20925: Burnham: Globe and Mail:Caring for the sick in Haiti's worst slum(fwd)

[Bob Corbett <corbetre@webster.edu>]

From: thor burnham <thorald_mb@hotmail.com>

Deep in Aristide territory, a Canadian MD says he can't afford to annoy the
thugs in the hospital, MARINA JIMENEZ reports

By MARINA JIMENEZ
Monday, March 29, 2004 - Page A3


PORT-AU-PRINCE -- Montreal physician Paul Fillion braces himself for the
unexpected every morning when he goes to work at the only hospital in Cité
Soleil, the toughest slum in Haiti.

The hospital's only latrine is an open sewer. There is no potable water or
electricity, and thugs steal the fuel that powers the generator. There is
only one blood-pressure pump and, until recently, no thermometers. Oxygen
masks and antibiotics routinely go missing, only to reappear in the chaotic,
filthy markets outside the hospital's green iron gate, where they are hawked
for a fraction of their value. The government hasn't paid the nurses in
months.

But the real challenge of working at the 64-bed Choscal hospital is the
presence of chimères, the gangs once supported by former president
Jean-Bertrand Aristide. They remain the de facto rulers in this slum city of
400,000, where there is virtually no state presence.

"Most doctors are too frightened even to come here on their own," said Dr.
Fillion, 50, who is here on a short-term contract with Médecins du Monde
Canada. "We are deep in chimère country. It is difficult to work without
having good relations with them. And it is hard to know whom to trust."

During the uprising, the hospital looked after many gang members who came in
with shotgun wounds expecting VIP treatment.

Despite the end of the uprising and efforts to disarm them, many of these
gang leaders remain armed, and experts say it will be next to impossible to
integrate them into any form of civilian life. Yet the doctors in Cité
Soleil know they cannot afford to alienate these clients and their families.

The hospital is the only lifeline for dozens of expectant mothers and
children who file into the waiting room every day. Routine problems such as
diarrhea and respiratory infections can be fatal here because of chronic
malnutrition and poor immunity. Then there are children who are abandoned
here, such as twin girls Loveli and Lovela, only a few days old, who were
brought here from an orphanage in Petit Goave, 50 kilometres outside
Port-au-Prince.

When they came in, the fragile two-pound babies needed oxygen. But the
hospital has no pediatric oxygen masks, so Dr. Fillion's Haitian colleague,
an energetic woman named Dr. Armide Jeanty, had to fashion adult ones to
size using white medical tape.

"It is so common for mothers to abandon their babies here. We have at least
several every month. They leave their kids at the hospital and just never
come back. They have no money to support them," says Dr. Jeanty, who has
worked at the hospital for eight years.

Many international non-governmental organizations left Haiti for security
reasons in the weeks before Mr. Aristide stepped down, and the hospital shut
down for six days during the armed rebellion that led to Mr. Aristide's
ouster. But Médecins du Monde stayed.

Dr. Fillion and the other doctors here desperately hope other
non-governmental organizations will set up in Cité Soleil, because the needs
are so great: People live in huts made out of pressed garbage; pigs and dogs
forage with ragged children in the trash heaps; and many are ill with
respiratory infections, asthma and diarrhea.

"There has been an emergency situation here for months, and now that Mr.
Aristide is gone, people finally recognize this," said Elenore Senlis, who
oversees Médecins du Monde's Canadian mission in Port-au-Prince.

Funded by grants from the Canadian International Development Agency and the
Quebec government, Médecins du Monde helps to operate the emergency clinic,
as well as a program to prevent HIV-positive pregnant women from
transmitting the disease to their babies.

Haiti receives more Canadian aid than any other country in the Americas, a
total of $587-million since 1968. Canada recently pledged an additional
$7-million in emergency assistance. Yet it can be difficult to see any
long-term improvement. International organizations such as the World Bank
and the Inter-American withdrew altogether after the disputed elections of
2001 that eventually led to Mr. Aristide's downfall, although they have now
begun to disburse loans again.

In a report assessing Canadian aid from 1994 to 2002, CIDA concluded that
projects such as democracy building and police training have met with only
limited success. It recommended Canada terminate aid to public institutions
and concentrate on programs that meet basic human needs, such as a national
immunization project and the Cité Soleil health efforts.

Haiti ranks 150th out of 174 countries on the United Nations'
human-development index, making it one of the poorest countries in the
world.

In the face of all this, Dr. Fillion and Dr. Jeanty maintain their good
cheer, knowing that without their presence at Choscal hospital, the people
of Cité Soleil would be even worse off. Dr. Fillion looks down at Loveli and
Lovela, lying side by side in rusted iron cribs, tiny fists curled, eyes
just beginning to open as they struggle to hang on to life.

"I think they're going to make it," he says softly.

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