Local doctors and philanthropists support a hospital in Haiti
By Chris King Of the St. Louis American
Last week, a young physician from Haiti named Herardony St.-Fleur, M.D., visited St. Louis, seeing patients with a local internist, making the rounds with the chief resident at St. Mary’s Health Center and surveying the dental clinic at People’s Health Centers.
He also saw his first Major League baseball game, where he dined on that distinctive American health food, the hot dog.
He was the guest of William Guyol Jr., M.D., who previously had visited St.-Fleur at his home hospital, Hôpital Sacré Coeur in Milot, which is said to be the finest hospital in northern Haiti, serving more than 225,000 people in the surrounding area.
Their collegial relationship is part of a unique symbiotic relationship between physicians and philanthropists in St. Louis and Hôpital Sacré Coeur which dates back to the mid-‘80s, when a local surgeon, Ted Dubuque, M.D., recovered from Hepatitis C and decided to dedicate half of every year to medical missionary service.
The Catholic Medical Mission Board in New York connected Dubuque with Hôpital Sacré Coeur, which a Haitian physician, Herve Thelusmond, M.D., had just developed from a small clinic. It had six beds, an emergency room but no emergency medical equipment, and no surgeon – until Dubuque arrived in Milot in the fall of 1986, with money and medical supplies he had raised in St. Louis.
A stockbroker friend of Dubque’s, the since deceased Carlos Reese, visited him that winter and decided to get involved with fundraising. Gradually they turned a bare bones facility into a functional, if struggling, 64-bed hospital that now employs some 200 Haitians, with seven full-time physicians, three part-time physicians and a staff dentist.
The financial base that has made these improvements possible is known as the Crudem Foundation. With the spirited help of many St. Louisians (mainly well-heeled white folks from St. Louis County), it continues to raise funds and consciousness for Hôpital Sacré Coeur.
Meanwhile, local physicians like Guyol, Dr. Don Mehan and Dr. Tim
O’Connell continue to follow in Dubuque’s footsteps, making medical pilgrimages to this distant hospital in a desperately poor region, where unemployment is at 70 percent, only 20 percent of the land will support crops and there is no pipe-borne water or sewer system.
“The people are indigent and there is no running water, but they come to the hospital, often after walking many miles, dressed and pressed and polite,” Guyol said.
“For a doctor, it’s heaven. There is no money involved. People need you, you take care of them, and they are grateful. It’s medicine without the nonsense.”
Financial support from the Crudem Foundation makes medical care and medicine very inexpensive at Hôpital Sacré Coeur – it costs less than $1 to see a physician and roughly $5 to deliver a baby – but it is not free. “There is a fee, so that people will understand that the care is of value,” said local attorney and entrepreneur Thomas Schlafly, one of six St. Louisians who serve on the foundation board.
Even at that, Guyol noted during his brief visit that many of the patients suffer because they can not afford regular care or frequent journeys to the hospital. When they can make it to the hospital, Guyol said, a highly competent staff awaits them
“I saw their emergency care, cardiology clinic and diabetes clinic. It was a wonderful exchange of ideas,” Guyol said.
“The doctors are very good. The difference comes down to money – only money.”
In medicine, a difference in money means, above all, a difference in technology. During his week in St. Louis, St.-Fleur paid close attention to the hi-tech tests, such as CT scans and MRI, that Americans take for granted but which Hôpital Sacré Coeur can not yet afford to make available.
Another difference is that the hospital in Milot is so flooded with emergencies and chronic complaints that there is little opportunity to focus on preventive care.
“Medicine in Haiti is simply to save patients’ lives,” St.-Fleur said.
“We don’t have CT scans or MRI, but we will still try to save you. We don’t have technology, so it is up to us to improve our skills to save our patients.”
Guyol described one instance of patient care that illustrates the difference between medical contexts here and in Milot.
“We saw a man who had had surgery earlier in the week. He had come in with chest pain. There was an abnormality on his lung exam. His chest X-ray was normal. Dr. St.-Fleur correctly diagnosed him with a pulmonary embolism (blood clot to the lung) and admitted him,” Guyol said.
“He was placed on an IV drip with a blood thinner, regulated by counting the number of drips per minute, without the ability to measure how thin his blood was. Fortunately, the patient did well. In the U.S., he would have had $500 worth of blood work, a $2,000 CT scan and he would have been placed on an automated heparin drip with constant blood tests to monitor how thin the blood was.”
Though his trip to St. Louis was St.-Fleur’s first visit to the U.S., he had previously visited France and thus had some familiarity with more developed economies and health care systems. Neither visit to the West tempted him to stay. Rather, they motivated him to return home and work harder to make up for the technical limitations of Hôpital Sacré Coeur.
“The only reason I would be tempted would be to stay and learn the technology, in case one day we are able to improve our technology at home. I would want to learn and go back,” St.-Fleur said.
“I want to take what I learn here and go back to treat my patients proudly and try to save lives. Because we don’t have so much technology, we have to be that much more dedicated to focus on patient care.”
– Translations from the French provided by Karley M. King
For more information, visit www.crudem.org or call (314) 754-7471. Donations can be sent to: The CRUDEM Foundation, P.O. Box 804, Ludlow, MA 01056. Medical volunteers may contact Dr. William Guyol Jr. at (314) 646-7015.
