Letter from Haiti: Chronicle of a Humanitarian Eye Clinic

by Mark Rakoczy, OD, FVI
President, VOSH-PA

Often when you hear about Haiti, the fact that it was the first black republic and the first country to ban slavery does not come to mind. Instead, the images we have become used to are of poverty, insecurity, lack of functioning institutions, violence, and gangs. In the current instability that affects Haiti, finding hope for the future seems harder than ever.

The significant health needs of the population trigger the immediate wish to help. Several VOSH (Volunteer Optometric Services to Humanity®) chapters have worked in this country, offering eye health services to thousands of Haitians as part of their humanitarian work. No matter how good we feel about it, we are conscious that this is a drop in the ocean. Without the involvement of local optometrists and other health professionals, the impact will be reduced, and the challenge will continue.

In recent years, VOSH/International in collaboration with VOSH-PA (Pennsylvania chapter) has focused support to the student chapter in the optometry program at the Université d’Etat d’Haïti (SVOSH-UEH-FMP-EO). Our efforts have been aimed at offering Haitian optometry students supervised clinical practice while serving the local population’s eye health needs. In calm or rough waters, VOSH-PA has been a reliable partner in implementing this work while continuing with its humanitarian work. This has included strengthening the partnership with Haitian New Hope Hospital in Plaine du Nord, in northern Haiti where both partners have established and are equipping a purpose-built eye clinic to serve 250,000 local inhabitants.

The Challenged Original Plan

Between March 3rd and 8th, 2024 VOSH-PA organized its latest humanitarian clinic at New Hope Hospital. The 6-people VOSH-PA team included Drs. Mike Satryan, David McPhillips, and Mark Rakoczy along with technicians Crystal Vermeulen, Melissa Zapotoczny, and Victoria Hallberg. The seasoned local team of interpreters included Joseph Telemaque, Marc Louissaint, Savio, and Flavio Fayette. The plan was to include three graduating Haitian students of optometry, Mirlène Toussaint, Ronalde Escanier, and Abigail Adjanie Auguste into the team, increasing their opportunities to practice and serve their community. Part of the plan was to send the gift trial lens sets, trial frames, and charts, purchased thanks to the fundraising dinner in New Orleans, for the rest of the graduating class.

Unfortunately, a day before their scheduled departure from Port au Prince, the security situation deteriorated significantly, with gangs attacking areas close to the airport forcing us to postpone their trip to a future date. This was a hard and disappointing decision to make, but the security of our young Haitian colleagues was a priority.

The then Haitian Prime Minister had gone on an official visit to Kenya to secure the country’s commitment to lead a UN-backed multinational police force to be deployed to Haiti to address the insecurity and gang-led violence. In his absence, coordinated gang attacks swept the capital, trying to overturn his government. To prevent his return, the gangs first blocked the international airport in Port au Prince, and as the situation deteriorated, the airport at Cap Haïtien, which the VOSH-PA team travels to and from, also stopped operations later that week.

The Eye Clinic and the Heartbreak it Can Bring

On Sunday the work focused on setting up the equipment. The New Hope Hospital eye clinic now has three complete lanes and an incomplete one used to do VA’s. The equipment has been donated by VOSH/International and VOSH-PA and is progressively being completed. The VOSH-PA team was joined by two other Haitian graduating students, James Gregoire and Christopher Pierre, who are currently doing a residency at the Clinique Mémoriale in Grande Riviere. Both received their gifts and started using them with their patients the next day. Nothing beats motivated young people to encourage us to continue.

During the four days of the clinic, a total of 649 patients were seen, including 56 students of different ages attending neighboring schools. A lot of previously diagnosed glaucoma patients received medications through the hospital’s pharmacy. Thirty-three patients were referred for cataract surgery, nine for pterygia, two for narrow angle glaucoma, one for acute closed-angle glaucoma, one for chronic chalazion, one for conjunctival growth, and the saddest case in this clinic, one bilateral papilledema.

No VOSH clinic leaves you untouched. This time, when a female patient walked into the exam room, she seemed quite disoriented. Her vision was Hand Motion in both eyes. IOP was low and normal. Her blood pressure was normal. The three doctors discussed what might be causing this: extreme hypertension, idiopathic intracranial hypertension, or a lesion in the brain. After further observation, it was agreed that a CT scan was needed.

The New Hope Hospital hosts the only CT in the north, owned and managed by another company. After securing the (exorbitant) payment for the scan from prior VOSH-PA members’ donations, the results indicated that there was a 6.5 x 4 cm left cerebellar tumor, probably a pilocytic astrocytoma with moderate hydrocephalous.

Under normal circumstances, this makes you sad, but in Haiti, this is devastating news to communicate, and little hope that can realistically be offered. Without specialized surgery and treatment, the life chances of this patient are really limited. Every day the conflict continues in Haiti, it is a day less in finding a solution for her. However, despite the huge challenges this represents, as President of VOSH-PA, I am trying to find options for this patient.

Returning Home

Due to the closure of the Cap Haïtien airport, we considered the options to leave Haiti safely and hopefully as scheduled. In collaboration with VOSH/International, an alternative plan was identified. It was an up-and-down roller coaster of knowing if and when we could leave, but the VOSH-PA team was able to fly out of Santiago, Dominican Republic at 4 am on Saturday morning.

Reaching this outcome required the successful completion and coordination of various activities. The resourcefulness and persistence of Pam Rakoczy and Victoria Hallerg’s daughter who spent hours on the phone to get the return tickets changed, and maintaining the US connections, were essential to ensure the VOSH-PA team could fly back home from the Dominican Republic.

In Haiti, with the support of and accompanied by the director of the New Hope Hospital, Dr. Maklin Eugene, the VOSH-PA team made the two-hour road trip to the Dominican border without problems. For added safety, two husky armed policemen came along.

It is important to acknowledge the value and reliability of our fellow VOSH chapters and partners. VOSH/International took charge of the crossing into and support once in the Dominican Republic. As we did in 2021, when Dr. Twelker, Past President of VOSH/International, had to be evacuated from Haiti when the Haitian President was assassinated, the support of our colleagues at the Dominican Technological University of Santiago (UTESA) was called upon. UTESA has a campus in Dajabon which borders Haiti and is the main crossing point where the VOSH-PA team had to enter the Dominican Republic.

Following the introductions made by the UTESA HQ in Santiago, the rector at
the UTESA campus in Dajabon, Dr. Haydeli Toribio, ensured that all Dominican migration and military authorities in the border were aware of
the coming of the VOSH-PA team and facilitated that Freddy Lora would be available to help the team during the crossing and take them to the bus station for the bus ride to Santiago. Because of an hour time zone difference
between the two countries, the Dean could not wait due to previous
commitments, and Freddy Lora stayed with us until our departure to Santiago.

Dajabon is a market town, and every week thousands of Haitians cross to the Dominican Republic to trade goods. The escape of thousands of prisoners from Port au Prince jails increased the risk and insecurity levels, resulting in the Dominican Republic closing its borders with Haiti.

The bus ride to Santiago was uneventful, except for being stopped at checkpoints where guards entered the bus and checked passports. Upon arrival in Santiago, Enyel Rodriquez, president of the VOSH-FUMVISION-Dominican Republic chapter, and his daughter — who are both enrolled at
the optometry school in Santiago — met us and took us to the hotel for the night. There, we met some VOSH-Southeast members who had been working with Enyel’s chapter in Santiago that week. It was very interesting to exchange views and meet some of the surgeons in this chapter.

Early in the morning on Saturday, March 9th, and after a short delay, the VOSH-PA team started the return journey to the USA. Although the situation in Port au Prince is truly dangerous, the VOSH-PA team never felt unsafe while in Haiti.

VOSH-PA and VOSH/International are grateful for the generosity, care, and selfless support offered to our volunteers during their recent visit to Haiti and transit through the Dominican Republic by Dr. Eugene and his team at the New Hope Hospital, Dr. Toribio and the UTESA team, and Freddy Lora and Enyel Rodriguez of the VOSH-FUMVISION-Dominican Republic chapter.

Despite the current situation, our commitment to the people of Haiti remains strong. We can challenge the way Haiti is perceived because we know Haiti has talent, resilience, leaders in the north of the country like Drs. Eugene and Previl to inspire new generations, and a shared vision for a better future. Times are difficult now, but VOSH will be back to continue working with our Haitian partners and supporting the optometry students on their professional journey, listening and learning from Haitians for the benefit of Haiti.

For more information on VOSH-PA, its work in Haiti and to support it, please contact Mark Rakoczy at mrakoczy831@gmail.com

The Haitian healthcare system has received a huge blow in this recent crisis. Find out more about our Haitian partners in the north of Haiti. They need our help, to continue helping Haitians in need.

More information on the New Hope Hospital at https://www.partners4newhope.org/ and its Facebook page https://www.facebook.com/Partners4NewHope/

More information on the Clinique Memoriale at https://www.eewshm.org/

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