EcoWorks International

Only days after the January 12th, 7.0 Richter scale-earthquake hit Haiti, Americans raised millions of dollars to help the Haitian victims, and thousands volunteered.  The magnitude of the tremor, the shoddy construction standards and the proximity to the epicenter of the most populated places in Haiti resulted in devastating results: so far, 95,000 buried, 150,000 feared dead, two million homeless, hundreds of thousands amputees, orphans and, at this point, a significant number of malnourished and sick children and adults due to a pervasive and incomprehensible lack of food and medicine.

EcoWorks International (EWI) was fortunate to receive part of the funds raised by the American Jewish community through the American Jewish Distribution Committee (JDC).  The $50,000 grant is being used to provide urgent feeding programs.  EWI has also received generous contributions from individuals and corporations that support our work.  These funds are used to address immediate medical needs.  As the situation on the ground changes, we will adapt our programs accordingly.

EWI has a long-term project in Haiti in the commune of Ganthier, about 20 miles East of Port-au-Prince, the capital.  This is a five-year, comprehensive program that encompasses eight projects including a 20,000 laying hen egg farm, a rural cooperative, an entrepreneurship program, access to healthcare, an early childhood education program, and a reforestation project with income generating trees.  The project serves a community of 72,000 and is in its development stage.  Having worked in Haiti for some time, we have a good understanding of the culture, structure and politics of the country.  We also have a strong network of professionals and decision-makers that enables us to be efficient and productive.  Our main support for this long-term project comes from USAID. 

As of January 12th, EWI has put on hold its long-term activities to concentrate all efforts on earthquake relief in Port-au-Prince and the immediate vicinity.

On January 17th, Henryka Manès, the Executive Director of EWI, left for Haiti.  In order to reduce overhead to the maximum and devote as much funding directly to aid, EWI partnered with The Haitian League (THL), the Haitian Diaspora organization, to travel and implement part of its food program. The Haitian League provided us with housing and the use of an office in Port au Prince.  Once we reached the capital, we quickly focused on the Bernard Mevs hospital since it is an institution whose permanent mission is to serve the indigent population; therefore, we felt that all investments made there will serve the poor population on a long-term basis, beyond the earthquake emergency.  In normal times, Bernard Mevs is known for providing much needed surgeries for free to people who cannot afford to pay.

The needs of the Haitian population and our hospital at every level were overwhelming.  There was and still persists a lack of basic medication and supplies such as antibiotics, painkillers, and sutures.  Some amputations were performed without anesthetic.  Amputees were given Tylenol and Aspirin as painkillers. In addition, patients and members of their families who must stay with them day and night to assist patients and alleviate the work of the nurses, did not eat or drink during the preceding four consecutive days.  Patients lay on the ground all over the hospital as there was no room inside, nor did the patients want to be inside for fear of aftershocks. The hospital lacks x-ray, or lab facilities to help diagnose severe cases.

Despite this, the two surgeons, Dr. J Bitar and M Bitar (twin brothers) who run the hospital, their Haitian medical team and the US medical team THL and EWI brought with them worked very hard to treat between 100 and 120 patients each day, including hundreds of emergency surgeries.  And, delivering babies, which is always such an uplifting event amid despair.    

The Israeli field hospital: the Israelis were the first to arrive in Haiti! They deployed a field hospital which is the best bar none. It is, without doubt, THE model for all worldwide disaster medical response.  It had every medical specialty possible, from pre to post-natal, orthopedic surgery, OBGYN; gastro-intestinal, etc. It had x-ray, ultrasound and a complete lab, and a high ratio of doctors and nurses to patients.  An example of their thoughtful adaption to the requirements of disaster situation: the general practice is that a patient is put on a stretcher, then he is moved from the stretcher to a bed, then, he is put on a stretcher again if he needs an x-ray or surgery, then he is moved again onto the operating table, then back on the stretcher and then to his a bed.  These are all instances during which the patient with fractures can be further injured.  The Israelis put a patient on the stretcher and then the stretcher is put onto a solid “holder” and becomes the hospital bed without moving the patient at all.  Now, why is this not the norm in disaster relief when so many patients suffer from multiple and very serious fractures?

Each patient at the Israeli hospital was photographed, given a file number and a wrist band.  Most other hospitals had no registration of any sort and no patient charts which makes the possibility of medical errors acute.  The overall sense was that the Israeli field hospital was an extremely well organized, professional and efficient medical facility.  Every other hospital I visited was completely chaotic, including admittedly our own.   This is not to take anything away from the hard work and complete devotion of most of the medical teams, but in terms of the foreign medical aid, all field hospitals should be modeled on the Israeli one.

We negotiated with the Israeli hospital to bring our critical patients for treatment we could not provide. This helped in saving lives and limbs. We were also able to bring patients to get x-rays, ultra sound or lab test to help us better treat them. Unfortunately, the Israelis left January 29th, judging that the extreme emergency phase was over.

Food and water are essential in the healing process as the body requires more calories than usual and hydration is vital in enabling the skin to produce new cells to heal.   Also lack of water can lead to fatal kidney failure. When we arrived, we realized that the patients at Bernard Mevs had not eaten or drank for four consecutive days. In two hours, EWI bought water and distributed it to all patients, family and staff at the hospital.  Within 24 hours, EWI organized the daily provision of 250 cooked very nourishing meals for patients and their families.  We were ably assisted in this project by Israna Germain, the Vice President of the Haitian League.  Finding food was nothing short of a miracle so few days after the earthquake. 

We hired a team of Haitians who prepare and cook the meals and others who fill the individual food containers and pack them in large boxes for delivery.  We use regular SUV’s to deliver the food discreetly.  This is important for security reasons otherwise our convoy would be attacked.  A group of volunteer graduate students in psychology treat traumatized patients and they also help in food distribution at the hospital as it is a wonderful way to approach patients and start a conversation.  One fourteen year old girl stopped talking when her house collapsed and it is through the food delivery that the therapist was able to engage her in communicating.  

We identified a solar water filtration system that purifies 74,000 gallon of water each day.  Two systems arrived with Reverend Mike Roth who installed one in Carrefour last week.  He was assisted by John Dubois who is the EWI Haiti Coordinator.   Others will be trained in maintenance.  The system has been installed in a church and will serve the whole community of Carrefour.  Carrefour is located West of Port-au-Prince center and thus is closer to the epicenter.  Whole areas of Carrefour have been leveled and people live on the streets in makeshift tents.  The lack of space forced some of them to pitch their makeshift tents in the most precarious place: on the median between the two sides of the main road. 

The filtration systems have been purchased by the “Saron Church” of Linton, Indiana, which is Mike’s congregation.   Mike flew to Miami on his own and from there the Southern Command flew him on a military plane to Port-au-Prince.   EWI used JDC funds to pay for building the steel support of the main water tank, for two water tanks, the car battery that stores the solar energy gathered during the day, and part of Mark’s stay. This is a truly ecumenical effort. 

We will be installing the second system the week of February 8th and we may purchase two other systems for hard hit communities where water supply is still a problem.

Current Developments

Food

The reality on the ground is that there is a total breakdown in food delivery on the part of the large institutions that are supposed to specialize in emergency food distribution.  Every day, the EWI team goes door to door to ask for food and we are told time and again to come back another day. 

We will go out to the provinces to buy food ourselves.  Since the prices have tripled or quadrupled, we will be able to buy a much smaller amount than needed.  And the cost is multiplied again because we not only need to hire a truck, driver and helpers, we also must pay armed guards as attacks on food trucks have become common.

Medicine

There is an egregious lack of medicine and supplies that endanger lives.  Urgently needed are antibiotics, insulin, pain killers, iron for pregnant women and lactating mothers, vitamin K for babies who are bleeding, sutures, and thousands and thousands of wound dressings, which must be changed every other day.  

We need tents.  With the coming rain season, the homeless population is vulnerable, especially those who have had amputations, serious surgeries and open wounds. We hear that all of this is in Haiti or coming to Haiti, but on the ground we see very little of it. 

One organization that stands out in the medical supplies field is Americare.  They have a place near the airport that is well organized, and has a clearly defined registration system.  Once registered, NGOs and local hospitals can come to get what they need.  When supplies are available, Americare gives it equitably to all.  This is an organization worth supporting.

Another outstanding organization is the Rotary Club.  They provide “Shelter in a Box” a wonderful tent that can sleep up to 10 people, and it comes in a hard plastic container filled with necessities: cooking pans, basic tools, waterproof blankets and even a backpack for children with coloring books etc.   Their team came to our hospital, installed ten tents in about one hour.  They were well organized and efficient. They are installing these tents in much needed places such as tent camps to protect patients who must be kept dry in order to avoid life threatening infections.   But their supply is limited. 

We, the NGO community, expected the American Red Cross to take the lead in providing critically needed medications and support to local hospitals.  For example, there is a huge lack of ambulances.  We transported a woman with a broken pelvis in our car.  ARC received hundreds of millions of dollars.  How is this money being spent?  Why the American Red Cross is not out front providing much needed medical supplies?

New Developments

In addition to the egregious lack of food and medical supplies, new developments are taking place.

Thousands of Haitians are migrating from the capital to the towns and villages they are originally from.  These places, however, are totally unprepared and incapable of providing food, water or shelter.  In fact they cannot take care of their current residents.  Thousands sleep outside and go hungry.  The early waves of migrants are realizing that their towns and villages are unable to provide for them so they are returning to Port-au-Prince, which is in ruin and desperate to feed the thousands who sleep in street camps. 

The Ministry of Health and NGOs are monitoring for an outbreak of cholera and bacterial diseases. There is a need to move the street camps outside of the city to a more organized and better supplied structure but whether the Haitians will move is another question.  Currently there are approximately 400 street camps, and thousands additional families sleeping near their homes also on the street.

The reality is that jobs such as clearing the debris and construction will be available in Port au Prince.  Therefore, in order to keep the internal refugees in the provinces, job creation is a priority. Without jobs, tens of thousands will flood Port-au-Prince.

There is a feverishness on the part of Haitian and foreign builders to obtain contracts.  Many of their ideas on how it should be done are destructive rather than constructive. EWI promotes the following approach:

• No temporary housing should be built.  Experience shows that temporary housing becomes permanent and because of its shoddy nature, such dwellings become seeds for slums.

• Discussions should be focused not on building houses but on building communities with schools, clinics, meeting halls and churches. These communities must be much better than what existed before.  It is the only way to truly honor the dead.

• To constantly repeat that the Haitian government is not functional is unhelpful.    Haitians are a highly organized society and the government, which suffered great losses of staff and buildings, can be assisted and shouldered by the international community to gain capacity.

• Long term education and job creation must be a priority.  Families that have a way to earn a living will take care of themselves.  Even before the earthquake, EWI promoted the need to create an investment fund (not microlending) to help Haitian entrepreneurs get off the ground.  The fund should be run rigorously but the expected returns should be modest in the first few years.  Such a fund is needed now more than ever.  Small and medium size businesses are the ones that create 60-70% of jobs in any country; this is true for Haiti as well.  Could this be a perfect opportunity for a Haitian Diaspora initiative?  Let’s point out that the largest privately owned fish farm in the Caribbean is in Haiti. There are many such entrepreneurship examples in Haiti.

• We need to change our discourse.  The phrase:“Haiti, the poorest country in this hemisphere” is so often repeated that it has become like a tag line attached to Haiti.  We all know the statistics; but let’s refer to Haiti in terms of its potential – it could be the Switzerland or the Israel of the Caribbean with a strong emphasis on intellectual achievements, inventions and innovations that will result in new patents, agriculture, high-tech industry and tourism.

Next Step for EWI

We will continue to focus on medical and food needs.  We are committed to helping three orphanages and the communities of Carrefour, Gressier, Delmas, etc. We are starting to encourage the gathering of school supplies to distribute to displaced children.  To write or draw is extremely helpful and enables children to express their pain and fears. We will also start working in Ganthier, our partner community, to help with the absorption of 7,000 internal refugees that recently arrived and, when possible, we will resume our work on the long term project which is needed now more than ever.

Recently, we have joined a group that is reflecting on the reconstruction of Haiti to promote, what we believe, are the important considerations we mentioned above.

We thank our families, friends, partner organizations, corporations and individuals for their outpouring support which enables us to carry on our work and uplifts our morale.  Your generosity and encouraging words sustain us in these difficult times. 

Most of all, we pay tribute to the Haitian people for their endurance, fortitude and amazing spirit.  We will continue to travel this road together.