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 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

Nov 3, 2011

Childhood Malnutrition - November 2011 Update

In Haiti, PIH and Abbott harness local resources to fight childhood malnutrition

On November 2, the New York Times published an article about Nourimanba, a peanut and vitamin supplement produced and distributed to malnourished children in Haiti by Partners In Health.

making nourimanba

In Haiti, local communities grow and harvest the peanuts used to make Nourimanba.

“The uniquely Haitian product…is an essential medicine for about 10,000 severely malnourished children a year,” writes Duff Wilson in his article “Making Nutrition a Sustainable Business in Haiti.”

“Even before the 2010 earthquake heaped more misery atop the poverty in Haiti, one in four children had stunted growth,” continues Wilson. “An estimated 2.2 percent of Haitian children under the age of 5 had severe acute malnutrition, according to the United Nations Children’s Fund.”

In early 2008 Abbott Laboratories began supporting PIH projects in Malawi and Haiti. “In early 2009 we began thinking about how we could work with Abbott in a more comprehensive fashion, we decided to focus on our nutrition work in Haiti,” says PIH’s Brandie Conforti. “In December 2009, Abbott leadership toured our work in Haiti and then in May 2010 we formalized our partnership and began laying out plans for a Nourimanba facility. By June we were working on the design.”

“Groundbreaking on the new factory was delayed this year by an outbreak of cholera,” writes Duff. “Now groundbreaking is planned for January and production before the end of 2012.

“While the rudimentary production plant makes about 70 tons of Nourimanba for 10,000 children a year, the new one will push capacity to more than 350 tons and 50,000 children,” according to PIH’s Andrew Marx. “Children receive it daily for six to eight weeks. The new operation will also expand on the 300 or so farmers who have a guaranteed market for their peanut crops.”

“The relationship with Abbott goes beyond the Abbott Fund and it engages their employees,” continues Conforti. “It really has buy-in from the entire company and it models a new trend in corporate giving. What’s unique about this factory is the notion that eventually Nourimanba production will be self-sustaining.”

Read the New York Times article in its entirety.

Links:

Oct 12, 2011

Mirebalais Hospital - September 2011 Update

Wiring moving along quickly, hospital to have power in late September

 

Work is moving along quickly at the Mirebalais National Teaching Hospital. Hurricane Irene passed by with little more disturbance than rain luckily. The electrical crew has arrived and is making impressive progress.

Wiring in major parts of the new facility is now in place.

Wiring in major parts of the new facility is now in place.

This week the crew completed running conduit and pulling wire in the Outpatient, Women’s Clinic, Community Health, Endoscopy and Pharmacy buildings. Furthermore, they have finished the Main Electrical Room switchgear in building 4.1 (mechanical, kitchen and laundry) and have begun running conduit and installing panel boxes in building 2.1 (labor and delivery).

All this was done in less than three weeks. Also, thanks to the National Rural Electric Cooperative Association (NRECA) we will have permanent power to the site within 10 days!

The wall tile in the kitchen is complete and the crew can now start on the floor tile. Once the tile is complete, they will be able to start installing cabinetry and equipment. The tile work is almost complete in multiple bathrooms, including those of Outpatient, Women’s Clinic and Community Health.

In late August, Paul Farmer made a visit to the site. This was a very exciting day for everyone as they were happy to be able to show him the progress that has been made. 

With tiles up, the walls begin to look more like a hospital.

With tiles up, the walls begin to look more like a hospital.

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