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Haiti’s Health Care System Faces a ‘Defining Moment’

Child amputee, Haiti; UN Photo/Marco Dormino

As Haiti continues to rebuild from January’s earthquake, educating and training more Haitian doctors and nurses is essential to reviving and restructuring the country’s hobbled health system, says the country’s health minister.

“The state of New York has more Haitian physicians than Haiti itself,” Health Minister Alex Larsen said at a panel discussion on the health system’s future, held in Washington, D.C., Wednesday.

Speaking through a translator, Larsen emphasized the need to train and retain health care workers by providing better salaries and incentives to stay in the country, and by keeping foreign recruiters from luring Haitian trained workers away as soon as they receive diplomas.

Even before the earthquake, the country’s health system was in dire straits, relying heavily on NGO assistance. According to 2009 World Health Organization statistics, Haiti had one nurse and three doctors for every 10,000 people, and that was before the quake killed as many as 300,000 people and left 1.5 million homeless.

The emergency medical response to the earthquake has “stabilized,” Larsen said, and the ministry has developed an 18 month recovery plan that emphasizes even “more attention to the human resources than the physical infrastructure.”

Already a public health school is being created to train mid-level workers, meaning community health workers, midwives and nurses. The country also hopes to capitilize on increased interest from outside medical universities willing to play an educational role in Haiti.

Andre Vulcain, faculty liaison of the Haiti Project at the University of Miami Miller School of Medicine, said the new focus is important because the mid-level work force, “that’s where you win or lose the battles usually.”

The earthquake has also shone a light on the mental health needs of Haitians, especially in working to address the stress and trauma caused by the disaster.

“We are starting to address mental health needs, mental health is an area that was incredibly neglected before the earthquake,” said Donna Barry, advocacy and policy manager for Partners in Health, an NGO that has worked in Haiti for decades. The group is training community health workers to reach out to families, hiring social workers and psychologists as well.

But no broader and long lasting improvements to the system will be possible without the full commitment of the international community, said Barry.

“We have seen over and over and over that donors conferences happen, billions of dollars are pledged, then maybe 30 to 40 percent of what was pledged [will] actually get to Haiti.”

In early June, Haiti’s President Rene Preval told a donor’s summit that little of the more than $5 billion pledged by governments had actually been delivered and that only Brazil had fulfilled its full commitment of $55 million.

In the last few decades, much of the decision making and responsibilities of the health system have been transferred to NGOs, said Vulcain. The health system has not been able to provide the level of services required for the population in the past, but those responsibilities need to be restored to the Health Ministry to make progress, he said.

“I really think that we are at defining moment for the health care system of Haiti,” Vulcain said.

Larsen agreed, and thanked the international community for reaching out after the quake.

“From every corner of the world people were coming to help Haiti, we are forever in debt for this type of assistance,” Larsen said. “It’s never too late to do good, so we are going to try to do the good now.”

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