‘Haunting realities’

Priest DO dedicates life to Haiti’s poor

The Rev Leo R. Frechette, DO, has committed his life to serving Haiti’s poorest children by establishing and running the country’s only free pediatric hospital.


“Trying to weave dignity out of humiliation,
Trying to weave hope out of cynicism,
Trying to weave a full tomorrow out of a broken today,
Trying to multiply loaves and fishes, and then bakeries and fishing rods,
We need to join forces in the great work of building a better world.”

—The Rev. Leo R. Frechette, DO, on Compassionweavers Haiti

In the quiet mountain village of Kenscoff, Haiti, 25 miles from poverty- and crime-ravaged Port-au-Prince, St. Hélène Orphanage ministers to the physical, emotional and educational needs of more than 500 children. Situated in the Tabarre district of Haiti’s capital, St. Damien Hospital provides inpatient, outpatient and outreach medical care to as many as 30,000 patients annually.

A Passionist priest who grew up in Connecticut, the Rev. Leo R. “Rick” Frechette, DO, has overseen St. Hélène and St. Damien for more than 20 years. In the mid-1990s, while in his early 40s, he decided to become a physician.

“I felt I could do more for the people of Haiti by getting medical training,” recounts Dr. Frechette, who today serves as both the national director of Nos Petits Frères et Soeurs Haiti and the medical director of its parent organization, Nuestros Pequeños Hermanos (NPH) International.

Access to medical care remains a tremendous challenge for Haiti, which has one physician for every 15,000 people, he points out. The Western Hemisphere’s poorest country, Haiti has a per capita income of only $450 per year, below the average for countries in sub-Saharan Africa, and an unemployment rate of 80%.

With the support of his Roman Catholic religious order, which emphasizes missionary work and the alleviation of suffering, Dr. Frechette attended the New York College of Osteopathic Medicine (NYCOM) of New York Institute of Technology in Old Westbury from 1994 to 1998. Continuing to manage both the orphanage and the hospital, often returning to Haiti on weekends as well as school breaks, he left a lasting impression on his classmates and teachers, recalls Dennis J. Dowling, DO, a former chairman of NYCOM’s Department of Osteopathic Manipulative Medicine.

“Father Rick was one of the stars of his class and a leader whom everyone admired regardless of his or her religious background,” says Dr. Dowling, who specializes in OMM in Syosset, N.Y.

Connecting with others

“Classmates of all faiths would come to Father Rick for advice,” Dr. Dowling notes. “He was respected for his insights and known as a great listener, so they would confide in him.

“He could give a sermon if the situation warranted, but he doesn’t monopolize conversations. He is an all-around nice guy.”

Known simply as “Rick” while at NYCOM, Dr. Frechette dressed like his peers. “I can remember just a couple of times when he wore a liturgical vestment,” Dr. Dowling recalls. “Most of the time, he looked like other students. He connects with others; he doesn’t set himself apart.”

Once when Dr. Dowling was out jogging on campus, he came across Dr. Frechette and some other students playing tennis. “Father Rick insisted that I join them in doubles, even though I had never played tennis before,” Dr. Dowling remembers. “He was very patient with me and a good teacher.”

Dr. Frechette captivated his professors and peers with his easy charm and kind sense of humor, according to Dr. Dowling. “During OMM practicals, he would sing the theme songs from television programs that were popular when he was a boy, shows such as ‘Gilligan’s Island,’ ” Dr. Dowling recalls. “He knew all the words. His classmates got a kick out of this, in part because most of them were several years younger than he was.”

One of Dr. Frechette’s classmates, Lawrence M. Barnard, DO, was among 10 NYCOM students who accompanied the priest to Haiti during the summer break between first and second year, a time when the country was considerably more stable than it is now.

“To prepare us for the experience, Rick said to think of the worst camping trip we’ve ever been on and then imagine conditions that are much worse than that,” recounts Dr. Barnard, who practices OMM in Melville, N.Y. “He also made it clear that we would encounter practices and beliefs that we might find odd or disturbing.

“Giving us a lesson in cultural sensitivity, he emphasized that we would need to adopt the attitude that we can help these people.”

Dr. Barnard found his experience in Haiti to be so rewarding that he returned to the country several more times, serving elective rotations there and assisting Dr. Frechette during summer breaks. “I loved the place, the people and the work,” Dr. Barnard says. “It was such a pleasure to help. Rick is a remarkable person with amazing energy and determination.”

After graduating from NYCOM, Dr. Frechette served a one-year internship at the former St. Clare’s Hospital and Health Center in New York City before returning home to Haiti to practice osteopathic medicine and carry out his pastoral and organization management responsibilities full time.

Formidable challenges

Dr. Frechette’s ability to get along with all sorts of people has served him well in Haiti, where he has tangled with warlords and kidnappers while battling such public health scourges as acquired immune deficiency syndrome and tuberculosis.

“Father Rick told me that one day he and an Italian physician were stopped on the road by thugs who aimed machine guns at them,” Dr. Dowling relates. “But once the gang members saw that Father Rick was in the vehicle, they backed off, afraid that they would get in trouble with their leaders if they hurt him.

“Father Rick is so highly respected that it affords him some but not complete protection.”

For the young adults who are now on their own after growing up at St. Hélène Orphanage, one of Dr. Frechette’s most formidable challenges is countering the many adverse influences on the country’s youth, from glue sniffing and drinking to what he views as cynicism and aggression often spread on the Internet through certain images and forms of music.

“We work very hard to offset the negative influences and to offer these young people options,” Dr. Frechette says. “Unfortunately, their country offers them nothing.”

Many of the residents of St. Hélène have lost their parents to disease or violence. Some children are placed there because their parents lack the means to care for them properly, while other children have been abandoned because they have AIDS, other infectious diseases or disabilities.

“The orphanage is a collection of little broken families,” Dr. Frechette says, noting that St. Hélène tries to keep siblings together.

The children who live at St. Hélène are not available for adoption. Many of them have emotional difficulties, health issues and physical or cognitive impairments. The orphanage becomes a large but stable family to these children and gives them the opportunity to obtain a good education, become self-sufficient and focus on their personal and spiritual growth, according to Dr. Frechette.

On 15 acres, 5,000 feet above sea level, St. Hélène consists of 22 residential cottages and a school run by the Salesian Sisters. Residents of the orphanage plus more than 100 children from the surrounding community attend preschool through secondary school at St. Hélène.

Through the “Orphanage to Work” program, Dr. Frechette and the St. Hélène staff strive to secure vocational training and sometimes a university education for the high school graduates so they will have a better chance of success after leaving the orphanage. Two former orphanage residents recently trained to become surgical assistants in a program in Italy and are now working at St. Damien Hospital. And 14 graduates of the St. Hélène school currently are studying in universities.

Former residents of the orphanage established and run the St. Luke outreach program, which helps the poorest of Haiti’s poor by assisting with education in street schools, water delivery, dignified burials, disaster relief and other challenges. “We instill in our children the value of giving back to the community and helping others,” Dr. Frechette notes.

Whole-person calling

One of Dr. Frechette’s most significant accomplishments in the past few years has been establishing a new St. Damien Hospital, according to Dr. Dowling, who most recently saw the priest at a NYCOM alumni association fundraiser for the orphanage and hospital last September. Originally housed in a converted five-story hotel in Pétionville, Haiti’s only free pediatric hospital opened its modern 120-bed facility in December 2006.

St. Damien includes surgery, cancer, infectious disease and noninfectious disease wards; critical care and emergency departments; an isolation room; a radiology unit; a laboratory; a pharmacy; and a dental clinic. In addition, a 2,300-square-foot rehabilitation and physiotherapy center opened last year adjacent to the hospital.

Although a state-of-the art facility in terms of equipment, much of the healthcare at St. Damien is provided by nursing assistants who have task-specific training, Dr. Frechette says.

“But the hospital personnel are very good at the jobs they do,” he maintains. “For example, we have been training people to use a portable digital X-ray machine we recently acquired. They have become very skilled at taking and reading X-rays. In fact, they’re better at it than most nonradiologist physicians in the United States would be.”

Dr. Frechette spends much of his time taking St. Damien’s mobile clinic into Cité Soleil, Wharf Jeremy and other slums of Port-au-Prince. Through the mobile clinic, as well as its main facility, St. Damien focuses on combating human immunodeficiency virus and AIDS, tuberculosis and malnutrition.

Out of a population of 9.1 million, an estimated 120,000 Haitians are HIV-positive or have AIDS. In 2007, 6,800 Haitian children were HIV-positive or had AIDS, while a total of 7,200 Haitians died from AIDS that year.

After AIDS, tuberculosis is the country’s most common infectious cause of death in both adults and children, according to the World Health Organization. In 2006, 5,400 Haitians died from TB.

One-fifth of Haiti’s children die before the age of 5, while the average life expectancy for Haitians is 48 years.

“In a country with little statistical improvement, we must focus on the small things we can do to ease distress,” Dr. Frechette emphasizes, noting that every day he makes use of the holistic approach to care he learned at NYCOM. “I have taught a team of nonphysicians to do thoracic movement to ease pulmonary TB symptoms,” he elaborates. “But more important than osteopathic manipulative treatment is paying attention to the whole person and realizing that a patient is not a mechanical system or a laboratory.

“In really futile situations, you make a difference simply by spending time with the patients and trying to understand them.”

Dr. Frechette encounters many obstacles in caring for the poorest Haitians. Currently, one source of intense frustration is the difficulty in obtaining medication for patients who have TB. “There are not enough medicines for everyone in Haiti with TB, so preference is given to those who are sputum smear-positive—those who can spread the disease,” he notes. “This means if you have TB and are not sputum positive, you may go without medicines and die.”

According to the WHO, Haiti had 28,290 new TB cases in 2006. Of these cases, 44% were pulmonary sputum smear-positive.

Although kidnappings have decreased somewhat in Haiti because of the presence of United Nations peacekeepers, they still occur, notes Dr. Frechette, who has interceded with kidnappers on behalf of a patient. He describes this ordeal in an article written Dec. 6, 2007, that was posted to a blog sponsored by the Institute for Justice and Democracy in Haiti.

“After coming out of the bank with a good bit of money to pay for the schooling of her three young children, [Esmine] was grabbed by strangers and gone,” Dr. Frechette writes in an account of how he spent days negotiating with the kidnappers, who were threatening to kill the woman if the ransom wasn’t paid.

“I put up half the ransom for Esmine,” he reveals. “I even went to do the drop-off for the kidnappers.”

Released at 4 am the day after the ransom was delivered, the woman visited Dr. Frechette in the hospital right away. “She had been beaten, she was humiliated, she was full of fear of the streets, of society, of the future,” he writes. “She rolled on the ground in front of me, crying out her grief but also sputtering out words of thanks for our help in freeing her.”

As a priest, Dr. Frechette also takes care of patients after they have died. He obtains inexpensive cardboard caskets that are shaped like high-cost wooden ones, and he presides over many burials of the destitute. Most Haitians cannot afford funerals for their deceased loved ones.

“We bury about 100 a week,” Dr. Frechette writes in his article posted on the Haiti justice blog. “Their poverty and humiliation still hound them after they are dead. Their disgraceful condition, their lack of a place even to drop dead on, their exile from a final resting place, are haunting realities.”

How to help

Since 2004, when former President Jean-Bertrand Aristide was ousted in a military coup, “slow progress” has been made in Haiti, according to Dr. Frechette.

“The UN peacekeepers are helping to lessen the violence,” he says. But he still urges caution for US physicians who take part in medical missions in Haiti because of the risks of kidnapping and other violent crimes, as well as the health threats. Dr. Frechette, who says he has a “robust constitution,” has endured malaria twice and dengue fever.

The series of hurricanes that wreaked havoc on Haiti last September worsened the country’s financial outlook, which has been further marred by the worldwide economic downturn. “Remittances from Haitians living in the United States and Canada are way down,” he points out.

Dr. Frechette makes frequent trips to the United States to participate in fundraisers for St. Hélène Orphanage and St. Damien Hospital and to procure cancer medication and medical supplies that aren’t available in Haiti.

He welcomes monetary donations for the orphanage and hospital. In addition, through Friends of the Orphans, the fundraising arm of NPH International, individuals can sponsor children who live at St. Hélène.

But Dr. Frechette insists that the osteopathic medical profession can do even more for Haiti by being sensitive to the needs of the many Haitian immigrants in the United States, some 30,000 of whom are currently facing deportation. “You can do so much for Haiti just by treating Haitian immigrants with respect and providing them with top-quality medical care regardless of their ability to pay.”


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