Community Health Evangelism in Haiti

Report prepared by Osse St Juste, Coordinator of Medical Ambassadors Haiti

Community Health Evangelism (CHE) first started in Haiti in 1993 in the area of Labruyere, in the north of the country.  A team was trained at a Training of Trainers 1 (TOT1) in the Dominican Republic and started implementing the CHE principles in the following villages in the North province (“Nord” in French – see map): Milot, Grand Ravine, Labruyere, and Bayeux.  Out of those four communities, CHE really got started in Labruyere and a little bit in Bayeux.  Through contacts that were made, CHE began to be implemented in trainers' hometowns of Monben Kwochi (in the Northeast province, or Nord-Est), Lenbe, and the area of Lakil (both in North).  There are several ways that the program can expand:  through churches, partner organizations, clinics, or other local organizations.  There are some programs in Haiti that receive direct support from Medical Ambassadors International (the original organization which started CHE in so many countries).  There are other international organizations and churches that ask the local team, Ambassadeurs Medicaux d'Haiti (AMDH, or Medical Ambassadors Haiti) to accompany them.

As of today there are around 80 communities in Haiti that use the CHE tools.  About 35 of those programs are overseen by different partner organizations.  Of the over 40 CHE programs overseen directly by AMDH there are a total of 72 trainers, 350 committee members, and 1152 community health evangelists (CHEs, the house-to-house volunteers).  There are even more communities that are hoping to start the first training, a TOT1.  The CHE communities have gone through several stages:  the awareness seminar, committee training, training of the CHEs, then often Women's Cycle of Life and Children's CHE.  The majority of the CHE communities in Haiti have already reached the stage of doing home visits.  As we begin seeing CHEs start to visit homes and small local projects planned and executed, we start to see changes in communities.  We often have a party to celebrate the beginning of home visits, and everyone who went through the training gets a certificate.  We call this the “Change Party.”  We perform evaluations to verify that people have retained what they learned.  The trainers also evaluate the homes that are visited.

Different missions and organizations plan and partner with AMDH when they see that we have common goals.  AMDH then accompanies these organizations as they organize and plan trainings.  We do a vision seminar for the communities involved and then offer a series of trainings:  of these trainings, TOTs 1 and 2 are critical.  A TOT 3 is done if there are several active CHE programs that are working well and expanding.  Together with our partners we have CHE programs now in multiple provinces (“departments” in Kreyol):  North, Northeast, Artibonite, Central Plateau, and now some new programs starting in the West province.  In the southern part of the country (in the West province in particular) the programs are led by church and mission organizations.  (Click here for a map of Haiti showing the provinces.)

We see success in the physical and spiritual realms with this program because the training is holistic and participatory.  In each meeting the trainers teach a physical and a spiritual subject.  Behavioral changes and belief changes are seen in people who are in the program.  People's mentality starts to change – they think more about sustainable development and they want to participate in it (as opposed to waiting for handouts).

Activities Accomplished
After the trainers complete a TOT 1 they share the CHE vision in their communities, typically through awareness seminars.  The community members elect a committee which is then receives 18 training sessions.  Once the committee is trained they select between 25 and 50 CHEs, who will be trained in different lesson modules such as:  basic lessions, sanitation and hygiene, agriculture, health, etc.  The CHEs then visit 6 to 10 families regularly, once per week.  Water sources are improved, water is treated so that it is potable, they organize seedling gardens and plant trees (for reforestation), start vegetable gardens, raise chickens and rabbits, dig fish ponds.  They also do evangelism and have small group Bible studies.  The entire process is facilitated by a group of master trainers who are responsible to supervise two or three CHE programs, as well as a team of two to four local trainers who volunteer in their community, training the committee and the CHEs.

What are some reasons why are there challenges implementing CHE?

• The trainers weren't well chosen.
• No local community leaders open doors or integrate into the process.
• The community is very used to receiving relief work.
• People are not motivated to work voluntarily toward holistic development.
• They want to start with projects rather than receiving training.
• They think more about the way to resolve problems rather than thinking about the resources they have that can help them advance.
• Non-governmental organizations with a lot of money give gifts and do relief work in the community.
• Natural disasters or political crisis.

Needs

• Reinforce the capacity of the trainers, committee, and CHEs in order to have both quantity and quality of programs.
• Ensure that there are models for people to grow under, particularly spiritually.
• Increase the spiritual training that is done in the home visits, in order to truly see a holistic change.

Practical Advice

• The vision seminar should be done with the principle leaders of the mission or organization – the decision makers must be there.
• The choice of the trainers who are invited to the TOT 1 is critical.  They must:
• Have a good witness in the community.
• Live in the community or live no further than 45 minutes away.
• They must be able to read and write.
• Have the ability to share what they learn.
• Available to volunteer around four hours of time per week.
• Start to put into practice what they learn and model what they teach.
• Christians who are faithful.
• Interested in both the physical and spiritual aspects of people.
• Participate and accompany the community members in their activities.

Osse St Juste in Kansas, where the above report was shared this month with one of AMDH's partners, Church of the Resurrection

A week in Mombin Crochu, northeastern Haiti Day 5

Continuing posts from a week spent traveling in northeastern Haiti last summer.

Plaj Labe -- we stopped here on our way back from gathering stories

Friday, July 19, 2013

When you go to bed at 3 am, the morning comes early! As I get dressed, I discover that my trusty leather sandals finally gave up the ghost . I bought them in Peru a few years ago and they have been great – pretty yet also reliable. I have flipflops to wear here, so no trouble. But the drag is that my other pair of sandals are really too ratty to wear to church now, and I get home to Cap Haitien on a Saturday afternoon – meaning I can't buy anything either before church or before I leave for the Dominican Republic on Monday morning. Hmm, wardrobe difficulties.

Here I am, out and about with what for many people is footwear worn only around the home.  Yikes.  :-)

Breakfast this morning is boiled plantains with an oily sardine and tomato sauce. Since we're not scheduled to go to communities this morning my co-workers left early for a konbit, which is the word used for when a group of people get together to to do physical labor. In this case they wanted to dig a pool in which to breed tilapia fish. For me this means that no one will know if I eat the sardines or not.  And I bought granola bars on my trip to the DR last week, heh-heh.

Sardines, breakfast of champions

I didn't have any meetings in the morning but I had a lot of translation work to do. For this I needed electricity since I would need a fully charged computer for the afternoon meeting, and so I went to the town center to the dance class to plug in to the generator we were using. I decided for the millionth time that I have an awesome life, as I worked with the stories and pictures we'd collected with little kids surrounding me, cha-cha music playing and people dancing in front of me.

Trainers Eric, Osse, and Adelin.  Osse coordinates all of the CHE programs for Medical Ambassadors Haiti.  Eric and Adelin coordinate the programs in the province called "Northeast."

And they're smiling!  It is very common culturally for people to look serious in photos.  It is possible to occasionally capture smiles, though. And it wasn't hard to smile here -- after an afternoon spent driving motorcycles on rough mountain trails, these guys are catching a well-deserved rest.

It's [Almost] Christmas Time, Pretty Baby!

The tree!  I tried to capture the beautifully-frosted windowpanes in this photo but you can't see them.

So I've been jokingly posting on Facebook about how I succumbed to temptation and started listening to Christmas music early this year – before Thanksgiving, even! As I put ornaments on my tree tonight, I had a few gloomy thoughts:

• All these songs about a special day – this isn't really leading up to anything this year for me since I'm working Christmas Eve through to the day-after-Christmas morning.  Since I live alone, three hours from my nearest family, this means that even though I probably won't be busy in the hospital the whole time I still won't be able to come home to any family. And I already will miss seeing family on Thanksgiving!
• I haven't been in town for a lot of Sundays yet, and so even if I'm not busy in the hospital and can go to a random Christmas Eve service, it won't be at my "home" church, or even at a church I really know.
• The last time I decorated my own Christmas tree I couldn't put anything breakable on the bottom branches because of my beloved kitties.  I don't have cats now, nor will there be any cats in my foreseeable future (I live alone and travel too much, also they're not allowed where I live).

Now, before you tell me that Christmas is all about Jesus (and not about cats -- what?), well, I'll just head you off there and tell you that I hope that my whole life is all about Jesus. It is true, we do set aside this time of year to particularly remember the mystery and wonder of the incarnation. But the rituals and the family celebrations are also important -- the beautiful parts of our American culture's celebration of light in the midst of darkness, of peace and harmony and giving of ourselves, of family togetherness. (And still ultimately Jesus-y, since “every good gift and every perfect gift is from above, coming down from the Father of lights.”)

My mood didn't stay consistently down tonight because I know (thanks to the Holy Spirit and good brain chemistry and practice – I can't always separate those) that the following statements are also true:

• My family loves me lots and have already started planning a weekend to “do Christmas” when I can get to town.
  
• After spending so many Christmases overseas, I actually got to be with family for Christmas in 2012 and 2013. And since I'll be in the US this year, phone calls to family will be free!
  
• The ornaments I bought a few weeks ago at the second-hand store – feel-good item! not directly supporting the labor of political prisoners! – came with a business envelope filled with hooks (phew, I didn't have any extra and was in the decorating mood tonight)
  
• Most of my ornaments are ones that I haven't seen since Christmas 2006! These bring back memories, since the majority are gifts from my mom, but also from my brother, stepsister, and a good friend. Also a stocking from my dad's wife that she sewed my initial onto, a manger scene my aunt gave me...aww....
  
• I've gotten to see more family members and more often during these past four months than in any of the past 10 years! Woo-hoo!
  
• Whenever I've worked on Christmas it has been a blessing – camaraderie with the staff and getting to help patients and families who are bearing the terrible burden of being sick over the holidays.
  
• And, last but definitely not least: Elvis Christmas music. Double entendres and all. Tee-hee!

We will all have different joys and sorrows in this upcoming season. I know that the ones I mention in this note pale in comparison to death and injustice and deep loss.  May we all experience love and grace in the midst of both the laughter and the pain. For now I'll wish you a Merry Ordinary Time! (That's a joke for you liturgical folk out there.)

Stories of Transfomation -- Community Health Evangelism (CHE) programs around Logat, northeastern Haiti

Stories collected in my travels to northeastern Haiti last year.

Iranise Fleremé, committee member, Logat

My younger brother had a baby, but the baby died. They didn't go to the hospital, she gave birth at home. When she got sick I went to see her. People said she had a zombie. But when I saw her, I saw that it wasn't a zombie – I saw that she had a bad infection and they hadn't sent her to the hospital. I came and I got two other people to find a stretcher so we could get her to the hospital [a three-hour walk]. When she got there they took over her case. It was because of CHE that I knew what to do. Without that she would have died. This was in 2012. She just gave birth again, a little girl.

(c) copyright Iranise Fleremé. Used with author's permission.

Lupisient Oranise, delegate to the LaHatte CHE committee

I really love CHE because CHE has done so much for me. Since CHE came I have learned so many new things.

I didn't used to have a home vegetable garden. But a CHE (Community Health Evangelist) came to my house and encouraged me, so I started one. After I planted the garden I encouraged my neighbors to start one, too, and everyone now has one. I go to their houses and I tell them not to cook food on the ground, not to eat on the ground. In this way children won't be burned. When I cook my food on an improved, raised cooking stove, even if dust comes flying it won't be able to reach the food and bring bacteria.

When the trainers have us meet they study the Bible with us. This is another reason why I love CHE, because I know more about the Bible. They tell us how we should love our brother as we love ourselves. What we wouldn't do to ourselves we shouldn't do to our brothers. I have changed. There are so many things I don't do anymore. You repent – when you remember the lessons you decide not to do bad things because you are in CHE.   

(c) copyright Lupisient Oranise. Used with author's permission.

Joseph Francilo, trainer in Logat

Before CHE came to Logat we had a lot of pregnant women die in childbirth. At that time it was really difficult to get them to go to the hospital. Even the midwives were lacking training. As CHE came to do perinatal training for the pregnant women and the midwives, the midwives started encouraging the women to go to the hospital. They don't just encourage them to go, but they even go with them to the hospital. So now there is more checking up on the women. Every time someone has pain they tell a CHE and the CHE finds a midwife or a trainer. We get a group together and go to her house, and according to the signs she presents with we may have her go to the hospital. Fewer women now die in childbirth, and fewer children die in childbirth. . .

It's now rare that you hear of a woman dying in childbirth, it only happens if she has something particular that's going wrong.

Before CHE, we couldn't get people to go to the hospital. People thought that if you took them to the hospital by stretcher they would die. They thought they should only go by truck, if not they would die. But now, after training, they know they can go by stretcher [a three-hour walk]. Everyone is more motivated to help save the pregnant women.

Before CHE, churches didn't meet together, they didn't want to sit down together. We have three churches in Logat. After a week-long Bible study, in which we had pastors, preachers, and sacristans husband participate together with us, there has been a great improvement. If there is a training done in a church, everyone can come to it. When there are activities, we do them together. This has been since 2008. Pastor Christian did the training (a missionary that was active in the program).

Before CHE, when people were sick they wouldn't tell you, they hid it. Even when there were vaccination campaigns, the parents didn't want to say when the children were born. Even the pregnant women didn't want to say the day of their last menstrual period. They believed they could die if they told you – it's a belief here. But with training this has diminished.

There was another belief, too: women didn't want to tell you about their bodies. They were shy, they were ashamed, they thought it was improper to talk about things like this. Through the CHE training everyone now talks openly. When they are sick they tell you about it without any problem.   

(c) copyright Joseph Francilo. Used with author's permission.

A week in Mombin Crochu (Northeastern Haiti) -- Day 4

Continuing my posts from last year's travels to collect stories from Community Health Evangelism (CHE) communities

Seen while walking just outside the village of Mombin Crochu
(My first picture of the pastoral scene didn't quite turn out since one of these donkeys abruptly mounted the other one!  Nature.)

Thursday, July 18, 2013

I wake up and look at the fruit basket that was placed in my room yesterday. Curiously, there's part of a mango missing. While washing fruit later in the day (for mangos this means scrubbing and soaking them in “regular” water, then rinsing them in treated water) I show the half-eaten one to Adelin. He says, “Oh, yeah, a rat must have started eating it.” I say I didn't know they liked mangos. He answers, “Oh, sure. Rats are wily – they will even climb up a mango tree to eat the mangos!” (FYI, mango trees are really tall!)

After a rough motorcycle ride we arrive in Logat. Osse enters the church and sits down on a pew, extending his legs, looking tired. I say, “These roads are not a joke.” He answers, “No indeed, they are not a joke. They are body-breaking.” I think about this often while traveling – that in other countries people pay dearly to play “extreme” sports, and in Arizona they build little hills for dirt bikers to have fun. But here these things are tiring, and sometimes life-threatening.  (Stay tuned for stories from Logat.)

I found out on this trip that Osse has been involved in community development since even before he started working with CHE in 1993.  He was the founding member of an organization that helped to start the first high school in his village in the early 1990s.  Osse was invited to the high school graduation in the evening and he'd asked if we would accompany him.

Kids playing with a make-shift kite on the grounds of the new high school building in Mombin Crochu.  The government built a second high school some years after Osse's group started their high school.  The new president of Haiti has a building campaign and is constructing this larger building to accommodate the increasing number of secondary school students.

Continuing adventures with a kite!

The small Catholic school that Osse helped found threw a great celebration.  There were, of course, a lot of speeches: the president of the graduating class, the president of the junior year class, the “godfathers” of each of those classes, the “godfather” of both classes combined. Then the “delegate,” Osse, the “sponsor,” and the class president of the high school all spoke.

Roselande (dance instructor Claudin's wife) with a sandwich and kleren (raw rum) with pineapple.

The students put on a play in typical Haitian comedy style: two of the actors are dressed as country bumpkins and there is broad physical comedy. At one point one of them pretends to own a rich man's house to impress his girlfriend. He invites her in to the house and starts telling tall tales, including about how he'd cut a deal with a foreigner for something. Later, he repeats the story about the foreigner and, for proof, he points to me and says, “See, there she is!” Nice bit of improv!

There were many beverages served, all very typical.  After the kleren we were given a choice of sparkling wine, Prestige beer, or the energy drink Robusto.  Above are some of the drinks on my table.

At around 11 pm we were told there was a slight problem and the food wasn't yet ready. They played some music and the kids started dancing konpa.

Konpa!

Supper!  Fried plantains, beet salad, goat, beans and rice.  After supper we each received a Dixie cup full of popcorn.  This was followed by bwason dous (a sweet liqueur) and cake.

By 2:00 am the festivities were done. We started to walk home – super-slowly, the way everyone walks that I'd always attributed to the hot sun, or the steep mountains. But even in the cool night air on a flat road we are sauntering. Osse dropped me off at his house -- where everyone was already asleep -- and left to accompany the couple to the house they're staying at. Taking advantage of the fact that the house wouldn't be locked up for the night until Osse got back, I took a quick bucket bath and was in bed by 3 am.

From gazebos to clean water to parties to growing churches!

Much of our funding for 2014 has come from the organization World Challenge.  Most funds are spent on training, but we also sometimes support community projects or provide funds for events to encourage our volunteers.  Here are just two stories that I received in July:

Shelter and benches that were built for meetings and trainings in La Planj

Before the CHE program started in La Planj we had lots of difficulties, especially with our water. The water was really in a bad state and a lot of people suffered from typhoid, intestinal worms, and cholera. We were not well-informed about what was happening. When the CHE program came, because of the good training they brought and the way we applied the principles, well, everyone worked together to clean the water sources and protect the springs. Now the water isn't wasted (by falling on the ground) and the animals cannot put their bacteria in the water. Everyone is so happy because they have good water to use. In the name of the CHE program we thank you for your help with the gazebo we now meet under (completed in 2014) as well as the improvement of our water source (completed in 2013). To the supporters of World Challenge we say think you. We hope that God will protect you and your communities. We will always remember you in our prayers. Thank you so much. – Borgella Lucile, secretary of the La Planj CHE committee
.

Mother's Day party in Grand Ravine:  CHEs, committee members, and community members were present

We had 32 community health evangelists (CHEs) in Grand Ravine, but some of them had stopped being active in the program. This Mother's Day party (given with World Challenge funds) was important because it showed those CHEs what they were missing out on, what we were giving to the people with our trainings. Also, there were others who came and were interested in the CHE program who now want to be trained. The CHE program is very important – since it started in Grand Ravine four years ago the community is different. Spiritually, the churches in the area have more people and more evangelism is done. There were 100 people in my church before CHE and now there are 150! Every Tuesday they go out in groups and evangelize. – Vitalus Victales Wilnique, trainer in Grand Ravine

Stories of Transformation -- Community Health Evangelism (CHE) programs in Lospinit, northeastern Haiti

Noël Anisia, committee member

For me, before CHE came to Lospinit we had so many things ravaging the community. For example, we had kwashiorkor, children with bloated bellies. We learned a lot about nutrition, and now the children are more well-nourished.

Also with cholera, God really extended grace to us through the CHE program – the trainers taught us great lessons. They taught us to wash our hands before we eat, to make a Tippytap to wash our hands. They taught us to make a dish rack, to make latrines, keep our yard good and clean, and gather up the trash. Oh, man, this was really good.

The trained a committee and community health evangelists (CHEs). The CHEs started doing home visits. Whatever house we go to, people are really glad and they tell us not to get discouraged and to keep visiting them. After we learn something we show it to our family.

Something else we teach people is to sit down once a month to share. We meet the fourth Sunday of every month – the trainers, committee members, and CHEs. We gather funds into a pool, we call this a “mutual.” We loan the money to each other, and for every 100 gourdes you borrow you have to pay back an extra 10 gourdes. It's for when one of us has a problem, this augments what we have. Once I had a need and at our monthly meeting everyone gave me 100 gourdes. . . I resolved the problem. In two months I repaid the loan.

In terms of what we learn in CHE about wisdom: even if it's not easy, because of the training we learn -- even if we are the loser in a situation we control ourselves, we use wisdom, we measure our words.

Do you have any more spiritual brochures that we can leave with people? We do the lessons with them, but particularly the ones that have Bible verses in them people say they would love to have them at their house so that they can read them again. [Someone else added: Yes, yes! They always say they would like this!]

(c) copyright Noël Anisia. Used with author's permission.

François Jean, committee member

CHE has taught me many things. I have learned how to have better hygiene. I have learned SODIS [solar disinfection of water]– we do this quickly and we see it's a really good way to treat water. Before I treated water with chlorine but that's difficult because you have to buy the chlorine. SODIS is easier.  Also, we help people built latrines so that they can protect themselves against bacteria. 

 CHE also teaches us how to evangelize better and in a way that is more brief. We don't talk on and on like we used to. With what we learn in CHE we learn we should speak briefly and simply. We shouldn't talk on an on, brief is better. I like to use the brochure “Peace with God,” we teach a lot of people how to use it.

Once I was walking down the street and I came across a person who was evangelizing. He was talking a lot and made people tired. I looked for him later on so that I could teach him this method. He thanked me, saying that he thought the brochure was really good. He asked if I could get one for him and I said I would look into it for him.

(c) copyright François Jean. Used with author's permission.

Amelie Jean-Baptiste, Community Health Evangelist

What I like about CHE is the Bible teaching. When you see a portion of Scripture, that really helps you. If you have a disagreement with someone we have learned we shouldn't yell at people. We have changed this and really behave better with people within the CHE group and with our neighbors. We even tell the children they should live like brothers and sisters and not argue or hit each other or throw stones and hurt one another. When there is fighting the children suffer and their parents suffer, too. They listen to us, and even though they still fight sometimes it's gotten better.

(c) copyright Amelie Jean-Baptiste. Used with author's permission.

A week in Mombin Crochu (northeastern Haiti) -- Day 3

Continuing my posts from a trip I took last year to collect stories.

Wednesday, July 17

No communities to go to this morning. I went to bed with a headache and woke up with one. I've been told that perhaps I'm tired, so I take a nap. I wake up and there's a crate filled with mangos and pineapple in my room.

In the afternoon we walk a short distance up the road to the community of Lospinit.  As we wait for people to gather these three children come over to play.  

Next post:  stories from Lospinit.

Encouragement

This morning in church the priest said that we would do something special for Mothers Day (celebrated today in Haiti).  He said that mothers give us life – that they cannot do so without men, of course, but that we must recognize the role of women as essential to life.  He then said that instead of the regular “passing of the peace,” the mothers should all sit and we should greet them with a kiss.  I went around to women who were seated  and I greeted them with a “Bon fèt” and a kiss on the cheek.  A man I’d never met before came up to me and kissed my cheek.  I said, “Oh, I’m not a mother.”  He said, “It doesn’t matter.  Life comes from women.”  He stepped away, then came back a moment later and said, “Also, I don’t know what you do here [I am clearly a foreigner, which means I likely work for a mission organization], but if you give your life to help others, you are a mother -- more than a mother.”

I thought that was very sweet – and very much in keeping with what we’d heard in the sermon from the intern just a few minutes earlier, who'd said (better than this, but I didn’t take notes):  When you receive someone in love, you [?].  When you respond to others with sweetness, you are allowing the Holy Spirit to work in you.  When you encourage someone, you are true to your baptism.”  Thanks for the encouragement today, Holy-Spirit-by-way-of-a-stranger guy!

On the Road Again

Depending on how you count the moves, you could say that I have moved six times in the past eight months:

• From Haiti to Arizona -- although I was only there for a few weeks, that is where I moved all my things back to (and where I still have many boxes!)
• From Arizona to my aunt's in Minnesota
• From my aunt's to a friend's in St. Paul, MN -- I thought I would be there for several months but it turned out to only be weeks
• From St. Paul to a now-friend's house in southwestern MN -- where I thought I would only be a few weeks but it turned out to be several months  :-)
• From that house to a furnished apartment in the same town, waiting for another place to be renovated
• From the furnished apartment to my own apartment in the same town -- got the keys last week, move in tomorrow!

Why so many moves?  What's the plan?

Ever since moving overseas in 2007 I've been planning to come back to the US to prepare for my every-10-year family medicine board exam (taken two days ago).  See, after completing my family medicine specialty ten years ago I worked in a prison (mostly men, with very few women and children and no hospital work) and then worked in community health and development overseas (administrative and teaching work).  I'd been away from full-spectrum family medicine much longer than I'd been in it.  After starting the process back here in the US last fall it soon became clear to me that would take much more than just a few months to get back up to speed.  But there was still no one with the language and cross-cultural skills available to fulfill the role I played in the continually growing ministry in Haiti, so I also wanted to stay involved there.

So here's the plan:  for the next several years I intend to continue working half-time as a physician in rural Minnesota, taking one day off per week to work administratively with the Haiti team and several US partners (via phone, e-mail, and Skype), as well as spending several months per year in Haiti.  After having my things scattered between several states and countries for years (I have lists of what is where), I am very excited about having one place where I'll have my home and my home office, so to speak.  I will admit that last fall I had hoped to not move anywhere new again (sigh) but this situation has turned out great -- my colleagues have been very supportive about mentoring me and I've met a lot of really friendly people.

Today was my last official day at the clinic before spending a few months in Haiti.  One of our hospital administrators stopped by with a card and had written,  "You truly 'Bloom where you are planted' and we are grateful that your roots are growing here."  I am feeling blessed tonight.

More community stories: from Dèyè Gad, Venbal, and Lagwamit

The ministry tools of Community Health Evangelism (CHE) encourage people not only to come to a living faith in Jesus, but also to work out their faith on a practical level.  Just like in the United States, in Haiti it is challenging to walk as Jesus walked, to love our neighbors and give of our time and our efforts to bless them, to be people of peace and reconciliation in our communities. 

Unlike in the United States, a majority of people in Haiti struggle to meet their everyday, basic needs (in large part because of policies that keep the U.S. and other countries rich -- but we can talk about systemic injustice another time).  Many people walk long distances every day to get water for their household.  They do not have consistent water purification systems to remove the cholera and E. coli from the water.  They do not have latrines.  Our volunteers teach some very simple methods that help with these daily needs, including teaching about the Tippytap -- a simple system that allows people to wash their hands using a minimal amount of water (remember, they spent a lot of effort to get that water) and also be able to wash their hands without having to call another person over to pour the water for them.  We also teach gardening techniques and help people find seeds to help with the daily challenge of feeding a family in a very food-insecure environment.

Here are some more stories from three communities in northeastern Haiti: Venbal, Lagwamit, and Dèyè Gad.

Edouard André, committee member in Venbal

I haven't been with CHE long but the little bit that I've been involved with has really been good for me, both physically and spiritually. When they talk about washing hands after we leave the latrine, not walking barefoot. I'm not perfect at it but I'm trying. Also with trash cans, not leaving trash on the ground, raised cooking fires so that children don't get burned.

We also really have seen resolution of some problems in the neighborhood, we have started to talk together.

(c) copyright Edouard André. Used with author's permission.

Philius Fils-aimé, community health evangelist in Lagwamit

We did a survey – there were people that didn't raise up their cooking fires, but I left my house to help them to do so. We also learned how to make Tippytaps, something we'd never seen before. It doesn't cost any money, it's something you can do for free. I really applaud CHE for this.

A lot of people now live in peace because they participate in a savings program in CHE and can get advances from that. . .

On Sundays before going to church I visit five to ten houses.

There are some people that are interested in starting vegetable gardens when they see how nice my garden is.

(c) copyright Philius Fils-Aimé. Used with author's permission.

Cheristen Renellus, committee member in Dèyè Gad

I was kind of lazy – I didn't do anything at home all day. I didn't dig a hole for a toilFrançois Jeanet. But the trainers explained all of this and really set me in a good direction. I see that I've become a different person. And I want to keep moving forward so that I can change completely.

The trainers come and pray with us. We used to have division among us but now there is peace.

I have a lot of children at home – eight kids plus my wife and me makes ten. Almost everything is completely changed: we have a Tippytap, we have a raised cooking stove.

I go to church, and now I have the skills to change my life so that I am stronger and live in God's presence.

(c) copyright Cheristen Renellus. Used with author's permission.

Pierre Jacsen, vice-president of the Dèyè Gad CHE committee

Those of us in our community, we really weren't living well in a physical sense.  Those of us on the committee wanted to choose our worst problem.  We decided to work on the problems of dish racks and latrines.  We started with latrines.  One of our neighbors, he had a lot of children.  He never dug a hole for a latrine, we saw him go to the bathroom a few inches from his house.  We wanted to help him get out of that situation.  We chose a CHE [community health evangelist] to go to his house, but the man wouldn't let him talk to him.  After two or three different trips the CHE made, some of us committee members went secretly to see how the work was going.  We saw that he had started to dig a hole!

People were putting their dishes on the ground and all sorts of animals, dogs would walk over them.  We brought people information, we explained to them how to build dish racks.


(c) copyright Pierre Jacsen. Used with author's permission.

Life is Messy

Last night I was called to the hospital to assist a C-section. I haven't been first assist in a surgery in over 10 years. It was fun – surgery is fascinating, from the organization and orchestration of it all to the privilege of seeing the inner workings of the human body. It was also challenging – I didn't always know how to best help the surgeon and I didn't have all the moves down (my non-dominant left hand had partially forgotten how to unclamp forceps, I wasn't always sure where to suction, etc.). The surgeon was one of my family physician co-workers, and he was nice about everything. He and I also discussed a few patients I've had recently that were challenging for me. I'm in my 40s now, so it's much easier to accept imperfection in myself – but in this profession it can be a head game trying not to perseverate over shortcomings.

I’m so far
away from my home
all out on my own.
Hang my tired eyes
on a clothesline in the sky. . .
Strong and stable
I’m capable
and my life
is still and yet haunted.

Those are lyrics from a song by Joy Kills Sorrow, a band I first heard today. Yup – “I'm capable . . . and yet.” And, “far away from my home”?   No kidding – for the past 17 years I've moved to a different state or country every one to three years. I also have "tired eyes" today – I've noticed that head colds require lots more sleep and coffee than they used to, one aspect of getting older that I don't appreciate. :-)

Except for one move back to St. Paul (where'd I'd lived for eight years just prior to all this craziness), all of my moves have involved making new friends and finding new communities. During these years of moving I have found great joy in following Jesus. My relationship with and understanding of Jesus have changed over the years, and I suspect will continue to do so.  Blogger Benjamin L.Corey posted today about some things that have been helpful to him as he left fundamentalism – which for him was a mental assent to Jesus plus some rules – and started to follow Jesus in a life-giving, life-changing way:

This isn’t a situation of “I used to like apples but now I prefer oranges.” Instead, when you have a paradigm shift within the Christian faith, it is more like: “I think I’ve misunderstood the beauty and complexity of apples. I am now going to begin a journey to discover a new and better way of understanding, appreciating, and enjoying apples“.

Yes!  See, I hear a lot about other gods that use the same name as Jesus.   The Jesus that will provide for everyone -- a job, the means to survive.  Stability, marriage, and kids -- you can have those, too.  But you know, I heard another Jesus say that in this world you will have trouble. I've learned not to buy into theology that isn't applicable for everyone, everywhere.  I'm trying to follow the Jesus who -- despite death being all around -- is the very author of life, the visible image of the invisible God, the one who says he'll give us rest and who calls us to imitate him in sacrificial love for others.

I've only recently (finally!) read Wendell Berry – he's a farmer, poet, activist, and fellow Jesus-follower. In his book Hannah Coulter, the protagonist says, “I began to trust the world again, not to give me what I wanted, for I saw that it could not be trusted to do that, but to give unforeseen goods and pleasures that I had not thought to want.” Indeed. Great literature and music, intellectual and character challenges, friends in unexpected places and times, a game of tag with children after a hard day's work – life is still messy and full of sorrow, but also beautiful and filled with joy.

More community stories!

In my last post I shared stories from the communities of Venbal, Birèl, and Derrière Garde.  Three other communities also sent representatives that same day to our meeting place in Bois de Laurence to tell their stories about the changes they've been a part of through Community Health Evangelism (CHE).  In this post I've added one brief story from each of these communities:  Lagwamit, Sylvestre, and Mapou.

Click on this link and scroll down to see Bois de Laurence, then zoom out to see where exactly these villages are located in northeastern Haiti.

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Soulvenie Succeda, community health evangelist in Lagwamit

Before CHE started we didn't have any training on hygiene or on lots of other topics.  Women died in childbirth.  Now not many women die, and children aren't sick very often.  There aren't so many cases of diarrhea.  We train the children, too, so that when they leave the latrine they wash their hands with soap and treated water so they don't get sick so often.

We also train people so that they don't get in fights on the street.  We say, “A village is a family.”  We should work together and get along.  We should help each other.  Neighbors used to not get along with other neighbors.  We did two or three trainings and people saw that what they were doing wasn't good, and now they don't fight anymore

Many of us started planting vegetables and we are much healthier now.  We started home vegetable gardens.  We invited everyone to plant, and 14 people decided to make a community garden – so we call our group “The 14 Organization.”

(c) copyright Soulvenie Succeda. Used with author's permission.

Davilus Montimer, trainer in Sylvestre

We started with CHE in 2003. When cholera came in 2010 we were really proud because we were able to teach others. As far as physical topics, we taught people to wash their hands before eating and after leaving the latrine. We taught people to drink treated water. We taught people to use better hygiene so that their children would have fewer parasites and less diarrhea. We taught them that every person should have a place where they go to the bathroom. We taught people about a spiritual life and gave people training so that they could walk with Christ.

So then, when cholera came, other organizations came in to train us. This is when we all felt proud, because when people came with the training they say that we already had all the information! No one involved in the CHE program died, thanks to God, thanks to the information everyone had.

Thanks to CHE. . .we have done perinatal training, and thanks to this we have fewer people die in childbirth.  Once I was in bed and I heard someone knocking at my door. It was someone coming to tell me that Madame Jiwani had abdominal pains. I asked when this started, and we found someone who had a bicycle and who could go get her. He put her in a truck and went to the hospital in Pignon. If she wouldn't have gotten there either she or the baby would have died. She always talks about CHE and says that it's thanks to CHE that she has her baby.

I went to a house where the people there didn't ever go to church. I took my Bible and went and tried to share some verses with them. I continued to talk about how Jesus loves us, John 3:16, he gives us hope. . . The woman of the house used to go out and sell things on Sundays, but now goes to church! . . She stays strong, she is continuing to follow God.

(c) copyright Davilus Montimer. Used with author's permission.

Junimode, trainer in Mapou

We were in darkness. We see CHE as a grace God gives to us, it is like cool water for us.

During the time cholera was ravaging the country, thanks to God we didn't lose a single person.  Mapou has become a beautiful mapou tree! [The community is named after the mapou tree.] We didn't know how to wash our hands, and the children played on the ground. Now when you see a child with a mango you'll hear someone shout: Hey, go wash that mango before eating it!

We had a problem with our road. We sat down together and we decided to come up with a plan to get there faster. No one from the outside helped us, we did it ourselves. Unfortunately, we weren't able to finish before the rainy season started. But thanks be to God, we began. We will get there.

(c) copyright Junimode. Used with author's permission.