Wednesday, August 10, 2005

PARTNERS IN HEALTH : Solidarity, not charity alone.

When Partners In Health (PIH) was founded in 1987 by Dr. Paul Farmer, its primary aim was to support the then ongoing activities in Central Haiti, which included a clinic and a training program for community-health workers.

In order to discuss the work of PIH today, you need the help of a world map because they have gone global working in seven countries and on four continents.

Working in Haiti since 1987 with its partner Zanmi Lasante (Zanmi Lasante is Creole for "Partners In Health.,"), PIH has been providing primary health care in the central Haitian village of Cange.

Zanmi Lasante and PIH run a number of programs together. One of those programs is a full-service hospital. They also run rural Haiti's only HIV/TB treatment facilities. A dozen or so schools, a women's health center, and several "cottage industries" are also included in their work.

Currently, Zanmi Lasante and PIH on a daily basis provide over 1,000 patients with free (or on occasion nearly free) quality medical care. This dynamic duo also works together to provide specialized health training to local residents with as pharmacists, birth attendants, and community health workers. They even arrange for advanced training for Haitian physicians and nurses.

Handicapped by the moratorium on development and humanitarian aid to Haiti since 2000, the work provided by Zanmi Lasante and PIH became increasingly more difficult, as over $500 million in approved international loans and grants were blocked by international donors due to a dispute between former President Jean-Bertrand Aristide and the coalition of groups that oppose him. This caused the Ministry of Health of Haiti to cut back on the services it provided, placing a heavier burden on NGOs operating in the country.

In the year 2002 over 190,000 people visited their hospital and medical clinic maintained in Cange. This number was three times the number of patient visits during the previous 12 months. Nevertheless, Zanmi Lasante and PIH had the commitment to expand their base of operations during 2002 and carried health services to additional towns and villages in Haiti's Central Plateau. Screening for malnutrition, tuberculosis, and HIV; vaccinating women and children; and diagnosing and referring sick patients to one of the medical facilities, Zanmi Lasante and PIH's clinical expansion sites in the surrounding area of the Central Plateau saw another 120,000 patient visits during the year 2002.

Despite these difficulties - not to mention the hurricanes - PIH was determined to hold to its mission, which is "to provide a preferential option for the poor in health care."

Within this context the organization has two overarching goals:

"to bring the benefits of modern medical science to those most in need of them and

"to serve as an antidote to despair.

Partners In Health is able to draw on resources from the world's leading medical and academic institutions it brings to that the "lived experience of the world's poorest and sickest communities" based in settings of poverty, by establishing long-term relationships with sister organizations, like Zanmi Lasante.

PIH says that it has a moral mission as well as a medical one. Its moral mission is based on solidarity, and not on charity alone.

Giving their patients in poor communities the same quality of care that they would give to their own families, members of PIH's health professionals, and other team members do whatever they can to provide access to care.

In holding to its mission the organizations maintained its outpatient clinics where patients were treated a variety of infectious and medical diseases. The TB treatment facility at the Hospital and Medical Clinic (Clinique Bon Sauveur) became the primary referral site for all cases of multidrug-resistant tuberculosis in Haiti, while the cases at the hospital included acute disorders from congestive heart failure to malaria.

Volunteer surgeons, nurses, and technicians from various locations in the U.S., such as South Carolina, Miami, and the Brigham and Women's Hospital in Boston, made several surgical trips. And a Cuban volunteer Dr. Pedro Ung directed the completion of a new surgical wing. And while all this was taking place, PIH also helped to reopen a hospital located near the Dominican border and that had been closed for 12 years. The PIH web site reports that: "In a single week, 25 surgical procedures were performed" in that hospital.

But as I stated earlier, Haiti is not the only country that is benefiting from the hard work of PIH. n April 2005 PIH began working in two rural health districts in Rwandawith support from the Clinton HIV/AIDS Initiative and private donors.

There, ased on the model of care developed in HaitiPIH initiated HIV care. In these two sites in Rwanda, PIH will focus on three primary activities.

First they will establish he "four pillars" approachthat worked so effectively in Haiti :

IV care and treatment that is integrated with primary health care,
Maternal and child health,
Tuberculosis control, and
Detection and treatment of sexually transmitted infections.

PIH's second priority is to establish a system of community-based care. The director of Zanmi Lasante's TB/STI/HIV/AIDS program in Haiti (Dr. Fernet LĂ©andre) has been leading south-south" collaboration between PIH's experienced Haitian staff and their new partners and colleagues in Rwanda The focus here is to identify, hire, and train local health workers.

Finally, PIH is working to strengthen the public health infrastructure in the two districts by "recruiting and training administrative and medical staff; rebuilding and equipping clinics; and securing reliable electricity, water, and communications systems."

Besides Haiti and Rwanda, there are seven other countries where PIH has programs, time will not allow me to write about all of them, but I happily present you with the "URL" for Partners In Health, which is:

Because there is so much more to Partners In Health and Dr. Paul Farmer that I can not even begin to scratch the surface with this short article.

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