Harding Magazine Spring 2010

Long before the Jan. 12 earthquake, alumni, faculty and students were planning their annual spring break mission trip to offer

A helping hand to HAITI

Text and photography by Terry Engel, associate professor of English

dentistThe road to the farm snakes through the village of Bois Marchand, past the community well and between cactus hedges that fence in the dirt yards of houses. News of the scheduled health clinic has spread throughout the area, and before 7 a.m. locals walk the dusty, rutted road or pick paths across fields of millet and corn to line up outside the farm gate. At 7:30 approximately 500 tickets guaranteeing admission are distributed, sparking a riot of shouting and shoving and illustrating how desperate the people are for modest medical attention and medications most Americans take for granted.

Located about 90 miles north of Port au Prince, Haiti, the Haiti Christian Development Project (HCDP) farm was created to teach locals organic farming, drip irrigation and animal husbandry. Yet that mission has been interrupted: in 2008 by the devastating floods following four tropical storms in the space of a month and most recently by the need to feed and shelter earthquake refugees from the Port au Prince area.

Today, the farm is the site of a medical, dental and vision clinic sponsored by HCDP and staffed by a number of volunteers, including Harding faculty, nursing and premed students, and alumni. The relationship between HCDP and Harding is so strong that David Smith (’67), a Little Rock, Ark., cardiologist, schedules the annual mission so that it falls on the University’s spring break.

Faculty and students from the University have been involved in medical missions to Haiti since 1992 when Jerry Myhan, a professor in the College of Nursing, agreed to sponsor a spring break campaign to Cap-Haitien. Myhan, a veteran of three years with International Health Care Foundation clinic in Haiti, had recently returned to the faculty and seemed a natural choice to lead the mission.

Also on that trip was Bob Lawrence (’93), a ministry student at the time. At the end of the week, the group spent their last day in Haiti relaxing on the beach near Labadee. Myhan remembers standing in the ocean with Lawrence, who told him that God had planted the desire to include health care in his ministry. Myhan recalls advising Lawrence against medical school, since he would have to start over and make up all the premed courses. Lawrence allowed that advice to simmer for a year, but the following spring, standing in the exact same spot, he told Myhan he still felt a call to medicine.

Twelve Haiti trips later, Lawrence, now an M.D., recognizes the value of mission trips for nursing and medical students. “When you’re in a place like Haiti, the letters behind your name are meaningless,” Lawrence says. “It’s about your willingness to help. It’s about using what you’ve learned so far in your training. It’s about compassion and competence.”

chartPracticing medicine in Haiti prepares a student to practice anywhere in the world, especially in makeshift conditions with limited medical supplies and equipment. “When you’re presented with a situation,” Lawrence says, “you have to ask two questions: What do I know how to do? And what do I have to do it with?”

Lawrence points out the importance of medical protocols adding, “Following a protocol is not a replacement for critical thinking.” A good example of what Lawrence is talking about happens in the middle of the day. The clinic is set up in a sandy patch under the deep shade of two massive mango trees. A homemade fence encircles the small grove so that patients and onlookers won’t overrun the clinic, and interested Haitians line the fence and crowd the entrance, awaiting their chance to be seen. It is a warm day under a cloudless sky. Most of the people have walked to the clinic and waited in line without lunch or water. When an old blind man collapses, dehydrated with his blood pressure dropping and headed toward shock, members of the clinic act quickly. They find a sheet of cardboard and lay the man on his back and elevate his feet with a chair. A liter of oral rehydration solution is prepared, and nursing students take shifts giving the man fluid. The student squirts a teaspoon of the solution into the man’s mouth every minute, slowly restoring the fluid in his body. After several hours he is able to stand, and Lawrence helps him into a truck so he can be driven home.

Heather Lehman Kellis (’07), an English graduate who later attended nursing school at University of Arkansas at Little Rock, saw the mission trip as a trial run for the type of medicine she plans to practice in Tanzania, where she has dedicated the next 10 years of her life. “I learned so much from the doctors and nurses who freely shared their knowledge and answered my questions,” she says, “and I feel like I cultivated relationships that I can draw upon whenever I have questions in the future.”

Kellis also learned from the Haitian people. “I came expecting to see devastation and earthquake wreckage, but I left feeling hopeful about Haiti.” She recounts how one patient talked to her about the importance of being able to savor being alive. “I learned a lot from the Christians we met,” she says. “They have strong faith, which encourages me to have a strong faith.”

Although the primary care and medicine provided by the health care professionals are highly valued by the Haitian patients, the clinics only offer temporary relief. The long-term benefit of the medical mission lies in the education provided by the nursing students and faculty. “Early on, we began to realize that the level of medicine we’re able to practice is like putting a Band-Aid on a bleeding wound,” Myhan says. “Then we began to focus on preventative health care as well as treatment.”

HaitiLisa Crocker Engel (’88), who coordinates the mission trip for students and faculty, began weekly orientation and training sessions two months in advance. The sessions not only helped prepare students for the cultural and psychological shock that comes from witnessing abject poverty, but they also focused on preparing students to teach the Haitian people about sanitation, malnutrition, clean water, rehydration and general health. 

These lessons have an immediate and long-term impact. During the clinic, doctors refer their patients to nursing students, who work through translators and use graphic, Creole-language handouts to teachHaitians about healthier ways to live. While the old man who collapsed is being rehydrated, nursing students take the opportunity to teach his family how to make a homemade oral rehydration solution using clean water, salt, sugar and fruit juice. The family will be able to continue treatments through the evening and have tools to address dehydration in the future. Two days later the man returns to the clinic showing significant recovery.

For the first time, the nursing students incorporated technology into their lessons. Using a rechargeable solar battery-powered DVD player and monitor, the teachers attracted more students to their sessions by first showing Creole-language instructional videos and then using interpreters and audience volunteers to reinforce the lesson. The films are produced by Harding missionary-in-residence Oneal Tankersley (’79) who uses a Haitian cast (many of them members of Poteau Church of Christ) to educate their neighbors in health care and prevention in their native language.

Tankersley’s latest project, a film on how to construct an “arbor loo,” was put to use at the clinic held at the Church of Christ in Bayonnais, a tiny village in the mountains. Because sanitation is so important to health, latrines near home are essential. However, the effort required to dig a permanent latrine and build a privacy shelter over it is enormous. Consequently, many latrines are never dug. An arbor loo is a portable cement platform which can be placed over a shallow latrine. Once the latrine is filled, a couple of men can easily transport the platform to a new hole. A fruit sapling is planted in the old hole to take advantage of the fertilizer. After watching the instructional video, Haitian men spent the afternoon digging and pouring the platform for Bayonnais’ first arbor loo. 

All of the nursing students appreciated the ability to have a direct and immediate impact among the Haitians. Senior Brianna Sims, who used the video equipment to help teach mothers how to make oral rehydration solution, says, “It’s cool to think that in the future, when a child has diarrhea and becomes severely dehydrated, they can use what we taught them and see immediate results.”

Senior Caitlyn McKuin, who spent much of her time in the eye clinic, remembers one 12-year-old who smiled after receiving a pair of glasses. She hadn’t been able to read at school and suffered from headaches, but McKuin feels now she will be able to study more effectively and have a chance at being more successful. 

Senior Tessa Markum, who worked in the pharmacy, points out that simple over-the-counter medicines Americans take for granted make a huge impact on the Haitians. She remembers an 80-year-old woman who received her prescription and told her “merci” over and over again before “she walked off with a big grin on her face.”

babyPost-graduate student Daniel Ramberger anticipated taking care of amputees and practicing acute care but, through his teaching experiences, feels he learned a lot about “compassion and education.” He adds that he had never fully understood the role of the nurse as a teacher. In Haiti, he realized “some of the things we’re teaching can make the difference in whether or not a child lives or dies.”

Of course, all the efforts of the Haitian Christian Development Project would be meaningless if the name and message of Jesus Christ were not proclaimed. Dee Ann Bennett Martin (’75), a pediatric nurse practitioner with seven trips to Haiti, believes that the “real mission is to support Haitian Christians and to draw local Haitians into their fellowship. We need to help them to realize that Haitian Christians are there. We need to work through Haitian Christians so that they can explain Jesus to their own people in ways they can understand.” When seeing patients, Martin took every opportunity to speak Jesus’ name because his “name is powerful.” She adds, “If we don’t let people know why we are here, our efforts are wasted.”

The idea of blending health care with a spiritual emphasis is not lost on the members of the mission. Lawrence points out that in the United States we tend to “separate medicine and ministry, but in Haiti these things are inseparable.” Kellis finds a “lot of meaning being alongside someone who is suffering. Touching someone while dressing his wound is like dressing the wounds of Christ.” She sees “nursing as a sacrament, a physical act that is also spiritual.”

Sadly, reaching out to the people of Haiti is challenging and often difficult, despite best intentions. Haitian people are aggressive by nature, and they function well in what Americans perceive as chaos. Competition for tickets to the clinic generates tensions that make Americans uncomfortable. Tankersley observes that Haitian arguments are frequent, loud and boisterous, but they rarely degenerate into fistfights or, even worse, violence. Martin warns we can be guilty of trying to Americanize the Haitian people. “But that’s not how they operate,” she says. “They don’t need everything American neat and orderly.” One of the hardest lessons learned on the trip was to let other cultures be other cultures.

What makes the trip meaningful for many of the students are the relationships that are developed with children who hang out at the farm, where the mission returns each evening for supper. Senior Sarah Crowder says of her two trips to Haiti, “Each time I’ve gone, it reminds me about how kids are the same throughout the world. They want to have fun, be loved and enjoy life. They are the ones that remind me that the simple things of life are what truly matter, and that is something I need to remember as a nurse.”

Kristen Edwards Hamilton (’07), a nurse, has made three trips to Haiti. She loves to play with the kids and develop a sense of trust. “It’s nice to be able to provide encouragement and show them that
someone cares for them,” she says.

Dentist Alex Hamilton (’05) finds inspiration is “going out in the country [where] you can see how happy the Haitians really are, even with just the little bit they do have.”

Junior premed student Molly Alexander says that “seeing the compassion of doctors in Haiti has confirmed my interest in a career in medicine. I chose to return this year because I believe the people are determined to persevere, despite all setbacks. Because of their courage, the people of Haiti deserve assistance from those who can provide it.”

Smith, who has been making trips to Haiti since 1984, was able to see a long-held dream come true on this trip to Haiti. On Sunday, Poteau Church of Christ, which has a very close relationship with HCDP, installed six elders — the first elders in any church in Haiti. Working through Gaston Pacius, who operates the demonstration farm, HCDP provides meals to more than 150 earthquake refugees, most of them members of Delmas Church of Christ in Port au Prince. In addition, HCDP is paying the school tuition of 13 refugees so that their education will not be interrupted. Smith has a dream for Haiti and a great love and compassion for the Haitian Christians.

But more than a dream, love in action is demonstrated each year through this medical mission. Compassion is shown and lives are changed, both Haitian and American, forever.

To learn more about HCDP, visit their Web site at www.hcdp.net.

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