Going the Extra Mile: Haitian Health Teams Reach Distant Patients

Wagner (not his real name), an HIV-positive father of two, was direly ill in late 2007 but now is thriving thanks to the commitment and creativity of the staff at MSH-supported Mont Organisé and Fort-Liberté health facilities in northeastern Haiti. Staff at the Mont Organisé voluntary counseling and testing (VCT) center informed Wagner of his status in 2007. Within a few months they witnessed his rapidly declining health and referred him for life-saving antiretroviral therapy (ART) at the nearest ART site, Fort-Liberté—more than 50 kilometers from Mont Organisé.   Because travel in Haiti is often very difficult and expensive, Wagner was offered transportation to the distant ART site, but the trip remained practically impossible. “We cannot afford to go along and stay with him during treatment. And Wagner himself is too feeble to withstand the three-hour, rough ride to the hospital,” said a family member at the time.

A Contingency Plan

The Mont Organisé VCT staff promptly responded to Wagner’s plight by approaching staff from the Fort-Liberté ART site. Fort Liberté staff agreed to prepare Wagner medically and psychologically, and provide the antiretroviral medicines. The nearby Mont Organisé team would make regular home visits, educate Wagner about his treatment’s possible side effects, and help him to adhere to the drug regimen. The Fort-Liberté doctor visits Wagner quarterly to assess any follow-up needs. Only a few months after starting treatment, Wagner gained 20 pounds and was strong enough to leave his bed to run local errands and spend time with his two lively children. He is deeply appreciative of the blessing of the “homemade care” he received when it seemed all hope was lost.

The Providers Also Benefit

“We felt enriched by this experience,” explains Dr. Kerling Israël, HIV Program Coordinator for both sites. “Mont-Organisé providers reinforced their capacities while the Fort-Liberté team developed their collaborative skills to support their peers. With the appropriate strategy, we know we can offer quality care in hard-to-reach places.”

The MSH-implemented Santé pour le Développement et la Stabilité d’Haïti (SDSH) Project currently supports local NGOs in the opening and operation of VCT sites in four towns in Haiti’s Northeast Department and one ART site in the department’s “chief town” of Fort-Liberté. The Mont-Organisé center alone provides access to VCT for 18,000 people, and over 430 patients now have access to HIV-related palliative care, including 145 patients who receive ART from the Fort-Liberté center.  

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