History: In 2010 long time SCNM NWB student club leaders Sarah Preston Hesler and Sean Hesler embarked on a journey to Haiti to work with a local birth center. The goal of this work was to support the birth center as Naturopathic Physicians; treating the root cause of disease, preserving cultural traditions and use of local medicines, and trying to mitigate the high rates of infant and maternal mortality while combating chronic disease progression and acute infectious disease transmission. During this time, another SCNM graduate, Zeenia Junkeer came to Haiti to work alongside the team. The three learned quickly that the needs of the community they were living, working and playing within was much greater than simple medical care. The need was steeped in the factors that continued to oppress and marginalize the community. Factors that were unable to be addressed by front line medical care solely. What they were seeing, play out in the lives of their community members, were the effects of the social determinants of health. The conditions in which people are born, grow, work, live, and age, and the wider set of forces and systems shaping the conditions of daily life. These forces and systems include economic policies and systems, development agendas, social norms, social policies and political systems. (WHO 2015, The Social Determinants of Health, retrieved fromhttp://www.who.int/social_determinants/en/). Spending time learning about the community they were serving allowed the three to truly be able to support community empowerment and capacity building in an authentic way. Combining their deep understanding of medicine and the need to address the root cause of disease and their desire to create a model of global health that was empowering, they decided to apply for 501(c)3 status for NWB which was granted in 2011. Returning to Haiti many times over the next two years, Sarah, Sean and Zeenia began to deepen their roots and connection with the community to better understand the needs and the opportunities to support initiatives that were led by the ideas from the community itself. NWB has had a full-time presence in Haiti since 2013 and has hosted over 150 volunteers, formed countless partnerships and relationships with local community leaders and non governmental organizations (NGOs) while supporting the education of future global health leaders and strong global citizens.
Medical Clinics: Our work is steeped in community capacity building, empowerment and support of local resources. We learned through our work on the ground that more foreign medical clinics were indeed not the answer to the disparaging health statistics that were coming out of Haiti. Instead, we knew education, training, lateral learning and sustainable practices were necessary. NWB uses our partnerships on the ground in Haiti to support clinical work in the communities which need it most. Clinics are set up in schools, churches or even outside under the trees; wherever it is convenient for members of the communities in which we work. NWB physicians, staff and volunteers regularly rotate through these selected communities to provide medical care and health education, always conscious to learn about local efforts going on in the area and to invite local health practitioners to be a part of our work. Since NWB began working on its own in Haiti in 2013, we have seen thousands of patients for a variety of health conditions, most of which stem from malnutrition due to food insecurity. The vast majority of our patients do not get enough to eat and do have access to enough clean drinking water. We see great progress being made when we are able to increase caloric intake and improve hydration. We also see a variety of other pathologies, including diabetes, hypertension, pain, skin conditions, colds and flus, developmental issues in children and more. The Haitian Minister of Health in the North Department frowns on foreign NGOs coming to Haiti to provide free care as it undermines Haitian physicians. Out of respect for this, we do charge a nominal fee though we will see all patients even if they are unable to pay. All money collected from patients goes to our Patient Emergency Fund which is discretionary income utilized to pay for patients who need medical care or medication we are unable to provide. It is rare that a clinic day goes by without a patient being referred to the local hospital and the funds are always put to good use. Unless a patient speaks English fluently, all clinic visits are conducted in Haitian Creole or rarely, French, with the use of interpreters by an advanced medical student who works closely with a supervising physician. Treatment modalities include nutritional counseling, local herbal medicine, nutritional supplements, hydrotherapy, homeopathy, acupuncture, physical medicine and medications. We generally see 30-40 patients per day, one to six days per week, depending on the number of physicians and volunteers we have in Haiti at that time. We are the only medical care many of these patients receive, as the barriers to accessing local medical care are too high for most of our community members. We have formed many important relationships with the local community and other organizations to provide the best care we can to our patients. We are seeking a local physician to partner with who wants to learn more about Naturopathic Medicine and can begin to provide alternative treatment options to the community.
“;p[Malnutrition Program: One in four children in Haiti are malnourished and one in five will die before their fifth birthday due to complications from malnutrition. When children are found to be malnourished, we enroll them in our Medika Mamba Malnutrition Program. Medika Mamba which means “peanut butter medicine” in Haitian Creole, is a peanut butter-based medicine designed to take children under the age of five from a malnourished to a well-nourished state in 12 weeks or less. The medicine in produced a few miles from where we work and we purchase it directly from the organization that makes it, Meds and Food for Kids (www.mfkhaiti.org). It costs NWB about $75 for one child to complete this program, at no charge to the child and their family. To date NWB has helped almost 75 children through this program.
Garden Pool: In February of 2014, five volunteers came to Haiti and built the first ever International Garden Pool site and NWB’s guest house. Combining a shade house with a tilapia pond, chickens and goats, the Garden Pool is an elegant solution to the gross malnutrition we see in so many of our patients. The Garden Pool’s founders were able to train 13 Haitians how to build and maintain a Garden Pool, giving them a unique skillset for potential employment and to make a difference in their community. The site was to act as a sample system for what could be possible and to determine which types of plants would be most effective to grow within the system. It was fully-functioning for more than 7 months before a storm damaged the system and nearly flooded NWB’s guest house in the process. Parts of the Garden Pool are still functioning but NWB is looking for an alternative location to rebuild it fully once again.
Shade House Construction: Global Compassion Ministries is a faith based organization we have worked around sustainable food production through the construction of shade houses. Though NWB is not a faith based organization and does not promote any particular religious or faith based programs, it has been our honor to work with Joe, Ron, Jaime and XX from GCM multiple times. The mission of their Sustainable Food Production (SFP) branch focuses on empowering people to provide for themselves. SFP builds shadehouses and teaches the art of agriculture to offer a sustainable supply of food for those who may not otherwise have one. This is imperative in the communities we work within as year and years of subsidized foreign aid, reliance on large scale agriculture versus individual family farming and a host of other factors have left current generations without the first hand knowledge and deep understanding about food production that their families historically had. This partnership allows us to learn about current methods of food production and offer opportunities to learn about alternative ways of growing food that may be able to yield more nutrient dense food or a greater variety of foods.
Infant Massage: Trainers from the International Association of Infant Massage (IAIM) traveled to Haiti to certify 39 Haitian community members as Certified Educators of Infant Massage (CEIM) infant massage. Contrary to what many people think, infant massage is not about massaging infants oneself, it is about teaching families and loved ones how to communicate and promote health in their infants and children through massage themselves. This training supported these individuals to take their new skill set back to their community and teach local parents the many amazing benefits of infant massage. This technique can help with parent-child bonding, reduce colic, improve sleep and digestion and more. We hope to offer another training in the future as there was such an amazing response from the trainees. Many were able to remember and recount experiences they had with their grandparents or older family members massaging babies and it was an opportunity to share their past experiences and to learn all the healing benefits of infant massage for themselves.
Haitian Herbalism Education: After meeting the only known Haitian herbalist (PhD), Lamour Docteur, we worked collaboratively to identify the most commonly (and wild grown) local herbs in our area. Dr. Docteur then used his knowledge and resources to create herbal monographs or materia medica for NWB that we supplemented with pictures we had taken of each of the plants. We had these translated into Haitian Creole and have been using this tool to teach interested Haitian community members and volunteers more about the rich tradition of herbal medicine in Haiti. We hope to expand on this knowledge and teach those who are interested how to use plants safely, effectively and responsibly.
Health Education Classes: NWB supports learning and growing wherever we can! Our staff Community Health Worker (CHW) and students, local and volunteer health assistants and physicians lead classes on a variety of topics relevant and of interest to the community. Often we conduct these health education classes and workshops for the patients while they wait at our clinics to see the medical providers. The intention of these classes is to expand on the individualized health education provided to each patient in their clinic visit. At least once per week, our CHW visit a community and provide further training for the community on topics such as healthy cooking, when to seek medical care for a fever, and basic sanitation practices. We love when our Haitian employees are off on their own teaching and empowering their own community through their lived experience and the wisdom they bring. This model is more empowering than the traditional aid models that rely on foreign support and assume that local community members do not have the wisdom needed to bring about change in their own communities.
Matwon (Traditional Birth Attendant) Trainings: 70-80% of births are attended at home by a Traditional Birth Attendant or “Matwon” in Haitian Creole; an individual who has not received any formal training in midwifery but often has life experience as a birth attendant. Traditionally, these individuals are taught how to deliver a baby by a family member or another member of their community, through apprenticeship. We have a strong relationship with several local experienced Matwons and as resources allow, we have tried to meet their request for birth materials and trainings. To date we have distributed over 300 clean birth kits to these individuals which allow them to improve the sanitary conditions of the births they attend an act which drastically reduces risk of infection and mortality to both the mother and baby. We have held trainings on hypertension in pregnancy, pre-eclampsia, breastfeeding, delayed cord clamping, nutrition during pregnancy, acupressure during pregnancy and proper sanitation and hygiene practices. Razors, string, gloves and gauze are all very hard to come by in Haiti. We like to source our materials locally when possible but many things have to be imported and this is a reality we live with.
Hygiene Kits: We have distributed over 500 hygiene kits to members of the community in Haiti to provide them with soap, a toothbrush, toothpaste, a razor, dental floss, shampoo and conditioner and a wash cloth. Many of these items are quite expensive or are unable to be found in Haiti and patients are grateful to have access to them. This is a great project for a classroom or kids’ club to work on to send down to our patients in Haiti.
Acupuncture Training: NWB physicians and acupuncturists have been working with medical professionals at Haiti Hospital Appeal, an NGO that provides quality health care and community support with a hospital, a health center, a children’s home and one of the few emergency ambulance services in the North department of Haiti. They also have the only spinal rehab center in the North and asked NWB to teach some of their doctors, nurses and physical therapists how to perform acupuncture to help their patients. The trainings have been quite successful and so far nearly 10 medical professionals have learned a handful of acupuncture points with proper technique and safety measures in place. The patients have given very positive feedback and have noticed improvement in some of their symptoms. NWB has also taught acupressure to health professionals who do not have prior needle training experience with positive results.
Massage Training: NWB volunteers have taught NWB employees in Haiti to do basic medical massage which provides these individuals with a unique skillset they are able to utilize to assist their community. Those trained in massage help patients with musculoskeletal complaints and pain and they also work with residents of the rehab center at Haiti Hospital Appeal.