Free Vasectomy Clinic – Dr. Chang returns from Haiti

No-Scalpel Vasectomy International

This past March, I was invited to join Dr. Douglas Stein and Dr. Ramon Suarez through No-Scalpel Vasectomy International on a mission trip to Haiti to perform and teach no-scalpel vasectomy. Coverage from their website can be found here and media coverage here. It was nice to have a Canadian presence with representation from Vancouver, BC and Pollock Clinics. The majority of the team was based out of Florida, USA. Dr. Pollock had previously been to Haiti to perform and teach newborn circumcisions which was a story covered by the National Post. With this mission we were able to lend our expertise in both circumcision and vasectomy to train Haitian physicians. Haiti is particularly of interest to us as it is the poorest country in the West.

Overpopulation in Haiti

For those who aren’t aware, Haiti has 10 million people on land the size of Maui. To put that into perspective, there are 30 million people in Canada; imagine a third of Canadians all squeezed onto a small island! But Haiti’s population keeps growing and is projected to be nearly 70% larger by 2050. The fact is that as Haiti still languishes after the earthquake, providing relief would have been much easier with a smaller population. This size of population and the scale of issues it creates only lead to an increasingly chaotic situation. More population demands more effort in solving humanity’s problems anywhere and not just in Haiti.

Birth Control for Men

On this mission, we performed vasectomies on 70 men in all, who had a combined total of 403 children between them. One of the men had 16 children! You would think that would be a record but apparently there was one man who had 26 children a few years ago. We provided teaching to some promising local Haitian physicians in hopes of establishing a domestic team to help ensure long-term sustainability. I believe that we can provide a means for family planning, but the population problem is still theirs to solve.

On our first day we put up banners to inform locals about our presence and what we were offering. Men who had a vasectomy were provided with 400 gourdes as income replacement for missing 2 days of work ($6 USD). We also paid 400 gourdes to facilitators for each patient they were able to counsel and recruit for us. Some of the Haitian men really look forward to such mission trips because for the time we are there they have an opportunity to earn income by recruiting men for vasectomies.

Meeting the Director of Health

Below is the team with Dr. Ernst-Robert Jasmin (centre), the Director of Health in Northern Haiti, whose letter of support prior to our departure allowed us to go through customs without having to pay for a fee (more like a “bribe”) to avoid having our luggage being extensively searched. This would have put us behind schedule and just a huge hassle. Thankfully the letter got us through rather quickly.

Training Haitian Physicians

On this mission we met Dr. Classaint St-Vil who was one of a few new trainees that I had the opportunity to help train one-to-one. He showed incredible promise and I hope to train him again when I return in July. There have been issues with trainees not coming back for training which is a pity given all the time and resources that goes into training. It definitely slows down the number of cases we can perform on each mission. As seen below, we all had to wear headlights because the rooms that we were in must have been no bigger than 100 sq ft, had no lighting, no electricity and no water. We purchased bottled water and rubbing alcohol locally to sanitize our equipment. Given the conditions, everybody received antibiotics prior to surgery.

Interesting Anatomy

On one particular day, we encountered a man who had a very very large hydrocele, which is essentially a collection of fluid in his scrotum. Because of this fluid there wasn’t enough space to access his vas deferens, which is where the vasectomy takes place. This had to be drained before we could proceed with his vasectomy. About 150cc of straw coloured fluid were drained. The patient was quite surprised that much fluid had been sitting inside of his scrotum!

Challenges Ahead

Overpopulation may not be the main cause for concern for Haiti but so many problems emerge from it that it is a hard one to ignore. It can single-handedly be blamed for most of the poverty that Haitians face and as I mentioned above, in the wake of a natural catastrophe, rehabilitation is a challenge for such sheer numbers. Fast population growth amplifies the problems of underprivileged Haitians; high fertility means more mouths to feed, more young people to educate and employ. Interestingly, nearly 40 per cent of its population is 15 or younger and without the education, resources, and infrastructure to support all the men and woman and their families, waste and garbage just get piled up on the side of streets everywhere you go.

Next Steps

We are hoping that what we began here with our services is continued on through our vasectomists in training who would ensure that family planning is inculcated to the grass root levels. Our efforts are only fruitful to the extent that the process remains ongoing. If the local physicians are unable to keep up with doing this procedure, then what has been done would be a drop in the bucket and unfortunately would not really bear any noteworthy results.

Nonetheless, I remain hopeful that our trainees can nudge Haitians into taking a step towards a better tomorrow-for them, their society, and their children. Their future depends on it.

I will be back to serve the people of Haiti in July and the Philippines next February. Depending on my work schedule here in Vancouver, I hope to go at least annually and will try to do a blog post to keep those interested up to speed.