April 21, 2005

One trip was all it took.

For Dr. David Walmer, an associate clinical professor in the obstetrics and gynecology department at Duke Medical School, a 1993 church visit to Haiti has been life-changing. His initial efforts have blossomed into an innovative relationship to promote spiritual and medical healing in third-world countries.

Walmer's endeavors, which include the creation of the non-profit organization Family Health Ministries, are but one example of a University-wide push to combat worldwide health inequalities. For the past few years, Duke has had a growing interest in serving those most in need. In his inauguration speech, President Richard Brodhead stated a desire to make global health a priority on campus.

While many local groups have supported Walmer's efforts, the interest of the Duke Chapel, which funds part of the project, is but one example of the global health initiative's expansion beyond Duke University Medical Center.

Fostering friendships

Walmer first visited Haiti with a group from the local Triangle Presbyterian Church. "I didn't go down with any specific agenda, but when they found out I was a physician, they asked me if I would separate from the group and spend a week with one of their doctors," Walmer said.

While working in Port-au-Prince - Haiti's capital - Walmer became friends with Jean-Claude Fertillien, a Haitian gynecologist.

"We started looking at ways that we could work together to help him deal with some of the limitations he was facing," Walmer said.

The first problem Fertillien wanted to address was cervical cancer prevention in Haiti. Cervical cancer is treatable when detected early and has an extremely low fatality rate in the United States. But very little preventative screening is done in Haiti, and the disease is much more prevalent as a result.

"It's a very isolating way to die, and it's very painful," said Kathy Walmer, executive director of FHM and Walmer's wife. "You smell bad, and people don't want to be around you."

The mother, she explained, is the main childcare provider and the backbone of the Haitian family. Consequently, her death affects the entire family structure. "If you can find a program that does screen and treat, you can make a significant difference in providing a stable family unit," she said.

The Walmers' project began in Leogane, a coastal community located a few hours south of Port-au-Prince.

David Walmer started his journey by bringing Fertillien and other Haitian doctors to Duke for colposcopy training. The colposcope is a device used to identify potentially pre-cancerous abnormalities in the cervix.

As Walmer expanded the cervical cancer prevention program into other Haitian communities, he began to include students in his trips to Haiti. The trip is now incorporated into the Duke course "Healing in the Developing World: A Medical and Theological Perspective." The course is available to medical, nursing and divinity students, as well as undergraduates.

"They learn what we think are culturally relevant ways of interacting with and supporting impoverished communities in the developing world," he said.

A divine experience

The Walmers decided to turn their efforts in Haiti into an official non-profit organization, FHM, because of the large amount of donations they received.

For Reverends David and Jamalyn Williamson, both graduates of Duke Divinity School and volunteers with the Walmer's organization, FHM's guidance was essential during their two-year stay in Fondwa, a rural mountain community.

While David Williamson describes his decision as a "blind leap of faith," his wife, Jamalyn, was inspired by Walmer's course, which she took as a student at Duke. "I can remember walking into the valley and having a strange sense of walking home," she said. "I had a sense that I wasn't finished with Fondwa yet; I felt like God was nudging me."

Many of Fondwa's inhabitants live in extreme poverty - the area has been deforested, water is scarce and malnutrition is rampant. "Because there are no trees, you can see every wrinkle in the landscape - it kind of looks like an old person's skin," David Williamson said.

Fondwa's challenging lifestyle increased the couple's desire to help the community's residents. Communication, however, was a challenge - the Williiamsons spent nearly six months of their stay learning to speak Creole.

"People were very patient with us," he said. "We were like little children who didn't know how to do things in their culture." The couple worked primarily at the local school and orphanage, both as teachers and caretakers.

Haitian children, however, are not your typical orphans. Often, the parents may be living but unable to provide sufficient food and care. The couple found the orphanage crammed with children and the school strapped for resources, with less than a quarter of its 650 students able to purchase books. In addition, the students - most of whom walk at least an hour to and from school - were coming to class unfed.

Through several fundraisers back home, the Williamsons raised about $10,000 for textbooks and were able to implement a nutrition program.

"For me, the most meaningful part was the relationships we built with the children and with our neighbors and the way they accepted and loved us," David Williamson said. "We didn't know the language, we didn't know the culture, and now it's like home to us."

While the couple will soon move to Indiana, they plan to revisit Fondwa and continue their involvement in FHM.

Expanded aid

The family health organization is working in several other locations as well. In Blanchard, a suburb of Port-au-Prince, FHM has partnered with a local church to build a public health clinic. Kathy Walmer describes the citizens of Blanchard as "extremely poor," having to travel hours outside of the city to obtain affordable health care. The new clinic is already under construction and will ultimately host a couple physicians, nurses and a pharmacy.

FHM may continue to grow, but its founders have not forgotten its roots. Later this month, Walmer will visit Tanzania to study cervical cancer prevention in women with AIDS. While caring for a growing family - including an adopted Haitian daughter - and running FHM may be a challenge, the Walmers are excited by their progress and feel there is much more to accomplish.

"In the end, they give us so much more than we ever give them - in being friends, in being mentors and in showing us in how you can have resilience and hope for the future," Kathy Walmer said.