In a rare interview, Loune Viaud tells Beverly Bell of the Huffington Post about Partners In Health's Haiti program, Zanmi Lasante, or Friends of Health. Loune serves as Director of Operations and part of the strategy and planning team in Haiti.
Beverly Bell: Tell us about Partners In Health, how it constitutes an alternative in health care and especially how its philosophy has contributed to bringing about another model of care in Haiti.
Loune Viaud: We started in Haiti more than 25 years ago. We realized right away that you can't talk about health without talking about the social aspects of health: justice and rights. That's why we try to embrace a lot of social elements underlying health. When a patient is sick, we don't see the sick person only, we see the environment and community they came from. After they leave the hospital and go back home, will they have water to drink? Do they have a place to live? Do they have food to eat? Can they send their children to school? Do they have work? We try to touch on all of it: job, home, nutrition, malnutrition, agriculture. We try to touch on schooling and sanitation, meaning potable water.
That's why we don't just consider ourselves a health organization, although we have a big medical team: doctors, nurses, pharmacists, lab technicians, etc. We also have community health workers, outreach agents, and agricultural agents who live in the communities and strengthen those communities.
BB: We know that Partners in Health's work is not only a social program, that it's tied to the idea of transformation, to the idea that as long as people are living with injustice and inequality they won't enjoy good health. I understand that people that in the village of Cange, where Partners in Health has been for so many years, really trust the group, and that this is one of the reasons you've have better success with people following HIV/AIDS treatment programs than even the National Institute for Health. How is power connected to the issues of treatment and the relationship to the patient?
LV: I don't want to start rejoicing about what you call success because we still have a lot of work to do. It's forward, forward, forward. Matter of fact, every time we see the numbers going down, we make more efforts to see if we can get them to zero.
I can't say that we change the lives of the people completely, but we've seen improvement.
Let's take for instance an HIV patient. We know that if that person can't afford medicine, can't eat, can't send their kids to school, doesn't feel that they're heard as a person and seen only as a patient, that person's not going to get well. But when people are sick and know that they can count on an organization to help them send their children to school, then they can concentrate on improving their lives, which means taking their medications. When people are sick and know they don't have to keep on drinking the river water they used to drink but can drink potable water instead, when they don't have to live in a straw hut in poor sanitary conditions and get bitten by mosquitoes anymore... even though physically they're not totally well, morally they know that they're recognized as a human being.
I think what makes us successful is our accompaniment program. Take tuberculosis, a disease of poverty. When a person comes in and tests positively for tuberculosis, what we do is send an accompanier to visit that person's home to see the social conditions they're living in. If that person sees they need a new house, we work with the community to get them a house that, as we say, can't fool the rain. In terms of water, we set up filters or other catchment and treatment systems. The accompanier goes to visit the sick person each day, assures that the patient takes their medications, assures that if the patient has a problem that he or she listens. Even if the accompanier can't solve the problem, the very fact that the person can talk about it and someone can listen without judging is really important.
Well, at that point, if the accompanier can't solve the problems by him or herself, he or she will go talk to the supervisor in the hospital. The accompanier becomes an advocate for the sick.
Health also goes alongside education. Early on we realized that the best thing we can do in a community is to send children and the youth to school so that they don't spend their time in the streets. What we did, starting in Cange, was to create a school with trained teachers, books, and at least one hot meal for the kids so they can concentrate and study. The parents don't have to worry about where they'll find money to pay. Now we have 15 schools throughout the Plateau Central. We have thousands of students, children who go to study, sometimes just primary school if that's what the town has, though in Cange the school goes up to 12th grade.
We also send young people to study in universities in Cuba and the Dominican Republic, or we send them to study nursing in [the Haitian towns of] Léogane and Gonaives. We help them find scholarships to go to Europe for specialized studies.