Grassroots Community Development in Borgne, Haiti.

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A powerful experience for H.O.P.E./ASB staff and the community of Molas

We ended a first experience that will be difficult to top but which cemented our belief that Sante Nan Lakou (Family-based Health Care), the model of health care delivery developed by H.O.P.E./ASB, works and saves lives! For those of us close to the field, the message is clear, we are on the right path and we are making a difference. Sante Nan Lakou is an effective model which makes sense in an environment like Borgne where the rugged terrain limits people’s ability to travel and access health care. The isolation of areas like Molas is a major barrier to any improvement in the health status of the community; it further limits this population’s potential to live healthier and more fulfilling lives.

A team of 34 which included doctors, nurses, lab and pharmacy staff, security guards, registration staff, administration, and kitchen staff set out before dawn from the ASB satellite clinic in Tibouk for a long and arduous trek that would take them to the edge of the rural district of Molas. Molas is the farthest and most isolated region of the commune of Borgne.  It was a hard climb for the team but the reception they received was well worth the effort!  People joined the caravan to help carry supplies and bags and welcome them to their community. This extended visit of a health team was a first for them and for us!

”When we reached the peak of one of the many mountains in the commune of Borgne, I was astonished by the landscape. The scene was absolutely breathtaking. Fog weaved around the mountain tops as the sun began to rise ”wrote Rachelle.

The team logged over 2500 patients for the week:  270 on Tuesday, 587 on Wednesday, 793 on Thursday, close to 500 Friday, and about 250 Saturday morning.


The work of tallying numbers, completing inventories and entering data is just starting but we know that this was a groundbreaking week for H.O.P.E./ASB in Borgne and in Rochester. It’s difficult to encapsulate and explain the significance of the experience from a development, community health, logistics and cultural perspective.  From a development and community health point of view, we are even more certain now that in order to improve health in areas like Borgne, where challenges include geographical isolation and lack of infrastructures, it is critical to understand the reality of peoples’ lives and address problems at the source. We take health care to the people, this is the foundation of Sante Nan Lakou. For a woman experiencing a difficult labor or the parents of a child with a high fever , the prospect of undertaking the five plus hours walk over rocky terrain to reach the hospital in the town of Borgne is daunting and too often fruitless—the patient may not survive the trip. We also learned a great deal about the logistics of putting a program like this in place—from setting up a supply chain to feeding and housing a team. We learned about generosity and gratitude when people who have little rushed to contibute labor, share meager resources such as sheets to build partitions for a field clinic, and whatever they grow (plantains, yams, corn, etc) to feed the staff! We learned about the strenght of the community when people waited patiently for hours to be seen and even demonstrated their gratitude through song and skits! Literacy levels in these remote regions is very low and so is the understanding of illness causation and epidemiology!

This was a true team effort in the spirit of collaboration and partnership that has guided H.O.P.E.’s work in Borgne since 1996! We’ve seen real leadership from Dr. Thony and the medical staff but also from the Wat/San team, the Community Health Workers and people from the area.