Charles King: Why Healthcare Relief May Fail in Haiti

Posted by Sunny Bjerk , January 26, 2010 at 7:10pm

On the last day of his second trip to Haiti to help set up three clinics, two for people with HIV, the other for families, Housing Works President and CEO Charles King explains why some doctors are turning their backs on badly needed primary care.

Jobanny, Jennifer Kasper and I get up at 3 AM to make our way back to Santo Domingo. Jennifer has a flight back to Boston where she has to make up shifts for pediatricians in the emergency room who covered for her while she was with us in Haiti. Jobanny has to pick up Dr. Marie Nomil, who will be heading up the PHAP+ clinic for us after Marcelo leaves, and Lisa Orloff from World Cares Center, who is working with us to get supplies in. Lisa has a donated charter flight direct to Port-au-Prince bringing in a load of donated medical supplies. We are getting her in with a truck to meet the flight.

On the ride to Santo Domingo, we talk about our biggest concern: Keeping a steady stream of medications flowing in to Haiti, along with a steady stream of providers. We need pediatric medications of all sorts. But so far we haven’t tapped into the right source. And now we have a whole list of medications to fill for the hospital in St.-Marc.

Doctors, on the other hand, are easy to find: We know that there are dozens of doctors and nurses hanging around the Port-au-Prince airport and the Central Hospital with nothing to do. We have tried recruiting some of them, but we aren’t doing the glamorous sexy stuff of disaster. That was so last week. Unfortunately, that is what many of the providers have come here for. The clinics we are supporting aren’t intended to be field hospitals. We aren’t doing amputations or dramatic rescues.

We are, however, providing critical urgent and primary care to people who have long suffered under an inadequate health care system and now have no system whatsoever. We need family practitioners, pediatricians, infectious disease and AIDS doctors and nurse practitioners, the basic staff that are the heart of any primary care setting.

When we explain to doctors what they will be doing at the clinics we are working in, it doesn’t seem so urgent to folk to drop everything. Some people who have committed drop out altogether, others schedule for a more convenient time. Meanwhile, we are trying to figure out how we are going to get the coverage we need to keep all of the clinics open.

Jobanny, Jennifer and I make it to the Las Americas airport in Santo Domingo without incident. Jobanny, who has now been working 16-hour days without stop since the earthquake struck, makes a sign to greet his arriving passengers. Jennifer and I sprint off to deal with our flights.

Arriving in New York, I speak with Jobanny. He is frustrated. We have hired the truck to bring in another load of supplies. But it is a holiday in the Dominican Republic and all of the wholesalers are closed. Making his way back to Haiti, the SUV has a flat. Unfortunately, the spare is a different size from the rest of the tires. He is going to have to limp in to Port-au-Prince.

Just before I fall asleep, I get an e-mail from Marcelo. The PHAP+ clinic saw over 50 patients today. We have seen more than 180 men, women and children since the clinic opened just four days ago…and we have a written chart on each one of them.

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