[Episcopal News Service – Miami, Florida] An ecumenical group of people involved in medical missions to Haiti has offered colleagues in the Episcopal Church and beyond a set of “core principles” that ought to guide those efforts.

“With the common goal to stimulate growth and sustainability of accessible quality health care in Haiti, we believe these core principles to be essential and covenant in this collaborative effort to apply them in the development and implementation of all Haiti Partnership Program medical mission efforts,” those attending the Sept. 6-7 Haiti Medical Missions Best Practices Symposium at the Miami Airport Marriott said in a “covenant statement” they released after the meeting.

The partnership program is an effort of the Episcopal Diocese of Haiti to coordinate and facilitate the desire of Episcopalians outside of Haiti to come to the diocese on mission trips.

The attendees’ covenant statement said all organizers of mission trips should develop a partnership agreement that include:

• Performing a community assessment that would document community resources, identify needs, listen to what the community wants, what current initiatives are in place, needs and history of other missions.
• Developing a plan for sustainability, which the statement describes as “empowerment of the community through partner (Haitian and American) accountability, trust, honesty, and commitment with the ultimate goal of ‘It will be there when I am gone.’”
• Forging a medical mission-to-recipient partnership that will be a community-to-community effort of people working side-by-side.
• Coordinating and communicating about resources between medical mission organizations and with Haitian organizations, as well as paying attention to scheduling of trips and identified needs to be served.
• Clearly defining the intent of the mission, including having measurable goals.
• Developing and implementing ways to evaluate outcomes and assess what is accomplished.

The Rev. Frantz Cassesus, Diocese of Haiti canon to the ordinary, who attended the symposium, has reviewed the covenant statement with Bishop of Haiti Jean Zaché Duracin, and the bishop is pleased with the work initiated at the symposium, the Rev. Clelia P. Garrity of St. Paul’s Episcopal Church, Delray Beach, Florida, told ENS.

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Among the questions discussed by the attendees was how to define “sustainability” and how they try to apply the concept to the work they do in Haiti.

James Ingvoldstad, an obstetrician/gynecologist who has worked for 12 years with La Gonâve Haiti Partnership, said his understanding of sustainability has changed over those years.

“My first thought was: Go in, teach people how to do stuff, teach them how to fish, leave and then they can fish,” he said. “I’ve discovered that isn’t very possible in Haiti at this particular time. I realized that we’re a little bit naïve and maybe pompous to think that could exist when you look at …non-profit hospitals in the United States [which] could not operate on patient revenues. They all have huge endowments. That’s their sustainability.”

Ingvoldstad said he knows that sustainability is not “somebody with a big bucket of money coming down there every other year because that’s going to fade away; you get tired, you get burned out.”

Perhaps, he said, corporate investment with accompanying corporate investment in Haiti’s basic needs ought to be fostered.

[A video of the Rev. Kesner Ajax, Diocese of Haiti partnership coordinator, explaining to the gathering why the La Gonâve Haiti Partnership works so well, is here.]

Another element in forging sustainable programs “comes from the relationships that you form,” said Bob Sloane, a doctor who manages the guest house for mission trips to Hôpital Sainte Croix (Holy Cross Hospital) in Léogâne.

“It’s not only the teaching-the-person-to-fish element but, enabling that person, empowering that person and building the kind of trust … so that if you’re removed from the equation, that person is still empowered on-site, has initiative … and can sustain themselves to a certain degree,” he said.

Referencing Ingvoldstad’s concern about organizers getting burned out, Sloane also suggested that “transition leadership” has to be part of any mission plan, “so that there is a next generation that has the same passion.”

Hilda Alcindor, dean of the FSIL School of Nursing in Léogâne, said creating sustainability means having a long-term plan.

“You just don’t come and say ‘Oh, those poor people; gotta do something for Haiti,’” she said, adding that money spent for those kind of trips is ultimately wasted.

One of the goals of sustainability, she said, must be empowerment.

“We need to teach the Haitian people how to take care of themselves. It’s not for you to come and be the boss,” Alcindor said, adding that mission trip participants must work side by side with the Haitians.

“We do count. We’re in-country. We know what’s going on,” she said. “Don’t come and tell us what to do. Share with us what we need to do. That’s going to be sustainability when you share with us. We tell you, you tell us and then together we come with a plan. You don’t come with your plan and impose it; it’s not going to be sustainable.”

The Rev. C.J. Van Slyke, a nurse and a deacon in the Diocese of Alabama involved with that diocese’s companion relationship with Haiti, said that participants have been learning to talk with their Haitian partners about what they want and need, and what they could do.

“We’ve learned over the years how much more effective and meaningful it is if you can respect and keep developing those relationships and working from within,” rather than simply coming into Haiti with preconceived ideas, she said.

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In his keynote address Sikumbuzo Vundla, the diocese’s chief operating officer, called for partnerships in Haiti to be based on mutual trust and respect and include “regular and frank discussions” about the course of the relationship and the work involved.

“Our resources in Haiti are challenging,” he said, adding that the diocese is still trying to rebuild its resources after the 2010 earthquake, and it will continue to need resources from outside the country. However, he said, partnerships where all the resources come from outside the diocese can be lopsided. And so the diocese is trying be “more responsible and more responsive and take more ownership of the programs that we’re doing, and trying to contribute more from within.”

“People in partnerships must trust one another and the Diocese of Haiti will be working on that trust, building that trust, rebranding ourselves, if you like,” he said. “We have seen from our own experience that lack of trust in many cases has led to miscommunication.”

Vundla said “partners should be accountable to each other” and to the recipients of their efforts, and partnership should be based on a business model “in terms of commitment and time.”

“Too often partnerships fall because people do not take the time to make them work,” he said. “That is why we are saying [that] in the Diocese of Haiti it is not business as usual. We are taking every precaution, every measure, to ensure that our partnerships continue to improve, continue to strive for the benefit of the beneficiaries and those give us the resources to serve the people of Haiti.”

Both Alcindor and Frantz Large, president of the Haitian Society of Opthamology, cautioned against encouraging what they called the “beggar mentality” that exists in Haiti.

“You get there,” Alcindor told the attendees, “you give them everything. They need to give you something. Stop giving for free.”

Holding her upturned hands out in front of her, Alcindor said “stop keeping my hands like that … I want to hold my hands down … I want to be proud, with my head up.”

Haitians living outside of Haiti, who are known as the Haitian diaspora, are not involved enough in helping their birth country “because we were never taught how to serve; it is a cultural thing so we need to teach the children to serve, how to help out,” she added.

Large said some people who could pay for medical services instead come to free clinics, thus making it difficult for Haitian medical professionals to make a living.

Large and Alcindor called for mission trips that include teaching and training components so that Haitians can learn best medical practices. And, Large and others said, mission teams need to be willing to coordinate their trips to serve the needs of recipients best, based both on their location and their illnesses.

Ingvoldstad said he once asked Alcindor to send a nursing school graduate to help on La Gonâve. She told him to send her someone from La Gonâve to studying nursing and she would send that person back to the Haitian island.

“I said: ‘Oh, this is a nice lesson. I was a beggar and she made me be a participant,’” Ingvoldstad said.

The conference was sponsored by Grey Dove Inc., whose goal is to stimulate the wellbeing and sustainability of communities throughout the world by providing primary and specialized medical care and prevention education. Garrity founded Grey Dove and she is also president of the board of directors of the South Florida Haiti Project and coordinator of Esther’s Voice, a human trafficking awareness initiative in South Florida.

– The Rev. Mary Frances Schjonberg is an editor/reporter for the Episcopal News Service.