Sustainability in health care isn’t only about energy efficient buildings, innovative technology, and effectively using resources. It’s also about people. It’s about access. And, it’s about creating health care solutions that work within the context of other constraints, such as culture, infrastructure and economy.
Need proof? Just look at the medical crisis now unfolding in the aftermath of the devastating earthquake in Haiti. To be clear, earthquakes are acts of nature. But, as Tracy Kidder explains in the New York Times, the Haitians’ “extreme vulnerability to earthquakes is manmade” —and it only serves to underscore the urgent need for sustainable, community-based health care in the world’s poorest countries.
The Boston-based international aid organization Partners in Health (PIH) has been working for more than 20 years to fill that need for several of the world’s most indigent populations.
Since PIH’s flagship project launched in Haiti in 1985, the organization’s community-based health care model has proven successful in delivering effective care both for common conditions like diarrhea, pneumonia, and childbirth —which often prove fatal for poor and malnourished populations—and for complex diseases like HIV and tuberculosis.
According to PIH’s website, a key to this success—and to the PIH model of care pioneered in Haiti—has been training and hiring thousands of accompagnateurs (community health workers) to prevent illness, monitor medical and socioeconomic needs, and deliver quality health care to the chronically ill. In short, it’s these accompagnateurs who make PIH’s work sustainable.
PIH, long recognized as the largest health care provider in rural Haiti, now operates 10 hospitals and clinics in partnership with the Haitian Ministry of Health. Located a few hours from Port-au-Prince, all of these survived the earthquake, and all are still intact. As a result, this week PIH probably became the largest health care provider still standing in all Haiti, Kidder says.
The PIH workforce—about 4,000 strong, including 100 physicians and some 600 nurses, and constituted almost entirely of Haitian medical workers—is now administering aid to earthquake survivors.
In fact, several PIH doctors who live in Port-au-Prince have reportedly turned their homes into clinics to help treat the wounded.
These doctors exemplify the PIH Vision—“Whatever it takes:”
At its root, our mission is both medical and moral. It is based on solidarity, rather than charity alone. When a person in Peru, or Siberia, or rural Haiti falls ill, PIH uses all of the means at our disposal to make them well—from pressuring drug manufacturers, to lobbying policy makers, to providing medical care and social services. Whatever it takes. Just as we would do if a member of our own family—or we ourselves—were ill.
I first learned about PIH back in 2003, when I read Tracy Kidder’s bestselling book, Mountains Beyond Mountains.
If you would like to learn more about PIH and how you can help support its efforts, please visit their website. You can stay tuned to updates about their work to help those affected by the earthquake in Haiti here.
UPDATE: In an email sent to supporters yesterday (January 17), Ophelia Dahl, PIH executive director, reports that the PIH team in Haiti has been designated by the World Health Organization to serve as the coordinators of the public hospital, Hopital de l’ Universite d’Etat d’Haiti (HUEH), where thousands are suffering in need of medicines and surgeries.
In this new role, PIH will support the administration and staff and recruit other NGOs to help restore services, particularly triage, nursing, and surgical, at the city’s central hospital. PIH’s inital priorities are to increase stock of medicines and supplies, ensure steadily functioning operating rooms, and guarantee sufficient medical staff is available, particularly for nursing care to help with post-op recovery, iv management, and other care that has had to be self managed over the past three days, Dahl says.
“It is clear to us all that relief for Haiti must rely on our collective immediate response and our sustained long-term commitment to building back better. Our approach to health care delivery in resource-poor settings-partnering with the public sector, employing locally, and investing for the long-term-is a key part of the solution for Haiti now and in the future,” she concludes.