Help Haiti’s People in the Poorest Slum of Waf Jeremy

Project location: HAITI, Waf Jeremy
Project start date: December 2011 - Project end date: September 2012
Project number: 2011-35
Beneficiary: Fondazione L’Albero della Vita ONLUS

PROJECT TIMELINE: from January 2016 to September 2016
The project goal is to provide health and nutritional assistance to the population of Waf Jeremie, the poorest slum of Haiti where 50,000 people lives in an unhealthy environment, characterized by degradation, social exclusion, widespread violence and food insecurity.
As far as operational context is concerned, since 2015 Haiti has been going through fragile political phase which reached the climax during the summer when the mandate of the interim President Jocelerme Privert expired.
The institutional uncertainty in the country brought to acute violent protests in the Capital and an increase of gang violence throughout the country.
In this framework humanitarian context in Haiti remains severe due to multiple risks factors: persistence of cholera, El Niño affecting food security, natural disasters, and migration crisis with the Dominican Republic.
The project started in January 2016 with the preparatory activities. The San Franswa Clinic successfully opened to the public after a break due to restructuration needs of the clinic, reaching the peak of 1900 visits per month. In comparison with the previous project it has been an increase in the monthly visits of children (8,82%) and pregnant women (3.9%).
In the last quarter of 2015 the San Franswa clinic underwent an urgent structure renovation since a risk of collapse of the structure appeared to be highly probable. The works run till the end of February due some delay with suppliers. The rotten wooden beams of the roof were replaced and a metal sheet was installed. In the clinic rooms has been renovated maintaining the previous organization: a waiting room, two rooms for medical assistance and routine checkups for mothers and children. During this time, health component of the project took place in children’s home Kay Pe’s Giuss run by Sister Marcella, the Health coordinator. Even without all required equipment, Sister Marcella ensured good quality health service. The clinic is the only one in the slum offering free access to health assistance and medicines.
Activities implemented
Health Cluster
Activity 1.1 Provision of medical staff

The project staff is composed by: one health coordinator, one doctor, two obstetricians, a nurse, three paramedical staff and three persons in charge of the security. By this set up clinic staff visits during the project 9450 persons: of which 6300 children, 3150 pregnant women, 105 children with severe forms of malnutrition.
The health coordinator, Suor Marcella Catozza has been in charge of the activities in the clinic both for the health cluster and for the nutritional cluster. She selected the clinic staff, trained them to use the medical equipment and monitored the activities (January-April 2016). Thus, she was involved directly in the project from June to September supplying the presence of the medical staff - nurse and obstetricians- who for the worsening of the security situation  were not able to reach Waf Jeremie on daily basis. For this reason, FADV added a month to the Health Coordinator to face the difficulties.

Activity 1.2 Provision of 24 hours first aid service
The Clinic is open from Monday to Friday 5 days per week; furthermore, when the clinic is closed, basic health assistance is ensured at the children’s home Kay Pe’ Giuss, located nearby the San Franswa Clinic. At the Kay Pe’ Giuss Sister Marcella staff keeps ensuring urgent health services for slum population. When required the paramedical staff transports patients to the nearest hospital in Citè Soleil or in Port-au-Prince specialized medical centers.
In Waf Jeremie the most common pathologies are related to the poor hygienic conditions and malnutrition. Children (0-18) suffers of the following pathologies:
- Bronchial asthma, bronchitis and pneumonia
- Gastrointestinal disease often related to intestinal parasite
- Dermatologic pathologies (scabies, mycosis, dermatitis)
- Dehydration status

Activity 1.3 Provision of free test of HIV, TBC and malaria
This year TBT tests and Malaria Test has been suspended because are not available in Haiti meanwhile HIV Tests have been suspended since they reach an unaffordable cost of 2 US dollar per test.

Activity 1.4 Allocation of medicines
The health coordinator and the doctor scheduled the purchase of medicines according with the needs of the clinic; this year it appeared to be necessary to increase the budget allocated for the medicines as a consequence of the increase of the cost of transportation in the widespread violence context. The most used medicines purchased in the projects are:
•           Paediatric antibiotics
•           Paediatric Multi vitamins
•           Lactic acid
•           Mebendazole
•           Albendazole
•           Paracetamol
•           Metronizadole
•           Intravenous fluids
•           Band-aids, bandages, gauze, wire suture
Activity 1.5 Mother and child survival programme
The mother and child survival programme is a cornerstone of the project. The project provides a unique service in the neighbored. Thanks to the information activities implemented by project staff on the importance of pre-natal checks and nutritional status, word of mouths and the excellent relationship with Sister Marcella, the number of women enrolled in the project increased every year. During the project 3150 pregnant women has been visited, the monthly average increase of 3.9 % compared with last year. Hence, it is relevant to underline the importance of Nando and Elsa Peretti contribution since without the clinic none of the women would undergo pre-natal nor the newborn would receive medical checkups.

The programme goal is to prevent child mortality. According to Unicef the 45% of deaths of children under five occurs during the first days of life. Newborn deaths are due to complication related to preterm birth, intrapartum events such as birth asphyxia or infections. Thus, targeting these time frame the mother and child survival programme produces a huge impact in the slums, savings children lives.

The Clinic hired two obstetricians – Suzie Ompremiere and Beaunise Pierre Rubes – who ensured medical check up to pregnant women and control the nutritional status both of mothers and children weekly. In Haiti women prefer to deliver at home in order to comply with traditions and perform popular rites. Nevertheless, during the project 70 women delivered in the clinic in line with the monthly average of the previous project. A consistent work has been provided to raise awareness among women on the importance on giving birth under medical assistance.

Nutritional Cluster
Activity 2.1, 2.2, 2.3, 2.4 Implementation of nutritional support program for children

The project gives special attention to the Nutritional Programme since malnutrition is the main cause of death for children under 5; its consequences are severe and longstanding preventing brain and body to reach their full potential. During the project the Nutritional Programme  enrolled 455 Waf Jeremie children.
First, the children received an initial assessment which defines a personal schedule based on their health situation, secondly they receive weekly screening till complete recovery.  Children classified with light malnutrition – from 1 to 2 degree of malnutrition – are treated with high proteins food like rice, beans and oil; children with severe malnutrition – from 3 to 4 degree – are treated with therapeutic food such as plumpy nuts; children with severe acute malnutrition are hospitalized.
A monthly average of 15 children are classified with severe malnutrition.
Final Results
In Waf Jeremie the security situation deteriorated during the year for the institutional uncertainty, gang violence is widespread and gunfire are frequent during nights. In this context the San Franswa Clinic is an essential pillar for the health assistance, recognized by the people of the slum. Among difficulties the Clinic managed to take care of people in needs and to supply free medicines. All the foreseen results have been reached: mother and child programme had increased its efficiency, ensuring prenatal and postnatal care to 450 women. Nutrition programme has been ensured in terms of provision high-protein food for children and malnourished women.

Results obtained during project implementation:
-          6300 children visited
-          3150 pregnant women received medical checkup
-          70 women delivered in the clinic
-          105 children with severe form of malnutrition assisted
-          455 children enrolled in the nutritional programme

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