Medical Director Musings: Haiti #3

Gonâve Island is an island of Haiti located west-northwest of Port-au-Prince in the Gulf of Gonâve. It is the largest of the Hispaniolan (Haiti/Dominican Republic) satellite islands. The population is approximately 120,000. Haiti itself is the poorest country of the Western Hemisphere and Gonave is poor even by Haitian standards. It is the site of GR3’s first major collaboration with SOS (Sustainable Ocean Systems) to bring fresh and clean water to the island.
Gonave is a relatively dry arid and barren island and historically not much if anything has been grown there. In fact, during the colonial period the colonizers didn’t even bother to pay much attention to the island resulting in locals, including wanted bandits, to flee to the island for safety. Runaway slaves as well sought refuge.
Water has historically been scarce on the island but this has been punctuated over the past several decades by over-grazing, over-exploitation and water fun off. In 2005, the mayor formed the Water Platform. In an effort to bring attention to and help with this issue. Multiple politicians, humanitarian groups, world financiers and churches have been involved with this project. The members of the Water Platform have been working to address the water needs of the island by capping springs, building rainwater catchment cisterns, building water systems and drilling wells. However, as our recent trip to Haiti demonstrated, these efforts have not been sufficient. Despite this project, the people still do not have clean water to drink to cook and to clean.
In collaboration, GR3 and SOS offer a unique and hopefully more comprehensive and long term solution. SOS has developed technology that will permit the desalinization of water on a large watercraft off the coast of Gonave. Water will be salinized on board and transported via pipeline to the coast of the island. Once on the island there are numerous possibilities for the transfer of water to the people of the island. This method is clean, sensible and cost efficient. (Notice I did not say cheap.)
Last blog, we talked a bit about water borne disease. It is our hope that this project will not only result in improved quality of lives for the residents but also reduce cholera, typhoid and the other waterborne diseases. We will be working with local public health to track the prevalence of these diseases over the next years and hopefully we will be able to provide evidence that we have indeed accomplished what we hoped.
In addition to providing water for the island of Gonave, I am in charge of organizing a medical clinic on the island to serve the vastly underserved on Gonave. There is no indigenous reliable healthcare on the island the people relying on the occasional and sporadic help provided by missionaries. It is our goal to create an ongoing clinic initially staffed by GR3 associated physicians so that care can be provided on a regular ongoing basis. I personally have little use for Mission Trips that come in and stay for a few days then leave the next next year to travel to another location. Studies have shown that this one shot access to treatment, while with good intent and goals, does little good and in fact may be harmful. (I am talking about chronic disease here. Obviously surgeons who fix cleft palates or perform life-saving cardiac surgeons are exempt from this criticism and I in no way minimize the wonderful work they do.) Ultimately, it will be ideal to staff this clinic with local providers but it will take time and effort to learn if this will be feasible.
It is perhaps a bit ironic that I write this today on a day I was supposed to leave for a visit to the island to set up our clinic. Unfortunately, riots and gasoline shortage make it impossible for us to travel as expected. But, I will let you all know soon when we go back and what kind of progress we make.
Shalom and Aloha

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