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...
Mar 16, 2015

PIH Haiti Earthquake Recovery - March 2015 Update

Thank you so much for your support of Partners In Health (PIH) and our work to build back better in Haiti after the devastating earthquake that nearly destroyed the capital of Port au Prince in January of 2010.  With the help of supporters and partners, PIH and our sister organization in Haiti, Zanmi Lasante, have made great progress over the past five years. While there is still much to be done, we continue to look forward with optimism, knowing that together, we'll save and improve more lives every day. 

Please take a moment to watch and listen to a reflection from our Co-Founder Ophelia Dahl:

Ophelia Dahl: Haiti 5 Years after the Earthquake

Thank you again for your critical support. 


Feb 24, 2015

University Hospital in Mirebalais, Haiti Feb. 2014

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

Thank you so much for your generous support of our work to continue improving access to quality health care in Haiti.  With your partnership, Partners In Health and our Haitian sister organization, Zanmi Lasante, now provides comprehensive cancer services at University Hospital in Mirebalais.  Below, you'll find an update on this work as told through an interview with oncology program director Dr. Ruth Damuse. 

Dr. Ruth Damuse, oncology program director for Partners In Health's Haitian sister organization, Zanmi Lasante, helped establish PIH/ZL's formal cancer care in Haiti. Zanmi Lasante's oncology program started at its hospital in Cange in the Central Plateau and now serves patients at University Hospital in Mirebalais. The hospital sees an average of 22 oncology patients each day, and patients receive care free of charge. To mark World Cancer Day, Feb. 4, we asked Damuse a few questions about PIH/ZL's cancer care.

Before Zanmi Lasante started offering oncology services, what was likely to happen to a person with cancer in rural Haiti?

Before ZL officially offered oncology services in our network, people in rural Haiti didn't have any chance to have access to cancer care. A few patients would try to get the services in the capital, Port-au-Prince, but the cost would be so high, they would start a treatment and stop in the middle of the process.

Why is it important for patients at University Hospital to have access to oncology services?

Because it was our promise to the community. University Hospital was built to become the center of excellence for quality care in Haiti and to be the place where the next generation of Haitian health professionals would be trained.

How has cancer care evolved at University Hospital?

Since the oncology services moved from Cange to Mirebalais, the number of cases has more than doubled and continues to grow every day. Our diagnostic capacity continues to expand, and we routinely perform biopsies (mostly core needle biopsies) as well as CT scans in order to diagnose and stage patients. In November 2014, an oncology rotation was added to the internal medicine residency program for second-year residents. So far, two second-year internal medicine residents have completed a four-week rotation in the oncology service.

The first patient who had surgery at University Hospital was a breast cancer patient. We are working to integrate oncology care with surgery, and we even have a surgical oncology clinic each week. Oncology cases make up a significant portion of the surgeries performed at University Hospital. Our diagnostic and staging capability has significantly increased since moving to University Hospital, and we can use the CT scanner for staging as well as for procedures such as CT-guided biopsies, something not available anywhere else in the public sector [in Haiti].

Through our integration with internal medicine and our collaboration with other teams throughout the hospital (surgery and mental health, etc.), we are able to offer comprehensive services to patients with a variety of cancer diagnoses.

How has PIH’s partnership with Brigham and Women’s Hospital and the Dana-Farber Cancer Institute helped improve cancer care?

The partnership with the BWH and DFCI is the key to our success. I like to tell our patients that even though they can only see our local team, there is an even bigger team of experts working on their cases. The BWH/DFCI provides ongoing support to our program. The pathology lab of the BWH processes all our samples with no cost, which is vital for the diagnosis and treatment of patients. This level of pathology services is not available anywhere in Haiti.

We hold weekly calls with DFCI-affiliated oncologists to discuss patient care. Each week we review individual patient cases to determine care plans and monitor progress.

DFCI also allowed us to extend our psychosocial team by supporting the salary of an assistant social worker. They continue to support us financially, providing essential tools and programmatic support. They also facilitated the process to have another internist working in the program.

What makes this program unusual?

We are the only center in the country to provide free cancer care and also the only hospital to offer comprehensive cancer care, including palliative care and psycho-social support. We provide the highest quality of cancer care anywhere in the country, and we do so for free.

Jan 20, 2015

PIH Cholera Response in Haiti - Jan 2015 Update

Photo: Jon Lascher / Partners In Health
Photo: Jon Lascher / Partners In Health

In 2010, Partners In Health responded to the devastating 7.0 earthquake that struck Haiti, as well as the subsequent cholera outbreak. Above, community health workers conduct public outreach as part of the cholera vaccination campaign.

Thank you for supporting Partners In Health and our work to eradicate cholera in Haiti.  Below is a reflection written by PIH/Haiti staff member Ralph Ternier, 5 years after the earthquake and subsequent cholera outbreak.  Your support enables us to continue making progress and saving lives in Haiti. 

Ralph Ternier is director of community care and support at Zanmi Lasante, Partners In Health’s sister organization in Haiti. Here he reflects on his experiences during the country’s earthquake in 2010—and the five years since.

A few days ago we celebrated the 211th anniversary of the famous Haitian Independence Day. This tiny land of contradiction has witnessed stunning and unfortunate events over the last two centuries. Some people keep saying the nation is damned; others who are attached to the country speak of hope, solidarity, and compassion, especially after having faced one of history’s most destructive and deadly earthquakes.

In a few days we will remind ourselves how fragile and precious life can be. For many years into the future we will tell our grandchildren about that day of sorrow. Some might refuse to believe such a narrative. Even I was incredulous toward what the Dominican taxi driver told me that Tuesday evening five years ago.

I had left Haiti to go to the Dominican Republic at 4:30 p.m. on January 12—20 minutes before my people plunged into the deepest desperation. I returned to Haiti two days later in a small airplane with two Partners In Health colleagues. From the sky I could watch the chaos on the ground—people with their belongings running away from death, an abyss of curse.

From that day on, we spent the whole year rescuing, saving, and relieving as many as possible, guided by one label: TNTC (too numerous to count). Then the first cholera epidemic in the country’s history hit, stressing and weakening the health system further.

But always there is opportunity.

We have learned particularly in this last decade that all these unfortunate events and disasters must be a platform to revitalize the health system. Five years after the terrible earthquake, it is important for us to reflect on our major achievements, impediments, and perspectives.

In addition to the roughly 1 million people that received emergency and general health care, we pride ourselves on the legacy of the teaching hospital in Mirebalais that came from all the international support. During 2010, Zanmi Lasante (ZL) understood that this massive contribution to the public health sector wouldn’t be productive without sustaining the community health structure. Therefore we formalized all ZL community activities through the new department of community care and support.

Very often we ask ourselves how we would adequately fight cholera without these tireless workers who still go door to door to raise awareness of the epidemic and ensure that community members are safe and protected. In many narratives we’ll frequently link cholera and the earthquake: they happened the same year, they created panic and chaos, and they took away so many lives.

But we have become stronger in the wake of these disasters. Our network of community health workers has grown to 350 members, and we now have several thousand accompagnateurs—compared to fewer than 100 before 2010.
Challenges, however, persist. The earthquake destroyed most of the important public health facilities in several departments, especially in West, where the needs of the surrounding population dramatically increased. To respond to these needs, the community network stepped up to expand services, such as rehab and mental health care in the communities.

A few days ago, I drove into the so-called downtown of Port-au-Prince. At points I felt as if I was living in 2010 as rubbles is still piled on many avenues. One of my friends in the car from the diaspora asked me how I kept morale and stayed in the country. With a beaming smile I responded with what someone had told me the day I came back: “This country cannot be worse; it can only be better.”

After five years, everything that we are doing for the health system, for the patients, must be better, better than what it was before 2010, better than what it was during the cholera outbreak—better for the sake of our beloved lost during these tragedies.

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