GlobalGiving.org: Partners In Health Haiti Earthquake Recovery

Haiti Earthquake Recovery - January 2012 update

Laura Soucy — Tue, 10 Jan 2012 20:38:14 GMT

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."

Mirebalais Hospital - September 2011 Update

John Driscoll — Mon, 13 Jun 2011 21:10:39 GMT

The construction of this new hospital in Mirebalais, Haiti, will bring to bear all that Partners In Health and Zanmi Lasante have learned over the past 25 years about hospital design that serves health care delivery, provides a dignified setting for patients in very poor settings, and allows health professionals to train and develop new skills. Workers broke ground on the facility on July 3, 2010. When completed it will house 320 beds, serve an estimated 450 - 500 patients a day, and help to train Haiti's next generation of doctors, nurses and medical workers.

*******

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.

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.

Links:

Click here for thelatest news about Mirebalais Teaching Hospital

Earthquake Recovery - Community Rehab Programs

Christine Hamann — Fri, 11 Mar 2011 19:03:54 GMT

Following the January 12, 2010 earthquake in Haiti, Partners In Health (PIH) and our Haitian sister organization Zanmi Lasante (ZL) immediately began to both respond to immediate medical needs and plan for the long-term recovery and rebuilding of Haiti's public health system. Now, nearly 15 months after the earthquake, PIH/ZL's focus is on these long-term programs, including our community-based rehabilitative medicine program.

In general, patients have sustained one of four types of injuries: a closed fracture which will need follow-up x-rays and cast changes; an open fracture, which requires wound care in addition to typical fracture care; an amputated limb, which often requires additional surgical procedures for prosthesis fittings; or permanent neurological disabilities, which include spine fractures, spinal cord injuries or paralysis. No matter what the injury, these patients require specialized rehabilitation. Recovering from a fracture means not only learning how to walk with a crutch, but also retraining muscles, ligaments and tendons to walk again. Patients who have had limbs amputated or who have been permanently disabled will need occupational therapy to learn how to live with their disability, in addition to ongoing physical therapy to strengthen their muscles. Patients who underwent life-saving surgeries in the aftermath of the earthquake will require months, and in some cases years, of follow-up and aftercare.

PIH/ZL’s Community-Based Rehabilitative Medicine Program has two main components: Clinical Care and Community-Based Care. When an injured patient first comes to one of PIH/ZL's hospitals or clinics, they are seen by a clinician, who then refers appropriate patients to the rehabilitative team. A doctor of rehabilitative medicine handles all medical issues related to this disability. After a complete evaluation, the rehab doctor develops a care plan, 90% of which takes places outside of the hospital with PIH/ZL's team of community health workers. In cases of extreme injury, patients are reffered as inpatients to PIH/ZL's rehabilitation clinic (currently in Cange, while a state-of-the-art rehab center is being planned and constructed in St. Marc).

Back in the community, each patient is visited regularly by a home visit team, a three-member unit: a rehab doctor and/or nurse (for clinical support), a rehab technician (for physical and other rehab therapies), and a rehabilitation educator, who is a community health worker (CHW) who has been specially trained to tend to the needs of people with disabilities. Throughout this time, the patient's CHW visits him or her daily to monitor the patient’s state, providing in-home support and accompaniment throughout the healing process.

Thank you so much for your support of Partners In Health's earthquake relief and recovery programs. If you wish to continue supporting these types of programs, be sure to take advantage of the GlobalGiving Bonus Day on March 16! All donations made on 3/16 will be matched at 30% (up to $1,000 per donor)!

For video on our rehab program, click below:

Links:

Haiti Earthquake Recovery - PIH Annual Report 2010

Christine Hamann — Wed, 08 Dec 2010 17:26:01 GMT

When the earthquake struck Haiti on January 12, Zanmi Lasante was uniquely positioned both to provide emergency care and to help develop and implement plans for long-term reconstruction. ZL provided life-saving care to thousands of injured people, opened clinics to serve more than 100,000 people in four spontaneous settlement camps, and launched a $125-million plan to help rebuild Haiti's public health and health education systems.

By the numbers:

2,961 earthquake victims received emergency care at ZL hospitals during the first month after the earthquake
146,940 patient visits at ZL clinics in four spontaneous settlements
733 volunteers sent to Haiti, including 312 nurses and 239 physicians
1.5 million pounds of supplies moved to Haiti
30,000 children under 5 examined and treated at clinics in settlements
12,000 women seen at sante fanm (women's health) tents in settlement clinics
4,247 psychosocial and mental health services delivered in settlement clinics
500 displaced children enrolled at ZL-supported schools
1,000 vulnerable families trained in innovative farming techniques

Highlights from the response:

Provided emergency care for earthquake victims

In the first hours after the earthquake, Zanmi Lasante took immediate action to provide emergency medical care to earthquake victims both in Port-au-Prince and at our facilities in the Central Plateau and Lower Artibonite. ZL medical and engineering staff arrived at the badly damaged general hospital in Port-au-Prince just after the quake, where they helped restore electricity, deployed volunteer surgical teams and urgently needed supplies, and worked with partners to get 12 operating rooms up and running around the clock.

As thousands of injured people fled the ruined capital, ZL opened up new emergency wards and brought in volunteer orthopedic teams to help perform emergency surgeries at four of our largest facilities in central Haiti. In the first four weeks after the earthquake, these facilities delivered life-saving medical care to 2,961 patients with earthquake-related injuries.

Provided comprehensive primary care for displaced communities

Just two weeks after the earthquake, ZL set up health clinics to serve over 100,000 displaced people living in four spontaneous settlement camps around Port-au-Prince. ZL's clinics provide comprehensive primary health care and social support services — including maternal and child health, reproductive care, HIV and TB testing, mental health care, and malnutrition treatment — to roughly 10,000 people each week.

Each clinic is staffed by a team of Haitian physicians, nurses, psychologists, pharmacists, and lab technicians. ZL also trained and hired local residents to serve as community health workers at each location, improving outreach into the settlements and providing jobs and income.

Strengthened specialized clinical services to meet the needs of earthquake survivors

Many of the more than 300,000 people wounded by the earthquake suffered crush wounds, compound fractures, spinal injuries and other severe injuries that will require ongoing and specialized rehabilitation. Tens of thousands more were scarred emotionally by the loss of family members and friends, homes and livelihoods. To meet their needs, ZL more than doubled the size of our rehabilitative medicine and mental health teams. By the end of June, the physical therapy team had distributed 400 wheelchairs and was providing care to 50 people with amputations. The mental health and psychosocial support team had offered more than 4,200 support services in spontaneous settlements, including psycho-education, counseling, and individual and group therapy.

Broke ground for a new national teaching hospital

In partnership with the Haitian Ministry of Health, PIH/ZL is building a world-class, 320-bed teaching hospital in Mirebalais. The new hospital will train the next generation of Haitian doctors, nurses, and lab technicians, equipping them to take on the challenges of rebuilding and strengthening the Haitian health care system. When its doors open in late 2011, the Mirebalais hospital will be Haiti's largest public hospital outside Port-au-Prince. It will house clinical facilities not currently available in Haiti, including an intensive care unit and six operating rooms, and will contribute to the national goal of decentralizing services, including both clinical care and education for health professionals.

Links:

PIH's 2010 Annual Report

PIH responds to cholera outbreak in Haiti

Christine Hamann — Fri, 22 Oct 2010 20:04:19 GMT

A cholera epidemic has broken out in the Lower Artibonite region of Haiti. As of Friday morning, October 22, more than 2,000 cases and 140 deaths had been reported. PIH has rushed clinical reinforcements and supplies to the region and has mounted a massive community education and mobilization campaign. Community health workers are fanning out throughout the area to distribute oral rehydration salts and soap and to warn people of the need to drink only clean or purified water and wash their hands frequently—the two keys to preventing further spread of the disease.

Starting on Tuesday evening, patients suffering from acute watery diarrhea began arriving at Hôpital Saint Nicolas in St. Marc, which PIH operates in partnership with the Haitian Ministry of Health. By Thursday evening the hospital in St. Marc was overflowing with over 500 patients, of whom 12 had died. Another 437 patients were taken in between 6:00 Thursday evening and 5:00 Friday morning. Other hospitals in the Lower Artibonite region—including PIH facilities in Petite Riviere and Verettes—also reported large numbers of patients with similar symptoms and high mortality rates.

Although the diagnosis of cholera was not confirmed until Friday morning, PIH, the Ministry of Health, and other partner organizations had already launched urgent treatment and prevention efforts. The most effective treatment for both cholera and other acute diarrheal diseases is oral rehydration; and prevention hinges on providing access to clean water.

Zanmi Lasante dispatched reinforcements for both the clinical and community outreach efforts from our team in Port au Prince and our facilities in the Central Plateau. And several longstanding partner organizations have rallied to support PIH and the Ministry of Health on both fronts. Operation Blessing, which has worked closely with PIH to provide clean water in settlements around Port-au-Prince, rushed to St. Marc to help. Two branches of Médecins Sans Frontières (MSF-Spain and MSF-Belgium) deployed clinical team reinforcements to St. Marc and Petite Riviere, where they are taking the lead in setting up systems to separate cholera cases from non-cholera cases.

Lack of access to clean water has long been a major threat to public health throughout Haiti. Zanmi Lasante has worked with partner organizations to combat the problem on many fronts:

at the household level—by building and supplying filtration systems to households in isolated areas;
at the community level—by constructing spring caps and piping water to kiosks for use by local residents; and
at the national and international level—by advocating for changes of policy and commitment of resources to make clean water available to all as a fundamental human right. In a study published in 2007, PIH documented the damage to public health caused by a 10-year delay in disbursing loans that had already been approved for construction of water improvement projects in several Haitian communities, including St. Marc. Learn more.

As we work urgently to treat cholera patients and halt the epidemic before it can spread to the crowded settlements around Port au Prince, PIH will continue to emphasize that strengthening public infrastructure, especially the water supply, must be a top priority in post-earthquake reconstruction efforts.

Links:

Stand With Haiti - Six Month Report

Christine Hamann — Fri, 23 Jul 2010 17:41:11 GMT

SIX MONTH REPORT OVERVIEW

Six months have now passed since a devastating earthquake ripped through Haiti. Every day since January 12, 2010, Partners In Health (PIH) and our sister organization Zanmi Lasante (ZL) have been working to help Haiti's people build their lives and their country back better.

Although not yet fully funded, the Stand With Haiti Fund we established in March has provided PIH and ZL with the resources and the strategic vision to begin the process of building back better in Haiti through a combination of: strengthened clinical services at our existing health centers and hospitals as well as in new facilities; expanded social and economic support programs for the most vulnerable patients and community members where we work; and investments in long-term, strategic revitalization of the public health and medical education systems.

Over the past 26 weeks, our efforts have saved lives through emergency critical care and surgical services; helped seriously injured patients regain mobility; resettled abandoned and disabled children into a safe group home; comforted communities in need of spiritual and emotional solace; and provided strategic planning assistance to Port-au-Prince's General Hospital (HUEH) as well as the Haitian Ministry of Health (MOH) leadership.

Hundreds of thousands of earthquake survivors across the Central Plateau and Artibonite Valley regions as well as in four large settlements of displaced people in Port-au-Prince have benefitted from the generosity of all those who supported and continue to give to PIH's Stand With Haiti Fund. This report summarizes what you have helped make possible since that terrible afternoon in January. For more detailed information and multimedia content, please visit www.standwithhaiti.org/six-months.

We have been able to respond to the disaster and embark on the work of building back better thanks to the extraordinary generosity and solidarity of individuals, organizations, and institutions who through June 30 had contributed a total of $85 million, including a substantial sum designated specifically for long-term rebuilding and strengthening Haiti's public health system.

Of that amount, we have expended $26.6 million to date. The table below (see link: PIH Six-Month Report: Overview) presents a summary of how that money has been spent and the graph provides a projection of how we intend to use the remaining $98.4 million of our planned $125 million fund over the next two years. These projections are consistent with the general parameters outlined when the Stand with Haiti Fund was established. They have been and will continue to be refined and adjusted regularly based on our understanding of shifting needs and priorities.

Our work is far from over. The rubble has yet to be fully cleared. More than a million people are still living under tents, tarps, and makeshift shelters in crowded encampments, with limited access to food, water, sanitation, schools, jobs, and social services. Many people are still in pain, hungry, and desperate.

But with over 25 years experience and a local staff of nearly 5,000 people working through an expanding network of public hospitals and health centers, we're committed to continuing to provide quality health care to those who need it most and striving to bring long-term strategic improvements to Haiti's public health and medical education systems. To do this, we will use the same values and approach that have guided our work for many years: solidarity with the Haitian people and the communities in which they live; partnership with the government of Haiti and other institutions and organizations; and a comprehensive vision of what is comprised by health care.

Links:

Attachments:

PIH Six-Month Report - PDF (PDF)

Mental Health Services at Partners In Health/ZL

Father Eddy Eustache — Fri, 07 May 2010 19:03:43 GMT

PBS NewsHour recently interviewed Father Eddy Eustache, a priest and psychologist who serves as Director of Mental Health and Psychosocial Services for Zanmi Lasante, PIH's sister organization in Haiti. Below is an excerpt from the interview. Read the full piece at the link below: Q: What are the most common mental health challenges you are seeing in Haiti at this point?

A: Almost four months after the earthquake we are seeing people having various kinds of emotional distress responses. These include difficulty sleeping, heart palpitations, somatic complaints, and significant sadness, worry and anxiety. Some of these can be seen as normal reactions to a highly abnormal situation. However, the level of distress for many is severe. We also see people who have developed psychotic reactions, and other more acute mental health problems, since the earthquake.

One major challenge is a general lack of services in Haiti to address significant mental health problems. Haiti had few mental health professionals, and limited organized mental health services prior to the earthquake. There was not a clear understanding of the prevalence of mental health problems in Haiti prior to the earthquake, but we can expect that the mental health dimensions of the earthquake, overlaid on the pre-existing issue of poverty, will have significant ramifications for mental health. Our hope is to further develop the services needed to assist with such problems, in a culturally appropriate way, for the long-term.

Q: How are mental health workers trying to address the needs?

A: Interventions are needed that respect people's capacity to recover from such an event, that do not pathologize normative responses to such a terrible circumstance, that do not risk harm to individuals, that have some evidence for their efficacy, and that are appropriate to the Haitian context.

At Zanmi Lasante [Partners in Health] we have expanded our team to 17 psychologists from three prior to the earthquake, and to more than 50 staff focused exclusively on mental health and psychosocial services. We have been working ... to provide communal opportunities for mourning, to develop community-based supportive interventions in collaboration with schools and churches, and we have expanded basic clinical services.

This has included training of doctors and nurses in management of acute mental health problems, and planning for expansion of the system of care to include community health workers attuned to mental health, and development of effective referral networks to providers.

Read the full interview at the link below:

Links:

Q&A: Addressing Mental Health and Trauma in Haiti

Stand With Haiti: Three-Month Progress Report

Christine Hamann — Mon, 19 Apr 2010 20:54:19 GMT

In response to the devastation following the 7.0 magnitude earthquake that ravaged Haiti on January 12, 2010, Partners In Health (PIH) and its sister organization, Zanmi Lasante (ZL), with 4,403 local staff and a large network of public hospitals and health centers, immediately began delivering treatment and care to earthquake survivors in Port-au-Prince and across the Central and Artibonite Departments.

The long-term ramifications of this disaster will be significant and far-reaching. To address them, PIH/ZL has taken on relief, recovery, and rebuilding activities in three core areas: clinical services, social and economic support services, and health systems strengthening. This report outlines PIH/ZL’s activities in these program areas from January 12 through April 12, 2010. Highlights include:

• In the first month after the earthquake, PIH/ZL emergency medical efforts treated 4,961 critically injured patients through facility-based interventions, set up, stocked, and staffed 25 operating rooms, identified roughly 1,000 additional patients and referred them to collaborating medical relief organizations, and evacuated 140 patients to the USNS Comfort and hospitals abroad.

• PIH/ZL established clinics in four settlement sites to serve the basic healthcare needs of 88,000 displaced people in Port-au-Prince. Since January 25, these four clinics have treated more than 50,000 patients.

• During the first three months, PIH/ZL hired 358 additional local staff, shipped more than 422 tons of medicines, supplies and equipment, and deployed 516 clinical and technical volunteers.

• PIH/ZL has already supported more than 10,000 people and their families with social or economic support in the form of cash, food, agriculture assistance, educational support, jobs, or other services over the course of the past three months.

• Bolstered capacity at our 12 clinical sites in the Central Plateau and Artibonite to meet the needs of both thousands of injured survivors and tens of thousands of displaced people, who are in need of basic health services.

PIH/ZL approaches “building back better” in Haiti with the same values and principles that have guided our work for many years, namely: partnership with the Government of Haiti to achieve sustainable, long-term improvements to the country’s public health system; pragmatic solidarity with the Haitian people to address their basic needs; and a comprehensive approach to help lift communities out of poverty.

Please open the attached PDF for the full report.

Attachments:

PIH Three-Month Progress Report (PDF)

Partners In Health's Medium and Longer-Term Plans for Earthquake Recovery

Christine Hamann — Fri, 26 Mar 2010 16:35:44 GMT

The long-term ramifications of the earthquake in Haiti, already the poorest country in the western hemisphere by a wide margin, are staggering. One month following the devastation, PIH began to move beyond the acute phase of response in order to formulate and execute medium and long-term plans for the rebuilding of lives and livelihoods, communities, and the public health system. Though we are sure our plans will continue to develop as the needs on the ground evolve, on February 12, 2010, PIH launched a Fund for Building Back Better in Haiti to support a three-year recovery and rebuilding plan with an initial budget of $125 million.

Below we have outlined the current projected activities and efforts that the Fund will support with the knowledge that the scope of our interventions, and therefore the size of the Fund, may grow in the months to come.

Medium-Term Activities (1-6 months)

1. Continue urgent medical and surgical care operations for earthquake survivors.

PIH/ZL will sustain our expanded volunteer deployment, logistics, warehousing and distribution system in support of the increased demand for medicines, medical and surgical supplies and equipment and the need for specialized surgical and medical teams to reinforce and help train our existing staff. These efforts will continue to serve patients in Port-au-Prince at the University Hospital (HUEH) and at PIH/ZL facilities in the Central Plateau and Artibonite Departments.

2. Sustain community-based care and mobile clinic outreach within Port-au-Prince.

PIH will operate mobile clinics serving between 80,000 and 100,000 displaced people within five or six communities in Port-au-Prince to provide comprehensive primary health care, reproductive health services, treatment of pediatric malnutrition, HIV testing and referrals, and disease treatment and prevention.

3. Provide assistance to displaced people and affected households in PIH/ZL's catchment area.

In collaboration with partner organizations and through our existing community-based social and economic support initiatives, PIH/ZL will help strengthen food & agriculture, housing, safe water, education, and income generation programs for the most vulnerable people in the areas we serve.

4. Build capacity for acute trauma counseling and overall mental health services within our sites.

With key partners, PIH/ZL is conducting an initial needs assessment at our sites and in the spontaneous camps. The assessment is particularly focused on identifying consultation psychiatry needs, developing a training plan for staff and community health workers, outlining additional medicine requirements, and defining key psychosocial support activities.

5. Support the social and economic needs of Zanmi Lasante's more than 4,000 staff.

Almost all our Haitian staff have lost family members in the earthquake and are taking in relatives who have nowhere to go. To ensure these front-line workers, the majority of whom are medical personnel and community health workers, can continue to perform their jobs over the long-term, PIH/ZL is distributing financial assistance to staff to help them with basics during this very difficult time.

Long-Term Initiatives (2-3 years)

1. Expand capacity for specialty clinical services needed to care for earthquake survivors.

PIH/ZL will develop new facility and community-based capacity for post-operative care, rehabilitation and physical therapy, and mental health services by forging strategic partnerships, recruiting additional expertise, and conducting extensive training. Surgical care will be greatly strengthened at all of our facilities in the Central Plateau and Artibonite, with higher-level surgery available at five hospitals and capacity for emergency obstetrical care available at all sites.

2. Strengthen our clinical operations and the public health system.

In partnership with the Haitian Ministry of Health, PIH/ZL will strengthen our network of community health workers as well as the clinical operations at 12-15 hospitals and health centers that provide comprehensive health care to our catchment area in the Central Plateau and Artibonite Departments, which together may grow from 1.2 million to 1.7 million people.

3. Build and renovate public health infrastructure.

Construction and renovation projects, in the form of new hospitals, training centers, pharmacy/warehousing buildings, surgical suites, outpatient clinics, and inpatient wards, will take place at six sites already identified.

4. Strengthen the public medical and nursing education system in Haiti.

A new hospital and teaching center will be constructed in the town of Mirebalais, which is estimated to serve roughly 450 patients per day. The Mirebalais facility will serve as one of Haiti's national teaching hospitals, with PIH/MSPP facilities in the Central Plateau and Artibonite serving as satellite teaching sites.

5. Expand PIH/ZL's programs for social support, community development, and poverty alleviation.

Roughly 2,000 additional community health workers will be hired and trained to work in tandem with mobile clinics, health centers, and hospitals to expand the reach of services. Funding Need

On February 11, 2010, Dr. Paul Farmer articulated his view on the crisis and need in Haiti: "We are in uncharted territory here, and a certain humility about diagnoses, prescription, and prognosis is surely warranted...So what is to be done? ... Might addressing the acute needs of the displaced and injured afford us a chance to address the underlying chronic condition?" After some reflection, he summarized, "So the diagnosis is: natural disaster in a setting of great and longstanding privation... Haiti needs to build back better and stronger than before. This, then, should be the treatment plan."

While PIH/ZL's role in building back better is only a small piece of Haiti's overall plan, our vision of accompanying Haiti has resounding effects in the small country and beyond. As of February 12, 2010, we have raised roughly $57 million toward our $125 million plan to build back better. Our expectation is that $15 million will be spent before July 1, 2010, and an estimated $110 million in the two to three years that follow. We welcome and encourage both longstanding and new partners to contribute to the STAND WITH HAITI Fund as a way to engage in sustained, long-term recovery to rebuild lives, livelihoods, and communities.

Links:

PDF version - Stand With Haiti Fund

Standing - and Walking - in Haiti

Christine Hamann — Thu, 25 Mar 2010 14:51:32 GMT

With thousands of survivors needing amputations to save their lives following the January 12 earthquake, the PIH/Zanmi Lasante team has been increasingly concerned with how to help amputee patients literally get back on their feet.

A partnership with Hôpital Albert Schweitzer (HAS) is starting to fit these patients with prosthetic devices. With a well-stocked factory in partnership with prosthetics manufacturer Hanger, HAS has already begun accepting patients referred by PIH/ZL from the Central Plateau and Artibonite regions.

In early March, the PIH/ZL team brought three patients with lower extremity amputations to HAS for their prosthetic fitting. Staff noted the immediate change in the women as soon as they received their new legs--they were each able to stand up and walk with the aid of parallel bars, and quickly left behind their fears, prejudices, and doubts with each determined step. PIH/ZL staff also report that the three women are now able to walk as well as kick soccer balls - and next up on their agenda is dancing.

These three women are just a few of the patients who have undergone procedures at our hospitals and will be receiving prosthetic care through this partnership. Thank you for enabling this work!

3 Weeks Later: An update on PIH's Earthquake Response

Christine Hamann — Wed, 03 Feb 2010 18:26:13 GMT

MedEvacing a young patient in Haiti

PIH had more than 100 doctors, 600 nurses, and a total of 4,000 Haitian employees on the ground in Haiti working from 12 existing PIH medical facilities in Haiti before the earthquake struck on January 12th. • PIH quickly established field hospitals in Port-au-Prince, helping set up 20 operating rooms, 12 of which were able to function around the clock. • PIH established a comprehensive triage and relief transfer system to move patients back and forth from Port-au-Prince to PIH sites in the Central Plateau and Lower Artibonite Valley. • PIH is evacuating patients in critical condition to hospitals in the United States and Dominican Republic as well as to the U.S.N.S. Comfort. • PIH has sent 66 plane loads with more than 235 medical volunteers – orthopedic surgeons, anesthesiologists, surgical nurses and other medical professionals – and roughly 100,000 lbs of medical supplies to support the large network of PIH’s local health care providers already working in Haiti. • The long-term ramifications in Haiti are going to be significant and far-reaching with a new, large group of vulnerable and displaced people. PIH has the experience and commitment to Stand With Haiti for many years to come.

Looking ahead, PIH’s efforts will be spent in three core areas: 1) supporting the public sector’s ability to provide health care; 2) mobilizing people at the grassroots level to participate in the health care system; and 3) addressing the mid- and long-term health, social, and economic ramifications of the resettlement of tens of thousands of people from Port-au-Prince to areas where PIH works.

A surgical team at PIH's main hospital in Cange, Haiti

The church in Cange, Haiti - turned into a patient ward

Links:

Haiti: From Rescue to Reconstruction

Dr. Paul Farmer — Mon, 01 Feb 2010 17:50:06 GMT

Dr. Paul Farmer, PIH co-Founder and United Nations Deputy Special Envoy for Haiti, recently testified at the “Haiti: From Rescue to Reconstruction” hearing of the U.S. Senate Foreign Relations Committee.

"I am at my core optimistic about the possibilities before us and the potential of our support to help rescue and transform our poorest neighbor," stated Paul in his submitted testimony. "The response from citizens of the United States to the recent events in Haiti has been overwhelming and encouraging. There is the promise of solidarity by our leadership to make long-term commitments to the kinds of investments needed in Haiti—and to fulfilling them."

"For two centuries, the Haitian people have struggled for basic human and economic rights, the right to health care, the right to education, the right to work, the right to dignity and independence,"he continued. "These goals, which Haitians share with people all over the world, should direct our policies of aid and rebuilding."

Read and watch the complete testimony at the link below:

Links:

Read and watch Dr. Paul Farmer's testimony

Message from Dr. Evan Lyon of Partners In Health

Christine Hamann — Tue, 19 Jan 2010 00:43:10 GMT

An operating room in the General Hospital (HUEH), Port-au-Prince

Sent on January 17, 2010, 3:34AM, General Hospital in Port-au-Prince (HUEH) by Dr. Evan Lyon of Partners In Health:

can't get through much now but beyond the horror, one very striking reality is that things are totally peaceful. we circulated in PAP in the middle of everything until just now. everywhere. no UN. no police. no US marines and no violence or chaos or anything. just people helping each other. drove past the main central park in PAP 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.

we had a late day opportunity to evacuate 4 patients to the US. these may be the first haitian nationals allowed to leave for the US. but martinique has taken over 200. the DR has taken many many more. so we circulated in PAP looking for urgent cases. found hundreds but picked up the 4 to get out, hopefully to philadelphia. open fractures, gangrene, one 4 year old boy with a leg broken in 3 places, a minor head wound, and now 4 days of sleeping outside with IV fluid and maybe some pain meds. probably none.

at the airport, we drove onto the tarmac to meet the air ambulance. surrounded by marines and UN, massive weapons. a humvee with a gunner turret at the top drove by. the noise from the large transport planes was deafening. us citizens and haitian american citizens leaving by the hundreds on US planes. and our small team of haitian and american docs evacuating a drop in the bucket. my ears are still ringing from the noise of it all.

in contrast, port au prince is silent. no current. no car traffic. people sleeping in the streets but little else. beside the impossible weight and tragedy of this city completely devastated, one lasting impression was the stillness of the city. in shock, tragically sad, but quiet. so good to get away from the airport.

sleeping tonight in the house of a dear PIH friend and doctor. attending to neighbors here and able to rest. safety and the work is with our sisters and brothers in this beautiful, proud, and strong nation.

the safest and best way to be here and help is with our colleagues and friends. wonderful to be in the city, away from the airplanes, and working shoulder to shoulder with people we know and love and will continue work with to mourn, assist, and rebuild this special country.

in the photo you see the first time operating of any kind possible at the main general and academic center.

for press / outreach strategy, we might highlight the generosity and getting it done kindness of the air ambulance team. they also left us all the supplies they had on board - water, meds, IV material, blankets, food.

goodnight everyone. love. evan.

1/17 and 1/18 Update from PIH in Haiti

Christine Hamann — Tue, 19 Jan 2010 00:39:41 GMT

1/18/2010

• From Dr. Evan Lyon, 7:00pm, from the General Hospital (HUEH) in Port-au-Prince: “Incredible progress in our capacity here. 7 ORs running. 10-12 by tomorrow night. We have electricity and will be operating overnight tonight for the first time.”

• Surgical services are ramping up rapidly at the central hospital in Port-au-Prince, where PIH has been assigned by the World Health Organization to coordinate the response of seven other non-governmental organizations from around the world. Five operating rooms are now staffed and performing surgeries around the clock. But they have a desperate need for all the resources required to run a hospital: surgical equipment—anesthesia machines, sterilizers, autoclaves; surgical consumables—alcohol, suture; surgical instruments—scalpels, saws; and the essentials of life—water, food, and fuel. PIH has managed to deliver some essential supplies. With more than 1,000 patients awaiting surgery, large-scale shipments from larger governmental and charitable organizations are urgently needed.

• Hundreds of thousands of earthquake victims need food, water, and shelter NOW. While scattered incidents of violence have made the headlines, they are no excuse for delaying delivery of humanitarian assistance. Our team on the ground, which has been criss-crossing Port-au-Prince at all hours, reports that the city is remarkably calm and quiet amidst the devastation. While security must be a concern wherever and whenever people are desperate to provide for themselves and their families, the most effective response is not military intervention but massive, well-organized, and equitable humanitarian assistance.

• Paul Farmer, PIH co-founder, is in Port-au-Prince today meeting with government officials and international relief organizations to assist in the coordination of the relief efforts.

1/17/2010

• Yesterday, a PIH team of 25 medical professionals (surgical teams, anesthesiologists, emergency room physicians and nurses) arrived in Haiti and were operating and caring for patients within hours after they touched down. Many of the patient they are seeing are very serious cases (mostly amputations). There remains a great need for additional medicines (anesthesia and narcotics), medical equipment (anesthesia machines and x-rays), medical supplies (IV’s, tubing, irrigating saline), and water. PIH will be sending additional planes with medical teams and supplies into Haiti in the course of the next 48 hours.

• Yesterday, PIH succeeded in transporting four very critical patients and one guardian out of Haiti on a MedEvac plane to Philadelphia, where they landed in the early morning hours today. All four patients desperately needed surgical and post-op care not possible under current conditions in Haiti. To the best of our knowledge these are among the first patients evacuated to the US since the earthquake. All four patients survived the trip to Philadelphia and are already receiving the urgent care they need.

PIH Haiti Earthquake Response Update 1/16/2010

Christine Hamann — Sat, 16 Jan 2010 18:56:32 GMT

Treating a patient in the Ministry of Health/ZL Hinche Hospital

Partners In Health: Sat. 1/16 Report from Haiti

Partners In Health (PIH) has been providing vital health care services in Haiti for more than 20 years and has over 100 doctors, 600 nurses and 4,000 employees on the ground in Haiti working from 10 existing PIH hospitals to provide relief services to those affected by Tuesday’s earthquake. PIH surgical teams are currently located in: Port-au-Prince, St Marc, Cange, Hinche, and Belladere and medical teams located elsewhere.

“We find that years of patient investment in building a strong local partner organization mean that we are again in the position of responding effectively to a natural disaster. We are very proud of our team.” – Paul Farmer on Partners In Health and Zanmi Lasante

Here are the latest on-the-ground developments as reported by the PIH team in Haiti: • The PIH team in Port-au-Prince has been designated by the World Health Organization to serve as coordinators at University Hospital (HUEH). In that role, PIH is supporting the administration and staff in restoring services at the city's central hospital, which will also serve as the base of operations for our emergency triage and surgical teams in Port-au-Prince and for referring patients who need more advanced care for transport to our facilities in the Central Plateau and Lower Artibonite. • Today, PIH is sending 25 medical professionals (surgical teams, anesthesiologists, emergency room physicians and nurses) to support ongoing efforts. The doctors and nurses are from Partners Health Care and Dartmouth Hitchcock Medical Center and many speak Haitian Creole. PIH has also sent engineers to assess structural damage and safety at HUEH and PIH facilities. Additionally, PIH is sending over 300,000 bottles of potable water and well as approximately 1,500 lbs of critically needed medicines, medical supplies and equipment. The medical teams and supplies are being transported via four separate planes and set to arrive on the ground in Haiti by later this afternoon/evening. • PIH teams located in the Central Plateau are reporting a wave of massive reverse urban migration among more able bodied Haitians fleeing the devastated and chaotic capital looking for safety, shelter and medical care. PIH experts believe these migration trends will have long-lasting impacts on the settlement patterns across Haiti with profound impact on the public health system and social services. PIH was built in partnership with the Ministry in Health for more than 20 years. • PIH co-founder Paul Farmer flew into Haiti on Friday (1/15). He witnessed the devastation, met with Haitian government officials and reviewed the situation at the University Hospital, confirming the importance of restoring its capacity to serve as the hub of the medical response in the capital. In his capacity as the UN’s Deputy Special Envoy for Haiti, he also met with staff from the UN mission that lost its headquarters and over 100 colleagues in the earthquake to offer his solace and support.

Red Cross workers bringing a patient to Hinche Hospital

Complicated, compound fractures being examined

A post from Tracy Kidder; Paul Farmer and Tracy Kidder on CNN and MSNBC

Tracy Kidder — Sat, 16 Jan 2010 04:57:58 GMT

The catastrophe in Haiti spared the country’s largest – and, I believe, most effective – rural health care provider, Partners In Health. The organization’s principal founder, Dr. Paul Farmer, is on his way to Haiti now with a surgical team. The staff already in Haiti will welcome his arrival, but they have been at work for days now. Indeed, they were some of the first medical personnel to respond to the crisis. This is a large, highly skilled group of about 2000 community health workers, 500 nurses, and 120 doctors. All but a few of them are Haitian. They are spread out now. Thousands of injured people have been traveling from the capital to the hospitals that PIH operates, along with the Ministry of Health, in the Central Plateau – 10 hospitals, all well-equipped and fully functional. Others of the PIH-Haiti team are in the capital Port-au-Prince, where they have set up mobile clinics and where they are now establishing a central base of operations. The plan is to provide emergency care to all comers and to stabilize patients who need higher levels of care and arrange to get them to the PIH hospitals.

Personally, I take hope from the example that PIH has set and is setting again. I think it is one excellent model for the reconstruction of Haiti to come: an endeavor that employs and trains Haitians every step of the way, that builds infrastructure while attending to the basic needs of the poor, that does all it can to strengthen the public sector.

Many people have been writing to ask what they can do. Paul reports, “I just talked to some of my Haitian coworkers who are in Port-au-Prince in the general hospital, and they’ve reported to work. [But] they don't have electricity yet. They don't have the supplies that they need. But there's a lot of Haitian health professionals, doctors, nurses, aides who would like to [do their job], but to do that you need the supplies. You have to have the basics. Gauze, plaster, or other casts. You have to have the equipment that you need. Anesthesia, pain medications, antibiotics. And that's what some of my medical colleagues are asking us for, supplies."

PIH is purchasing and procuring donated supplies around the clock. To aid in these efforts, please consider making a donation to their efforts today.

- Tracy Kidder

Links:

Update from the ZL/MOH hospital in St. Marc

Christine Hamann — Sat, 16 Jan 2010 04:52:09 GMT

Tremors from Tuesday’s massive earthquake were still being felt in Port-au-Prince this morning. “Little earthquake passed this morning, it’s not done yet,” wrote Dr. Fernet Leandre, a physician at PIH’s sister organization Zanmi Lasante. “[People are] crying, yelling… some are still alive under houses’ debris or ruins.”

Like our facilities in Hinche and Cange, the St. Marc Hospital where Fernet sent his message from, is handling many cases from Port-au-Prince. "The crowd of injured continues to arrive at St. Marc, and there's no surgeon," he said. He and Zanmi Lasante staff are working to bring in a surgeon to handle the many orthopedic cases facing the facility.

January 14, 2010 Update

Christine Hamann — Thu, 14 Jan 2010 22:38:44 GMT

Trip to Port-au-Prince reveals more of the tragedy:

A report from Cate Oswald, one of our staff in Haiti, reveals a tragedy more dire than we could have ever expected. Yesterday, she traveled through the Central Plateau to Port-au-Prince and back with our two trucks of meds and supplies. She described the scene:

"We started seeing destruction from Mt. Cabrit (where big rocks lie in the middle of the road) through Croix de Bouquets where it doesn't seem as bad but lots of walls down. Then the scene gets much, much worse. Tonight, everywhere throughout the city, as we drove by the national plaza, there are thousands of people sleeping outside. While I was in Port-au-Prince, there were still aftershocks being felt. I didn't venture into other parts of the city, but as you all know, koze sa pa jwet menm [Haitian saying literally translated as 'this is not a game']."

The trucks met up with PIH staff, including Dr. Louise Ivers in Port-au-Prince, at the UN’s Log Base in Port-au-Prince. Louise was one of two doctors attending at the time, and they had nothing but aspirin until our trucks showed up. The conditions are horrific and people are dying, but in Cate’s report she was hopeful that the supplies will help those at Log Base for the time being. Tomorrow, we plan to move PIH/Zanmi Lasante’s base of operations to the public hospital in the capital city. Some of our colleagues are at the public hospital today assessing the needs and are organizing the next steps of getting supplies, equipment, and additional staff there.

Importantly, given the patients already flowing out of Port-au-Prince to St. Marc and our other facilities outside the city, we cannot leave our hospitals understaffed. So we are recruiting surgeons, anesthetists, nurses, and other medical professionals to go down in the next couple of days to help with staffing, particularly as many of our staff have lost family members and friends.

There are still a handful of our colleagues unaccounted for – we continue to have every hope that it is due to lack of ability to communicate via telephone and the lack of electricity for computers, but we do not know.

Our staff has more or less been working around the clock in Boston and Haiti. We will be paying close attention to our team in Haiti and hope that the volunteer medical groups will help give some of them time to rest, particularly those who have just experience the trauma of being in Port au Prince for the worst of the earthquake’s wreckage.