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.)