What is a Community Health Center (CHC) Anyway?

“A community health center is defined as a community-based and patient-directed organization that serve populations with limited access to health care.” For people living in Port-au-Prince Haiti a CHC is so much more. On Tuesday, December 16, the Congressional staff delegation went to visit an urban community health center in Petit Place Cazeau, operated by the SSQH project and funded by USAID.  The first thing you notice when you walk into the clinic is the crowds of people organized into stations for services.  Video screens are in every waiting area to make sure patients and their families are “learning while waiting,” videos today focused on sexual violence and what to do if someone has been violated. As you continue walking around the clinic, it’s clean, open and quite welcoming. Another thing you notice is the men in the clinic, many are holding their children or simply waiting with pregnant partners. This clinic provides a fully integrated package of health services but most women are here for prenatal services, including HIV screening. Often men are not integrated into clinic visits due to space; in this clinic there was room for men and other family members to accompany their partners.

Years ago, I was the clinic director for a similar type of clinic in Houston, Texas. Women, many needing subsidized services, came into the clinic to find out if they were pregnant or to receive prenatal services. Very early on, one of the things that was obvious  was the need for space for children and other family members to accompany the women. Simply having enough chairs helped women stay longer and come more frequently. Another tool to maximize time in the clinic was the use of educational videos on topics such as support for victims of violence, long term birth control methods, and prenatal health. My visit to Petit Place Cazeau was a reminder that women and their families, no matter where they lived in the world, want the same access to quality health services and how important these services are to so many.

Funding for programs like these clinics, both in the US and around the world, not only help provide lifesaving services but they also promote the basic principle that “health is a human right” for everyone.

A mom and her baby at the SSQH clinic. Photo credit: Crystal Lander/MSH.

A mom and her baby at the SSQH clinic in Petit Place Cazeau. Photo credit: Crystal Lander/MSH.

Recap: Day 5 – December 18

The delegates’ last morning was an exciting one as they started the day with a breakfast meeting with the US Ambassador to Haiti Pamela L. White. Ambassador White and the delegates discussed the US’s investments in Haiti’s health and development. The meeting was a great opportunity for the delegates to engage and learn more about the US’s overall role in Haiti.

The delegates and US Ambassador Pamela White (middle, red dress). Photo credit: Therese Cafaro/USAID/Haiti.

The delegates and US Ambassador Pamela White (middle, red dress). Photo credit: Therese Cafaro/USAID/Haiti.

Following their meeting with the Ambassador, the delegates learned about supply chain management as they visited a warehouse run by and met with staff from the Supply Chain Management System (SCMS) project. SCMS, a PEPFAR-funded project through USAID and implemented by the Partnership for Supply Chain Management, saves lives by providing critical medical supplies to those in need in Haiti and worldwide. SCMS’s activities are focused on ensuring the provision of best quality anti-retroviral (ARV) drugs and other HIV commodities through needs assessments, forecasting, procurement, shipping, warehousing, and distribution at the national level. SCMS improves infrastructure, provides technical assistance, and improves the ability of clinics to manage supplies to ensure proper storage. SCMS was instrumental in saving lives after the January 2010 earthquake and the subsequent cholera outbreak in Haiti, by providing commodities for the emergency response and by procuring and distributing cholera-related commodities. As of 2013, SCMS also manages the national pharmaceutical waste management program as part of its efforts to help strengthen Haiti’s health system.

The delegates talk with SCMS staff at the old warehouse. Photo credit: Therese Cafaro/USAID/Haiti.

The delegates talk with SCMS staff at the old warehouse. Photo credit: Therese Cafaro/USAID/Haiti.

Before concluding the tour with a debrief discussion, the delegates met with the Centers for Disease Control and Prevention’s (CDC) In-Country Director, Dr. David Lowrance, and the CDC’s Senior Policy Advisor for Health Systems and Strengthening, Zara Ahmed. Lowrance and Ahmed provided the delegates with an overview of the CDC’s work in Haiti, highlighting another way the US invests in Haiti’s development.

After a whirlwind week full of meetings, site visits, and events, the delegates departed Port-au-Prince with a greater understanding of how US investments in Haiti impact Haiti’s health and development.

Recap: Day 4 – December 17

The last full day in Haiti started with the delegates visiting a local business development community followed by a meeting with the Secretary of State for the Integration of Persons with Disabilities, Gerald Oriol, Jr. Secretary Oriol, Jr. is the head of the Bureau du Secrétaire d’Etat à l’Intégration des Personnes Handicapées (BSEIPH), which aims to establish public policy for the integration of disabled people into all spheres of life in Haiti. After the 2010 earthquake the needs of people with physical disabilities rose dramatically. Under Oriol’s leadership the government and civil society are working together for change. One impact of change is all new buildings in Haiti will have disability ramps and bathrooms. Thanks to the US government many schools have been modified for ramp access, making school more accessible for more children.

The delegates and Secretary Gerald Oriol, Jr. Photo credit: Therese Cafaro/USAID/Haiti.

The delegates and Secretary Gerald Oriol, Jr. Photo credit: Therese Cafaro/USAID/Haiti.

After their meeting and overview of BSEIPH, the delegates visited Healing Hands for Haiti (HHH) Rehab Center in Port-au-Prince. HHH trains Haitians to deliver quality, sustainable physical medicine and rehabilitation education,, training, and care for adults and children with physical disabilities in Haiti. Prosthetic limbs are also made and fitted on site. Through their meeting with Secretary Oriol, Jr. and visit to HHH, the delegates gained a better understanding of how Haiti is meeting the needs of its disabled citizens and empowering them to help themselves.

During the afternoon, the group had the opportunity to meet with the Haitian Minister for Public Health and Population Dr. Florence Guillaume. Minister Guillaume provided the delegates with an overview of the MSPP’s work and how it is addressing health systems strengthening, donor partnerships and investments, and successes and challenges in ongoing earthquake reconstruction efforts. The delegates engaged in discussion with Minister Guillaume on Haiti’s health plans for the future and their National Health Plan.

Minister Guillaume (left) engages in discussion with the Congressional staff delegates during their meeting at the MSPP. Photo credit: Crystal Lander/MSH.

Minister Guillaume (left) and Assistant Director MSPP Dr. Jean Patrick Alfred (middle) engage in discussion with the Congressional staff delegates during their meeting at the MSPP. Photo credit: Crystal Lander/MSH.

After their visit to the MSPP, the delegates toured the L’Hôpital Universitaire d’ État d’ Haïti (HUEH) and National Campus of Health Sciences (NCHS). These facilities were massively impacted by the earthquake, with almost 50% of HUEH being destroyed. During the tour, the delegates were able to witness firsthand the progresses that have been made rebuilding these facilities, thanks to a joint effort between the Haitian, US, and French governments, and the impact they have in providing essential health services to the Haitian population.

Finally, what a better way to celebrate an amazing week and the last night in Haiti than to do with Haitian food and art. The delegates were welcomed to Kolektif 509, a local art gallery whose mission is to promote the artwork of contemporary artists in Haiti by showcasing their talent both locally and internationally. The delegates engaged with Haitian and US leaders from both the public and private sectors. Guests included Uder Antoine, General Coordinator of the Management and Human Resources Office of the Government of Haiti as well as USAID/Haiti staff and members of the private sector community.

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Delegate and reception guest at the Haitian Leaders Reception. Photo credit: Crystal Lander/MSH.

Reception guests and delegates pose for a quick picture. Photo credit: Crystal Lander/MSH.

Reception guests and delegates pose for a quick picture. Photo credit: Crystal Lander/MSH.

Recap: Day 3 – December 16

The third day of the study tour kicked off with the delegates visiting an urban community health center in Petit Place Cazeau, operated by the SSQH project, where they followed a community health worker to a “rally post” and toured a USAID-funded clinic that provides a fully integrated package of health services.

Delegates look on as a CHW weighs a baby at the rally post. Photo credit: Crystal Lander/MSH.

Delegates look on as a CHW weighs a baby at the rally post. Photo credit: Crystal Lander/MSH.

After the health center, the group visited Caribbean Craft, a  Haitian women owned manufacturing company based in Port-au-Prince which employs more than 300 local artisans. Caribbean Craft trains and employs local artisans, provides design assistance and exports the artisan’s work around the world.

TOMS Shoes painted by the artists at Caribbean Craft. Photo credit: Crystal Lander/MSH.

TOMS Shoes painted by the artists at Caribbean Craft. Photo credit: Crystal Lander/MSH.

The delegates then met with Melissa Rosser from USAID/Haiti’s Office of Democracy and Governance, during lunch for an overview and discussion on governance in Haiti.

Following lunch, the group visited a multi-drug resistant tuberculosis (MDR-TB) hospital operated by GHESKIO. This MDR-TB facility is the only one of its kind in Port-au-Prince, serving the Ouest department. The facility provides in-patient treatment to MDR-TB patients suffering from the most drug-resistant strains of TB and who require at least 22 months of closely monitored follow-up care.

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Delegates and GHESKIO staff tour the MDR-TB facility in Port-au-Prince. Photo credit: Crystal Lander/MSH.

Delegates and GHESKIO staff tour the MDR-TB facility in Port-au-Prince. Photo credit: Crystal Lander/MSH.

The day concluded with a dinner and discussion on Haiti’s health priorities. Local experts and the delegates discussed the state of health in Haiti and how diverse partners are engaged in improving health and overcoming emerging challenges.

Walk a Mile in Her Shoes

We have all heard this saying many times: walk a mile in her shoes then judge. Well on Monday, December 15 congressional staffers visiting Haiti with MSH traveled to Calebasse, a suburb of Port-au-Prince, to spend the morning with a community health worker (CHW) with the Services de Santé de Qualité pour Haïti (SSQH) project, funded by USAID. The SSQH project provides about 50% of the Haitian population with basic health services. The CHW, with the team in tow, visited three families and a group of women, where children were immunized for polio and other key vaccines and mothers received their monthly depo provera shots and prenatal checks.
The delegates follow a CHW on her home visits in Calabasse, Haiti.

The CHW leads the way to one of her home visits in Calebasse, Haiti. Photo credit: Crystal Lander/MSH.

The CHW is nominated by her community and receives extensive training on how to give basic vaccines and how to use local mobile technology in her daily visits by following a specially designed app in Creole. The data collected during the visits, up to 15 daily, is then uploaded to a larger program database for tracking. The community health worker program is part of the Haitian Ministry of Public Health and Population’s National Health plan and the goal is to expand the program exponentially.
The delegates and SSQH staff during their first site visit.

The delegates following the CHW in Calebasse, Haiti. Photo credit: Crystal Lander/MSH.

The true stars of the visits were the faces of the very healthy babies whose moms happily reported that they were exclusively breastfeeding their children.

The CHW weighs a baby during one of the home visits in Calebasse.

The CHW weighs a baby during one of the home visits in Calebasse. Photo credit: Crystal Lander/MSH.

We only walked a mile in the shoes of one community health worker but it was enough to realize how hard this woman works and the tremendous impact she is making in her community.

Recap: Day 2 – December 15

The delegates started the second day of the trip bright and early with a visit to the Services de Santé de Qualité pour Haïti (SSQH) project where they accompanied a community health worker (CHW) on her home visits around Calebasse. While on these visits, the delegates learned more about the SSQH project and the CHW’s work as she weighed babies, dispensed vaccines, and provided medical advice to families. The SSQH project is Haiti’s largest health service delivery program, funded by USAID and in partnership with nonprofits and the Ministry of Public Health and Population (MSPP). It delivers essential health services to the central and southern regions of Haiti.

The delegates observe the CHW as she provides essential health services during a home visit in Calebasse, Haiti. Photo credit: Crystal Lander/MSH.

The delegates observe the CHW as she provides essential health services during a home visit in Calebasse, Haiti. Photo credit: Crystal Lander/MSH.

After the visit, the delegates met with USAID/Haiti global health staff to learn more about USAID/Haiti’s health projects and the advancements made in Haiti’s development since the 2010 earthquake. During this meeting the delegates met with staff from the Haiti Health Infrastructure Program (HHIP), which reconstructs, renovates, and equips major MSPP facilities and facilities in the US Government development corridors.

Before attending a special dinner and discussion event, the delegates viewed different locations around Port-au-Prince where tent city settlements were once located. These former tent city locations, which are now transitioning back to being parks and common spaces in the city, demonstrate the progress made in Haiti’s post-earthquake reconstruction as the tenants have been able to resettle into permanent housing.

The day concluded with a dinner and discussion on the big picture of Haiti’s development agenda with USAID/Haiti Office Chiefs and MSH staff.

Recap: Day 1 – December 14

The tour started bright and early in Washington, DC yesterday as delegates met and got to know one another on the flight to Haiti. After a short layover in Miami, the group arrived in Port-au-Prince ready for a busy week of site visits, meetings, and events!

Before the long travel day came to a close, the group attended a welcome dinner where delegates received an overview of the trip and met with study tour coordinators and USAID/Haiti health staff.

Some of the delegates, USAID/Haiti and MSH staff at the welcome and overview.

Some of the delegates, USAID/Haiti and MSH staff at the welcome and overview.

Stay tuned as we provide recaps of each day on this exciting trip!

Welcome and About the Tour

As our study tour kicks off in Port-au-Prince, we wanted to say a few words about why we’re going to Haiti, why these tours matter, and our plans for the future.

The overarching theme of this five-day study tour is to examine the US government funded health efforts in Haiti. The approaching five year anniversary of the Haitian earthquake has brought the country’s rebuilding efforts to the forefront of international development conversations once again. Unfortunately, much of the post-earthquake development dialogue has focused on the setbacks and delays of large-scale infrastructure and rebuilding projects without considering sectors such as health that have made relative progress. It is clear that greater awareness is needed among U.S. decision makers and the press in order to disaggregate the good from the bad and to recognize the health progress being made in partnership with the Haitian Ministry of Public Health and Population.

The staffers have a packed schedule each day. Through meetings with local leaders and implementers, tours of US and non-US supported project sites, and visits to local health facilities and communities, the trip will demonstrate the work still to be done while celebrating the progress made to achieve a healthy future in Haiti. Some activities of note on the trip include meetings with the Haitian Minister of Public Health and Population, the US Ambassador to Haiti, and USAID/Haiti staff and site visits to an urban community health center, MDR-TB hospital and the State University of Haiti Hospital (HUEH). Each night concludes with a special dinner discussion with key Haitian and US leaders, in both the health and development sectors. (For the full schedule, click here).

Learning tours like this one are key for global health advocacy: they educate and engage Congress on global health issues and provide staffers with the opportunity to witness US development investments firsthand.

After we return, we will build on the knowledge gained and lessons learned from the tour to host debrief meetings with the NGO community and on Capitol Hill. We will also be hosting a full day policy summit on Haiti’s health progresses on Capitol Hill followed by a reception celebrating Haitian culture, collaboration, and future of health in Haiti.