The Kay Mackenson Clinic for Chronic and Non-Communicable Diseases (Montrouis, Haiti)

by Zahra Kamal

I travelled to Montrouis, Haiti, to complete my internship for my Master of Science in Public Health on May 28th, 2017. I spent three months at Kay Mackenson, a clinic that focuses on early detection, management, education, and prevention of acute and chronic complications of non-communicable diseases such as diabetes, heart disease, kidney disorders, and juvenile arthritis.

My research involved characterizing the clinical phenotypes of Haitian children with diabetes and determining how socioeconomic status, psychosocial and mental well-being, illness perception, health literacy, self-efficacy, and lifestyle habits associate with glycemic control and quality of life. This essay will explore the three challenges and lessons that allowed me to be successful in my internship in Montrouis.

Language Barrier

 I had my notebook filled with Haitian Creole and English words and phrases that I had been practicing. Arriving in Haiti and spending my first week, I did not know enough words and kept forgetting the ones that I did know, resorting to the use of hand gestures and body movements to communicate. I feared that I would not be able to last a month in Haiti as I did not understand the natives and they did not understand me. To overcome this barrier, one of the cooks expressed her interest in learning English; in return, she was willing to teach me Haitian Creole. We decided that after dinner, we would do a 45-minute lesson of English and Creole lessons to benefit both parties. This proved to be very helpful, as I built rapport with the staff and children as well as learned Haitian Creole. My difficulties with the language taught me how lonely and helpless it is when you are the only one in a setting who could not speak the native language. This made me reflect on how individuals, such as immigrants and refugees who do not speak English or French, feel daily in Montreal and Canada. I hope to spend more time reaching out to these individuals and connecting with them even if it is as simple as a “hello”.

Tough Lessons and Helplessness

In Haiti, I learned that there is a high probability that poverty and lack of access to resources can become exacerbated. I had a difficult time understanding why and how a government could allow its own citizens to be so disadvantaged. I would become frustrated, shocked, and angry when I would observe these injustices. Often, as a society, we romanticize and glorify the work that NGOs do without fully realizing how much inequality and inequity continue to exist. What is astonishing is the fact that Haiti is not the only country in the world where political uncertainty, poverty, and social inequities/inequalities have a significant effect on the citizens’ lives. However, there are many agents of change and NGOs that continue to do amazing work.

Agents of Change

There are agents of change within communities that work to make a difference in Haiti. One example came during a home visit. We asked one participant whether his friends knew of his diabetic condition. He mentioned that he would not tell his friends until his school graduation because he wanted them to know that a person with diabetes can play soccer, have friends, go to school, and graduate with flying colours. It was his goal to be an example to his group of friends and showcase that individuals with diabetes and chronic illnesses are able-bodied and motivated. This was an incredible example of an individual making a small difference in his community to reduce stigma.

My time in Haiti has allowed me to apply my knowledge and skills gained in my courses in a global health context. This has also allowed me to reflect on my role as a student and future public health professional and to further understand disparities in health, the importance of relationships, and small changes in a community. I hope to return to Haiti to further my relationship with the Kay Mackenson Clinic.