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Do No Harm Due Diligence: A Checklist for Medical Outreach in Haiti

  • May 8, 2018
  • Blog
Julie Hard

Julie Hard

Julie Hard is the Country Director for Americares Haiti. A physical therapist by background, she arrived in Haiti to work directly with victims immediately after the 2010 earthquake and to manage health programs to assist in recovery. As Americares Country Director, Julie leads the Americares professional team in providing medicines and medical supplies as well as a program support and technical advice to health care partners across the country. Julie holds a Masters of Science in Physiotherapy from McMaster University.

Since the devastating 2010 earthquake in Haiti, Americares has been operating an office in Haiti to provide local health partners with medicines, medical supplies, equipment, funding and technical support.  Our work with the Haitian Ministry of Public Health and Population (MSPP), Haitian and international NGOs, public and private hospitals, and clinics and community health programs across the country gives Americares a unique, informed view of health care delivery in Haiti. We’ve summarized lessons-learned into a checklist we call “Do No Harm—Due Diligence in Haiti.”

Before planning your Medical Outreach trip to Haiti, use the checklist to help ensure that the impact of your trip extends positively beyond the life-changing medical interventions that you will provide.

1. Is the partner with whom you are working registered?

Health care facilities should be recognized by the MSPP and appropriately registered to provide health care services in order to ensure compliance with health regulations and health priorities.  Inquiring about your hosting partner’s registration status and whether the partner meets with the health care priorities outlined by the MSPP is important in establishing accountability to the advancement of Haiti’s overall health care infrastructure.

Orphanages pose a unique challenge in Haiti as many are unlicensed and operate outside of governmental structures designed to protect, regulate and support care for children.  If your trip includes visiting orphanages or other children’s centers, it is important to ask if the center is registered with the Haitian Social Services Department Institut Bien Etre Social (IBERS).

2. Are the medicines you are bringing on the list of essential medicines?

Since 1977, the World Health Organization has regularly updated its essential medicines list as a recommendation to manage the quantity and kind of medicines circulating within countries.  In Haiti, this list has been elaborated and revised to form the Liste Nationale des Médicaments Essentiels (LNME) to assure availability and accessibility of quality medicines considered essential to the Haitian population.  The present list is comprised of 214 medicines necessary to respond to the pathologies most commonly found in Haiti.  Medicines not found on the list can be imported into Haiti with the appropriate permissions provided by the MSPP through the Direction de la Pharmacie, du Médicament.  The list is reviewed and revised every two years by the Commission Nationale du Médicament.

Liste Nationale des Médicaments Essentiels (LNME)

3. Do you have a referral plan?

It is inevitable that you will encounter people who require longer-term assistance beyond the scope of your planned medical outreach.  It is helpful to know that there are resources available for chronic health issues and for people with physical disabilities.

Hypertension and diabetes are highly prevalent in Haiti (estimated 5.9 percent nationally) but many people may not be aware of their diagnosis or may not know how to adequately manage their illness.  Ensure that you have a strategy in place to assist and link patients to ongoing care, especially if any medications are prescribed.

All reference hospitals within each department should be prepared to receive referrals for diabetes and hypertension.  The following facilities also provide affordable care for chronic disease management and may be considered as places for referral:

• Fondation Haitienne de Diabète et de Maladies Cardio-vasculaires (FHADIMAC) is a specialized center located in Port-au-Prince providing care for people with diabetes and cardiovascular illnesses. https://fhadimac.org/index.php/fr/contact-fr

• Clinique St. Etienne, in Les Cayes, South Department – steeve@hopeforhaiti.com

• Hôptial Albert Schweitzer, in Deschappelles, Artibonite – https://hashaiti.org

• Hôpital Sacre Cœur de Milot, North Department – http://crudem.org/volunteer/

Disabilities: The effects of the earthquake added to the pre-earthquake estimate of 800,000 persons with disabilities already living in Haiti. Americares partnership with the BRAC Limb and Brace Center (BLBC) in Port au Prince ensures prosthetics and orthotic devices are available to people with physical disabilities. 

Contact BLBC in Haiti: +509 2230 6060 or +509 3109 3080

Dr. Mazair St. Fleur
Programme Manager (BLBC)
BRAC Limb and Brace Center
12 rue Jacquet, Jacquet Toto
Delmas 95, Port-au-Prince
Haiti

E-mail: brac.haiti@gmail.com

4. Do you know how to respond to diarrheal disease?

Access to sanitation and clean drinking water presents an enormous challenge for the majority of Haitians.  Without sanitation and clean drinking water, diarrheal disease poses a serious health risk. Even before the cholera outbreak in 2010, diarrheal disease was the leading cause of child mortality and the second leading cause of overall deaths in Haiti.  Although the number of cholera cases has decreased, the disease along with other water-borne illnesses continue to threaten communities throughout the country where adequate sanitation and hygiene practices are lacking or altogether absent. 

Regular hand washing, proper food preparation and appropriate water treatment and sanitization reduces the risk of diarrheal illnesses including cholera.  When diarrheal illness presents, rapid treatment with an oral rehydration solution, following the cholera protocols, and early referral to the nearest health center save lives.