I recently traveled to Haiti and had no idea what to expect- this, in turn, was thrilling to me. I’ve spent most of my years working in Latin America, East and Southern Africa, and bits and pieces in SE Asia. Being in the Caribbean, and French/Creole speaking Caribbean is completely new to me. Sure, I spent 3 years living and working in El Salvador however it is the only country in Central America that does not span both the Pacific and Caribbean coasts- so living in El Salvador, I was not exposed to Afro-Carribean culture. Sure, I ordered pan de coco from the bus while traveling from El Salvador to the Carribean coast of Honduras, and ultimately the Bay Isalnds 15 years ago, and that was the extent of it.
The only phrase I can use to describe Haiti is rich. Like a rich piece of cake, so delicious, but maybe you can only eat the corner of your slice, or it gets to be too much. We’ve all read about Haiti. We remember the earthquake in 2010 and anytime a series of hurricanes hits the Carribean, I assume Haiti’s been hit too. I was traveling with 80 lbs of weight on my back, to include prototype diagnostics to be evaluated for work and arrived wondering how logistics would play out. I’m told foreigners shouldn’t walk in the streets of PaP and was picked up by an NGO pickup at the airport. The air was hot and muggy and chaos reigned through the customs line. I’m not sure what PaP is like, because upon my pick up, and consequent inability to converse with the driver, we weaved through back roads up the hills of the city until we landed on my beautiful hotel. I don’t choose business hotels, typically, but instead base my choice on the size of the grounds, or garden of the hotel, and whether I can have my morning cup of coffee in said garden. Really, I like to be in a place that is open to the world around it, and not closed, so any access to local culture and conversations is sought after.
I got about 14 hours of downtime before getting picked up again and heading back to the airport, this time a much smaller version of the main terminal. I was headed to the city of Jeremie, in the department of Grand’Anse, and had no idea what my transit would look like. I spotted a tiny 12-seater plane near the door facing the landing strip and figured that was me. I asked some folks, “is that my plane” and they quickly responded, “no, that’s the big plane”. Turns out I was in a Cessna, 6 seater, with the back seats taken out and room for 3 total passengers, as the rest was reserved for our cargo. I think missionary trips is the small travel line’s lunch ticket and the folks waiting for planes typically were Americans with Southern accents visiting a sister city, or parish, of sorts. When anyone of them asked what I was doing in the area, and I in turn responded, “malaria elimination” I was mainly received with a glazed over look.
Most people know that malaria is deadly and that it exists in hot places. It actually takes more lives a year worldwide than armed conflict and about 400,000 people a year die from malaria and that most of those people are children under the age of five. The Bill and Melinda Gates Foundation, one of the most influential global health entities in this world is doing everything in its power to end malaria and yet, with their mighty muscle, malaria still proliferates. Transmission patterns are changing all of the time and just like the arcade game, “whac-a-mol,” when you hammer down one ugly monster, the parasites someone seem to come up in another place. Great minds and institutions are doing everything in their power to combat this deadly disease, and still, it’s taking lives, and reducing health outcomes for children who obtain the parasites while in utero. Low birthweight and cognitive issues, including still term or early term pregnancies are some of the issues that form from malaria in pregnancy.
Arriving in Jeremie meant landing on a gravelly strip in the middle of tropical trees. It was obvious who the scientists were waiting for me- so I walked toward them and we headed to drop bags at the hotel- this time a lot less magnanimous- but with pleanty of open air all the same. We then drove another 2 hours to the site where I would be training on the diagnostic devices.
Haiti is on path to malaria elimination and has the goal of reaching elimination in 2020. The tools we were testing would determine whether people had antibodies from recent malaria infections- this would be able to demonstrate on a village level whether malaria was present or absent, and ultimately help malaria control programs determine where to put more treatment and prevention efforts- like bed nets, screen and treat campaigns, and indoor residual spraying. The rains were unusually heavy during my visit to the Grand’Anse and all the days I was there, most schools, and even clinics, were cancelled because health care workers, teachers, and students couldn’t make it across the river or along the road to reach their destination- shining light on challenges for rural people- like access to school or health care. Malaria transmission, or numbers of people testing positive, was also unusually high during my visit, and if numbers remain this high, elimination would not be in site.