Zanmi Lasante / Haiti

The situation in Haiti

Even before the devastating 2010 earthquake, the island nation of Haiti was already one of the poorest countries in the Western Hemisphere and one of the poorest in the world. Before the earthquake, Haiti’s per capita income fell below two dollars a day, at about $660 annually. At the same time, the health of the Haitian people also ranks as the worst in the hemisphere. 

Haiti has the worst malnutrition, the highest rates of infant and maternal mortality, and the worst AIDS epidemic in the Americas. Nearly half the population is chronically undernourished. Of every thousand children born in Haiti, 71 die before reaching the age of 5, in stark contrast with nearby Cuba where the rate is only 4.6 deaths for every 1,000 live births. 

HIV, tuberculosis and cholera are the major causes of adult mortality. Maternal mortality, largely due to obstructed labor and hemorrhage, is at 523 per 100,000 live births, compared to less than 20 per 100,000 in the United States and only 2 per 100,000 in Sweden.

Though poor in wealth, infrastructure and natural resources, Haiti is a country rich in culture and democracy. Originally a French slave colony, Haiti was founded by a revolution in 1804 and became the first black republic. It was the first country to break the chains of slavery, to force Napoleon to retreat, and the only to help Simón Bolívar liberate the indigenous people and slaves of Latin America. Despite adversity, democracy thrives in Haiti. Tragically, the history of liberty and self-determination has drawn two centuries of political and economic ire from powerful countries, resulting in policies that have served to impoverish the people of Haiti.

PIH's work in Haiti

Zanmi Lasante (“Partners In Health” in Haitian Kreyol) is PIH’s flagship project – the oldest, largest, most ambitious, and most replicated. The small community clinic that first started treating patients in the village of Cange in 1985 has grown into the Zanmi Lasante (ZL) Sociomedical Complex, featuring a 104-bed, full-service hospital with an infectious disease center (the Thomas J. White Center), a women’s health clinic (Proje Sante Fanm), a laboratory, a pharmaceutical warehouse, a Red Cross blood bank and a dozen schools.

ZL has also expanded its operations to a dozen other sites across Haiti’s Central Plateau and beyond, with an additional site in the Dominican Republic. Today, ZL ranks as one of the largest nongovernmental health care providers in Haiti – serving a catchment area of 1.2 million people, with a staff of 5,400 Haitians.

PIH/ZL's work in Haiti by the numbers (FY 2011):

• 2.8 million patient encounters
• 13,784 children received educational assistance
• 6,268 HIV-positive patients on treatment
• 98,735 pregnant women seen in antenatal clinics
• 53 houses constructed or repaired
• 482 TB patients treated
• 75,000 cholera patients treated

Our community-based model, which involves thousands of accompagnateurs (community health workers), is instrumental to preventing illness, monitoring medical and socioeconomic needs, and delivering quality health care to people living with chronic diseases such as HIV and tuberculosis. 

In 1998, Zanmi Lasante launched the world’s first program to provide free, comprehensive HIV care and treatment in an impoverished setting. PIH's HIV Equity Initiative is now a global model for the delivery of complex diseases in community settings.

ZL has also been an incubator for other innovative programs, such as its Program on Social and Economic Rights (POSER). PIH has long championed the need for social as well as medical support for our patients. POSER addresses the social inequalities that put our patients at increased risk of disease by providing nutritional support, building houses, paying for school fees and installing well caps or filtering systems to ensure access to clean drinking water.

The Earthquake

On January 12, 2010, a massive earthquake struck Haiti, killing over 250,000 people and leaving 1.5 million homeless. PIH’s staff in Haiti and around the world immediately launched into action, bringing emergency medical care and supplies to survivors.

In the 2 years after the quake, PIH registered 4.6 million patient encounters, among them many earthquake survivors and nearly 80,000 cholera patients. In addition, PIH and the Ministry of Health have nearly completed construction of the Mirebalais National Teaching Hospital. The team has also expanded agriculture, nutrition, education, and income-generation programs to help survivors feed and support their families.

Once the scope of need in Haiti became apparent, PIH designed and began implementing the Stand With Haiti Fund, a 2.5-year, $125-million plan to help the country rebuild. By June 2012, PIH will have spent the entirety of that fund, fulfilling the promises made in the weeks after the earthquake.

The Stand With Haiti Fund allowed PIH to expand and strengthen healthcare services, with an emphasis on specialties like rehabilitative medicine and mental health that had been weak before the earthquake and were even more desperately needed after it.

But much remains to be done. Working in partnership with Haiti's Ministry of Public Health and Population and the Port-au-Prince-based organization GHESKIO, PIH and Zanmi Lasante are preparing to implement a cholera vaccine demonstration campaign. And within months, the doors to the new 320-bed Mirebalais National Teaching Hospital will open.  

Read an update of PIH’s post-earthquake work.

Learn more about PIH's work in Haiti.