Haitians delivering healthcare to Haitians - photo gallery
By Nyka Alexander
WHO Communications Officer
16 March 2010
Much has been reported about the international response to the earthquake that struck Haiti on 12 January 2010, but the primary response to the emergency, including its health consequences, has come from the Haitian people themselves.
Neighbours have been helping neighbours, rural families have taken in displaced victims from the city, and communities are developing new strategies to adapt to changed conditions.
The following story describes different types of services that have been set up by and for the Haitian people. Three clinics have been opened, handling a wide range of health conditions, from tending to physical wounds to helping address the less visible mental scars.
The green-roofed Ministry of Public Health building collapsed in the earthquake, but no employees are reported to have died. Of the 80 significant hospitals and health care centres in Port-au-Prince, 49 were damaged. Against this backdrop of collapsed infrastructure, Haitian doctors and nurses stepped into the gap in many cases to provide immediate care in new ways.
Dr Jocelyne Marhône Pierre, a Haitian Ministry of Public Health employee who heads the national food and nutrition programme, lost her house in the earthquake. She took refuge in the yard of a collapsed church, the Eglise Saint-Louis Roy-de-France, but soon started helping hundreds of her neighbours who needed aid. With all that was at hand - toilet paper and tissues for bandages, water and soap for cleaning - she and her fellow doctors began caring for the injured. Sitting behind her is Dr Childerick Dorvilus, a former student of Dr Marhône’s whose house was also destroyed. He and Dr Marhône were the first two doctors to treat patients.
More than two months after the quake, the clinic continues to see an average of 140 patients per day for a wide range of conditions, from the injured to those with chronic conditions. Several emergency procedures are also performed nightly. The clinic offers vaccinations, rehabilitation for the wounded, and in-patient care for those who need to stay longer term. All of this is being offered in tents and tarps set up in the open air.
Dr Marhône speaks with Montse Escruela Cabrera, PAHO/WHO’s nutrition expert in Haiti. They had worked together for many months on developing Haiti’s nutrition guidelines. After the disaster, PAHO/WHO delivered basic medicines immediately from the warehouse of PROMESS, the Programme for Essential Medicines, which PAHO/WHO has supported in Haiti since 1992. PROMESS provides essential medication to Haiti’s public health institutions, not-for-profit private health care centres, and those run by non-governmental organizations. Since the earthquake it has been a clearinghouse for donated medicines and has provided other pharmaceuticals for free to its regular clientele as well as mobile clinics.
Mobile clinics like this one sprung up shortly after the earthquake as a means of bringing health services directly to those in need. This one operates five days a week in a temporary settlement of 2800 people at a damaged Toussaint high school. Doctors and nurses work from 9 a.m. to 3 p.m. and see 70 to 100 people a day, 30% of whom are children.
Mirlene Cherelus took her son, Jeffrey, 7, to the clinic to after an allergic reaction on his scalp. The reaction started before the earthquake but the cost of going to a doctor was too high - approximately three days’ salary. The Government has decreed that consultations and medicines will be free in mobile clinics for the time being. International partners and donors, including PAHO/WHO, are working with the Government to design a reconstruction plan for the health care sector to meet community needs for more accessible and affordable health care. Mobile clinics will likely be integrated into in the new plan.
Mental health is another area where the Haitian community has developed services. This girl is attending day classes set up in school buses near the Champ-de-Mars settlement. The temporary school, called Plas Timoune (which means "the children’s place") welcomes 420 children a day, divided into three time slots and age groups. The buses were donated by the Dominican Republic and driven overland to Port-au-Prince. Cuba donated books and toys.
Jenny Seneque has been director of the play centre since it was launched in March 2010 as an initiative of First Lady Elizabeth Preval’s. She was a marketing student before the earthquake destroyed her school. The children come for two hours at a time, three days a week, to play, paint, do sports, listen to music and do pottery. Jenny says the centre aims to help children move beyond the trauma of the earthquake and start being kids again. The teachers and others who work at the centre say it has also helped them regain a sense of purpose. The centre refers severely traumatized children - those who seem closed in on themselves and unable to speak - to trained psychologists.
When children first arrived at the centre, they tended to often talk about the earthquake, recalling what happened to them and members of the family. But after a few days, says the centre’s director, most began talking about the games they are playing and to take interest in each other. Helping children regain a routine and a sense of normalcy is one of the best ways to support them after natural disaster.