30046: Leiderman: news: award for Project Medishare (fwd)

[Bob Corbett <corbetre@webster.edu>]

From: leiderman@mindspring.com

dear Readers:

an article today about an American medical treatment and training organization working in Haiti, in Lawrence, Massachusetts Eagle-Tribune newspaper.

additional information:
http://www.projectmedishare.org/
http://www.internationalhealthvolunteers.org/cgi-bin/view_org.cgi?id=138
PROJECT MEDISHARE FOR HAITI INC
aka Medishare, 8260 NE 2nd Ave, Miami, FL 33138
Phone: 305.762.6448   Fax: 305.762.6446
Primary Contact: Ellen Powers (ellenpowers@projectmedishare.org)

additional articles:
http://www.haiti-science.com/haitech/2art4.htm
http://www.haitiinnovation.org/node/23

thank you,

Stuart Leiderman
leiderman@mindspring.com

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http://www.eagletribune.com/pulife/local_story_050120234?keyword=secondarystory

Published: 02/19/2007 [Lawrence, Massachusetts] Eagle-Tribune

Local authors work for the health of Haitians; Humanitarian efforts focus on stemming spread of AIDS

By Julie Kirkwood
Staff Writer

Merrimack College graduate Arthur Fournier's humanitarian work in Haiti has saved hundreds of lives and is bringing millions of dollars in international aid to the nation's rural villages.

Yet it might not have happened at all if Fournier and his colleagues hadn't been accused 25 years ago by the leaders of the Haitian-American community in Miami of racism.

Fournier was one of the first doctors to bring the world's attention to how the AIDS virus was spreading not only among gay men, but also among heterosexual Haitian immigrants.

Though well-intentioned, their report on 22 Haitians with AIDS cast a stigma on the entire community of 150,000 Haitian immigrants in South Florida, Fournier said.

So a decade later, when Fournier's neighbor, who was in a car pool for their kids, asked Fournier to take a trip to Haiti, he jumped at the chance. He had developed close relationships with many of his Haitian AIDS patients over the years, and as he watched each one of them die, he wondered what it was about being Haitian that made a person vulnerable to this horrible disease.

"Perhaps I could make up for past mistakes," Fournier wrote in his new memoir, "The Zombie Curse, A Doctor's 25-year Journey into the Heart of the AIDS Epidemic in Haiti," co-written with his best friend, Dan Herlihy of Newburyport, a former Methuen English teacher.

Fournier had seen poverty before his trip to Haiti. He grew up in a working- poor family in Peabody, he said, one of six children of a father who worked a variety of low-wage jobs. After graduating from Merrimack College in North Andover with a degree in biology, Fournier went on to medical school and did his residency at Jackson Memorial Hospital, the hospital of last resort for poor patients in Miami Dade County. For several years, he helped run a homeless medical clinic in Miami.

None of this prepared him, though, for what he saw in Port-au-Prince, Haiti's capital.

Patients were packed into the city's university hospital, sometimes two per bed, on stained mattresses without sheets. Flies buzzed through the surgical wards. They had no running water or toilets. Patients' family members acted as nurses, running across the street to a poorly stocked pharmacy to fill prescriptions and then administering the medications themselves.

As they toured Cite Soleil, the poorest neighborhood of Port-au-Prince, Fournier had an epiphany. The children pressing against their caravan were desperate. They asked for money, for affection and even for the Americans' four used Dixie cups. An angel-faced girl of about 12 stroked Fournier's friend's leg and asked sweetly for her purse.

It occurred to him that these children were vulnerable because of their poverty. He had heard people speculate that AIDS was brought to Haiti through sexual tourism, but for the first time he understood how easily that could happen.

Fournier felt he finally had an answer to people who misinterpreted his study, to people who thought there was something inherently wrong with Haitians that caused them to catch AIDS.

"I realized it's not about being Haitian," Fournier said. "It's about being poor. ... It was sexual tourism. We created the world's biggest Petri dish and this virus was going to outsmart us if we didn't do something about it."

After that trip in 1994, Fournier returned to Haiti 105 more times, determined to treat AIDS as well as the economic conditions that allow it to flourish. He co-founded a charity called Project Medishare, which began by bringing groups of medical students from the University of Miami, where he teaches, to Haiti on their spring and summer breaks to run health fairs in orphanages and villages.

They quickly realized, Fournier said, that "Americans coming in on an episodic basis are not going to have any impact."

Project Medishare still runs medical student trips, but now the core of its mission is to train Haitians to be health workers in their own rural communities, traveling the rugged terrain to visit people who are sick. Some of these Haitians are traditional healers and voodoo practitioners, but they work under the guidance of a nurse who gave up her job in Miami to take the position. The charity pays the Haitian health workers' salaries and also built their clinic.

The program works because it is sensitive to Haitian culture, Fournier said. The community health workers do a special kind of triage to determine whether a patient is sick with tuberculosis or HIV, in which case they are brought to a clinic, or with something like love sickness, in which case they go to see a traditional healer.

The workers deliver medications to patients at their homes and keep records to make sure they are following the prescribed schedule. They also perform immunizations, health education and pediatric care in their communities.

Fournier found out this month that Project Medishare's Haiti work has been selected as a Millennium Village by the Earth Institute. The designation means millions of dollars for Haiti, Fournier said. It will be the first Millennium Village in the Western Hemisphere, and one of only a few dozen in the world.

"This will bring a new level of health, education and community development to this community," he said.

But as much as Fournier has done for Haiti, he has gotten back much more in return, he said.

Practicing medicine in Haiti broke him out of what he calls the "zombie curse."

In literal terms, the zombie curse was a punishment used by Haitian witch doctors to deal with social outcasts. The doctor would give the victim a toxin to induce a death-like state, and then give an antidote to bring the victim back, but in a zombielike, enslaved state.

In his book, Fournier draws the comparison between the zombie curse and AIDS, which also attacks social outcasts - the poor, the mentally ill, drug addicts - and leaves them weak and enslaved by the illness.

But in terms of his own professional life, Fournier said, he felt as though he was under a zombie curse when he was working as a traditional American doctor.

"Doctors are sleepwalking through their professional responsibilities," Fournier said. "They're worried about being sued. They're worried about how much money they make. They're worried about their lifestyles. ... The clinical art is being threatened and their very existence is being threatened."

Working in Haiti reminded him that medicine is more than billing and medical technology. It's about getting to know the patients and understanding them in a socioeconomic and cultural context.

It's combining modern medicine with the human touch, he said, or "working with both hands, as the Creole expression goes."

Fournier is still teaching in Miami, but he travels to Haiti whenever he can. In the years to come he plans to spend even more time in Haiti and less in the United States.

The one thing that's clear to Fournier after all these years is that AIDS, like so many diseases throughout human history, disproportionately preys upon the poor.

"What the majority does is they blame the victim," Fournier said. "It's something they're doing - they're making bad decisions. ... When women are forced to decide whether to let their children starve or have sex with the truck driver who's going to bring their goods to market, it's a tough choice."

It doesn't have to be that way, he said, if people who have the means work to improve conditions for those who don't.

Fournier said he has great hope that the people of Haiti can improve their health-care system and fight AIDS. In fact, he said, he has more optimism about the Haitian health-care system than the American system.

The Haitians certainly have the intelligence and creativity to make their system work, he said.

"As much as I was shocked by the poverty," Fournier said, "I was totally overwhelmed by the beauty of the people, the culture and their ingenuity."

Telling the Haiti story

Art Fournier and Dan Herlihy met on their first day at college in 1965 and have been best friends ever since, even after Fournier moved to Miami to practice medicine and Herlihy stayed here teaching English in Methuen and developing real estate.

When Fournier realized what an unusual perspective he had on the early days of the AIDS epidemic in America, he started writing down his experiences. He wanted to memorialize his patients who died and tell the story of heroism and fear within the medical community at the time.

The manuscript never got very far.

"I had never written anything like this before," Fournier said. "More importantly, there was no happy ending."

Fournier sent the manuscript to his best friend for honest editorial advice. Herlihy didn't hold back.

"One of the reasons he put down his pen after the first 100 pages is because I told him it was terrible," Herlihy said. "Early on, I realized he'd be better off writing prescriptions than a book."

Yet gradually a happier ending developed as Fournier got his charity, Project Medishare, improving health care in Haiti and fighting AIDS by addressing the socioeconomic factors that allow it to spread.

As the story unfolded, Herlihy helped him put it into words. They mailed drafts and arranged meetings to write.

"It wasn't easy," Herlihy said. "It involved a lot of swearing."

He and Herlihy are now working on a new book about voodoo in Haiti. Contrary to popular belief, voodoo is not about inflicting pain by sticking pins in dolls, Herlihy said. In fact, he thinks their book could make voodoo the next Buddhism in terms of popular religions in America.

"There is a whole lot there about how one looks at one's life and how one looks at death," Herlihy said.

Their current book, "The Zombie Curse: A Doctor's 25-year Journey into the Heart of the AIDS Epidemic in Haiti," is published by Joseph Henry Press. The authors' advance and all the proceeds go to Project Medishare. - Julie Kirkwood

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www.greenff.org/international_health.shtml

Pediatric Infectious disease - Immunology - International Health

Project Medishare is a 501(c)3 non-profit registered in the State of
Florida, dedicated to improving the health of the Haitian people by
re-establishing the health infrastructure in several communities and
facilities throughout Haiti.

Project Medishare accomplishes this mission through the following objectives:
Continuing commitment to rural communities by establishing and funding sustainable programs; Training of Haitian physicians, nurses and allied health professionals; and

Providing technology, supplies and equipment to our clinic in Thomonde, Haiti and other affiliated programs throughout Haiti.

Project Medishare has formed a unique partnership with Partners-in-Health/Zanmi Lasante (PIH/ZL) and the Haitian Ministry of Health to provide healthcare to the community of Thomonde. This partnership has allowed Medishare to renovate the community clinic and provide financial assistance to hire full time doctors, nurses, pharmacists and lab technicians.

Prior to Medishare's involvement the clinic only received 10 patients a day ? today over 100 patients a day receive quality health care and education. Additionally, Project Medishare, in collaboration with PIH/ZL, funds a community health program. Under this program, PM hired and trained 37 community health agents and 5 supervisors to deliver - direct observed therapy - (DOT) to TB and HIV patients in Thomonde. Over 80 TB patients have completed the 8-month program and the cure rates for the region have gone from less than 50% to close to 100%. Since 2001, Project Medishare has also provided direct observed therapy with highly-active antiretroviral therapy (HAART) to 26 patients                       with advanced HIV disease.

The Initiative will allow Project Medishare to dramatically expand the local community health program by hiring and training more health agents to not only provide DOT but also provide basic health care and education to the most remote sections of Thomonde. As a result, over 40,000 people will have access to quality health care and desperately needed medicines.  The Department of Pediatrics at the University of Miami The Department of Pediatrics was organized in 1952 as one of the major Clinical departments of the newly created University of Miami School of Medicine. Since that time, the Department has become a leader nationally in children's medical care, by building upon its strong tradition of excellence. The Department has consistently been recognized by U.S. News & World Report's survey as one of the best pediatric departments in the nation. One of the largest and most prestigious pediatric departments in the nation, it is led by R. Rodney Howell, M.D., Professor and Chairman and is comprised of an extensive faculty of renowned physicians, scientists and other professionals committed to providing outstanding clinical care, research, teaching, and
education on childhood diseases. Additionally, the Department consistently ranks among the top in National Institutes of Health (NIH) funding for medical research. The award of NIH grants is a key indicator of research quality and competitiveness.

Kool Kids
In addition to our prevention through education program, our PROJECT CRADLE
offers several HIV support groups. The importance of support groups is
evidenced by the improvement in psychosocial functioning. When psychological
problems are addressed, compliance with health care and treatment regimens
improve. The Kool Kids support group consists of young people with HIV who
are aware of their diagnosis, between the ages of 7 and 18.

Project Cradle
PROJECT CRADLE is an affiliated volunteer organization of the University of
Miami School of Medicine's Department of Pediatrics. The group was
co-founded by Gwendolyn B. Scott, M.D., Director of the Division of
Pediatric Infectious Diseases and Immunology, and Mary Jo O'Sullivan, M.D.,                       Director of the Division of Obstetrics and Maternal Fetal Medicine at the
University of Miami School of Medicine, both of whom are internationally
recognized authorities on HIV infection and AIDS in children and pregnant
women, respectively. Together, they developed a "family unit" approach
offering medical care, research opportunities, case management services,
psychosocial intervention and other ancillary services to children and families with HIV infection.

The Initiative will allow the Department of Pediatrics to continue to enhance its academic mission of excellence in research, education and health care programs for children, including support for ongoing TB research that could affect worldwide childhood vaccination practices. The Initiative will also help to continue and enhance vital psychosocial services through the Pediatrics Department Support Groups. Additionally, the Initiative will support                       the development of an international program whereby information, training, and supplies will be shared with physician scientists in targeted areas throughout the world - starting in Haiti.

Â2003 Copyright

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leiderman@mindspring.com