My first memories are of a bustling mission clinic compound in Limbe, Haiti. My parents, a doctor and a nurse, did a two-month stint of medical work there when I was two years old, and they brought my older brother and me along for the ride.

I remember–or think I remember–running around naked with my underwear on my head, playing with the other children. I remember the pet raccoon named “nush-nush” (Kreyol for “raccoon”–original, I know).

This is the cholera quarantine area of a temporary relief clinic located in a large Port-au-Prince tent village, home to 55,000 people.

I remember the hoards of Haitians who waited outside all day to be treated by the all-foreign medical staff. And I remember Dr. Hodges, the man who founded the clinic, and how he sat at the head of the long dining-room table and blow his whistle to signal the start of each meal.

I recently heard a broadcast about Haitian healthcare on This American Life. It actually mentioned the clinic at Limbe which, since Dr. Hodges died, has turned into a ghost town.

This stamp tells people that the hospital’s building has been inspected by engineers and deemed structurally sound.

This is a scenario typical of missionary-controlled health care. Clinics such as the one at Limbe serve many people during their short life-spans, but tend to die out soon after their white directors die or leave.

Closing Up Shop

21 years later, I am back in Haiti.  As I have wandered around the Port-au-Prince area during the last two weeks (fully clothed this time, with my underwear in its proper location), I’ve seen a different model for health care emerging. But like the missionary model before it, this one relies mainly on foreign medical personnel.

The aid money that poured into Haiti after January’s earthquake was used to set up free clinics to treat the millions of injured across the country.  Many of these are still in operation, taking on even more patients as the cholera outbreak continues to spread.

Since the quake, HCH and a partner organization have been providing physical therapy, a service that is rare in Haiti. Volunteer therapists provide hope to patients like this woman.

However, as Haiti falls out of the news, many of the aid-funded clinics are closing up shop and heading home.  Of course, this comes as no surprise. While aid-based relief was invaluable directly following the quake, this model of medical care is short-term and unsustainable.

At a Crossroads

I was not here right after the quake, but my mom was here in April. As we observe the state of the city, I see devastation, but she sees improvement. The changes between then and now show evidence that Haiti has reached a new stage, a crossroads that requires a change of focus from the immediate need to the long-term development of the country.

The problem is that such a shift of focus involves painfully difficult decisions. Often it seems that addressing the immediate need is destructive to long-term development, while investing in long-term development appears to ignore the immediate need.

Haiti needs a new medical philosophy, a sustainable one that utilizes Haiti’s own resources–namely, the Haitian people.

We hear a lot about Haiti’s lack of resources: poverty, poor education, deforestation. Obviously, these reports are true and these issues need to be addressed. But the picture of Haiti we so often see is missing vital information.  It rarely depicts the best resource that the country does have: its people.

A Valuable Resource

The other day, I was able to experience one of Haiti’s valuable resources when I took a tour of the Haitian Community Hospital, which is located in Petionville, right outside Port-au-Prince.  HCH is a Haitian-run institution that was founded in 1984 and has been going strong since.

The Physical Therapy Department is still located in a tent.

Because it is private, the hospital generally does not give free care. It relies on both patient fees and outside funding to stay afloat. However, after the earthquake the hospital made a huge exception.

Doctors and nurses volunteered their time and skills and the hospital gave of its supplies and resources. All of the hospital’s 75 beds were filled, and the courtyard and much of the parking lot were covered with tents and cots. In the three months following the quake, HCH gave free care to over 10,000 patients.

In fact, the hospital gave so much that it almost closed due to lack of funds. Another private hospital nearby actually did close a few months after the quake because it had been drained dry. HCH managed to stay alive–but barely.

The hospital now faces a difficult transition: trying to move back to their normal system while staying relevant in the aftermath of the disaster.

A few months ago, this area was covered with the tents of the overflow hospital. Now, the plants are growing back.

Although it struggled with a lack of patients when it first reinstated fees for care, HCH is once again a bustling place and is working toward reaching a new equilibrium.

The Grass is Growing

During my tour of the hospital with Dr. Edith Hudicourt, one of HCH’s founders, she pointed out a courtyard that had been covered in tents after the quake. She told me that, during the time of the crisis, the once-beautiful grass that had covered the courtyard was trampled. Now, she said, “The grass is growing back. I never thought it would grow back.”

Just like the grass, Haiti can come back from the devastation of the earthquake. But foreign medical aid cannot be the complete answer.

True change in Haiti must come from within.

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Next Steps
    • Listen to Episode 408: “Island Time,” a three-part radio broadcast that aired on the public radio show This American Life. The episode focuses on three different issues related to Haiti, and the second part on healthcare in particular.
    • Check out the Haitian Community Hospital’s website to learn more about its work.
    Next Steps

About the Author: Calah Schlabach is a freelance journalist with World Next Door. She graduated from Calvin College in 2009 with a degree in English and a concentration in long-distance running, then spent a year volunteering in Hanoi, Vietnam. She doesn't know what the next turn her life will be, but is planning to make sure it includes sampling plenty of strange/delicious food!

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Comments

  1. Erika said... 

    Reply

    November 30th, 2010 at 8:29 am  

    The fact that this hospital utilizes Haitian staff and is HAITIAN run really says something…and the fact that it’s been in operation since 1984..wow! Just out of curiosity, Calah… Are there Medical Schools in Haiti? Does this hospital have a residency program for students? What draws Haitian physicians to practice there?

    Great article! Keep them coming…

  2. Donna Hutchinson, PT said... 

    Reply

    December 19th, 2010 at 11:44 am  

    What a positive article in the midst of so much negative press about Haiti lately! We are the Global Therapy Group who created and run the therapy department in the tent at HCH. A few of us arrived as volunteers in early April, saw the dire need for PT and OT services, and created a clinic and our non-profit organization. Prior to the earthquake there were 25 PTs in all of Haiti and therapy was not a medical service people had access to. We have recruited over 50 volunteers from around the world so far, who work at the clinic in two week rotations. We hope to expand, get out of the tent (!) and continue through 2011 and beyond until a Haitian trained staff can take over. We now have a staff of three Haitian translators and treat an average of 20 patients a day. We struggle weekly for funding and to find ways to get the word out to PTs and OTs that their skills are needed in Haiti and we need volunteers. We were so excited to see our little clinic’s picture in your article. Thank you!

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