A Reminder & A Reflection on What Comes Next

I spent last weekend in Port-au-Prince, attending the funeral of a cherished friend and true hero, Raphael Louigene. To be clear, this was not a Locally Haiti related trip, and Raphael Louigene had no relationship to Locally Haiti, other than that he was vaguely aware of our work because of our friendship. I could never do justice to what Raphael accomplished with his life; to what an example and inspiration he has been. He was the most courageous person I’ve ever known. Two weeks ago Raphael died of a stroke at St. Luke’s Hospital in Tabarre, Haiti at the age of 41. 

Father Rick Frechette, a mentor and friend, shared this beautiful reflection on Raphael’s life. If you’re interested in learning more about what Raphael meant to Haiti and to his family at the St. Luke Foundation, please take a look.

I share this with you for two reasons:

The first is that the lessons I learned from Raphael are relevant to our own moment in Petit Trou. You don’t have to look hard to find health facilities in Haiti that do not function well. To say that access to healthcare is lacking in Haiti is not controversial. It’s a point that doesn’t need proving. What does perhaps need our attention, is the opposite. That success is possible, and that there is a path to attain it. From 2010 to 2012, Raphael helped reveal that path for me. He did so by example, each and every day, and under the most challenging circumstances.

In the aftermath of the earthquake of 2010, Raphael was everywhere. Trained as an EMT in the U.S., and with a practical knowledge that far exceeded that, Raphael rescued people from the rubble, started IV’s by the light of cell phones, cleared roads and rushed children to life saving surgeries. As the days became weeks, Raphael mounted a field hospital. Between the direct response in the streets, and the patients seen in the field hospital, Raphael saved countless lives. When cholera was brought to the country later that year, Raphael was there. Another field hospital went up, this one in tents and specific to cholera. Again, thousands of patients, received and watched over by Raphael. He was tireless in his work ethic, tireless in his compassion, tireless in his belief in the importance of the patient in front of him. Eventually, thanks to extraordinary generosity from abroad, Raphael and the team transitioned the field hospital to a long-term, first class facility with capacity for higher acuity interventions and continuing education. This dramatically raised the ceiling for quality of care.

Raphael relied on two key guiding lights. 

First, relationships. In the areas and neighborhoods he worked, relationships were essential. You can not be a humanitarian without focusing on the human, and Raphael never lost sight of this. Patients, families, neighborhoods, regions, social contexts - it was all one fabric to him.

Second, a commitment to the practical; to progress, not perfection. When the cell phone light was the only available tool for triage, he did his work. When a repurposed shipping container became the next space, he noted the progress and he kept on working. And finally, when something better, something longer term became possible, he doubled down his commitment, leveraging the facility to benefit as many patients as possible while also seeing clearly what the hospital could become in the long term.

For years now, Locally Haiti’s work has focused on community health workers, prevention, nutrition, education, vaccinations. The new hospital will be a continuation and reinforcement of that work, and, like all we do, it will be firmly based on community-based relationships. This hospital is not a break from our previous approach, it is the natural culmination of it.

The new hospital will be a lighthouse, an indicator of what’s possible, of what will come further down the road with continued engagement and support of local leaders. Will it be perfect? No. Will it be close to perfect? Probably not. Will it represent practical and life-saving progress? Yes. 

The second reason I felt compelled to share this reflection is that the situation in Port-au-Prince does in fact relate to the hospital project. During my weekend in Port-au-Prince I had many conversations about the devolving situation there. I heard stories of the very real tragedy unfolding. The gangs in Port-au-Prince are very real, as is the danger and degeneration that comes with them. The stories I heard were heartbreaking, and the courage and resistance being shown by my family and friends at St. Luke is remarkable. 

We hope for better days in Port-au-Prince. We pray that some measure of stability will come soon. At the same moment we recognize, because we see it with our own eyes in Petit Trou, that internally displaced people are migrating to the countryside. St. Paul’s School now has 538 students, a 25% increase from last year. While not all those new students came from Port-au-Prince, many did. More broadly speaking, Mayor Wilnor has shared his certainty that Petit Trou is stretching and growing to accommodate internally displaced families fleeing the violence of Port-au-Prince. 

Our goal is to help local leaders build a Petit Trou that is strong from the inside out. The community is growing, and our investment and partnership are more important than ever. Reinforcing local health institutions so that they can receive the influx is an urgent opportunity. The hospital project will be a central pillar, a monumental and luminous step.

There was a phrase we often repeated and relied on during my time at St. Luke. I’ve written about it before.

Do the next right thing. 

It’s usually the case that the next right thing is something small, practical. It’s not often about grand plans - it’s usually about what’s in front of you. But in this case, in our particular moment, the next right thing is not small. It’s enormous, in fact. Two years after the earthquake, our next right thing is to move forward and break ground on this hospital. 

On the Zoom call tomorrow we’ll share more information on some of the challenges we’re facing. The construction bids have come in higher than expected due to the problems of transportation and insecurity in the country. But we are close. 

We are in a final round of conversations with two extremely well qualified construction firms. Those final discussions should be complete in the coming days, and once that choice is made, we are hopeful to announce a groundbreaking date for the fall. 

The stories of hardship and tragedy that you see in the news are very real. 

And so is the light from leaders across Haiti, shining as resistance and spotlighting what’s possible. 

Thank you for caring about the darkness, and for believing in the lights.

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