By Francesca Andre
As the coronavirus takes hold in Haiti and the Caribbean, officials in Haiti grapple with a rapidly spreading virus against the backdrop of social, economic and political turmoil. Jean Pierre Louis, executive director of Capracare — a nonprofit dedicated to developing sustainable community health programs for children and their families living in Haiti — however isn’t letting the country’s seemingly persistent problems prevent him from organizing his own response to the pandemic.
What are some of the challenges that you are currently facing as an organization serving a rural community in Les Cayes Haiti?
Jean Pierre Louis: As an organization serving rural communities in Haiti, we are constantly dealing with a lot of challenges pertaining to the greater infrastructure of doing business in Haiti. Lack of access to electricity, internet connectivity, low-level education of the community makes it more challenging for them to understand not only the work but the importance of them applying things that they are being taught. Transportation is another issue, oftentimes, it’s hard to reach them because the roads are terrible. Any amount of rain can cancel a day of work or keep people home. So, electricity, communication, education, and lack of roads are some of our main challenges.
Tell us a little bit about Capracare’s efforts in response to the pandemic and what you have been doing to educate the Les Cayes community?
JPL: Before the pandemic was an issue in Haiti, Capracare was already preparing our team to respond. In February 2020, we started our fifth cohort of training locals to become community health workers and part of our curriculum included workshops on hygiene and handwashing. So transitioning our team wasn’t much of a challenge because we already had a cohort of people ready to assist in educating the community. So far we’ve distributed over 1,000 clinical masks and manufactured our own liquid soaps and hand sanitizers to share with the community. We’re also hosting small-group education workshops to keep students engaged while out of school. Our community workers are also conducting weekly community door-to-door outreach and education on the promotion and prevention of COVID-19. Lastly, in partnership with St. John’s University, Department of Pharmacy Administration and Public Health, we developed a “COVID-19 Knowledge, Support and Perceived Stress Impact Assessment” to assess the level of preparedness and knowledge of the community pertaining to COVID-19.
Has it been challenging educating the Les Cayes community about social distancing?
JPL: Yes, it has! It’s partly because this is not something people are used to doing. At the beginning of the pandemic, people were anxious and fearful which helped to keep them away from crowds but now they almost don’t believe the severity of the matter – especially with many of them calling it a fever. Now you have conspiracy theorists saying this is the government’s own doing to make money, which causes a lot of sick people to not go to the hospital.
There have been a lot of talks about social distancing and not so much about mental health, what is your organization doing in that department?
JPL: The coronavirus pandemic is very stressful for a lot of people in resource-rich nations with all types of support and infrastructure. Now, imagine how stressful it is for a low-income nation like Haiti where the infrastructure is hanging on shoe-strings support! People receive very little to no support from their government – no stimulus packages, no food pantries, no remote learning for students, no free testing, and the likes. The amount of fear and anxiety about this new disease and what could happen is beyond overwhelming for the people we serve! We are seeing strong emotions in adults and children. Capracare conducted a survey called “COVID-19 knowledge, support, and perceived stress impact assessment in Haiti’ and the results clearly show that the community is in dire need of mental health support. To inform our guidance on providing mental health support, our own validated surveys were used to assess the psychological impact of COVID-19, in relation to perceived stress, anxiety and depression. The perceived stress scores for the sample ranged from 1 to 12, with the highest scores representing greater perceived stress. Among the survey respondents, the average perceived stress score was 7.33; a standard deviation of 1.95.
In terms of anxiety, over one third (32.4%) of the survey respondents’ scores were suggestive of experiencing anxiety as a result of the COVID-19 pandemic. And, for depression, nearly half (41.7%) of the survey respondents’ scores were suggestive of experiencing depression. As a result of this new information, everyone who comes to Capracare for health services is offered mental health counseling to help decrease their stress and anxiety. This also includes ear acupuncture as well. Today, our Acupuncturist Without Borders (AWB)-trained staff are starting to offer in-person treatments in Fonfrede, Haiti. The staff offers a treatment of 5 needles, or “ear seeds”, in each ear to help reduce stress, improve sleep, and increase an overall sense of wellbeing. This service is offered to everyone who comes in for health services at Capracare.
Capracare has experience dealing with natural disasters, what are some lessons learned and advice you can share with the global health community?
JPL: Oh yes we do!!!! We’ve dealt with the Haiti earthquake, cholera, chikungunya, Hurricane Matthew, and COVID-19 just to name a few. I would advise them to be consistent in their actions. It’s important to have good pre-existing relationships with key members and leaders of the community as they are instrumental in any key plans you may have for the community.
As a global health leader, what do you find the most challenging right now dealing with COVID-19 and what have you learned so far that can help you be a more efficient and empathetic leader?
JPL: I have nearly 12 years of global health work but nearly 20 years in Public Health. I find collaboration with other organizations can be fruitful. Collaborations can be shared resources or information. A current example is the creation of the Haitian Sud Committee, which meets weekly to discuss COVID-related issues and updates among the health care community. Also, learning to understand what life is like for Haitians in Haiti can help you be more empathetic. It’s important to try to see things through their lens of living in Haiti and not from a privileged life from the western world.