COVID-19, a stigma to many, quietly taking toll on South Florida's Haitian community

©Miami Herald

MIAMI — Fritzner Fabre, a healthcare aide who cared for coronavirus patients, spent his final days holed up in a ramshackle North Miami-Dade efficiency, coughing and wheezing. He was 41 when he died at the hospital.

Another Miami man, architect Pierre Martin, suffered from heart troubles and diabetes. Believing he’d simply caught a cold, Martin refused to go to the hospital until it was too late. He was 69 when COVID-19 killed him.

Then there was Pastor Marcel Métayer, who kept his Fort Lauderdale Baptist church open as a spiritual haven for the local Haitian-American community, even as the coronavirus surged during the summer. The faithful noticed Métayer, 63, gasping during his sermons. He blamed his labored breaths on getting wet in the rain.

Métayer had in fact contracted COVID-19, and was admitted to Fort Lauderdale’s Florida Medical Center. He died on July 28. Hours later, one of his assistant pastors, Féquière Espérant, 65, also died from the disease at the same hospital.

These deaths, only a few of over 100 officially documented, underscore a troubling reality: The highly contagious coronavirus is quietly ravaging South Florida’s Haitian-American community. And there are complex cultural factors that make COVID-19 a particular challenge to deal with — and sometimes to even discuss — for many Haitians.

“The stigma is huge,” said South Florida Dr. Sidney Coupet, who heads a public health task force within the Haitian American Coalition of South Florida that was created to improve outreach, testing and services during the pandemic. “A patient who I treated in the hospital … . They discharged her. She beat COVID. The way she was speaking to me, it was as if she was embarrassed. They’re afraid their families and friends would never come visit them again.”

The exact scale of how the virus is affecting South Florida’s Haitian Americans is difficult to gauge because state health officials do not track infections by ethnic groups other than Hispanics. But at least one statistic suggests an outsized impact: deaths.

With Miami-Dade County Commissioner Jean Monestime — the sole Haitian American on the commission — and other Haitian community leaders pressing for more details on COVID-19 victims earlier this year, the Miami-Dade Medical Examiners began adding “Haitian” when a victim’s background could be documented using information culled from families, hospitals and, mostly, funeral homes who submit biographical details to the state for death certificates.

Those numbers have proved sobering. At least 5% of the county’s COVID-19 victims have been Haitian Americans, a group that comprises an estimated 4% of the county’s population. In all, at least 105 of more than 2,000 deaths in Miami-Dade as of the end of August have been members of the Haitian community — and experts say that tally is likely a significant under count because it has not been possible to conclusively trace the background of many victims.

In fact, the first documented COVID-19 victim in Miami-Dade was a 94-year-old Haitian woman, Dieumene Etienne, whose family couldn’t be reached.

Missing data on ethnicity and hospitalizations obscure the pandemic’s real impact, said Nancy Krieger, a social epidemiologist at Harvard’s T.H. Chan School of Public Health. “It’s not possible to discern, with any precision, if Haitians are being disproportionately affected — and that by itself is a problem,” she said.

The Broward County Medical Examiner’s Office does not identify Haitians among the dead but community leaders believe the toll there likely has been similar.

“It’s impacted the Haitian community more than people realize,” said Pauline Louis-Magiste, president of the Haitian American Nurses Association of Florida. “Unfortunately, the data collection doesn’t really give you the statistical number on how Haitian Americans are being impacted.”

But this is clear: More than six months into the pandemic, minorities have borne the brunt of the novel coronavirus, suffering and dying at disproportionate rates than whites. The U.S. Centers for Disease Control itself says “long-standing systemic health and social inequities have put many people from racial and ethnic minority groups at increased risk of getting sick and dying from COVID-19.”

In Miami-Dade, Blacks overall have died at disproportionate numbers — 19% of COVID-19 deaths for a group that makes up 17.7% of the county’s population. Blacks also have been hospitalized at a higher clip.

Like other ethnic groups, Haitian Americans suffer disproportionately from underlying conditions such as diabetes, hypertension and obesity, have less access to healthcare and often work jobs that require them to be out in the community. From nurses to caretakers at nursing homes, Haitian Americans also make up a sizable part of South Florida’s healthcare workers who are most at risk of contracting the novel coronavirus.

And beyond medical conditions, community leaders say that language barriers, belief in herbal remedies over traditional medicines, and historical discrimination and stigma stemming from the HIV/AIDS epidemic, make the community even more vulnerable to COVID-19.

Some Haitians have a hard time accepting COVID-19, said Louis Herns Marcellin, a University of Miami socio-cultural anthropologist and director of the Global Health Studies program.

“They will talk about la fièvre,” Marcellin said, using the French and Creole word for fever, echoing the dismissive tone often used by people in Haiti. “They talk about it in terms that are not necessarily public health terms that we can understand … that we can use or rationalize to generate interventions or prevent action.”

From the start of the deadly pandemic, community leaders and some local elected officials recognized that raising coronavirus awareness among Haitian Americans would be a challenge. Like their friends and relatives in Haiti, they did not understand the virus, did not fully believe in the science of it and were reluctant to change behaviors so ingrained in Haitian culture — like greeting one another with a kiss.

Early on, Coupet, the health task force chair, joined with other prominent Haitian-American doctors and nurses to start the task force under the coalition, a group of about 20 community-based organizations. Along the way, they’ve recorded public-service announcements in Haitian-Creole, spoke on Facebook Live events and called religious leaders to talk about safety measures for their congregants, hoping to employ them in the battle given the community’s strong faith and work ethic.

“When everyone else was practicing social distancing, they were still out there working as taxicab drivers, cleaning ladies, those who are getting paid cash for different types of work,” Coupet said. “And I know that intimately because I take care of those people.”

County commissioner Monestime said he successfully pushed the mayor’s office to include Creole translators at press conferences, and helped establish, with state Rep. Dotie Joseph, a walk-up testing center at North Miami’s Holy Family Catholic Church.

“They’ve taken small steps, but I don’t think they’ve done enough,” Monestime said of county efforts. “This is an issue that has been addressed with the county, over and over again but the county has turned a blind eye when it comes to outreach.”

The office of Miami-Dade Mayor Carlos Gimenez says the county has included Creole versions of every post, video and press release, and had voice-overs for every press conference on COVID-19 done by the mayor. Outreach workers, known as the SURGE team, have also passed out Creole-language fliers in hot spots.

According to the county, $188,427 — or 22% of money spent on outreach — has been spent on Haitian Creole outreach to buy radio spots, produce billboards and posters and newspaper and digital ads. The county is also planning to soon release a series of public-service ads with Miami medical personnel of color.

“It’s a recognition that they’re a high-risk group,” said Myriam Marquez, a mayor’s spokeswoman.

Still, Haitian-American leaders say not enough has been done by Miami-Dade or Broward and

the governor’s office to spread the message to a population that relies heavily on Creole-language radio for information, not social media or YouTube.

“The challenge is how do you communicate with people who are so hard to reach?” said Leonie Hermantin, co-chair of the coalition’s social services task force. “We tried to talk to the County communications office … They sent us to a YouTube channel. That’s what they did. One day we were blitzing a news conference asking, “Kote Kreyòl? Kote Kreyòl?” — Where is Creole? Where is Creole. Again, they referred us to a YouTube channel.”

North Miami Vice Mayor Alix Desulme, whose city is majority Haitian American, wrote a letter in March to Florida Gov. Ron DeSantis pleading that more steps be taken to communicate key points in Creole. He says he received no response about his concerns that little outreach has been done statewide.

“We spent some money on radio,” Desulme said. “As a city I think that we have done the best that we can, not having many resources but in terms of a global outreach, there has not been that.”

Fred Beliard, who owns Island TV, a cable news station that provides news in Creole, said he has received no money from the county for ads. The few spots about COVID-19 that ran during Haitian Heritage Month, between May 4 and May 31, aired free of charge.

“We’ve been trying but we got very little,” Beliard said. “The county hasn’t paid for COVID-19 ads. They only paid for Census.”

This week, after Herald inquiries, the county informed Beliard that it had approved his COVID-19 proposal, and will purchase $7,500 worth of airtime for a 30-day COVID-19 campaign on the station.

In Broward County, Mayor Dale Holness acknowledged his administration hasn’t conducted a specific campaign to target the county’s growing Haitian community. But he said he’s done plenty of interviews on Haitian and Caribbean radio stations.

“I don’t know that we’ve done enough but I believe that the reach is there,” Holness said. “Folks are getting the information that we have available as to what’s going on.”

THE VICTIMS

In both counties, the Medical Examiner rolls reveal a broad cross-section of Haitian Americans who have died. The Haitian elderly, as they have among all racial and ethnic groups, have been hit particularly hard.

Marcel Pierre-Charles Senatus was 80-years-old and one of 25 elderly patients who died after contracting the disease at the Claridge House Nursing & Rehabilitation in North Miami-Dade. On April 18, staffers called his wife to say he was being sent to Jackson North Hospital.

“The nursing home never said what he had. They just said he was running a high fever,” said his daughter, Sabine Senatus. “They couldn’t control it and they had to ship him out. And the next thing, he passed away on the 20th. He was on a ventilator and they said he had a heart attack during the night.”

In a culture where honoring the dead is so important, his funeral was muted — most of his large family was forced to view his funeral on a laptop.

Family could never figure out how Pierre Martin, the 69-year-old architect who died at North Shore Medical Center, caught the virus. He largely stayed at home, although he made some runs to Costco, said his wife, Guyrlda Martin.

“They need to be careful. They need to be cautious,” Guyrlda Martin said of fellow Haitian Americans. “This is not a game. This is serious.”

In Fritzner Fabre’s case, he was much younger — he had been a rapper in Haiti with a group called Majik Clik. In Miami, he toiled in anonymity as a healthcare aide, and had “extensive sick contacts” with people diagnosed with COVID-19, according to a Miami-Dade Medical Examiner’s report. Other major factors in his demise: “poorly controlled” illnesses, including tuberculosis.

A neighbor recalled that in the weeks before he died, Fabre could be heard coughing and wheezing. ‘Neighbor, I’m sick. I don’t have anyone who can make soup for me,’ the neighbor recalled Fabre saying through the door.

The neighbor often brought Fabre soup, leaving it on his porch. Finally, on May 18, a friend drove him to Jackson Memorial Hospital. He died on May 30 after going into septic shock.

Another healthcare worker who died of complications from COVID-19 was 43-year-old nurse practitioner Julie St. Preux.

Her family said she had heart surgery in February but had recovered and resumed working at a nursing home in Hialeah. Her daughter said St. Preux tested positive for COVID-19 after a hospital visit in the weeks before her death — but then claimed she took another test that said she was negative.

St. Preux’s husband denied that his wife had died because of COVID-19. His daughter acknowledged they’d had a “big funeral.”

Evans St. Fort, who runs St. Fort’s Funeral Home & Cremation in North Miami Beach, said accepting that COVID-19 is the cause of death, has been difficult for many of his primarily Haitian-American clients. Business has increased by 30 percent, since the pandemic began in early March.

“I get phone calls every single day from families, at all times, explaining that they are so confused because their loved one was fine, and all of a sudden they check into the hospital and are diagnosed with COVID and a couple of weeks later, that family member passes away,” St. Fort said. “I see a lot of individuals in their 60s and 70s.”

BATTLING MISINFORMATION

As with the public as a whole, community leaders say denial and misinformation have been particularly vexing for South Florida’s Haitian-American community.

When the pandemic hit, North Miami Beach’s Legene Gouin kept working at a Chinese restaurant until he fell ill with a cough and a fever. His boss sent him home. Even though he went to get tested for the coronavirus, Gouin — who suffered from hypertension and obesity — kept running errands, assuring relatives he was fine except for a stomach ache.

“We told him to go to the hospital because there was this disease out there. He said ‘No,’ “ said the mother of his children, Marie Fleurimond.

Fleurimond discovered Gouin, 51, dead on the couch of his North Miami Beach house on July 2. Two weeks later, a testing lab — not knowing that he died — called Gouin’s cellphone to say his test results were ready. Fleurimond said the representative hung up the phone when she said Gouin was dead.

Like with the public as a whole, some Haitians have fallen for conspiracy theories — many spread through Facebook and the messaging service WhatsApp. One tale that went around: that masks were being sprayed with poison.

Combating the spread of misinformation has been a huge focus of Sant La, the Miami social services agency that established the coalition and started a morning radio hour on WSFR, a Haitian radio station, during the pandemic to reach the community.

“There is another world that we don’t see. It’s the world of WhatsApp and the miscommunication that happens,” said Hermantin, who works for the agency and has access to scores of community groups, many of them churches, on her cellphone. “We fight to bring the right information and we are fighting with the focus that people are spreading misinformation on WhatsApp.”

UM anthropologist Marcellin and others also note that some in South Florida look to how Haiti itself is coping with the pandemic — in most cases, turning to traditional herbal teas, normally used for coughs and fevers, to prevent or cure COVID-19.

“I love my heritage but we are stubborn when it comes to medicine,” said Louis-Magiste of the nurses’ association. “Unfortunately, COVID is not afraid of your natural herbs.”

Marie Etienne, a nurse who is a member of the task force, has seen the misinformation firsthand.

A few months ago, she volunteered to help at a testing site in Homestead when a young man in his 30s walked by. Staffers beckoned him to come get tested. He shook his head and refused. Etienne walked over and began speaking to him in Creole. Surprised, the man began peppering her with questions: Will you implant something inside me? If I get tested, will I be able to travel back to Haiti? Are you injecting something inside me?

He even asked to see a business card showing she was a nurse. Finally, he agreed.

“Haitians are afraid to come out, for fear of being deported, for fear of being stigmatized,” Etienne said. “We have to debunk all of those myths.”

CHURCHES HIT HARD

Etienne, Louis-Magiste, Coupet and others on the COVID-19 task force say faith leaders are critical in sharing information and raising awareness especially as Haitian-American Protestant and Catholic congregations are starting to get hit hard by the deadly disease.

At the iconic Notre Dame D’Haiti Catholic Church in Little Haiti, funeral services have been held for at least 17 parishioners who have died of COVID-19, according to the parish’s priest, Father Reginald Jean-Mary.

The deaths of the pastors of Renaissance Evangelical Baptist Tabernacle in July jolted the tight-knit Protestant community in South Broward and North Miami-Dade, as well as Haitians as far as New York, who heard the news. Until then, most of South Florida’s Haitian community deaths from COVID-19, had taken place in silence.

While many churches closed their physical doors earlier this year, Renaissance kept its doors open, hoping that requiring masks, adding hand sanitizer stations and limiting congregants would ward off the virus. Many of its congregants are essential workers in healthcare and other jobs that required them to be out during the pandemic.

“As much as they were doing social distancing, they were wearing masks, I said, ‘Come on. You’re in the closed church for hours. It’s just a matter of time before somebody sneezes, something happens and you know one person can infect everybody,’ “ said Jennifer Lovelace, a longtime church member and nurse practitioner who ended up caring for both pastors during their hospital stay at Florida Medical Center.

With both pastors sharing the same microphone, Lovelace said she “strongly” believes they got infected in the Church.

On his hospital bed, Métayer told Lovelace that he planned to move services completely online. He died before he could return. News of his death flooded the social media feeds of Haitian Americans. The church has since been shuttered.

“It’s a heartbreaking story,” Lovelace said. “We are all in disbelief.”

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(Miami Herald Staff Writers Rob Wile and Nicholas Nehamas contributed to this story.

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©2020 Miami Herald