In this issue:
- From the desk of Amanda Schwartz
What does it mean to build a movement? A grant writer working in PIH's Boston office shares her firsthand experience at building a movement for social justice with some of our youngest supporters.
- From the desk of Elna Osso
What's it like to work for PIH's partner organization in Peru? After two months on the job, Socios En Salud's newest staff member shares her thoughts.
- Fiery support
Get a limited-edition, autographed Arcade Fire DVD and hand-silk-screened poster and support PIH's programs in Haiti!
- Calling all student interns
Do you have a summer internship or job working on a health-related issue abroad? Take a quick survey to help with a Harvard study!
- Tiny twins get double the care in the Central Plateau
Born a month premature, severely underweight, and in the impoverished Central Plateau of Haiti, the Joli twins faced an uphill battle for survival.
- Dateline PIH: Project updates from all over
Sponsoring students in Peru, Team Heart operates in Rwanda, and a scene from PIH Lesotho's newest site.
- Plus: Shaping the future of PIH; Twittering about global health; This I Believe; Special envoy to Haiti; and Just doing it.
Above photo: Young mother with twins at Rwinkwavu Hospital in Rwanda. Like the Joli twins born in Haiti, twins and low-birth-weight babies born in rural Rwanda often face many obstacles to survival.
From the desk of Amanda Schwartz,
PIH Grants Development Assistant
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Amanda Schwartz
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Dear Friends,
When I first started working at Partners In Health, almost two years ago, I'm not sure I really knew what it meant to "build a movement." I knew what it meant to deliver modern medicine to the poorest of the poor, and I could understand why supporting community health workers is the cornerstone of PIH's model of care —both are tangible examples of service delivery and bolstering local capacity. In fact, as a member of PIH's grant-writing team, these are the kinds of things I write about to our foundation and corporate donors on a day-to-day basis. I write about the 1.9 million patient visits recorded in Haiti, the 800,000 poor living in rural Rwanda we now reach, or the 110 marginalized HIV patients that are currently being supported by PACT's health promoters in Boston. But what I very rarely seem to write about —and therefore what has taken me longer to fully grasp —is what it means to say PIH is building a movement in solidarity with the world's poor.
Last fall, PIH received a grant award from Operation Day's Work (ODW), a unique foundation that is actually a collection of middle and high school students who vote on submitted proposals, and spend their school year fundraising for their chosen cause. We had asked ODW to fund our school fee assistance program in Haiti, knowing that the four hurricanes and tropical storms that devastated Haiti last August and September would make it tragically more difficult for poor Haitian parents to send their children to school. Having voted to fund this work, the students of ODW began learning about Haiti and fundraising, with the hopes of sending thousands of Haitian children to school this year.
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Ali Lutz, PIH's Haiti program coordinator, speaking to students in Vermont.
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Last month, I had the opportunity to join Ali Lutz, PIH's Haiti program coordinator, to attend ODW's annual regional meeting held at their headquarter school in Thetford, Vermont. There, over 300 students listened to our presentation and asked thoughtful questions about Haiti. I looked at the faces staring up at Ali as she showed photos of Paul Farmer and Cange (the very first hospital of PIH's partner organization Zanmi Lasante) twenty years ago, and Cange and Zanmi Lasante's work today. And as I watched, I realized I was watching a movement build.
So what does it mean to build a movement? Some might say it is an office of 70 dedicated Boston-based staff and 7,000 others across the world spending their time delivering and expanding and healing and fighting and managing and fundraising and caring. Others might say that movement-building is an organization started by college students now known nationwide as FACE AIDS. Some might say it's lobbying for debt relief or writing letters to Congress or op-eds to The Boston Globe. And there are some who might even admit that it's the household name Mountains Beyond Mountains —which introduced PIH to a world that would otherwise never have heard of the impoverished community of Cange and its woes.
These days, I say it's a room of hundreds of young students in Vermont —students who are asking why kids in Haiti can't go to school; who are demanding answers; who are moved to make change, one bake sale at a time; and who now believe that the poorest of the poor deserve dignity and respect. It is in these students that there is indeed hope for the poor to receive what they deserve. Movement building is ODW's role in shaping the belief systems of these students and many others who are now compelled to become teachers, and share what they know about the poor in Haiti and in poor communities around the world.
- Amanda Schwartz, PIH Grants Development Assistant
From the desk of Elna Osso, Peru International Project Coordinator
The newest member of PIH's partner orgaization in Peru, Socios En Salud (SES), Elna Osso recently jotted down her reflections after her first two months on the job. Born in Peru, Elna comes to SES after working for many years in public health and nursing in Maine.
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Elna Osso (right) has spent the past two months visiting Socios En Salud staff and patients in and around Lima, Peru.
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Dear Friends,
Since arriving in Peru in early March, I've been getting to know the various projects at Socios En Salud. After spending many hours traveling from one extreme of the capital city of Lima to the other in traffic jams and scorching sun, I've gotten a glimpse at the long hours that promotores (community health workers) and field staff spend in the car, not to mention the patients who do not have the same comfortable transportation that I do.
No matter how many times I've seen it before, the suffering of the poor always moves me, just as the human spirit that prevails in this environment continues to amaze and inspire me. It's not surprising to see that it is those with emotional support and encouraging environments who improve faster or maintain positive attitudes. In many cases, the SES promotores have played this important role of being trusted friends and supporters. It is because of this that it's easy to see that the promotores, who accompany patients day after day, are largely responsible for the success of SES's work. All of the efforts involved in ensuring timely treatment for patients would fail if the patient were to decide not to take his or her medicine.
Throughout my visits during these weeks, I've met patients in different stages of their battles with disease and poverty and it is clear that the medical and socioeconomic support that SES provides is also very logical. For example, I visited a woman who lost her husband and now, having survived infections of both TB and HIV, must continue to raise her two children by herself. The microcredit she received from SES has allowed her to keep a sewing machine in her house. She is now able to care for her family at home and continue to improve her situation. And she is thinking of expanding her business with other family members.
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Elna meeting with SES staff.
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This philosophy of promoting independence is also evident in the work of the supervisors I accompanied during my travels. They knew exactly when to ask a patient to be more self-sufficient and they also knew when a patient wasn't ready for that step. It showed me the value of really knowing well the people you are working with and the importance of empowering patients to be more independent.
Having lived for many years in rural Maine, I love spending time in rural areas and so really enjoyed my visit to Huarangal, a remote community in the north of Lima. We met with Veronica, the promotora responsible for monitoring children's physical and social-motor development. In this isolated region, she is also the first contact when a problem comes up, and thanks to her strong relationships with the mothers of the community, she is also able to help them seek necessary medical care. In general, the work of fortifying the community by educating mothers and teachers, detecting malnutrition or development problems early on, and empowering young people to help out in their community at a young age are important efforts that strengthen our work by keeping a focus on comprehensive health care. My visits to the rural botiquines (health posts) allowed me to meet other incredible promotores like Isabel, who generously offers her time to manage health services in the isolated community where she lives and be the first source of care where there is no alternative. Coordinating doctors' visits once every two weeks, Isabel ensures everything runs smoothly and that everyone who needs care is seen. Her dedication to health has rubbed off on her teenage daughter as well, who proudly displays a sexual health poster that she shares with other young adults. I feel so grateful and proud to be part of the SES team.
- Elna Osso, Peru International Project Coordinator
Fiery support from Arcade Fire
Are you a fan of the Canadian rock band Arcade Fire or do you know someone who is? Get a special limited edition autographed Miroir Noir DVD and an exclusive hand silk-screened Arcade Fire poster, individually numbered and signed by the artist!
Longtime supporters of PIH, the band is donating all proceeds from this special offer to help PIH's work in Haiti.
There are only 250 DVD and poster sets available, so get yours today!
Going abroad this summer? Help with a Harvard research study!
Are you working or interning abroad this summer on a health-related project? If so, please consider contributing to a research study being conducted by Harvard University's Global Health Delivery Project. The study will help fill a gap in research literature aimed at describing the operations of health delivery agencies in resource-poor settings. The goal of the study is to roughly measure the sophistication of organizations in a variety of domains, including finances, human resources, logistics, and leadership. Find out more information about the study and how you can contribute to it.
All responses will be confidential and no identifying data will be shared. Additional questions can be directed to maria_may@hms.harvard.edu.
Tiny twins get double the care in the Central Plateau
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The Joli twins about 2 months old.
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Weighing less than two pounds, the tiny baby would have struggled to survive in even the most well-equipped neonatal intensive care unit in Boston. But born on the rural central plataeu of Haiti about a month prematurely, the small infant and her equally tiny twin brother faced grim odds, said Dr. Koji Nakashima, a resident with Boston's Brigham and Women's Hospital who also works with Zanmi Lasante, PIH's partner organization in Haiti.
Being born so early and underweight left the Joli twins without the simple mechanisms for life, wrote Koji in a recent email. "They had no body fat to keep warm, no sugar stores to fuel their bodies, immature nervous systems to coordinate breast feedings, immature skin that allowed vital fluids to evaporate away," he added.
Luckily for the Joli twins, the Cange pediatric ward and its tireless nursing staff were able to accommodate their early arrival into the world, and their slow and fragile transition to independent life.They were placed in incubators, warmed to maintain a safe body temperature, and humidified to maintain vital body fluids. The began their nutrition through a tube placed from the nose into the stomach every three hours, and slowly over weeks advanced until breastfeeding could give them enough fluid to maintain hydration, sugar to maintain energy, and protein to grow.
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The Joli twins and their parents.
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"Throughout this time, the twins' mother maintained an equally steady vigil, spending every day of the three weeks, at first pumping her breast milk to nourish her children through feeding tubes, then gently coaxing them to her breast," said Koji.
They were recently deemed healthy enough to go home with their parents after spending two months in the hospital. "They're doing great," said Koji in a follow-up email. "They have gained weight rapidly and their mother says they are voracious eaters."
Dateline PIH: Project updates from all over
Peru: Every year, staff from PIH's partner organization in Peru, Socios En Salud (SES), organize an intiative to sponsor children who might otherwise not have the opportunity to go to school. These children, ranging in age from 4 to 18 years old, are connected to the initiative through various other SES projects, including programs for patients with tuberculosis and HIV/AIDS and their families. The staff initiative supplies the needy children with school fees, uniforms, books, and/or school supplies needed for the school year. This year, 50 children are being supported.
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Claudine in recovery after receiving cardiac surgery from Team Heart.
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Rwanda: Claudine desperately needed heart surgery, a procedure that no facility in her home country of Rwanda could perform. The 15-year-old girl's condition was only exacerbated by the overwhelming poverty of her family, who live in a hut made of banana leaves with a dirt floor. However, things are starting to look up for the teenager. Along with 12 other critically ill patients, Claudine recently received the life-changing surgery she desperately needed from Team Heart, a cardiac surgery team from Brigham and Women's Hospital in Boston. The 13 surgeries were part of Team Heart's second trip to King Faisal Hospital in Kigali.
In addition to working to help Rwanda build up a national cardiac surgery program to treat patients like Claudine, PIH, Team Heart, and its partners are now also working to provide social support to the cardiac patients, hopefully including better housing for Claudine and her family.
Read more about Team Heart.
Lesotho: Outside Manamaneng, the newest rural health clinic for PIH's partner organization in Lesotho.
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