On January 7, 2011, Britt Lake and I visited one of GHESKIO’s seventeen Haitian locations in Port au Prince in order to introduce ourselves and GlobalGiving in person and get a better feel for their work. As soon as we pulled into their property, it was obvious what a well-run facility they operate. From the multi-level security to the comfortable and clean executive/administrative offices, we were clearly in a professional environment. And when we were kindly given a tour by Sylvie Jadotte, during which we learned about their various specialties and services, their work only became more impressive. For patient privacy and confidentiality purposes, we were not able to take photos of patients or beneficiaries, but I can assure you they were there and seemed to be thriving. We saw the impressive physical rehabilitation equipment for post-earthquake surgery patients, the teen center and family planning section, the nutrition room and electronic library patients are given access to, the HIV treatment area, the mother and child wellness center, and the professional intake and assessment area.
Not only has GHESKIO been operating these high-end medical services since 1982 with the support and partnership of organizations like Cornell University and NIH, but they have adapted their services since the earthquake due to the changing community needs as well. They now run a 7,000-person IDP camp (tent city) near their facilities, for which they provide healthcare services, and for which they’ve secured clean water with the help of the Spanish Red Cross and bathrooms with the help of UNICEF. And they’ve started a school that serves two-hundred children from the camp. In addition, they will soon be opening a vocational school with seven skill set areas, which will open in the next few months – we saw the rooms being constructed during our visit.
GHESKIO has clearly found a way to help local Haitians by providing free healthcare in conjunction with other NGOs as is necessary, and they seem able and willing to adapt to the growing and changing needs of their beneficiaries successfully.
Health officials in Haiti are reporting that Hurricane Tomas, which battered the Caribbean nation last weekend could dramatically worsen the cholera outbreak that has killed hundreds of people and hospitalized thousands since it began in October 2010. As of November 8, 2010, the official death toll attributed to the outbreak was 544, with more than 8,000 confirmed cases.
While previous cases had been centered in Haiti's Artibonite and Central Plateau regions, including the city of St. Marc, north of the nation's capital, health officials today confirmed the first case of cholera in Port-au-Prince -- in a 3-year-old boy who lived in a tent city very near the GHESKIO Center.
Health officials fear that the water dumped by the storm will create overflow from latrines and septic tanks that can contaminate the supply of fresh drinking water and contribute to the spread of the bacteria.
Funds are critically needed for clean drinking water supplies, to provide oral rehydration fluid and anti-biotics to individuals who are stricken with cholera, and to continue the GHESKIO Center's efforts to improve the living situation for thousands of Haitians who remain displaced after the magnitude 7.0 earthquake that devastated Haiti on January 12, 2010.
On September 28, 2010, we received the following dispatch from Dr. Jean William Pape, Director of the GHESKIO Center in Port-au-Prince:
"I returned to Haiti today to find out that a bad storm destroyed this past week-end over 300 tents in our Tent City. I am doing all I can to create a permanent village where this population could be moved."
Since the January 12, 2010, earthquake that devastated Haiti – killing thousands and leaving many more without homes – the GHESKIO Center has been providing humanitarian assistance and emergency care to those affected by the disaster, and has continued to provide life-saving medications to people with HIV/AIDS.
Additional resources are needed to continue to feed and clothe the refugees the GHESKIO Center has housed in its Tent City. But even more pressing, because this has been an especially harsh tropical storm season, contributions are needed to allow Dr. Pape to construct the permanent village he noted in his dispatch as critically necessary to house and provide much needed medical and other services to this population of people.
Haiti has entered its rainy and hurricanes season which, because the country’s tropical vegetation was decimated by years of deforestation, leaves the tiny island-nation vulnerable to flash flooding and deadly mudslides. Contributions and donations permitted the Centre GHESKIO staff to move all 7,000 people in the “GHESKIO Tent City” to higher ground. The new site was prepared with gravel, sand, and irrigation canals so that the ground can stay as dry as possibly throughout the season – however there are concerns based on recent experiences in which higher than expected precipitation and hurricane-force winds have wreaked havoc and cost lives. Centre GHESKIO thus is preparing to maintain and rebuild the new site, as necessary, throughout the season, which ends in October.
Care for patients with HIV/AIDS continues. Almost 95% of patients who were on antiretroviral therapy before the earthquake remain on therapy. In order to facilitate care and follow up, Centre GHESKIO needs cell phones to communicate with patients and remind them to take their drugs. There are also outreach efforts being made to get the remaining 5% of patients not currently on therapy back into active HIV clinical management.
The GREATER need is related to tuberculosis (TB). As a consequence of the earthquake, the number of TB cases in Port-au-Prince has increased by almost 200%. TB is a major infectious disease and is passed from person to person through the air in crowded living conditions. During the earthquake, the three major TB sanitariums in the Port-au-Prince were destroyed along with a number of outpatient treatment centers. This means that at least 3,000 TB patients stopped their treatment and dispersed to crowded tent cities WITHOUT their medications. Centre GHESKIO’s laboratory is thus the only one in the country capable of performing TB diagnostics. They have also opened a TB field hospital that is currently providing care to 50 patients. However, the need is much greater (in the thousands), and currently available resources are extremely limited.
Field Update (March 5, 2010)
The GHESKIO Field Hospital and Clinic After the Earthquake in Haiti
By Jean William Pape, MD
Note: This field update paraphrases from dispatches recently published in the New England Journal of Medicine.
The Port-au-Prince clinic of the Haitian Group for the Study of Kaposi’s Sarcoma and Opportunistic Infections (GHESKIO) has become a refugee camp and an emergency field hospital, even as we continue to run our clinic for thousands of patients with AIDS or tuberculosis. Despite our own losses (4 GHESKIO staff members died, 4 were critically injured, 28 lost an immediate family member, and 90 are homeless), we continue to provide medical care around the clock, working with international partners.
The GHESKIO AIDS and Tuberculosis Clinic has continued to provide outpatient care to patients with AIDS or tuberculosis. We also operate an inpatient tuberculosis sanatorium. Since the earthquake, 85% of our 6000 patients with AIDS.. have returned for their medications and clinical follow-up. Patients are being seen in an outdoor courtyard, since neither staff nor patients trust clinic buildings.
Continuing tuberculosis treatment and prevention in Port-au-Prince is critical, since tuberculosis spreads easily in poor, crowded housing. The GHESKIO tuberculosis sanatorium at Signeau collapsed. It housed 80 patients, including several with multidrug-resistant (MDR) tuberculosis; 4 patients died, and a number are missing. We have traced all our patients with MDR tuberculosis, and they are receiving their medications.
The number of people living in the GHESKIO refugee camp has swelled… A census counted 6,109 people, including 1,046 children under 5 years of age, crowded into 1,162 makeshift shelters. The Danish Red Cross visited our camp and noted that it was the most densely populated one they had seen in Port-au-Prince. Most of the refugees come from two large nearby slums...
Obtaining essential supplies has been difficult – the bureaucracy is overwhelming... We have purchased some supplies… and received funds from partner organizations…
The first phase of the disaster in Haiti is now ending, with hundreds of thousands of people having died from trauma. But the second phase promises to be as cruel as the first, with deaths due to exposure, starvation, and infectious diseases. Millions of Haitians are homeless and have no food, clean water, sanitation, or primary health care. And the rainy season is coming…
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