16311: Raber: Re: 16299: Louissant: Re: 16284: (Hermantin) Miami-Herald-Haitian widow's mission: Improve care in hospitals (fwd)

[Bob Corbett <corbetre@webster.edu>]

From: P&M Raber <raber@valkyrie.net>

Mr. Louissaint,


The Haitian Community Hospital would not be a new center as you seem to be
thinking.  It is a facility that has been in existence for 20 years and was
in the planning since 1975.  It was the brainchild of the Dr. Yvonne Sylvain
who was one of the first couple of women physicians in Haiti. The mission of
that hospital is to serve all sectors of  Haitian society.  They were the
first hospital in Haiti besides "Hopital General" to function like a true
hospital and offer 24 hour emergency care.  They have also opposed the
tradition of patients having "private nurses" at their bedside to combat the
often lack of care staff nurses tend to (not) provide in many hospitals in
Haiti to try and  force the patients to hire them as private nurses on their
next shift.  They offer emergency care wether the patient has money to pay
or not.  In contrast, at General Hospital, you must first go and purchase
every item needed down to the last band-aid and can die waiting for each
employee to be at their post at the various places.  Several times a week ,
Haitian Community Hospital receives gunshot wounds, accident victims etc...
and provides life saving care to all sectors of society.  Jean Dominique was
taken there but unfortunately was dead by the time he got there.  Policemen
are often treated there.  When patients end up transferred to a different
hospital, it often happens that the Community Hospital does not get paid for
the services provided.

Upper class patients continue to choose other hospitals for care due to a
shortage of private rooms and so far the unfinished food services at HCH.
Families must still bring food to the patients.  Community hospital sees all
patients on a sliding fee schedule.  People get the same quality of care
regardless of they social origin.  The difference in only in the fees.  This
may sound normal to Americans but equal care is a revolutionaty concept in
Haiti.  They hope one day to have all the private rooms they need to attract
more higher fee clients.  The fees charged to those wealthier people would
help subsidize the care of the less fortunate.  Many well to to people
already come to the HCH but often as their second or emergency choice.  This
is still one of the rare places you can have X-rays or blood work done 24
hours a day or night. The pharmacy is also open 24 hours (And you will find
the pharmacist at her post).

 They have lots of land to build the rest of the hospital on although some
current government people have twice attempted to steal the land since 2001.
It is a well thought of project.  It was conceived to be achieved in phases.
There are 3 phases.  They are still in phase one.  One item of interest is
that the entire thing was basically almost completely built with local
Haitian funds.  It has never been out of construction.  Local businesses
used to support it quite a bit. However, with the difficult times there has
been much decrease in local funds.  In the past they have even been able to
finance some expansion from income from the outpatient clinics. Nowadays,
with patients being less and less able to pay they are having to put all
monies into daily operation..  At the moment, they have a state of the arts
brand new dental clinic waiting to be installed with all the supporting
equipment to replace the aging 20 year old clinic.  Unfortunately, no fund
to install the equipment since it involves moving some other service to a
part of the hospital that is now under construction but cannot be finishe
due to lack of fund.  Be certain though that things will move forward.  One
thing is sure over there:  progress may be done slowly but they move forward
not backward.

Another item of interest is that it is not a free place. You cannot be free
and continue to exist.  Officially general hospital is a free place. The
reality though is that due to corruption, the poor are likely to spend much
more at the General Hospital than they are paying the bottom fees at the
HCH.  I will illustrate this with two cases I was involved with:

1-Little boy from needs Nose surgery.  One phone call to HCH hospital, and
2500 gourdes takes care of everything.  Treatment is provided smoothly, poor
country side parents rave about the Community Hospital.

2-Old lady from country side needs goiter surgery.  After 10 trips
(including one overnight) to general hospital with various side trips for
various tests from just about everyone who has a private "laboratoire"
around the general hospital but works at the hospital, I am short 5000
gourdes and the lady never gets her treatment.

The community hospital faces the same types of problems as everyone in Haiti
but they are not shy about cracking down.  They hire and fire when they find
corruption or intentional neglect.  No job position is sacred.  Yet they
strive to treat all people with compassion and understanding.

A third item of interest is that the Haitian Community Hospital  is one of
the major training ground for the medical students and nurses from
Universite Quisqueya and Notre Dame Universite.  For those who are not aware
of it, the governement medical school has been graduating severely
inadequate and at times plain unethical people.  The smart kids no matter
what their social status choose to go to Notre Dame or Quisqueya instead.
At least there you don't have strikes or working conditions that endanger
your life.  I know of several kids from poor illiterate parents attending
those private schools. Some have sponsors, some family in the States paying
their way.

A fourth item of interest is that many times already, the HCH has received
visiting specialist with the encouragement of local Haitian specialists. The
Haitian doctors had pre-selected the cases and over several trips by the
American specialists, new procedures were taught to the Haitian doctors.

The Haitian Community Hospital has a very serious volunteer board.  Some on
Corbett may ditch the validity of that board since it is comprised basically
of Haitian bourgois professionals.  Worthy people everywhere are willing to
improve Haiti.  I continue to be convinced that each culture, nationality,
race, social group has a given number of crooks and potential crooks but are
basically made up of mostly of decent people wanting the human condition to
improve and willing to do something about it.

HCH has a US tax-exempt number and a Miami address for US donations but they
spend absolutely 0 money on running a stateside office.  We have all heard
of the Red Cross CEOs and managers using up donations before they get to a
cause.  This would not happen with HCH.

Hopes this shed some light for some

M. Raber

fromFrom: "Bob Corbett" <corbetre@webster.edu>
To: "Haiti mailing list" <haiti@lists.webster.edu>
Sent: Wednesday, August 06, 2003 11:31 AM
Subject: 16299: Louissant: Re: 16284: (Hermantin) Miami-Herald-Haitian
widow's mission: Improve care in hospitals

 P Louissaint wrote
>
> I am very sorry for what happen to the dentist Michel Carvonis. This is
very sad. However, this is happening daily to many in Haiti.
>
>
> The solution is not to start from scratch with a center for those who are
"well connected" . We should try to find the solution as a society. There
are top Haitian physicians in Haiti or abroad. I know for a fact that the
Association of Haitian Physicians Abroad (AMHE) has made many attempts to
help. The Haitian Medical Association (AMH) is also a real asset that can
help make a structured and sustained change.
>
> Let's find the solution as a society ! I am sorry for Mr Carvonis and many
other unknown Haitians dying in the same circumstances (without making the
Miami Herald). The underlying problem is not a new one. A "patch solution"
is temporary and will be a waste of resource.
>
> Cuban intern physicians, telemedicine (via video or telephone) from Miami
are "patch solutions". The problem will be properly tackled when hospitals
will be well equiped and staffed by well trained physicians serving the rich
and the poor. Let's start by having a competent (not necessary militant)
Minister of Health...
>
> Comments are encouraged on this important topic
>
> Paul Louissaint
> --
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