25 Years of Continuous Positive Pressure

In our last newsletter, we shared the heartbreaking news of the loss of our dear friend Nate Nickerson.

Since then, many members of the Konbit Sante community have reached out with memories, condolences, and also some important questions: What does Konbit Sante look like now? Will there be any changes in the work or in Konbit Sante’s plans going forward?

Here are our answers:

We will continue the work.
We will continue to show up for one another.
We will continue and strengthen the relationships we’ve built over decades.
We will continue to put our faith in the future even during extraordinarily difficult times.

Nate often used the phrase “continuous positive pressure.” For those outside the medical world, the phrase comes from Continuous Positive Airway Pressure, or CPAP, a simple but life-saving intervention used to help newborns and other patients breathe when they are in distress. In many ways, Nate adopted the phrase as a philosophy for life and for Konbit Sante’s work in Haiti.

Not grand gestures.
Not quick fixes.

Just the steady sustained support that helps people keep moving forward, even during difficult moments. The belief that if you keep showing up, keep working together, and keep investing in people, meaningful change will happen.

That spirit continues to shape Konbit Sante’s work every single day.

This spring, severe rainfall flooded roads across Cap-Haitien and surrounding communities. Transportation stalled. Traffic sat for hours. Entire neighborhoods struggled through worsening infrastructure conditions and daily disruptions.

Yet amid the flooding and uncertainty, community health worker Fabien Daniel still organized and led a rally post at Étoile Eben Ezer on April 23rd. As Miss Saint Jean, Konbit Sante’s Community Health Program Manager, shared recently:
“We have to congratulate the employee for his courage and determination.”

Fabien has worked with Konbit Sante for 15 years. For 15 years, he has continued showing up for children and families in his community through political instability, natural disasters, fuel shortages, economic crises, and now the deep uncertainty following major cuts to international aid programs.

In many ways, Fabien’s story reflects the quiet philosophy Nate lived by.

Keep going.
Keep showing up.
Keep helping.

The impact of that steady investment reaches far beyond any single program or moment.

Through his employment with Konbit Sante, work largely supported through USAID funding before it was cut, Fabien has not only impacted the lives of countless children and families in his community. He has also put two of his own children through medical and nursing school.

That is what long-term partnership can do.

And Fabien’s story is not unique. Over the past 25 years, many people who worked alongside Konbit Sante have gone on to become leaders throughout Haiti’s healthcare system and communities:

• Residents at Justinien University Hospital are now physicians leading departments and are training younger doctors
• Staff members are now Ministry of Health officials
• Community health workers have become trusted local leaders
• Students have gone on to build private medical practices serving their communities
• Haitian colleagues are now educators, advocates, and board members helping shape the future of this work

These stories are part of Nate’s legacy too.

Not because he sought recognition, but because he believed deeply in people and in the importance of staying committed long enough for that investment to ripple outward through families, hospitals, and entire communities.

For 25 years, Konbit Sante has helped strengthen healthcare in northern Haiti not only through infrastructure and programs, but through sustained and supportive relationships with people who continue carrying this work forward every day.

That work continues now. Steadily. Persistently. Together.