Three volunteer engineers from Maine traveled to the Justinien Hospital this Januaruy to work with Konbit Sante and Justinien Hospital staff to improve the water situation at the Justinien Hospital.
The electrical company - EDH - continues to supply poor quality power to the hospital. Only one of the three phases is working well, which means that 3-phase equipment (e.g., the JUH well #1, the refrigeration system in the morgue and the SOP sterilizer) only works when the hospital runs its generator. The well pump, which KS installed a few years ago, was no longer working. It might have been damaged by the poor power, but we don't know for sure. Instead of replacing the pump with another needing 3-phase power, KS installed a new pump with a single-phase motor. This means the well will work whether EDH or the hospital is supplying power. We worked with one of the local electricians, to install the electrical work for the new pump and with two others on the plumbing. The pump is now working.
The other well pump was also having problems caused by the poor EDH power. It runs on 220V and it wasn't getting the power it needed. We switched the circuit breaker to the phase that was working and made a few other electrical changes. The hospital now has three operational pumps - two electrical and one hand!
Konbit Sante volunteers also completed a major project that they have been working on over numerous trips. After receiving specialized training in the US this fall, our volunteers finalized and completed the installation of a very large hospital grade sterilizer. This sterilizer increases the ability of the entire hospital to sterilize surgical and medical equipment, reducing the spread of infection.
These volunteers have returned regularly and have accomplished exceptional improvements, in partnership with staff at the hospital. We will be meeting in March to conduct an evaluation of the work completed and help finalize a plan for next steps for the coming year. Haiti has been in the news often, but one rarely hears of successes, and Konbit Sante as an organization would like to thank our donors and our volunteers who work alongside Haitian staff to make lasting improvements together.
Thanks to all of you for your continued support!
The Justinien Hospital received a 40 ft container filled with medical supplies and equipment from Konbit Sante, sent in early June and arrived on July 25th, 2012. The container included a large supply of materials for our US volunteers ( a collective of engineers and electricians) who will implement and continue training of local staff to maintain the wells that currently provide water to the Justinien Hospital.
Critical components included a replacement pump and parts for one of the wells that is currently not functioning, a large supply of electrical equipment that will provide safer and more stable power to run the pumps, tubing, tools and parts work to further redirect and isolate waste water.
Konbit Sante staff in Cap Haitien has propositioned and inventoried the equipment and secured it at the hospital. Staff from the US will travel in September to conduct an evaluation and make certain that all items are in place to make the most of our professional volunteers who will be traveling in October and November 2012. The next trip includes plans for evaluation of individual services, such as maternity, to determine the current level of access and make improvements, and to finalize the plumbing needed to bring a sterilizer online in surgery.
In the fall of 2011, four Konbit Sante infrastructure volunteers ( three engineers and an electrician) traveled to the Justinian Hospital in Cap Haitien, Haiti.
When they arrived, the Justinien Hospital had no working wells. Water shortages were critical.
Primary goals of the trip included: troubleshooting and correcting pump problems at the two existing wells at the hospital, finishing plumbing and electrical connections to a new operating room sterilizer installed on a previous trip, hydraulic evaluation of a newly installed well and installation of pumping equipment in the new supply. Electrical supply problems at the #2 Well were responsible for pump failure at that supply, rendering it out of service. Given the failure of the # 2 Well, hospital staff inadvertently over-drafted the # 1 Well in a desperate attempt to maintain a minimal water supply to the hospital. Unfortunately this resulted in the failure of that supply as well, leaving the hospital without any source of supply. The only alternative to the hospital administration was to purchase a minimal supply of water from outside vendors and then also pay for it to be trucked to the hospital. This was an extreme drain on their already overtaxed operations budget. Fortunately this need was communicated in advance of the shipment of a supply container to Cap Haitien by Konbit Sante. New pumps and other replacement parts were included on that shipment and volunteers believed that they had everything necessary to restore both sources back to operation.
Once in Cap-Haitien, the volunteers quickly mobilized and coordinated its activities to achieve the primary goals. In keeping with the Konbit Sante mission statement, the volunteers not only attempt to fix and repair problems, they also work to teach and impart their skills and knowledge to Haitian staff and hospital personnel. Working long and hard hours together, the team was able to replace the pumps at both the #1 and #2 Wells. New piping was installed at the # 1 Well as part of the pump replacement project. In addition, while the source was down, the old galvanized water main connecting this source to the hospital distribution system was replaced with a new run of plastic water piping.
The restoration of the # 2 Well allowed the team to conduct a simple drawdown observation of the # 3 Well. This test allowed the team to determine whether a hydraulic connection existed between the two sources. Given the close proximity to each other, it was suspected that the pumping of one well would affect the water level in the other. As suspected this connection does exist and this knowledge gave the volunteers the information they needed to install pumping equipment that would allow use of the new source in such a way as to not adversely affect the operation of the other. A new Bison hand pump was installed in the # 3 well to accomplish this objective. The Bison pump had been purchased and shipped on an earlier container by Konbit Sante for use on another supply project that had never come to fruition. As a hand powered pump, it requires no electrical supply giving the hospital a dependable supply of water irregardless of the status of the municipal power system.
Secondary trip goals of the group that were also accomplished during this trip included: the installation of two new washing machines and one new dryer, training of hospital staff in the use and operation of the new laundry equipment, cleaning and lastly, organization and cleaning of the infrastructure work area and supply space.
Since their return, we have been working to preposition a large quantity of supplies for water maintenance and repair. These items will be sent by Konbit Sante on their next shipping container in April 2012.
The Justinian Hospital, the largest public facility in northern Haiti, serves over 700,000 people from Cap Haitien and the surrounding community. Years ago the municipal water system failed, forcing the hospital to rely on its small well and an electric pump that was often idled by power outages. In early 2007, damage to the hospital’s electrical supply limited to well pump to running only when the hospital had enough money to run its diesel generators. Medical staff and patients have lacked water for basic hygiene, and the water they had was often contaminated. Polluted groundwater entered the water distribution system through deteriorated pipes.
Volunteers with Konbit Sante have coordinated support from Global Giving, the United Nations, and Rotary International to improve the water system. The first construction project focused on eliminating a major source of contamination, a deteriorated pipe from the well to the storage tank that passed through a waste pile. In 2006, a team of local workers installed a seamless plastic pipe, encased in concrete. The type of pipe was not readily available in Haiti, so Konbit Sante shipped it along with medical supplies in a container.
Work in the summer of 2008 focused on maximizing the output of the existing well. Volunteers and hospital staff installed a new electrical service for the existing well. The improvements included a backup power supply and equipment that allowed the pump to run on generator and the municipal power supply. Hospital staff were very pleased with the improved supply, but the volume was still inadequate for all the various needs.
In September 2008, a local contractor installed a new well. Konbit Sante hired a contractor to build the supporting well house and completed the water supply in 2009.
The estimated yield was 8 gallons per minute, which tripled the water supply; however, the water was contaminated with bacteria and nitrates. Konbit Sante installed a temporary chlorine disinfection system and is evaluating longer term solutions.
Since the well installation, Konbit Sante has continued to work with the hospital to improve its water supply. We have worked with the local plumber to install plastic piping and valves to repair leaks in the distribution system.
In 2010, we used funds provided by Global Giving donors to purchase 10 pedal-activated stainless steel sinks. These sinks automatically shut off to minimize water waste and allow staff to wash their hands without touching faucets. This is key for improving hygiene and reducing infectious disease.
Thank you for your support. Your donations have improved the water supply and quality at the largest hospital in northern Haiti. We continue our work to improve the health system in Cap Haitien, having dedicated considerable resources in 2011 to combating cholera.
The water project that Global Giving donors have supported has helped the Justinian Hospital respond to the current crisis in Haiti. The hospital was spared much physical damage, being distant from the earthquake epicenter. This allowed it to function as a trauma center. Trucks, cars, and helicopters have transported patients to the hospital. They are fortunate to have an adequate water supply at a time when so many items (e.g., sutures, x-ray film, medications) are in short supply. Our organization is working on several fronts to address these other shortages.
Our approach has been to address long term needs in a sustainable fashion. Our commitment and relationships in Haiti have led the UN to turn to us to help coordinate medical care in the northern part of the country. These are difficult times, made more so by the diversion of funds from needs in Cap Haitien and other cities to Port au Prince. The needs of the capital are extraordinary, but so too are the needs in the rest of the country as it responds to the disaster.
Volunteers with Konbit Sante and hospital staff completed construction of the new well in 2009. The new well increased the hospital water supply by approximately six times, bringing it closer to what is needed by a 250-bed hospital.
The team returned in October 2009 to adjust the disinfection system and to test the water quality. Preliminary water tests found the water was contaminated with nitrates. Tests in October confirmed the nitrate concentration exceeded 40 mg/l, about four times the acceptable level. Nitrates are dangerous for infants and pregnant mothers, but are fine for children and adults. Since most of the water is used for sanitation and personal hygiene, and very little water is consumed, the hospital can use the water for its primary needs and purchase water for drinking.
We explored the option of using the original well as a dedicated drinking water supply because it is free of nitrates and bacteria. The hospital administration decided against it. They thought there were viable alternatives for drinking water.
We started the installation of new piping to reduce the water loss through leaks. We are threading new plastic pipe through the existing galvanized pipe. This protects the plastic and eliminates both leaking connections and sources of contamination. Our next steps will focus on repairing the distribution system and improving the plumbing in the buildings.
We are also exploring sanitation solutions that will reduce the nitrates in the ground water. This will be a complex problem due to the urban setting. The hospital administration is resistant to using composting toilets, but until there is a municipal treatment system, this represents one of the better options.
Thank you for your continued support. Your donations have improved the water supply and quality at the largest hospital in northern Haiti.
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