Recovering from Disaster — Partners in Health and the Haitian Earthquake

PerspectiveTheNEW ENGLAND JOURNAL ofMEDICINE


The earthquake of January 12 killed many of
Haiti’s doctors and nurses and destroyed a
large part of the country’s medical infrastructure.
But Zanmi Lasante (ZL), the Haitian branch of

Partners in Health (PIH), was left
intact. ZL had been the largest
health care provider in rural Haiti.
After the quake, it became (tem
-
porarily, at least) the largest and
one of the most important in the
entire country.
PIH was founded in 1987 by
Dr. Paul Farmer and a small group
of colleagues. Together, they built
a clinic in a rural, desperately im
-
poverished squatter settlement of
farmers who had lost their land
to a hydroelectric dam. PIH now
works in 12 countries on four con
-
tinents, but in many ways Haiti
remains its heart and soul. ZL has
become a comprehensive public
health system supported by inter
-
national donors but staffed al
-
most entirely by Haitians: about
4000 people in all, including some
120 doctors, 600 nurses, and 2000
trained and salaried community
health workers. It has brought
AIDS and tuberculosis under con
-
trol in the province called the
Central Plateau, vaccinated nearly
everyone in its large catchment
area, cleaned up water supplies,
built houses for the poorest pa
-
tients, renovated and supported
schools, and launched programs
to feed thousands of Haitians
daily with locally produced food.
All in all, ZL directly serves 1.2
million people, at no cost to the
local population, and has built or
renovated 12 hospitals and clin
-
ics, six with surgical facilities, all
with well-stocked pharmacies, and
made the Haitian Ministry of
Health its partner in their owner
-
ship and operation.
Members of ZL’s staff were
some of the first health care work
-
ers to respond to the disaster.
Some ZL doctors have homes in
the capital and happened to be
there at the time of the quake.
One of them, Dr. Patrick Almazor,
set up a clinic in his backyard
and spent the night caring as he
best he could for about 50 injured
people. Dr. Louise Ivers of Har
-
vard Medical School was also in
Port-au-Prince, attending (ironical
-
ly enough) a United Nations meet
-
ing about emergency prepared
-
ness. Once she had escaped from
the crumbling building where the
meeting took place, she and a
number of volunteers set up an
impromptu clinic in a driveway,
using license plates for splints.
The leaders of ZL know their
way around Haiti, and they aren’t
obliged to wait for instructions
from PIH headquarters in Boston.
As soon as they heard of the
devastation, several of the senior
doctors at ZL’s hospitals loaded
Recovering from Disaster — Partners in Health
and the Haitian Earthquake
Tracy Kidder

http://www.ijdh.org/wp-content/uploads/2...tracykidder.pdf