Category Archives: Health Care

Haiti Mobile Health Care Clinic

An open stairway climbs the outside back wall of a church in the village of Lorie, in rural northern Haiti. It leads to a low abutting roof, a gap in mason covered wood slats, and a view into the church.

The photograph below looks in from behind the pulpit, and across the nave and pews. The furthest point is the front door. The day before people filled the sanctuary to pray. This day the area has been transformed into a medical clinic.

Over the past 8 years, the Haitian Caribbean American Organization of Texas (HACAOT) has brought a team of doctors and medical professionals to Haiti every November, to run a mobile health clinic and treat the medically disenfranchised. They stay in a house in the northern city of Cap Haitian.  Each morning they leave at dawn, travel to an area in need, and set up a full functioning healthcare clinic. They work non-stop until dusk, pack up, go home, and do it over again the next morning.  Typically, 250-300 patients are seen each day.

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J/P HRO Petionville – Earthquake Tent Camp Photographs

One of 23,000 Residents of the JP/HRO, Petionville Tent Camp.

January 12th, 2010 was a typical day in Port Au Prince, Haiti.  The streets were busy, the skies were partly cloudy, the air was humid and the temperature was in the mid 80’s (Fahrenheit).  Life for two and a half million people in the surrounding area moved along like any other day.  Then, without warning, at 4:53 pm, the ground, buildings, roads, structures, people and animals shook violently for 30-40 seconds.  When the quake ended, over 200,000 people were dead, 300,000 injured and 1.3 million were displaced.  The sun set at 5:30 that evening, and the city was dark by 6:00.  It happened in about as much time as it would take you to read this paragraph out loud.

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Midwife of Lorie Village

Bernadette Joseph is a  traditional Haitian midwife working in the Lorie Village area of northern Haiti.  The following is from an interview I did with her last week.


Q: What’s your name and what do you do?

A:  They call me Bernadette Joseph.  When the women are pregnant I deliver the babies.

Q: How long have you been a midwife?

A: For a very long time.  More than 10 years.

Q: Why did you become a midwife?

A: When I was a young girl there was an old lady who used to do this, and I used to watch her.  That’s how I learned how to deliver babies.

Q: How many babies have you delivered?

A: All those babies over there (pointing to the closest row of people in the clinic – photo above), I delivered all of them.  In a month, on average, I have about 4 or 5 babies that I deliver.  I have babies that I have delivered that now are pregnant.  Everybody calls me because they know how well experienced I am.

Q: What kind of training did you do to become a midwife?

A: I learned from the old woman in the village when I was young, and by myself, and with the help of god.  Nobody (formally) taught me anything.  There are others who are beginners, but I am the most qualified in this area.

Q: Where are the babies delivered?

A: I deliver the babies at the patient’s house.  Then I have to give them a bath; the baby and the patient.

Q: What do you like most about being a midwife?

A: I’m the type of person who likes to do good for everybody and that satisfies me.  They don’t pay me to do this.  I like to do this so much that the whole community calls me Grandmother.

Later in the day after speaking with Bernadette, I past by her house and took this photo with her husband and three of their five children.

Copyright 2011 Adam Bacher, All rights reserved. Absolutely NO usage without prior authorization.

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HACAOT Saves Boy’s Life

This boy arrived to the HACAOT mobile medical clinic in severe respiratory distress.  He was immediately taken from the waiting crowd, and given a nebulizer to open the airways in his lungs (photo below).  A doctor worked with him for two and half hours.  Each time the nebulizer was removed he went into respiratory failure.

To give him a chance after the clinic closed, a medical technician fashioned a take home treatment device from an inhaler and an empty water bottle (seen below).

The device was never used as the boy began to crash (an abrupt decompensation of a patient’s clinical status).  Arrangements were made and he was rushed to a hospital.  “If the doctors from HACAOT hadn’t been in Cap Haitain, there is no doubt in my mind this boy would have died,” said a staff member.   There are too few hospitals in Haiti, and all are severely overcrowded and under staffed.  Without HACAOT’s presence, this boy wouldn’t have been able to go to the hospital.

Copyright 2011 Adam Bacher, All rights reserved. Absolutely NO usage without prior authorization.








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2 School Girls from Cap Haitian


“We play with little plates and little cooking pots and little cups.
We have little cooking utensils that go in the houses.
We pretend to eat.”

They have tea parties – just like our children.

(click this link for slides and video)

Copyright 2011 Adam Bacher, All rights reserved. Absolutely NO usage without prior authorization.


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Mobile Medical Clinic in Dondon, Haiti

3 of 500 people in Dondon, Haiti, waiting for HACAOT mobile healthcare clinic.


The city of Dondon, with a population of roughly 50,000, is a one and a half hour drive from Cap Haitain, Haiti.  On Wednesday morning, at 5:30 am, the HATCAOT medical team traveled to Dondon to set up a one day mobile health clinic.  Their goal: Treat as many people in need as possible.

More than a third of the medical team rides in a truck bed with the supplies.

A convoy of 4 vehicles transported 25 HACAOT members, medical supplies, basic diagnostic equipment, water, and clothing donations.  Not everyone rides inside.  In the back of the truck is a Physician’s Assistant, 3 Nurses, a Clinical Lab Scientist, 2 Triage Evaluators and 2 Translators.  When the group arrived there were over 500 people waiting for a chance to be treated.  By late morning the crowd swelled to nearly 1000.


Woman in crowd waiting for treatment at Dondon clinic, Haiti.

One of 410 people treated by the HACAOT team on November 9th, 2011.

Over 500 people were waiting when the team arrived.

View of clinic from above. The HACAOT team was treating people within 15 minutes of arriving in Dondon.

A baby girl comes in with an abscessed wrist that needs to be cleaned and bandaged.

Bandaging the little girl’s wrist.

In the comfort of a mother’s loving arms.

Dr. Fred with children from Dondon.Chronic dehydration is an underlying condition for most of the people in Dondon, and exacerbates all other illness.  Some residents are less dehydrated like the children pictured above.   And some are severely dehydrated like the woman seen in the next two images.


This woman was brought through the crowd on a stretcher.  Dr. Frank, (on the right), and his daughter (on the left), examine her to determine a diagnosis.  Ashley graduated from Nursing School this August, 2011.  When she returns home she’ll start her first full time job as an orthopedic and neuro nurse.


Once they determined it was a case of severe dehydration, she was lifted off the stretcher (partly to free it up), and sat down with a bag of intravenous fluids to rehydrate her. She stayed in the chair most of the day, then walked out without any help.


The woman above was having her eyes examined for cataracts.  The photographs that follow were portraits taken at the end of the day.  Five of the people made it in, four did not.  There was no more time.


The clinic has to shut down before dark.  There is no electricity.  Only the front 10 people on the landing at the top of the stairs were able to get in – no one else.  The man sitting on the concrete railing and staring at camera was one of the very last.  It’s the hardest part of the day for everyone on the team.

By the time the clinic was packed up it was dark.  410 people had been treated, given liquids to drink, vitamins,  all necessary medication except for the most serious cases,   a worm pill for almost everyone, and some clothes.   302 adults and 108 children were given a great gift by a team of 18 volunteers from the United States and 8 form Haiti, working for the HAitian Caribbean American Organization of Texas – HACAOT

ALL photography and writing copyright 2011 Adam Bacher.  Absolutely NO USAGE without prior authorization.  All rights reserved.




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Portraits of Haiti: HACAOT Mobile Medical Clinic in Village of Lorie

 By the numbers:   HACAOT  Mobile Medical Clinic to Village of Lori

25 Team members including doctors, nurses, clinicians, interrupters, logistics and support staff, are based in a house in Cap Haitian. There are 3 bathrooms and 3 bedrooms: 7 men in one room, 6 women in a second room, 4 men in a third room.  Others sleep on air mattresses downstairs and on two large porches off the front and back of the second level.

At 6:00 am breakfast is served and at 6:30 am the team departs for Lorie, a half hour away.

People waiting when we arrived at 7 am


Empty church before set up

Pharmacy dispensing station at back of church. Medical stations on right and left going toward front.

At 7:00 am the team arrives at an open church and by 7:15 the first patients are in triage.  Inside, the following specialized stations are set up:

– 3 Intake and triage stations

– 3 Physician stations

– 1 Lab Station

– 1 Dental Fluoride Station

– 4 People running the pharmacy station (foreground above – center to right)


Waiting outside to be seen in the clinic


Elderly woman being escorted to Mary Fargen’s station

Floride and dental sealant being applied to a child’s teeth.  Out of 129 kids, Carolyn was only bit twice by scared toddlers

Triaged to the front for breathing problems, a nebulizer with a bronchodilator will clear her lungs.


Cell phones are a way of life no matter your economic status

By the end of the day 11 hours were spent treating patients.  271 were seen in total. 129 were under 16.


All photography and writing COPYRIGHT 2011 Adam Bacher.  Absolutely no usage with prior authorization.  All rights reserved.


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Mary Fargen – HACAOT Team Member and 2011 Physician Assistant of the Year Award Winner

At 6:00 am Monday morning a team of 18 doctors, nurses, clinicians, and founding members of the Haitian Caribbean American Organization of Texas  (HACAOT), will  leave for the first of five days to different regions of  Cap Haitian, the second largest city in Haiti.  Each day the group will set up and break down a health care clinic capable of treating hundreds of severely under served people a day.

Mary Fargen, the Medical Director for the non-profit  HACAOT, is here on her 14th trip to Haiti.  This year Mary received the 2011 Humanitarian Physician Assistant of the Year Award, presented by the American Academy of Physician Assistants.  The video linked to this post tells her story much better than I could. Tomorrow I’ll photograph her in action.  The time you take today to watch this video will be enriching.

Click here to WATCH a video about MARYS WORK



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