her very best to prepare the group for the culture shock.”
The visitors from America were certainly kept busy while there. Patients arrive early in the morning and sit in an orderly fashion on benches outside of the clinic, and are seen in order throughout the day. On the second day, Martin said, she and a nurse practitioner saw 79 patients.
“Every evening was spent counting and packaging medication,” Martin said, “One evening, four of us counted, packaged and labeled over 30,000 pills!
“Probably the most common complaint was back pain,” Martin went on. “The majority of the people walk everywhere, and the majority of the people do not have horses or donkeys, and if they do, they’re used to carry things, not to ride on. One commonly sees residents, men and women, carrying large sacks of grain, flour and rice or large plastic gasoline containers filled with water on their heads. Adults balance five gallons on their heads; children balance two- and three-gallon containers.”
In Jeremie, most get water from a business-controlled spigot. Outside Jeremie one goes to the nearest river, stream or pond. Except for the affluent, there is no filtered, safe running water in the home. Those who have it get it via a personal well and their own water filtration system.
High blood pressure was also a commonality seen by Martin during her visit. High cholesterol, though, wasn’t an issue, though, as Haitians are typically limited to a subsistence diet. Breadfruit is abundant and provides a sense of fullness. Unfortunately, breadfruit has no nutritional value at all.
“With patients seen only once a year or who are brand new to the clinic, we automatically treat for intestinal worms -- that’s because of the water they drink,” added Martin. Martin was always accompanied by a translator in the clinic because French-Creole is the native language.
Martin and her fellow medical professionals were lodged in multiple places during their time in Haiti. The clinic complex has two buildings, with one structure serving as the clinic and housing an urgent care room, a room for pelvic exams, two “regular exam” rooms, a business office and a medical records room. The second building has an X-Ray department, lab and pharmacy, as well as second-floor bedrooms in which they stayed for three or four nights. Other nights were spent in Jeremie, at Wolf’s home..Life in Haiti, and the hurricane
While much of the time was spent at the clinic, Martin said she was also to observe how much different life in Jeremie -- which has nearly three times as many people living in it as Worthington -- is than here.
“The country of Haiti has rolling electricity. It is typically available only 6-8 hours a day,” she detailed. “In Jeremie, during the day, stores and businesses housed in big Colonial-age buildings all function in the semi-dark. Hospital Antoine in Jeremie suffers with similar restrictions, though it does have a gasoline generator to augment services. Gasoline is very expensive, so even the generator is used sparingly.
“Hot water is non-existent, though with daytime temperatures between 95 and 105 degrees it was not missed,” Martin continued, “Paved roads between Port-au-Prince and Jeremie, a 140-mile distance, do not appear to have been repaired for decades. On a good day, the drive is eight hours, but that doubles depending on the time of day or day of the week. The hospital there was built in 1871 and there have been additions since, but there’s little money and it essentially runs with those same electricity restrictions. Once again, they have to conserve their use of electricity because it’s so costly.”
Hot water is non-existent and daytime temperatures hover between 90 and 100 degrees, accompanied by high humidity, Martin said. Mosquito repellant was a must, as malaria is prevalent there and the Zika virus in the emerging stage. Christian churches, meanwhile, were “packed to the gills” on Sunday, making driving even more time-consuming once services wrap up.
There was another component of Haitian life that Martin experienced during her visit that had to do with the nation’s political climate.
“National elections were scheduled to take place four days after we returned,” she said. “Because of the election, Haiti was completely incommunicado with the outside world. Politicians in Port-au-Prince managed to block internet and cell phone function throughout the country. Instead, trucks with bullhorns drove up and down the streets blaring out their political message.”
As a result of that environment, the Avera volunteers were completely unaware that a tropical storm was brewing.
“We were in Miami (on the way home) and I was reading in the paper that there was Hurricane Matthew was developing. It was anticipated that Haiti would suffer,” Martin said. “In fact, the eye of the storm did pass directly over. When the news posted photos of the devastation in Jeremie, I recognized streets and areas I’d been through.”
Martin wanted to go back, but between limitations on travel because of dangerous landing conditions and her inability to speak Hatian Creole, she opted to remain in the U.S.
While it was “heartbreaking” to not go back, Martin plans to return with another Avera group in March -- led once again by English, who has been to the country on many occasions..Planning a return
“I would like to make this a regular part of my life,” she said. “I am not going to intrude myself. … Dr. Wolf does have other groups that come down, and there are times when she has things to attend to where she doesn’t need someone like me there. I would not have gone if I felt that what we were doing wasn’t making a difference. Avera views this as a mission.”
Martin was particularly taken with the people of Haiti and how they hold their heads high in the wake of all the struggles they regularly face.
“I’ve been to Mexico a number of times, I’ve been to Guatemala for an extended period, I’ve been to Peru -- mostly in the mountains -- for an extended period of time. I’ve been to Egypt twice, and have been to China … as well as Palestine and Israel. The point is, I was not surprised by the poverty. But I have never encountered people, who despite their poverty, are at once so dignified and so stoic despite their hardships.”