Haitian SOIL

The need for soil in Haiti is as great as perhaps anywhere in the world. Given its long history of deforestation caused by its people’s need to cut down trees for firewood, Haiti suffers from an epidemic of erosion. In 2006, Sasha Kramer and Sarah Brownell founded Sustainable Organic Integrated Livelihoods (SOIL, www.oursoil.org) in part to address this situation. SOIL is a non-profit organization whose mission is to protect the remaining Haitian soil, empower communities and transform wastes into resources. It is the transformation of wastes into resources, however, that provides the foundation on which SOIL’s mission is based.

Sasha Kramer

Initially located only in Cap Haitien and its surrounding communities, SOIL began by focusing on providing public ecological sanitation, or Ecosan, toilets that would drain urine, which is sterile, into the ground, while collecting feces to be composted. The decision to concentrate on public toilets was based on a desire to provide as much sanitation, as well as to produce as much compost, as quickly as possible. Initially, the members of the community where the toilets were located would maintain them, but a basic problem with this system soon manifested itself.

“It’s very difficult to make public toilets work, because people don’t want to clean up other people’s poop,” Sasha told me.

There was also a design flaw in the early toilets that exacerbated the situation. Originally, the toilets had large chambers that took six months or more to fill. When it came time to empty them, it turned out that the feces had not dried out as expected. So the community members emptying the toilets were essentially faced with the task of manhandling a huge vat of semi-liquid feces, clearly an unappealing proposition.

Nevertheless, in spite of these difficulties, SOIL proceeded to establish a pilot composting project in Limonade, near Cap Haitien. There, the human waste from the public Ecosan toilets, together with rum processing wastes, garden wastes and market scraps, are aerobically composted into a high quality agricultural fertilizer. Such naturally produced fertilizer could become a critical asset to Haitian farmers, given the generally poor quality of Haitian topsoil and the cost, more than most farmers can afford, of commercial fertilizers. However, first it must be shown to be safe and effective.

A Haitian SOIL employee checks the temperature of compost

A recent study by John Strutner of Notre Dame University found the SOIL compost to be free of fecal pathogens, including cholera, clearing the way for the compost to be tested on SOIL’s pilot garden in Shada. Even though Sasha is very encouraged by this result, further testing needs to be done before the compost can be put into widespread use. Meanwhile, after the January, 2010 earthquake, SOIL expanded its operations to Port-au-Prince, applying the lessons learned in Cap Haitien.

The first change SOIL made was to switch to smaller plastic drums to collect waste. This was followed by a change in the way SOIL manages its public toilets. Due to the logistics of the situation in Port-au-Prince, SOIL realized it would need to hire someone to maintain the toilets it installed in 23 tent camps and 8 schools around the city. While this is more efficient than having the communities maintain the toilets, funding is an issue.

It currently costs about one dollar per drum, or $300 a week, to collect the waste and transport it to the composting center not far from the U.S. Embassy. In the wake of the earthquake, SOIL has been able to acquire sufficient emergency funding to pay for the maintenance service. But with the earthquake now a year in the past, that funding is fading out and Sasha is investigating alternative strategies. One possibility, for the smaller camps at least, is communal toilets.

A Haitian SOIL employee carries plastic drums to be cleaned

These would be shared by four or five families, with each family having a key allowing access. SOIL would pick up and transport the drums, covering the cost out of its budget. While additional funding sources will eventually need to be found, the cost of maintaining the communal toilets should remain less than hiring someone to provide the service. Eventually, however, SOIL’s goal is to move away from public toilets.

“As an organization, we would like to move to household toilets,” Sasha told me.

Although the design has not yet been completed, what Sasha has in mind is basically a wood box that can somehow be sealed to contain odors, with two five gallon buckets, one for solid waste and one for urine. “It would be good if it looked like a piece of furniture, so it wouldn’t be obvious it was a toilet.”

These household toilets would be placed, at least initially, in urban slums. SOIL would probably start with Cite Soleil, in Port-au-Prince, where it already has a foothold with 19 toilets, although not of the household kind, and a pilot neighborhood composting project. The rationale for such a strategic shift has both a personal and a commercial aspect.

From a personal viewpoint, private toilets are more dignified. No one, or very few people anyway, enjoy being in a situation where friends and neighbors can watch one’s toilet going routine as a matter of course. Also, having a toilet inside one’s house conveys a certain social status that most people aspire to, and can therefore be a boon to a person’s self esteem. As can operating a small business, which is central to the commercial aspect of the rationale.

What Sasha envisions is a situation where, ultimately, members of the community start businesses to deal with all aspects of the process, from collecting the drums and delivering them to the local composting center, to composting the waste, to selling and delivering the compost to local farmers. “I’d like to eventually see a market chain develop.”

SOIL’s role in the development of this chain would be to lead each phase, facing its risks and problems first. “I’d want to see SOIL continue to pilot until all the initial mistakes have been made and the system is working.” Sasha’s dream is to ultimately be able to turn the entire enterprise over to Haitians.

Although she has no plans to move from Haiti, at that point she would basically shift to a consulting role. She would also have time to travel to other countries to spread SOIL’s message of sustainability. This is a long term goal, however. There is still much work to be done in Haiti, and Sasha remains in it for the duration.

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Megan Coffee, M.D.

Early on the afternoon of January 12, 2010, Dr. Megan Coffee, 33, was working at a computer on the University of California, Berkeley campus modeling the spread of infectious diseases, research she does for that university and the U. S. Veterans Administration. In the midst of her work, she received an email from a friend in Haiti before the news even broke, informing her that a huge earthquake had struck Port-au-Prince. An infectious disease Fellow at the University of San Francisco Medical School, Dr. Coffee had studied infectious disease in Haiti and intended to come to the country, using her saved vacation time, in May. The earthquake changed her plans.

Megan Coffee talks with a TB patient being sent home from the hospital.

Cat Laine, who works with the Appropriate Infrastructure Development Group (AIDG) (www.aidg.org) , an NGO in Haiti, contacted Dr. Coffee not long after the earthquake and asked her if she could come down to help with the infectious disease situation. Almost all of the local infectious disease specialists were missing for one reason or another, and very few foreign doctors with this specialty had come, as initially the need was for surgeons and other trauma care specialists. Dr. Coffee arrived in Haiti, via the Dominican Republic and bringing as much medication as she could manage, two weeks after the earthquake struck.

Once on the ground, Dr. Coffee was approached by a relative of a Haitian-American doctor and asked to work at the Hopital l’Universite d’Etat d’Haiti, the General Hospital in downtown Port-au-Prince. She met with one of the few Haitian infectious disease specialists remaining there and realized immediately that tuberculosis, TB, was the most significant infectious disease affecting the post-earthquake population. However, in many cases the TB was complicated by the patient also being HIV positive. Together with Mulhouse Charles, a Haitian nurse who recruited other nurses to come to work at the hospital, Dr. Coffee established an approach for addressing this dual threat.

“Actually, living and working in San Francisco was excellent training for Haiti. It’s probably the only place in the U.S. with a higher HIV infection rate, among men anyway, than here.”

Megan Coffee studies a TB patient's x-ray.

Due to their weakened immune systems, HIV positive individuals tend to get worse cases of TB than those who are HIV negative. They are also more likely to contract new strains of TB from other patients in the hospital. TB, for its part, further stresses the already weakened immune system, making the development of AIDS more likely. To break this vicious circle, Dr. Coffee decided to simply treat all HIV positive TB patients for both conditions.

HIV treatment has now developed to the point that a patient only requires one pill a day. For TB, the regime is a bit more onerous. TB treatment requires the patient, depending on weight, to take between two and five pills, each of which contains four medicines, each day. The patient should also take one multivitamin each day to prevent nerve damage that causes foot pain.

“People taking their meds makes a huge difference. It not only helps the individual, but reduces illness in the general population as well.”

The TB/HIV ward, a large tent on the grounds of the hospital, opened January 1, 2011. Dr. Coffee now has a staff of sixteen Haitian and one American nurses. She depends on a variety of NGO’s, International Medical Corps (www.internationalmedicalcorps.org), (See International Medical Corps), Partners in Health (PIH) (www.pih.org), (See Guerrier Carmen and Kerline Jean Louis, June, 2010) and Operation Blessing International (www.ob.org) among them, as well as the Haitian government and the kindness of strangers, to supply the means to continue her work.

A patient in the TB/HIV ward

“It’s amazing. People just show up with stuff. A woman came by the other day with a carload of diapers. I don’t question it.”

As for the future, Dr. Coffee plans to stay in Haiti at least until July. Her one year leave of absence from her UCSF infectious disease fellowship is up July 11. Nevertheless, she’s frankly undecided about what she will do. Obviously, it’s not easy to leave possibly the most rewarding job you’ll ever have.

Postscript

Using the phone number Brillant got from her sister Rosemante, International Medical Corps located the woman in the Acra Sur tent camp who had been wasting away from an undiagnosed illness for a year or more  (See Acra Sur Tent Camp).  An International Medical Corps team transported her to the Hopital l’Universite d’Etat d’Haiti (General Hospital), where Dr. Coffee examined her and determined that she is suffering from TB.  The woman is now receiving treatment at the hospital and her condition is improving.

To see more pictures, go to  www.vichinterlang.com.

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Eating Crow in Carrefour

When Brillant and I arrived at the Route des Rails median tent camp for the third time (See Route des Rails Median Tent Camp, Carrefour and Route des Rails Moving Day for accounts of our previous visits), it was immediately obvious that major changes had occurred, but whether for good or ill remained to be seen. Whereas before, there had been almost a solid row of tents running down the median for half a mile or so, now only a relatively few remained, separated by long stretches of empty ground littered with rubble and the detritus of the residents who had departed. The question was, where had they gone, and did they go willingly?

Empty median where tents once stood

We approached a couple of guys sitting in front of their still standing home and Brillant inquired. They responded that all of the residents who had left had moved to the new USAID and ACRA sponsored housing by the sea. There were still eleven families on the median, but they expected to move soon. Apparently, the residents’ fears, expressed to us on our last visit, that only ten families would be allowed to move and that everyone else would be evicted with no place to go, were unfounded. Given this, we set out for the new beachfront subdivision.

Out and about in the new neighborhood

As we entered, the roll of barbed wire that had blocked the entrance on our last visit now tossed aside, the first thing that caught my eye was a row of laundry hanging to dry off the back of an orange house. Once among the houses, we immediately saw people going about their lives, children playing, a young woman combing out another’s hair while a friend sat nearby with a tray full of candy, gum and cigarettes for sale, a man shining his shoes and people walking to and from their neighbors’ homes to visit. After a few minutes, one of the young men who had intercepted us summoned an official of some sort, who arrived shortly thereafter.

Once Brillant explained, yet again, who I am and what I was doing there, the supervisor escorted us through the neighborhood facilitating my asking questions and taking pictures. As we meandered along, we ran into a number of the same people we had met on the median. Without exception, they said that they were happy with their new homes, and indeed, it was obvious even without them saying anything. Their manner and activities clearly expressed their joy and excitement. The old woman I photographed in her home on the median with her grand-daughter beamed at us from her new doorway, before going inside to pose on her relocated bed.

Old woman in her new home

Because closing the wood door and windows the houses come with isn’t really a viable option due to the heat, everyone had hung curtains, usually white or pink, and sometimes a little sheer, to provide some privacy and decoration. Inside, peoples’ belongings, regardless of how many or few they possessed, were neatly arranged around the walls. We came upon one woman busily painting a metal frame that appeared to be intended to hold shelves as a string of laundry hung between two houses behind her. All in all, it was a beautiful day in the neighborhood, but not a perfect one.

Short term, the buildings that will house the toilets are still not completed, leaving the residents to continue to fend for themselves in this regard. Longer term, there are at least two matters that should be of serious concern. One is the question of what chemicals have leached from the adjacent refinery into the soil the houses are built on and the water that embraces that soil, and the effects those chemicals may have on the residents. And the second, and most obvious, is the question of what happens to these houses built at sea level when the next hurricane hits.

The foregoing notwithstanding, however, I must admit that my initial impression of the neighborhood, and of the local authorities, was unfairly critical. The Caribbean colored houses are a huge improvement over the Route des Rails tent camp. And the authorities do seem to intend to move, at their own pace, all of the residents of that camp to the new housing. Clearly, attempting to impose U.S. standards of health, safety and efficiency on Haiti is not only unrealistic, but unfair. Pass the crow.

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International Medical Corps

The International Medical Corps health clinic in the Tabarre tent camp on the outskirts of Port-au-Prince, a well developed camp on its way to being dominated by actual structures rather than tents, provides primary care to the camp residents, and anyone else who finds their way to it. According to Crystal Wells, International Medical Corp’s Communications Officer in Haiti, these primary health care clinics, there are two others in the Port-au-Prince area, one at the Petionville Club Camp, also known as JPHRO, or Sean Penn’s Camp, and another at St. Bernadette’s Church in Martissant, deal primarily with common Haitian health issues, such as malaria and diarrhea, as well as chronic issues like hypertension.

Initial patient waiting area

The clinics, staffed almost entirely by Haitians, also act as an entry point to the cholera treatment system. They are set up to diagnose the disease and immediately provide hydration fluids, in the form of an iv, if necessary, before transferring the patient to a site that can provide higher level care.

The local staffing is a hallmark of  International Medical Corps (www.internationalmedicalcorps.org), whose mission statement is “From Relief to Self-Reliance”. Dr. Robert Simon founded International Medical Corps in 1984 as a response to the destruction of Afghan medical care by the 1979 Soviet invasion. Having established medic training centers in Pakistan’s Northwest Frontier Province, International Medical Corps recruited Afghan medic trainees from the remotest areas of Afghanistan. After a nine month course of training, these medics then returned to their communities with a stock of equipment, supplies and medications to set up clinics. International Medical Corps has now established this model of self-reliant health care in more than fifty countries across the world.

A local International Medical Corps staff member checks a patient's blood pressure

The care procedure at the clinics is a well oiled machine. Patients, with the exception of emergency cases, are seen in the order of their arrival. Their first stop is with a nurse, who takes their blood pressure and temperature, weighs them and asks them why they have come to the clinic. Once the reason for the visit is established, the patient goes to a second waiting area consisting of a row of benches. The patient then waits their turn to get a vaccination, see a doctor, or see a mental health worker. The last stop is the pharmacy, where the patient picks up any drugs that have been prescribed. There is no charge for the care provided.

A local International Medical Corps staff member vaccinates a child

During the hour or so I spent at Tabarre, about 30 or 40 patients were in the process of being seen. A number of children received vaccinations. Two doctors each saw several patients reporting a variety of ailments. And there was one young woman who had given birth the previous day receiving fluids through an iv. A steady stream of patients also stopped at the pharmacy to pick up medicines.
One service I didn’t witness was International Medical Corp’s safe spaces for children tent, where teachers educate mothers and caretakers about the importance of play and affection in a child’s development. For that, I had to go to the Petionville Club Camp.

A local International Medical Corps staff member teaches parenting skills

The teacher sat at the far end of a large tent set up within the clinic building displaying a page on a flip-chart showing pictures of child, and parent-child, activities. With a very animated manner, she discussed the activities, among which were a child rolling a hoop with a stick and a mother teaching her child to walk, with the seven women and one man who, with their children, sat barefoot in a circle on the straw colored mat covering the floor. From time to time, a woman would ask a question and the teacher would enthusiastically respond, encouraging self-reliance beginning with the most fundamental of human relationships.

Postscript

Using the phone number Brillant got from her sister Rosemante, International Medical Corps located the woman in the Acra Sur tent camp who had been wasting away from an undiagnosed illness for a year or more  (See Acra Sur Tent Camp).  An International Medical Corps team transported her to the Hopital l’Universite d’Etat d’Haiti (General Hospital), where Dr. Megan Coffee examined her and determined that she is suffering from tuberculosis (TB) (See Megan Coffee, M.D.).  The woman is now receiving treatment at the hospital and her condition is improving.

To see more pictures, go to www.vichinterlang.com.

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Route des Rails Moving Day

Wilfrid Asmath and his daughter Madlene

As planned, Brillant and I, along with our driver Erid, I having decided to forego public transportation for the long trip across Port-au-Prince, returned to the Route des Rails tent camp in Carrefour on Friday, January 14, a little after one p.m., to witness the residents’ move to their new houses on the coast at two. We arrived to find a number of the inhabitants in a highly agitated state. Apparently, the local government had changed the terms of the move.

Patrick Toussaint, one of the camp residents, told us that a local government representative had come the day before to tell them that now only ten families would be moved into the 160 new homes supposedly dedicated to accommodate all the residents of the camp. Not only that, but everyone else in the camp was supposed to move, no one had any idea where, by the end of the day.

Patrick Toussaint and his son Fernande in their home

Other camp redidents verified Patrick’s story, and a few expanded on it. Degradala Joseph, who said in English that he was almost crazed from lack of sleep caused by the constantly passing traffic, showed us his photo identification card, along with a photocopy. He said that the government had required the heads of the families living in the camp to make two photocopies of their cards, one to sign and leave with the authorities and the other to keep. Joseph stated that the government representatives told the residents that by signing the copy, they were reserving a new house for their families. Other camp residents energetically supported Joseph’s story and several showed us their identification cards and copies as well.

Degradala Joseph (center) outside his home

The consensus opinion of the camp residents with whom we spoke was that the government had lied to them about the move, never intending to move all of the camp residents to the houses built under the auspices of USAID and the Adventist Development and Relief Agency (ADRA). Instead, the residents were convinced that the government plan all along had been to only move a token ten favored families, although no one seemed to know why they were favored, or even who they were, and then sell the rest of the houses. As it was now approaching two o’clock, Brillant, Erid and I returned to the car for the short drive to the ceremony celebrating the move. At the entrance to the new subdivision, the road was blocked by a coil of barbed wire, which the guard rolled away to let us enter.

Toilets under contruction

At the end of the long central street leading towards the sea, some men were working on setting up a stage. Aside from them, and some workers constructing two buildings to house toilets, which were clearly nowhere near complete, the camp was empty. We stood in the shade of the last house facing the sea for a while, catching the breeze. After a half-hour or so, we retired to the car to await developments. But there really weren’t any.

Over the next couple of hours, small groups of people would gather on the far side of the barbed wire, hanging around for a while before dispersing, to be replaced in a bit by another group. A few people skirted the wire, walking along the levee separating the subdivision from the adjacent refinery complex, on their way to somewhere. The guys manning the barbed wire gate started drinking beer, and showing its effects. Nothing indicated that any organized activity was imminent, and only the stage hinted that anything was planned at all.

Ocean view housing

Erid and Brillant were of the opinion that this was a typical government bait and switch and that no move was going to occur this afternoon. They believed that because the government was only going to move ten families, it would not do so at the announced time when international media might be present to ask awkward questions. It was now approaching 4:30, a full two and a half hours after the ceremony was supposed to occur, and at most an hour until dark. Concluding that Erid and Brillant were right, I pulled the plug on the stakeout.

We drove out slowly through the neighborhood bordering the new subdivision, and here also, the activity was totally routine, with no hint that anything out of the ordinary was about to occur. At the tent camp, residents sat on the curb outside their homes in the now fading light, watching us pass by and getting ready for another night on the median.

To see more pictures, go to www.vichinterlang.com.

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Acra Sur Tent Camp

Acra Sur tent camp, Delmas 33

At the entrance to the expansive Acra Sur Camp, Brillant and I were met by a welcoming committee of five or six young men. After Brillant explained that I’m a journalist covering Haiti a year after the earthquake and that we would like to visit, one of them went off to a tent to get authorization. He came back and led us up the hill to meet Isidor Franc Ky, a member of Terrain ACRA Camps des Sinistres, or TACS. Isidor, along with his comrade Jocelyn Walson, took us to the TACS office, a one room pre-fab structure sparsely furnished with a plastic chair, which Isidor offered to me.

In the course of a brief interview, Isidor told a familiar tale. He reported that since the earthquake, basically the only help that has been provided to the camp of six hundred families was the provision of a stainless steel water tank by the French Red Cross almost a year ago. And it is far insufficient to supply the camp. He stated that the Haitian government at every level, from national to the mayor of Delmas, had failed to provide any assistance. And, he added, at a meeting that very morning between members of the camp and the mayor, the mayor’s security detail had beaten a number of the camp residents and the mayor himself had shot one.

Our next stop was a meeting with Jean Louis Elie Joseph, the Porte Parole, or effective mayor, of the camp. An older man, probably in his early to mid-forties, we found him surrounded by camp residents. After being introduced, he agreed to speak to me about the conditions in the camp. Reiterating what Isidor had told me, he added that the residents of the camp didn’t feel that there was any reason to commemorate the anniversary of the earthquake because the government, and international aid organizations, have done nothing for them and have actually been making money off their suffering. And he had a plan to remedy the situation.

He said the money from international aid organizations should be put directly into banks so that the residents of the camp can get credit. With credit, they would be able to start businesses and buy homes, with mortgages to be paid back over fifteen or twenty years, just like in the developed world. As he was concluding his presentation, Geammy Yonel arrived.

Geammey Yonel shows his swollen cheek

Mr. Yonel had been struck in the face and leg with a baton by the Delmas’ mayor’s security staff that morning, Mr. Joseph stated. Looking somewhat unsteady, Mr. Yonel had a swollen right cheek. He didn’t make a statement before being assisted off.

Concluding the interview with Mr. Joseph, Brillant and I set out to exit the camp, but were detained by two incidents. In the first, a woman named Rosemante asked me to take a photo of her sister, who has been very ill for a year. We followed Rosemante to her sister’s tent and she is indeed very emaciated. Rosemante, lamenting her sister’s condition, said that she used to be quite large. I took a few pictures and Brillant got Rosemante’s cell phone number with the intention of trying to do something to help.

Rosemante with her sister

The second incident occurred as we were almost to the camp’s exit. A group of four or five young men hailed us, wanting to know what I was up to. Brillant explained, and it turns out that one of the young men has been working with children, now located in the camp, for a long time. He asked if I had time to visit, but I told him we needed to get to the Champs de Mars for the earthquake commemoration, but that I would try to come back. Brillant got his phone number and, with that, we were on our way.

Postscript

Using the phone number Brillant got from her sister Rosemante, International Medical Corps (www.internationalmedicalcorps.org) located the sick woman .  An International Medical Corps team transported her to the Hopital l’Universite d’Etat d’Haiti (General Hospital), where Dr. Megan Coffee examined her and determined that she is suffering from tuberculosis (TB) (See Megan Coffee, M.D.).  The woman is now receiving treatment at the hospital and her condition is improving.

To see more pictures, go to www.vichinterlang.com.

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Port-au-Prince, January 12, 2011

On this, the first anniversary of the earthquake and a national day of mourning, Brillant and I left the hotel after he finished work at eleven. Traveling by tap-tap, we came upon a church whose worshippers spilled out into the street. Having stopped to check out the scene, I tried to take some pictures, but with the usual result of people fleeing the frame. After just a few minutes of this, Brillant asked a woman if we could get permission to photograph and she said we’d have to talk to the pastor. Given that the pastor was at that moment inside conducting the service, and that even if he gave his permission it wouldn’t matter to the people outside, I decided we should move on.

We took another tap-tap to the transfer point for the final ride down to the Champs de Mars, where the official commemoration was to be held. Although it wasn’t to occur until 4:53, the moment the earthquake struck, my idea was to go reconnoiter the scene and see if some preliminary activities might be taking place. However, we had some trouble finding a ride for the final leg, so Brillant suggested we walk a little ways to another tap-tap stop.

Strolling down the broad avenue, I noticed that the level of pedestrian activity, while still substantial, was significantly less than usual. Most of the roadside stands were closed, their wooden frame structures pulled back from the street, leaning against buildings. At the bottom of the hill we turned left and boarded a tap-tap for Champs de Mars. Luckily, as it turned out, we had to sit in the back.

As we were waiting for the tap-tap to fill up, I glanced back the direction from which we had come and noticed a large group of people dressed in white enter the intersection. White is the color of mourning in Haiti, so I knew immediately that this must have to do with the anniversary. While I watched, people continued to flood into view.
Hey, Brillant. There’s something going on down there.

Yes, yes.

Climbing down from the tap-tap we set out at a brisk pace, Brillant saying, Yes, this is what we are looking for.

Members of the Eglise de Dieu de la Verite commemorate the earthquake

When we got to the intersection, the crowd had halted at the exit, but was still flowing into the entrance. As the people waited to proceed, some of them, many holding Bibles, began to chant and spread their arms. Within a couple of minutes, traffic wardens dressed in light blue shirts, and dark blue skirts or pants depending on their sex, at the head of the march, followed by a young man waving a large flag, moved forward, walking up the street Brillant and I had just come down. However, within a couple of blocks, they stopped, and perhaps at a signal I didn’t perceive, or perhaps spontaneously, the marchers dropped to their knees and seemed to enter an ecstatic trance.

A member of the Eglise de Dieu de la Verite commemorates the earthquake

Some of them spread their arms wide. Some raised their arms up before them. Some leaned forward on all fours, hanging their heads. Others bent their foreheads to the pavement. All the while they chanted, praising Jesus, their eyes closed. This continued for at least five or ten minutes until, exhausted from their exultations, or, again, perhaps at a signal I didn’t catch, they slowly arose and formed up to move up the street.

Brillant and I continued walking with the group, which was the congregation of the Eglise de Dieu de la Verite, or the Church of God of the Truth, across the sprawling Delmas neighborhood to their church, a distance of probably three or four miles. But there were only minor outbursts, and no further collapsing to the pavement, the rest of the way. Looking down the long hill from the church at the stream of worshippers that looked to me to number at least a couple of thousand, I couldn’t believe they would all fit in the church, but almost all of them did. Brillant and I didn’t enter and left for the almost adjacent Acra Sur tent camp before the service concluded.

We spent a couple of hours at the camp before leaving for Champs de Mars. But that’s another story. With only an hour and a half until the commemoration ceremony was to begin, I was afraid we would have trouble getting to the site of the actual ceremony. I had visions of thousands, if not tens of thousands of Haitians, and a huge press presence, clogging access. I was half right.

Making better time than expected, we arrived almost exactly an hour before the time of the earthquake. As we walked down the street in front of the Presidential Palace, there were a lot of journalists, mostly foreign, about, but a surprisingly small number of Haitians. About halfway down the block there was a circle of people, so we made for that to see what was happening.

Dancers at the commemoration of the earthquake

I managed to work my way to a point where there were only a couple of people in front of me and in the center of the circle was a dance troupe performing a decidedly non-mournful repertoire. I suppose they were celebrating life. I raised my camera over the heads of the people before me, and with a few practice shots to get the range, succeeded in taking a few decent pictures.

When the dancing ended, a few staff members from the Universite d’Etat d’Haiti Hopital, the primary Port-au-Prince hospital, marched solemnly past the Palace. This was more of the atmosphere I was expecting and I followed them, or actually, led them, around the corner up the intersecting street on the side of the Palace. After a block or so, I peeled off and Brillant and I went back around front, where there was still a surprising dearth of action.

Staff from the Universite d'Etat d'Haiti Hopital in front of the Presidential Palace

Haitians and foreign journalists milled about, mostly separately. The low wall at the base of the fence in front of the Palace was lined with Haitians, but there didn’t seem to be any particular sense of anticipation. At the far end of the street, a stage had been set up and there was a fair size crowd listening to music, but it seemed to relate only tangentially to the upcoming ceremony. There were definitely no crowds pouring in to participate.

As the clock ticked ever closer to zero hour, Brillant and I continued to circulate, looking for a focus of the upcoming event. Then, just as we happened to be near the end of the road towards the stage and at about 4:50, I spotted a small group of twenty or thirty Haitians in white coming our way. I moved to intercept them and they stopped near the end of the Palace nearest the stage, close to the curb in front of the Champs de Mars tent camp.

Members of the Eglise de la Victoire observe a moment of silence

Having arrived before almost any other photographers, I had front row position. Right at 4:53, the group, which consisted of members of the Eglise de la Victoire, the Victory Church, observed a moment of silence, which actually stretched out for several moments. Following that, there was some chanting and singing, accompanied by arm waving, but less extreme than what we had witnessed earlier in the day. But then one or two members of the group were apparently seized by the spirit, shaking and quaking, but not falling to the ground.

And with that, the ceremony ended and the assembled press, myself and Brillant included, began to disperse into the gathering darkness. It seems like it was a very small commemoration of a very large tragedy. But then, I guess the real commemoration took place all day long in churches across the city.

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Route des Rails Median Tent Camp, Carrefour

Two tap-taps and two buses, or the rough equivalent thereof, are required to get from the Ideal Villa Hotel on Delmas 53 to the Route des Rails tent camp in Carrefour, at least for Brillant and me. The first tap-tap deposited us next to the national soccer stadium where, unfortunately, a mob of people was flowing in for the Franklin Graham, son of Billy, crusade. Wading upstream through the flow of mostly well dressed attendees, many carrying Bibles, we finally reached the departure point for buses going to Carrefour. There, we entered into quite an alternate reality, boarding the Gangsta Rap bus

Gangsta Rap bus

from hell.

This “bus” was actually not a bus at all, but a long-bed truck of the type furniture stores use to deliver their merchandise, which seems fitting. A domed door had been cut out in the middle of the right side of the orange, red, green, blue and white passenger compartment, flanked by two cut out shamrocks where windows would have been if there had been windows. After climbing up into the bus using the considerately placed handrails on either side of the door, Brillant and I had to climb up again to slide into the first bare wooden bench seat we came to as the bottom of the seats were at the level of the bottom of the cut-out shamrocks.

Settled against the left side of the bus, where there were windows, I realized that my head was about two inches from the ceiling and that I could end up with a serious headache if we hit any major potholes along the way, a not unlikely prospect. However, looking around, I comforted myself by contemplating the calming décor. The bus’s owner had lined the interior walls and ceiling with pressed sheets of metal in a baby blue and white tiled pattern, with black diamonds at the corners, reminiscent of a summer sky being traversed by a flock of crows. Unfortunately, my bucolic idyll didn’t last long as the driver soon decided to entertain us early boarders, and perhaps attract like minded customers, by cranking up the music.

So, from five small speakers, each probably three inches across, pocking the front wall of the cabin like large caliber machine guns, the serenade began with a boom of bass that shook, only slightly, the window by my head. By the time the bus was fully occupied fifteen or twenty minutes later, my discomfort was somewhat reduced by a significant, and I hoped temporary, loss of hearing.

As for the songs themselves, I only recall a lot of apparently very angry “yo, yo, yo’s”, and the requisite liberal use of what I shall here delicately refer to as the “F word”, in pursuit of money the singers seemed to feel they were being unfairly denied. Oh, and I believe there were some “Ho’s” thrown in as well, probably as a counterweight, but perhaps as a complement to, the “yo’s”. In any case, by the time I reeled from the bus into the bustling Carrefour street scene, it seemed as placid as that cumulus blue sky on the roof of the bus had before the music started. Crossing the street, Brillant and I came to a gate through which was the wrong camp.

This isn’t the camp.

No? But this is the only camp I know here.

It’s not the one we want, Brillant. The one we want is in the middle of the road, the Route des Rails.

Okay, okay.

So with that, Brillant began asking around and soon he had a lead. We set off in the same direction we had been going on the bus, but I was more than happy to be walking. After ten or fifteen minutes we boarded our second tap-tap of the journey. This took us perhaps a couple of miles to where the street we were on dead-ended into the Route des Rails, where we debarked. Once again, Brillant asked around, but no one seemed to know anything about the camp. After a few minutes hesitation, Brillant said, Okay, let’s walk this way, and turned right. I don’t know why he thought the camp was to the right, but, trusting his judgment, I went along. We walked for a while past empty median before he asked me, Are you sure this camp is on this road?

Unless it’s been torn down. But the last information I have is that it’s still here.

Okay, okay. We will walk a little farther.

But only a short while later we boarded a traditional bus. The boulevard died out and we bumped over rutted dirt roads, through oil refineries right on the sea, heading back in the direction of Port-au-Prince. By this time, I had pretty much given up on finding the camp. I figured we had either turned the wrong direction, or the camp had, in fact, been dismantled since the last story I’d read about it had been written. Then, suddenly, we were back on the boulevard and Brillant said, There it is, and it was. A row of tents and makeshift structures filled the median from curb to curb as far as the eye could see.

Routes des Rails median tent camp

Exiting the bus, we found ourselves on the back side of the camp, so we slipped through a gap where a tent had probably once been. All along the row of tents, people were standing in the street, or sitting on the curb, outside their homes as the traffic whizzed by. Children played on the curb. Women swept the street. Not quite sure how to proceed, Brillant and I withdrew to the gap we had come through to think about it. While we discussed what to do, basically concluding that we would have to ask people for permission to photograph them, a young, clean-cut young man, probably in his late twenties, approached us and asked what we were doing.

A bus passes by the Route des Rails tent camp

Brillant explained in Creole that I’m a photojournalist here to report on the one year anniversary of the earthquake and when he finished, the man, Joseph Emmanuel, said, Okay, now we’ll speak English. As it turns out, he’s an unemployed English teacher who lives close to the camp. He told us that on Friday, January 14, all of the residents of the camp are supposed to move to new housing a short distance away and asked if we wanted to go see it.

We set out down a dirt road in the direction of the sea and within a half-mile, after passing some houses and shops, came to a spit of land at sea level protruding into the Caribbean. Perched on it were 160 brightly colored, fiber-board, one room houses for the residents of the tent camp. With a refinery in plain view not more than a quarter-mile to the left and the shoreline covered in plastic bottles and other garbage, a more forlorn subdivision could hardly be imagined.   Still, the structures here were more substantial than those on the median, and there was no danger of being hit by a speeding vehicle.  I raised my camera to take a picture and, naturally, a fat functionary came running at us waving his arms.

Brillant explained who I am and what I was doing and the functionary said he would call the deputy. After a few minutes the deputy showed up and after hearing Brillant out, said that I couldn’t take pictures at that time, but that I could return on Friday to document the tent dwellers moving into their new digs. With that, the  functionary escorted us out.

First photo subjects

Back on the boulevard, I asked Emmanuel if he could help us get people to allow me to photograph them, as the people living in the camp know him. He was amenable, so we started down the row of tents. The first people to agree were two women, one standing in the doorway of her home and the other her neighbor. Then the neighbor threw open the flap to her tent to reveal her mother sitting, and a child asleep, on the bed that almost filled the structure. The grandmother agreed. And from there word seemed to spread that I was okay. But then we came to a group of six or seven young men who seemed suspicious of me, and this could well be cultural bias, vaguely threatening.

They more or less surrounded us, wanting to know who I am and what I was doing there. As Brillant explained and asked if I could take their pictures, there seemed to be a fair amount of jocularity, but I couldn’t tell if we were meant to be included, or were the target of it. And no one had agreed to be photographed. Then one guy, wearing a green cap backwards and a white tank-top with green piping around the neck and armpits matching his cap, his hair in short dreadlocks and with a drooping left eye, very possibly drunk, stoned, or both, waved his left arm in a manner that clearly meant, Okay, take my picture. And with that, the dam burst. All his buds then wanted their pictures taken as well. The only difficulty was getting away from them.

Making new friends

We worked our way to the end of the camp, and very few people along the way objected to being photographed. It was certainly the most thorough job I’ve managed to do shooting the residents of a tent camp. And yes, I do plan to return Friday to capture their reactions as they move into their new, government approved homes.

To see more pictures, go to www.vichinterlang.com

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Acra Tent Camp Redux

Residents collect water from new tank

One change to the Acra tent camp since my last visit in June was apparent at its entrance. Whereas then, residents were collecting water in plastic buckets from a spigot whose output was of unknown provenance, now there is a shiny stainless steel tank ten or twelve feet tall and twenty or thirty feet in diameter filled with potable water. However, once Brillant and I passed this fountain of health, if not youth, the camp reverted to its prior character.

As we trod the same dusty trails lined by rivulets of flowing sewage that we had traversed before, we encountered familiar sights. Children abounded. Women of all ages sat outside their stiflingly hot homes, shelling peas, washing clothes in colorful plastic tubs, or just chatting with neighbors. We passed tiny shops selling candy, gum, cigarettes and a variety of other everyday sundries. The tailor’s shop, though not the tailor, that I had photographed on my last visit was still there, looking about as permanent as anything can in a tent camp. Then we came to the drainage canal that splits the camp and saw, on the far side, the cholera hospital, a toxic oasis completely surrounded by a ten foot tall blue tarp fence.

Woman shells peas surrounded by children

Crossing the canal on the new wood bridge, we walked around to the opposite side of the hospital, where the entrance is located. Brillant explained to the Haitian woman just inside the gate that I’m a journalist here to do stories on the situation one year after the earthquake and asked if we could speak to someone about access to the hospital. She disappeared for a few minutes, then returned followed by a young woman with short blond hair. Once she, her name is Julie, arrived, we were allowed to enter the camp. This involved three separate steps.

First, we had to rinse our hands in an antiseptic solution contained in a large bucket with a spigot. Then we had to step into and out of an antiseptic bath contained in a plastic pan about two feet wide by eighteen inches long, by four inches deep, sunk in the ground. Lastly, the gatekeeper sprayed the soles of our shoes. Once we were admitted, I explained to Julie in English why I was there and she said she would go get her colleague who speaks English better than she does to discuss the matter with me.

Brillant gets sanitized entering cholera hospital

Justine, who is also young, but dark haired, is a nurse. Julie is a logistician and the two of them, forming a sort of salt and pepper team, are the sole representatives of a French NGO, Alliance for International Medical Assistance (ALIMA), under whose auspices it was created, in the hospital. Everyone else is Haitian, the idea being to have a minimal foreign presence and to organize the hospital so that if the foreigners leave, the Haitians will be fully capable of carrying on without them. ALIMA was founded only a year ago by several former members of Medecins sans Frontieres who wanted to do more community based work than MSF does.

In keeping with this concept, the three ALIMA cholera hospitals in the Port-au-Prince area are surrounded by a series of community clinics staffed completely by Haitians, which act as entry points to the system. Part of Julie’s job is to set up these clinics in association with the American Refugee Committee (ARC). When patients begin to show symptoms, they know through community outreach done by the Haitian ALIMA staff, to immediately go to the nearest clinic. Once there, they are transported by ambulance to the central ALIMA cholera hospital for their district.

Children on bridge leading to cholera hospital

At the hospital, patients enter through a triage tent where ALIMA staff determine the severity of the disease and assign them to one of three treatment tents in ascending order. Patients assigned to Tent A are only mildly ill and able to re-hydrate by drinking fluids. Patients assigned to Tent B are beyond the point where they can re-hydrate by drinking and must be given fluids through an IV. Patients assigned to Tent C, the most severely ill, and usually children and the elderly, receive fluids through an IV and the maximum level of monitoring.

Scavenging for cholera

Justine reported that the number of new cases has been in decline, averaging only ten or so a day recently, although the number spikes when it rains. Over the past two months, the Acra hospital has seen 600 patients. As it is forbidden to photograph patients at the hospital, and pictures of empty tents are of minimal interest, Brillant and I departed, repeating our ablutions on the way out, after concluding the interview. As we were working our way towards the camp exit, I spotted a nicely dressed man on the bank of the drainage canal, searching for something, probably loose change, with his hands plunged to the wrists into the water. Good thing for him there’s a cholera hospital on site.

To seee more pictures of the Acra camp, go to:  www.vichinterlang.com.

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Fort National

From Champs de Mars, we made our way over to the almost adjacent Fort National camp. Walking through, we came upon a group of three women running a makeshift fruit and vegetable market under a blue tarp. Brillant once again inquired about my taking photographs, explaining who I am and what I’m doing, and once again got the same negative response. Sensing that matters were not likely to improve in this regard, he took my arm and pulled me aside and said, I think you should just take the pictures without them knowing it.

Clandestine market photo

This is something I don’t like to do, both because I feel it’s a violation of privacy, especially when the person has said they don’t want to be photographed, and because usually the pictures aren’t very good. But desperate times call for desperate measures, so I reluctantly agreed. We turned back to the women and, as Brillant continued discussing the matter with them, I shot a few frames with the camera hanging from my neck as I pretended to listen.

Leaving the market, we continued walking through the camp, and, using the same technique, I shot a few more pictures of people we encountered until we came to a dry swimming pool where several young men were playing an improvised game of soccer. Deciding to revert to honesty, at least for the moment, I asked Brillant to ask the eldest of the guys, who was probably no older than twenty-five, for permission. After a bit of discussion in Creole, the soccer player turned to me and asked in English, What is it that you are doing?

Stanley Dorelus (red shorts) playing soccer

I told him the same thing I’m sure Brillant did, and he seemed satisfied and said it would be okay for me to photograph. But then, before I could begin, he said that he, his name is Stanley Dorelus, was in a documentary film about the ultimately unsuccessful attempt by a Dutch rescue team to save his cousin Paula after she was pinned in a collapsed building by the earthquake. He added that the team had managed to save Paula’s daughter Juliana, who was about two at the time, in spite of her being buried for four days without food or water. He asked me if I wanted to see pictures and of course I said yes, so he entered his one room, tent draped plywood house through its hinged wooden door to get them. The photographs showed Paula’s head protruding from the rubble, barely discernible from the undifferentiated gray background, and the Dutch rescue team working to free her. They eventually succeeded, but at a very high cost, having to amputate both her legs in the process. There was a picture of her and Stanley in the ambulance on the way to the hospital, where she died a short time after arrival. Apparently she was conscious until near the end, because she told Stanley, despite his protests to the contrary, that she wasn’t going to make it and that he needed to look after her children, who include Jeffre, Jessica and Auguste in addition to Juliana. Only Juliana, however, was trapped in the earthquake.

Stanley with picture of Juliana

Stanley had a couple of pictures of her, covered in dust, being held by one of the Dutch team shortly after she was freed. Aside from suffering from dehydration, she escaped essentially physically unharmed. Stanley said she and Paula’s other children are now living with family in Canada. With this encounter, our luck turned slightly.

Shortly after leaving Stanley, we had two other people agree to be photographed. The first was a mother sitting with her two daughters in front of their home. The second was a young woman manicurist who had set up shop just outside her door and was perhaps hoping for some free publicity. We spent an uneventful while longer in the camp before moving on to Acra.

To see more pictures, go to www.vichinterlang.com.

Manicurist at her shop

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