Whittington & Associates, LLC

Central Florida Doctor (July 2008)
Love of Country, People, Draws Kaplans to Help in Haiti

By R.P. Whittington

Although his wife Elisabeth is a native of Haiti, it was not the link to her family's homeland that got Altamonte Springs Pediatrician Ted Kaplan, MD involved in providing medical and humanitarian support to the small island nation in the Caribbean.

Instead it was the work of a group of students and physicians in Project Medishare that prompted Dr. Kaplan to give his time and expertise to raise funds and give of his own time to help.

"I was just reading about a Project Medishare group from my alma mater (the University of Miami) that had made a trip to the island and just decided I wanted to get involved," Dr. Kaplan said.

Project Medishare for Haiti, Inc. was founded in 1995 by Drs. Barth Green and Arthur Fournier from the University of the Miami School of Medicine. Since that time, several other schools have become partners in its work – including Morehouse School of Medicine, George Washington University School of Medicine and School of Public Health, The Mayo Clinic School of Medicine, and Emory University School of Medicine.

The non-profit agency was formed to share human and technical resources with Haitian partners with the mission of bringing quality healthcare for island residents using two distinct but complimentary programs – the Community Health Program and surgical and medical care trips.

For example, the group's Community Health Program in Thomode, a city located in central Haiti, provides services to about 72,000 people who live in that district. Over a three-year period, Haitian doctors, nurses and other health care personnel working with American personnel and students conducted more than 28,000 home visits and 118 mobile clinics, increased immunizations of children from under 10 percent to 86 percent and administered oral re-hydration solution to more than 8,000 children – treating nearly the same number of children for worms.

"There are a lot of treatable ailments like malnutrition, diarerra and skin infestations that are easy to identify and treat," Dr. Kaplan said. "You see many things the people there could be doing to improve their health, and there are many Haitians who are making some progress against impossible odds."

Officially named the Republic of Haiti with its capital city at the Port-au-Price, Haiti is a French- and Creole-speaking Latin American country located on an island it shares with the Dominican Republic. It has remained the least-developed country in the Americas, with social and economic indicators showing Haiti falling behind other low-income developing countries since the 1980s – most recently ranking 146th of 177 countries in the United Nations Human Development Index taken in 2006. An estimated 80 percent of the population lives in poverty, and Haiti is the only country in the Americas on the United Nations' list of Least Developed Countries. Economic growth was negative in 2001 and 2002 and flat in 2003 – the most recent figures available. And of Haiti's 8.7 million inhabitants, just below half are illiterate – making its literacy rate of 53 percent the lowest in the region.

Exacerbating the problem: Haiti has consistently ranked among the most corrupt countries in the world on the Corruption Perceptions Index. Foreign aid makes up between 30 to 40 percent of the national government's budget. The largest donor is the United States followed by Canada and the European Union. Venezuela and Cuba also make various contributions to Haiti's economy.

In Haiti, there are thousands of children (and adults as well) with little or no access to health care, and nearly no access to pediatricians or sub-specialists in the field. Through Project Medishare, teams made up of about 30 physicians and medical students make trips periodically throughout the year to deliver medical care to Haitians of all ages.

"My wife and I have always enjoyed artwork, so we decided our first effort would be a fundraiser for Project Medishare," he said. "We collected some Haitian Artwork and held an art auction to raise funds for supplies and medicines that we could donate to the cause."

The couple collected $1,800 at their first fundraiser, and the couple has since opened a permanent art gallery, Le Couleurs:Art of Haiti, located at Go Electric in Longwood, Florida. Traveling to Haiti about six times a year to provide medical help, the Kaplans also buy Haitian Art that they bring back to display and sell at the gallery – with proceeds going to support Project Medishare. And Dr. Kaplan has also created a website to promote Haitian aid at www.missionpediatrician.org.

Dr. Kaplan notes that while his wife is Haitian and she has brothers who still live there, she hadn't traveled back that often to visit before they became involved with Medishare last year.

"What really motivates me is that the issue of helping Haiti doesn't resonate with many Americans compared to other causes," he said. "I've found you have to put out a lot more publicity and make a lot of phone calls to get people involved. But there's something about the island that sort of grabs you when you visit. It's a beautiful country and the people who live there are very friendly. Once you meet them and give your time there, you just want to help them as much as you can."

The Kaplans made their first trip to Haiti a year ago. Although he's a pediatrician, and many other doctors who visit the island bring other areas of specialization, it is typically their experience in general medicine which is in need the most.

"Most of the doctors involved have a family practice, but we do have ophthalmologists, oncologists and physicians from other fields who help," he said.

In providing services, Dr. Kaplan says Medishare uses a health fair model that was so successfully used in the lower Florida Keys several years ago.

"It's a great method of seeing a lot of people quickly and identifying problems and remedies," he said, noting that he usually sees 40 to 50 patients a day over five days when he visits Haiti. "In addition to the field work taking place, Medishare has also helped to reopen a hospital there."

Ground breaking began last June for the construction of the Medical Complex and Training Center for Childhood Nutrition and Treatment in Thomonde. Of the $422,000 donated so far, the University of Miami Rotaract raised $122,000. Project Medishare still needs to raise $1.4 million over the next three years to fund the project.

The Medical Complex & Training Center will consist of three facilities: the Akamil Production Facility, the Childhood Nutrition Treatment Center and an education and training center. The complex is located near the community hospital on four acres of land.

The Akamil Production Facility will manufacture and distribute AKA1000, often referred to as Akamil, a mix of locally-grown products such as cereals (rice, corn, millet, wheat) and vegetables (beans) all blended into powder. It is a product of great nutritious value containing building and energetic nutrients, and is affordable to poor families. With the expert consultation of a nutritionist, the finished product will be fortified with a mix of important vitamins and minerals such as iron, zinc, and Vitamin A. Introduced in the 1970s, Akamil is well-known and accepted in Haiti and offers a satisfying nutritional value that can combat the malnutrition currently observed among children, pregnant and breastfeeding women and TB/HIV patients in Haiti.

"It's a relatively cost-effective food supplement that the Haitians can grown and produce themselves," Dr. Kaplan said.

The facility's output will be used by The Treatment Center of Advanced Childhood Malnutrition that, in collaboration with the full-service medical facility in Thomonde, will help stabilize and restore malnourished children to the point where they can return home. Children and caregivers will be housed in a designated residential section of the center for as long as three months – offering follow-up care and referral as needed.

"There's a great deal of work being done in Haiti by many other organizations as well, but we could always use more help," Dr. Kaplan said, adding that if he can just get physicians to come just once to Haiti that they, like him, would become more involved in helping the people there.

"It's hard to get someone to follow through, again, because there the issue doesn't really resonate much in the general population," he said. "But once you get them there and they see the shame of the situation, they're hooked."

Side bars

Dr. Kaplan suggests those physicians who might be interested in Haitian Aid to read the book "The Zombie Curse," written by Arthur M. Fournier, M.D. – one of the founders of Medicare.

The story details Dr. Fournier meeting with his first AIDS patient on an autumn afternoon in 1979. Neither Fournier nor his colleagues at Miami's Jackson Memorial Hospital fully understood the ominous nature of what they are seeing, confounded by the fact that the patient fails to respond to treatment and, ultimately, dies. Over the next several months, scores of additional patients present themselves with similar symptoms – and meet the same fate. Beyond the medical similarities, there is another bond that groups these patients together: they are all Haitian immigrants.

Deeply affected by the epidemic's impact on Miami's Haitian community, the doctor vainly treats physical symptoms and prescribes medications that seem to have little effect, he slowly recognizes the cycle of poverty and disease that is contributing to the disease's true devastation.

The experience motivated Fournier to take his first trip to Haiti, where AIDS and a host of other ailments are crippling its population, which led to the creation of Project Medishare.

Traveling to Haiti

In addition to the time you donate to helping in Haiti, your decision to travel to Haiti provides an important economic stimulus and boost to Haiti's once strong but now moribund tourist industry. You will probably be surprised to hear that there are many gorgeous and wonderful hotels and scenic sites in Haiti, despite a general lack of visitors. This page will give you some information to help in planning your trip, and ideas on some places to visit while in Haiti, before or after medical service.

Travel Requirements: As with every foreign destination, a valid passport is required to enter Haiti. Americans do not require a visa. There is a $28 exit tax, usually included on flights leaving Port au Prince, but required in cash on flights leaving Cap Haitien. You should be aware that the US State Department has had continuous strong warning about travel to Haiti for several years. You can see this and register with them by going to https://travelregistration.state.gov/ibrs/ui/

For another side of the issue of safety in Haiti, see this article http://www.nzherald.co.nz/section/2/story.cfm?c_id=2&objectid=10509468&ref=rss

Health Requirements and considerations: The following vaccines are recommended, in addition to being up to date on tetanus and all usual vaccines: Hep A (two dose series) and typhoid (oral or injected) Yellow fever vaccine is optional. Malaria prophylaxis with chloroquine (fortunately, malaria is still sensitive in Haiti) is recommended, starting one week before travel, and continuing weekly until four weeks after return. Malaria netting is a good idea, as well as insect repellant and sunscreen. Drink only bottled water and fluids, and bringing a couple bottles in your checked baggage may come in handy.

Airlines: American Airlines and Air France go to Port au Prince 2-3 times per day from Miami. Spirit and American go to Port au Prince once a day from Ft. Lauderdale. Lynx Air goes to Cap Haitien by turboprop (2 1/2 hr flight) almost every day from Miami and from Ft. Lauderdale. There are propeller plan flights from PAP to Cap Haitien and several other cities.

Car Rental: Secom (Secomhaiti.com) provides the best service, from the airport or Petionville. There is Avis, Hertz, Budget, and some no name companies at the PAP airport. There is Hertz and another local company at/near Cap Haitien airport. Drivers can be hired through the rental car companies or with their own cars. (A four-wheel drive SUV, preferably running on diesel, is recommended.)

Hotel List: Rates range from 30-150 per night. Many of these have websites or other listings. For details, visit www.missionpediatrician.com.

Media Contact: Ron Whittington (904-563-0402)