One sentence sums up today. “I have never, ever seen this before.” Spoken by Wyatt as we walked through one of the most impoverished communities I have ever visited.

We spent the greater part of the morning preparing for our visit to Medan Bélize, a community of 340 individuals settled on the arid banks of stunning Lake Azuéi, the second largest lake in Hispaniola. We helped to make 350+ food packets, consisting of peanut butter sandwiches and hard-boiled eggs, to distribute in Medan Bélize as part of an upcoming and sustained school feeding project slotted to begin in September.

Dorothy Louis, of OBI, prepped us for our visit by describing the demographics (25% under the age of 5) and terrain (arid land and brackish water = absolutely no drinking water) but we were all shocked when we saw it with our own eyes. A huge, beautiful blue lake right out in front of you, and there is no water to drink. As we made our way down the road to the village, we saw several individuals on their way to collect water by foot or by hired motorcycle. Upon arrival, we met the community leader, Profit, divided into two groups and traveled from household to household to distribute the food. The houses were tiny structures built from straw, mud, tin, and tarp. Many people were at market for the day or out fishing on the lake, but the people we met, especially the children, were so friendly and appreciative. We brought some sporting equipment and stuffed animals with us to give to the children, and we thoroughly enjoyed playing with them before we left (especially a competitive game of soccer!).

The protein-rich food we distributed is obviously just a start, and it was exciting to hear the plans in store in the near future for this community. OBI and the Clinton Foundation will be expanding the local school to include more grade levels (including hiring teachers), will sustain a 5 times/week school feeding program, and will continue to investigate water and food security issues. In addition to distributing food, we had planned to distribute water, as well. OBI’s water truck (pictured in yesterday’s blog post) had a few mechanical issues en route to the village today but made it out there after our departure.

We headed back into town and stopped to tour St. Luc’s and St. Damien’s hospitals, just right around the corner from OBI’s guest house where we’re staying. The story behind these two hospitals, like much of what we are seeing here, is an incredible testament to the power of one person to make a difference. St. Damien’s, founded by Father Rick Frechette, is the premier pediatric facility in the country and provides all services free of charge. We enjoyed touring the impressive facility colored by statues of wild animals in the green courtyards and a beautiful chapel where daily services are held. It was exciting to hear of a residency program through CHKD to be held at St. Damien’s and to see the facility in person where Dr. Hanson and her team hold their ultrasound trainings.

St. Luc’s is the adult hospital that emerged in the aftermath of the earthquake out of sheer need. What once was a field of medical tents is now a collection of semi-permanent buildings that house an emergency room, a cholera ward, an ICU, and a soon-to-open surgical unit. Teams from the Mayo Clinic come down frequently to train, teach, and collaborate with the staff of St. Luc’s, and when they are not present in person, they converse about cases via Skype. It was quite an eye-opening experience for our team to witness for the first time formalized healthcare delivery in a resource-limited place.

In my opinion, the best part of each day is the downtime between activities when there’s a chance to digest what we just saw and ask endless questions to our knowledgeable hosts. During our car rides today, our conversations included the role of international NGOs in a context such as Haiti, the varying ways you can work to affect change either on the ground or from a diplomacy/policy standpoint, the state of the economy (both formal and informal) here in Haiti, natural disaster relief, the United Nations system, and how to make difficult decisions (e.g. choose to treat one patient over another) when resources are limited.

Tomorrow, we head to Hinche with stops in Mirebalais and Cange en route to tour the Partners in Health hospitals we’ve read so much about in Mountains Beyond Mountains and Haiti after the Earthquake.

A quick note: I know a picture is a worth a thousand words. Fortunately and unfortunately, during some of our experiences, it is inappropriate or distracting to have a camera out. It allows us to fully absorb the moment we’re in but it makes documentation of our experiences a challenge. I hope this at least offers a glimpse into what we’re up to here.

Aneesh’s Highlight of the Day: Noticing how even the poorest kids in the world can also be the happiest.

Brian’s Highlight of the Day: Realizing how out of shape I am while playing a competitive soccer match against the kids of Medan Belize.

Bridget’s Highlight of the Day: Giving back by making and distributing the food packets in Medan Belize.

Elizabeth’s Highlight of the Day: When smiles of joy lit up a desert wasteland in Medan Belize.

Stuart’s Highlights of the Day: 1) Interacting with and providing food for the kids and families at Medan Belize. 2) Car ride conversations.

Wyatt’s Highlight of the Day: Connecting with the kids in Medan Belize while playing soccer with them.

The inaugural cohort of Global Health Fellows (GHF) officially commenced their four-year exploration of global health today! Our group of six fellows, Ms. Massey, and Mr. Fowler convened for a few hours on the Norfolk Academy campus for a mini global health “boot camp” before embarking on our week-long excursion to Haiti.

We began the afternoon with the arduous task of packing all of our supplies and donations. About an hour and several weigh-ins later, we had successfully squeezed all of our personal belongings and donations into twelve 50-lb suitcases. That might sound like excessive baggage for just a week-long trip, but we are carrying a variety of donations with us for the organizations and people we will be working with this week. These donations range from Lifesaver water filtration jerry cans to bathroom scales for a nutritional campaign to school supplies to diabetes test strips to sports equipment to clothing. Shipping or mailing supplies to Haiti is often hit-or-miss (most likely a miss) and so nonprofit organizations and individuals living in-country typically rely on volunteers and travelers to carry down supplies for them. More information on all of these supplies and why we are bringing them to come…

After our packing extravaganza, Dr. Ed Lilly, the grandfather of GHF Elizabeth Lilly, presented an informative lesson on Haitian history, its modern day challenges and values, and provided personal examples of the collaborative learning and training he experienced while working in-country several times since 1990 through Physicians for Peace. He shared anecdotes and statistics that illustrated the reality that the developing world endures 90% of the global burden of disease with only 10% of the medical resources. He shared with us the well-known adage: “Give a man a fish and he will eat for a day; teach a man to fish and he will eat for a lifetime.” We will carry this notion of sustainability with us in the days to come as are introduced to various development projects in both urban and rural Haiti. We will strive to critically consider and evaluate different models of public health interventions during this next week.

Following Dr. Lilly’s presentation, Dr. Lisbet Hanson and Dr. John Kenerson, parents of NA alums Rose and Mike Kenerson, addressed our group. Drs. Hanson and Kenerson have been the single (or double) most instrumental force in helping to craft this first GHF experience in Haiti. Both practicing physicians in the Hampton Roads area, they have devoted much of their professional life to developing health training and delivery models abroad, most notably in Haiti. They have been involved in global health in a myriad of ways and their knowledge and expertise has proven invaluable to us.

Dr. Hanson started off with a brief Creole lesson to help us converse while in Ayiti (Creole for Haiti). She set the stage for the sights and sounds we will be experiencing, from the tap taps (public transportation) to the artisan wares to the infrastructure to the mountains beyond mountains to the singing and dancing. She outlined the variety of projects they have been involved with in Baptiste, near the Dominican border, ranging from blood pressure screenings to traditional birth attendant training to anti-parasite programs to ultrasound training. One sentence really stuck out to me: “In 25 years as an ob-gyn in Virginia Beach, I’ve never lost a mother. Within a few days of being in Haiti, we lost a patient. The sole difference in the two scenarios is access to resources.”

Dr. Hanson and Dr. Kenerson left us with the charge to keep our eyes open this next week. At times, the poverty and lack of resource can be overwhelming, but we do not want to miss the beauty of Haiti and the inspiring individuals we will meet. Dr. Hanson encouraged us not to judge but to absorb the experience. Dr. Kenerson predicted we will be “humbled by the enormity” of what we see and experience.

Thank you to Dr. Lilly, Dr. Hanson, and Dr. Kenerson for setting the stage of what is sure to be an exciting and fulfilling week! Thank you to Mr. Wetmore and Mr. Manning for seeing us off. Many thanks to others who have been active in developing this experience: Jon Gellman and Dr. Terri Babineau of Eastern Virginia Medical School; Angela Cruciano and Crawford Nelson of Operation Blessing, International; Nadene Brunk of Midwives for Haiti. We are most grateful for your guidance and support throughout the planning process.

GHFs with Dr. Ed Lilly

A quick note: In retrospect, today’s “boot camp” of sorts really began months ago. During final exam week, the GHFs convened for a discussion with Richard Vander Burg, the Vice President of Humanitarian Affairs for Lifesaver, the organization that makes the water filters we will be distributing this week. Hailing from Australia, Richard has an impressive background in global health. Before joining Lifesaver, he worked for Project HOPE and then Operation Smile as their Chief Strategic Officer for several years. Richard guided us through the history of global health within a public health framework and introduced us to the ideas of health inequity, monitoring and evaluation, and the drivers of mortality and morbidity in developing countries. He charged the fellows to become familiar with using common public health jargon: “force multiplier vs. vertically isolated intervention” and “daly: disability adjusted life years.” He challenged our team to think critically when analyzing the health interventions and “best practices” we encounter. We look forward to reflecting upon our week in Haiti with Richard, a clear global health guru, upon our return.

Highlight of day: That this day is finally here!!