Focus

Yesterday I was afforded a much-needed change of pace. Rachel, an OB/Gyn resident currently performing research in Haiti, invited me to listen-in on one of her focus groups. Over an approximate four week period, Rachel has scheduled six such groups (she has since completed five), each comprised of six to ten women. The sessions generally last one to one and a half hours, during which time the women are asked their opinions and thoughts on a number of healthcare issues, as well as issues concerning general well-being. The overall goal is to determine what these women believe their current healthcare needs to be and what they think would be the best/most useful ways to address these needs within their communities.

All in all it was a most adventurous day. We took a tap-tap to a “bus station” (not really sure what to call it, as it was a somewhat random conglomeration of stores and market stalls which seemed to be a designated stopping point for tap-taps, moto-taxis and donkeys) halfway up the mountain along the Jacmel road. Here, we secured six moto-taxis (one person on each, to maximize “safety”), which were to take us further along the unpaved, winding mountain roads to the city of Trouin. It was quite a trip! Though the views were undoubtedly breathtaking, I was considerably preoccupied with 1) clinging for dear life to the back of the moto 2) strategically repositioning myself, as I kept sliding forward, right up against the back of the driver and 3) trying to ignore the occasional bouts of nausea (I don’t usually get carsick, and yet…), seemingly induced by the blazing sun, the jolting, swerving ride and the clouds of dust.

Nonetheless, I could not resist digging for my camera to catch the rest of my party as we made our way up the mountain. I managed two pictures before fear of falling off the back of the moto made me hastily throw my camera back in my bag and return my other hand to its death grip on the moto’s rear metal bar.

moto in the mountains

Following our 45 minute ride, we arrived at the clinic. The nurse working there was most friendly and was responsible for inviting local women to participate in the focus group. She had been there for 2 years, and was originally employed by Hopital St. Croix (the former hospital in Leogane); however, once the hospital closed, she stopped receiving a salary… she kept working anyway, and continues to see patients (namely for prenatal care and child-well checks) for free.

Klinic la

As for the focus group, the nearly unanimous (but not very surprising) response: health care access is severely lacking. Previously, patients could at least get care in Leogane (which mind you is well over an hour away, requiring the extra expense of transport); with the closure of Hopital St. Croix, however, there are no good options, except the long trek to Port-au-Prince. In addition, cost remains a major obstacle, with necessary surgeries and even obstetric care exceeding the average Haitian’s means. These themes have been consistent throughout all of the focus groups, as has the women's desire to have a local hospital (which is Family Health Ministries ultimate goal for Leogane). In addition, it is clear that these women recognize the major problems within their communities; they are concerned about the same diseases/conditions (diarrhea and fevers/malaria, filariasis, prenatal care, vaccines and AIDS to name a few) and acknowledge the need for things like improved sanitation, clean water, electricity and nutrition programs. Most are passionate, well spoken and eager to have their voices heard; their responses will hopefully shape the development of the future Leogane Family Health and Research Center (http://www.familyhm.org/Leogane%20Family%20Health%20%20Research%20Center%20Nov%202008.pdf).

On a lighter note, there were a few other interesting things that colored my day:

1. A stroll along the countryside, where we were intermittently followed by gaggles of giggling school children eager to get a look at the blans roaming their mountain town.

let's play follow the blans...

2. A truck from Ridgefield, NJ

3. My trip to the latrine. Hard as I tried to balance the sweating invoked by the sun and my subsequent water intake, I couldn’t avoid needing to use the restroom at least once during the day. I have used latrines before, and as far as latrines go, this was not the worst I have seen. However, the cement block serving as a toilet was not made for the short kids, creating a slight logistical problem. As such, I was forced to maintain the hover position while simultaneously trying to prop myself up against the front of the cement block with my feet. I succeeded (it was quite a balance act, believe me), but the extra time required meant that all the mosquitoes residing in said cement hole had some additional minutes to feast on my un-bugsprayed behind. Needless to say, subsequent water restriction ensued and my next bathroom adventure was in the comfort of the guesthouse.