New Website!

Haitian Hearts has a new website1 It's at the same address as our old site: http://www.haitianhearts.org/ It is clean, easy to navigate, and up to date site, filled with John's wonderful photographs.

Please check it out when you have a minute!

Poor and Alone

John is in Haiti now, so I'll be able to indirectly and vicariously post live from Haiti

He spent his first week teaching at a nursing school in Les Cayes, the third largest city in Haiti, on the coast of the southern penisula. As part of one class, John interviewed a 19-year-old who was in the hospital by herself. Her story was sad; she was sick, possibly with AIDS, and had a baby who was somewhere in Port-au-Prince.

They were about done with the questioning when one of the student nurses asked her if she had anything else to add. The young woman said she felt bad because unlike the other patients in the hospital, no one visited her, no one brought her anything.

Class concluded and John noticed the nurses in a little group. They were taking up a collection for the young woman.

It isn't the poor in Haiti who are the problem.

Good News!

I am very happy to announce that we recently have had two patients accepted at hospitals! Given the current economic/health care environment, these are huge successes. Much credit goes to my husband John for his persevernce in advocating for his Haitian patients. He has to hear a lot of "no's" before a patient is finally accepted.

With one of these patients, the details are still being worked out, so I'll leave those for a future post. But today I can tell you that 7-year-old Modjina has been accepted by St. Louis Children's Hospital. You can see Modjina's picture and read more about her here.

Haitian Hearts has had a long and happy relationship with St. Louis Children's. Modjina is the fifth patient they have accepted in the past several years.

We are looking forward to completing the paperwork and bringing Modjina to St. Louis sometimes this fall.

Pictured above are two healthy girls in Haiti

Farewell Heurese

In our house today, we are missing Heurese. She is a 30-year-old Haitian woman who lived with us for the past five months. Four days ago, she returned to Haiti. Despite the lavish life she was leading with us (relative to her life in Haiti with no running water, regular electricity, and much skimpier meals), she wanted to return to her home. And for good reasons: her 5-year-old daughter and her 3-year-old son.

Though Heurese came to the United States in December 2008 for heart surgery at Cleveland Clinic, she has not seen in her children in almost a year. Prior to surgery, her sick heart made her so weak that she was unable to care for her children. They lived with her mother in another town. We know there was a happy reunion in Port-au-Prince this past Saturday.

Heurese was fully recuperated from her heart surgery--the installation of an artificial valve that will last her the rest of her life. She has more energy than she has ever had in her adult life. She will need it to negotiate life as a poor person in Port-au-Prince. So much energy goes into activities like getting water, gathering fuel for cooking, washing clothes--all processes that are automated in the developed world.

It is amazing how fast humans can bond to each other. Heurese was a wonderful presence in our home. Intelligent, kind--a lovely person, who helped us a lot. We will think of her often and look forward to seeing her on future trips to Haiti.

Roldolphe Richeme 1985-2009

This is an e-mail that my husband John received, regarding a young medical student/doctor in Haiti, Roldolphe, who died of severe liver disease. The e-mail was written by Rodolphe's brother, who prior to this, had campaigned with all his heart, mind, and effort to get Rodolphe medical care in the United States. He even offered part of his liver to be transplanted into his brother. Rodolphe was never granted a visa to the United States, and he died in Haiti

Dearest Friends,

God has made everysingle 1 of his creature for one purporse like he has made ROLDOLPHE RICHEME borned in our family, for us to have a sense of lifestyle in the Heaven as he was pure angel living temporarily on this earth for 24 years 7 months old (DOB 12-5-84). The Richeme's family was blessed by God to benefit that grace of having Roldolphe in the family.

No one can come in direct competion with God as we (the Richeme family+yourselves) through Roldolphe's illness end stage were pleading, fighting, shaking the earth and heaven for Rodolphe to live longer on this earth. God wins always the battle as he indeed retrieved Rodolphe prematurely from this earth on a mourning day of july the 4th while some earthly people were rejoycing where 1 other was agonizing, putting out all his blood from his body resulting from the sevrity of his unassessed medical affection experimenting in 3 months on the pitiful eyes of the Lord.

Some would have emphasixed that I would correlate Rodlophe's death on the account of the USA since he could have had better assistance and care there, but no, it's to more emphasize that weirdly according to Independence day celebration in the USA, Rodolphe took his independence from this earth which is an even better fulfillment of Lord's willing. After much sufferings, God decided that RODOLPHE worths more in Heaven then on this failing earth where he had to face sins of all nature and now HOME FREE and away from all pain, sorrows and diseases and iniquities of all kinds.

RODOLPHE's departure would live a unfilling huge gap in the Richeme's heart and yours as my grandma 86 years old fainted last night on hearing that sad news and taken right away to general hospital las night in Port-au-Prince as she wanted to make trip before Rodolphe and asking herself why Rodolphe but not her. Though through this toughFUL experience, we remain more faithful to God and praising Him more than ever not only in good times but as well in bad times like this as each of the trial takes us to a different growth maturity level and the TO BE READY AT ALL TIMES for this EARTH-HEAVEN TRANSITION as Rodolphe is not dead and just ahead of us and we are already anguish to join him to continue to rejoyce with him in songs of Honor and reverence to the Lord.

RODOLPHE HAS CHARGED ME AND FAMILY TO THANK YOU FOR ALL YOUR CONTRIBUTIONS AND ASSISTANCE FROM ALL NATURE but felt unsecure about you being ready for that transition as the Kingdom of Heaven is freely open to all of us as we get Lord's redemption.

Rodolphe's funeral is scheduled for this saturday the 11th of july and you are part of our guests to join us for that symbolic event but be sure that Rodolphe won't rest in peace as he is alive in our heart and alive in heaven eternally.

You may want to stop all medical and financial donations regarding Rodolphe's case at this point. The prayer supports are indeed requested for my family as God is the only one comforter and body and soul healer.

GOD BLESS YOU

THE RICHEME'S FAMILY

Just Like Here

John has returned from his trip to Haiti. As usual, he found some new heart patients, a couple of whom I've written about. We've had contact from someone who is interested in helping us find hospitals--always the biggest challenge--for a couple of new patients. I will keep you posted on the progress.

On this trip, John examined 3-year-old Lydia, pictured above with her mother, who has Down Syndrome, Unfortunately, she also has some of the congenital heart problems, that can accompany this syndrome. In Lydia's case, she has AV canal, a defect where the walls between the heart's chambers didn't form properly. She was referred to us by a pastor in Missouri who had met the little girl and her family on a recent trip. The little girl and her mom and dad made the three-hour trek to Port-au-Prince from their home in Gonaives to see John.

Please keep Lydia and her family in your prayers.

Follow Up With Marie, A Haitian Hearts Patient

Marie Myrtha, who had artificial valve replacement surgery at Provena St. Joseph in Joliet in June 2007 visited John today in Port-au-Prince. John examined her and was very happy with the results, Her heart rate was 84 at rest. The beat of her heart is crisp and clear and her most recent echocardiogram looks good. She has a large supply of required meds and is faithfully taking them. Her lungs are clear and her pacemaker is working effectively.

After all the work of getting a Haitian to the United States for heart surgery, seeing these kinds of results is so gratifying. Marie could barely walk before surgery; now she doesn't have to worry each day if her heart will give out. We are grateful to everyone who helped make it happen.

Frandy Has a Blog

Our friend in Haiti, Frandy, started a blog. It is an on-the-ground look at life in Haiti. Frandy can report with complete credibility what it is like to live in a poor country because that is what he is doing. He knows this territory well. Frandy has many hopes and dreams for his life and is working harder than we can imagine to make them come true.

Today, Frandy accompanied my husband John to the clinic in Cite Soleil where John works as a doctor. John was impressed with Frandy's logic and judgment as Frandy witnessed the ravages that poverty has on the health of children.

We are thankful for the contributions that Frandy makes to Haitian Hearts. Make sure to check out his blog.

Bob Corbett

Bob Corbett is a retired professor from Webster University, who has a long time interest and involvement in Haiti. He has a very comprehensive website on all things Haitian and also moderates a list serve about Haiti, to which I subscribe.

People from all over the world and with all kinds of ideas about Haiti post to this list. I have posted twice, most recently about Father Gerry Jean-Juste.

Quite often, spirited debates break out on the list. Recently, people have been debating how best to help Haiti. Once inawhile, Bob posts on the list, and I thought what he had to say was worth thinking about. It follows below.

I agree fully that there are innumerable decent Haitian people.
That's not what's at issue. The issue is: How do people change the
reality of THEIR Haiti?

I recall a very imporant learning experience for me. I
won't identify the person or place for fear I would jeapordize things in that
area. But, it was way back in Duvalier days. I was deeply impressed
with the work in one area and offered to provide some financial aid. The
Haitian leader of that group told me, "No thank you." I was quite
astonished. Every other place people just wanted anything I might be able
to offer. This leader told me:

1. If I take money from you and it gets out, then the "gwo neg"
in the area will wonder what we are up to, want their share, and we will be in
trouble.

2. Soon, YOU will be suggesting we do this or that....

Thanks, Bob, but no thanks.

Eventually I got this leader to agree to allow me to give his group
anenvelop each month with cash, no questions ever asked, and no mention of
it. That ended up helping what is today a rather successful group, but
part of that success is DEFINITELY related to this leader's understanding of the
need to protect such information.

The problems in Haiti are not a lack of decent and hard working and
ambitious PEOPLE. It's leadership. There is a political class which
is a complete sycophant upon the people. There is an economic class which
is a complete sycophant upon the masses. There is a force -- it used to be
army, now it is police or thugs, who enforce the will of the powerful and keep
the masses in conditions of shocking poverty and powerless over their own
lives.

Okay, there may be a period of history here or there that I've over
exaggerated the disgustingness of leadership, but not by much.

Again, given the hard reality of the PRESENT, I think the best bet that
people of good will have in helping Haiti and Haitians is to forget "Haiti" as a
nation, and go to the villages, the more remote the better, and go SMALL.

Help the market women who need some funds for an initial investment,
help the farmer who needs a hoe or gwo bef or seed. Help the community
that needs water, help the community organization that needs a local store
ordispensary of medicines. Help the local community that needs a school
building or a teacher.

Those are things that many of us in the outside world can DO. We
can either do it alone, or we can bond with a small group of others and get
things moving.

At the same time, go small. Try NOT to be noticed. Try not
to attract the sychophants who will use power and force to steal the
benefits.

THAT HAITI, the Haiti of the real people, the non powerful, the
politically insignificant, they are the hope of the future, be they in the slums
of the city or the more rural areas of tiny villages.

And pardon me if I step on toes here, but get the hell out of the
SPIRITUAL lives of the Haitian people. They can do that quite well
themselves. They need material help and medical help and educational help,
they don't need outside help with their spiritual lives.

Bob Corbett

Out of Balance

Michael Jackson hasn't even been dead for eight hours, and I'm already weary of the coverage. I know his death needs to be acknowledged but the time that is being spent on it seems all out of proportion to what is important. This is a blindingly obvious observation and yet the situation of our out-of-whack priorities persists.

I wish we could hear more about children like Love, pictured above. Love, as you can see, was a beautiful child, and, yes, my use of the past tense means that she has died, probably from infection. You can read more about Love's short, sad life here at John's blog.

I would really like for us to hear more about Love, and the millions--billions?--of children like her, before malnutrition and disease take them away. And I think, Michael Jackson, from his current perspective, would agree. Why isn't saving these precious children the world's number one priority?

We Are All Broken

I thought maybe I could use a funny photo to help make a point about Haiti, which I will get to eventually. One of John's childhood neighbors sent him this picture yesterday. It was taken sometime around 1964. John is on the right in the back row and his brother Tom is sitting next to him shirtless. The boys are acting goofy, as young boys often take pleasure in acting.

Over the past few days, I've been reading a book, Living Gently in a Violent World by Stanley Hauerwas and Jean Vanier. Stanley is a university theologian and Jean Vanier founded L'Arche, "an international network of communities where people with and without intellectual disabilities experience life together as human beings who share a mutuality of care and need."

So much of what is in the book reminds me of Haiti. First, just the juxtaposition of the words Gently and Violent in the title, for Haiti and Haitians are both gentle and violent. I find the people to be gentle and when they are not, it is often the violence of the poverty that elicits the violence.

Jean Vanier talks about God's vision for the world: "It is a promise that people can get together. It is a vision of unity, peace and acceptance. It is a promise that the walls between people and groups can fall, but that this will not be accomplished by force. It will come about through a change of heart--through transformation. It will begin at the bottom of the ladder of our societies." (Italics mine)

It will begin in places like Haiti.

I want to quote a number of passages in the book where Jean Vanier is talking about people with disabilities. What he says, I think, also applies to Haiti.

"Jesus wants to break down the walls that separate people and groups. How will he do this? He will do it by saying to each one, 'You are important. You are precious.' There can be no peacemaking or social work or anything else to improve our world unless we are convinced that the other is important. Your are precious. You--not just 'people' but you."

"When we listen to stories of terrible pain and know we can't do anything about it, we touch our own vulnerability. We have heard the scream of pain, but we don't know what to do with it. None of us knows what to do with the deep brokenness of our world. Maybe that realization can bring us back to community. We can do nothing on our own. We need somewhere to be together."

"We must begin at the bottom. Jesus came to announce good news to the poor, freedom to captives, liberty to the oppressed, sight to the blind. Let's help the poor to rise up, and then help those who have power and money to see that for the sake of peace, which is the greatest good human beings can seek, they too should enter into this vision and start helping the weak to rise up."

"Jesus came to change a world in which those at the top have privilege, power, prestige and money while those at the bottom are seen as useless. Jesus came to create a body. Paul, in 1 Corinthians 12, compares the human body to the body of Christ, and he says that those parts of the body that are the weakest and least presentable are indispensable to the body. . . Who really believes it?. . .Do we really believe that the weakest, the least presentable those we hide away--that they are indispensable? If that was our vision of the church, it would change many things."

"I have been trying to point out that our deep need is to meet those on the other side of the wall, to discover their gifts, to appreciate them. We must not get caught up in the need for power over the poor. We need to be with the poor. That can seem a bit crazy because it doesn't look like a plan to change the world. But maybe we will change the world if we are happy. Maybe what we need most is to rejoice and to celebrate with the weak and the vulnerable. Maybe the most important thing is to learn how build communities of celebration. Maybe the world will be transformed when we learn to have fun together. I don't mean to suggest that we don't talk about serious things. But maybe what our world need more than anything is communities where we celebrate life together and become a sign of hope for our world. Maybe we need signs that it is possible to love each other."

My head is swirling with the truth of these statements. Let me just add a few more thoughts. Sometimes I get a little nervous when people start talking about how happy the poor are, not that I think that's what Jean Vanier is doing at all. People living in poverty have much to teach us about what is important. But I also think that some of the horrid, torturous conditions that I have seen children living in shouldn't be tolerated and we should work fervently to alleviate those conditions.

Secondly, when I think about how people at the bottom of the ladder are seen as worthless by the rest of the world, I think of my son. My son, who is an absolute dynamo, smart, compassionate, athletic, loving, my son was on the last rung of this ladder until God brought him to us. For me, he represents all of the children in the developing world who exist in such conditions that their gifts are lost to them and to the world. We are not seeing clearly.

Thirdly, we are all broken. All of us, probably none so much as those of us overachievers in the First World. Even those cute, little boys in the picture at the top, who all went on to become successful men. But as Jean Vanier would point out, they are having fun.

Because I've been so inspired by him, I'll give the last words to Jean Vanier: "The heart of L'Arche is to say to people, 'I'm glad you exist.'"

When the Government Makes Problems Worse

John wrote a great post at his blog, Dying in Haiti, an interview with Bob Moliere, an activist in Haiti.

Moliere says, "I ask you to tell the international community not to donate money and goods to government of Haiti. What goes in the right hand of the government quickly goes in the left hand and eventually makes its way back to the United States. . . . Haiti really has no government. There is no one to defend the poor. . . . When we (poor Haitians) need help, the Haitian government won't help. The people in Goniaves know this. International money did not reach the people in Gonaives after the flooding."

This reminds me of the argument that economist Dambisa Moyo made in her book Dead Aid that I wrote about here. Bob Moliere is making the same argument from the perspective of someone who is working with poor people.

Whenever we've talked with poor people in Haiti, they've outright laughed at the idea of the government helping them.

Haiti reminds me of a line in Bruce Springsteen's song, Born in the USA.

"You end up like a dog that's been beat too much 'til you spend half your life just covering up."

The historical and present day horrendously bad treatment that Haiti has received from the international community is part of the country's problem. But now Haiti's internal dysfunction is an equally big problem. Government corruption and incompetence are big parts of this dysfunction.

Home Away From Home

John is off for Haiti today. Because of the fruit-basket-upset nature of our lives, he's never quite sure he's going to go until the night before he is scheduled to depart. There's always a lot to coordinate here and in Haiti. He's pretty much got packing down to a science; the indispensibles are: two cell phones, computer, camera and attachments, batteries, headlight, passport, scrubs, and lots of medicines. John always has to make at least one run to a pharmacy to get meds for our Haitian patients. We are also grateful to the many people who donate medicines, including the Heading Avenue Sisters.

It's a relatively short trip this time, but John will get a lot done, like he always does. His plans include: working in the clinic at the Daughters of Charity's place in Cite Soleil; examining a child who has Down Syndrome and a heart problem which can accompany this syndrome; delivering medicines and other supplies to our patients and their families; examining new and old Haitian Hearts patients, bringing Frandy a TOEFL book and a surprise; attending the funeral of Father Gerry Jean-Juste at the cathedral in Port-au-Prince and also his burial in Cavaillon. Of course, the unplanned activities take up a lot of time too

When he left this morning, John wasn't sure where he would be staying during his trip. Some guesthouses and hotels are full, a good sign for the country. But he will manage, in this place that lays claim to a big part of his heart.

The Difficulty of Arranging Things in Haiti

Sometimes in Haiti, you can work so hard trying to make something happen, something that shouldn't be that difficult to arrange and then it doesn't happen.

I'll quit being so vague. On John's last trip to Haiti, he identified three new heart patients. He then learned that there was to be a team of medical professionals, including a pediatric heart surgeon, from Florida going to Port-au-Prince the first week of June. He asked the team if they would examine these three new patients, and they said yes.

The good news is that we think two of the children made it to the hospital where the team had set up shop and were seen.

But we know for certain that one patient did not. And this was after dozens of e-mails and many phone calls setting up the appointment. When things fail in Haiti, there is usually more than one reason why. It can be a combination of techonological failure, language barriers, transportation problems, illness, human error, and the chaos of life in a developing country. Tasks that we take for granted here or that are simple to perform are far more difficult in a place like Haiti where every day life is hard.

We are disappointed that this patient wasn't able to be seen. But we haven't given up and we will think of new ways to bring her to the attention of those who maybe able to help her.

Our Friend Frandy

Frandy is a young man in Haiti who, in extremely difficulty circumstances, is working to better himself. How many languages can you speak? Me, growing up middle class in the United States with two graduate degrees, can speak one and a half. Frandy, a young man who has not had many advantages, is at four. He is working hard to master English, in all its complexities.

Frandy came to the United States a couple of years ago for medical care. He is very grateful to the Ebel family in St. Louis who hosted him and has composed the following letter of thanks:

Host families The roles of the host families of Haitian Hearts mission is very great, and needed to be saying aloud. The Ebels are very wonderful people, and it’s the same for the other host families across different states where the Haitian Hearts patients often settle to receive medical care in USA.

You save many lives when you provide your houses to the Haitians who can’t even afford to get $ 2 U.S per day for their daily food. I am up there to thanks you for all, and those lines below go to you.

Thanks for saving lives and helping on other ways. CONGRATULATIONS!!!

Homes are usually given by you.

Often there to share you culture with the guests

Satisfactory occurs toward your encouragement

Times for care and hospitality

Feelings to drive the patients through the admirable steps

A strong effort to save lives of people that you have never made any experience with before

My memory always reminds me how you paid your attention over me

It is radically appreciated

Love surrounds your houses

Imagine the way you provide your assistance, then you will see its impacts on everyone of us.

Explain us most of the important things about USA

Saving lives is very dear and significant; therefore thank you for saving mine

Thank you Frandy for being an inspiration to us!

Stuffed and Starved

Have you ever had the experience where you've learned something new and then, seemingly suddenly, you see references to this new topic all over the place? That's happened to me with the book Stuffed and Starved: The Hidden Battle for the World Food System. I bought the book a couple of weeks ago from an independent book store, You Know You Love A Book, in Peoria Heights.

This isn't a book review, because I haven't even had time to crack the cover, though I am looking forward to reading it. But today on the Corbett list that I subscribe to was this link to the Brooklyn Food Conference, where Jean-Baptiste Bazaelais spoke on the program, Seeds for Haiti.

And also a speaker at this conference? Raj Patel, author of Stuffed and Starved. You can read more about his book at his blog.

We are surrounded, inundated by food in the United States. Meanwhile, my husband John is haunted by the image of a little boy Jimy and his father, who were so very obviously hungry, if not starving, in Haiti. "The father didn't ask for anything," said John. "He had so much dignity."

We have learned that since John has returned from Haiti, Jimy has had two fainting spells. You know, when you don't get enough to eat, this happens. We have decided to adopt this family in Haiti and send them money for food.

This action doesn't address the systemic problems that Raj Patel writes about, but it will make a difference to Jimy and his family.

And Another Heart Patient

This is five-year-old Jimi, a patient John came upon during his most recent trip to Haiti. Jimi has a Ventricle Septal Defect, VSD, which is a hole between the two lower chambers, or ventricles, of the heart. A VSD is a congenital heart defect, or, in other words, a heart problem a child is born with.



Jimi has had an echocardiogram in Port-au-Prince, which has been reviewed by an American pediatric cardiac surgeon. The good news for Jimi is that he may not need surgery; some VSD's don't pose much risk to a child's health. Jimi will hopefully be examined by the medical team from Florida and this prognosis will be confirmed.

A New Heart Patient

When John was in Haiti for three weeks in May, he worked, like he always does, at clinics and hospitals, seeing patients who have a host of problems. In the course of his work, he comes across children with heart abnormalities.

Modjina, pictured above, is seven years old. She has mitral regurgitation and is in heart failure. She recently had an echocardiogram in Port-au-Prince. Hopefully, during the first week of June, she will be examined by a team of doctors from Florida.

John gave her mother medicines for Modjina: enalapril (to lower her blood pressure), furosemide (to get rid of excess fluid), lanoxin (to strengthen the pumping power of her heart), and penicillin (to ensure that she doesn't get rheumatic fever, which could have caused her heart damage to begin with). These medicines will buy us some time, but she likely needs surgery.

So if anyone out there knows of any hospitals that might be willing to accept Modjina, please let me know with an e-mail.

Thanks for reading.

Father Gerry Jean-Juste 1946-2009

Here is what I remember about Father Gerry Jean Juste:

Seeing him say Mass at his beloved St. Clare’s in Port-au-Prince. During his homily he said, “The first community of Christians were not in need because they shared. We don’t share. We say we are Christians, but we are hypocrites. We are only 600 miles from the U.S. and we are so poor. We are part of the Americas—a continent of Christians, but we don’t act like it.”

He brought a young girl up on the alter who had been severely burned when a propane tank exploded. She was covered in silvadene cream, and Father explained that her family had spent all their money on her medical care. He asked the people of his parish for donations for her family and the people gave. After Mass, Father, who was clearly exhausted, took the time to listen to each person waiting for him with their problems and concerns. When we remarked on his stamina he said, “As long as I have time to pray, and especially to say Mass, I am fine.”

Seeing him in prison in 2005, where he spent months on trumped up charges, designed to ensure that he was not free during Haiti’s presidential elections. My husband John Carroll, a physician, examined him and realized that Father’s swollen neck indicated that something was likely seriously wrong. “We will call it my freedom neck,” Father joked as we planned with others how to petition for his release to receive medical treatment. Despite his unjust imprisonment and his poor health, Father Gerry was amazingly cheerful for himself but very sad about what was going on in Haiti. “Peace and development,” he said. “These are the two things Haiti needs.” At the end of the visit we all held hands and he prayed for each one of us. As we left, we asked Father if there was anything we could do for him. He had heard earlier that we had been able to secure more medical care for the little girl who was burned in the propane explosion. “You already have,” he said.

Sometime when you meet a great person, you can be a little disappointed. Maybe they act pompously or even unkindly. Maybe they are too big to do certain jobs. Maybe they don’t live like they talk. Father Gerry Jean-Juste was the real deal. He spent his life living the Gospel and challenging others to do so also, trying to help those who most needed it. This extended to his preaching, his organizing, and the way he treated each person. And in all his labors and hardships, he exuded joy.

Haiti needs heroes like Father Gerry Jean-Juste. This world needs them. It’s a huge loss that he is no longer with us. As my husband said, “He’s the guy who would do the most for Haiti, and he’s the one who was exiled for 18 years, he’s the one who was in and out of jail, he’s the one who was prohibited from saying Mass by the Church, he’s the one who gets cancer, and he’s the one who dies at age 62.”

Sometimes it can seem like goodness is snake bit. But I feel confident that isn’t the lesson that Father Gerry Jean-Juste would want us to draw from his life. No, the lesson that he would want us to learn is that love can win on this earth. We just need to follow his example.

Katina Rocks!

Katina sailed through heart surgery at Cleveland Clinic. The surgeon was very pleased and she went home a few days after surgery, which is amazing when you think about what they do to you--cracking open your chest, stopping your heart, etc. etc. And of course this is the second, and God willing, last time Katina will have this done. She has a spanking new heart valve that will last forever.

We give thanks to God and all who made it possible for Katina to come to the United States and get world class medical care. It is a great thing.

What is there to say?

My better half has been in Haiti for two weeks now. He is working at a clinic in Cite Soleil. John has sent some heart-wrenching pictures. The poverty seems particularly intense. Everyday events, like a rainfall, create huge public health problems as people's homes fill with water and mud.

John has diagnosed a few new heart patients--a baby and toddlers who have heart murmurs likely indicating a congenital defect. He has sent them to a cardiologist in Port-au-Prince who will do an echocardiogram. John will get a written report and a videocassette of the echo that he will use when he presents these childrens to medical centers and doctors in the United States.

In the meantime, almost all of the patients he is seeing suffer from the far less--in some ways--medically complex problems of not enough food and too much dirty water. We need to keep working and praying for the political will of the people of the world to make this unacceptable.

Cancelling a Trip to Haiti to Help a Haitian?

My husband John was scheduled to leave for Haiti two days ago. He was packed, ticketed and ready to leave for the aiport at 10:30 the night before his early morning flight.

But Katina is in the house (U.S.) and she will likely have surgery sometime in the next couple of weeks. John is her medical guardian and has to give verbal consents for surgery and pre-surgical procedures, which, because of Katina's sickle cell anemia, are more complex than usual. Katina is 14, but weighs only 66 pounds. Her heart condition, sickle cell, and socio-economic condition are the main reasons she is so small. But she is smart, smart, smart and a delightful girl. After she has a new mitral valve put in, her heart function will improve and this will hopefully permit her to put on weight, as so much of her energy will not be going to her cardiovascular system to compensate for her sick heart.

Although phone communication between Haiti and the United States is greatly improved from several years ago, when John had to hope that clouds wouldn't interfere with his calls from a satellite phone, a clear, a consistent line cannot always be guaranteed.

So John postponed his trip.

We will keep you posted on Katina

Catching Up with the News

A few weeks ago, Clinton, pictured above with UN Secretary-General Ban Ki-moon, Haitian-American singer Wyclef Jean, and most importantly, a sister we know and beautiful Haitian children, traveled to Haiti.

In the above picture, which I found at Wyclef Jean's website, Clinton and company are visiting an oasis in Cite Soleil run by the Daughters of Charity. In their complex, the Sisters have schools, a medical clinic, programs to teach women how to sew, a malnutrition program for children and other things I know I am forgetting. In the squalor and harshness of Cite Soleil, the Sisters' place is a calm, beautful setting where people are safe and cared for, at least for awhile.

John has volunteered at their medical clinic. It is one of his favorite places to work in all of Haiti.

Clinton traveled to Haiti, where he is very popular, thanks to his role in restoring Aristide to power in 1994, to encourage the international community to invest in Haiti. There are a lot of people in Haiti who want work and who will work hard.

Also in the news recently was Cardinal Francis George of Chicago's welcome call for President Aristide to extend Temporary Protected Status (TPS) to Haitians currently in the United States. Here's an excerpt from the Cardinal's excellent letter:

Haiti meets the standard for TPS because it has experienced political tumult, four natural disasters, and severe food shortages in the last year, not to mention the devastation of Hurricane Jeanne in 2004. In April 2008, starving citizens took to the streets to protest rising food prices, causing political instability.

In August and September 2008, Hurricanes Gustav and Ike and Tropical Storms Fay and Hanna passed through Haiti, causing severe damage and the death of close to 700 persons. Massive flooding from the storms has destroyed homes, crops, roads, and bridges, and largely rendered areas like Gonaives inaccessible to relief workers. Over 90 percent of Haiti has been impacted. Tens of thousands have been displaced, and the fate of thousands more is unknown. More than 300,000 children have been affected.

As the Cardinal goes on to say, the conditions in Haiti are as bad as or worse then El Salvador, Nicaragua, and Honduras, where TPS was recently extended.

Here's hoping the Cardinal's letter helps.

Ronald is USA Bound!

Whew and Finally! Ronald received his Haitian passport and then after a few tense days, a U.S. visa, so he can come to the States for heart surgery.

Ronald is in the process of being adopted by an American family and because that paperwork is pending, the U.S. consulate in Haiti was initally dragging their feet on granting a visa. But then they saw the light (i.e. there might not be any boy to adopt if he didn't have heart surgery and soon) and issued him the visa. His American advocate in Haiti, his host and adoptive family in New York, Dr. John Carroll of Haitian Hearts, and other interested people worked hard to get Ronald accepted at a hospital and then to secure all the necessary approvals. Thanks to all!

We are very happy! Ronald should be in the good, old US of A sometime this week. We will have updates on his situation.

Practicing Creole

For all the time I've lived in Haiti, I should be a better speaker of Haitian Creole. But my Creole is broken at best.

I was able to communicate with my son Luke, who was three-years-old when we spent seven months in Haiti awaiting the finalization of his adoption. And I am able to talk some with 30-year-old Heurese, who is currently living with us. I seem to be able to make myself understood to her, but it often takes me awhile to fully comprehend what she is saying. I say, "Mwen pa comprend" a lot.

I think Heurese understands and speaks more English then we realize. Between my limited Creole and John's fluent Creole, she isn't having to speak as much English as she would with most American families.

To our shame, Luke remembers none of his Creole; he can't even pronounce the words properly. I am hoping that with Heurese here, he will pick up a little of his native language.

Speaking of Heurese, John conducted an interview with her that is posted on his blog. It's very interesting and tells a lot about what life is like for poor Haitians.

The Difficulty of Getting a Haitian Passport

A Haitian passport can be very difficult to procure. We have a patient, 16-year-old Ronald, who has been accepted for heart surgery in the United States. Ronald is very sick and getting sicker each day.

Ronald was accepted by the hospital two months ago. His American advocate hears various excuses when she attempts to get his passport in Port-au-Prince. Or she is told to come back another day and the passport will be ready, and then it isn't. We have heard that Haiti is out of the blue books that are used to make the passports.

When we were waiting in Haiti for our son's adoption papers--and at least this wasn't a matter of life and death--one of the things we needed was a particular agency's stamp. For weeks we were told that the stamp was broken and a new one was on order from Germany.

Excuses like "we are out of blue books" or "the stamp is coming from Germany" are hard to believe. It's difficult to know whether we're dealing with bureaucratic incompetence or bureaucratic lying.

In Haiti, we've noticed a lack of urgency about situations that are considered crises in the United States (like children dying). Perhaps this is because it happens too often.

We hope Ronald gets his passport soon.

Katina is Patient #137

Hurray! Thirteen-year-old Katina has been accepted by a medical center in Ohio. This will be her second trip to the United States. Katina came to Peoria in 2002 and had her mitral valve repaired. Now this valve needs to be replaced.

Haitian Hearts has been monitoring Katina in Haiti for the past seven years. We know her particularly well because she spent eight months in Peoria when she was here in 2002. She is a sweet girl from a loving family who has been attending school regularly. The children and families from St. Thomas the Apostle Grade School in Peoria Heights helped financially support Katina's education and pay for other necessities.

Katina already has her Haitian passport so as soon as the paperwork from the United States goes to the U.S. consulate in Port-au-Prince and she is granted a visa, she will travel to Ohio. We are thrilled that she is getting this opportunity to have her heart fixed for good!

Haitian Creole

There were Haitians in the house last night--five of them. I loved hearing their laughter and their Creole; it was like a party. Haitian Creole (or Kreyol) is one of two official languages in Haiti, the other being French. Not everyone in Haiti speaks French but everybody speaks Creole.

I remember reading a fascinating account of how these Creole languages evolve. Here's what I remember as it applies to Haiti. When slaves were brought from West and Central Africa, they spoke different tribal languages. Not only could they not initially understand the French, they often couldn't communicate with each other.

The slaves began learning a rudimentary French so that they could understand the slave masters and talk with each other. The first version of this language was called pidgin; it was no one's native language. The next generation of speakers makes this language their own and it develops into a more sophisticated creole language. In the case of Haiti, much of the vocabulary comes from French while the grammar more closely follows the African languages. As a written language, the words in Haitian Creole are spelled phonetically. For example, "yes" which is written "oui" in French is written "wi" in Creole. Makes more sense, don't you think?

We had a houseful of Haitians because three young people came to visit Heurese and after a few months in the United States, I know she enjoyed hearing Creole spoken by Haitians. The youngest Haitian, our son Luke, slept right through it

Heurese in Peoria

One of our most recent Haitian Hearts patients, Heurese, is continuing her recuperation from surgery with us. As you can see in the above picture, she looks great and hasn't felt so good in a long time. It's amazing what a difference a functioning heart valve makes!

Heurese is a lovely, soft-spoken woman who is a pleasure to be around. She understands a lot of English. I am trying to communicate with her in my broken Haitian Creole, and we're pleased that Luke will hear his native language.

Heurese is a wonderful addition to our home.

Is the United States Racist?

I'm in Florida today, which is as close as I'm going to get to Haiti for awhile. It's a good time to contemplate a couple of things about Haitians who reside in the United States. First of all, there are close to 1,000,000 of them. This group of people is referred to as the Haitian diaspora.

When I think about how Haiti manages to remain even a little bit functional, I, and others, come to the conclusion that it is because of the estimated $1.2 billion that Haitians in the United States send back to their families in Haiti. These remittances total one-third of the Haitian economy.

TPS, or Temporary Protected Status, is the second thing to contemplate regarding Haitians in the States. According to the U.S. Citizenship and Immigration Services website, TPS can be granted by the U.S. government to people from countries that are experiencing "ongoing armed conflict, an environmental disaster, or other extraordinary and temporary conditions." Before he left office, President George W. Bush extended TPS for the citizens from El Salvador, Honduras, Guatemala, and Nicaragua.

Wouldn't you think that given Haiti's four back-to-back hurricanes in 2008, on top of a whole lot of other problems, that its citizens might qualify for TPS? Haitians might qualify, but they weren't granted TPS.

Why? Given the other nationals that we've extended TPS to, there is no credible answer to this question. Haiti definitely has suffered from repeated "environmental disasters." If you worry that granting TPS to Haitians would causes masses of them to sail for Florida, recent history refutes this. According to the Miami Herald, in the 1990's, the Clinton administration allowed 50,000 Haitians to stay in the country; there was no big deluge of immigrants.

Really, if you look at all the evidence, the only conclusion you can come to is that Haitians are denied TPS because of racism.

There is no other answer, and I take it personally.

Carnival!

Nobody does Mardi Gras or Carnival, like Haiti. It's a whole season of partying, culminating today, in Fat Tuesday. The whole country will be one big party with many coming from the States to join in the festivities.

For Richard Morse, the owner of the fabled Hotel Oloffson and leader of the Haitian band RAM, Carnival is a busy time, with his hotel busy and the band playing all over the country. Richard posts regularly to the Corbett list and his comments are always interesting. Here's recent example that has nothing to do with Carnival

When the population eventually rises up and puts an end to Haiti's archaic economic system, controlled by the Gang of Eleven, controlled by "Friends of the Embassy", people will be screaming bloody murder. People will have forgotten how the Gang of Eleven decided to import rice and sugar, instead of producing it locally. People will forget how when the Gang of Eleven used the Haitian army to wipe out thousands of less fortunate Haitians, when their personal and economic interests were questioned. People will forget how in 2009, people couldn't get to work, children couldn't go to school, because the Gang of Eleven didn't like the lowering of the public gas price. There were no complaints about windfall profits when the price went up, but the reversal of fortune is unacceptable to the Gang of Eleven.

Despite all of our time in the country, we at Haitian Hearts have never gotten too involved in the cultural aspects of Haiti, though I find learning about the culture interesting and Carnival sounds like a lot of fun. In theory, it's the big, indulge-all-your-desires blowout before the abstinence and penance of Lent begins on Ash Wednesday. When Haiti was a predominantly Catholic nation, this was probably more the case. But even though the religious significance may have faded, the parades, parties, bands, dancing, costumes have remained. So party on!

What's the Solution?

Sometiemes when we've been in Haiti in a clinic, the waiting room overflowing with sick and poor children, I want to scream, "Why doesn't the world do something?" Why is it that the suffering children of the world don't command our attention, our compassion, our action?

Calm-headed sages might take me aside and say, "Maria, fixing this problem just isn't so simple." How do you go about making life better for these children? To use a hospital analogy: if sick poor children are the patient it seems the disease requires both the emergency room and long term chemotherapy.

Aid from the developed world is one of the accepted solutions to developing world poverty. Well, not according to Dambisa Moyo, a Zambian-born economist with a book coming out called, Dead Aid. In this interview in the NY Times, when asked what she thinks has held back Africans, Moyo responds,

I believe it’s largely aid. You get the corruption — historically, leaders have stolen the money without penalty — and you get the dependency, which kills entrepreneurship. You also disenfranchise African citizens, because the government is beholden to foreign donors and not accountable to its people.

She believes that things like capitalism, microfinancing, small businesses are the way to change a country as she says is happening in China.

Perhaps she's right and this is a better solution. In any case, how many children will have to die before things change?

Katia Needs a Job

Katia, pictured above with my dad, had successful surgery in Joliet in 2004. She had a heart damaged by rheumatic fever. I vividly remember the autumn day that we got her U.S. visa. What a time of celebration!

After recuperating for a couple of months, Katia returned to Haiti in May 2005. We see Katia when we travel to Haiti and keep her supplied with the medicines she needs.
Katia sent John the following e-mail last week:

i got a problem, i don't work i don't go to school but you know in my country the situation isn't good but i want to make something to live; i haven't no one,then i want to ask you for seconde if you can help me in that case but i let choose for me any way you give i will accept to do it.please you know i considere you as my father. i don't feel me well cause every day i stay in my house.my mother would to help me but she can't.then please try to understand me. when you stay to do nothing that's bad please thinking about that for me please. i pray god for you for give you the possibilty.god bless you.kiss for every body.

Katia concerns embody Maslow's Hierarchy of psychological needs. Now that she has her pressing health need met, she can turn her attention to higher level needs. One of these is to be productive and contribute.

Katia's note is a good reminder that we work to restore people's health in part so that they can make their unique and necessary contribution to the world.

Walls

In the past year, my 77-year-old father Ed has been to Haiti twice. These have been his first trips to the island nation. Each time, my husband John has invited dad to help escort patients back to the States.

I must admit that I have been a little nervous about my dad going, mainly because if he were to have a health problem there would be little chance that he could get adequate care. But each trip has gone well.

There's really no substitute to going to Haiti for understanding the country. Hmm. . . understanding might not be the right word to use; perhaps encountering would be better. I have spent so much time in Haiti that I was interested in what a first time visitor's impressions were. Following are some comments John made about my dad's observations.

The first morning Ed looked at me, chuckled, and said, "We are surrounded by walls." Ed had surveyed the neighborhood that morning. And he was right. There were walls everywhere. The top of the walls that surround private homes in Haiti have broken glass and razor wire embedded in cement. One would really have to want to get inside the walls to run the risk of going over top. . .The formidable walls in our neighborhood in Haiti's capital startled him since he has spent most of his adult life trying to tear down walls.

Later that first morning in Haiti we piled into a pickup and traveled south and east of Port-au-Prince to an elite suburb called Petionville. We wanted to visit the site of La Promesse, the school that had collapsed suddenly one morning in early November. This tragedy had riveted the world's attention on Haiti and its courageous people. The UN soldiers in Haiti dug through the rubble. International disaster experts were flown in. Pope Benedict sent his condolences. The world seemed to care about these Haitian students and their families.

When we arrived at the site, a small contingent of UN forces from Jordan was walking up the street from the collapsed three story building. A big empty spot was apparent on the side of the street overlooking a steep ravine. About 30 Haitians were milling about on top of broken cement, rubble, and twisted rebar. Many were staring down into the ravine. Most people were quiet. . . I wondered about crushed little bodies that may lie just beneath my dirty shoes. One mother had lost 5 kids in the crush at the school named " The Promise".

Madame Telemak, a neighbor lady, standing in the debris with us, told me she heard a loud noise at 10 AM the morning the school fell. She ran over and witnessed the panic and screaming that enveloped the neighborhood. Family members and neighborhood people dug with their bare hands attempting to free anyone they could get to.

Walls of adjacent homes that had been attached to La Promesse were hanging in various states of disarray and shambles. The walls had been partially ripped off when the school collapsed and again with the process of extrication of survivors and victims. . .After a short time, there wasn't much more to see or talk about. Helpless doesn't describe the situation. A few pictures and collective shaking of heads, and it was time to leave. . . I agree with my sagacious father-in-law. Walls everywhere, not just in Haiti, need to be removed so places like La Promesse don't collapse and crush the future for all of us.

Host Families

Haitian Hearts could not do what it does--bring children to the States for life saving surgery--without the generous contributions of host families. Actually, "generous contributions" doesn't do these families' involvement justice. For they open their homes often for months to poor children with serious medical problems from another country who don't speak English.

As you can imagine, in addition to not feeling well, these children are often afraid and homesick. In a short plane ride, they have been transported from their familar world to one that, however more prosperous, is jarringly different and filled with strangers.

Thanks to our host families, these children are soon among friends. Our families feed, hold, play with, rock and in all ways help these children make the adjustment to the States and prepare and recover from surgery. They take them to appointments, sit by their beds, and act as their surrogate parents with as much love, caring, and effort as they do for their own children.

So many dedicated families have helped Haitian children through the years, but I'd like to mention one in this post: Jim and Jane Ebel of St. Louis. Jim is a physician and Jane is an art teacher. The Ebels, who have four grown children are a close knit family, who are devout in their faith. Jim and Jane make a good team and have provided a wonderfully loving home to children from the ages of 10 months to 17 years. Jim monitors the children's health and Jane does art projects with the kids. They take them to church, to family events, and to the sights of St. Louis, as well as everything mentioned above that goes into caring for a child who has had major surgery. Actually, this list seems woefully inadequate because what the Ebels really do is make the child part of their family.

They have done this for five children and even two of the children's mothers. Jim and Jane keep in touch with some of their guests after they return to Haiti. They have really given of themselves to these children.

I think I know Jim and Jane well enough to know that they would say that they have received as much or more as they have given. In a awesome and mysterious way, isn't this how it works?The Ebel Family is an inspiring example of the principle. We thank them and so do a lot of people in Haiti.

Heurese Update

Heurese, the young woman who had surgery a couple of months ago in Cleveland, is doing very well. She is continuing to recover in Cleveland.

Heurese had a state-of-the-art artificial heart valve put in to replace her defective valve. One of the really excellent things about this new valve is that she shouldn't have to be on blood thinners for the rest of her life.

You may know that blood sometimes clots around artificial things in the body. In order to prevent this, patients with artificial valves have to take medicine that thins the blood for the rest of their lives. For people who live in Haiti, this is problematic because they have to monitor their blood to ensure that it doesn't get too thick or thin. This can be done in Haiti, but like many things, it is extra difficult. For reasons I can't explain, Heurese's new valve will not require her to take blood thinners.

Heurese is a very industrious person. With her health restored, she is helping her host family with chores and in any way she can.

She is a blessing to all of us.

Frandy

Life is very hard for poor people in poor countries. All their energy and attention is focused on survival: getting enough food to eat, having safe shelter, obtaining clean water. It's hard for people to try to better their lives or the lives of their children in these circumstances.

Once in awhile, though, you come across a person who for many reasons, is able to think of and work toward a better life. We know such a person in 20-year-old Frandy. We met Frandy seven years ago when he came to John about his heart.

Frandy lives on top of a mountain with his mother and two older brothers in the seaside slum of Carrefour, next to Port-au-Prince. He is very thin. I remember when we went to Frandy's home. We hiked and hiked and came to a two room, concrete block structure with a tin roof. Frandy welcomed us, and his mother served us Coca Cola that they had gotten for the occasion of our visit.

Frandy had a hole in his heart, and he came to St. Louis for medical care. His mother accompanied him. On the first night here, as his mother soaked up the incredible luxuries of this country, she said, "We are in paradise."

Frandy did not have to have surgery, which was a blessing. Another blessing for him was an opportunity to experience the blessings of the United States.

He returned to Haiti after a two month stay. Frandy was already a driven person who excelled in school. He was now motivated to work even harder and with the support of people in the States, he saw a way that he might attain the almost impossible goal for a poor Haitian of going to college.

Frandy's supporters paid for his education in Haiti. He studied and studied. He listened to the Voice of America. He practiced writing English through sending e-mails and speaking English with anyone he could. He became quadralingual in the process. Frandy speaks French, Haitian Creole, English, and Spanish.

He passed the Haitian equivalent of high school, a huge achievement for someone from Frandy's background. Later this month, he will take the TOEFL (Test of English as a Foreign Language). Passing TOEFL is a requirement for a foreign student to attend college in the United States. Say a prayer that he does well, will you?

I think Frandy is succeeding because he is: intelligent and driven. These may be God-given qualities, but Frandy is making the most of them. He also has people willing to invest in him. Without this, attending college in the United States would be a cruel dream.

Frandy sees a better life for himself and his family and that vision draws him on. I admire him a lot. God willing, he will succeed.

Stop and Think Some More

I've been railing to anyone who will listen--as I'm sure many have--about the outrageous greed, arrogance, and even criminality of the corporate executives whose companies have received bailouts from us and who are using money to reward themselves with bonuses that are insane in the best of times and to buy lavishly appointed jets and outrageously expensive office furniture that doesn't even make sense. And then to justify their actions, they say things like if we don't pay these bonuses, we won't attract the best talent. The best talent?!!! You mean the talent to drive the financial system and everyone's 401K into the ground?

I remember in the 1980's when Reagen took on the welfare queens--women who were scamming the system and collecting multiple checks--regaling us with stories about a Cadillac-driving, fur wearing welfare mom. These guys from New York make her look like a piker. The sense of undeserved entitlement is mind boggling. These guys think they are playing a game--a winner's game--where there are no consequences and no matter how badly you screw up, you never lose. And in this game, we all are the bank, like in a Monopoly game, dispensing endless qualities of money whenever they want it. What kind of fantasy universe are they living in?

Apparently the same one I am and this is where this post finally relates to Haiti. For I don't want to let the above guys off the hook--they truly are criminal--but when I examine my assumptions and expectations about my standard of living as it relates to the majority of people in Haiti and other developing countries, I find my world view too similar to that of the head of Merrill Lynch. I have my comfortable, warm, water tight home, a never ending supply of food, vacations to look forward to, my own car, my own computer, and really all the books I want to buy. And the Haitians? Well, they're eating too many mud pies or not at all.

How do the terrible living conditions (to put it mildly) of the people in Haiti relate to the way I--or you--live? Well, they do, my friends, they do, even if it's as simple as that I could use more of my disposable income to buy food for people in Haiti. The more complicated, systemic reasons that the developed world's standard of living comes at the cost of those who were unfortunate to be born in poor countries is detailed in Paul Farmer's book, "The Uses of Haiti" which I will summarize in future posts.

For now, suffice to say, there is plenty of blame to go around.

Stop and Think

The picture of the above little girl is one my husband took on his most recent trip to Haiti. She lives in Carrefour, a large slum adjacent to Port-au-Prince. We have this picture hanging in our kitchen.

So one day this week, I was getting my lunch together in a hurry, kind of stuffing my face, to be brutally honest, and discontent with the offerings of our refrigerator. I turned around and my eyes caught the above picture. It stopped me in mid-chew.

How can I live my life the way I do when so many children are suffering? Why doesn't it matter more to everyone?

Painful questions with unsatisfactory answers.

Patient #136

One of the things that I'm most proud about John and Haitian Hearts for is the commitment made to patients. So despite my numbering Ronald patient #136, the fact is that he has a previous patient number also.

In 2004, Ronald and his father traveled from their home in Les Cayes to Port-au-Prince to see John because of Ronald's poor health. Ronald indeed had a heart problem, and in 2005, we brought him to the United States for heart surgery. He stayed with a wonderful family in upstate New York.

When Ronald was staying with his host family, and after consulting with Ronald's parents, this family decided they wanted to adopt Ronald. As is the case with many Haitian families, Ronald's parents were delighted that someone in the States wanted to adopt him. Life is very difficult for poor Haitian families, and the parents would love to give their children a better chance, even when it means giving them up. This is particularly true when the child has had serious health problems.

The idea of giving a child up for adoption like this is often very difficult for Americans and others from developed countries to understand. As heartbreaking and as un-ideal of a solution as it is, we would probably understand better if we spent even a day enduring what these families endure. They are doing it out of love. We need to work hard and urgently for a more just world where these kinds of Sophie's choice dilemmas don't exist.

So Ronald returned to Haiti to await the completion of the adoption paperwork. Haitian Hearts continued to keep track of Ronald so that we could monitor his heart. This ongoing contact allowed us to diagnose that his heart needed more surgery.

Thankfully, the same hospital and surgeon that first operated on Ronald are going to do the second surgery. He will once again stay with his host, soon to be adoptive, family.

Ronald's heart is very sick, so the news of his acceptance came in the nick of time. Now, we pray that the passport and visa paperwork will go quickly.

Ronald is pictured above.

Upstream and Downstream

Do you know the difference between upstream and downstream work? Sometimes they're called justice and mercy work. Upstream or justice work addresses the root causes of a problem, while downstream or mercy work concerns itself with delivering immediate help to people who need it now. It's prevention versus cure.

For example, Haitian Hearts mainly works in the downstream or mercy arena. We provide medical care to poor Haitians and bring children and young people to the United States for surgery. We respond to these emergency problems, most of which have their root in poverty. We don't more broadly address this poverty.

Some of our patients with heart problems have these problems due to rheumatic fever, a preventable disease. For rheumatic heart disease, upstream work might focus on educating doctors and people on strep throat and its treatment (penicillin) so that rheumatic fever doesn't develop. Work further upstream might be getting funds for more clinics and doctors and nurses in Haiti so that health care is more widely available.

A nun I know frequently talks to me about a friend of hers who runs an orphanage in Ecuador. This orphanage takes in mainly disabled children who have been abandoned. This seems to fall under the category of downstream or mercy work. But then it struck me: any work that benefits children must be considered upstream work, too. Children, we have so often heard, are the future. They will grow up and create the world anew. Helping children contributes to a just future, a future that is downstream for us now.

What could be better than that?

Bring on 2009!

Whoopee! Happy New Year's everyone. It's a very big day in Haiti, as January 1 is also their independence day. In 1804 on this date, the bloody, more-than-10-years-long Haitian Revolution finally came to an end, with the former slaves defeating Napoleon's finest. Haiti became the world's first and only country established through a slave rebellion.

Here's an interesting and important way that the Haitian war for independence affected American history. As Napoleon and France went down in defeat to the Haitians, the Emperor decided to sell the Louisiana Territory to the United States for $15 million dollars, or less than three cents an acre. The Louisiana Purchase, which now comprises 13 states, doubled the size of the United States.

With the loss of Haiti, called the Pearl of the Antilles for its rich agricultural output, as a French territory, Napoleon lost one of France's cash cows. Some thought that Napoleon had designs on North America, but the difficulty he had in Haiti forced him to forfeit these plans and sell the Louisiana Territory.

So the United States owes Haiti. We repaid them by not recognizing Haiti for more than 50 years, as we didn't want our own slaves getting any ideas about revolutions.

Fast forwarding to today:with four hurricanes and their resulting damage, skyrocketing food costs, widespread malnutrition and even starvation, more kidnappings, etc. etc., 2008 was not one of Haiti's better years. I guess that's true for the rest of the world too, Obama's election notwithstanding.

And on a personal level, I'm glad to see 2008 come to an end.

Let's work to make 2009 a better year for Haiti and all of us.