Jean Manie is a CLM member who lives in Chimowo. Working with CLM members is always challenging, but Jean Manie has presented Alancia, her case manager, with real difficulties. I’ve written about her before. (See Jean Manie.)

Many of the special challenges she presents grow from her upbringing as a restavèk, a child living in domestic servitude in someone’s home. She spent her earliest years at her aunt’s house. Her own parents died when she was an infant. But by the time she was a very young girl, she had moved in with her married cousin Irma and Irma’s husband Moussa and was doing all sorts of unpaid household labor — from cleaning and laundry to farm work and babysitting — to earn her daily bread.

She never went to school of any sort. But what’s worse, she never was encouraged to see herself as capable of anything. Especially decision-making. Jean Manie was never encouraged to imagine herself doing anything but other people’s hard work.

The first big change that CLM was able to bring to her life was when her first case manager, Sandra, convinced Moussa to send for Jean Manie’s eight-year-old boy, Patrick. As a toddler, Patrick had been shipped off to the home of Jean Manie’s aunt. Moussa had said that he couldn’t afford to feed both him and his mother. Jean Manie would visit him occasionally, when she “really missed him,” by hiking across Boukankare from Moussa’s home in Chimowo to the aunt’s on Mòn Dega.

But that was really only a start, because it quickly became clear that Jean Manie would never make any progress until we could help her leave Moussa’s home. Any investment CLM would make in her would be sabotaged by Moussa’s insistence that his work be her priority. He allowed her to accept the young goats that we gave her, but wanted us to allow him to simply add hers to his. When Alancia, her second case manager, wouldn’t agree, Jean Manie’s goats quickly grew ill. She simply had no time to take care of them. And that wasn’t the worst. The healthy pig we gave her gave birth to piglets — that’s a lot of value — but its death followed shortly after theirs because Moussa would not give her the time she needed to keep them fed.

When Moussa insisted that she should build her CLM house on his land, Alancia put her foot down. A short series of events led to a usefully disastrous deterioration in the relation between Jean Manie and Moussa and his wife. They threw her and Patrick out.

She and Patrick now live in their own small, two-room house near Chimowo. They’ve been there since November and could hardly be happier. Patrick had been a picture of oppression when he lived with Moussa. If he spoke at all, it was in barely audible tones. He wouldn’t look anywhere near you, keeping his sad eyes focused on the earth in front of him. When I spoke to him in November, he said that “they” could kill him. He would not return to Moussa’s house. Not even just to run an errand. Eerie words from such a little boy.

Now he’s a picture of happy boyhood. He runs to Alancia, calling to her, when he sees her approach his mother’s house each week. He climbs on my motorcycle, pretending to be its driver. That is: He now does just the sorts of things that happy boys do. As our program’s director, Gauthier, puts it: “He’s free.”

One key step in their progress came in a manner we could not have predicted. In talking with Claude, the secretary of the Village Assistance Committee that we helped establish near Chimowo, Alancia discovered that he had long heard rumors that he was Patrick’s dad. He admitted that he had relations with Jean Manie on one occasion, though they had never dated. In further conversation, he admitted that Patrick’s resemblance to him was striking. So he talked with his wife, and decided to accept Patrick as his son. Though Patrick would remain with Jean Manie, Claude would make a commitment to helping them out. He’s the one, then, who gave her the land she needed to build her little house, and helped significantly with its construction. He took her goats for her and nursed them back to health, and he now cares for her small cow.

Things started looking up for Jean Manie. Patrick was happy and in school. She and he were in a nice, though small and basic, new home. And her asset base — her livestock — was stable and ready to grow: two now-healthy goats and a cow that she bought with sales from the meat of the dead pig and her savings.

The key would be if she could develop a regular income stream to ensure household expenses, but this problem seemed solved, too. She entered in to relations with a young man. He worked at a local sugarcane mill, and would bring her logs of the unrefined brown sugar that rural Haitians use to make, among other things, their morning coffee. She’d sell them and use the money to put food in the house. He also asked her to look after his pregnant pig. Normally, that would earn her a share of its young.

But the relationship soon deteriorated. Jean Manie went to the hospital because she wasn’t feeling well — an encouraging sign of her sense of responsibility — and was told she had a minor infection. The nurse told her said that she should abstain from sexual relations for about ten days. When she explained that to her new boyfriend, he assumed that she was making an excuse to get rid of him and grew angry. He took his pig, his other belongings, and some things that belonged to her, and left the house. At the Village Assistance Committee meeting shortly afterwards, members decided to talk to him to convince him to return the things he took, but Jean Manie has decided that the relationship is over.

So she is going to have to establish a regular micro business now. She and Alancia have decided she’ll sell kerosene in the local markets. She should be able to make enough money to keep herself and Patrick fed if Claude occasionally contributes as well. And he says he will.

The problem is, that she can’t do any but the very simplest math. She can calculate change for numbers ten or less, but when Alancia asked her how many Haitian dollars she would give a customer who purchased three dollars of kerosene with a twenty-dollar bill, she said, “One hundred fourteen-ten.” That’s “sankatòzdi” gourds, and it makes no more sense in Creole than in English.

But she needs to start her business, so she’ll start it small. Alancia will work with her on making change. Jean Manie and Alancia got another CLM member, Tona, to agree that they could set up their businesses next to each other. Tona will keep an eye on Jean Manie as she makes change.

So Jean Manie is set to move forward again, and it’s none too soon. She scheduled to graduate from the program in June or July. She needs to be running a small business that she can count on by then.

“Madanm Sara” means two different things in Creole. On one hand, it’s a kind of bird that lives in noisy communities of dozens and dozens of nests, distributed through neighboring trees. On the other, it’s a kind of businesswoman. It’s a woman who has a “komès tèt machin,” or a business she manages riding on the top of a truck. These women buy produce from farmers or small-scale merchants in rural markets and sell it in Port au Prince or other large cities. Typically, they don’t pay for their ride to Port au Prince. They pay a fee for the transportation of their merchandise, and then just ride with the merchandise on the top of the truck. Very often, a group will travel together, and they talk constantly, loudly, and mostly merrily as they go.

Deline Descartes lives in Kafran, on the road that connects Chanbo, in Central Boucan Carré with the national highway that runs through Domond. She’s just 26 years old, but she’s been a Madanm Sara for over fifteen years, having started when she was just ten. She would buy fruit like sour oranges or avocados in the nearby Dufally market and sell them in the capital. “In those days, you could start a business with very little money,” she explains. “I saved up from little jobs that I did, and started to buy and sell.”

But it was hard to keep her business going. She has four little girls, and each pregnancy hurt her business. “I had to stop working for a while, and there were expenses.” Her girls’ father didn’t help. “He didn’t want to know how I managed to feed our kids.”

When the CLM selection team found her last summer, her business was dead. Her own illness finished it off. “I was sick with cholera. So was one of my girls. We were in the hospital for five days, and even after they let us out, I was too weak to work.”

By the time she joined the program, she was healthy again but was sitting at home because she had no money to buy with. She could have gotten herself back into business by using the loan sharks who are very active in that part of Boucan Carré, but by that time she had no hope that she could get started. She knew what she wanted to do: Go straight back into business. The will had been there, but she lacked the means. She took the 1500 gourds’ worth of merchandise that her Case Manager helped her buy and sold it in Port au Prince. She now goes once or twice each week, leaving her girls for a night with her mother. Just a few months after she started, the business is already worth 2500 gourds, and it’s growing.

Other aspects of her life are changing, too. She didn’t have any savings or animals when she joined the program, but now she has three pregnant goats and a small savings account. More importantly, she now knows how to protect herself and her children from cholera. With CLM’s help, she’s built a latrine and she has a water filter in her home that ensures that all her family’s drinking water is safe. She hasn’t built her new home yet, but most of the materials are ready. It shouldn’t take long.

She’s not satisfied yet. She wants to buy a cow. “That way, I’ll have something I can use if something comes up.” She’s got a ways to go, but things are going well. She’s shown an energy and an entrepreneurial spirit that promise great results.

I’ve written about Jonise before. (See: Jonise And Gladys.) She is a CLM member from Bay Tourib. When I first met her, she was homeless, living with a fellow CLM member because she had nowhere else to go. As I wrote at the time, Jonise “had been living with her children’s father, in a house on his mother’s land, when he decided he’d had enough of her. He threw her out. Her neighbor became fond of her while they were in enterprise training together, and when she saw her out in the street, she invited her into her home.”

At the time I wrote, we had been most struck by the steep challenges facing Jonise. She seemed confused. Not only was she unable to say how old she was — that’s common enough here — but also she didn’t know how old her children were. A neighbor told us that the kids were about five and three. The three-year-old girl died shortly after we started working in Bay Tourib. She also had, and still has a problem with writing. Not only was she unable to write her name, she couldn’t really that copy letters that her case manager wrote for her in her notebook. Here is a photo of Jonise’s copy book. Benson, her case manager, assigned her to practice writing “ni.” You can see the effort she has made, filling the page. But somehow she’s not seeing the letters clearly enough to copy them.

What’s worse, she is one of a small percentage of CLM members who “pa konnen lajan,” or don’t “know money.” In some cases, that means that someone can’t distinguish different denominations; in some, it means that they can’t do the simple arithmetic necessary to calculate change. In Jonise’s case, both were true.

So Benson started working hard with her. She didn’t choose small commerce as one of her two enterprises. It wouldn’t have made sense for someone who can’t make change. But she could never be really independent without learning to handle money, so Benson started by paying close attention to how he was giving her the weekly 300-gourd food stipend. He would vary it, using bills of different denominations: 25, 50, 100, and 250 gourds. He was careful to insist that she always count the money in front of him. Within a couple of months, she was identifying all denominations accurately. He also started teaching her math, using piles of small stones to help her add and subtract.

He talked to the father of her child, and they agreed that, whether or not the man is together with Jonise, he has a responsibility to his child. So they found one of her cousins willing to give her a small piece of land, and the man put up a frame of a new house for his little boy and Jonise. H covered it with the palm tree seed pods that are the poors’ standard roofing material. Benson then helped Jonise save up 500 gourds from her food stipend, and she used it to pay a builder to put up the walls.

Now Jonise and her boy are in a nice little house. Soon, she will have the roofing material replaced with the corrugated tin that we’ve given her. The house is small enough that she’ll be able to sell some extra tin roofing and use that money for something else. She’s taking good care of her goats and her pig, and may use the money to buy more livestock.

Most importantly and impressively, she’s started a small commerce. She invested only about 400 gourds, about $10, in rice and sugar. She saved that money from her weekly food stipend. Now she runs her little business from out of her home. It brings in just enough to keep her and her little boy fed.

The biggest difference is in Jonise herself. It’s visible. Jonise on the left is Jonise when we first met her. On the right, you see the new Jonise.

She is now cheerful and alert. She chats happily with her neighbors, even advocating for one fellow CLM member who had a problem the day we visited her to get us to go by the troubled woman’s home.

She has a long way to go. We need to help her learn to sign her name, and that won’t be easy. She’ll have to keep working at care for her livestock, and her small commerce as well. But she’s committed to the fight, to working with her case manager to continue to change her life. And she’s seems, to us, very likely to succeed.

With her case manager, Benson Pierre Derat

Sherley is a case manager in Bay Tourib. She and her fellow Bay Tourib case managers have been working feverishly to buy assets and transfer them to the CLM members they’re responsible for. Purchasing and delivering assets, like livestock and construction materials, is time-consuming, and the worst thing about losing that time is that it interferes with the regularity of weekly visits to members’ homes during a phase in the process that is especially fragile.

Members have been trained to take care of their goats, the first income-generating asset they receive, but that training needs regular reinforcement, reinforcement that can only come through weekly visits. Many of our members are unaccustomed to having their own goats to look after. And their poverty makes caring for those goats even harder than it would otherwise be. The goats require grazing, and for families that have little or no land, ensuring proper pasturage is no easy matter. Unless they receive support and direction regularly, many members incline to the easiest solution, free grazing. They simply let the goats loose to fend for themselves.

The problem is that the goats get into people’s gardens — they are especially fond of pigeon peas — and do a lot of harm. Farmers who catch goats in their gardens can react harshly. They throw rocks to chase them away, or do much worse. In the areas where we work, we encourage farmers to capture the stray goats and get payment for their return. That’s one common Haitian solution to the problem. But it’s not always what happens.

Chape is the husband of a CLM member, Elimène, and a farmer in Bay Tourib. Elimène has being doing well so far. She received two goats from us, and they are both pregnant. She’s taking good care of them. She also bought a third, with money that she saved up from her weekly stipend, and it is pregnant as well. Chape planted a small garden with pigeon peas and sorghum, and they were looking forward to the harvest. Things were looking up.

Then one morning, Chape got to the garden and found it ravaged. Livestock had devoured almost all the sorghum. In the middle of the garden, he saw several goats and assumed that they were the culprits. Enraged by the loss of a yield that he had been counting on to feed his children, he reacted badly. He caught four of the goats and killed them. This, too, is a common Haitian solution to free grazing. All four goats belonged to CLM members, two to Marie Rose and two to Milouse. Two of the four had been pregnant, one with two little kids. So the total loss was seven goats: a huge setback for our members.

When Sherley heard the news, she reacted swiftly. She spoke to members of the village assistance committee (VAC) for Fonpyèjak, where the incident occurred. We establish these committees as a vehicle that permits community leaders to play an active role in CLM. By doing so, we bring a range of men and women on board who know the communities we work in and the communities’ residents better than we do and who are, what’s more, in those communities all the time. They help us support our members by extending our reach in several ways, such as adding emergency contacts and field supervisors to our team by putting a community’s own resources to work.

Sherley went to see all three members affected with Emonès, a leading member of the committee, and the two CLM members who serve on the committee as member representatives. They made a preliminary decision to confiscate the assets we had given Elimène, pending a decision. Some of the committee members had wanted to insist that Chape and Elimène pay for the goats he had killed, but Emonès pointed out that, if the couple had had that kind of money, they wouldn’t be in CLM. The committee members went to the couple’s home, and led away all three goats. They also took away the roofing material we had given them for home repair. The members’ initial thought was that we should consider removing the family from the program entirely.

Killing the goats, even under serious provocation, seemed to them a very grave offense, especially since Emonès concluded that the goats had not done the real damage to the garden. He observed the damage done to the sorghum, and concluded that it had been eaten by animals taller than goats — horses or cows — and also noticed that the pigeon peas — which larger animals don’t feed on — had been left alone. As the dry season continues, owners of large livestock sometimes let them loose to feed at night, not knowing how else to get them fed. This is a crime against the neighbors in whose fields they graze, but it is one that is very hard to uncover.

The committee didn’t want to make a final decision, however, without a hearing. They thought that it would be better to let a few days pass so that cool heads could prevail, and they also wanted CLM’s leadership to have a say. So we scheduled a hearing for Tuesday evening. I got to Bay Tourib Sunday afternoon, so I would CLM’s representative.

On Monday night, I had a long talk with Emonès. He said that Marie Rose and Milouse were very different victims. Both had obviously let their goats roam, but Milouse was known to have done so regularly. Marie Rose never had. Her goats had gotten free because she had rushed to the hospital in Tomonn with her husband, who had been suffering with prostate problems. The person who had agreed to look after her goats had failed her.

I told him that I wanted to avoid removing Elimène from the program. She was in it because she needs it. Kicking someone out solves nothing. I proposed that we return the roofing material to Elimène and ask her to give a goat to Marie Rose and one to Milouse. That would distribute the harm that had been done. Emonès agreed.

But we had the hearing the next night, and that’s not what we finally decided. We started a hearing with a report from Sherley. We asked her for a general summary of the facts, as she understood them. Then we asked Elimène, Marie Rose, and Milouse each to respond. Milouse defended herself against the claim that she habitually lets her goats roam. Marie Rose explained how unhappy she was that her goats had gotten free. Elimène talked about how much she and Chape had counted on their harvest and how little they had to show for all their farm work now.

When they were finished talking, I announced the decision I had made, but I framed it as a proposal. I asked for their feedback.

At first, everyone agreed. But then Emonès spoke up. He had, he said, been thinking about the matter constantly since he and I had spoken about it, and he wasn’t quite comfortable with what I had proposed.

He had not previously known Elimène. He met her when he went to her home with Sherley and the other committee members to seize her assets. He had been very much impressed by the way she conducted herself: polite and helpful. His original thought when he had heard about the incident had been to remove her from the program, but when he visited her home he realized that she was just the sort of person the program had come to Bay Tourib to help.

Though he could not condone the killing of the goats, he had been thinking about ways to minimize the damage all around. He knew that the two women had sold meat from the slaughtered goats. This is common. If it’s sold quickly, it can bring in some money, though not much. He suggested that Elimène be asked to give each of the other women only the difference between the money from the sale of the meat and the price of a goat. He had done a rough calculation. Elimène might still have to sell a goat to generate that money quickly. She probably didn’t have it on hand. But she’d still lose only one goat instead of two. We all agreed that this seemed like the best solution, and left it in Sherley’s hands to help the women make it work.

Emonès was, obviously, the star of the evening. His patience, first as an investigator, then as a sheriff, and finally as a juryman and a judge, brought us to what was perhaps the best solution of an unhappy case. And it went a long way to helping us through the process without rancor, too. He exemplified the role we try to give to leaders in the communities we work in. If we could help such leaders establish themselves everywhere that we work, that would go a long way towards guaranteeing the success of the members whom we, and also those leaders, serve.

by Wilson Ozil, Regional Director, CLM

Mecianie Casseus is a forty-seven-year-old mother of ten. She has children with four different fathers. Two of the fathers are dead, and one of them doesn’t care about his children. She only has one kid with the man she is living with right now.

Before joining the program, she said that her life was upside down. The earthquake destroyed the straw house that she had been living in. She was lucky enough to receive a tent from Concern worldwide, so she could shelter her family. She had no land and no productive assets. The most she had was a little goat someone gave to her to look after.

She caught a break when one of her older daughters married a guy who took her to live in a small town outside the capital. The daughter agreed to take five of her other children with her, leaving the mother with only the four younger ones to take care of. Even after that, things were still very difficult. She got by going to the market for her better-off neighbors. In return, they would give her loose change, which she would use to buy food for her children. At other times, she would travel to a nearby town to wash clothes for people. She said that she would find money in their pockets, and would return it, so they came to trust her. Because of that trust, they would also take her to sell plantain with them. They would let her gather the loose ones, and she would sell them to take something home to her family.

She explained that after she was selected for the CLM program, she went and told her older daughter because she couldn’t believe it. It seemed too good to be true. Her daughter told her to give her name instead of her own just in case it was something cursed, that would kill her. The daughter would then die in her mother’s place, and the mother would be left to care for the other kids. She used the name Assedie Simonise.

It took her six months for her to realize that the CLM program is truly there to help her, and that she has nothing to fear. That is when she told us her real name, Mecianie Casséus. That is also when we started teaching her how to write her own name, because she had been learning how to write her daughter’s name before.

She explained that things were so bad that when her oldest daughter was younger, the girl had only one little dress. Whenever it was dirty, she would take her to the river, and while the girl was bathing, she would wash the little dress and open it to the sun, waiting for it to dry before they would go back home.

“My life has changed since I joined CLM. I remember the first training days when I received 75 gourdes a day for 6 days. I used that money to buy some clothes, because I didn’t really have any, and a chicken. What was left, I used it to buy food for the kids.”

She said that the program has done so much for her. At asset transfer, she received two goats and a pig. She now has five goats, two pigs, a horse, a cow, few turkeys and some chickens. She said that her husband didn’t contribute much to the house before CLM. He had other women and he wasted the little money he made as a day laborer on them. Now he is working together with me to help the family build a good asset base. She mentioned that as a matter of fact, he is the one encouraging her not to waste but to save.

Mecianie is proud of what she is accomplishing, “I am no longer the person I was before CLM.”

When Primène first joined CLM, she was struggled badly just to feed her children. “I had no resources, just a little goat that someone gave me to look after for them,” she explains. “My husband has two women, so he’d disappear for days at a time. I couldn’t count on him. There were days when my children were hungry because I had nothing to give them.” She has six children, the youngest being twins who were infants when she joined the program. With them on hand, it was hard for her to find the time to work to feed the others.

Primène was lucky. Thanks to a special gift from Bothar, twenty CLM members in Boukankare received a cow as one of their productive assets, and she was one of them. But a cow takes time to begin generating income, whether through the young or the milk they produce. The cow alone would not have helped her solve her immediate needs.

So together with her case manager, she thought about what she could do with the other resources that CLM could provide. She gave her older boy responsibility for the two goats she received as a secondary asset, and she now has five. In addition, a neighbor who was impressed by the care he took of her goats gave him another to take care of, so the family now has six. But even that wasn’t going to help her with the family’s basic needs. She needed a way to ensure a regular income stream.

But she saw an opportunity: Primène lives next door to a gagè. That’s a cock-fighting ring. Cockfighting is a popular activity in rural Haiti. The men who attend cockfights like to smoke and drink while they watch and bet. Primène began to sell rum and cigarettes at the cockfights, and her business took off. She hasn’t grown the business very much, but it has remained steady at about 700 gourds, or just under nine dollars. It generates enough income that she’s able to keep her family fed.

In the meantime, she’s been building up additional small assets. She doesn’t want all of her money in one place. She has two female pigs — a mother and her daughter — and assorted barnyard fowl. With savings from her business and the stipends that the program provided, she was able to buy a horse as well. As her twins grow older, she’ll be increasingly able to use the horse to develop larger and more profitable commerce at the rural markets around Boukankola, where they live.

“My life is different now. It used to be that if my children needed something simple, like a pair of sandals, I’d have to wait for my husband to give me the money to buy it for them. Now I can do it myself.” And it’s not just her economic situation that has changed. Her attitude has changed as well. Graduation is still six months away for Primène, but she has no doubts about herself. “Even if CLM were to leave me now, no one would have to worry. I feed my children twice a day without any problem.”

Primène still has work to do. She doesn’t yet own farmland, which is one of her ambitions, and her children still only eat twice each day. But she has a pregnant cow, almost ready to give birth, a very small but thriving business, a variety of productive assets, and a determination to succeed. She’s well on her way.

Research and photos for this piece by Ellien Delice.

Verona’s house is a little different from most of the other homes in Marekaj. Marekaj is a village that sits across a valley from Opyèg, the market just on the Tomonn side of the border with Boukankare. It’s an area pleasantly divided between farmland and trees. Most of the houses are clustered in little groups of five or six, which Haitians call “lakou.” Generally, a lakou will be home to a single extended — or not so extended — family. Haitian houses, especially in the countryside, tend to be small, but even a family with a relatively large house will spend little time indoors. Life in rural Haiti passes in the lakou, not in the house.

What sets Verona’s house apart in Marekaj is that it’s set apart. It stands by itself, on the top of a hill, a good ten-minute uphill walk from her nearest neighbor. It’s surrounded by a coffee grove. Not, unfortunately, a productive one. She lives with a few of her sons — two of them grown — and a couple of grandchildren.

She’s been doing fairly well in our program. Her youngest two boys appear to be taking good care of her now-pregnant goats. She’s been buying poultry with what she can save from her weekly food stipend, and she took money from her savings club and started a small commerce. She buys coffee beans in the market across Bay Tourib, in Regalis, and sells them in Opyèg or down in lower Boukankare.

Chemen Lavi Miyò is fundamentally an education program. It includes giving our members assets, which they need to establish regular income and protect their health, but it has very little in common with simple giving. Our goal is to help extremely poor families fundamentally improve the way they live, and these improvements depend in part on their learning new habits, so the heart of the program is the education that it offers.

CLM education has several different aspects. It includes basic training in management of income-generating assets: six days at the start of the program and four-day review sessions every three months after that. More importantly, it includes weekly one-on-one coaching with a case manager for the full eighteen months.

During those coaching sessions, members receive advice about caring for their livestock and managing their businesses, they talk with their case managers about their own and their children’s health, and they are pushed to plan, to make decisions that reach deeper than just where to find their next meal. Much about these coaching sessions is almost as unpredictable as any dialogue could be. We know that there are certain topics that must come up for discussion, but it’s hard to foresee just what will be said.

One part of each weekly visit, however, is tightly scripted. We call it the “issue.” Every week, members and case managers go through one out of a rotating list of ten health-related subjects. Going over the week’s issue involves dialogue. We try to draw from the members what they already know about the issue, and since the issues are repeated every ten weeks, members have more and more to say as the time goes on. But the dialogue is not open-ended. We don’t leave it to our members to decide whether vitamin A is good, whether prenatal care is important, or whether they should keep their homes and their children clean.

When presented properly, the issues have a three-part structure. First, we ask a member to consider a danger that hangs over her family and herself. We want her to feel threatened. We then go over the measures the member can take to protect herself and her family from the threat. Finally, we push the member to commit herself to making the changes she needs to make.

Last week’s subject can serve as an example. The issue was, “Too Early Pregnancy is not Good.” We start the issue by going over the dangers inherent to mother and child when the mother is too young. We describe how childbirth can tear apart an undeveloped body, how very young mothers can suffer or even die, and how their children are likewise at risk. We also describe how rarely very young mothers are socially or economically prepared to take care of their kids, and how rarely they can expect the baby’s father to help them out. Then we suggest to them that girls should refrain, if they can, from sexual activity until they’re at least eighteen, and that they should probably not have kids until they’re 25 or settled enough to be capable of taking care of them. Finally, we ask them to say how they can integrate the lesson into their lives, and to commit themselves to doing so.

In the case of too early pregnancy, that last step might be hard to imagine. After all, everyone selected for membership in the CLM program is already a mother. Many of them are already grandmothers. Verona, for example. Talk about too-early pregnancy might seem as though it comes too late to do any good.

But Verona responded to the issue with enthusiasm, and we quickly learned why. When I asked her how old she had been when she had her first child, she said she had been thirteen. She explained that she had become pregnant after an older man raped her. The baby died during labor. Verona explained that her body had just been too small to give birth. She had been badly wounded herself, and took over a year to recover. As she said, only her mother’s care brought her back.

So the commitment Verona made was to talk to the girls she knows about her experience, to help them see the importance of patience. And she wasn’t the only one. The previous day, I had spoken with another grandmother, Elimène. She lives with children and grandchildren in Fonpyèjak, just uphill from our base in Bay Tourib. The lesson brought her oldest daughter, Sensilyèn, to her mind. At 25, Sensilyèn already has eight children. She simply started too young. Elimène can see the price the whole family pays. Like Verona, Elimène told her case manager that she would talk to the girls around her, her younger daughters and her granddaughters especially, about how important it is for them to take care.

And it is not merely a matter of giving our members advice that they can share. I think there is something deeper involved. Our members start with a strong tendency to take their poverty for granted. They think of it as something that has happened to them. It’s a destiny for some; for others, an accident. They look at it as something outside of their control.

One critical part of the transformation that CLM members need to undergo is for them to understand that poverty has some causes that they can act upon. Members need to learn that their decisions matter. Everything we can do to help them learn that the decisions they make can dramatically affect their lives is a step on the road from victim towards actor. And walking that road is a key part of the pathway to a better life.

The isolation that CLM members have lived with prior to joining our program means that they often come to us with serious problems that have never been addressed, health issues among them. Healthcare in Haiti’s Central Plateau is inexpensive for everyone, thanks to our close collaborator, Partners in Health, but access to healthcare depends on more than just its availability.

It’s only literally available to rural Haitians who would have to walk three-four hours or more to get to a clinic. Even under those circumstances, one finds expectant mothers, for example, who hike to their monthly prenatal check-ups, but not all are convinced enough of he importance of these check-ups to make that sacrifice. Healthcare is also practically unavailable to anyone who doesn’t know how to access it or who doesn’t know that they have that right. And it’s not accessible to someone for whom going to see a doctor doesn’t present itself as an alternative to hoping that things will somehow turn out all right. That’s why, for particular diseases like AIDS and tuberculosis, which Partners in Health especially emphasizes, the institution has pioneered the use of professional accompaniers, who make regular home visits to people in treatment, ensuring that they are on their meds and doing well.

Our CLM team thus comes across instances of striking, untreated illness that only our members’ lack of connectedness to their neighbors and their resignation in the face of their poverty can explain. We work hard to get them to pursue diagnosis and treatment in these cases. Our special relationship with Partners in Health means that all our members receive healthcare that is free, rather than merely cheap. But we find we have to invest a lot of time and energy in getting members to use the services nonetheless.

That’s why I spent a day recently at the hospital in Kanj, with a social worker from Partners in Health and three CLM members’ kids: Yvona, Elisson, and Raynold.

Yvona and Elisson are blind. Neither one has been so all their lives; each could see until a few years ago. Yvona is probably about twelve or thirteen. Elisson is almost twenty. Their families have watched each lose their vision without knowing what to do about it. Elisson and Yvona spend their days sitting in their parents’ front yards, with neither the vision they would need for normal participation in their families’ lives nor the adaptation to blindness that someone sightless from birth would naturally have.

I first met Elisson a few weeks ago, when hiking through his village, Elmani, with his family’s case manager, Benson. Benson has only been with us for a few months, so the main purpose of going out with him was to coach. One of the important, if peripheral, parts of his job is to get to know the whole family well, ensuring that he can speak to any of them about issues that are important. When I saw a boy sitting alone in the middle of the yard, detached from Benson’s presence, not obviously even aware of the visit, I went up to him to chat. I wanted Benson to see my effort to engage the boy in what we do. That’s when I discovered that Elisson is blind. His vision has steadily deteriorated over the last three years. When we met, he told me that he can see dark shapes pass across his field of vision, but that he can’t identify them.

We made an appointment for him at Kanj on a day we had confirmed that the ophthalmologist would be available. He and his mother got there early, and were in line before I was able to arrive with one of my other charges, and by the time I saw them, he and his mother were being led out of the hospital by Nahomie, the Partners in Health social worker who is part of our Bay Tourib team. The news was bad, and their faces showed it. Elisson has glaucoma. There is nothing anyone at Kanj can do to restore his sight.

I wasn’t aware of Yvona’s blindness until the case managers told me that they had decided to send her to Kanj the same day I would be there. She lives with her family close to the town of Bay Tourib, not far from our residence there, but I haven’t yet been to her home. She’s a thin little girl. Her news is much more encouraging. She has cataracts, and Kanj can do the necessary surgery. She’s been scheduled for February, and stands a very good chance of recovering her sight.

Raynold’s case is more complicated. I met him at his mother’s house in Anba So, a remote neighborhood of Boukantis, an area outside of Bay Tourib. I’ve written about the area before. (See: MoreCholera.) He was at home the day I went to his neighborhood with one of our case managers to spray the area with bleach. It had been hit suddenly with multiple cases of cholera. Raynold’s parents were away when I arrived. They left him to look after their nine younger kids, so he’s the one who let us into his parents’ house so we could spray, and he’s also the one who showed us to the other houses we needed to see. A couple of weeks later, he met me when I returned to the area to see how folks were getting on, and he spent the day walking with me from house to house.

That walking was not easy for him, not as easy as it should be for a boy his age. But Raynold suffers from scoliosis (http://en.wikipedia.org/wiki/Scoliosis). His spine is badly curved. He lives with constant pain around his right hip. He can walk only slowly. The curvature also puts pressure on his ribcage, which affects the way he breathes. It’s enough for regular breathing when he’s resting, but won’t allow any vigorous effort at all.

Getting him to Kanj involved some planning. His mother couldn’t take him because she would be in a weeklong workshop with other CLM members when we wanted him to go. So we picked him up on a Monday morning, and brought him to spend the night with us at our residence in Mirebalais. Tuesday, I would put him on the back of my motorcycle, and take him to the hospital myself.

I had a Monday evening meeting it Port au Prince, so I had to leave Raynold at the residence with our team. I wasn’t sure how that would work. Here was a seemingly shy rural boy, from a very isolated little settlement, suddenly dropped into the middle of a residence full of strangers and strange experiences.

When I got back at almost nine, I discovered that there had been nothing to worry about. Raynold had been well-fed by our residence hall cook, Nanoune, and was listening to music with one of the case managers, Ismith. Ismith had insisted that Raynold spend the night in the empty bed in his room, had shown him a Haitian movie on his laptop, and was chatting away with him like they had been brothers since birth. Raynold was a happy as could be.

The next day, we went to the hospital, where the news was not what we had hoped. The Kanj orthopedist said that Partners in Health does not have the expertise on staff to treat Raynold. They sometimes have visitors who could do so, but it’s not a regular, predictable thing. All he could do is suggest that we bring Raynold to see him regularly, so that he can keep track of the curve as it develops. As Raynold grows, he said, the spine may well continue to both bend and twist. Things could thus get worse. For now, all we can do is watch.

Raynold got back on the motorcycle, and I drove up towards Boukantis to drop him off. We spent quite a bit of time talking when we got there. He hadn’t really understood much of what the doctor had said to him, and I wanted to make sure he had a clear message he could give his mother when he got home. So we went over things several times. I also told him that the social worker would come to see his mother this week, and that I’d be in Bay Tourib next week if his mother still wanted to talk.

But before he walked away, he told me that, if it was all right with me, he’d just tell his mother that he was leaving home to come live with us in Mirebalais. He said she wouldn’t mind.

It was easy enough to understand. He’s the oldest of ten kids in an extremely poor home. His mother can barely have the means to feed them all. She hasn’t been in the program very long. And as an older child he’s no doubt asked to make sacrifices for younger kids who don’t yet understand. Nanoune fed him wonderfully, and Ismith made him feel liked a well-loved young boy.

Raynold with his new best friend, Ismith

I explained that I thought that his mother really needs him. He can see that, with CLM, she’s working really hard to change their lives. But none of it is easy, and many of her children are still small. I want her to succeed, I said, and cannot imagine how she’ll do it without him. He said that he understood and agreed, but I’d be lying if I said that I felt sure that he did, or that I was certain about my own words. The reality is that we cannot turn our CLM residence into an orphanage. We need to keep focusing on helping the kids we encounter have better lives in their own homes.

So we will have to continue to stay close to Raynold. At the very least, we need to help ensure that he sees the Kanj orthopedist regularly. We’ll also look for any others who might be able to help him out. He deserves a chance at good health. But not only that: As a strong and healthy young man, he could be a major part of the path out of poverty that his family takes.

Working with CLM members means more than just giving them assets. We visit them weekly to coach them as they struggle to turn those assets into livelihoods. And that coaching must include much more than business advice. Each visit addresses specific matters, like good nutrition, hygiene, and other key aspects of a healthy life. And the visits must address broader and more fundamental questions as well. Everything about the way a member lives can affect her ability to lift her family out of poverty.

Jean Manie, whom I recently wrote about, is only a particularly striking example. Because she was living in servitude, she had no way to care for her pig. So it died. Her goats managed to survive, but they’ve suffered from neglect as well. Now that she and her boy are living in their own new home, we hope and even expect that she’ll start moving forward towards graduation. It won’t be easy, but we believe she will succeed. (See: Jean Manie.)

But you don’t have to be living in servitude to find yourself in a social situation that will block your progress. Jean Manie’s fundamental social barrier to progress seems to have turned out to be removable. We have, however, come across much less dramatic barriers that we could not get past.

We regularly find women, for example, who qualify for CLM but who do not agree to join the program because the people who live around them — their neighbors, the members of their family — convince them that it would be a bad or dangerous thing. The women are understandably suspicious of a program that claims it will do as much for them as we will do. No one has ever done anything for them before. And the people around them, for any number of reasons, turn these suspicions into fears that we cannot always overcome. We work hard to face these issues, but we can’t always resolve them.

In addition, we come across some women who cannot join CLM because the men in their lives are unwilling to let them try. For convenience, I’ll call these men “husbands,” though the word may apply only loosely. These husbands might resist the program for a variety of of reasons. Some are moved by the same suspicions-turned-fears that motivate reluctant women. We had a young father in Nan Joumou, named Soiye, who initially discouraged his also-young wife, Perrona, because he was pressured by his older brothers to do so. Are far as I can tell, the brothers were simply jealous that they had not qualified for the program. Soiye and Perrona are teenagers, and they lacked the moral resources they would have needed to resist their elders’ views.

Soiye’s pressure and Perrona’s own nervousness combined to keep her out of the program for six months. Happily, hers was one of the rare cases where she could reject the program when we passed through her area and still join it later as we signed up new members in a neighboring zone. And because Perrona’s mother and Soiye’s older sister joined the program and are prospering, the couple received encouragement that countered the pressure they had first received. They are now making good progress, thanks to a case manager who cheerfully hikes a difficult hour each way, every week, to get to their home from the nearest other homes on his route.

Other husbands may worry that a program that helps their family by building up their wives could threaten their position in the home. The social reality here is that it’s hard for a woman to join if her husband won’t agree. We have one member in Mannwa, Sorène, who left her husband, in part because he was blocking her, and is now moving forward without him, but that’s not the usual way of things. And it isn’t always clear whether Sorène’s solution is worth even hoping for. She has three girls under six and is pregnant, she and her husband have nothing to do with each other, and in Haiti there is no way to insist that he help support his kids.

Even after women have joined the program, relations between them and their husbands sometimes get in their way. Husbands who collaborate closely with their wives can do a lot to help the family move forward, but husbands who do not can make things very hard. That’s why Martinière, a CLM case manager, and I spent Saturday morning with Oranie and her husband, Sentobè, trying to help them work through their differences.

They live in Gapi, a neighborhood along one side of a steep hill overlooking Viyèt, in northeast Boukankare. In some ways they’ve prospered since Oranie joined CLM. The three goats we gave her are now eight, and she and Sentobè now live in a nice new house. They got fourteen sheets of roofing material from us, and that would normally be the factor that determines their new home’s size. But through their own hard work, they bought ten additional sheets, so they were able to make their house much bigger than our members normally would.

But not everything is going well. Oranie has really struggled to establish her small commerce, and Sentobè is a big part of the problem.

Commerce was the enterprise she chose to go together with her goats. All CLM members choose two. This helps them manage the risk involved in any financial activity. Commerce is especially useful because it can provide a source of daily income. Though goats are the most popular and reliable enterprise among our members, they just can’t bring in money every day.

Oranie’s commerce started off well. She invested in beans. She would buy a sack in Opyèg, a rural market in the mountains north of Gapi, and carry it on her head to sell it at a significant profit in Difayi or Domon, more accessible markets down the hill. It meant hard work, but the business was starting to prosper.

Oranie’s problems started when she and Sentobè got into a fight. He beat her up, enough so that she couldn’t lift her beans to carry them to market for sale. By the time her case manager, Martinière, got to her, Sentobè had fled, abandoning her and their children. Oranie told Martinière that she did not think he would be back, and the two of them began to plan a new business.

They chose charcoal. She could buy trees and pay someone to turn them into charcoal for her. For better or worse, it’s Haiti’s principal cooking fuel, and so it sells very reliably. It also has a very long shelf life, so it would not be a problem if Oranie had to wait to fully recover before she could start moving it to market.

So she started filling sacks with charcoal and storing them for sale. She started slowly, but Sentobè returned and her production then grew. With him there, Oranie no longer had to hire someone to make the charcoal. Sentobè could do that part of the work. Before long, they had produced 21 sacks of the stuff.

He also started selling the sacks. This might have been helpful, as she was just getting strong enough to start moving them around. But he wasn’t accountable to her about the income they were making. He would invest some in his farming, but she wouldn’t know how much. He’d give her some household money for expenses, but she had no idea where the rest of the money was going. Asking questions only led to further arguments, and since he had shown his willingness to speak with his fists, she was reluctant to make much noise. Martinière continued to visit them regularly and hear her complaints, but somehow, whenever he showed up, Sentobè would be elsewhere. Though he had spoken with Sentobè when Sentobè first returned to the house, enough so that he had been able to communicate quite forcefully that Sentobè’s abusiveness could not go on, they hadn’t seen each other since.

But Oranie kept telling Martinière how unhappy she was with Sentobè, so he sent Sentobè a message asking him to stay home on a Saturday morning to meet with me. Martinière and I wanted to go up together to see whether we could help them figure a way to work things out. Sentobè was willing to ignore a meeting with Martinière, but he wasn’t as comfortable avoiding me.

You would have a hard time finding two less likely, less qualified marriage counselors than Martinière and me, but others were not available, so we spent much of the morning talking with them. In our presence, Oranie was willing to tell her husband forcefully that he needed to stop treating her so badly. She said that he had been hitting her and threatening her for all of their eleven years together, but she spoke without any leverage except what Martinière and I could manufacture. Her family is dreadfully poor. If she were to leave him, it is hard to see where she would go. Her mother lived with them briefly, but Sentobè apparently accused her of sponging, and she left.

For his part, Sentobè professed a willingness to change. But the issues between them were hard to address clearly and in depth, especially since we felt obligated to begin and end the discussion with what amounted to a threat: If he hit Oranie again, there would be hell to pay. We told him that violence is not a CLM matter but a police matter, that our team has very good relations with local law enforcement, and that if we had to come again, we would not come alone. It’s hard to have a frank and serious conversation when threats are in the air.

But on a more constructive note, Martinière went minutely through Oranie’s finances with both of them. We wanted Sentobè to see the financial interest he has in peaceful collaboration with his wife. Not to be unsentimental, but a big part of their relationship is a simple economic partnership. We also wanted to establish where that partnership stood. Oranie said that Sentobè owed her — or at least owed the partnership — 3000 gourds (about $75) in income from the sale of the last seven sacks of charcoal.

Sentobè at first admitted having borrowed only 500 gourds from her. We asked him not to look at things quite that way. We wanted to avoid suggesting that he owed her money, because we wanted them to look at household finances as a common problem. We wanted him to see that the work that CLM is doing with her is good for them both.

What really seemed to get Sentobè to be serious was when Oranie complained that she had saved up enough to buy school uniforms for their three kids but that, because Sentobè had squandered their money, none of the kids was yet in school. He had to agree that, for a couple that had sold 21 sacks of charcoal in the last couple of months, the fact that their kids had uniforms but were not in school was both sad and strange. After much discussion, he agreed to put 2000 gourds back into the common pot. We told him that he, Oranie, and Martinière would sit together once he produced the money to figure out how they could use it to get their kids into school and her business back off the ground.

Martinière and I returned to Gapi on Wednesday near the end of a very long day and were surprised to hear from Oranie that Sentobè had left again. He had told us on Saturday that he would be going to Port au Prince for a couple of weeks to earn the 2000 gourds, but Oranie wasn’t sure he was coming back. She had offered him the hundred or so gourds he’d need to get there, but he refused — angrily, she said — to take “her” money, and instead sold a chicken.

What’s worse: One of his neighbors claims that Sentobè stole produce from his garden on his way down the hill. We don’t yet know what the evidence is. It could be merely that he left his home unusually early in the morning, around the time at which the malanga roots are thought to have been stolen, but it’s rumored that he was seen carrying them down the hill. The neighbor told others that he will have Sentobè arrested immediately if he returns to Gapi. He added that the only thing keeping him from burning down the new house is that he knows that Oranie is responsible for most of the work. For now, at least Oranie seems safe.

In some ways, this accusation, by threatening to keep Sentobè from returning home, might be a good solution for Oranie. But it’s hard to know for sure. She’s living in a home she built on her husband’s land. I worry that, without him there, her hold on the house might be fragile. Her own family is too poor to have anything that they can offer her.

In any case, Oranie is determined to move forward. As the end of December draws near, the price of goats should increase. She has arranged with Martinière that she will sell three of hers at the end of the month. She’ll use the proceeds from that sale, together with some of her savings, to buy a horse.

Having a pack animal could make all the difference for Oranie. It means that she won’t have to depend on her own strength to carry merchandise from the remote markets she buys in to the places where she sells. It instantly means she can make her business at least three times as large as it can be as long as she carries all her merchandise on her head. She’d like to be able to send the kids to school right away, but she knows that they’ll be better off if she can get her business on sound footing. Sentobè’s 2000 gourds would have helped her, but she’s ready to succeed on her own.

Oranie with her case manager, Martinière

Poverty is not a uniform condition. That’s why Fonkoze has different approaches for families that face different degrees of poverty. CLM is for the poorest of the poor, the families that credit could not help. Put a loan in their hands, and the money will go to feed their kids. They won’t be able to repay.

But extreme poverty, the kind CLM is designed for, is varied as well. Families find themselves in extreme poverty for many different reasons. For some it is an inheritance. We have many CLM members whose daughters are also CLM members and whose mothers and grandmothers would probably have qualified for CLM before them. Others slip into the misery they face because of a crisis: a prolonged and expensive sickness, a funeral or two, or the destruction wrought by an act of nature — a fire, a hurricane, or the earthquake of 2010. Some members come from what are poor, though not extremely poor, families but seem to have developmental issues that prevent them from effectively managing the little they have. Or they simply have more children than they can support. Finally, there are some of whom we’d typically say, “It’s a long story.”

Clothilde did not grow up in extreme poverty. Nor did she grow up in Bay Tourib. She now lives there with three children in an area called Anba So, or “Below the Falls.” It’s a deep and narrow valley just off the road that leads from Bay Tourib to the town of Tomonn. The paths that lead down the side of the valley are so steep that pack animals can’t use them. Horses, mules, and donkeys have to take the long way around, entering the valley from one of its ends.

She could hardly live in greater isolation. The valley pinches shut within a few hundred yards of either side of her house. There are no other houses in her part of the valley. Her nearest neighbor — also a CLM member — is a half-hour’s hike downstream from where she lives, in a separate, larger opening between the valley’s two walls. One of her hopes for her time in CLM is to rent a piece of land up closer to the road. “I like it here.” she explains, “I’d like to keep farming this land. But I have no neighbors at all. If I have a problem, no one will hear me call for help.”

She grew up in Mibalè, the small but busy city at the southern end of the Central Plateau. It’s a city unusual in Haiti for its infrastructure. A nearby dam means that there is electricity almost all the time. There’s easy access to water through most of the town. There are lots of schools.

Clothilde herself is one of the best educated of our members. She made it through the ninth grade. Then she got together with a man, and they had two boys.

But somehow the man came into conflict with neighbors. He was accused as a “malfektè.” Literally, that just means “evil-doer,” but its usual meaning in Haiti is narrower. A malfektè is someone who uses Haiti’s folk poisons to do someone harm.

He and Clothilde had to flee Mibalè, and so they settled on his family’s land in Anba So. Then the man died, leaving her alone with their two boys on his parents’ land.

She got together with another man. She needed someone’s help just to keep her boys fed. The man already had two other wives. They now have to rent the land from her former in-laws. They pay almost $100 a year. But her new husband helps her farm it, and the soil is rich. Nine months ago, she had a little girl. (Her husband’s other wives are, by the way, also members of CLM. Polygamy is a reliable source of poverty.)

But it is just as Clothilde said: Where she lives, if she has a problem, there’s no one to help. Their girl developed a high fever. Clothilde couldn’t run to the hospital right away, because her husband wasn’t there and she has no neighbors who could look after her other kids. Before she could get her baby to the hospital, the infant was dead.

It’s possible to get Clothilde to smile right now, but it takes some work. It’s hard for her to think about anything but the baby she just lost. She keeps talking about what a very good little girl she was. She knows, however, that she must see to other things as well: manage her goats, prepare for her pig, and handle the farm as well. She has three other children who depend on her, so she has little time to look back.

In the photo, her home is hard to make out. It’s beneath the palm trees in the center of the picture.No one else lives in this small valley.