SDSH

Santé pour le Développement et la Stabilité d’Haïti (SDSH)

A volunteer nun tending to a chld at the Drouin health centerOn Tuesday and Wednesday, Dr. Serge Conille, the HIV/AIDS technical Advisor of the USAID-funded SDSH project led by Management Sciences for Health, and designated lead of the project's emergency cholera task force, and I visited project-supported health facilities in the epicenter of the epidemic in the lower Artibonite Department (Province).

We drove into the cholera zone over a dirt track through a flat plain of fields, green, but neglected. The road ran parallel to what appeared to be a wide canal, the dikes on either side uneven and crumbling. Later, I found out that this was the Artibonite river, source of the epidemic. It was constrained and channeled some 25 years ago as part of a “whole valley development plan” which included promotion of rice cultivation. The rice is largely gone and the dikes are frequently overrun by the river which floods the surrounding countryside isolating some villages, sometimes for long periods of time.

Fragile states such as Afghanistan, the Democratic Republic of Congo, Haiti, Liberia, and Southern Sudan have among the worst health statistics – especially for women and children.  For political, economic, security and other reasons they can be extremely challenging work environments. Despite this, I have been deeply inspired to see what local health leaders have achieved when they have created strong partnerships among government, donors,  non-governmental organizations and where possible the private sector.  The charismatic former minister of health from Afghanistan, the  medical director of an urban clinic in northern Haiti, and the director of Torit hospital in Southern Sudan stand out as examples of local leadership in action under circumstances that would immobilize many of us.

In fragile states, constraints on governments often prevent them from simultaneously building their stewardship role and immediately expanding service delivery. Supporting the Ministry of Health to establish a basic package of health services, train local organizations to implement those services, and provide incentives (such as through performance-based financing) is critical to success. Additionally, the goal should be to move from many plans and actors across districts to one health plan with committed partners. 

The Santé pour le Développement et la Stabilité d’Haíïti (SDSH) project Chief of Party, Agma Prins, and Dr. Serge Conille are in the Artibonite department to support the MSH response to the cholera outbreak. They continue to coordinate with the Ministry of Health and other international and local partners. MSH is working with Pure Water for the World to educate communities about hygiene and provide access to clean water through bio-sand filters.

Additionally, MSH Sr. Technical Advisor, Dr. Georges Dubuche, is working with Direct Relief International to coordinate an air freight shipment of supplies including IV fluids. IV catheters, oral rehydration salt tablets, Pedialyte solution, tetracycline or doxycycline, exam gloves, soap, and IV equipment stands.

The MSH/SDSH project is funded by the USAID.

The Management Sciences for Health Haiti staff continues to work tirelessly alongside local partners to mitigate the cholera outbreak. A sample of today’s work is outlined below.

On Saturday, October 23, a four-member group from the Santé pour le Développement et la Stabilité (SDSH) project, led by MSH’s Dr. Patrick Dimanche, conducted an initial on-the-ground assessment and provided support for five local NGO partners---Service and Development Agency (SADA) in Mattheux/West Department, Saint-Paul Health Center in Montrouis/West Department, Pierre Payen Health Center in Pierre Payen/Lower Artibonite Department, Hospital Albert Schweitzer/Lower Artibonite Department, and Claire Heureuse Community Hospital/Upper Artibonite Department---that have cared for over a third of the 2,364 cases reported thus far. Ninety-eight of the reported 208 deaths have occurred in four of these five health facilities.

The three USAID-funded projects managed by MSH in Haiti---SDSH, Leadership, Management, and Sustainability (LMS), and the Supply Chain Management System (SCMS) project---are working together to deliver emergency commodities including bed sheets, towels, adult diapers, disposable gloves, oral rehydration salts, IV solution, water treatment tablets, and soap.

Yesterday the Direction of Civil Protection and Disaster in Haiti confirmed a cholera outbreak in two departments (districts) of the country resulting in 1,498 cases managed in health facilities and 135 cholera related deaths.

The USAID-funded, MSH-led Santé pour le Développement et la Stabilité d’Haíïti (SDSH) project is working closely with Haiti’s Ministry of Health and other local and international partners to coordinate a community-level response to the cholera outbreak.

SDSH is mobilizing its established network of over 4,000 community-based health workers to reach Haiti’s largely rural population. The project is working with local and international vendors to procure oral rehydration solutions, a critical component of first aid for diarrheal disease.

For more details reported by SDSH on the ground, see our press release from earlier today.

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