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...
Jan 12, 2012

Equip Mirebalais Hospital - January 2012 update

With only a few months until Mirebalais Hospital opens, workers strive to complete the entrance to the new hospital. Roughly 500 patients a day will soon find health care through these doors.

Some will come seek life-saving emergency treatment, others will arrive for routine care and check-ups. All will receive the highest-level of care at this state-of-the-art hospital, run in partnership with Haiti's Ministry of Health.

Once the hospital is running at full capacity, it will have over 30 outpatient consultation rooms, six operating rooms, and space to host trainings with over 200 participants. It will offer innovative technology — some of which was previously unavailable in Haiti — including digital radiography, a full-body CT scanner, teleconferencing capabilities, solar panels that will fully power the hospital during the day, on-site waste water treatment, and wall-mounted oxygen for over 60 percent of inpatient beds. The hospital is also designed to withstand earthquakes and high-winds from tropical storms. 

The photos below highlight many of the recent installments of systems and equipment at Mirebalais National Teaching Hospital:

Medical gas pipes being installed
Medical gas pipes being installed
Generators to power the hospital if power is lost
Generators to power the hospital if power is lost
A Haitian electrician caps the ends of wires
A Haitian electrician caps the ends of wires
Construction begins-Waste Water Treatment Plant
Construction begins-Waste Water Treatment Plant
Jan 12, 2012

Haiti Earthquake Recovery - January 2012 update

On January 10, 2012, the Chicago Tribune published the following article, written by Dawn Turner Trice:

Though world stood still, things moving forward in Haiti

This was the email Dr. Evan Lyon sent Jan. 17, 2010, five days after Haiti's devastating earthquake:

drove past the main central park in (Port-au-Prince) where at least 50K people must be sleeping and it was almost silent.

people cooking, talking, some singing and crying.

people are kind, calm, generous to us and others. even with hundreds lying on the ground, open fractures, massive injuries of all kinds.

there are few dead bodies on the street.

stench is everywhere.

the city is changed forever

Thursday is the second anniversary of the earthquake, and Lyon returned to Haiti last week to check on patients he hopes to bring back to this country for care, to help launch a new residency program for Haitian doctors, and to mark the anniversary.

Lyon, 40, is a Harvard-trained physician and assistant professor of medicine at the University of Chicago. He's also the medical director of the Right to Health Care Program for the international medical and social services organization Partners in Health.

When he arrived in Port-au-Prince last Friday, he headed to a hospital in Carrefour, the neighborhood that was near the epicenter of the earthquake. He was on his way to meet a 20-year-old woman whose bone cancer had metastasized.

Lyon had been working with the woman's doctors from his office in Chicago since last fall and they had asked him to explain to her why she was no longer a candidate for treatment in the United States, as her condition was terminal.

Although the woman's cancer had nothing to do with the earthquake, she and her mother had been living in a tent since the disaster.

"I'll be checking in with other patients who will be able to come to the States for care," said Lyon. "But unfortunately, this young woman isn't one of them."

On the way to the hospital, he said, the first thing that struck him was how quiet the streets of Port-au-Prince were. And that's a big difference even since September, the last time he was in the capital.

"We drove through the downtown in the middle of the city near the presidential palace and there's a massive refugee camp" around the site, said Lyon. "There are about 15,000 people in that part of town. But things are eerily quiet and it almost felt better when more was happening in the streets and there was more activity."

Tens of thousands of people lost their lives in the earthquake, and about 1.5 million were displaced. About 500,000 still live in temporary housing, according to Partners In Health.

Lyon said that though most of the residents have moved out of the capital and into long-term settlement camps, he fears that some people may not have immediate access to health care or other services.

"There's been more engagement, more work and, in some ways, more progress over the last two years than in years before," he told me. "But it still doesn't come close to meeting the size of the need."

As he rode through the city, he said that though the main roads have been cleared of debris and makeshift tents, none of the buildings housing the ministries of health and interior or the Supreme Court have been rebuilt. The landscape has gaping holes and, for miles, bears little resemblance to the Haiti he remembers back when he first arrived in 1996 as a music teacher.

Much work remains in Haiti, including stemming a cholera epidemic that began in October 2010, and continues with about 600 new cases a day. Lyon has been working with a human rights organization that's investigating the cause of the epidemic, which, as of Dec. 25, had killed at least 7,001 Haitians, according to the Haitian Ministry of Health.

Despite all of this, there are signs of hope.

Lyon said one example is a new residency program that was launched this week at a hospital Partners In Health runs with its Haitian sister organization Zanmi Lasante in St. Marc, about 50 miles north of Port-au-Prince.

"Of all the work that needs to be done here, this is entirely optimistic," Lyon said.

He said the program will teach Haitian doctors how to be family practice physicians.

As part of the program, Lyon and other physicians will conduct classes over the Internet and travel to Haiti to teach. The University of Chicago also will start a one- to two-year fellowship in which trained doctors will work and teach in Haiti for about six months a year.

"Two years after the complete destruction of the main hospital and medical school, we're making progress, although it never feels fast enough," he said. "Within a year, a new national teaching hospital (built by Partners in Health and Haiti's Ministry of Health) will open. It's a nice way to think about the anniversary. Despite the many challenges ahead, we're moving forward."

Jan 7, 2012

Response to Cholera in Haiti Update - Jan. 2012

A young girl receiving an IV in her home. The best way to treat cholera is to rehydrate the patient.

On October 20, 2011, NPR published the following article written by Richard Knox about PIH's response to the Cholera Outbreak in Haiti:

After A Half-Million Cholera Cases, Vaccination Will Begin In Haiti

A year after cholera burst upon earthquake-weary Haiti, plans are afoot to begin vaccinating people against the highly contagious disease.

Nearly half a million Haitians — about 5 percent of the population — have already been afflicted and more than 6,500 have died.

But the goal of the vaccinators isn't to stop cholera in its tracks. They can't do that in Haiti with just 200,000 doses — enough for only 100,000 people — that's all the manufacturer can offer.

The aim is to show the world that vaccination against the illness can be done. 

"We believe we can do it. I have no doubt we can do it," says Dr. Louise Ivers of Boston-based Partners in Health, which has negotiated the purchase of cholera vaccine from Shantha, an Indian manufacturer, at $1.85 per dose, or $3.70 per person. (The other cholera vaccine, called Dukarol, costs almost twice as much, she says.)

"I believe the first step is to get started," Ivers says. "As we show success, we can use that experience not just to show it's possible but do it while strengthening the Haitian health care system."

Meanwhile, Dr. David Olson of Doctors Without Borders tells Shots that his group is considering its own cholera vaccination project in Haiti. It would involve several hundred thousand people in northern villages too remote for life-saving treatment to reach. "We think it's a good idea," Olson says.

Ivers says Partners in Health will start vaccinating early next year in two areas — an urban neighborhood in Port-au-Prince, in cooperation with a group called GHESKIO, and a rural village near St. Marc, in the region where the cholera outbreak began last October.

Skeptics abound, but their numbers appear to be dwindling.

Haiti's new president, former bad-boy pop singer Michel Martelly, is for cholera vaccination. His predecessor feared it would incite riots because there wouldn't be enough vaccine to go around. But now the Haitian Ministry of Health says it will soon vaccinate 100 people in a pilot test.

The World Health Organization and the Pan American Health Organization have apparently abandoned their earlier opposition. Ivers says the U.S. Centers for Disease Control and Prevention, formerly reluctant to support cholera vaccination in Haiti, may be having a change of heart.

The WHO quietly took one big step toward making it possible earlier this month by "pre-qualifying" an oral cholera vaccine called Shanchol, the one that Partners in Health will use. That long-awaited seal of approval opens the door to purchase of the vaccine by international agencies. It also makes governments willing to allow importation, and encourages the manufacturer to ratchet up production.

But this doesn't mean all is smooth sailing for cholera vaccination in Haiti. For one thing, there's the matter of who will pay for it.

You'd think a few hundred thousand dollars to launch a vaccination campaign against a big and growing disease threat wouldn't be a problem. After all, donor nations pledged $4.6 billion to help Haiti recover from the calamitous earthquake of January 12, 2010 – the biggest international relief effort ever.

Donna Barry of Partners in Health says nearly 60 percent of those funds, or $2.6 billion, remains to be disbursed.

But yesterday the group's founder Dr. Paul Farmer was in California beating the bushes to raise money for the vaccination campaign, "which I regard as somewhat ridiculous," he says. "We're not entirely pleased that we're going out on a limb, looking for funding that should have been made available very quickly."

Farmer, who is U.N. deputy special envoy to Haiti, pointedly noted that the "so-called international community is associated with the introduction of cholera" to Haiti. All evidence points to U.N. peacekeeping forces from Nepal as the likely source of cholera in Haiti, which had been free of the disease for a century even as it colonized the rest of the hemisphere.

Apart from funding, there's a lot else that's uncertain about vaccinating Haitians against cholera.

For starters, there may be resentment among those who can't get the vaccine. Ivers says this will take careful explanation so that people understand there just isn't enough vaccine for everyone yet. And everybody (vaccinated or not) needs to keep taking precautions against cholera infection.

Then there's the big question of whether and how fast the maker of Shanchol will gear up to make more.

"What I'm afraid of now is there will be competition for the limited amount of vaccine available in the next six months," says Olson of Doctors Without Borders.

The WHO estimates there are up to 5 million annual cases of cholera worldwide, and maybe 130,000 deaths. And currently cholera epidemics are raging in Angola and Zimbabwe as well as Haiti. Still, there's no global stockpile of cholera vaccine — something Farmer and other advocates are pushing for.

Meanwhile, the augurs are not good for Haiti's ability to control cholera anytime soon.

Partners in Health's Barry says new figures from the U.N. Office for Coordination of Humanitarian Affairs show an alarming backslide in access to clean drinking water and sanitation in the displaced persons camps in Port-au-Prince.

In March, about half the camp residents had access to safe water. Now only 7 percent do

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