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2011 Annual Report
 
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2
Letter from the Executive Director
Dear Friends,I have been privileged to spend about half of my time in Cap-Haitien in this past year. People from home frequently ask meand other volunteers what we do there. The answer defies aneasy sound bite, because, as you can see from this report, theactivities and tasks are so varied. I would answer by simplysaying that we do whatever we can to help our Haitian neighborsbuild a functional health care system for their people, and wetry to walk together with them on their path to that end. Forme,
 konbit
means to walk and work side-by-side toward a sharedgoal. It means facing challenges together and sharing failuresas well as successes. It means being in it together. There are noshortcuts; it is a long journey predicated on a strong relationship.It has now been 10 years since the first group of volunteersfrom Maine visited colleagues from the Justinian UniversityHospital in Cap-Haitien and, after a week of introductions anddiscussions, agreed to embark on just such a journey together,even though no one among us knew where it would lead at thetime or the exact path forward. Speaking as one of those earliestvisitors, I can attest to the fact that we found the challengesfaced by the Haitian people and our Haitian health colleaguesoverwhelming, seemingly intractable, and stubbornly resistantto simple answers. Our most modest assumptions about existingresources and functional systems were overly optimistic. Haiti,in fact, has an oft-repeated reputation in the global developmentworld as a place where things simply can’t be accomplished.Our journey over the last 10 years has had many unanticipatedtwists and turns and highs and lows. However, we have learnedthat positive change
can
happen when it is not imposed onpeople, but rather when solutions are found together. It happenswhen our Haitian colleagues – who, after all, are responsible forthe provision of health care in Haiti – identify their priorities,what they can do to accomplish them, and what kind of supportis needed. Sometimes things can be accomplished simply bydoing business differently with some technical support. Othertimes, resources such as a sterilizer or a new well are needed, inwhich case we try to procure them together as partners.This
 konbit
relationship of working together has deepenedand evolved over the years and has enabled us to help in avery significant way through the overwhelming and tragicchallenges of 2010-11, especially the earthquake and thecholera epidemic. Our efforts, as humble and insufficient to thegreat task at hand as they sometimes are, are always aboutsupporting the people and capabilities of the public system of care and their partners.Through your generousinvolvement and support,
 
Konbit Sante has grownand evolved in its ability tohave a real impact. Once anentirely U.S.-based volunteerorganization, we now havea very gifted and passionatestaff in Haiti that is supportedby both U.S. staff andvolunteers.This annual report focuses onthe work and progress madethis past fiscal year. Youwill see that our experienceworking to address the choleraepidemic in Cap-Haitien hasdrawn us into the communityin a much greater way thanany other time in the past while still keeping our commitmentsto the major health care and training facilities in the area. Somany of you have made this work possible through generousgifts of money, time, knowledge, labor, and inspiration. By doingso, each of us has participated in the
 konbit
in the way that weare each able, and for that we are deeply grateful.We hope that this report will give you a glimpse of the impactthat your investment in the people and health care system of Haiti has made, and that you will join together with us and ourHaitian partners as we embark on the next 10 years of walkingthis path together.Sincerely,Nathan M. Nickerson, RN, DrPH
 Executive Director
Konbit Sante Executive Director NateNickerson and Dr. Israel Thelemaque of Action Sanitaire work together on watersampling during the cholera epidemic. Josué Limprévil (right), Konbit Sante electrical consultant, and Justinian Hospitalplumber Sully (left) get help from volunteer Bob MacKinnon (center) installing anew well pump.
“We have learned that positive change
can
 happen when it is not imposed on people, butrather when solutions are found together.”
 

3
Letter from the In-Country Program Manager
Bonjour,Konbit Sante began its work 10 years ago helping to improveservices at the Justinian Hospital. Although this workcontinues today and remains important, I am pleased byhow our work has shifted to include reaching out into thecommunity, to reach people who may not come through thedoors at Justinian or Fort St. Michel Health Center.The mobile clinic is one of the best ways to reach the poorestpeople. The people in the community often don’t have anyrights or any voice. They die only because of little or no accessto health care. When our staff and volunteers go into thecommunity, we step over barriers to reach people. For example,Haitians usually wear their best clothes to go to the hospital;they might refuse to go only because they don’t have anythingto wear and are ashamed. One time, a pregnant woman I metat one mobile clinic with pre-eclampsia said she didn’t go to thehospital because she didn’t have sandals. At our mobile clinic, the patients meet the same doctors andnurses who are working at the hospital. These doctors andnurses make the patients comfortable by showing them theyare receiving good care. Above all, they show them that thedoctors and nurses from the hospital care about them enough tovisit them in their community. Another important reason to go into the community is that thestaff at the hospital is not well aware about the life of a patient.When they treat a patient at the mobile clinic, they see his or herreality – the poverty and the dirty environment that the patientslive in. This experience increases their compassion for how theywelcome and treat them at the hospital. One doctor recently toldme that he just didn’t know how hard it was for a patient. At the mobile clinic we step over another barrier – cost. Therethe care is completely free –consultation, basic lab testing,drugs and education. At thehospitals, care is expensivefor the patients even withfinancial support from thegovernment and charitableorganizations. How couldyou ask someone to pay 25Gourde (about 60 cents) forconsultation when this persondoesn’t have 5 Gourde (12cents) to pay the tap-tap togo to the health center? Orwhen this person doesn’thave anything to eat or towear? Often their only hopeis praying to God when theyget sick. Once this person istreated at the mobile clinic, he’s open to listen and practice theeducational training the nurse or doctor demonstrated. Once helearns, he can become a leader to train his family members andneighbors.It is not possible for me to fully describe for you the peoplewe treat, but I hope this gives you even some small insightinto their lives. When you read in the annual report aboutour outreach in the community, including the mobile clinic, Ihope you can envision how we seek to treat our patients withunderstanding, dignity and care as we try to improve theirhealth system. Youseline Télémaque, MD
 In-Country Program ManagerCap-Haitien, Haiti
Dr. Youseline Télémaque, Konbit SanteIn-Country Manager, provides trainingto traditional birth attendants.Expectant mothers examine the birthing kits provided by Craft Hope anddistributed in a mobile clinic supported by Konbit Sante.Konbit Sante and Haiti Hospital Appeal sponsored trainings about choleraprevention and treatment to hundreds of community members.
“Above all, they show them that the doctorsand nurses from the hospital care about themenough to visit them in their community.”
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