Partners In Health
Encyclopedia
Partners In Health is a Boston, Massachusetts-based non-profit health care
organization dedicated to providing a "preferential option for the poor". It was founded in 1987 by Dr. Paul Farmer
, Ophelia Dahl
, Thomas J. White, Todd McCormack, and Dr. Jim Yong Kim
.
PIH strives to provide an alternative to the conventional curative method of treatment for the sick and instead tries to prevent diseases before they occur. This model believes that primary health care is essential because health is a right and therefore, it should be available to everyone. PIH strives to bring good medical care
to the poor by establishing long-term partnerships with local sister organizations.
The organization's model is described as being one in which: clinical and community barriers to care are removed as diagnosis and treatment are declared a public good and made available free of charge to patients living in poverty. For people living in poverty stricken areas, the treatment of AIDS and multidrug-resistant tuberculosis (MDR-TB) has been made possible by this model of care.
The idea for Partners In Health first began when Paul Farmer and Ophelia Dahl helped set up a community-based health project in Cange, Haiti
known as Zanmi Lasante
("Partners in Health"). For a number of years the organization focused its efforts almost exclusively on treating HIV/AIDS patients in rural Haiti. In the past decade, the organization's mission has expanded to include a more holistic approach to tackling disease and poverty. PIH devotes considerable resources to providing food, water, education and housing to sick patients. The organization also advocates for human rights both at the governmental and international NGO level.
In 1993, Dr. Farmer founded the Institute for Health and Social Justice (IHSJ), which is the research and advocacy arm of PIH. The IHSJ was founded using the proceeds of Dr. Farmer's John D. and Catherine T. MacArthur Award. The mission of the IHSJ is to analyze the impact of poverty and inequality on health, and to use these findings to educate and train students, academics, donors, policy makers, and lay people. As of 2006, the IHSJ is under the direction of Dr. Joia Mukherjee
, PIH's Chief Medical Officer.
PIH is a Harvard-affiliated NGO. The organization works closely with Harvard's School of Public Health and the Brigham and Women's Hospital.
One of the defining features that separates PIH from other NGOs is its commitment to hiring and training people who live in the communities where the organization works. Of the nearly 15,000 employees working for PIH, fewer than 150 are American.
(“Partners In Health” in Haitian Kreyol) is PIH’s flagship project – the oldest, largest, most ambitious, and most replicated. The small community clinic that first started treating patients in the village of Cange in 1985, has grown into the Zanmi Lasante (ZL) Sociomedical Complex, featuring a 104-bed, full-service hospital with two operating rooms, adult and pediatric inpatient wards, an infectious disease center (the Thomas J. White Center), an outpatient clinic, a women’s health clinic (Proje Sante Fanm), ophthalmology and general medicine clinics, a laboratory, a pharmaceutical warehouse, a Red Cross blood bank, radiographic services, and a dozen schools. ZL has also expanded its operations to 11 other sites across Haiti’s Central Plateau and beyond. Today, ZL ranks as one of the largest nongovernmental health care providers in Haiti – serving a catchment area of 1.2 million across the Central Plateau and the Lower Artibonite. ZL employs over 4,000 people, almost all of them Haitians, including doctors, nurses and community health workers.
PIH's community-based model has proven successful in delivering effective care both for common conditions like diarrhea, pneumonia, and childbirth that often prove fatal for Haiti’s poor and malnourished, and for complex diseases like HIV and tuberculosis. A key to this success and to the PIH model of care pioneered in Haiti has been training and hiring thousands of accompagnateurs (community health workers) to prevent illness, monitor medical and socioeconomic needs, and deliver quality health care to people living with chronic diseases such as HIV and tuberculosis.
As ZL has expanded, it has partnered with other nongovernmental organizations and the Haitian Ministry of Health to rebuild or refurbish existing clinics and hospitals, introduce essential drugs to the formulary, establish laboratories, train and pay community heath workers, and complement Ministry of Health personnel with PIH-trained staff. Clinics that previously stood empty now register hundreds of patients each day across twelve sites—Cange, Boucan Carré, Hinche, Thomonde, Belladère, Lascahobas, Mirebalais, Thomonde and Cerca La Source in the Central Plateau plus additions in the Artibonite region, Petite Rivière, Saint Marc and Verrettes. In 2008, ZL recorded more than 2.6 million patient visits at clinical sites.
Pulitzer prizewinner Tracy Kidder
's book Mountains Beyond Mountains: The Quest of Dr. Paul Farmer, a Man Who Would Cure the World
, details PIH's work.
, Socios En Salud (SES), has been treating disease and training community members to provide prevention and care for their neighbors in the shantytowns around Lima
. Based in the northern Lima town of Carabayllo
, SES is now Peru’s largest non-governmental health care organization, serving an estimated population of 700,000 inhabitants, many of whom have fled from poverty and political violence in Peru’s countryside. As a valued partner to Peru's Ministry of Health, SES has also had an impact on national policies for prevention and treatment of drug-resistant tuberculosis and HIV and provides important training and support to help implement those policies nationwide.
SES also provides food baskets, transportation, lodging and social support for impoverished patients whose needs have been confirmed by an extensive interview and evaluation. The project also provides opportunities for income generation projects, job skills training, and small loans to start businesses. One example is Mujeres Unidas ("Women United"), a cooperative workshop that participates in crafts fairs in Peru and has sold handicrafts as far away as the United States, Japan and Switzerland.
SES is currently in conducting the world's largest TB research study, called the EPI Project. Funded by a National Institutes of Health grant, the project seeks to understand how MDR-TB and XDR-TB spreads between people living in close quarters.
El Equipo de Apoyo en Salud y Educación Comunitaria (EAPSEC, The Team for the Support of Community Health and Education) was established in 1985 by a small group of Mexican health promoters. They initially worked with Guatemalan refugee communities in the Chiapas border region, and later expanded their work to other marginalized people in Chiapas. EAPSEC believes that "a life of dignity" is a human right. This includes a strong public health system that responds to the most pressing health needs of the population, and access to high quality health care.
Since 1989, PIH has collaborated with EAPSEC to improve medical infrastructure in the region and to recruit and train hundreds of promotores. Over the past two decades, EAPSEC has partnered with dozens of indigenous and rural communities throughout Chiapas to develop local health capacity. Recent work has focused on a network of communities in the area of Huitiupan in the highlands and in the area of Amatan. EAPSEC is dedicated to helping communities build self-sufficiency and counts many successful community health groups throughout Chiapas among its "alumni.”
The organization provides health care, legal accompaniment, and education to each of the communities with which it works.
PACT’s health promotion and directly observed therapy programs target the hardest-to-reach patients: poor people of color living in inner-city Boston neighborhoods who have fallen through the cracks of other health care delivery systems. Often these people confront racial and language barriers, social isolation, mental illness, and drug or alcohol abuse. Some are homeless. Almost all live in poverty. These obstacles often mean that patients have difficulty taking all of their prescriptions on a regular basis.
In spite of these challenges, PACT’s community-based approach has proven to significantly improve the health of their clients, and has reduced costs to Massachusetts’s Medicaid system. For example, a recent study showed that HIV-positive patients enrolled in the program for 12 months experienced an average increase in CD4 count (a measurement of immune system strength) from a dangerously low 133 cells per microliter, to a much-improved level of 293. One Boston-area hospital reported that hospitalizations of AIDS patients enrolled in the PACT program decreased by 17 percent, and the costs for inpatient stays dropped by 37 percent.
Partners in Health began working with local clinicians to improve treatment of MDR-TB in Tomsk in 1998. Joint effort got a major boost in 2004, when assisted partners in Tomsk in securing a five-year $10.8 million grant from the Global Fund to Fight AIDS, Tuberculosis and Malaria for efforts to improve prevention, diagnosis and treatment of TB and MDR-TB. Key components of clinical effort include improving diagnostics in order to detect cases earlier, developing a comprehensive strategy to promote adherence among patients, improving infection control in hospitals and clinics and decreasing transmission of TB to HIV-positive patients. Work in Tomsk also encompasses health education for the public and clinical and program management training for medical personnel in Tomsk.
From its very beginning, VHW fostered close ties with PIH. VHW founder Deo met PIH founder Paul Farmer while studying at the Harvard School of Public Health, and he soon began working with PIH's partner organizations in Haiti and then in Rwanda (another country torn apart by genocide and civil war). In 2005, Deo visitied Kigutu, the village where he grew up, for the first time since the violent war forced his family to flee in 1993. Seeing the poverty and dispair paralyzing his childhood home, he resolved to do whatever it took to help, a promise he began to fulfill by founding VHW in 2006.
was PIH's second project in Africa and the first in a country suffering from extremely high prevalence of HIV. Approximately one quarter of Lesotho's adult population is HIV-positive and life expectancy in the tiny mountain kingdom has plummeted to less than 40 years. In addition, the Basotho people are being ravaged by a second epidemic: tuberculosis. Lesotho's TB rate is among the highest in the world, and TB spreads rapidly and is particularly deadly where many people's immune systems are weakened by HIV. The PIH project in Lesotho was launched in 2006 following an invitation from the government of Lesotho and consultation with partners in Rwanda, the Clinton HIV/AIDS Initiative (CHAI, now known as the Clinton Health Access Initiative), about where to replicate that successful model elsewhere in Africa.
By the end of fiscal year 2011, PIH/IMB is on schedule to support 40 health facilities in three target districts, with over 1,280 clinical and support staff, and work with a network of 6,175 community health workers.
In early 2011, PIH opened the largest public hospital in Butaro, Rwanda.
The Clinton-Hunter Development Initiative (CHDI) targeted Malawi as a country desperately needing a rural health project to address the devastating HIV/AIDS epidemic in the region. About 14 percent of Malawi's adult population is infected with HIV and hundreds of thousands of children have been orphaned by the disease.
CHDI asked PIH to replicate the rural initiative programs that have proven so successful in delivering HIV treatment and comprehensive primary health care in Rwanda and Lesotho. The Malawi Ministry of Health directed PIH and CHDI to the impoverished rural area of Neno, and in early 2007, the partners began to implement an ambitious plan to combat the disease.
In 2010, APZU tested 17,606 patients for HIV. The organization clinics logged 332,619 patient visits. APZU supported 889 children, allowing them to attend school and receive food.
Consistent care is crucial to treating chronic diseases such as HIV and TB effectively. Because border populations are particularly vulnerable to lapses in care, making sure that everyone has access to care on both sides of the border is crucial for the long-term health of of all those living in the border region, particularly people who are infected with HIV or TB. This project works to integrate past cross-border experiences between Haitian and Dominican Republic providers of care, many of whom have worked in the border region for a decade or longer. The Zanmi Lasante site of Belledare in Haiti and health care providers in the Dominican Republic program in Elias Pena are working together to make the goal of consistent care a reality.
struck Haiti
on January 12, 2010
, PIH/ZL resources were in place to deliver aid. In addition to providing care to the hundreds of thousands who fled to Haiti’s Central Plateau and Artibonite regions, ZL established health outposts at four camps for internally displaced people in Port-au-Prince. ZL also supported the city’s General Hospital (HUEH) by facilitating the placement of volunteer surgeons, physicians and nurses, and by aiding the hospital’s Haitian leadership. In March 2010, PIH/ZL announced a 3-year, $125 million plan to help Haiti build back better called the Stand With Haiti campaign.
Part of this plan includes the construction of Mirebalais Hospital. This National Teaching and Referral Hospital is one of the first public-sector projects to start in Haiti since the earthquake.
Before January 12, 2010, PIH had been planning to build a new community hospital in Mirebalais. Then the earthquake struck, leaving most of the health facilities in and around Port-au-Prince in ruins, including Haiti’s only public teaching hospital and nursing school. Responding to an urgent appeal from the Haitian Ministry of Public Health and Population (MSPP), quickly scaled up plans.
Less than six months after the earthquake, the MSPP and PIH/ZL broke ground not for a community hospital but for a world-class national referral hospital and teaching center.
When the hospital opens its doors in early 2012, the main medical campus will encompass seven buildings offering a level of care never before available at a public hospital in Haiti. And at a time when Haiti desperately needs skilled professionals, Mirebalais Hospital will provide high-quality education for the next generation of Haitian nurses, medical students, and resident physicians.
Dr. Farmer is an American anthropologist and physician. He cofounded Partners In Health in 1983 while he was attending medical school. He is currently the Kolokotrones University Professor at Harvard University, formerly the Presley Professor of Medical Anthropology in the Department of Social Medicine at Harvard Medical School, an attending physician and Chief of the Division of Global Health Equity at Brigham and Women's Hospital in Boston, Massachusetts. In May 2009 he was named chairman of Harvard Medical School's Department of Global Health and Social Medicine, succeeding his longtime friend and collaborator Jim Yong Kim. On Friday, December 17, 2010, Harvard University's President, Drew Gilpin Faust, and the President and Fellows of Harvard College, named him a University Professor of Harvard University, the highest honor that the University can bestow on one of its faculty members.
Recently appointed to the position of President of Dartmouth College, Dr. Kim, continues to work with PIH, especially in the organization's efforts in Haiti. President Kim is a co-founder of Partners In Health and a former director of the Department of HIV/AIDS at the World Health Organization (WHO). He has dedicated himself to health and social justice work for more than two decades, helping to provide medical treatment to underserved populations worldwide.
Dahl is the president and executive director of Partners In Health. She first encountered Paul Farmer as an eighteen year old volunteer in Haiti, and has since dedicated her life to advocating for social justice and healthcare equity. She is a cofounder of PIH.
Dahl is the daughter of actress Patricia Neal
and author Roald Dahl
. Dahl contributed to the 2003 book The Roald Dahl Treasury, a collection of her father's stories, memoirs, letters and poetry, and is currently writing a memoir of her father. She graduated from Wellesley College as a Davis Scholar.
Health care
Health care is the diagnosis, treatment, and prevention of disease, illness, injury, and other physical and mental impairments in humans. Health care is delivered by practitioners in medicine, chiropractic, dentistry, nursing, pharmacy, allied health, and other care providers...
organization dedicated to providing a "preferential option for the poor". It was founded in 1987 by Dr. Paul Farmer
Paul Farmer
Dr. Paul Edward Farmer is an American anthropologist and physician. He is currently the Kolokotrones University Professor at Harvard University, formerly the Presley Professor of Medical Anthropology in the Department of Social Medicine at Harvard Medical School, an attending physician and Chief...
, Ophelia Dahl
Ophelia Dahl
Ophelia Magdalena Dahl is an Anglo-American social justice and health care advocate.As of January 2008, Dahl is the president and executive director of Partners In Health , a Boston, Massachusetts-based non-profit health care organization dedicated to providing a "preferential option for the...
, Thomas J. White, Todd McCormack, and Dr. Jim Yong Kim
Jim Kim
Jim Yong Kim is a Korean-American physician, and 17th President of Dartmouth College. He has been a Professor of Medicine and Social Medicine and Chair of the Department of Global Health and Social Medicine at Harvard Medical School. He was a co-founder and later Executive Director of Partners in...
.
PIH strives to provide an alternative to the conventional curative method of treatment for the sick and instead tries to prevent diseases before they occur. This model believes that primary health care is essential because health is a right and therefore, it should be available to everyone. PIH strives to bring good medical care
Medicine
Medicine is the science and art of healing. It encompasses a variety of health care practices evolved to maintain and restore health by the prevention and treatment of illness....
to the poor by establishing long-term partnerships with local sister organizations.
The organization's model is described as being one in which: clinical and community barriers to care are removed as diagnosis and treatment are declared a public good and made available free of charge to patients living in poverty. For people living in poverty stricken areas, the treatment of AIDS and multidrug-resistant tuberculosis (MDR-TB) has been made possible by this model of care.
The idea for Partners In Health first began when Paul Farmer and Ophelia Dahl helped set up a community-based health project in Cange, Haiti
Cange, Haiti
Cange is a small remote village in the Central Plateau of Haiti. Cange is the location of an American funded hospital, Zanmi Lasante, run by Partners in Health. Cange sits on the edge of Lake Péligre, created by a large hydroelectric dam. Some notable residents of Cange have been and are Dr...
known as Zanmi Lasante
Zanmi Lasante
Zanmi Lasante is a sister organization to the Boston-based Partners In Health that operates out of Cange in central Haiti. The name, Zanmi Lasante, means Partners In Health in Kreyòl. It was built in 1985 to treat patients incapable of paying hospital fees...
("Partners in Health"). For a number of years the organization focused its efforts almost exclusively on treating HIV/AIDS patients in rural Haiti. In the past decade, the organization's mission has expanded to include a more holistic approach to tackling disease and poverty. PIH devotes considerable resources to providing food, water, education and housing to sick patients. The organization also advocates for human rights both at the governmental and international NGO level.
In 1993, Dr. Farmer founded the Institute for Health and Social Justice (IHSJ), which is the research and advocacy arm of PIH. The IHSJ was founded using the proceeds of Dr. Farmer's John D. and Catherine T. MacArthur Award. The mission of the IHSJ is to analyze the impact of poverty and inequality on health, and to use these findings to educate and train students, academics, donors, policy makers, and lay people. As of 2006, the IHSJ is under the direction of Dr. Joia Mukherjee
Joia Mukherjee
Dr. Joia Mukherjee is a professor at Harvard Medical School in the Department of Global Health and Social Medicine.Mukherjee was born in what was then known as East Pakistan...
, PIH's Chief Medical Officer.
PIH is a Harvard-affiliated NGO. The organization works closely with Harvard's School of Public Health and the Brigham and Women's Hospital.
One of the defining features that separates PIH from other NGOs is its commitment to hiring and training people who live in the communities where the organization works. Of the nearly 15,000 employees working for PIH, fewer than 150 are American.
Project Locations
Haiti
Zanmi LasanteZanmi Lasante
Zanmi Lasante is a sister organization to the Boston-based Partners In Health that operates out of Cange in central Haiti. The name, Zanmi Lasante, means Partners In Health in Kreyòl. It was built in 1985 to treat patients incapable of paying hospital fees...
(“Partners In Health” in Haitian Kreyol) is PIH’s flagship project – the oldest, largest, most ambitious, and most replicated. The small community clinic that first started treating patients in the village of Cange in 1985, has grown into the Zanmi Lasante (ZL) Sociomedical Complex, featuring a 104-bed, full-service hospital with two operating rooms, adult and pediatric inpatient wards, an infectious disease center (the Thomas J. White Center), an outpatient clinic, a women’s health clinic (Proje Sante Fanm), ophthalmology and general medicine clinics, a laboratory, a pharmaceutical warehouse, a Red Cross blood bank, radiographic services, and a dozen schools. ZL has also expanded its operations to 11 other sites across Haiti’s Central Plateau and beyond. Today, ZL ranks as one of the largest nongovernmental health care providers in Haiti – serving a catchment area of 1.2 million across the Central Plateau and the Lower Artibonite. ZL employs over 4,000 people, almost all of them Haitians, including doctors, nurses and community health workers.
PIH's community-based model has proven successful in delivering effective care both for common conditions like diarrhea, pneumonia, and childbirth that often prove fatal for Haiti’s poor and malnourished, and for complex diseases like HIV and tuberculosis. A key to this success and to the PIH model of care pioneered in Haiti has been training and hiring thousands of accompagnateurs (community health workers) to prevent illness, monitor medical and socioeconomic needs, and deliver quality health care to people living with chronic diseases such as HIV and tuberculosis.
As ZL has expanded, it has partnered with other nongovernmental organizations and the Haitian Ministry of Health to rebuild or refurbish existing clinics and hospitals, introduce essential drugs to the formulary, establish laboratories, train and pay community heath workers, and complement Ministry of Health personnel with PIH-trained staff. Clinics that previously stood empty now register hundreds of patients each day across twelve sites—Cange, Boucan Carré, Hinche, Thomonde, Belladère, Lascahobas, Mirebalais, Thomonde and Cerca La Source in the Central Plateau plus additions in the Artibonite region, Petite Rivière, Saint Marc and Verrettes. In 2008, ZL recorded more than 2.6 million patient visits at clinical sites.
Pulitzer prizewinner Tracy Kidder
Tracy Kidder
John Tracy Kidder is a Pulitzer Prize-winning American writer of the 1981 nonfiction narrative, The Soul of a New Machine, about the creation of a new computer at Data General Corporation...
's book Mountains Beyond Mountains: The Quest of Dr. Paul Farmer, a Man Who Would Cure the World
Mountains Beyond Mountains
Mountains Beyond Mountains: The Quest of Dr. Paul Farmer, A Man Who Would Cure the World is a non-fiction, biographical work by American writer Tracy Kidder. The story traces the life of physician and anthropologist Paul Farmer. The book was a New York Times Notable Book for 2003.-External links:*...
, details PIH's work.
Peru
Since 1994, PIH’s sister organization in PeruPeru
Peru , officially the Republic of Peru , is a country in western South America. It is bordered on the north by Ecuador and Colombia, on the east by Brazil, on the southeast by Bolivia, on the south by Chile, and on the west by the Pacific Ocean....
, Socios En Salud (SES), has been treating disease and training community members to provide prevention and care for their neighbors in the shantytowns around Lima
Lima
Lima is the capital and the largest city of Peru. It is located in the valleys of the Chillón, Rímac and Lurín rivers, in the central part of the country, on a desert coast overlooking the Pacific Ocean. Together with the seaport of Callao, it forms a contiguous urban area known as the Lima...
. Based in the northern Lima town of Carabayllo
Carabayllo
Carabayllo is one of the 43 districts of the province Lima in Peru. It is located in the Cono Norte area of the province and was founded by General José de San Martín in August 1821 at which time it was the only district to occupy the area north of the Rímac River up to the province Canta.-...
, SES is now Peru’s largest non-governmental health care organization, serving an estimated population of 700,000 inhabitants, many of whom have fled from poverty and political violence in Peru’s countryside. As a valued partner to Peru's Ministry of Health, SES has also had an impact on national policies for prevention and treatment of drug-resistant tuberculosis and HIV and provides important training and support to help implement those policies nationwide.
SES also provides food baskets, transportation, lodging and social support for impoverished patients whose needs have been confirmed by an extensive interview and evaluation. The project also provides opportunities for income generation projects, job skills training, and small loans to start businesses. One example is Mujeres Unidas ("Women United"), a cooperative workshop that participates in crafts fairs in Peru and has sold handicrafts as far away as the United States, Japan and Switzerland.
SES is currently in conducting the world's largest TB research study, called the EPI Project. Funded by a National Institutes of Health grant, the project seeks to understand how MDR-TB and XDR-TB spreads between people living in close quarters.
Chiapas, Mexico
The residents of the southern Mexican state of Chiapas, including millions of indigenous Maya, have long struggled with poverty, political violence, and dismal health conditions. Chiapas is burdened with extremely high rates of maternal mortality, infant mortality, and tuberculosis when compared to other states in Mexico. Work aims to provide a more reliable, community-based alternative by training and employing local community health promoters, called promotores.El Equipo de Apoyo en Salud y Educación Comunitaria (EAPSEC, The Team for the Support of Community Health and Education) was established in 1985 by a small group of Mexican health promoters. They initially worked with Guatemalan refugee communities in the Chiapas border region, and later expanded their work to other marginalized people in Chiapas. EAPSEC believes that "a life of dignity" is a human right. This includes a strong public health system that responds to the most pressing health needs of the population, and access to high quality health care.
Since 1989, PIH has collaborated with EAPSEC to improve medical infrastructure in the region and to recruit and train hundreds of promotores. Over the past two decades, EAPSEC has partnered with dozens of indigenous and rural communities throughout Chiapas to develop local health capacity. Recent work has focused on a network of communities in the area of Huitiupan in the highlands and in the area of Amatan. EAPSEC is dedicated to helping communities build self-sufficiency and counts many successful community health groups throughout Chiapas among its "alumni.”
Guatemala
Equipo Técnico de Educación en Salud Comunitaria (ETESC, Technical Team for Education in Community Health) was founded by refugees of the Guatemalan civil war who returned to help rebuild their country. Today it has evolved into a community nonprofit that seeks to revitalize and repair the social fabric in the rural communities of Huehuetenango, Guatemala, through holistic development.The organization provides health care, legal accompaniment, and education to each of the communities with which it works.
Boston
The Prevention and Access to Care and Treatment (PACT) project serves the sickest and most marginalized HIV-positive and chronically ill patients living in the Greater Boston area. Adapting the accompagnateur model developed in Haiti, PIH’s only domestic health care program trains and employs community members as community health workers (CHW). These CHWs check in on some of the most marginalized and sick patients on a daily or weekly basis, making sure they attend medical appointments, take their medications, and have access to other essential needs and social services.PACT’s health promotion and directly observed therapy programs target the hardest-to-reach patients: poor people of color living in inner-city Boston neighborhoods who have fallen through the cracks of other health care delivery systems. Often these people confront racial and language barriers, social isolation, mental illness, and drug or alcohol abuse. Some are homeless. Almost all live in poverty. These obstacles often mean that patients have difficulty taking all of their prescriptions on a regular basis.
In spite of these challenges, PACT’s community-based approach has proven to significantly improve the health of their clients, and has reduced costs to Massachusetts’s Medicaid system. For example, a recent study showed that HIV-positive patients enrolled in the program for 12 months experienced an average increase in CD4 count (a measurement of immune system strength) from a dangerously low 133 cells per microliter, to a much-improved level of 293. One Boston-area hospital reported that hospitalizations of AIDS patients enrolled in the PACT program decreased by 17 percent, and the costs for inpatient stays dropped by 37 percent.
Russia
Partners In Health's work in Russia has a narrower medical focus over a vastly wider geographical area than any of other projects. From a base in the region of Tomsk Oblast, Siberia, PIH has been working since 1998, in collaboration with the Russian Ministry of Health, to combat one of the world's worst epidemics of drug-resistant tuberculosis (MDR-TB). In partnership with the Division of Social Medicine and Health Inequalities (DSMHI) at the Brigham and Women’s Hospital, PIH has focused on improving clinical services for MDR-TB patients in Tomsk while undertaking training and research to catalyze change in treatment of MDR-TB across the entire Russian Federation.Partners in Health began working with local clinicians to improve treatment of MDR-TB in Tomsk in 1998. Joint effort got a major boost in 2004, when assisted partners in Tomsk in securing a five-year $10.8 million grant from the Global Fund to Fight AIDS, Tuberculosis and Malaria for efforts to improve prevention, diagnosis and treatment of TB and MDR-TB. Key components of clinical effort include improving diagnostics in order to detect cases earlier, developing a comprehensive strategy to promote adherence among patients, improving infection control in hospitals and clinics and decreasing transmission of TB to HIV-positive patients. Work in Tomsk also encompasses health education for the public and clinical and program management training for medical personnel in Tomsk.
Burundi
In a country torn apart by civil war, extreme hunger and poverty, the village of Kigutu faced crippling disease, poor health, and misery in 2006. In an effort to respond to this crisis of care, Deogratias Niyizonkiza founded the nonprofit organization Village Health Works (VHW) to bring high-quality health care to this rural Burundi community, as well as to address the root of the village's poor health: poverty.From its very beginning, VHW fostered close ties with PIH. VHW founder Deo met PIH founder Paul Farmer while studying at the Harvard School of Public Health, and he soon began working with PIH's partner organizations in Haiti and then in Rwanda (another country torn apart by genocide and civil war). In 2005, Deo visitied Kigutu, the village where he grew up, for the first time since the violent war forced his family to flee in 1993. Seeing the poverty and dispair paralyzing his childhood home, he resolved to do whatever it took to help, a promise he began to fulfill by founding VHW in 2006.
Lesotho
PIH's project in LesothoLesotho
Lesotho , officially the Kingdom of Lesotho, is a landlocked country and enclave, surrounded by the Republic of South Africa. It is just over in size with a population of approximately 2,067,000. Its capital and largest city is Maseru. Lesotho is a member of the Commonwealth of Nations. The name...
was PIH's second project in Africa and the first in a country suffering from extremely high prevalence of HIV. Approximately one quarter of Lesotho's adult population is HIV-positive and life expectancy in the tiny mountain kingdom has plummeted to less than 40 years. In addition, the Basotho people are being ravaged by a second epidemic: tuberculosis. Lesotho's TB rate is among the highest in the world, and TB spreads rapidly and is particularly deadly where many people's immune systems are weakened by HIV. The PIH project in Lesotho was launched in 2006 following an invitation from the government of Lesotho and consultation with partners in Rwanda, the Clinton HIV/AIDS Initiative (CHAI, now known as the Clinton Health Access Initiative), about where to replicate that successful model elsewhere in Africa.
Rwanda
Partners In Health/Inshuti Mu Buzima (PIH/IMB) has been working in Rwanda since 2005. In partnership with the Government of Rwanda and the Clinton Health Access Initiative (CHAI), work supports the Ministry of Health to comprehensively strengthen the public health system in rural, underserved areas of the country. Initially, PIH and CHAI began by implementing a pilot project in two rural districts in Rwanda’s Eastern Province, Kayonza and Kirehe. Building off of PIH’s approach in Haiti, the project was designed as a comprehensive primary health care model within the public sector. The approach used HIV/AIDS prevention and care as the entry point to build capacity to address the major health problems faced by the local population. Haitian physicians, nurses, and managers traveled to Rwanda extensively in the early years of the program to provide training and program design assistance.By the end of fiscal year 2011, PIH/IMB is on schedule to support 40 health facilities in three target districts, with over 1,280 clinical and support staff, and work with a network of 6,175 community health workers.
In early 2011, PIH opened the largest public hospital in Butaro, Rwanda.
Malawi
In early 2007, PIH and Abwenzi Pa Za Umoyo (APZU; Partners In Health in Chichewa), started treating patients and training community health workers in the southwestern corner of Malawi, one of the poorest and most densely populated countries in Africa.The Clinton-Hunter Development Initiative (CHDI) targeted Malawi as a country desperately needing a rural health project to address the devastating HIV/AIDS epidemic in the region. About 14 percent of Malawi's adult population is infected with HIV and hundreds of thousands of children have been orphaned by the disease.
CHDI asked PIH to replicate the rural initiative programs that have proven so successful in delivering HIV treatment and comprehensive primary health care in Rwanda and Lesotho. The Malawi Ministry of Health directed PIH and CHDI to the impoverished rural area of Neno, and in early 2007, the partners began to implement an ambitious plan to combat the disease.
In 2010, APZU tested 17,606 patients for HIV. The organization clinics logged 332,619 patient visits. APZU supported 889 children, allowing them to attend school and receive food.
Kazakhstan
In 2010, Partners In Health launched a new partnership to combat drug-resistant tuberculosis (MDR-TB) in Kazakhstan, a central Asian country that borders regions in Siberia where PIH-Russia has spearheaded a successful MDR-TB program since 1998. Because of PIH’s track record of curing and curbing the spread of drug-resistant tuberculosis in the Russian Federation, the Kazakhstan Ministry of Health invited PIH to help fight one of the highest rates of drug-resistant TB in the world.Dominican Republic
The Partners In Health project in the Dominican Republic is a cross-border collaboration under the leadership of PIH's Haitian sister organization, Zanmi Lasante.Consistent care is crucial to treating chronic diseases such as HIV and TB effectively. Because border populations are particularly vulnerable to lapses in care, making sure that everyone has access to care on both sides of the border is crucial for the long-term health of of all those living in the border region, particularly people who are infected with HIV or TB. This project works to integrate past cross-border experiences between Haitian and Dominican Republic providers of care, many of whom have worked in the border region for a decade or longer. The Zanmi Lasante site of Belledare in Haiti and health care providers in the Dominican Republic program in Elias Pena are working together to make the goal of consistent care a reality.
Partner Projects
PIH also supports partner projects in the following countries:- Africa: Project Muso in MaliMaliMali , officially the Republic of Mali , is a landlocked country in Western Africa. Mali borders Algeria on the north, Niger on the east, Burkina Faso and the Côte d'Ivoire on the south, Guinea on the south-west, and Senegal and Mauritania on the west. Its size is just over 1,240,000 km² with...
; Tiyatien Health in LiberiaLiberiaLiberia , officially the Republic of Liberia, is a country in West Africa. It is bordered by Sierra Leone on the west, Guinea on the north and Côte d'Ivoire on the east. Liberia's coastline is composed of mostly mangrove forests while the more sparsely populated inland consists of forests that open... - Asia: Nyaya HealthNyaya HealthNyaya Health is a non-governmental organization providing free health care in Achham, a district in the Far Western region of Nepal. Nyaya operates the Bayalpata Hospital, one of only two hospitals in Achham , as a partner of the Nepali government's Ministry of Health and Population...
in NepalNepalNepal , officially the Federal Democratic Republic of Nepal, is a landlocked sovereign state located in South Asia. It is located in the Himalayas and bordered to the north by the People's Republic of China, and to the south, east, and west by the Republic of India...
Response to the Haiti earthquake
When the earthquakeEarthquake
An earthquake is the result of a sudden release of energy in the Earth's crust that creates seismic waves. The seismicity, seismism or seismic activity of an area refers to the frequency, type and size of earthquakes experienced over a period of time...
struck Haiti
Haiti
Haiti , officially the Republic of Haiti , is a Caribbean country. It occupies the western, smaller portion of the island of Hispaniola, in the Greater Antillean archipelago, which it shares with the Dominican Republic. Ayiti was the indigenous Taíno or Amerindian name for the island...
on January 12, 2010
2010 Haiti earthquake
The 2010 Haiti earthquake was a catastrophic magnitude 7.0 Mw earthquake, with an epicentre near the town of Léogâne, approximately west of Port-au-Prince, Haiti's capital. The earthquake occurred at 16:53 local time on Tuesday, 12 January 2010.By 24 January, at least 52 aftershocks...
, PIH/ZL resources were in place to deliver aid. In addition to providing care to the hundreds of thousands who fled to Haiti’s Central Plateau and Artibonite regions, ZL established health outposts at four camps for internally displaced people in Port-au-Prince. ZL also supported the city’s General Hospital (HUEH) by facilitating the placement of volunteer surgeons, physicians and nurses, and by aiding the hospital’s Haitian leadership. In March 2010, PIH/ZL announced a 3-year, $125 million plan to help Haiti build back better called the Stand With Haiti campaign.
Part of this plan includes the construction of Mirebalais Hospital. This National Teaching and Referral Hospital is one of the first public-sector projects to start in Haiti since the earthquake.
Before January 12, 2010, PIH had been planning to build a new community hospital in Mirebalais. Then the earthquake struck, leaving most of the health facilities in and around Port-au-Prince in ruins, including Haiti’s only public teaching hospital and nursing school. Responding to an urgent appeal from the Haitian Ministry of Public Health and Population (MSPP), quickly scaled up plans.
Less than six months after the earthquake, the MSPP and PIH/ZL broke ground not for a community hospital but for a world-class national referral hospital and teaching center.
When the hospital opens its doors in early 2012, the main medical campus will encompass seven buildings offering a level of care never before available at a public hospital in Haiti. And at a time when Haiti desperately needs skilled professionals, Mirebalais Hospital will provide high-quality education for the next generation of Haitian nurses, medical students, and resident physicians.
See also
- Dr. Paul FarmerPaul FarmerDr. Paul Edward Farmer is an American anthropologist and physician. He is currently the Kolokotrones University Professor at Harvard University, formerly the Presley Professor of Medical Anthropology in the Department of Social Medicine at Harvard Medical School, an attending physician and Chief...
Dr. Farmer is an American anthropologist and physician. He cofounded Partners In Health in 1983 while he was attending medical school. He is currently the Kolokotrones University Professor at Harvard University, formerly the Presley Professor of Medical Anthropology in the Department of Social Medicine at Harvard Medical School, an attending physician and Chief of the Division of Global Health Equity at Brigham and Women's Hospital in Boston, Massachusetts. In May 2009 he was named chairman of Harvard Medical School's Department of Global Health and Social Medicine, succeeding his longtime friend and collaborator Jim Yong Kim. On Friday, December 17, 2010, Harvard University's President, Drew Gilpin Faust, and the President and Fellows of Harvard College, named him a University Professor of Harvard University, the highest honor that the University can bestow on one of its faculty members.
- Dr. Jim Yong KimJim KimJim Yong Kim is a Korean-American physician, and 17th President of Dartmouth College. He has been a Professor of Medicine and Social Medicine and Chair of the Department of Global Health and Social Medicine at Harvard Medical School. He was a co-founder and later Executive Director of Partners in...
Recently appointed to the position of President of Dartmouth College, Dr. Kim, continues to work with PIH, especially in the organization's efforts in Haiti. President Kim is a co-founder of Partners In Health and a former director of the Department of HIV/AIDS at the World Health Organization (WHO). He has dedicated himself to health and social justice work for more than two decades, helping to provide medical treatment to underserved populations worldwide.
- Ophelia DahlOphelia DahlOphelia Magdalena Dahl is an Anglo-American social justice and health care advocate.As of January 2008, Dahl is the president and executive director of Partners In Health , a Boston, Massachusetts-based non-profit health care organization dedicated to providing a "preferential option for the...
Dahl is the president and executive director of Partners In Health. She first encountered Paul Farmer as an eighteen year old volunteer in Haiti, and has since dedicated her life to advocating for social justice and healthcare equity. She is a cofounder of PIH.
Dahl is the daughter of actress Patricia Neal
Patricia Neal
Patricia Neal was an American actress of stage and screen. She was best known for her film roles as World War II widow Helen Benson in The Day the Earth Stood Still , wealthy matron Emily Eustace Failenson in Breakfast at Tiffany's , middle-aged housekeeper Alma Brown in Hud , for which she won...
and author Roald Dahl
Roald Dahl
Roald Dahl was a British novelist, short story writer, fighter pilot and screenwriter.Born in Wales to Norwegian parents, he served in the Royal Air Force during the Second World War, in which he became a flying ace and intelligence agent, rising to the rank of Wing Commander...
. Dahl contributed to the 2003 book The Roald Dahl Treasury, a collection of her father's stories, memoirs, letters and poetry, and is currently writing a memoir of her father. She graduated from Wellesley College as a Davis Scholar.
- Zanmi LasanteZanmi LasanteZanmi Lasante is a sister organization to the Boston-based Partners In Health that operates out of Cange in central Haiti. The name, Zanmi Lasante, means Partners In Health in Kreyòl. It was built in 1985 to treat patients incapable of paying hospital fees...
- FACE AIDSFACE AIDSEstablished 2005. Executive Director: Julie Veroff Managing Director: Nicole Krenitsky Rwanda Program Director: Cher-Wen DeWitt Chapter Support Director: Eve Fine Recruitment and Partnerships Director: Austin Carroll Keeley...
- ONEXONEONEXONEONEXONE is a non-profit initiative based in Canada and the United States with the mission to preserve a basic quality of life for children locally and globally: because Hope Belongs to Everyone.- Operations :...
External links
- Partners In Health
- A Conversation with Tracy Kidder about Mountains Beyond Mountains by Mark KlempnerMark KlempnerMark Klempner is a folklorist, oral historian and social commentator.-Early life:Klempner grew up in New York City, and attended Cornell University, graduating Phi Beta Kappa in 1997, and winning a J. William Fulbright Fellowship. In 2000, he received an M.A...
, 2008.