Coals to Newcastle

For those of you unfamiliar, “taking coals to Newcastle” is the height of giving someone something they have plenty of. That is often how I feel when I try to explain the value of our Community Healthcare Workers. It is really not a concept we have in this country because what they offer is available on every street corner.

Let’s suppose you are awakened in the middle of the night and your 3 year old is burning up with a fever. We all know the feeling…panic. Most of us rush to the bathroom and grab the children’s Tylenol. At the very worst we ask someone in the house to run out to the all night drugstore and buy some, and while waiting we bathe the baby in cool water or alcohol to get the fever down. It is so easy for a young child to spike a fever and have a convulsion and that will get your attention in a hurry.

Then there are children spiking fevers in Haiti. Where do I begin? For starters, most of the over the counter medications I have seen for sale are in the dusty, day markets that are set up and taken down at the end of the day. One time in Port au Prince I was out on the street waiting to cross at the light and I realized that the telephone pole next to me had flat, bubble packs of OTC medicines attached to it as far as I could reach. They were held to the pole with large rubber bands that had been cut and tied together to hold the medicines on the pole. I was pretty certain they were not still there at 3 in the morning. And that was in the big city in the middle of the day. No drugstore in sight.

On La Gonave, you may find some medicines in the markets, but they are expensive and nobody has the money to buy something “just in case they may need it one day.” That concept alone is for another whole blog post. No, the families our Community Healthcare Workers serve in the mountains would be struggling to find matches and a candle so they could see what was wrong with their child. And, if they had a candle, it would be downhill from there. Cool clean water? Not likely. Children’s Tylenol? Most assuredly not.

But they could send a friend, spouse, or another child to run to the CHW’s house nearby and ask for help. Provided the partnership was holding up their end of the bargain by supplying OTC meds and supplies (or the funding for such) that CHW would have a backpack with medicines that would help that family. Later in the day she or he could go back and check on the child to decide if the child needed to be taken to the clinic. You see, in a tropical climate, children are exposed to life threatening fevers that can take them in a very short time if they don’t receive treatment. They don’t walk around with sippy cups of juice or water and they can become dehydrated in a matter of an hour or so. It is a midnight crises of a totally different magnitude.

Having a Community Healthcare Worker can mean the difference in bandaging a cut that is bleeding profusely, buying the time you need to get to the clinic. It can mean getting your well baby check and the necessary vaccines under a beautiful, shade producing mango tree near your home so you can get back to your chores, harvest your crops for market the next day and feed your family when the kids arrive home from school. Otherwise, the walk to the clinic with a small child could take hours one way and is often not done, leaving children unprotected from life-threatening illnesses. It can mean having access to birth control, deworming your children, and getting important prenatal care so you don’t die in childbirth.

There is a wonderful saying in Haiti, “poto mitan” and it means “the center post.” It is often used to refer to the woman’s role in Haiti, but it can also be used to describe the role that the Community Healthcare Worker plays in his or her community. They are the first line of treatment for individual healthcare as well as the “center post” for any public health issue that may arise, such as outbreaks of malaria, dysentery, or typhoid. CHWs file monthly reports about the births and deaths in each community. They can take blood pressure, screen children for malnutrition, and deworm entire schools to aid in the health of the students and are on hand for any remote clinic that might come to visit their community. They are called in when babies are being delivered at home and, with their backpacks, they are a walking CVS.

But, it is our job to be sure they are equipped with what they need for those midnight emergencies.

For those of us who have seen them at work, most will attest to the fact that it is some of the best money we spend for salaries. Currently a CHW makes $65 USD a month, but the problem is they are paid in Haitian gourdes. We are hoping we can raise that soon because in the last 2 years the buying power of that has dropped to $34 USD. That is due to the devaluation of the Haitian gourde to the US Dollar and is further impacted by the increase in the cost of living. Not to mention that part of their job is to travel to the Bill Rice Clinic once a month and file a report on what the have done in their communities and what types of illness they have treated. The biggest problem with their work is that most of what they do is not seen by many of us traveling to La Gonave.

So, what can we do to help? If and when you go down to LAG take OTC medicines. A list of what is most helpful is always available and being updated. Secondly, and maybe more importantly, we can support them by making regular, unrestricted donations to the Bill Rice Clinic. Their new raise will only get them back to the buying power they once had, but it will be a much needed raise.

On our donation page, you can arrange to make monthly donations of $50 and know that somewhere on La Gonave, even late at night, a family can get what they need when emergencies occur. That just seems really simple to me right now.

Deb Griffin

For the Partnership


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