Over the past year, we've brought you dozens of stories from the people and programs at our projects around the world. But because the subjects of our stories continue to live, grow, and face challenges long after we write about them, the passage of time often reveals even better stories. We are devoting this issue to revisiting past stories--and following up on what's happened since our first reporting. From a program for diabetes patients in Boston to a project aiding orphans in Lesotho to efforts to recover and rebuild after a devastating series of hurricanes in Haiti, these stories will continue to develop in the months and years to come. We hope to continue sharing them with you.
In this issue:
- In the storms' wake: building back better in Haiti
The flood waters receded a little over a year ago, but the work of rebuilding communities in Haiti has only just begun.
- A house for growing hope in Lesotho
Five orphans settle into a new house, a new school, and a new family.
- PACT takes on chronic diseases in Boston
The PACT project enrolls the first patients in a program that expands its use of PIH's accompagnateur model to provide treatment for diabetes and other chronic diseases.
- Raising quadruplets and a new district hospital in Rwanda
Four miraculous sisters celebrate their five-month birthday, as the hospital they were born in celebrates a growth spurt of its own.
- Serving up peace and hot meals in Malawi
A new restaurant opens along one of Malawi's busiest highways, serving hot meals to travelers and hope to the women who own and operate it.
- Interest-free inspires much interest: a microfinance project in Peru
An innovative microfinance project in Peru lends a nuevo sol and a hand to poor patients.
- PIH Russia helps battle MDR-TB in Eastern Europe and Central Asia
Through training and technical assistance, PIH Russia helps battle drug-resistant TB throughout Russia, as well as in former Soviet states.
- Act.pih.org
Join us in building the movement for health and social justice!
- Health and Social Justice Video Network
An online video network that doesn't show videos of dancing cats or motorcycle stunts.
- Still need holiday gifts?
Check out some unique gifts that will inspire and educate your loved ones while supporting PIH's work around the world.
- Plus: House calls and health care; AIDS treatment express lines; Forgiving children; Dartmouth's new leader; Bill Clinton's new deputy; Not just another death in Burundi; Dangerous IMF policies; Yes Haiti Can; and This I Believe. Also, find out about PIH summer internships and social network with us!
Above photo: PIH's partner organization in Haiti Zanmi Lasante organized a race as one of the events celebrating World AIDS Day on December 1st. Find out how other PIH sites around the world commemorated the day.
In the storms' wake: building back better in Haiti
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The hurricanes caused massive flooding in Haiti last year.
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In the fall of 2008, four hurricanes and tropical storms surged across Haiti, bringing floods and widespread destruction to the poorest country in the Western Hemisphere. As many as 800 people died and an estimated one million Haitians, almost 12 percent of the population, were displaced. Whole cities were flooded, including Gonaïves in the Artibonite Valley and Hinche in the Central Plateau.
In the days following the floods, PIH’s partner organization, Zanmi Lasante, worked around the clock to provide food, shelter, clean water, and medical care to those hit hardest by the storm. In the months since, the team has worked tirelessly to help rebuild—and build back better—so that the communities we serve have improved infrastructure and are better able to respond to natural disasters in the future.
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A new ward in Saint-Marc.
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The team placed priority on three specific objectives. The first was to strengthen medical facilities to cope with the existing needs of the community, and to prepare them for future emergencies. One major focus of this objective was the Hospital San Nicolas in the community of Saint-Marc, which became a refuge for thousands of people fleeing from the flooded city of Gonaïves. Since the hurricanes, the team has helped construct an emergency room, a post-operation ward for surgical patients, a maternity ward, and an imaging center with x-ray and ultrasound capabilities in Saint-Marc. In Petite Rivière, another community hit hard by heavy flooding, ZL helped construct two new operating suites and a lying-in center for pregnant women to stay in while awaiting labor at the public hospital Centre Medical Charles Coliman. The team also provided essential medicines and equipment, and training and supporting staff. ZL recently broke ground for a new hospital in the town of Mirebalais, where the decrepit old hospital was closed last spring, leaving a community 140,000 without a functioning hospital.
For the second objective, the ZL team prioritized programs to help alleviate hunger and malnutrition—problems that were already prevalent in Haiti, but were exacerbated when the flooding destroyed acres of crops in one of Haiti’s most important agricultural areas. Over the past year, ZL organized nearly 80 community-level agricultural trainings that included environmentally sustainable farming practices and techniques for soil conservation. The program also provided tools, seeds, livestock and additional training to local farmers and families with malnourished children. Many of ZL’s sickest patients and their families also received food packets.
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Constructing biosand filters to supply clean water.
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Finally, the team worked to expand programs addressing social and economic issues, including housing and access to clean water and education. ZL helped build 25 houses for families who lost their homes in the storms; supplied construction tools and materials to families with damaged houses; and helped 40 families resettle in rental homes on higher ground away from flood-risk zones. ZL completed three spring-capping projects, bringing clean water to nearly 10,000 residents, and delivered 200 biosand filters to other families without access to safe water. ZL’s education program provided school assistance to 2,228 children in hurricane-affected areas, and ran adult literacy programs in 77 training centers throughout Central Haiti.
A house for growing hope in Lesotho
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Driven by dual epidemics of HIV and tuberculosis, the orphan rate in the southern African country of Lesotho is the highest in the world. Nearly one out of every three children in Lesotho has lost one or both parents. In October 2008, we reported on five such orphans. All of these children had lost both parents, and had no one to care for them--no home, no one to provide food or clothing, no guardians.
Dr. Hind Satti of PIH Lesotho recalled the first time she met three of the children—sisters: "It was painful to see them, the wind was so freezing, they were so hungry... [Their clothes] hardly covered their little bodies." PIH Lesotho provided the sisters with a new home, a new mother, and the means to attend school—the key to a healthy, productive future.
Today, the children—the three sisters plus another brother and sister—are all still living together with their adopted mother, M'e Leomile, and still in school. Because of the months of school time they had missed while trying just to survive and care for ailing parents, all initially struggled to keep up on the classroom. Of the two eldest, only one has progressed to the next grade level. The other is still working to catch up on her basic reading and math skills. But all the children are beginning to realize the bright future in their grasp.
"I want to be a school principal when I grow up!" Tselane, a bubbly 9-year-old, recently asserted. Her siblings quickly chimed in, breathlessly sharing their ambitions of becoming nurses, teachers, and even a policewoman. M'e Leomile beamed as proudly as any mother would, and began preparing one of their favorite lunches--split pea soup.
Watch a video featuring the five children, M'e Leomile, and PIH Lesotho staff member M'e Maleshoane.
PACT takes on chronic diseases in Boston
Last year, the Prevention and Access to Care and Treatment (PACT) project in Boston began working with providers at the Codman Square Health Center to adapt PIH's accompagnateur model of care to treat diabetes. PIH and PACT feel confident that the model, which has a proven track record for treating patients with infectious diseases, such as HIV/AIDS and tuberculosis, can also be used to help manage non-communicable chronic conditions, like diabetes or cardiovascular disease.
In November, after months of planning, PACT and the Codman Square Health Center hired and trained community health workers (accompagnateurs), and enrolled the first three patients in the program, PACT Research Coordinator Thomas Roberts reported. At least 20 more patients are scheduled to be enrolled during December, with a goal of 180 patients to be enrolled over the next five months.
The project is targeting patients with the most serious, uncontrolled cases of diabetes. The disease severity is diagnosed with an A1c test (a blood test that measures a patient's average glucose level). The American Diabetes Association (ADA) recommends an A1c target of less than seven percent. Most of the patients in the PACT program will have an A1c above nine percent.
The program is part of a research study. Half of the patients will receive home visits and accompaniment from the community health workers—much the same way thousands of accompagnateurs visit HIV/AIDS and TB patients at PIH projects around the world. The other half will receive standard care from their health centers and serve as a control group in the study.
Raising quadruplets and a new district hospital in Rwanda
Five months ago, the Butaro District Hospital welcomed four babies into the world. One was a surprise, as the doctor had previously seen only two babies in the ultrasound. And one was a huge surprise—unknown to mother or doctor until after her three siblings had been delivered. All four were miraculous, particularly in a community where less than two years earlier there had been no functioning district hospital and residents recalled having to row across a large lake for emergency obstetrical care.
Today the quadruplets are happy, healthy baby girls, doted upon by their parents and five older siblings.
Likewise, the hospital is also growing. Last November, PIH and its partners broke ground for a new 150-bed district hospital to serve a population of 400,000 people in rural northern Rwanda. The hospital is being built almost entirely by workers hired from the local community, bringing many much-welcomed jobs into a local economy frustrated by a nearly 80 percent unemployment rate. Laborers are being hired in two-week shifts to help ensure that the wages are more equally distributed throughout the community.
See a slide show of images by photographer Adam Bacher, who recently visited the site.
Serving up peace and hot meals in Malawi
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Stella at the construction site for the future Mtendere Restaurant.
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Wearing a bright turquoise dress and a wide smile, Stella welcomes visitors inside the Mtendere Restaurant in Zalewa, Malawi.
For most of her adult life, and even part of her childhood, Stella had been forced to work as a commercial sex worker. This year, PIH's partner organization in Malawi worked with Stella and a dozen other women in similar circumstances to build a viable alternative—employment that did not routinely put them at risk of HIV infection, physical assault, or worse.
This fall, Stella and the other women opened the doors to Mtendere (which means "Peace" in the local Chichewa language). With aid from PIH, including training in literacy, business practices, and cooking, plus a renovated space complete with chairs, tables, and bright red tablecloths, the women are armed to offer hot meals and cold drinks to travelers stopping at one of the busiest trucking corridors in southern Africa. Many of the women are also employed by the local health center as community health workers and sexual health educators in the Zalewa community.
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Stella (middle row, third from left) and her colleagues are joined by BBC personality Alvin Hall (next to Stella) in front of the newly open Mtendere restaurant.
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Interest-free microfinance program inspires much interest in Peru
Geoff Gusoff spent last year hiking up and down the hills surrounding Lima doing something that very few staff at PIH or its sister organizations would ever do—ask patients for money.
As a volunteer for Socios En Salud (SES) in Peru, Geoff worked with an innovative new project: a micro-enterprise program with a preferential option for the poor. Micro-enterprise programs provide small loans (often a few hundred dollars or even less) to individuals to start small businesses. Although whole networks of micro-finance institutions have very quickly spread throughout the developing world, SES’s program is different.
Unlike many other micro-enterprise programs, SES provides the loans interest-free. Most of the patients seeking loans come from the poorest families in Lima. SES decided not to charge interest to prevent families from having to choose between basic needs and interest payments.
Also, unlike many other micro-enterprise programs, SES provides intensive business training with each loan. Each patient works with a mentor to develop and execute a business plan. Mentors visit the businesses once or twice a month to observe daily operations and offer insights. SES also tailors repayment plans to the patients’ needs, accounting for health problems and family crises.
So far, the program has benefited many patients who could not be reached through standard micro-enterprise programs. In the past two years, the program has grown from twenty participants to over a hundred all across the city. Businesses include bodegas, street vendors, shoe-makers, moto-taxis and restaurants. One participant with no previous business experience started a Chinese restaurant that is so successful he is considering opening another branch. For the vast majority of patients, the businesses represent an economic lifeline and a source of security for themselves and their families.
PIH Russia helps battle MDR-TB in Eastern Europe and Central Asia
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A training session in Kazakhstan.
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With PIH Russia’s track record of successfully treating multidrug-resistant TB (MDR-TB) in Tomsk Oblast in Siberia, other territories throughout Russia, and neighboring countries have been eager to attend technical training sessions organized by the Tomsk team. Over the past few years, representatives from every oblast (province) in Russia have received training in the management of MDR-TB.
In 2008, following up on its training program, the team began providing intensive technical assistance to the Russian territories of Novosibirsk Oblast and Altay Kray, which border Tomsk. This year, at the request of the Russian Health Care Foundation, PIH Russia began assisting two more provinces–Saratovsky Oblast and the Republic of Mari El.
PIH Russia has also responded to increasing international requests for assistance. With funding from the Eli Lilly Foundation, the Tomsk team, along with colleagues from Harvard Medical School, the Tuberculosis Office of Tomsk Oblast, and the Tomsk Oblast State Penitentiary System provided training to clinicians from ten countries that were formerly part of the Soviet Union. Among them was Kazakhstan—a country just south of Tomsk that suffers from one of the highest rates of MDR-TB as a percentage of new TB patients. About 20 percent of all new TB cases detected in Kazakhstan are multidrug-resistant, according to the World Health Organization.
This year, PIH and the Government of Kazakhstan began working together to fight this problem. And early in 2010, PIH will open an office in Kazakhstan to provide intensive technical assistance to the national MDR-TB program in two territories bordering Tomsk. Stay tuned for more news about this exciting new partnership!
Act.pih.org
 Want to be more involved with Partners In Health? Check out act.ph.org, a new online resource launched this fall that can help you:
- Find out about PIH events in your area
- Connect to other PIH supporters and partners
- Create events, track your fundraising goals
In the coming months, act.pih.org will be adding many new features that will allow you to read updates and blog postings about PIH project sites around the world, and join communities of people dedicated to social justice and global health equity. Stay tuned for more information and sign up today!
Health and Social Justice Video Network
Matt Damon, Tracy Kidder, and Nicholas Kristof starred in a few of the many videos featured on the Health and Social Justice Video Network. Launched in January of 2009, the network showcases projects at PIH sites around the world, as well as other organizations and individuals who share our commitment to health and social justice. New videos are frequently added, and viewers can either enjoy the rotating featured programming or watch videos on-demand.
We are always looking for new content to feature--please contact us if you have ideas!
Still need holiday gifts?
Check out some special gifts that will directly support the work of Partners In Health or the communities we serve. From a gorgeous 2010 Partners In Health calendar, to a hat knit by one of our patients in Malawi, to a copy of Tracy Kidder's Mountains Beyond Mountains, find gifts that will inspire and educate your loved ones.
Final shot: World AIDS Day 2009
On December 1st, PIH's sister organizations around the world celebrated World AIDS Day in a variety of ways:
Clockwise from top left: Village health workers on parade in Nohana, Lesotho; An information table at a health fair in Peru; Community members receiving voluntary counseling and testing for HIV in Haiti; Dancers performing in Lebakeng, Lesotho; A soccer match in Malawi; A band entertains the crowd in Mirebalais, Haiti; A walking condom greets passersby in Peru. Related: a foot race in Hinche, Haiti.
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