In this issue:
- From the desk of Paul Zintl
PIH's Chief Operating Officer explains how a recent watershed grant will fund expansion of services and research in rural Rwanda.
- Paul Farmer named as the UN's Deputy Special Envoy for Haiti
PIH's co-founder takes on another job--with Bill Clinton and the United Nations.
- Save the Date
Mark your calendars for PIH's 16th annual Thomas J. White Symposium.
- NOW on PBS zooms in on rural health care in Rwanda
Tune in to watch a PBS special featuring PIH's partners in Rwanda.
- Behind the mountains
An intern reflects on her summer with PIH's Institute for Health and Social Justice Internship Program.
- On our reading list
This fall, don't forget to check out two great books by Pulitzer Prize-winning author Tracy Kidder, both out on bookshelves starting August 25.
- Partner in Profile: Luz Nelia Benitez, PACT Community Health Promoter
A community health promoter in Boston shares her story.
- Plus: Moving our Boston office, PIH on Earth, Second second chances, OpenForum blog, and Twittering.
Above photo: Gishanda Primary School, Rwanda.
From the desk of Paul Zintl, PIH Chief Operating Officer
Dear Friends,
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Paul Zintl
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Over more than two decades of work, PIH and our partners have received several transformational grants from foundations or governmental bodies that have allowed us to accelerate the growth and elevate the trajectory of our work. Some of these grants have fueled major expansion of our programs. Others have funded research needed to evaluate, strengthen and disseminate our model of care. Most recently, I am happy to report, we have been awarded another major grant that will do both.
In August PIH initiates an exciting new implementation and research initiative in Rwanda, teaming up with several Rwandan government and academic partners and with the Brigham & Women’s Hospital and Harvard Medical School. The Doris Duke Charitable Foundation (DDCF) has announced that it will provide $8 million over five years for a rigorous evaluation of the effectiveness, cost and overall impact of the comprehensive approach to primary health care we have initiated in two eastern districts of the country.
DDCF has funded several consortia, in addition to ours, to establish Population Health Implementation & Training (PHIT) centers in a number of countries. Our PHIT initiative will have a number of important objectives:
- To improve population health by increasing access, quality and effectiveness of care delivered by community health workers (CHWs) at health centers and through district referral hospitals and systems.
- To analyze the impact of these interventions in collaboration with the Ministry of Health and the Rwanda National Institute of Statistics and to contribute that knowledge so that it helps the government of Rwanda replicate and sustain the most effective components of our interventions.
- To conduct an economic evaluation of the costs and cost effectiveness of the interventions and of their impact on household health spending.
- To help build Rwanda’s capacity for effective monitoring, evaluation and research, at the district level and in the Ministry of Health, the National Institute of Statistics, and the National University of Rwanda School of Public Health. To do so, we will provide financial support for Ph.D. and Master’s degree level students, drawn from these institutions, and will partner them with HMS and BWH faculty members leading these research initiatives.
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Community health worker Pascal Harimana surveys a family in his village.
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Importantly, the foundation’s support will pay for expansion and improvement of our primary health care initiatives and not simply for research. We will be able to expand our efforts to new health centers with DDCF resources and we will continue to integrate historically “vertical” health care programs, such as HIV/AIDS diagnosis and treatment, into delivery of quality primary care services. This innovative leveraging of vertical resources is especially relevant for impoverished rural settings, where vertical programs cannot improve population health without complementary and integrated attention to other pressing health needs. Most importantly, the PHIT Partnership intervention will focus on the most vulnerable residents of the rural districts where we work, those who are at highest risk for poor health, those least likely to seek health services and least able to access them.
The PHIT Partnership will strive to provide an evidence-based road map for the global health community. The goal is to achieve a higher standard of healthcare delivery in Africa while strengthening health systems and capacity to conduct implementation research. It is a bold plan to address the needs of people and communities suffering from the joint burdens of disease and poverty and to provide a long term benefit to the country of Rwanda that can be shared with other countries facing similar challenges.
- Paul Zintl
PIH Chief Operating Officer
PIH co-founder Paul Farmer named as the UN's Deputy Special Envoy for Haiti
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President Bill Clinton with Paul Farmer.
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Former President Bill Clinton has appointed PIH co-founder Paul Farmer as Deputy Special Envoy for Haiti. In a statement to supporters, PIH Executive Director Ophelia Dahl stated, "I'm delighted to let you know that he has officially accepted this position, an honorary role that will permit him to continue his teaching and clinical roles at Harvard and to serve the people of Haiti--his greatest teachers, as he has so often said. Paul and others on our team are enthusiastic about working alongside President Clinton and other friends of Haiti to advance economic development there and to assist the Haitian government in implementing its priorities. This is wonderful news for Haiti and for all of us. After 25 years of working hand in hand with our Haitian colleagues and partners, we are confident that President Clinton's mandate will bring much needed support and investment to the courageous people of Haiti."
Read the UN press release.
Save the date – PIH Annual Symposium
Partners In Health will hold its 15th annual Thomas J. White Symposium on the afternoon of Saturday, October 3, at the Sanders Theatre in Cambridge, MA. The yearly event brings together PIH staff, family, friends and fellow activists and advocates for health and social justice for the poor.
Please look for more information about this memorable event and how you can get free tickets in next month's e-bulletin. A live stream of the symposium will also be available at www.pih.org starting at 3pm EST on October 3.
NOW on PBS zooms in on rural health care in Rwanda
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NOW on PBS correspondent David Brancaccio interviews Rwandan community health worker Pascal Harimana.
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Tune in to your local PBS station on Friday, September 11. That night's episode of NOW on PBS will feature PIH's work with the government of Rwanda, the Clinton Foundation, and local rural communities to bring health care to those most in need. Check your local PBS station for listings of when the show will air in your area.
Behind the mountains: A reflection on PIH's Institute for Health and Social Justice Internship Program
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Reem Abu-Libdeh with fellow IHSJ interns.
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Each summer, PIH's Institute for Health and Social Justice organizes a summer internship program. Below is an excerpt from a piece written by Reem Abu-Libdeh, an intern with PIH's communications department. Read her full essay here.
A few weeks ago I went to a Haitian restaurant in Somerville, in a part of town not serviced by the subway. The restaurant stood on the corner, and big red block letters announced its name: HIGHLAND CREOLE CUISINE. Inside, the peach-colored walls were covered in Haitian art. Haitian music played softly in the background. The menu was in both Creole and English.
I was there with a large group and we were celebrating, or maybe mourning, the end of our summer internship with PIH’s Institute for Health and Social Justice. We had all met seven weeks earlier in a conference room, where we went around the table saying our names and where we were from (New York, California, Massachusetts, Peru, Tajikistan, and more). We smiled a lot, made small talk, tried to remember names and who was from where. Now, at the restaurant, the conversation was different—lots more laughter, lots more (very friendly) debates.
We had a lot to talk about.
For the past two months, in between our own projects—which ranged from grant-writing to working on curriculums for community health workers to researching cardiac care in Rwanda—PIH staff from all corners of the organization had sat down with us and talked about their work, their projects, their research. A young doctor from Lesotho described his successful male-targeted HIV testing and outreach initiative. He had engaged people in a way only someone from the community could. We spent an hour and a half with Paul Farmer, where we were given free rein to ask whatever we wanted. Project managers from Peru, Haiti, and Russia traced the sites from their origins to today, sharing lots of public health lessons along the way. Epidemiologists and anthropologists working at PIH sites across the globe broke down their research, and the community health promoters at the Prevention and Access to Care and Treatment (PACT) project left us in awe.
Read more about Reem's intern experience.
On our reading list: Tracy Kidder's new book and a new, updated edition of Mountains Beyond Mountains
Two books by Pulitzer Prize-winning author Tracy Kidder will be released on bookshelves starting August 25: a new deluxe edition of Mountains Beyond Mountains and Strength in What Remains.
Kidder's best-selling book Mountains Beyond Mountains tells the inspiring story Paul Farmer and the of the founding and achievements of Partners In Health. This new deluxe edition includes an updated epilogue that shares more of the continuing story of Paul and Partners In Health and their work since the original publication of the book in 2003.
Strength in What Remains tells the riveting true story of Deo, a young man from the mountains of Burundi in East Africa. After surviving a civil war and genocide in Burundi and Rwanda, Deo flees to America to start a new life. Deo's journey takes him from Africa to New York City to North Carolina to Boston (where he worked with Partners In Health) and back to Burundi. The book follows his growing determination to build something truly remarkable to help poor people in his home village and around the world.
In many ways Strength in What Remains is a natural companion for Mountains Beyond Mountains, and several of the same characters appear in both books, including PIH co-founders Paul Farmer and Ophelia Dahl.
Order these books and get information and materials for bringing them to your book club.
View Tracy Kidder's speaking schedule.
Read an excerpt of Strength in What Remains, as featured in Reader's Digest.
Partner in Profile: Luz Nelia Benitez, PACT Community Health Promoter
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Luz Nelia Benitez
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Luz Nelia Benitez’s very first client had an important question for her—one he already knew the answer to. Did she think she could get HIV from a quick touch to, for example, someone’s leg? Benitez, a community health promoter with the Prevention and Access to Care and Treatment (PACT) Project, answered quickly: of course not. The patient, who was HIV positive, quizzed Benitez a little longer on ways that HIV can be transmitted. She dutifully—and correctly—answered his questions. At the end, he gave her a hug.
“I felt so good,” Benitez says. “I felt like, Okay, now he knows that I’m for real. That I’m not trying to come into his home and impose on him.”
The Dorchester-based PACT, which is co-sponsored by Partners In Health and the Division of Global Health Equity at Brigham and Women's Hospital, serves the most marginalized HIV patients living in Boston and is based on the accompagneuter model in Haiti. Most patients are referred to the program by their physicians because of poor adherence to antiretrovirals (ARVs), or because the patients are often hospitalized for opportunistic infections. Community health promoters (CHPs) conduct home visits and check in on patients weekly or daily to ensure adherence to medications, educate patients on HIV and other health issues, support them during critical times, and guide them to appropriate social service agencies. The CHPs also accompany patients to medical appointments, both to show support and advocate for them. Benitez, who’s from Boston and lives around the corner from PACT’s offices, works with patients all across the city, from Medford to the South End.
“We’ll sit there and I observe them [the patients] fill out their pill boxes, and I’ll do a pill box check,” Benitez says. “Many of my patients are pros. If they leave a pill or didn’t take it, they’re usually honest with me. Then we talk about resistance, the importance of taking the drugs, if not on time, then at least daily.”
Benitez came to PACT six months ago after working with teens in a Chelsea high school for a couple years. Before that, she was a family advocate with ABCD Head Start, a family development program that supports pregnant women, children up to age five, and their families. While at Head Start, she juggled a full-time course load at Bunker Hill Community College and a new baby.
“I was a teen pregnant mom and I’ve been through the system. It’s very difficult to advocate for yourself,” she says.
Almost all of the patients enrolled in PACT are living in poverty and many struggle with domestic violence, mental illness, substance abuse, and homelessness. Some of Benitez’s patients are in denial of their illness or suffer from social isolation and stigmas that come both from the community and within. But she’s seen first-hand how when patients begin adhering to ARVs and start feeling better, they find hope in other areas of their life.
When she first started, Benitez had a client who had been nonadherent for two years and fallen into a severe depression. She had no income, no healthy support system. And so she walked—she would leave her house around 7 p.m. and walk until 2 or 3 in the morning. Since she started adhering to her medications, her viral load is undetectable, and she’s started to feel better in other ways.
“She stated that since she’s been seeing me she’s not going on walks anymore, she stays home, she’s not as depressed. So I feel good about that and it’s something that I always praise her about,” Benitez says.
“I’ve grown a lot from being in this job,” she says. “I’m more aware of my surroundings, more educated about HIV. I’m able to be there for people in my community because I’m part of this community. I’m able to establish relationships with them and help them through their obstacles, struggles, and barriers . . . and they appreciate that, just being there for them when they need you the most." |
