Partners In Health (PIH)

Our mission is to provide a preferential option for the poor in health care. By establishing long-term relationships with sister organizations based in settings of poverty, Partners In Health strives to achieve two overarching goals: to bring the benefits of modern medical science to those most in need of them and to serve as an antidote to despair. We draw on the resources of the world's leading medical and academic institutions and on the lived experience of the world's poorest and sickest communities. At its root, our mission is both medical and moral. It is based on solidarity, rather than charity alone. When our patients are ill and have no access to care, our team of health professi...
Aug 20, 2015

PIH Cholera Response in Haiti - August 2015 Update

Photo by Isaac Benito / Partners In Health
Photo by Isaac Benito / Partners In Health

(Eusuze Murat (center), a WASH hygiene promotion supervisor, and Joseph Rolles (right), a WASH engineer intern, walk with health workers to the town of Larang in Cerca-La-Source.)

Thank you for supporting Partners In Health and our efforts to treat and prevent cholera in Haiti, which has enabled us to continue working in partnership to make measurable progress fighting this disease and saving lives.

Cholera is a centuries-old disease, but it’s a relatively young scourge in Haiti. It entered the country in October 2010 when contaminated sewage from a United Nations peacekeepers’ camp leaked into one of the largest water sources, the 200-mile Artibonite. There have since been more than 745,500 cases of cholera and nearly 9,000 deaths, according to Haiti’s Ministry of Public Health and Population.

The disease is a day-to-day battle for health care professionals working with Zanmi Lasante (ZL), Partners In Health’s sister organization in Haiti.

There’s an immediate side to eliminating cholera, which requires identifying and treating patients for a potent diarrheal disease that could kill within 24 hours. And then there’s the long-term side, which requires infrastructural and behavioral change.

In 2012, Haiti government officials crafted a 10-year national plan to eliminate cholera by responding to both sides of the epidemic—curing those who are ill and preventing further infections by improving water, sanitation, and hygiene (WASH) in rural and urban areas. To support those efforts, ZL formally began a WASH program in January 2014, applying its nearly three decades of expertise in programs related to health; water, sanitation, and hygiene; and disease control. The WASH team promotes behavioral change and supports the construction and rehabilitation of water and sanitation infrastructure at ZL- and government-supported clinics, hospitals, and schools.

“At the end of the day, if people are dying from preventable water-borne diseases, no amount of medicine or health care access will make a difference,” says Elizabeth Campa, ZL’s senior health advisor and advisor to the WASH program. “Without WASH, we do not have health.”

WASH staff face an uphill climb. Haiti is the most underserved country in the Western Hemisphere in terms of water and sanitation infrastructure, according to a 2012 report by the World Health Organization and UNICEF. Only 69 percent of the population has access to a clean water source and 17 percent had access to improved sanitation facilities in 2010.  The latter is comparable to some countries in sub-Saharan Africa and far below the regional average of 80 percent for Latin America and the Caribbean.

The work of the WASH team was critical during the most recent waves of the cholera epidemic, and for the past two years, its rapid response team helped chlorinate water, disinfect homes, provide hand soap, and offer referrals to mobile cholera treatment centers.

WASH is also focused on long-term, community-based programs, such asCommunautes Assainies (Healthy Communities). Its goal is to reduce the prevalence of diarrheal diseases by 25 percent in 20 communities in and around Mirebalais and Cerca-La-Source within a 16-month period.

Since October 2014, the WASH team has supervised and provided technical support for community members who have built nearly 700 household toilets. The goal is to expand that number to 2,000 by January 2016. The team will also oversee the construction of water and sanitation facilities in 20 schools and five health centers over that same period.

A major, yet less visible, part of WASH's work involves improving social norms regarding hygiene and sanitation. The WASH team meets regularly with local leaders to understand common practices. Together they decide when to gather the larger community to inform residents on cholera’s reach in Haiti, its transmission through contaminated water, and its broader economic and social impacts. During those meetings, a volunteer committee is selected and asked to develop a plan for the community’s eventual certification as “open defecation free” (ODF). A local resident is chosen as the WASH community agent, tasked with smoothing neighbors’ transition to a new way of life.

Once activities are in full swing, WASH staff provide advice to community members on the proper location and maintenance of household toilets. Government officials and local representatives assess the community after several months' work and award ODF status once that goal is reached. They also continue to monitor the community to ensure residents remain faithful to their plan.

WASH can already point to success stories. Jeremy, a town in Cerca-La-Source, was certified this month an ODF community, and other towns have built dozens of household toilets and are working to change behavior regarding sanitation and hygiene—arguably the more difficult of the two steps.

Other WASH community projects under way in the Central Plateau include improving water, sanitation, and hygiene facilities in the Belladere hospital and Lacolline School in Lascahobas. And next year, WASH will begin improving facilities at 25 ZL- and government-supported schools.

“All our kids in the ZL network of schools will have a safe place to relieve themselves and access to water points for drinking and washing their hands,” Campa says. “My hope is that this project will plant a seed in our kids’ lives on the importance of sanitation, clean water, and good hygiene behavior.

“Adolescent girls will likely not miss so much school because they'll have a safe place to wash during their menstruation,” she adds. “And our team is striving to target the parents of these kids too in constructing their own household sanitation. The possibilities are endless.”

Jul 16, 2015

Support students in Malawi - July 2015 Update

Photo by Lila Kerr / Partners In Health
Photo by Lila Kerr / Partners In Health

(Above) Cecilia Kanjadza, a student supported by PIH, displays her admissions letter from Mzuzu University in Malawi. She is the first girl from a public high school in her district Neno to be accepted to university.

Cecilia Kanjadza Reaches University from Rural Malawi

Cecilia Kanjadza, 19, scanned the local newspaper in Neno, Malawi, for her name while standing in Partners In Health’s office. It was a moment she wanted to share with PIH staff. Earlier that day she had received a phone call letting her know she had been accepted to college. The newspaper, containing university admissions, would confirm this.

Edwin Kambanga, a PIH officer, laughed, recalling her delight when she found her name listed under Mzuzu University’s degree program: “As soon as she saw her name in the newspaper, she screamed, clapping her hands. She said, ‘This is wonderful!’”

The chance to pursue a bachelor’s degree is truly something to celebrate for Kanjadza and PIH. She is the first girl to be accepted to university from a public high school in Neno, a remote and poor district in the south of the country with a population of 150,000. Families struggle to help their children reach high school let alone university—a pipe dream for most, and certainly for girls without private schooling. Kanjadza is exceptional, both because she worked hard despite significant challenges, and because through a PIH program she was able to pay for her schooling.

Kanjadza’s victory is preceded by many difficult years for her and her family. Her father passed away when she was four and all his possessions went to his relatives. Kanjadza and her brothers and sisters—she is the fifth of six children—were left with nothing. Her mother decided to leave the country’s second largest city, Blantyre, population 1 million, and move the family to Neno, where they live in a small village called Kambale. For six months the family survives on maize they grow in their garden. The rest of the year, her mother must try to find work on nearby farms.
 
To have the financial stability to look after her mother was Kanjadza’s greatest wish. Although she doubted she would go to college, she let herself dream about it. She excelled in math and science classes. Her favorite teacher, Emmanuel Soko, spotted her talent and encouraged her to continue her education.

Doing this would require resilience as well as brains. Schools don’t always have enough teaching materials; libraries and laboratories are a luxury; and for most students, studying ends when the sun sets (95 percent of the population does not have electricity, according to the 2010 Malawi Demographic Health Survey).

Facing these difficulties and financial problems, parents are forced to withdraw their children from school. In PIH’s view, this is a devastating outcome for poor families who, without education, face worsening job prospects and have little hope of improving their situation. Without the money to live safely and comfortably with adequate housing and nutrition, their health will inevitably suffer.

This is why PIH began POSER, the Program on Social and Economic Rights, which addresses social problems that impact an individual’s health. Kanjadza and her siblings receive support from POSER, which she says was the reason she was able to stay in school. POSER supported 2004 students last school term, including 948 girls. With uniforms, exercise books, and school fees paid for by PIH, Kanjadza excelled in high school.

Kambanga, who works closely with Kanjadza and other families through POSER, knows what this means for Kanjadza’s future. “What we like to see when we support students is that their lives change,” he said. Once they go to university, they get a good job and are able to sustain themselves and their families."

It’s a shared victory for PIH and Kanjadza. After that initial phone call about her university admission and a dance of joy in her house, Kanjadza was quick to come to PIH’s office. “If there were no PIH, I could not have got into university,” she said. “I wanted to let POSER staff know.”

Amidst the excitement, there is the hope that Kanjadza’s story will become more common. Members of her community, intimately aware of the challenges she has faced, are now hopeful for other students. “I would like to encourage more girls to follow her example,” said Reuben Menyere, the district education manager. Younger girls have already approached her for advice on reaching college. Proud to be a role model for her community, she beams and advises them to work hard and believe in their goals.

Jun 22, 2015

PIH Ebola Response - June 2015 Update

Rebecca E. Rollins / Partners In Health
Rebecca E. Rollins / Partners In Health

Above: Partners In Health Chief Strategist Dr. Paul Farmer visits the doffing area of Maforki Ebola Treatment Unit in Port Loko, Sierra Leone, in January.

Thank you for supporting Partners In Health and our efforts to combat Ebola and rebuild health systems in West Africa. We're happy to share an article recently published in the Wall Street Journal, featuring PIH's work in Sierra Leone and Liberia that you help to make possible. 

The Wall Street Journal takes a look at the challenges facing Liberia and Sierra Leone’s Ebola-wracked health care systems, and Partners In Health’s efforts to help in each country:

HARPER, Liberia—J.J. Dossen Memorial Hospital, on the southeastern tip of this nation recently declared free of Ebola, has three doctors and spotty electricity. Sixteen of its 46 nurses left during the Ebola crisis. When two motorcycle accident victims needed X-rays, the hospital dispatched them in its only ambulance on a bumpy eight-hour ride to the nearest facility with a machine.

The deadly disease may have receded, but it is still exacting a heavy toll. Run-down, poorly staffed and equipped health facilities allowed Ebola to explode. Since it was identified in early 2014, the epidemic has claimed the lives of 507 health-care workers in three West African countries, all of which already were short of medical professionals. The health-care system was so overwhelmed with Ebola victims that many other patients couldn’t receive care for malaria, heart disease or pregnancy complications. That bill is coming due.

“There are more people who are going to die from Ebola, but not have Ebola,” says Paul Farmer, a Harvard professor and co-founder of the Boston-based charity Partners In Health.

Read the full article.

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