Thoughts on my visit to Partners in Health (PIH) in Haiti

Apr 1, 2013

I am happy to share this information from our former Associate Provost, Bette Ann Harris, who recently spent a week in Haiti with colleagues from Partners in Health.  Her comments highlight the wonderful work being done, as well as the opportunity to provide important services and support to those most deserving of our attention!    Thanks to BA for these wonderful comments and pictures!

A. Johnson, Provost.

Blog Prepared by Dr. Bette Ann Harris

The view at Mirebelais Hospital - note the beautiful medallions depicting life in Haiti-all artwork done by local artists. (Pictured above)

I recently had the opportunity to visit Haiti to see first hand the health care clinics and hospitals run by Partners in Health (PIH) and their sister organization Zanmi Lasante (ZL) . The work done in Haiti is PIH’s flagship project—the oldest, largest, most ambitious, and most replicated. PIH/ZL operates clinics and hospitals at 12 sites across Haiti’s Central Plateau and lower Artibonite.
I am a huge fan of PIH because of the extraordinary work they do in providing health care to the poorest of the poor both locally and around the world.  Their work is a true partnership with the locals, and a large part of their mission is to educate locals to create sustainable programs, provide jobs and improve the standard of care. 

The rehab techs and me. (Pictured above)

The entrance to the PT Clinic at St. Nicholas Hospital in St. Marc--All sings are in French or Creole. (Pictured above)
The primary purpose of my visit was to see the work that is being done in rehabilitation at the various clinics.  Given how many pressing needs there are for health care in poor countries, rehabilitation services are not a huge priority because of limited funding.  It is impossible to do everything one would like without an unlimited flow of monies. Although no one disputes the need – just other things are more pressing like improving infant mortality rate, controlling infections (I am sure you've all read about the cholera epidemic, TB, HIV) and improving nutrition but after the devastating earthquake in Haiti, it was clear that rehabilitation and basic physical therapy is necessary to help maximize function.

The entrance at Mirebelais Hospital. (Pictured above)


I have been a PH supporter for a long time and I got more actively  involved shortly after the earthquake, and with some wonderful Haitian graduate students from Suffolk University, helped to put together a teaching manual for those who care for or have had amputations.  I am also developing a curriculum (along with PTs from Spaulding, MGH and the IHP) for training rehabilitation technicians and accompagnateurs (community health workers).  To make a long story short, I am now part of an advisory board on rehabilitation and the long-term plan is to have a Center for Excellence in Rehabilitation and Education (CERE) as part of the new academic teaching hospital in Mirebalais.   Currently,  there are small programs in Cange (the original clinic started in the Central Plateau), St. Nicolas Hospital in the port of St. Marc and rehabilitation technicians provide home visits to provide follow up care throughout the Central Plateau. Just in case you are wondering, the results are impressive for those that are able to get services and there is a push to expand care in these programs.

Dr Andre Leroy, Director of Rehab with Jordan,a medical student at the clinic in Cange.(Pictured above)
We had a whirlwind 5-day visit that included hospital and clinic visits to L’Hôpital Bon Sauveur  in Cange, L’Hôpital Saint Nicolas (HSN) in St. Marc and the magnificent new academic teaching center Hôpital Universitaire de Mirebalais (HUM), in Mirebalais.  I was travelling with my friend Jody Adams who is on the board of PIH and a well-known Chef,  her husband Ken Rivard, and her children Oliver and Roxanne.  I spent time with the rehab team while Jody spent time in the kitchens (and the family also did the hospital visits and visited schools while we were tied up). I was lucky enough to go on rounds with Dr. Andree LeRoy, who is the Director of Rehabilitation for PIH and spent time with the patients and rehabilitation techs.  I was able to meet with these rehab techs and we reviewed cases together, problem solving difficult challenges.  It all felt so natural to me knowing that I could be so helpful (after 40 plus years as a PT, I had the experience of dealing with some of the types of problems that those younger clinicians who work in more modern facilities don’t see anymore).  We all got a chance to meet with the doctors, nurses (including Sheila Davis, who is the director of nursing and her seeing her in action is impressive), volunteers, administrators and many patients.  I was struck by the dedication, enthusiasm and commitment of all those involved plus the pride of the Haitians who work at PIH.  Although the clinics and hospitals are not sophisticated and many procedures we take for granted are not routinely done, the commitment to providing compassionate, humane care is there.  We also spent a long time visiting HUM which is beautiful and clearly will raise the standard of care and health care education in Haiti.  The facility has state of the art operating rooms, imaging equipment, spectacular teaching and patient facilities plus it’s almost 100% solar powered. (It just recently opened and eventually will have 300 beds as the funding increases).  This hospital is truly a major game changer.

The courtyard at Mirebelais Hospital. (Pictured above)

These lovely mosaics are throughout the hospital. (Pictured above)

Now, I don’t want to give you the impression that life in Haiti is easy.  I am still struggling to make sense of it all…I have never been so up close and personal with people who literally don’t have enough to eat and essentially no resources.  Walking through the markets where the poorest of the poor are trying to make ends meet nearly broke my heart….seeing little kids who are starving  and Moms’ desperate to feed them and people who look like they are 90 when they are only in their 40s is a jolt to one’s soul.  Yet,  most of the Haitians we met were kind, welcoming and always praying for you.  One of the driving forces for my visit, was to better understand the culture and country of Haiti given how much we hear about what a hopeless situation it is….a country that lacks infrastructure with a storied history of massive failures.   Many of my friends have asked me why am I involved in Haiti because the situation is too dire and trying to effect change there is like beating your head against the wall.  Well, the visit confirmed my belief in everyone’s right to health care (and basic necessities ) and although it’s a long uphill battle, I am hooked on the work that PIH does and with all my heart, I know it’s making a difference. Their model of care and developing joint partnerships is translatable worldwide, including this country.  When Paul Farmer (and Ophelia Dahl, Jim Yong Kim and others) started the clinics in the central plateau 25 years ago, the area was deforested….not only did these visionaries work out a wonderful model of using accompagnateurs and partnering with the Haitians, they planted trees…25 years later, the area is beautiful and to me  a testament, that small steps do make a difference… I am in!

A little girl that I had the chance to work with and her mom. (Pictured above)

There is no way in this short piece, that I can tell you everything that happened in our whirlwind trip, so I am linking you to my friends Ken and Jody's blog, the Garum Factory who put together a reflective photo journal of our trip on their blog (Ken is both a writer and a photographer) which  includes some of the cultural experiences we had the chance to do.
And finally, to really understand Haiti and what happened after the January 12, 2010 earthquake you should read the book by Jonathan M. Katz:  The Big Truck That Went By:  How the World Came to Save Haiti and Left Behind a Disaster.
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