Zanmi Lasante / Haiti

The situation in Haiti

The island nation of Haiti is the poorest country in the Western Hemisphere and one of the poorest in the world. Nationwide, Haiti’s per capita income falls well below a dollar day, at about $240 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, 81 die before reaching the age of 5, in stark contrast with nearby Cuba where the rate is only 7.5 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.

The eighty percent of the Haitian population who live in abject poverty and bear the brunt of the burden of disease have little access to health care, especially in rural areas. Since health insurance is not available or affordable for the vast majority of Haitians, households must pay for health care or go without. Almost three quarters of private sector spending on health care takes the form of out-of-pocket expenditures.

The Earthquake

When the earthquake struck Haiti on January 12, 2010, ZL resources were in place to deliver aid. In addition to providing care to the hundreds of thousands who fled to Haiti’s Central Plateau and Artibonite regions, ZL established health outposts at four camps for internally displaced people in Port-au-Prince. ZL also supported the city’s General Hospital (HUEH) by facilitating the placement of volunteer surgeons, physicians and nurses, and by aiding the hospital’s Haitian leadership. In March 2010, PIH/ZL announced a 3-year, $125 million plan to help Haiti build back better.

Read the Stand With Haiti One-Year Report.

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. ZL employs over 5,400 people, almost all of them Haitians, including doctors, nurses and community health workers.

Our community-based model, which trains and hires 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 2011, PIH recorded more than 2.8 million patient visits at our clinical sites in Haiti.

In 1998, Zanmi Lasante launched the world’s first program to provide free, comprehensive HIV care and treatment in an impoverished setting. PIH's Global Health initiative is now a global model for the delivery of community-based treatment for complex diseases within the context of comprehensive primary care. In November 2003, a lengthy article in the New York Times, datelined from Cange, stated, “No program to treat people in the poorest countries has more intrigued experts than the one started in Haiti by Partners In Health.”

In the course of expanding our care of HIV-positive patients and their families, we have also significantly increased our ability to identify and treat patients with other diseases.

Women’s health has always been a strong focus of ZL’s outreach activities, and is one of the four essential components of the HIV Equity Initiative. One of ZL’s first projects was a women’s clinic, Proje Sante Fanm, which offers family planning, pre- and post-natal care, assisted deliveries and caesarean sections, vaccination of women and children, and screening and treatment of HIV, other sexually transmitted infections and cervical cancer.

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.