GHESKIO: One Year Later

A Haitian family living in GHESKIO's tent camp. The three young boys are being treated for tuberculosis.

In the twelve months following the earthquake, we continued lifesaving HIV/AIDS and tuberculosis treatment for thousands of patients, provided humanitarian relief to 7,000 refugees who sought aid and medical care on our campus, and responded to the cholera epidemic. Below is a summary of our current activities and future plans.

Earthquake Refugees: With support from more than 2,000 generous donors, GHESKIO continues to provide medical care and support for 7,000 refugees. With the onset of the rainy season, the GHESKIO camp was relocated to a nearby field, which is above sea level. Women and children make up 80% of the camp population.

GHESKIO staff and community volunteers continue daily surveys to monitor camp residents for signs of fever, cough, diarrhea, rash or other symptoms, and to provide treatment. The camp residents receive chlorinated water, food supplements, and security. Most of the staff who provide these services are hired from within the camp. All services, including medical treatment, are provided for free. Social programs for women, teens, and children have been organized.

In April, we opened a school for children from the camp and surrounding neighborhood. Recognizing the success of the school and the important role it is playing in the present and future lives of its students, the Principality of Monaco has pledged to support the construction and operation of a permanent elementary school on the GHESKIO campus. A new Nutrition Center supported by the MAC AIDS Foundation will be located next to the school. This facility will support an expanded GHESKIO nutrition program, which currently provides supplemental food and education to HIV infected patients, pregnant mothers, and children.

In the immediate aftermath of the earthquake, GHESKIO hosted a US Health and Human Services Field Hospital for trauma patients. We continue to provide physical rehabilitation services for 2,500 patients, and hope to partner with public hospitals to form a National Rehabilitation and Training Center.

HIV/AIDS and Tuberculosis: We continue to provide full HIV/AIDS services to over 140,000 children and adults including counseling, HIV testing, antiretroviral therapy, reproductive health services, nutritional supplements, and prevention of mother to child HIV transmission. All services and medications remain free of charge.

Tuberculosis, a contagious and often fatal lung infection, remains one of our greatest concerns, particularly because of the crowded housing in Port au Prince’s slums and tent cities. At GHESKIO, we have already seen a 2-fold increase in TB patients, including drug resistant cases. Over 1,000 patients are now being treated in the GHESKIO clinics and field hospital. Construction of a new 35 bed TB hospital and outpatient clinic has started and is expected to be completed in January 2012.

Emerging Challenges: In October 2010 the first cases of cholera were diagnosed in central Haiti, and the disease has since spread throughout the country. Cholera is an intestinal illness caused by the bacterium Vibrio cholerae. The infection leads to severe diarrhea and vomiting, and can ultimately cause death due to dehydration. Cholera can be treated with oral rehydration therapy and antibiotics. Transmission occurs in areas with poor sanitation and is acquired primarily by drinking contaminated water.

To date, the cholera epidemic in Haiti has killed more than 4,000 people and infected more than 190,000. While the tent city populations generally have access to potable water and latrines, this is not the case for the one million people living in crowded, unsanitary slums in Port au Prince. As many as 600,000 infections are predicted within the coming year.

With support from the Clinton Bush Haiti Fund, UNICEF, and the CDC, GHESKIO is providing clean water to 40,000 families in the surrounding neighborhoods, including the nearby slum known as “City of God”. GHESKIO has set up two cholera treatment centers and trained personnel in cholera management. In the past two months we have treated 1,700 patients for cholera - 200 were seen in the last week alone. We also have created a 12 member community health team to educate the population in tent cities and surrounding neighborhoods about protective measures including, drinking only potable water, washing hands, seeking prompt treatment for diarrhea, preparing oral rehydration solutions, and the use of chlorox solutions.

Building Better: We are pleased to report that we have rebuilt or repaired 70% of our clinical facilities. Looking ahead we are moving forward with long term rebuilding and development efforts which we hope will build back a stronger, healthier community.

The Haitian government has identified land to the west of Port au Prince, as a potential area for the permanent relocation of our camp residents. This “model village” will serve as an example of reconstruction for other communities in Haiti. Construction of housing units will cost approximately $5,000 USD per unit. Plot allocation mechanisms will be devised to allow residents to rent and eventually own their home. A workforce development program is being launched with the creation of a vocational school in collaboration with Les Frères Salesiens to prepare skilled workers, with an emphasis on construction trades. The first phase will train 200 young adults over a 6 month period. Participants will be drawn from the refugee camp, 65% of whom currently have no income.

Recognition: GHESKIO’s efforts in providing health care to the Haitian people over three decades, and its response to the past year’s tragedies were recognized by former President Bill Clinton with the Clinton Global Citizen Award. GHESKIO also received the 2010 Gates Foundation Award, the Carlos Slim Award for Global Health, and the Christophe Mérieux Award. Dr. Jean Pape, Director of GHESKIO, was honored for his inspiring leadership and tireless dedication to the health of Haiti’s people over the past 30 years. Thank you again for your unwavering commitment to building back a better, healthier Haiti, and best wishes for a happy, healthy New Year.

Sincerely,

Jean W. Pape
Professor of Medicine
Weill Cornell Medical College
Director, GHESKIO Centers