GHESKIO: Six Months Later

Within 24 hours of the Haiti earthquake, GHESKIO was providing care to its established cohort of HIV patients, and emergency services to earthquake victims. Weill Cornell Medical College has been affiliated with GHESKIO for thirty years. Weill Cornell has received donations in support of GHESKIO from over 2,000 supporters ranging from school children to major foundations. We thank you all. Your donations have allowed GHESKIO clinicians to provide care to refugees and trauma patients, to diagnose and treat patients with tuberculosis, and to continue HIV services. 

Refugees: After the earthquake 7,000 refugees sought shelter on the GHESKIO campus in down-town Port au Prince. Most of the refugees came from the extremely impoverished neighborhoods which surround GHESKIO, and were among the most severely damaged by the earthquake. GHESKIO provides shelter, sanitation, water, food, jobs, health care, education, security, and social support to these refugees. The field where refugees initially camped was at sea level and flooded. Therefore, we prepared an alternative field across the street from GHESKIO. We raised the level with gravel, graded the field, and dug irrigation canals. The refugees and their tents were moved in three days from the flooded area to the new field.

GHESKIO staff survey the camp daily for people with fever, cough, diarrhea, rash, or other symptoms. If symptoms are present, then camp residents are referred to an on-site primary care clinic where a physician consults and provides medications. We also are providing other primary care services including vaccinations, prenatal care, and child growth monitoring. Underweight children and pregnant women are provided a locally grown nutritionally fortified peanut butter. Mothers are invited to “mothers clubs” where nutrition and health issues are discussed.  

Social support is also provided. This includes support for a teen theatre group, a soccer team (GHESKIO Lions), and music club. During the World Cup, three large screen televisions were placed in the camp so that refugees could watch the matches. GHESKIO has established a primary school for 350 children ages 6 – 12 who are living in the camp.

Rehabilitation for Trauma Patients: GHESKIO hosted a United States Department of Health and Human Services Disaster Medical Assistance Team (DMAT) for four weeks after the earthquake and they provided emergency and surgical services to 3,000 patients. GHESKIO supported the DMAT with physicians, nurses, laboratory support, x-rays, electricity, and interpreters. In addition, GHESKIO continues to provide intensive rehabilitation services to 1,000 severely injured trauma patients with amputations, major fractures, and neurological damage. GHESKIO has trained 23 Haitian physical therapists. Because Haiti did not have any physical therapists before the earthquake, we recruited trainers from the national soccer team and Haitian nurses. GHESKIO has started sending teams of physical therapists into other tent cities to identify trauma patients who are in need but have not yet received post-operative and rehabilitation services. We have established a “survivors club” for trauma victims who have successfully completed physical rehabilitation. Patients meet once per week at GHESKIO to talk and find strategies to reintegrate into life in Haiti.

Tuberculosis: As a consequence of the earthquake, the tuberculosis (TB) burden in Port au Prince has increased an estimated two-fold. TB is a major infectious disease killer and is passed from person to person through the air in crowded living conditions. Treatment requires 6 months of multi-drug therapy. Poor adherence with medications results in multi-drug resistant tuberculosis. During the earthquake, the three major tuberculosis sanitoriums in Port au Prince were destroyed along with a number of out-patient treatment centers. At least three thousand tuberculosis patients in Port au Prince stopped their treatment and dispersed to crowded tent cities.

GHESKIO is emergently working with the National TB Program and other partners to strengthen TB screening and treatment in Port au Prince. The GHESKIO laboratory is the only one in the country capable of performing tuberculosis diagnostics: microscope examination, culture, and drug resistance testing. We provide free TB diagnosis and treatment to all patients who come to GHESKIO. We have opened a TB “field hospital” to provide in-patient services. We are also performing TB diagnostics on samples sent to GHESKIO from other centers in Port au Prince including the State University Hospital and the National Penitentiary. 

GHESKIO is initiating TB treatment for 130 new patients per month. This is nearly double the rate from last year. GHESKIO alone diagnoses and treats more cases of TB than are diagnosed and treated in the entire city of New York.  GHESKIO’s TB field hospital has received 75 patients who cannot be treated as outpatients, either because of the severity of their illness, or the resistance of their disease. 

HIV/AIDS Services: During the last six months, we have provided HIV care and prevention services to 5,000 children, 9,000 adolescents, and 38,000 adults. In total, 52,000 patients have been seen in the GHESKIO HIV clinics since the earthquake.

GHESKIO provides a comprehensive package of care for patients with HIV/AIDS and patients at risk for acquiring HIV, including voluntary counseling and testing, tuberculosis screening and treatment, reproductive health services, HIV care including antiretroviral therapy, nutritional support, and services to prevent mother to child transmission of HIV. Importantly, all health care provided by GHESKIO is free of charge, including services and medications.  

Rebuilding: We have initiated four major rebuilding projects. 1) We have initiated and nearly completed repairs to GHESKIO’s HIV/AIDS clinics in down town Port au Prince; 2) We have broken ground on the construction of a new TB hospital; 3) Architectural plans have been drawn up and a construction company designated to build a new primary school at GHESKIO; 4) We are working with the Haitian Government to identify land where refugees can build new homes. GHESKIO will provide building materials and vocational training so that refugees can rebuild their own homes and work with partners to assure sanitation, community health, education, and jobs. We are seeking funds for rebuilding a nutrition center, a women’s health clinic, and a community health center. 

Thank you for your support. Follow our progress on line at: http://weill.cornell.edu/globalhealth/ Contact us at: GHESKIO Relief; The Center for Global Health; Weill Cornell Medical College; 440 East 69th Street; New York, NY 10021; globalhealthweb@med.cornell.edu; phone M-F 9am-5pm (212) 746-6680