A Garden for Healthier Babies

  This past week a group of American medical providers came to La Croix. Sunday we went around the clinic and planned out our week. Sunday moves pretty slowly, so I went with a few doctors to the clinic, they looked at the few patients there, and then we went outside and drew up plans for a garden around the clinic. As I was measuring out distances and trying not to step on the chickens wondering around (there seem to be chickens everywhere) I felt like we were wasting our time. I was with two seasoned providers, a nurse and doctor, and we were measuring out a garden. We weren’t curing any diseases, we weren’t setting bones, we were trying to figure out if we could plant over a septic tank. Sure the clinic was having a slow day, but we’re in rural Haiti, we could have gone a mile in any direction and found someone who needed medical help. Wasn’t this a waste of our time 

  I started to intellectualize this, thinking about the opportunity cost to putting in a garden at the clinic. How many people were we not treating by spending time on another project? I didn’t get too riled up because the opportunity cost theme continued in my thinking. The clinic is fully functional and sees many patients on a regular basis. Everyday when I see Dr. Abel (one of the doctors in charge) he tells me about all of the babies he delivered that day. When we went out into the community, one of the focuses was on preventative care. Part of what Shelly (the nurse serving with me) objective for public health is to distribute at home birthing kits. Most women in La Croix deliver their children at home. I thought that Dr. Abel delivered most of the babies in the area, but even though he sees a large number of babies, he only addresses a small portion of mothers because most deliver at home.

Women deliver at home for a multitude of reasons; some don’t have the money to go to the clinic, some go into labor before they can get to the clinic (they only way to the clinic is by foot or by taxi, and I can’t imagine a woman going on a taxi after she’s gone into labor), and sometimes women don’t feel very welcome at the clinic. This isn’t because the doctors are nasty or the clinic is poorly run, the clinic is one of the best run clinics in the area. The clinic is however further away from some of the communities, the landscape around is fully of briar bushes whose seeds stick to you and cut up your legs, and it doesn’t feel as familiar as home. If I were a woman in La Croix, though the clinic may be more sterile, I am sure I would feel more comfortable giving birth in my own home. Since many women are uneducated on issues cleanliness, the sterile nature of the clinic might not factor into their thinking, and unfortunately it might give the clinic an even more uncomfortable vibe. The opportunity cost of delivering her baby in the clinic versus delivering at home is something to consider.

As I considered this, I realized the value of planting a garden at the clinic; it would make the clinic a nicer place. No, it wouldn’t directly save anyone’s life, but might make a few more people come by. Right now there are nasty weeds outside of the clinic whose seeds stick to you when you go by. My legs were all cut up after marking off the area, I can’t imagine how they might make an expected mother feel. These weeds are a minor issue, but they are giving women incentive to stay at home and deliver at home. If we planted a big garden, we would make the community feel al little warmer about the clinic, and maybe encourage a few more mothers to deliver at the clinic who otherwise would not. This garden would open up the clinic to the community more.

This type of dilemma highlights the difficulty with community development. In order for places like Haiti to develop, they need to have strong community institutions like clinics. The stronger these clinics are, the better off the community is. Part of strengthening these clinics is having competent doctors, but another part is having nice gardens outside welcoming people in. This type of community development work might sound good but is extremely difficult to put into practice. Sure everyone knows that a clinic is necessary to a community, but in order for a clinic to function it needs patients. If a medical team goes out and addresses all the issues in the community for free, there won’t be any patients to go to the clinic. This means sometimes not giving people care in the communities and forcing them to go to the clinic, which is really hard to do. This also means that we sometimes have to plant gardens instead of treat people. Community development is not only a shift in actions, but it is an entire shift in perspective; we have to stop thinking “how much good can I give these people” and start thinking “what is my part in this community”.

Many times the result of community development is quite boring and anticlimactic. Setting a broken bone in rural village is a thrill, making a clinic look nicer is a bore, but which supports the greater needs of the community institutions? When we do work out in the communities, we have to think about how we affect the permanent community institutions. The needs of the community are usually pretty mundane, but the only way for Haiti to move forward is for Haitians to build themselves up. American doctors can only cure so many people in one visit, but a community clinic can treat the community indefinitely.

Many people will come to Pastor Pierre saying “I’m starving, why can’t you give me food”. If he sees that they have a cell phone, he’ll tell them to sell their cell phone before he can give them food. Even though this is better for the community as a whole, This is extremely difficult to do. It is no fun for Pastor Pierre and it creates a lot of resentment. Pastor Pierre would love to help as many people as he can, but if he gives food out freely to anyone who claims to be hungry, he’ll be feeding everyone, and anyone selling food will go out of business. He will give some food away, but he gives away very little, and won’t give food away if people can get it for themselves, even if that means selling their cell phone.

Though this may seem like a depressing topic, the result is a development in its finest form; clinics promoting public health, schools educating the next generation, and communities paving a new way forward. There are few days in pastor Pierre’s work where he can see a dramatic change. Much of what he oversees is pretty mundane, painting a school, purchasing a bus, planting a garden. That said, his commitment to community development over the past thirty years has created seven schools teaching over 3500 children, two fully functioning clinics, and a La Croix that improve itself.