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...
May 20, 2014

PIH Haiti Earthquake Recovery - May 2014 Update

The following article was published by Observer News on March 19, 2014.  In this article, the author discusses the successes observed during his most recent trip to Haiti, including PIH's University Hospital in Mirebalais, made possible with your support to help build back better in Haiti after the earthquake. 

Haiti Revisited, 2014

In nearly 14 years of witnessing the changes in Haiti, this trip was the first time I have seen real change.


Love. Hope. Determination. Pride. Extreme Poverty. Progress. Resilience.

These are but a few of the words that come to mind after my most recent visit to Haiti. I have been witnessing the ups and downs of the people of Haiti since my first visit to the country in April 2000. These people have suffered from corrupt governments and endured some of the most horrific natural disasters ever since they became free from slavery in 1804.

A gentleman in his sixties who moved to Port au Prince from a comfortable lifestyle in Canada told me once that Haiti was a “land of failed good intentions.” He explained that most of the aid going to Haiti was from churches and service organizations from the United States and around the world. People with the most loving and giving hearts bringing clothes, love, food, candy, beads and a labor force to build new churches, church schools and to feed countless starving children and adults.

For many years I was one of those Good Samaritans. And perhaps there is a need to fill a gap, to build hope and to provide food and a sense of belonging to something. Certainly, there was an urgent need to give them a leg up after the recent natural disasters.

But Jack Wall, the Canadian, and his wife, and now his daughter, taught me what Haitians really want. They do not want a handout. They do not want someone else coming to their country to tell them how to live and what to do or what to believe. For, in doing so, we help to create a country of beggars with poor self-esteem and a lack of dignity and self-respect.

The future of Haiti must be rooted in its people’s desire to be responsible, productive, participatory citizens. The rebuilding of their country must be in the hands of the Haitian people. Begin with what they have. Build on what they know. Work with them in their planning for a sustainable future.

 In my nearly 14 years of witnessing the changes in Haiti, this trip was the first time that I have seen real change. I believe President Michel Martelly and his government have truly accomplished more to empower the people and to help Haitians to help themselves than in any other time in the past. New roads, bridges, sanitation, health care, foreign investment, jobs, a safer environment policed by the Haitian police — all are but a few of the advancements I noticed.

There is a rebuilding of the country from the bottom up and from the top down. This was the first time that I entered the country that the smell of burnt charcoal did not permeate the air. Reforestry projects are increasing. Small rural farmers are getting small loans to practice sustainable agriculture. Haitians teaching Haitians and helping one another.

I visited a hospital in the central mountainous village of Mirebalais. The hospital was founded by the renowned Harvard physician Dr. Paul Farmer. Farmer is perhaps the world’s foremost leader and expert on global health care for the poor.

Named Hospital Universitaire, the facility just celebrated its first anniversary. It employs 56 Haitian physicians, more than 100 nurses and approximately 700 other people, more than 99 percent of whom are Haitian. The hospital covers more than 200,000 square feet and is equipped with the very latest technology. It offers nearly all specialty areas, including infectious disease, surgery, obstetrics, ophthalmology, dentistry, cardiology and oncology.

It has more than 300 beds. The entire medical facility, including dorms for doctors and nurses, is 100 percent solar powered. The cost for admission for care is the equivalent of $1.25 per person.

It serves not only a local population of 185,000 but also special-care patients who travel from Port au Prince, a three-hour trip. Yes, to get the project built necessitated support from around the world, but it is a hospital built, staffed and run by Haitians for Haitians.

I also visited an urban gardening project in a very poor part of Port au Prince. There I saw Haitians teaching and helping their neighbors to grow their own food from seed. They use any container available — from the back casing of an old television to an old tire. Within 15 days, they can harvest spinach to feed their families. Any harvest left after filling the needs of their families is given to their neighbors. A sense of community and trust is built.

In this one project, more than 170 people were growing beans, spinach, cabbage, carrots, tomatoes and other food that was totally unfamiliar to me. It is a project developed by Haitians, owned by Haitians and managed by Haitians.

Don’t get me wrong. I have no false illusions about the challenges that this country faces. With the average age of a Haitian being 22, and 200,000 new people coming into the workforce every year, there is no quick-and-easy fix. But foreigners must recognize that the hand-out philosophy of past decades has not worked to rebuild this country.

With perhaps a million people willing and able to work, does it make sense for our high-school-  and college-age students to go to Haiti to lay cement block for them? Will Haitians feel like they own that church or that church school that we foreigners have built for them? Yes, it makes us feel good about ourselves, but this is not a sustainable, participatory way to build a country of responsible Haitians with self-worth and dignity.

The empowerment of women is helping. Ending the myth that this beautiful island is not safe for tourists and foreign investment also will help. Sitting down side-by-side with Haitians who have a plan for a productive, participatory project and sharing with them ideas for them to reach their goals is, in my opinion, the best road to their future.

Mar 17, 2014

Maternal Mortality Reduction - March 2014 Update

Dear Supporter,

I’m writing to give you an update on our work to save mothers’ lives, and to show what you’ve helped accomplish as a Partners In Health supporter. Every day, thanks to your generosity, Partners In Health (PIH) is working to bring care to the people who need it most. And no patient we serve needs access to care more than a woman in labor.

Amazingly, in 2014, women still die in childbirth—nearly 800 every day. Almost all of these women live in poor countries. In the U.S., death during childbirth was all but eradicated at the turn of the 20th century. In fact, the Brigham and Women’s Hospital, where I serve as faculty, was founded in 1832 as the “Boston Lying-in Hospital.” Why? Because 150 years ago in the U.S., we recognized the need for women to be close to care when delivering their babies—close to doctors and nurses and close to facilities if surgical care was needed.

In the countries where we work, from Haiti, to Malawi, to Lesotho, we’re still working to spread this high level of care. And together with partners like you, we’re moving toward a future with zero maternal deaths—providing the first-rate health care every woman deserves, no matter where they live, and no matter where they’re from.

This past fall, my colleagues released the inaugural edition of PIH Reports, a series exploring innovations in global health care. The first report, The Role of Maternity Waiting Homes as Part of a Comprehensive Maternal Mortality Reduction Strategy in Lesotho, provides an in-depth look at how maternity waiting homes at remote clinics in Lesotho are increasing the number of facility-based deliveries, making childbirth safer in a country burdened with significant challenges. Per every 100,000 live births, 620 women will die in this tiny African kingdom, where rugged, mountainous terrain and a high burden of HIV present unique hardships. And to provide maternal health care to mothers across the nation, we’ve joined key partners to develop an all-inclusive strategy to save women’s lives.

In this report, we share the effectiveness of maternity waiting homes as part of this strategy to reduce maternal mortality. These homes allow women in Lesotho to make the rigorous trek a week or two before they anticipate going into labor. Once there, a woman can relax for the remainder of her pregnancy, knowing she’s only a few yards from trained medical professionals, needed equipment, and medicines. 

And to ensure a safe pregnancy and delivery for expectant mothers in Lesotho, we’ve developed a comprehensive plan—from the community health workers who accompany them to prenatal appointments, to the waiting houses, to the midwives, nurses, and doctors who provide safe deliveries at the health center. And these clinic-based deliveries, with medical staff at the ready and adequate supplies in tow, can be the difference between life and death. I’m excited to report that at the PIH-supported clinic in the village of Bobete, where this comprehensive approach was launched, the number of facility-based deliveries has increased 370 percent since 2009.

If you are interested in reading the report in full, you can download it on our website at

At PIH, we won't settle for a world where mothers die for lack of access to health care. Instead, we’ll expand our work to provide prenatal care, safe deliveries, and crucial family planning to women across the countries where we work—bringing the fruits of medical science to some of the world’s poorest, hardest to reach communities.

On behalf of my colleagues and partners, please accept my sincere thanks for your support and for believing in us.


Dr. Joia Mukherjee
Chief Medical Officer

Feb 27, 2014

Malnutrition in Haiti: Feb 2014 Update

Photo: Rebecca E. Rollins/Partners In Health
Photo: Rebecca E. Rollins/Partners In Health
A young woman has her upper-arm circumference measured at Hôpital Universitaire de Mirebalais, in Mirebalais, Haiti, to help determine whether she's malnourished. 

Need to Know: MUAC and Malnutrition

Spend a day at any Partners In Health site and there’s a good chance you’ll hear a phrase you’re unfamiliar with. Perhaps it’s a clunky acronym or polysyllabic drug name. But don’t worry: Keeping up with the ever-evolving world of global health is hard, even for insiders. In Need to Know, we cut through the complexity and deliver the most pertinent and interesting information on a single subject. Today, we fill you in on mid-upper arm circumference.

What is it?

Mid-upper arm circumference, often shortened to MUAC, is a measurement that allows health workers to quickly determine if a patient is acutely malnourished. PIH, as well as many other organizations, measures the circumference of a patient’s arm at the midpoint between his or her shoulder and elbow.

Why is it important?

The burden of malnutrition is staggering. According to a recent series of articles in The Lancet, more than 3 million child deaths every year are associated with malnutrition. Put another way, nearly half of all children who die each year die because they don’t have access to enough of the right food. Our health workers in Haiti, Malawi, Lesotho, and Rwanda, among other locations, encounter malnourished patients every day. MUAC provides a fast and effective first-line screening method.

How do you make the measurement?

There are specific paper MUAC bands that are color-coded. If the girth of the patient arm falls within the green part of the band, it indicates that the patient is not malnourished. A measurement that falls within the yellow part of the band indicates that the patient may be at risk of malnutrition. Lastly, the red portion of the band indicates that the patient is severely malnourished and at risk of death. Some bands include a fourth color, orange, which indicates the patient is moderately malnourished.

What happens after the measurement is taken?

Well, that depends on the measurement. Generally, if a child is malnourished, we provide treatment with ready-to-use therapeutic food, commonly known as RUTF. These foods are high in fat and protein and fortified with the vitamins and minerals necessary to treat severe acute malnutrition. A few weeks of treatment with RUTF can bring about significant improvements. PIH will often take steps to improve the long-term food security of patients’ families. This might include enrolling people in job training, delivering food assistance, or providing materials for farming.

Malnutrition is a complex problem. Is a paper arm band all you’re using in the fight against it?

Absolutely not. MUAC is an immensely helpful tool but it’s not foolproof. For instance, a simple arm measurement doesn’t tell us whether a patient has kwashiorkor, or protein malnutrition. Furthermore, the accuracy of MUAC diminishes as the child ages. That’s why we’re constantly devising and implementing new ways to alleviate the root causes of malnutrition and catch malnourished children earlier. In Malawi, for instance, we partnered with TOMS to combine the distribution of new TOMS shoes with malnutrition screenings. This approach has allowed us to screen more than 1,000 children, including 70 in need of malnutrition treatment. Meanwhile, in Haiti, we’re deploying mobile health clinics that travel into isolated regions to find patients who have the hardest time accessing medical services.  MUAC is merely one part of a comprehensive strategy that helps us make proper diagnoses and act accordingly.

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