After Earthquake, University Hospital is Transforming Lives in Haiti

Four years after an earthquake struck Haiti’s capital—damaging its already-weak medical infrastructure—a new public teaching hospital in Mirebalais, Haiti, is transforming the lives of people in the Central Plateau and beyond.

Since opening in March 2013, University Hospital has treated thousands of people who previously had little—or no—access to health care. The facility, built by Partners In Health and Haiti’s Ministry of Health, also serves as a training ground for Haiti’s future clinicians, and is a catalyst for economic growth in the region.

New access to medical services

University Hospital provides care for a referral area in which 3.4 million people live, including people in Mirebalais and two surrounding “communes,” or regions.

Since opening, staff members have registered more than 42,000 patients, providing more than 55,000 clinical visits. About 60 percent of patients are from the three regions closest to the hospital, and about the same proportion are women, according to data from the hospital’s electronic medical record system.

“The quality of care patients are receiving is speaking for itself, and the word is getting out,” said Marc Julmisse, University Hospital chief nursing officer, who is Haitian-American. "Our staff is doing an amazing job, and it goes to show—from outpatient services to inpatient care to the emergency room—that Haiti needs a hospital like this.”

Clinicians see more than 700 patients on a typical day.

The hospital employs about 700 people, including about 300 nursing staff and 50 doctors. Seventy percent of its employees are from the Central Plateau.

The hospital has an emergency department, state-of-the-art operating rooms, and a specially designed electronic medical record system. A system of 1,800 solar panels produces most of the facility’s energy needs. To read more about University Hospital’s solar energy system, click here.

Demand for services has grown as referrals from other facilities increased and word spread about free specialty care at University Hospital that was unavailable elsewhere in Haiti. For example, analyses of where surgery patients live show that people travel from all over Haiti to receive surgical care at the hospital.

Since the maternity wards opened, clinicians have delivered more than 800 babies, about 25 percent of which were born through cesarean sections—a rate that reflects the hospital’s role as a referral center for pregnancies with expected complications.

Since March, the following services have opened at University Hospital:

• HIV and tuberculosis clinic
• Outpatient clinic
• Women’s reproductive health services
• Community health services
• General surgery and orthopedic surgery (see “Cancer Patient Receives First Surgery at University Hospital”)
• Rehabilitation (see “After a Three-Story Fall, a Haitian Girl Recovers”)
• Emergency department (see “An Accident Tests University Hospital’s Emergency Department")
• Maternity wards
• Mental health
• Dental
• Cancer care (see “Cancer Care Expands at University Hospital”)
• Pediatrics and newborn care (see “After Grief, Joy: Haitian Woman Delivers Healthy Premature Baby”)
• Internal medicine
• Noncommunicable disease clinic
• Advanced diagnostics, including CT scanner

Training the next generation of clinicians

A key function of the hospital is to train Haiti’s next generation of social justice doctors, nurses, and other health professionals. Workshops and trainings began before the first patient stepped foot in the building, but training has ramped up as specialty services come online. Since June, the hospital has hosted more than 165 trainings, including cardiac resuscitation training for 91 medical staff.

In fall 2013, the teaching hospital marked a significant milestone with the entrance of its first class of medical residents. These 14 young Haitian doctors are training to become specialists in pediatrics, internal medicine, and surgery, and a new class will enroll every year. Read more about this first enthusiastic class of residents here.

In 2014, hospital leaders will begin training for other specialties. Nurses will be trained in anesthesiology and critical care, skill sets that are necessary for emergency and surgical care. New medical residencies are being planned for obstetrics-gynecology, orthopedic surgery, anesthesiology, and emergency medicine, which would be the first such residency in the country.

“You don’t learn how to be a doctor in medical school,” said Dr. Michelle Morse, who has helped plan medical education programs at University Hospital. “It’s during residency that you dive in and begin to understand what it’s all about.”

Catalyzing economic growth

University Hospital has also helped grow the economy of the Central Plateau.

Researchers from PIH, Haiti, and the United States teamed up to analyze the economic impact of University Hospital, using what’s known as an input-output model. They estimated that for every $1 invested in the hospital, $1.82 is pushed into the Haitian economy.

Essentially, the influx of resources in one sector of the economy—health care and teaching in this case—will affect other sectors of the economy through what’s called the “multiplier effect.” This will result in an economic impact far greater than that of the original investment.

“The idea behind the input-output approach is intuitively simple,” the researchers note in a working paper.

Researchers used an input of $16.2 million, the estimated long-run annual full-capacity operating cost of University Hospital. Using the model, the team found that a $16.2 million investment in the hospital spills over into other sectors of the economy, resulting in an impact of $29.4 million in the broader Haitian economy. To learn more and see a graphic illustration of this model, click here.

Four years after the earthquake, Partners In Health is grateful to the many supporters and partners who helped make University Hospital a reality for the people we serve, and we look forward to making an even greater impact through our sustained commitment to Haiti in the years to come.