Haiti: Field Report May 2012
July 6, 2012
Dr. Patrick Dupont
Improve the Quality, Accessibility and Sustainability of Public Healthcare, through Public/Private Partnerships in a scalable manner. In addition to this core goal, RMF seeks to provide building coordination among health services agencies and organizations involved in the relief efforts and strengthen Haiti’s overall health services sector over the long-term through sustainable development practices.
- Re-thinking and re-organizing RMF resources at Lambert Santé Surgical Clinic, a facility which since the January 2010 earthquake has never stopped providing much needed care to patients, in order to continue offering quality healthcare to people in need of primary, secondary and tertiary care:
- Primary care services (general, pediatric and trauma consults)
- Emergency care
- Maternal/child healthcare
- Secondary and tertiary care for medical & surgical conditions
- Rehabilitation and counseling for amputees
- Re-thinking the Hospital Consortium project with the ultimate goal of providing structured and continued Healthcareto the whole Haitian population.Capitalizing on local private facilities and implementing through Public/Private Partnerships leveraging economies of scale, existing facilities’ core competencies and expertise a viable network capable of providing quality and continuous care for the patients. Added subsidiary goals include:
- Management support, coordination and oversight of target activities
- Coordination and partnership development with other healthcare providers and specific organizations
- Develop partnerships with medical and nursing schools and implement teaching program
- Develop supplier relationships to support consortium w/quality products & services at reduced cost
Haiti: General situation overview
Haiti’s overall healthcare situation has not changed significantly in the past months, apart from continued efforts in emergency situations problem solving and regular basic care (cholera, primary care and preparedness for flooding and hurricane season).
The sociopolitical climate has been still reflecting strenuous negotiations between the executive and legislative branches of the government, now more than ever after the “forced” resignation of former Prime Minister, Dr Garry Conille after only 4 months in office, which came about after blatant show of conflict between him and the supreme executive power.
The now, almost forgotten IHRC, to which RMF had submitted a new project in September, like so many other organizations, seems to have been definitely forsaken and does not appear to be re-conducted in the near future.
Haiti’s socio-economic climate is at an all time low, as once more, Haitian parliament is reviewing the new designated Prime Minister proposed by President Martelly in the person of his former Foreign Affairs Minister, Laurent Lamothe. This process however seems to be moving much faster than before as his designation has already been validated by both the senate and the chamber of deputies and is scheduled to present his general political plan at the end of the week. Much faith is put in this new and hopefully final ratification of this Prime Minister to finally push significant change and reconstruction efforts.
One new hospital seems to have been implemented in the Tabarre area by MSF, receiving only, as usual, emergency trauma in the same collaborative effort with the MOH, and probable finality of leaving the facility at the end of operations to the government with little to no means to sustain the care provided.
From the original 2.1 million after January 12, 2010, approximately 490,000 people (a 67% decrease between July 2011 and February 2012) are still living in IDP camps more dispersed than ever, as the major locations in the GMA of Port-au-Prince have been cleared: St Pierre and Gregoire public squares in Pétion-Ville, the Prime Minister’s office in Bourdon and the airport camp and also the Champ-de-Mars square are being slowly evacuated. Half a million people appeared to have benefited from temporary shelters and others have been able to go back to their previous homes, repaired or rebuilt. Efforts are currently underway to rehabilitate neighborhoods that had been affected by the earthquake.
The cholera epidemic, through a joint effort, has registered a decline in the lethality rate (2.4% in November 2011 to 1.3% in February 2012) with nonetheless a still present probability of outbreaks during the rainy seasons and with flash flooding, as the disease appears to become endemic to the region according to the latest experts and as little to no efforts are being made in waste disposal, water and sanitation. The cumulative number of reported cholera cases was 532,925 as of April 8, 2012 with 7,095 deaths due to cholera since October 2010.
Summary of RMF/CSF-sponsored activities carried out during the reporting period under each project objective:
Hôpital Lambert SantéSurgical Center (RMF partner clinic and surgical center):
- The activities of the free clinic at Lambert Santé have sadly come to a halt as the possibilities of the surgical clinic’s own resources have made it impossible to continue. Only funded through RMF’s contribution since March 2011, when the other NGO contributing had shifted its goals and stopped their funding, it appeared rapidly that the joint efforts of RMF and Dr Degand were insufficient to respond to the continued visits and mostly surgical needs of the patients. Only two time-limited missions have been implemented during the months of March and April 2012 by the Heart Surgery Program with a team of surgeons from New York and a joint French/Haitian team from ALIMA to conclude already scheduled orthopedic surgeries.
- RMF has been actively researching ways of locating and securing funding to keep the clinic open and even increase its coverage to encompass more that it did with both NGOs funding it. One of these efforts has been the submission to the IHRC of proposal for implementation of a pilot Consortium Hospital at Lambert Santé, proposing in such a base model of the public/private partnership envisioned capable of demonstrating the viability and relevance of this model. The project, submitted for an initial annual budget of approximately $2,500.000, was sent to the IHRC for approval and funding on September 6, 2011, But ad posteriori (and precluding upon next quarter’s report), this project, a clear portion of the already approved Consortium project, was not approved in a very impersonal and non explicative letter on October 17th. Subsequent inquiries to the IHRC regarding possible reasons or explication for refusal remain to this date unanswered.
- Complete funding has yet to be accessible for this project as only a portion of the budget needed to operate this pilot project has been made available since November 2011 by Medical Mission International.
- Shipment of much needed medical equipment, targeted to improve this facility’s care delivery has finally been made possible through their efforts and should arrive in Haiti in the following months.
Public/Private Hospital Consortium:
- As the formerly pledged funding for this project is finally unobtainable and efforts to secure other sources have so far not been successful, we are currently shifting our goals to envision this project by implementing a smaller scale public/private partnership, first with Lambert Santé but also through another healthcare facility, capable of becoming RMF’s headquarters for this hospital network, which remains for us one of the more viable solutions for betterment of the Haitian population’s current state of health.