MSH Hosts Health of Haiti Congressional Briefing and Reception in Washington, DC—Calls for Continued NGO/Government Partnerships in Haiti for Health Impact
On the day of the earthquake in Haiti, Dr. Florence Guillaume and her colleagues were planning for a Haiti Success Fair in Port-au-Prince that was to be held a week later on January 21-22 and to be opened by President Preval. The fair did not happen and Dr. Guillaume and her colleagues at the MSH-managed and USAID funded health network Santé pour le Développement et la Stabilité d'Haïti (SDSH) were instead scrambling to assist wounded victims, assess health centers and ensure delivery of medicines and supplies. On March 22, 2010, MSH along with Dr. Guillaume and her colleague Uder Antoine presented information on the remarkable health successes achieved before the earthquake at a Congressional briefing and reception on Capitol Hill held in conjunction with the House Foreign Affairs Western Hemisphere Sub-committee and Congresswoman Yvette Clarke. Congresswoman Diane Watson, member of the Foreign Affairs Subcommittee on Africa and Global Health and long time advocate of Haiti, also attended.
Over 60 NGO colleagues, congressional staffers, UN agencies, and partners viewed the posters on display celebrating remarkable health successes from 2008-09 by the USAID funded MSH-SDSH network of over 147 government health sites and 4,000 community health posts.
"Around this room you see posters that reflect some of the progress we have made toward improving the Health of Haiti," said Paul Auxila, MSH Executive Vice President and Chief Operating Officer and a Haitian American who led MSH projects in Haiti for 14 years. "In addition to this work, MSH and our partners have been coordinating and securing the supply chain of critical medicines, family planning commodities and lab supplies. We are delivering medicine to more than 100 sites and family planning supplies to 300 sites. We are training pharmacists and drug dispensers how to properly forecast and dispense appropriate medicine. And we are helping the ministry and local NGOs improve their health management and leadership skills to better coordinate community mobilization efforts and increase HIV and AIDS awareness."
In 2008-2009, for example, the SDSH network made an impact on maternal health, training and supporting over 4,000 traditional birth attendants. As a result, 45% of pregnant mothers had three prenatal visits, and 40% received a home visit within three days after giving birth. They also tested 49,196 pregnant women for HIV, and saw over half of those who tested HIV positive through the entire course of treatment to reduce the risk of HIV transmission to their babies.
The network also achieved significant improvements in child vaccination, increasing its coverage of DPT3 vaccines for infants by 26%, and providing vitamin A therapy to over 250,000 children to combat malnutrition. By training and equipping 1,035 community health agents to promote family planning, the network contributed to a 24% increase in the use of modern contraceptive methods. And by the end of 2009, the SDSH network had scaled up antiretroviral treatment for AIDS to 2,077 patients and provided palliative care to over 11,000 People Living with HIV & AIDS.
The SDSH network has also contributed to Haiti's economic development by creating jobs. Almost 4,000 community health agents were employed by public and private sector partners and the services of another 4,000 trained traditional birth attendants (matrones) were supported. Additionally, salaries were paid for over 1,150 facility based health providers.
Before the earthquake –with USAID funding—MSH had been assisting the Ministry of Health to bring about a paradigm shift in the Haitian health system—and transition from a national system characterized by a multitude of well-intentioned but uncoordinated actors implementing a diversity of plans to a health system where each geographic department of Haiti has one health plan, under the leadership of local health authorities and with the support of both local and international partners contributing funding and evidence-based expertise.
"This is an example of the capacity, systems, and experiences in Haiti's pre-earthquake times that offers lessons learned and opportunities that we can and must capitalize on as we move forward to address the challenges we face together—we, Haitians, and the international community as we partner together in an unprecedented effort to rebuild a stronger and better Haiti," said Auxila.
"Our vision is clear: leaders, health managers, and communities in developing nations are increasingly able to tackle complex health challenges. They will have strong management and leadership skills, practical tools, and the financial and human resources needed to save lives and improve the health of their citizens. They will have more sustainable health systems in place and medicines and quality health care services will be available and accessible to all," said Auxila.
"Indeed and fortunately, in Haiti, which looks like "Nowhere" today, the US government has helped us, using our health mandate and engagement to develop alot of effective models and approaches, which can be shared with others and multiply our joint success," said Dr. Guillaume, a pediatrician by training.
"It is about starting at the base—planning from needs to resources to priorities, harnessing underutilized resources, increasing public-private partnership, increasing complementarities, synergy and accountability. Fostering local empowerment, governance, coordination, and democracy—towards peace and stability," said Dr. Guillaume.
"I want to stand as proof the fast resumption of integrated primary care at the institutional and community level after the earthquake. I invite you to take a tour and read the posters which will give you a better sense and flavor than my simple words," said Dr. Guillaume.
She outlined the outstanding results obtained rapidly with the performance-based financing approach, not only for the private sector NGOs but in some targeted public sites, where immunization went from 40 to 85% as well as some maternal health, family planning, and HIV & AIDS indicators. This includes management system indicators for the public sector.
"We miss a common vision. We miss the leadership and guiding principles aligned to all actors, we miss the concept of priorities at all levels, we miss the concept of accountability and focus on results by all actors, we miss the concept of effective coordination and synergy," said Dr. Guillaume. "I believe in the concept of going toward people, understanding where they live and building on what they have. I'm calling for decentralization. In the spirit of partnership and coordination, I'm calling for the pooling or efficient use of resources for better impact. I'm calling for results. I believe in the adoption of a common vision, I am calling for integrated planning, involved in one national plan."
Congresswoman Diane Watson said "We must plan to stabilize health infrastructure and what's left of it." She noted the extreme inadequacy of psychiatric care in Haiti and the enormous amount of amputees now needing care.
Congresswoman Yvette Clark said, "How can we support self-determination of a nation trying to put the pieces together? US technical capacity and financial must be paired with Haiti's humanity willing to be mentored in growth and development of civil society. Civil society can't govern and NGOs can't work alone—we must strengthen the Haitian government, reinforce it, trust in it, and not build a dependency on NGOs alone- need to develop the government and work truly in partnership."