BRINGING

BY RYAN FORD

HAITI

HOPE TO

conditions there have further complicated travel between cities. Communities in dire need of medical expertise nd themselves isolated; however, Londons LifePaths Global Alliance (LGA) is working to reach them using the cutting-edge technology of telemedicine. In May, LGAs founder, Elaine Knight, and executive director, Fatima Haleem, travelled to Haiti along with telemedicine pioneer and former Londoner Dr. Paul Gahlinger and four London-based physiotherapists to work toward bringing telemedicine to communities in need. In Canada, telemedicine amazes with its ability to bridge the gaps in our vast nation; in Haiti, the effect would be impossible to overstate. Telemedicine uses everything from telephones to video conferencing to datatransmitting instruments to connect patients and doctors over great distances. According to Haleem, at its most basic, telemedicine requires little more than a laptop with a webcam and teleconferencing software, a doctor on one end and a trained pair of hands on the other. Everything can run on batteries, a crucial consideration in a nation whereTubs the electrical grid is in operation for Hot about two hours a day, on average. LONDON

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Satellite Footage of Earthquake Ravaged Haiti

In January 2010, the world witnessed an unprecedented tragedy as a 7.0 Magnitude earthquake levelled one of the poorest and most vulnerable countries in the Western Hemisphere. In a matter of minutes, the quake claimed more than two hundred thousand lives and ruined an estimated two hundred fty thousand residences and thirty thousand commercial buildings. When the shaking stopped and the dust settled, hearts stirred and governments and relief organizations geared up to help the survivors. However, the enormity of

the task at hand dees comprehension. Estimates of the volume of rubble needing to be cleared range from thirty to seventyeight million cubic yards. The average dump truck holds just nine cubic yards, and such heavy equipment and the skilled labour to operate it are in short supply. Much of the work must be done by hand, with sledge hammers, picks, shovels and wheelbarrows. The trouble removing the rubble on Haitis treacherous roads, sorting it for usable building materials, and nding a suitable spot to dump the rest, all point

to a long-term process before rebuilding can begin in earnest. To provide some perspective, each tower of the World Trade Center contained four hundred twenty-ve thousand cubic yards of concrete, and that cleanup took over a year for the worlds richest nation to complete. However, in the most unlikely place, technology is overcoming seemingly insurmountable difculties, and its being brought by Londoners. With many of Haitis roads in rough shape even before the quake,
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In Haiti, LGA teamed up with Dr. Joey Prosper, a thirty-eight year old physician who runs a clinic in Port-au-Prince and a mobile clinic serving rural areas. Following the earthquake, Prosper routinely put in fteen-hour days, providing his services for free to those unable to afford medical care, and with little support from aid agencies. Travel accounted for much of his time, greatly affecting both his productivity and the quality of care his patients received. With all the pieces seemingly in place the LGA team arrived in Haiti ready to get to work, but the situation on the streets of Port-auPrince quickly skewered their expectations. We assumed that wed be seeing a lot of amputees, says Knight. We understood there were six thousand amputees in Portau-Prince...We thought maybe we could get the telemedicine hooked up and then we could hook up doctors here in London with doctors there in Haiti to help with the amputees and prosthetics, that type of thing. When we got down there, we found out that there werent as many amputees out and about as we thought. We didnt see them because theyre in the tent cities.

Theyre stuck in the tent cities; they cant get to the doctors. Haleem and Knight found that the tent cities erected in haste by various relief organizations to temporarily house quake survivors have created unintended consequences. The roads are blocked

is there rubble, there are people climbing all over the rubble some are trying to work, but some are just hanging out because its cooler than in the tent cities. With those in the capital having difculty reaching the help they need, Haitians in rural communities have too often been overlooked. LGA will initially be setting up a telemedicine unit in the town of Lestere, an area previously hit hard by hurricanes Gustav, Hanna and Ike, and tropical storm Fay, all within a three week period in 2008. The town, about one hundred-thirty kilometres north of Port-au-Prince, exemplies the isolation of rural areas in Haiti. On their initial fact-nding trip, the LGA team discovered just how isolated Lestere had become since the earthquake. It was a fteen hour day, says Knight, but you know, the time at the clinic was maybe three hours - it was the travel there and back that was horrendous. So we found out quickly that telemedicine was something that was going to be very useful in Haiti. As Haleem and Knight travelled around Haiti, isolation would prove a recurring theme. Outside Prospers clinic, their van became

stuck in mud after rains washed out the road. They couldnt even enter another city without an all-terrain vehicle. While driving between Port-au-Prince and Jacmel, it became evident that they werent the only ones having trouble getting around. There were lots of signs that said We need help and then an arrow pointing down some rubble (lled) road, says Knight. So there were a lot of people who didnt get any help at all. Leveraging telemedicine technology in Haiti will not only provide access to health care in remote areas, but will also have a profound impact on the quality of health care available. As well as doctors in London, Haitians will be able to consult physicians from across the globe, providing world-class care around the clock. The aid of Gahlinger in particular has been indispensible for LGA. We were really lucky to hook up with Dr. Paul, says Knight. I met Paul last year when he was organizing a trip to Mongolia just to prove the concept of telemedicine. He was on the back of a camel with his telemedicine unit, and he was able to use it there...It was him showing that you can get health care

anywhere in the world if you really want it. When we phoned him and asked if he wanted to go to Haiti, he said Yes I do, just like that. Following his trip to Mongolia, Gahlinger developed a curriculum for teaching those willing to learn how to be the hands of

students could learn to be the equivalent of a registered nurse. Theyre hiring people there right now, to work and learn how to run the telemedicine unit in Lestere, says Knight, and then Dr. Joey can stay in Port-au-Prince and communicate back and forth by video. LGAs ambitions do not stop at telemedicine, however. They see the potential to begin rebuilding around the jobs, education and health care provided by telemedicine. The idea would be to take a place like Lestere, build in the telemedicine, also build a community centre that houses it and also houses a health care centre so that people can learn preventative medicine, and use that as a model, says Knight. Such plans may take time to implement in this fragmented, half-buried country, but one village at a time, Haiti will heal. It starts with hope, a laptop, and a few dedicated people. To learn more, please visit yourmagazines.ca/YourCity www.

Lester Community Project: Picture taken by: Elaine Knight Location: Lestere, Haiti In this picture: Children from the neighborhood wearing LGA t-shirts and holding up pencils that were given to them by LGA

Picture taken by: Jean Eddy Dieujuste Location: St. Josephs, Port-au-Prince, Haiti From Left to Right: Elaine Knight, Dr. Joseph Prosper, Fatima Haleem, school children in the area

because the tents are hot, says Knight. At seven in the morning everybody goes down into the street and thats where they stay until night time when its cooler. So now not only

a doctor. The training takes two weeks to complete; in their case, six Haitians will travel from Lestere to Port-au-Prince to train with Prosper before returning to serve their community. The curriculum has also been expanded so that, with a years training,

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