World Wellness, #119

Dr. Nathan Nickerson:

Our basic approach is really to work with, identify and work with Haitian colleagues and try to help them be successful in building their health system and their capacity to take care of their people and to respond to things that come up.

Mark Carter:

Construction help is all very temporary and I keep telling my volunteers and our board that it's really not about projects. Even though we're project oriented, it's about people. And the construction part will only last a short time. But bringing some hope to people is what we're doing trying to do.

Dr. Lisa Belisle:

This is Dr. Lisa Belisle and you are listening to the Dr. Lisa Radio Hour and podcast show number 119, World Wellness, airing for the first time on Sunday, December 22, 2013. Today's guests include Dr. Nathan Nickerson, executive Director of Combit Sante, and Mark Carter, president of Neighbors First. Last week on the Dr. Lisa Radio Hour, we reflected on the spirit of giving that is so prevalent in our Maine community. This week we speak to individuals who are contributing to World Wellness by giving of themselves both in Maine and abroad. From purifying hospital water supplies to providing homes, Dr. Nathan Nickerson and Mark Carter are making a difference one patient and one brick at a time. We hope you enjoy our conversations. Thank you for joining us. I'm very pleased to be sitting here today with an individual that I met as a family medicine resident when I was in Portland and also then a preventive medicine resident and a student in the Masters of Public Health program. At the time, this individual, Nathan Nickerson, was working for the City of Portland's Public Health Department. Now, fast forward a few years. Nate is the director, the Executive Director of Khanbit Sante, which is an organization that is offering health care for people in Haiti. Thanks for coming in and talking to me about this latest adventure in your life.

Dr. Nathan Nickerson:

Sure, it's my pleasure to be here.

Dr. Lisa Belisle:

We've been introduced to Khanbit Sante through our discussion with Deborah Dietrich of MaineHealth and I actually had the privilege of reading a journal that she wrote when she went down there for the first time and her eyes were really open to what it meant to be practicing public health. It means something very different, I believe, than what it means to practice public health up here.

Dr. Nathan Nickerson:

Well, I think the concepts are the same, the sort of the environment and context and maybe the starkness of the issues are much greater there. But the underlying idea of public health in terms of having a whole spectrum of preventive health in the community to treatment and higher level care is all the same. I think the biggest difference obviously is the context, the extreme poverty in which people live and the resource challenges that people who are trying to provide care face every day.

Dr. Lisa Belisle:

And I think that's what I was reading in her journal was really, you're right. It's not that we're doing any things any differently. Everybody needs clean water, we all need food to eat and we all need clean air. But in Haiti, it seems as if it's more challenging to get even the basics in place.

Dr. Nathan Nickerson:

Yeah, I think Haiti has a really unique history that it's not well understood in this country, but has resulted in a situation where systems are not working well and the environment is very challenged and the people, by and large, the vast majority of the people are very, very poor and the systems are resourced poor as well. So even things like basic Haiti has. The average citizen in Haiti has the poorest access to potable water in the world, for instance. Just being able to get water to drink that's clean is a major challenge for the average Haitian. So that's obviously a huge public health challenge right there, aside from provision of medicine and medical care.

Dr. Lisa Belisle:

When I was on your website, I was reading about the work that you had done with acquiring water and there was some very. Some percentage of the amount of water that was currently available. When you had come in, you were only getting about 4% of the water that you needed for the work that you were doing in healthcare. Does that sound about right?

Dr. Nathan Nickerson:

Yeah. And I think you were probably reading about the water water project at the Justinian Hospital. And the Justinian Hospital is a public hospital in Cap Haitian where we work, which is in the northern part of the country. It's the second largest city in the country. And so it has. It's the site for the. There are two major public hospitals in the country. One in the capital in Port au Prince and one in Cap Haitian. They're the training grounds for the new residents and nurses coming through the system. There's they're supposed to be the referral hospital for the higher level cases and so forth. And yet at this hospital, I think the water situation is kind of emblematic of their entire situation. When we came, they had a single well that supported the water needs of a hospital, a 300 bed water hospital. I mean, a 300 bed hospital. And they had, from that single well, they had a pump that was essentially a residential pump, what you would have in your home. On top of that, the electricity was very unreliable, so it was only running a few hours a day. So that's where you get the figure that compared to their needs, what we would consider the minimal needs for a hospital of that size, they were only getting about 4% of what they would need. That was complicated further by the fact that the infrastructure was so poor that the piping had degraded and was porous, that it was allowing sewage basically to come into the water system that was distributed to the hospital. So not only was it in insufficient quantity, it was grossly contaminated when it arrived out of the spigot. So, yeah, that's an example of just really poor infrastructure in which people are struggling to provide care. This is a hospital that does surgeries, so people need to scrub with water coming out of those sinks. And water is just a basic need in terms of patient care, hydration and food and so forth. So, yeah, we worked together with the Rotary clubs in this area in New Hampshire to raise some funds to replace that distribution system, the external distribution system, and install two more wells and have a chlorination capacity so that disinfects that. So those pipes now are now seamless, so they don't have contamination entering them. But it continues. It's still within a context of a very challenged infrastructure. So it continues to be a challenge, but better than it was. It's sort of a step by step process.

Dr. Lisa Belisle:

What is the history of Haiti that has contributed to the infrastructure issues that you're talking about?

Dr. Nathan Nickerson:

Well, I think, and it's interesting, I hope kids are being taught this in school today. I know that I wasn't, and I'm a little, you know, go back a few years, but history. Haiti was the first freedom republic that was born out of a successful slave revolt. So the French, I guess in a nutshell, the French had colonized the island after the native peoples there were eliminated through slavery and disease. Very quickly, they started bringing in people from Africa to drive their economic engine, the plantation life and everything. At one time, at that time, Haiti was responsible for more than half the GDP of France because it Was so productive and so fertile, but it was all done all built on the backs of slaves. In 1804, after 10, 11 years of struggle, the slaves finally overthrew the slave owners and threw them out of the country. They really rejected the whole plantation system and the agricultural system that was imposed upon them, Dismantled. That move to more of a sustenance small farming model, which is largely that agrarian model that they've adopted, has largely been undermined by international intervention, which is a whole other story, but it's really collapsed at this point. There's been a lot in the interim. There's been a continued problem, Class struggles within haiti Even after their independence. So most of the people have been maintained In a very poor state. One of the things I think there's been a lot of ecological degradation. The country's almost completely deforested, Largely because charcoal is still the fuel which people cook with. It reminds me, I lived down east in maine for a while, and if you had no other job and you live in a cash economy, you could dig clams or dig worms in haiti, For a very poor person, if there's no other way to get cash, you can make charcoal. Regardless of the fact that it's the damage in the overall ecological situation that's led to a whole cascade of other challenges. Because of the deforestation, and there's really nothing to hold the soil On a very mountainous country. The topsoil washes out to the sea. The topsoil that washes out to the sea Destroys the fishing reefs, so that people have to go further and further out to sea to get adequate fish. And it's sort of a cascade of things that were all predicated on the birth of haiti. Being born as a country of slavery and their independence coming in the early 19th century predated emancipation in the United States by about 50 years. So obviously, the colonizing countries of europe and the united states Were not thrilled with the idea of a black republic that would be spreading the idea of slaves overthrowing their slave owners. And so it was a pariah state from the very beginning. And so there's a lot of things, and that's really not that long ago, that it's got locked into a trajectory that's been very, very, very, very difficult.

Dr. Lisa Belisle:

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Mark Carter:

I'd like to take this opportunity to wish you and yours a holiday season filled with an abundance of love and gratitude. Be Thankful for the things in your life that matter most and enjoy your

Dr. Nathan Nickerson:

time with family and friends

Mark Carter:

from all of us here at Shepherd Financial. Happy Holidays

Dr. Lisa Belisle:

in the United States. One of the things that happened during the early AIDS epidemic was that it was quote, unquote, the Haitians that were one of the primary, thought to be one of the primary causes. I can't imagine that that had a very positive impact from a PR standpoint.

Dr. Nathan Nickerson:

No, I think, yeah. I remember in the early AIDS epidemic they would talk about the four H's and it was hemophilia, homosexuality, heroin and Haitian. I mean, I think, interestingly, I think there's, there's reason to believe that Haiti didn't import AIDS here. We imported AIDS to Haiti and there was a. But it, Haiti at one point was a tourist destination and the bottom fell completely out of that related to those fears connected to aids.

Dr. Lisa Belisle:

When you and I have discussed the fact that you're dealing with day to day issues that are very challenging. Water is one that you've described. But you've also been in Haiti during a major cholera outbreak and also an earthquake. It sounds like you kind of keep peeling back the layers and you find something you have to deal with there. Peel back the layers, you find something there, but then something explodes and you have to deal with that. That's an interesting challenge.

Dr. Nathan Nickerson:

Yeah, it is. I mean, Haiti is obviously a very challenging place to work anyway. I think it is for the people that are there. I think our basic approach is really to work with, identify and work with Haitian colleagues and try to help them be successful in building their health system and their capacity to take care of their people and to respond to things that come up. Before the earthquake, Katie was in a. Had suffered routinely suffered disasters not on the scale of the earthquake, but that was something that they have a vulnerability because of the lack of Public health response and infrastructure, and the poor housing and sanitation that people suffer. So our sort of approach of what we call accompaniment is working together with the people there in a supportive role, not in the front, but sort of behind, Identifying people who are the champions for the people in terms of advancing their health status and their health care and work with people there. It means walking through those times too, when there are major events, eruptions like the earthquake. Earthquake was. We never envisioned ourselves to be a disaster response organization, nor do we still. But when we had to walk through that, if we're going to walk with our partners, we have to walk through those times too. And it was an interesting thing. We had been in Haiti for eight or nine years when the earthquake struck. So we had very deep relationship with people in Cap Haitian, particularly with the public system, with the Haitian system. And so what we saw when that struck is that people flew in from everywhere to help Haiti. And there was hundreds of millions of dollars supporting groups from away parachuting in, essentially, metaphorically or literally to provide these sort of urgent care. But the public system in Haiti, no one gave any money to the public system in Haiti. So here was, we were working with the second biggest public hospital in the country, and they didn't have. They didn't have. They literally didn't have a penny. And so they're relegated to watch all the saviors come in to do this work when they had a really rightful role to be major contributors in the response. And so our efforts were really not to be on the forefront, but really to help them play the role that they could play, to help support them so that they could mount their response to the best of their ability. And that's really kind of the role we played there. And we played it, I think, in the color epidemic as well. So that meant when they didn't have supplies, it really helped them get supplies. After the earthquake happened, the government announced that all victims of the earthquake would receive all their health care for free, which is fine if you're a well resourced group, but if you're a poor public hospital that has no resources, how do you do that? So one of the things we did, by the way, there was just such a great outpouring of local support that we had some resources to. To work with them, some substantial resources that we hadn't had in the past. So we actually paid for the care of the victims that were cared for at the hospital. So they actually had some cash flow that they could keep the hospital open and do the work that they needed to do. And we were able to work with a number of other partners to bring in the supplies, medical supplies they need. There were teams that came down to augment the staff there, some trauma surgeons from here and other people. But the whole point was that the Haitian system could play its rightful role in responding to their own needs.

Dr. Lisa Belisle:

That is an important point, that understanding the culture, as opposed to coming in and imposing one's own culture, ends up likely being more successful in the end, being more sustainable. Is this something that we've gotten better at, do you think?

Dr. Nathan Nickerson:

That's a good question. I don't know. Overall, I mean, there are a lot of efforts. I think we believe in the long run, the answers that are sustainable will be Haitian answers. I mean, we can play a role in terms of assistance and sort of joint problem solving. We bring something to the table, but we don't necessarily bring all the answers to the table. The answers are going to have to be a mix of what their understanding is and what's culturally acceptable, what's feasible in that context, politically and economically, with. With what we can bring to the table as well. And so I think I was saying to you that often when I've described our model, which I think is a little challenging to describe, sometimes people say, oh, yeah, no, no, I get it, it's teaching a man to fish thing. And I really don't think it's that. I think it's really about sitting down and figuring out how to fish together. Because the challenges that they face are really outside the realm of experience of most of us. When we go there, they're not. The clinicians who go down usually have at their fingertips a whole battery of diagnostic testing equipment and things. And the people that are even in our public health services, the things that we take for granted just don't exist there. We take for granted that when. That our population here, when they turn the spigot in their kitchen, they're going to get clean water that comes out of that. Not that you might have to spend five hours a day finding an adequate amount of water to drink, and it may not be clean even then. So we really have to be very humble in our approach that it's really not just about, we know how to do this, and if you just did it the way we did it, everything would be okay. So it's. But it's, you know, we're a culture that's wed to fast results and quick impact and not the due diligence that's required to really understand the situation and take step by Step block by block to build something substantial and sustainable.

Dr. Lisa Belisle:

Nate, you have a doctorate in public health, and you also have an RN degree. And you probably could use this in a way that, I don't know, might be more economically advantageous to you, might give you more stability in your life, perhaps more prestige. And yet you have chosen not only to go down to Haiti to be the executive director of Combat Sante, but prior to that, work in the public health system in Portland, Maine's largest city, and along the way, where you met your wife, who's also in the healthcare field, work for a homeless health program out of Boston. You don't seem to like the easy path, I guess, or the prestigious path, or, I don't know. Tell me how this has all happened to you in your life. Why has this become the path that you've chosen?

Dr. Nathan Nickerson:

Everybody who's involved in this kind of work has their own kind of internal motivations and things and things that give them satisfaction, you know, And I think for me, it's more. It's sort of my little contribution to the peace movement, I guess, or social justice or whatever, that. I get satisfaction out of seeing somebody get something that they wouldn't. That they deserve, from a human rights perspective, in this case, health care that they wouldn't otherwise get. And if I can be a catalyst to that and with other. And join with other people in being a catalyst for that, then that's, you know, deeply satisfying. I think it's. It's, you know, it's a. It's a real privilege to be able to do what you want to do and not have to work in a particular area just because you have to do that. So, you know, we live in a place and a time where we're very, very fortunate. And I think a lot of us think, well, too much is given, much is expected. So I think everybody who's been involved with this has some flavor of that in terms of why they're involved. They want to give something back. They want to be part of a global community. They want to see their neighbors as more than the person who lives next door, but have a sort of a global sense of who our neighbors are. They want to share from their good fortune. I mean, I really believe, and I've told my kids this growing up here, that there are probably other places in the world with a standard of living as good as Portland, but probably not better. Where things are safe from random violence in general and from disaster and from, you know, horrible events that are conditions and war and these things that Many, many other people in the world live with daily. So we come from that place of privilege and. And it's also a privilege to share some of what we have.

Dr. Lisa Belisle:

You have a very active support community in Portland, which is not to say that you couldn't use more support or more financial contributions, but you convince. Sante was founded by Dr. Michael Taylor and also, I believe, his wife Wendy, and many, many clinicians or allied health professionals have given of their time and their finances, their resources. How do you sustain the interest in this?

Dr. Nathan Nickerson:

Yeah, I think. And Michael and Wendy, as you've alluded to, were really the kind of both. Not just. This isn't just their brainchild, this was their heart child, to sort of pull this, at least an original group of people together and then really continue to reach out and talk about this work and promote it and facilitated people coming down and meeting people. And I think that's part of it. There are people from all over the community who've contributed in some way. There are a lot of people who are not traveling to Haiti. For instance, there's a local company, JB Brown, that has donated warehouse space. So we collect medical supplies and equipment and so forth. We have volunteers who work in that warehouse sorting and loading containers when we send them down. There are people who work on selling Haitian metal art to raise money. And then there are the people who go down on the ground. And most of those people are the best ambassadors. They come back and talk about their experience, what it's meant, what what people can do to help and to contribute. And there are many, many, many donors. It's been a very, very generous community through the years. And I hope, and I hope one of the reasons is that we can provide a little different narrative than people hear about Haiti in the media. I think there's a lot of media saying that Haiti is kind of a hopeless place, that nothing can change. I think what people can see and hope they see and hear is that with really careful, respectful, humble collaboration and joint problem solving and things, you can see movement in the right direction and that results, that directly results in benefit to the people in that community. Some years ago, Portland agreed to become the sister city to Cap Haitian. So there's some sense of we want to, as a community, have a sister city in which we can share from both as a community, formally share what we have. And. And I think there are lots of other people who take satisfaction in taking some part in that, whether that's making a donation, working in the warehouse, selling things, if they have a skill set that's appropriate for being on the ground there then doing that. And I would mention it's not just healthcare people. We have a whole group of people who are professional trades engineers. And we talked about the water project. That wasn't done by clinicians, that was done by water engineers and electricians and people like that. So we try to take a very holistic view of what health care means. When I worked for the Healthcare for the homeless program, I used to have a poster on my wall in my office that said housing is healthcare. It's sort of a recognition of the idea that the whole environment in which people find themselves contributes to is expressed in their health. So we try to take a bit more holistic view, I think a public, more of a public health view of what health is about. And so we have people with those kind of skills to help out as well. We try to be very. We try to not be. I think we've developed from a model of let's go down and see what we can do to really negotiating goals and objectives with our partners there and then finding the skill sets we need to move those forward. So it's not a random mishmash of a federation of well intentioned people, but really matching people's skills with what's needed. Much like supplies. Most supplies that come into Haiti are sent by people who are well intentioned but have a good idea of what's actually needed. So they'll fill containers with. And so, you know, Haiti needs everything, so let's fill it with everything. Well, actually they can't use everything and so much of that goes wasted in the same way. We really tried to move towards help them develop an inventory system so we actually know what the uptake is, how much of what kinds of things are useful so that we can match what's available with what's needed there. It's the same side that's the same way on the volunteer side that we really want to match the skill set with the goals that are set up so that we can move forward on those and make real progress.

Dr. Lisa Belisle:

We all like to believe that volunteering in another country, perhaps in a medical capacity is somehow superheroesque or glamorous or life changing. And it's interesting to me that what I'm hearing for you is from you, is that a lot of what you're doing is logistical. It's systems oriented. It's probably not that glamorous or sexy, but it's having a much bigger impact on many more people than just swooping in to save the day yeah, it

Dr. Nathan Nickerson:

is different than that. And it's really not the typical mission model of coming down and doing clinics in the community and things like that. Because actually when Dr. Taylor convened the first group, many of the people had experience doing that type of model. And I think it's probably, at least in the short term, very gratifying. You're able to go and give out lots of things to people. But it was a group of people who I think really questioned, well, what's left in the end in terms of. And I think there are probably particular conditions and situations where if someone needs a surgery, you can do the surgery and then that's life altering. But for medical care and public health and those kind of things require a maintenance of effort that's ongoing, not once a year or anything. It's really helping build capacity on the ground to provide those kind of services that kind of help work with the community, that understands the community, can speak with the community. And so that's where this different kind of thing that you're right isn't so glamorous. It's a lot of grunt work, but it is focused. But there is another kind of part of it we work with and people have established really deep and long relationships with Haitian colleagues who are passionate about improving the situation in their country. And there's now some people who have their back who can give them support, whether it's materially, supplies, technical assistance, work with them on trainings. The new generation of clinicians coming through help improve the environment in which they're working, help develop curriculum for those trainings, help with program development. We do a lot of work with operational kind of research and try to improve the quality of care and outcomes within a hospital with strategies, try to negotiate within their resource means because we don't have real deep pockets to bring to the situation. But it's a different kind of partnership that way. It's really about trying to, if I had to boil it all down, it's really about problem solving together. So I think people still find it deeply satisfying when they can have those kinds of relationships and long term impact.

Dr. Lisa Belisle:

Nate how can people find out about Khanbit Sante?

Dr. Nathan Nickerson:

Well, I think the quickest way is to get on the website and we're certainly happy to talk with anybody who wants to talk with us about it. And I think our contact information is on the website, which is combizante.org or healthyhaiti.org would get you to the same site and probably easier to remember and spell, but kombizante is k o n b I t s A-N-T e.org or healthyhati.org

Dr. Lisa Belisle:

We've been speaking with Nate Nickerson, Nathan Nickerson, who is the Executive Director of Convict Sante down in Haiti. We know you're not up here all the time, so the fact that you came into the studio and were able to tell a bit of the story is really important to us. Us. And I thank you for the work that you're doing for Haiti and also within the Maine community to bring support to Haiti. And thank you for your time.

Dr. Nathan Nickerson:

Oh, it's just a pleasure to be here. Thank you.

Dr. Lisa Belisle:

As a physician and small business owner, I rely on Marcy Booth from Booth, Maine to help me with my own business and to help me live my own life fully. Here are a few thoughts from Marci as we close in on the holidays, I want to take this moment to wish you all a Merry Christmas and happy holiday season. Enjoy this beautiful time of year with family and friends. I'm Marcie Booth. Let's talk about the changes you need. Boothmaine.com

Dr. Lisa Belisle:

People in Maine are a generous group. I know having worked with Safe Passage, the organization that educates children in Guatemala. I know that we do a lot of work with education. We also do a lot of work with caring for people in other countries in the medical field. Mark Carter from Neighbors first is going to talk to us today about work that he's been doing, which really is about construction and architecture and really creating places for people to live in countries such as Colombia and other parts of Central and South America. But he also works right here in Maine. So thanks for coming in Mark and talking to us today.

Mark Carter:

Thanks for having me, Mark.

Dr. Lisa Belisle:

This idea of Neighbors first is intriguing because I know a lot of people will think about, well, I'd like to give to somebody in another country, because I know they don't have much, but you specifically, specifically called your organization Neighbors First. Why did you do that?

Mark Carter:

Well, neighbors are both near and far. We're a Christian organization, nonprofit corporation. And the description of neighbors in the Bible is that it's someone in need. So we called it Neighbors first because we are helping those in great need with construction related help.

Dr. Lisa Belisle:

Your background is as an architect and you lived in southern Maine for a number of years before moving back up to your native Presque Isle. That was a bit of a journey.

Mark Carter:

It was big change.

Dr. Lisa Belisle:

Why did you decide on architecture?

Mark Carter:

Well, in high school, my summers were spent on the construction site. Most people in northern Maine work a lot, and that was no exception for me both on the potato farms When I was young and during high school, I worked construction for different contractors and really got hooked on building. But I thought I wanted to do something a little bit even more. So I went into the design area. My first job was right here in Portland, right around the corner on Exchange Street. So this was a nostalgic walk for me this morning, like I was going to work 20 years ago.

Dr. Lisa Belisle:

And your wife Debbie is also from northern Maine?

Mark Carter:

Yes, both from Presque Isle.

Dr. Lisa Belisle:

So how did you meet?

Mark Carter:

We met in high school, actually. Classic high school sweetheart story. And we went off to college, separate ways. And when we graduated, we were married and settled right here in Portland.

Dr. Lisa Belisle:

And you told me a story about something that really caused you to think about your life and where you wanted to live and what you wanted to be doing with yourself. I think our listeners would be interested in that.

Mark Carter:

Well, some 25 years ago or so, I was asked to go to Mexico with a group that was going to be constructing a medical clinic. And they wanted me along for my design and building expertise. So I agreed to that, not knowing really what I was going to see or experience in Mexico. But after several trips beyond that, I found myself in a migrant worker camp in Mexico, which the housing conditions were much more like a cattle farm than it was like human housing. So I think that influenced me a lot. And it caused me to think that perhaps the way I was living, what I was doing, had a little access to it. So we pulled up roots. We felt God was telling us to move and get rid of the things we had here in Portland and move back to northern Maine, for some reason weren't entirely sure. And many of our families and friends thought we were somewhat crazy for doing that. But we did it anyway, and it's been good. It was a great place to Raise our three children and perhaps Neighbors first is an outgrowth of that move and big change in our lives.

Dr. Lisa Belisle:

How did Debbie feel about that?

Mark Carter:

When we, when we first talked about moving north, that wasn't very popular. But soon after she understood that was kind of a call that we were supposed to do. And it's been good ever since. Our families are both in Prescott and we have a lot of friends there, but we still keep contact with our really good friends in Portland. So it's nice to have friends all across Maine. In fact, we still serve together in Central and South America when we go. We have friends from southern Maine that join us on our team. So it's been good to have the experience throughout Maine.

Dr. Lisa Belisle:

Faith has been a very big part of your life, your family's life, and how it is that you've chosen to live. Tell me about that. Is this something that started when you were younger?

Mark Carter:

Not very young. I had little to do with anything of faith until the age of 18. And at that point I was not sure what to do with life as many 18 year olds would probably have that same experience, but made a decision to put God first in my life. And from then on I've made an effort to follow Christ wherever he wants me to go. And that means helping people. Because there's this common theme throughout the Bible that says that we're to help anybody that has need for the widows and the orphans. And because of that, many men that I've known over the years were like minded with this concept. And so we formed Neighbors first. And it has had a big influence on myself, the way we live, the way we give, the way we raise our children.

Dr. Nathan Nickerson:

And

Mark Carter:

it has been a life pattern and we want to honor God with what we do.

Dr. Lisa Belisle:

What I hear from you really is about the not only honoring of God, but also honoring fellow human beings and really understanding them and having compassion for them in a way that is open and giving as a neighbor to a neighbor.

Mark Carter:

That's right. We enjoy helping people. We were just this past weekend re roofing a family's home in Caribou and my team of guys were all working on the roof and the young lady of the home came out and spoke to me and said, you guys don't seem like you're working, you seem like you're having more fun than you are working. I said, well, that's truly the case. We thoroughly enjoy helping other people and we have a great time doing it and we just want to bless people with a little bit of help, you know, construction help, Is all very temporary. And I keep telling my volunteers and our board that it's really not about projects, even though we're project oriented. It's about people. And the construction part will only last a short time. But you know, bringing some hope to people is what we're trying to do.

Dr. Lisa Belisle:

What has it been like to try to identify the people in Presque Isle or around Presque Isle in parts of Maine that might need your assistance?

Mark Carter:

A little different than in Central and South America. When you travel to developing countries and see the need, the questions about the need are not so varied. They're pretty obvious. In North America it's a little more difficult to determine what's need and what's want. So we work hard with that. And that's why we partner with a local church on all of our projects, whether they're international or local. We want to have a local church involved because they have the insight of their own neighborhoods, their own areas, people that really have need. And so we connect with them and say, look, if you have recognized a need, we'll partner with you and you can provide some help and we'll provide our help and we'll get it done together. And that way when Neighbors first is finished with the construction related project, the continuity will be there. We kind of charge our partners with, you know, follow up with people and see if there's anything else that they really need or encourage them. And that way it's just not a one time thing.

Dr. Lisa Belisle:

What type of people are in need of your help and what type of projects do you help them with?

Mark Carter:

Central and South America projects are a little different than the northern Maine projects that we've worked on. In northern Maine we've tended to do a lot of roofs for widows and some access projects for roof widows. And we've had provided homes for people that have great need. We were made aware of a widow in northern Maine a few years ago that was living in literally a shack. And I've been to a lot of different poor areas in several countries, but this rivaled them all. And it was right in our backyard. And so before the building fell down around her, we provided a home and set her up with that. So those projects are varied. In Central and South America it ranges from building a whole new building which we've done several times. We've done orphanage dormitories and churches and homes. And we currently have a project ongoing program for providing concrete floors for people living on dirt floors in Central America. So people donate $250 and people volunteer their time and money to go and put in these floors. And it's been very had a great impact on these families to get this. What we take for granted is a decent floor that you can keep clean.

Dr. Lisa Belisle:

That seems like in the grand scheme of things, not that much money. In order to give somebody something that seems fairly basic, $250 gives you a floor.

Mark Carter:

That's very true. I think people would be surprised at how far a small amount of money will go. In a developing country, we've built entire buildings for 17,000 or $18,000, where here it would be $250,000. Because there's a lot of labor, there's a lot of willingness to build what they need, but they don't have the funds and there's no way to get them. They're living day to day. Most people we're working with in these countries are making, you know, two, three dollars a day. So there's no way they can build onto their home or even provide themselves a concrete floor. But out of our excess, we can give just a little and make a huge difference for someone.

Dr. Lisa Belisle:

What do you find happens when you provide somebody with a floor? If you're starting with somebody who has very little, they have a dirt floor, you give them a concrete floor. What does this do for their kind of emotional and mental well being and their view of themselves?

Mark Carter:

It's a big boost for them. Something as simple as a concrete floor. It's hard for us to relate to living on a dirt floor because we just don't do that. But there are chickens and animals wander in and out of their homes and their children have to sleep on the ground. And something as simple as a concrete floor that they can sweep and keep clean. Along with the concrete floor, we provide a gate for the opening to the home. The home is usually made out of sticks with a thatched roof. And we provide a gate and a little bit of instruction that says, you know, just keep the gate closed and keep the chickens and the pigs out of the house and keep the floor clean. And it gives the housewife a very big boost. They're absolutely thrilled because no longer are they sweeping the dirt floor, which we see all the time with their homemade brooms. They're keeping their concrete floor clean and it just makes a big difference. Big good for their self esteem and gives them a little bit of hope that they've made a little progress and they can provide for their family a little bit. So it's a win win all the way around.

Dr. Lisa Belisle:

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Dr. Lisa Belisle:

I met you at the Maine Home + Design show this last June and you were there as an architect, but also as the founder of Neighbors First. It must be an interesting contrast for you to be working as an architect designing homes for people who have, I would assume, more money than the people that you're designing homes for down in Central and South America. What Is that like.

Mark Carter:

Well, I've often told people that my profession, I'm an architect by profession, is really just a way to support my full time habit, which is my faith and helping others. So, not that I just discount my profession. I love my profession and enjoy it very much. But it is a means to help others. So I use the things I've learned over the years to help design very simple but very effective structures and also to assist our volunteers and how they can help. Even though they're not skilled construction workers, they can all help. So my years of experience with construction has helped with that. And we have two building contractors on our board as well, so they're great organizers and teachers as well.

Dr. Lisa Belisle:

Many people are these days moving away from the county or have been moving away from the county. You moved back and you were able to live happily with your wife Debbie, and also with your kids, Gillian, Nathan and Alex. It seems to me, and having spoken to people who live in the county, that there is a quality of life that's different than perhaps other parts of the state.

Mark Carter:

That's a. That's generally true. I think most people that are from the county recognize that it's a little bit. And even people that visit Aroostook county and stay for a certain amount of. Decent amount of time will recognize that. That there's a very good work ethic there and there's a good community feeling that people feel like they belong. We're a bit remote from many people's standards, but you get used to that. And yeah, we complain about it sometimes, but it takes forever to get any place. But overall, it is a very good place to live and it's a great place to raise a family and it's a good place to have roots. Even a lot of people that have moved away from Aroostook county maintain their connection there and return. And I think the roots are always pretty strong for the county folks.

Dr. Lisa Belisle:

You have three children and two of them have been influenced to do work in their own lives. That has something to do with the work that you've exposed them to through Neighbors First.

Mark Carter:

Yeah, actually all three of them have very compassionate hearts. And that is something that my wife and I are very proud of. And I think our kids are just doing great. And my daughter Jillian is a teacher, and not just a teacher, of course. She wanted to teach the kids that are having difficulties. So she specialized in special needs kind of education. Now she's at home with three little kids. So that's a big challenge on its own. But she just Has a heart for kids that have a little bit of a hard time. And that compassion, I think, I hope, has been something that's rubbed off on her. My two boys, they are both going into prosthetics and orthotics. One is in residency and the other will be entering his master's program next year. And both chose those professions because they wanted to help. They wanted to help people and they wanted to bring that skill to developing countries to assist in Christian mission as well. So they both have a great heart and they work with other organizations as well. So we're very proud that they have that compassion and hoping that kind of rubbed off from the way we live. People know me as not a person that has a lot to say. I'm a fairly quiet guy, but I believe that actions speak louder than words and a lot more is caught than taught. So hopefully the example that we set for our children will continue on to the next generation. And also the example we're trying to set as an organization, Neighbors first, to motivate people to help others.

Dr. Lisa Belisle:

So if you're a man of not many words, it must have been an interesting thing for you to consider coming on our radio show.

Mark Carter:

Indeed. I probably used up all my words for the day and I'll be very quiet for the rest of the day. It's good that I'm driving home alone.

Dr. Lisa Belisle:

Well, Mark, what can people do to help out Neighbors First?

Mark Carter:

Neighbors first is 100% volunteer and 100% donation based. So the monies that people donate to Neighbors first are used to buy building materials. And people donate their time and their money to pay for their own tickets or their own expenses to go with us on project trips. And so if people are interested in helping, obviously they can look on our website and see the type of project we've been doing and understand more about how we work. And of course, donations make the work happen. If we had more donations, we could do more work. So that's the equation. So we're always looking for people to partner with us. And even the smallest of donations like I've been talking about, even very small donations go a long ways. We put that money right to work.

Dr. Lisa Belisle:

What is your website?

Mark Carter:

It is neighborsfirst.org well, Mark, I'm really

Dr. Lisa Belisle:

thrilled to have spent time with somebody who is, as you said, kind of living the life that you hope your children would live and providing an example to people that we can help our neighbors, whether they're neighbors here or whether they're neighbors overseas. So I appreciate your driving the. What is it five, six hours?

Mark Carter:

Yeah, four and a half. We'll keep it to four and a half.

Dr. Lisa Belisle:

Four and a half hours down from Presque Isle to have a conversation with me about Neighbors first. And I hope that people who are listening take the time to go to your website, think about donating, possibly helping out in some way and really getting involved in a way that help helps them, helps you with the compassionate work that you've been doing. So thanks for coming in. We've been speaking with Mark Carter, founder and President of Neighbors First.

Mark Carter:

Thanks for having me.

Dr. Lisa Belisle:

You have been listening to the Dr. Lisa Radio Hour and podcast show number 119, World Wellness. Our guests have included Dr. Nathan Nickerson and Mark Carter. For more information on our guests and extended interviews, visit drlisabelisle.com the Dr. Lisa Radio Hour and Podcast is downloadable for free on itunes. For a preview of each week's show, sign up for our E Newsletter and like our Dr. Lisa Facebook page. Follow me on Twitter and Pinterest and read my take on health and well being on the Bountiful Blog. We love to hear from you, so please let us know what you think of the Dr. Lisa Radio Hour. We welcome your suggestions for future shows. Also let our sponsors know that you have heard about them here. We are privileged that they enable us to bring the Dr. Lisa Radio Hour to you each week. This is Dr. Lisa Belisle. I hope that you have enjoyed our World Wellness Show. Thank you for allowing me to be a part of your day. May you have a bountiful life.