Haiti Updates

Dr. Bibiana MacLeod, Regional Coordinator, South America and Caribbean
Enoch Firmin, Community Health Evangelist in Cap Haitian

_________________________________________________________________________________________________________________-

This morning I had the privilege of worshiping God with hundreds of my displaced brothers and sisters. We sang for God’s name to be glorified, we proclaimed how good God is to us, and we renewed our commitment to serve Him with all that we are. During the service a young woman fainted and they took her outside. Liz Carl asked me to go and see what was happening. Apparently she’d had a moment of low blood pressure which was caused by a few different factors—earlier this morning she’d started to have diarrhea and she hadn’t had anything to eat or drink yet. It was also 8:30 in the morning and it was already a little warm in the tent-church where we were meeting. Being dehydrated with an empty stomach was surely enough reason to lose consciousness. I keep asking myself how we can help those who live in the camp to purify the water they drink and cook with in these months that are so hot.

After praying with Denise, the woman who had fainted, we took her in our pickup to the tent hospital that the J/P Haitian Relief Organization has on top of the hill. (This refugee camp was a golf course before becoming home to 36,000 people.) They attended to her right away and gave her intravenous fluids.

When we got back to church the sermon was almost over. The pastor then surprised me by inviting us to say a few words. I told them my story, about how I had changed from giving out medicine to cure preventable illnesses to facilitating holistic health development for which the entire community is responsible. From Luke 2:52 I shared how Jesus is our model of transformation. I asked them who, in this huge camp, is capable of presenting development in all its senses: development of our body, our emotions, our relationship with God, and our interpersonal relationships. They shouted, “The church!” Looking at this new “neighborhood” we see that it is the new community. The task of the local missionaries has been renewed, and they need to understand what it is that God is asking them to do. There were several hundred people at the service, many of them youth. What tremendous potential to change this community for Christ—with the values of the Kingdom and health in each and every tent!

When the church service ended, a young girl with Down’s syndrome came up to hug us. Liz told me that Jillie’s gift is hugging, and she told me the story of a young woman visitor who was crying because she had lost all the pictures from her digital camera at the very end of her stay in Haiti. Jillie saw the young woman go off to a corner of the tent church to cry over her loss. Jillie went up to her, looked at her, and gave her a hug so full of warmth that her tears dried and she was able to let go of her sorrow for something that was really so trivial. Jillie loves to hug everyone. Her precious hands join together at the back of the person she’s hugging with so much tenderness and affection.

When I saw Jillie I immediately noticed that she had very prominent lymph nodes in her neck, one of which was ulcerated and draining. From my years of medical work in Haiti the first thing I would want to make sure of is that she doesn’t have tuberculous lymphadenitis (tuberculosis of the lymph nodes), which is not uncommon here in Haiti. So we asked a church leader to find her family and take her to the tent hospital. Concerned that the visiting doctors in this hospital would overlook the seriousness of the case (Jillie had already been seen for these lymph nodes and no follow-up had been suggested), I wrote a note to the hospital coordinator, Beth, who is also a Christian. Beth has asked me to bring together people of prayer to intercede for the J/P center which is giving such good care to the displaced. Our dear missionary, Dr. Liz Fleming, has offered to help in the future once she has settled in Haiti.

We’re thinking that Liz Fleming could be a key person to transmit the need for Community Health Evangelism (CHE) to the administration of this tent hospital and to other organizations that work in the same camp. We already have a scheduled a training of CHE trainers for the third week in November. Please pray for the two Christians who are working in this secular environment and for the donor that keeps this hospital going. He’s a famous American man who also needs Christ. Please pray that, together with Luidgi Larco, his brand-new wife Jackie (pictured here), Pastor St. Cyr, and his church, this camp will be transformed by the power of Jesus Christ. Pray that we will see individuals, families, and their living conditions change and that they will become a light for other refugee camps and a testimony to the nations of what God can do.

Bibiana

____________________________________________________________________________________________________________________

August 12, 2010

When I returned to Cap Haitian I was wonderfully surprised by a visit from a Dominican pastor, Rafael Peniche. God had placed in his heart the desire to help us by guiding the rebuilding effort for the Bayeux Health Center. We were able to plan the work and calculate the costs to determine just how much we will be able to accomplish with the funds that we currently have. We will start work in the next week

Anias and Clercilien, the two people who are responsible for the SODIS (solar disinfection of water) program met with me this morning to work out our plans for 2011. Their enthusiasm is contagious as they tell of how excited they are to already see champions in some of the communities where SODIS has been well-received. When Clercilien got to one of the houses he found 80 bottles on the roof! Rafael Peniche brought us several plastic bottles which had been collected by the Community Health Evangelism (CHE) trainers in the neighboring Dominican Republic to be used by the Haitian trainers. How beautiful to see how God provides through our CHE family! In the photo above you can see trainers taking the donated bottles to their communities. We have three well-defined goals for communities to achieve a health change in prevention of diarrhea: SODIS, latrines, and “Tipi Taps.” A Tipi Taps is a gallon jug that allows people to wash their hands frequently while using a minimal amount of water.

Anias and Clercilien are well-aware of the challenges of working in the communities. They explained to me that even though during this beginning of the project we have been seeing a lot of enthusiasm on the part of the CHE volunteers, there is always the possibility that the time will come when we aren’t seeing new families implementing the method. Up to now the people who have been getting most involved have been our own volunteers. Aware of this situation, we have decided to delegate the assignment of multiplying the training in the community and in the local schools to the CHE volunteers. Bob Dell, a Canadian, is planning to come and present SODIS to the governmental authorities and organizational leaders at the end of October. Will you please pray for these plans? Pray that God will confirm these projects are indeed His and that He will provide the ideas, resources, and help of key people to continue to expand the program to more people in each community?

Another meeting I had today was with the provincial (department in Haiti) public health director. We talked about his needs and challenges. A lot of health centers need generators to be able to work the lab equipment. Many also need furniture and shelving, others need repairs or refurbishing of housing for physicians and nurses. I would like to be able to help with funds and ideas, but we haven’t yet received any contributions towards the repair of other clinics besides Bayeux. What we have received and are still using—are the resources to construct a storage unit and repair the roof in Bayeux, although we are still lacking some of the funds necessary to complete the housing for a physician and nurses. That building doesn’t yet have a roof, the walls are still without plaster, and there are no doors.

The provincial public health director and I also talked about SODIS and I invited him to come to our meeting at the end of October. He seemed open, but did not confirm that he would come. May God move in his heart so that we would have his permission and there would be no roadblocks in the way of working with the communities that are in his jurisdiction. The last item we discussed was Liz Fleming’s arrival. I gave him the papers that are required for her to be accepted by the health ministry so she can work in his region as a physician. All of this is moving ahead smoothly and the only thing he has asked is that Liz would visit him upon her arrival in Cap Haitian so he can meet her. God is preparing six months of intense work for Liz, of that I am certain.

It’s late, it’s very hot, and there is still so much to do. But tonight I’m going to go to sleep happy to be here with my brothers and sisters in Christ, being a witness of what God is doing in our midst, knowing that He is here with us, guiding us, transforming situations all around us, and providing all that is needed. God is present here in Haiti.

Bibiana

____________________________________________________________________________________________________________________

August 6, 2010

Will our brothers and sisters be able to pass along what they’ve learned to their neighbors? This has been our third training in 2010. Thanks to the offerings we’ve received from those who give sacrificially, we’ve been able to train 50 people since the month of March. We’ve taught on counseling, preparation for community surveys about diarrhea, SODIS (solar disinfection of water), how to use materials on project planning and micro-enterprise, as well as reviewing lessons on nutrition and childhood development.

The short-term results are measured by simply saying that the participants have been equipped, but we want to know what’s really happening in the communities. What changes have these activities produced that give evidence to God’s presence among them, encouraging them to grow in the knowledge of God’s word and in the abundant life that God has promised to everyone? And how have the changes that were made in one community affected the neighboring villages?

We’re encouraged by hearing that in the last two months a new community has asked for training! One of our Community Health Evangelism (CHE) families in Ennery hosted the trainees since they live so far away. It would have been too difficult for trainers to walk for three hours over mountains with materials and personnel for the training. So volunteers from the nearby CHE programs organized a Training of Trainers (TOT) for them, and we provided materials and the transportation costs. Marcelo Lopez brought his mate (an Argentine tea), his charango (a small Andean guitar), and his wonderful lessons on how to start a business.

Solancia told me this morning that as a result of the last training she opened a small store selling items for bicycles. She really wants to continue as a volunteer CHE trainer in Novion—she goes there on her motorcycle once a week to facilitate classes for a group of 15 local volunteers. Lucson has a homemade jam business and asked me for books on how to learn to work in a more advanced way with the products he makes. He even has a business card! While they learn to get their own small businesses underway, thanks to the CHE lessons and Marcelo’s visits, these volunteers also travel to train new partners and we hope that other organizations will offer to cover their costs.

The SODIS surveys haven’t been finished yet, but we’ve gathered perhaps half of the information needed. Up to now we’ve discovered that 45% of those surveyed have someone in their family who has had diarrhea in the past month. This number is very high, and it appears that mostly children and adults (from 17- to 55-years-old) are affected. We will be analyzing these results in order to come up with interventions to diminish the incidence of diarrhea in these 35 communities where the program is being developed.

The local team is responsible for so much. Please pray for them. Please pray for unity of vision and that they would grow both in their interpersonal relationships and in their relationship with the Lord. Please also pray they will remain firm in their conviction that what they do is in obedience to God’s commandment to make disciples.

Marcelo and I will travel to Port-au-Prince on Sunday to visit people and ministries that have been supported by offerings from Argentina in these past few months. Marcelo will return to his home in Argentina on Tuesday and I’ll go back to Cap Haitian for a few more days.

May God prepare the way for permanent change in all of our lives: in those who give, in those who go, and in those we serve.

In Christ,
Bibiana

_____________________________________________________________________________________________________________________

August 5, 2010

Dear prayer warriors:

I really hope that you continue your commitment to intercede for our Haitian brothers and sisters with passion! There is a lot of activity here in Haiti. Different relief organizations keep coming and going, and they have a lot of temporary personnel with high expectations for making significant changes in the situation here. The national government finds itself in the position of having a lot of foreigners who come and go with their own agendas. It must be very difficult for the nationals to maintain a clear vision of what they want to do and how they want to do it without feeling threatened. And yet, on the other hand, the nationals also might sense that they do need some guidance to be effective in realizing their dreams of bettering the situation of their country. What most worries me is the rapidity with which the large organizations that showed up after the earthquake change their field personnel. They ignore the need to understand the culture and construct relationships and instead focus on achieving their goals and objectives. I wonder how they are able to make decisions in the midst of so much fluctuation in leadership.

The capital city still has a lot of rubble and few opportunities for reconstruction since there are still no clear laws or construction codes for safe anti-earthquake construction. In the streets I see a lot of workers breaking stones, but very few trucks hauling them away. Even though I read in the United Nations report that every day 300 trucks remove rubble from the city, I don't think I have seen even one in the—admittedly brief—time I was in the elevated Delmas area. Perhaps they were working in places that I didn't get to. Many groups have decided not to wait and are reconstructing or bringing in equipment from outside the country to restore private institutions that need to continue functioning to provide services to the population.

The refugee camps have become a heavy burden that doesn't seem to be resolving any underlying problems. Since many organizations are only focused on the victims who live in tents, many people who could look for other places to live have moved into the camps to receive the free benefits. It’s interesting to see that the majority of the displaced are people who didn't actually lose their own houses, but rather were renting and then were displaced and now don't want to look for or pay for something they can currently receive for free. I heard that a well-known Christian organization is trying to move many of the displaced to a location 30 kilometers outside of the city. I wonder: Why would they want to be taken far away from the commercial activity that could help them find a regular, daily income to a new place with fewer economic options and very few services available? What would motivate them to move? I remember our sad Argentine history of the 1940s, when those in need received things for free that they didn't deem necessary nor see as their own—so the best use they could put those things to was to sell them and get cash to return to their old situation, but at least with something in their pockets. Yet again this confirms our ministry’s vision that relief work done in the long-term damages those that we want to help and leaves us feeling frustrated by the lack of permanent change we wanted to achieve with our help. Relief is a tool to be used at a specific moment in time, defined by life-or-death situations. May God give discernment to those who have so many funds, that they may use them effectively!

The refugee Camps also offer a great opportunity for evangelism, because the people don't have anything else to listen to. The mass conversions that have been seen haven't been accompanied to nearly the same extent by fruits in keeping with repentance or with true commitment. This doesn't mean that God hasn't used the disaster to bring many to Himself. There are so many testimonies of people whose lives have been changed that they could be put in a book. Nevertheless, the need for follow-up and discipleship is evident. There are pastors working very hard on this in each camp. Many of these pastors are there because they lost their churches and congregations during the earthquake.

On Wednesday, August 4, I went to a meeting of the health network, or “health cluster,” composed of organizations that have intervened on issues related to health since January 13. Many interesting items were discussed, including their intention of continuing with the national vaccination program in spite of the challenges of the displaced, how to identify and refer cases of tuberculosis, and what to do with disposable material from the mobile clinics such as needles, dirty gauze, and organic material. There are only 12 incinerators in all of Port-au-Prince and they just barely meet the needs of those hospitals and clinics who own them.

I asked where they get drinking water for the refugee camps. The organizations pay daily for water trucks to come to the camps. This water is already contaminated from the moment it is collected and then distributed to each family. I think that the solar disinfection method, SODIS, would be a good complement to what they are doing, although I imagine that while the bottles are lying in the sun they would be stolen unless 1) each family had some way of identifying their bottles and 2) it were an initiative of the community itself through community leaders. In October we’ll have 15 minutes to present the SODIS system at the health cluster meeting. I’ll be back in Haiti then with Bob Dell, who is coming to teach SODIS with me. The Water School, the organization that is financing us in SODIS promotion in Haiti, has an article about SODIS on their website at: www.thewaterschool.org/partnersMacleod.html

In Port-au-Prince I met with Luidgi Larco, who has two tents where he sees patients in the Petionville refugee camp (that was formerly a golf course). He provides round the clock service and has connections with larger clinics in the camp which have made him a key player in the health system that began there out of necessity. Nevertheless, I believe that the time of curative medical care might be coming to an end, and I offered to provide training in Community Health Evangelism (CHE) to help them get a handle on preventive care from a holistic point of view. Luidgi is a new Christian and thanks to Liz and Dan’s discipleship he is growing in his faith and commitment to the Lord. He has been living in the Petionville camp with his wife Jacqueline since the earthquake. He has seen so much suffering that right now he is unable to look to the future. We have been providing some financial support for these past six months to help with his relief efforts, but now we need to discern how to make the transition—if indeed God places on his heart the desire to advance in his work there—toward rehabilitation and development. I ask for your prayers for Luidgi, Liz, and Dan. We can't continue to support the work unless we are all focused on the same thing.

There is so much more I could share with you, but I think I’ve already written a lot. I’ll write more when I can. I love you all very much and I'm very conscious of the fact that I'm only here thanks to all of you. God has called us to be present with a clear message of redemption and change. I firmly believe this

Bibiana

__________________________________________________________________________________________________________________

August 3, 2010

Returning to Port-au-Prince after six months was very interesting. As soon as you leave the airport a sea of tents is visible, where people continue to do their normal daily activities. There are some latrines at the edges of the refugee camps with flags of the organizations that have participated in the relief efforts.

Liz Carl, who came to get me at the airport, has been helping Dr. Larco in his spiritual growth. He sees patients in a small clinic set up in the large refugee camp at Delmas 48, which was a golf course before the quake. Marcelo Lopez and I will visit Dr. Larco there when we return to Port-au-Prince after spending time in Cap Haitian.

At that same refugee camp Liz is helping a pastor who has been working as a chaplain for the camp. This man of God lost both his church and his house, and yet the day after the earthquake had already begun ministering to the victims who had started to gather at the golf course. He’s now raising funds to buy some land and build a new church. Since Liz and her husband Carl’s work is to guide lay people in ministering to children, they have been sharing their materials and training with this pastor.

Marcelo and the Haitian team have already started doing workshops in Cap Haitian. I will arrive in Cap Haitian a little later in order to be able to attend the biweekly meeting of the “health cluster” (a group of NGOs) which is taking place in Port-au-Prince today. I want to gain a better understanding of where their energies are focused and what the challenges are that they face. If possible, I would like to present SODIS (solar water disinfection) to them as an alternative for water purification in the camps, but I'm not sure I’ll have the opportunity. Either way, I am looking forward to knowing more who is who in the relief effort here. I have asked Liz and Dr. Larco to go with me to the meeting so that there will be continuity in the future.

I have a flight to Cap Haitian tonight.

Thank you for your prayers! We need God’s guidance and discernment in everything that we do. It is the Holy Spirit, not we, who brings people to God and completely transforms their lives.

In Christ,
Bibiana

_________________________________________________________________________________________________________________

June 9
Today was truly different. Our classes mostly focused on nutrition and we also taught two agricultural lessons. Everyone was in good spirits and really excited to learn.

The participants represented 35 communities which are all doing Community Health Evanglism (CHE) except for one. La Gonave is an area which only recently started receiving CHE lessons. There are 18 villages implementing SODIS, solar water disinfection, which has been a complete success. Our only challenge, which has been significant, has been in obtaining plastic bottles for some of the communities.

Blessings,
Bibiana

haiti 6

Studying Philippians, Haiti – 6-10 Small group study, Haiti – 6-10

__________________________________________________________________________________________________________________

June 8
In our devotional time here at the CHE trainer conference we have been focusing on Philippians 2: 1 – 14. We talked about the great risks that are present when leadership doesn't copy Jesus' attitude but rather looks out for their own interests, treating others as inferiors and not as important as themselves.

We ended up talking about this topic during each day of the conference, particularly focusing on verse 14: we don't want to be grumbling or arguing. The conditions in the conference center were difficult, and so we kept being reminded of those verses!

The first day of teaching it rained so much that we had to cancel some lessons. The room we were in had a corrugated tin roof with no ceiling, and so the rain made it so loud that we couldn't hear each other. We all got on our knees and submitted the meeting time to God. We lost several hours of class time and the other difficulties we'd been having were making the entire conference a challenge. We
returned to the place where we were sleeping – tired and pretty frustrated, hoping for a better day the next day.
___________________________________________________________________________________________________________________

June 7

Our first stop: the Community Health Evangelism (CHE) program in Ennery, with Renaud, Gerline, and Miss Jini. We visited the homes of people who are being taught by the CHE volunteers. We really loved seeing the evidence of the close relationships and love between the neighbors and their CHE workers. We were also really encouraged by seeing Renaud and his children putting into practice the SODIS teachings in their home. Renaud no longer has to spend money to buy drinking water or for such frequent trips to the doctor.

After our sunny, mid-day walk up and down the hills of the community, the CHE workers were waiting to receive words of encouragement and to be heard. They told us that they most want is to be trained in perinatal care topics and other lessons, to receive visits from experienced trainers and to feel supported by local leadership.

Second stop: Andre, one of the five communities that Pastor Celidon has been working in for the past three years with his two sons, Jerry and Johnson. These programs were begun by the agronomist Josias from Hope Seeds. Representatives of the committees from those five communities came to meet us. The land is a desert: desolate, rocky, gray. They have only one water pump for 1500 people.

We went to visit the home of a committee member, and there we found a four-month-old baby crying. Her mom was 18-years-old. A week earlier she had completely stopped breastfeeding and in place of that she was giving her powdered milk (whole). This is totally inadequate for her age , it is truly impossible to replace breast milk this way. The mother had come to Andre to leave her child with the baby's father's family, since she wants to continue studying in the capital and is living with another man. It's inevitable that the baby will be weaned, but we insisted that it was very damaging for the baby. We told her that sometimes we create situations that can lead to another's death, and which are avoidable. We begged the baby's grandmother to stop giving her powdered milk. Madame Grimard had the
mother start breastfeeding while we were there, but we don't know how the story will continue. We are praying this mother will decide to do what is best for the health and well-being of her baby.

After this they took us to see a spring that they would like to protect to provide drinking water for the community. They wrote up the project and are awaiting a response.

Third stop: We arrived in Gonaives, where CHE trainers from around the country are coming for a meeting. It was truly a day filled with remarkable experiences!

Thanks for your prayers!

Bibiana haiti 8

Sodis Water Project – Haiti – June 2010

___________________________________________________________________________________________________________________

June 6

We met with the four CHE facilitators for Haiti who are still really spending a lot of time complaining and focusing on relational problems. We need to pray for unity and love in action.

Thanks for being present with us!

Bibiana

___________________________________________________________________________________________________________________

June 5

Having had so many challenges with our vehicle, we decided to leave it in Limbe to avoid further problems, especially since we needed it to return to the Dominican Republic. Leaving one of Madame Grimard's nephews responsible for finding a mechanic to put a rubber piece between the nut and the metal rod, we paid a local driver to take us to the Community Health Evangelism (CHE) program in Terre Blanche, which is associated with the Free Methodist Church.

The village of Terre Blanche is located 100 km from Limbe, via mountains and more gravel roads. We were scheduled to arrive at 10 am, and really arrived with perfect timing, since we noticed after pulling in that we had a flat tire. The driver put on the spare while we met with Dr. Avril and his team of trainers.

I was amazed to see how well they had assimilated the CHE strategies with their community health program. In three different communities they have committees and also have CHE workers doing home visits.

They have other teams—agriculture, micro-enterprise, animal husbandry, etc.—that are not participating in the program because they've primarily taken on the topics related to physical health. We spoke about integrating the other areas and finding ways to utilize all of what the CHE lessons offer. They were very interested. We were really excited about the Biosand water filters they are constructing and the latrines that have been built in some homes. Their emphasis is on prevention of diarrhea and perinatal care.

We returned to Madame Grimard's house after going up and down many more mountains. We were really tired, but were also really blessed by Madame Grimard's hospitality.

___________________________________________________________________________________________________________________

Liz Fleming, Renee from Canada, Madame Grimard, and I traveled to Bayeux in the afternoon after working all morning in the office completing the manuals for the next week's training.

The car that I drive here in Haiti is my faithful Mitsubishi. We keep it in Santiago for ministerial work there. We heard a strange noise as we were driving along the road (road = dirt/gravel/deep holes/puddles). The noise didn't go away in spite of the fact that we tried to ignore it for a few minutes. Finally we stopped and tried to find where the problem was coming from. It turns out that a nut that holds the stabilizing bar of the rear left wheel had come off, and returning the bar to its original position required more skills than I have. What else could we do but stop the next vehicle that passed, especially if it had a United Nations sign on the door? They didn't help us much, but they tried, and when they left they promised that one of them would return with a nut. Meanwhile, we got out the jack and started to raise the car to see if in taking off the wheel we would have better access to the problem area. Just then a patient from the Bayeux clinic passed by on his motorcycle. He recognized me and was happy to help us. Other people soon joined him—that always make me a bit nervous because everyone has an opinion and they begin to use a lot of force without first understanding the problem.

I decided it was time to call Sandy in Canada (who happened to be in Kyle's dentist's waiting room). I didn't even know how to describe the problem in English, so that wasn't really much help. We simply prayed a few times and then put ourselves in the hands of the volunteers on motorcycles. Within an hour and a half they had gotten a nut and then used a lever to put the bar back in place so that we could keep on.

Despite our late arrival, the clinic employees were patiently waiting for us in Bayeux. We met to discuss how things were going and to prioritize the needs of the clinic, which are primarily reconstruction of all of the buildings at the site. Liz was able to take pictures of the damage in each building and I left them the money that had been raised on different occasions from churches from Cape Breton in Canada. They were very glad and grateful to be able to be able to begin the repair work on the clinic.

At the end of the day we arrived, exhausted, at Madame Grimard's house in Limbe. We stayed there for the next three days.

Bibiana
Clinic damage, Haiti, 6-10 Clinic Damage, Haiti, 6-10 Bayeux Clinic Workers, Haiti, 6-10

____________________________________________________________________________________________________________________________________________

June 3, 2010

Hello, everyone!

We got to Cap Haitian yesterday and sat down in the office to work right away. The Haitian training team was already using their new computers, inputting information about the diarrhea survey that was done in 11 of the 31 communities that are implementing CHE. There are 930 surveys to be evaluated. Anias was very happy, learning Excel and coming to work dressed very formally. He travels 40 km from Fort Liberte to Cap Haitian to use the computer one day per week and the rest of the time he visits the communities. There are already four CHE communities using the SODIS method for water potabilization (SODIS is "solar disinfection"). Anias managed to get 1100 plastic bottles from Port-au-Prince which will help with implementation of this method. Our biggest challenge has been finding enough bottles for everyone. We asked him how he felt upon returning for the first time to the capital after the earthquake – back in January he had to leave all of his belongings to escape a sure death.

This morning I had a meeting with Dr. Jazmin, the Public Health Director for the Northern Department (state) of Haiti. I told him
about the many brothers and sisters from different churches that are ready and willing to come to Haiti or to help in other ways to
strengthen the existing health care system in such times of overwhelming need. He really appreciated our focus on reinforcing
what is already working well in the country and he told me that the greatest challenges are in assigning professionals to permanently work
in rural health centers. They have nurses, nursing assistants, and lab technicians, but the government does not have the funds to be able
to hire them. Another area of need is building reconstruction. A third request for assistance is for essential medication. I asked him
if there would be the possibility of complementing these rural clinics with professionals with foreign degrees and licenses. The challenges
are: 1) they come for such a brief period of time and 2) they do not know the culture or the language. It would be good to be able to rely on the assistance of French-speaking people to meet medical needs or to teach healthcare professionals. In terms of contracting
professionals on a local level, the health ministry would hire them for six to twelve months at a time to try to cover immediate needs.

Dr. Jazmin said he will send me a report of his priorities. He knows (and we both laughed about this) that my priority is the Bayeux
clinic, where I worked for ten years. For the past ten years they have been doing very well at being self-supporting, but now they need
significant building repairs and provision of basic teams to be able to function better. In addition to Bayeux, he thinks that there are
at least eight other places where there are needs. We left it that he would send me the information via e-mail.

We also met today with Demetrius Smith, a young man who is in a wheelchair. On our previous trip we visited with some people from the
association of handicapped people that he started. Smith is interested in training his people to do CHE in the city of Cap Haitian. They have a committee which is already formed and they would like our team to begin to train them as soon as possible.

Today we finished correcting, editing, and printing the lessons for next week's trainings. We still need to photocopy them and tomorrow
we will bind them to distribute them as the training books. We are very surprised at the high lodging costs for the training's participants. We contracted a bus so that everyone can go together on the two and a half hour drive to Gonaives where we will be meeting from the seventh to the tenth of June.

Tomorrow we leave for Bayeux as soon as we finish making the lesson books. On Saturday we will visit two CHE communities and on Monday we'll visit one more. God willing, on Sunday we will be sharing at Haitian churches. I'll have Liz send you a photo or two that she took today. She's been a big help for me and I'm grateful to God that she's with me. Renee, a Christian from Canada who works with
Partner's International Canada, is accompanying us to learn more about CHE.

Bibiana
_________________________________________________________________________________________________________________

Wednesday, June 2, 2010

Dear friends who faithfully follow our updates,

Here I am in Santiago, Dominican Republic with Liz Fleming. God willing, we are ready to go to Haiti this morning. We won't have
reliable internet access while in Haiti, so I wanted to let you know some prayer needs. We will be in Cap Haitian for two days, then we
will go to Bayeux to visit the clinic and evaluate with the local committee what they would like to repair first. The offerings that we
have received will cover only a third of what is necessary to make the repairs, however it is a very good start and we are very grateful to
God for his provision.

After that we will be visiting new Community Health Evangelism (CHE) programs in the Gonaives area. We have gotten to know some Christians who started working with us in the past year. We want to encourage them and provide lessons and a guide that will enable them to continue working towards the holistic transformation of their people. On June 7 we will start the second series of trainings. We hope to teach on nutrition and project cycles, training the trainers both to teach these two topics in their communities and also to help their people to write development proposals for other organizations.

I received a message from the missionary Miguel Ovalle, who is in Port-au-Prince. He started a soccer camp for children who were
victims of the earthquake. Our trainers taught Miguel's team the counseling lessons they learned in April with Silvia, Delores, and the
rest of us who went on that trip. We have heard many testimonies of children that were able to open up and express their grief, alongside
other children who consoled them and spoke about the emptiness that God is able to fill. We are really excited to see how God uses people from afar to equip nationals to work with their own people. May God continue to give tools to our brothers and sisters there!

We drive from Haiti to the Dominican Republic on June 12 and will be meeting with Dominican Christians who want to be guided to effectively help their brothers and sisters on the other side of the border. This is a challenge for a people who have never considered Haiti as a mission field for Dominicans, just like the history of the Samaritans and the Jews. Sending people long-term from here has been
unthinkable!

May God guide us as we work alongside him and may he use us for his glory! We count on your prayers!!

Bibiana and Liz

______________________________________________________________________________________________________________________

This has been a very special Easter! At six o’clock on Sunday morning we celebrated the resurrection of our Lord with other missionaries that are nearby. Later we went to another church in the city where only Haitian Kreyol is spoken. It was a real experience to sing hymns of praise to our Lord in different languages: Kreyol, Spanish, and French! In the afternoon we went to visit some older people who are homebound, showing care for them by singing praise songs.

In the afternoon we went to visit a support group for handicapped people. There we talked about our values (the core values of Community Health Evangelism), our work, and we also shared words of comfort and strength. We brought them a wheelchair that was donated by the Bible Temple in Santiago, Dominican Republic.

We are so grateful to God to have met a Haitian physician who is working at a refugee camp in Port-au-Prince. He lost his house in the earthquake and is living in a ten among those he serves. A few weeks after the earthquake he started to work at the refugee camp and he accepted the Lord there. He is being discipled by a missionary. When we found out about the medical work he is doing there completely on a voluntary basis, and that he lost all of his possessions, Bibiana offered him financial support for the next six months out of the offerings we have received.

__________________________________________________________________________________________________________________

We arrived in Haiti on Monday, March 29, where we attended a three-day conference. The topics included a new children’s series on how children experience grief, how to work with children in a disaster situation, and displaced children. Other topics included stress in adults and how to reduce a community’s vulnerability. These topics are key as we anticipate the arrival of the rainy and hurricane season.

During the conference we listened to testimonies of those who experienced the earthquake. It was a time when we were able to minister to one another and recognize that although the scars will always remain it is very necessary to begin the healing process. There were tears, pain, laughter, singing, and love shown during this time of sharing.

Also during the conference we developed a survey that will be used in the 30 communities represented by the 57 participants attending the conference. The survey will gather information about cases of diarrhea and the hygiene practices of each family. We hope that in every community they will evaluate the responses themselves, and that this will be the beginning of the process to implement practical methods of water purification and hygiene.

Thanks to the offerings that you sent we were able to provide money to one of the clinics for a generator. Additionally, the costs of this conference and the teaching materials for each participant were paid for through your gifts. Thank you to all; the job is getting done! We see that the three objectives we had proposed for this time period are being accomplished. We give thanks to the Lord because He has been guiding us and providing the people and resources for this work.

In Bayeux they need an engineer who can evaluate the medication storage area as well as equipment construction, and groups that can help to repair, paint, and improve the clinic building. I will share more needs later.

___________________________________________________________________________________________________________________

March 5, 2010
We are home for ten days as we prepare our first post-quake short term team with very specific tasks for HAITI. I will be going with people in association with The Water school, (SODIS promotion, with a baseline survey on diarrhea to be done in the next three months, before implementation). The Water school has granted us funds that will help support one CHE trainer to provide communication and very clear help to CHE communities that will be teaching others how to purify water with this simple method. Also, joining the team are two Counselors, one from Argentina and one from Canada, that helped us prepare new lessons on Children, stress and crisis. There is also a new lesson on Disasters called Local Management of Risk. The emphasis of the series is to help people work on their vulnerability factors. So, with the funds raised for HAITI we will be holding an equivalent of an Area Council every three months. We will be planning another Area Council in June. We gather all 54 volunteer trainers to provide these lessons. We hope to have time for prayer, refreshment and sharing emotions too. One team comes from one of the most affected areas. The rest of the trainers will be helping in their own communities, also affected in a more indirect way, with overcrowded homes, clinics, schools and lots of unemployed relatives or friends that need to find a new way of living. Once the CHE workers start visiting homes with new lessons, we hope to see a renewed desire to multiply CHE in other communities. Also, Samaritan’s Purse could be interested in the later phase of their intervention in Haiti to teach those they help today about CHE. Please, be praying for a good and open contact there.

We praise the Lord for the blessing of funding. It makes it so much easier to have adequate funding to move along with the opportunities we see to serve our people in Haiti! We pray that the rest of the CHE coordinators around the world will find some way of relief in this matter too.

Thank you all for your prayers on behalf of the Haitian team: Madame Grimard, Enoch, Osse and Evelyn. Continue to pray for these precious brothers and sisters.

________________________________________________________________________________________________________________

Today we concentrated on meeting with the team of Community Health Evangelism (CHE) leaders in Cap Haitian, as well as finding some loved ones with whom we hadn't had contact for a long time. Sandy was able to help on two occasions by using his mechanical skills.

Part of the medications we brought were distributed at the clinic in Seminaire Limbe, as well as toys for the refugee children who lost their homes in Port-au-Prince and are staying at a Baptist camp.

Those present at the meeting of CHE leaders were: Enoch, Osse, Evelyn, Madame Grimard, Dr. Steve James and his wife Nancy, Sandy, and I. We discussed the role of Medical Ambassadors Haiti in light of the earthquake and its effects on the country.

Our mission continues to be the same: awakening in community leaders a vision of holistic transformation and accompanying them in the process, either directly or via other Christian institutions, so that the local church takes ownership of the vision.

In light of the earthquake we will concentrate on certain tasks which will be key in the next few months:

If you feel the desire to support these efforts either with your presence or in your professional capacity, please feel free to contact us. The commitment with Haiti must be something that goes beyond the first week of emotion. The country is in ruins, every inch has been affected by the earthquake. The families around us all have eight to ten more people to feed in their houses for who knows how long. The refugee camps will be moved to specific locations, but in the provinces the exodus is having a tremendous impact on both the family economy and local economy. We believe that CHE is a very valuable tool to contribute to the solution of the problem. We will need $50,000 to cover April through December of 2010. This amount includes transportation, meetings with key people, trainings, community visits, partial salaries for seven people, and communication and office costs.

We send our affection and appreciation for all of you who have been giving ideas, sending support, praying, and offering help.

____________________________________________________________________________________________________________________

February 3, Milot hospital
N Haiti-operating room.jpg

Sandy and I arrived at midday to Milot, the hospital where Dr. Robin, Jane, and Adrian (from the Northpark Church in Ontario) have been working since Saturday. Dr. Robin is a plastic surgeon and he’s operated on many, many patients since he arrived, sleeping little and spending most of his time receiving those who were burned or had limbs amputated, as well as taking care of all types of wounds.
The hospital in Milot wants to receive tents [the type used for camping] for the family members of the patients that have come from Port-au-Prince and don’t have anywhere to sleep. We’ve met several people in this situation. We met one woman who has two daughters, one of which has had internal hemorrhaging and had already had three different operations. When I asked her where she’d been sleeping she answered, “Wherever I can find where I can sit down.”

When we arrived Robin was operating on a girl who’d been burned. So while I was waiting for him to finish I went to speak with the hospital’s medical director, Dr. Previl, who is an old friend of mine. He showed us the six military tents that had been donated to shelter 300 more patients and promised to e-mail me with a list of items that are most needed in order for them to function well. The hospital has ever-increasing demands since helicopters keep arriving with more patients from either the hospital ships or the capital – which is in ruins.
Later we visited some friends on our way to the CHE office, and then in the office we met with three of the four Haitian CHE leaders. We all shared how we were feeling and news from the last few days.

Tomorrow we will be meeting with the CHE leaders again and we will deliver some of the medicines that we brought to a local clinic.
The deep and extensive conversations we have been having with our colleagues here are helping us to get some clarity in this situation, which is so confusing.

We need your prayers. God answers. This morning, on our way to Haiti [from the Dominican Republic], we prayed that God would show us where to look for Esteban and Ramiro, children of Uruguayan missionaries that had stayed here by themselves when their parents needed to return to Uruguay. At that very moment, Ramiro – who had not shown up for school –appeared alongside our vehicle. I gave thanks to God for showing me how He is working in the little things as well as the big

__________________________________________________________________________________________________________________

January 25 Life is almost impossible in Port-au-Prince. Massively, the residents are moving toward the country sides in search of shelter where they can breathe, drink, eat, and sleep. The local hospitals are full of broken people. Just today the US coast guard helicopters finally stopped transporting new patients to a hospital here for surgeries.

The Medical Ambassadors of Haiti received food supplies and medicines yesterday… The four senior CHE trainers in Cap are thankful to the Dominican CHE trainers. Yesterday afternoon, we visited with some of the 150 victims at the hospital who do not have relatives nearby. We distributed some items and encouraged them through the Bible. It was so hard to listen to their stories; they all acknowledge that God is good all the time. We see real need for psychologists in the country now.

________________________________________________________________________________________________________________

January 23 I am back in the United States. We will be preparing a new ministry plan in light of the pressing needs that the earthquake has created throughout the country as a whole. The survivors continue to flow from the capital city to the provinces. There is a need to reinforce the local healthcare systems and have a broader program. What is most needed now is good coordination beginning with nationals’ decisions – the Haitian leaders are truly my heroes of this past week. I saw so much effort: from the rescue of the victims, to transportation, to home visits, to medical care by volunteer professionals in spite of their personal losses, that I am truly encouraged to begin to think of a completely new Haiti that will arise from the strength of its people and teamwork with foreigners. WE MUST GET ORGANIZED were the words repeated over and over by local missionaries. We truly feel the greatest strength is in the Haitians themselves, a resource that has not been fully appreciated. We must pray for those who have decision-making power, that they will include the many nationals who want to be part of the solution.

__________________________________________________________________________________________________________________

January 22 We’ve now visited 11 sites, the last one in Delmas 48 golf club. There are 20,000 refuges, including 4000 children. It was remarkable to see the amount of tents and cardboard structures. In the corner of the camp Dr. Luigi Largo was working with few resources, attending patients who were sobbing and shouting from pain. We were sent to a pharmacy with a list of medications for all 11 sites we visited. We were turned away; I was so disheartened. We went to the UN offices and told our story. They took us very seriously and promised to have all our medications for us tomorrow. We were so thankful. We know how many missionaries are without supplies. I feel that God put me exactly in the right place to be the most effective, networking with others and speaking for those who do not have a voice so that their work will be easier.

In the second phase of the work here, we will consider various factors. STEP’s CHE program has lost two of their CHE workers. Others that survived from that program lost close family members and their homes and belongings. I would like to focus the immediate support on these brothers and sisters while preparing another worker to run a rehabilitation program focused on spiritual and emotional support of the victims, training them in participatory lessons and community ownership.

A CHE trainer in Cap Haitian (a major city in the north) wrote to say the gym is filled with refugees. The local churches are taking offerings every day to prepare food for the people. There is so much to do in the north as well. Many families are arriving from Port-au-Prince to be with relatives in Cap Haitian. May God give us wisdom to channel efforts and resources appropriately. I hope to be able to return to Haiti in the first few days of February.

__________________________________________________________________________________________________________________

January 20 We just experienced a 6.1 earthquake at 6 a.m. Since we sleep dressed and with passport in my pocket, it was a quick flow of people out the door to the yard.

Yesterday we were in Christianville. The clinic there is severely damaged and they started seeing patients yesterday. These people had wounds that had not been cared for before, broken legs and arms, and infected wounds. Some people are getting hurt because they try to go home and start clearing up, moving debris, and wires; they end up getting cuts and bruises. The CHE committee has been helping… We have seen a lot of people who need to talk and express how they feel, to be assured of God’s unshakeable love for them.

SODIS will be a good teaching tool if we can get organized in this chaos. I plan to go to Cap Haitian the first week in February and get our teams to help with planning and priorities.

This afternoon we went to Bolosse to encourage Petion, who is the leader of the CHE program with the STEP organization. His wife’s mother died in the earthquake and her sister’s house was destroyed. Their ministry has 5000 refugees making their home on their lawn – very well organized, without any relief services or any food distribution in that area. The children are playing and singing with Petion’s wife and other volunteers, who are committed to minister to others in spite of their personal losses. During the day the people leave the compound to look for food in the markets and return later to sleep.

January 19 Good news! We’ve heard from Anias. He arrived at his home town on foot, after he was robbed on the way home. However, he survived and we are so happy with this news. (Editor’s note: Anias had been missing since the earthquake on January 12.)

_________________________________________________________________________________________________________________

January 18 We arrived in Port-au-Prince (PAP) at 2:30 p.m. We went with our contact, Miguel, to the Argentine mission of the UN. We passed by gigantic tents with different groups of Americans taking care of about 450 patients. The tents were filled with patients on cots, many of whom had IVs. The Argentine group we needed to meet with was there, working in a tent. They were very happy to see us and took us to the coordinator of the medical unit, Dr. Alonso, who told us that “every grain of sand is needed to make a beach.” Dr. Alonso’s office building was destroyed. He told us that he ran out of the building and the only thing he saw was the dust behind him. Now his “office” is his telephone. He has nothing else to work with, but the work he does is invaluable. What is most needed here are orthopedic surgeons and casting and splinting supplies.

Driving down the streets on the higher side of town one can see some collapsed buildings…the dead bodies that were piling up on the sidewalks are no longer there. They have been removed or burned, although the bad smell in the heavily damaged areas remains due to the bodies that are still buried under the rubble. There were no more tremors today, everything is calm.

People are rationing water. They aren’t using water to wash themselves or even for the toilets or housecleaning. The priority is to use the bare minimum needed to keep the most indispensable things clean and to cook. No local shops are open, but people are receiving food through distributions made by local churches: local leaders prepare the people before the food drops occur so that things go in a more orderly fashion. We distributed our SODIS material (for water purification). We need to mobilize the people on this as quickly as possible.

The search and rescue groups aren’t able to meet the immense needs in so little time. This is one reason the people are very sad, because they would still like to search for survivors… Person after person tells how they were saved from a sure death by a sudden decision, or because they had left the Caribbean Supermarket just in time – many died there, and they still haven’t been able to excavate it completely. Only thirty people were rescued from that building.