ACCESS finds a way in Haiti: Meeting the needs of women and newborns during difficult times
April 2006
Despite the sociopolitical unrest that has plagued Haiti, the ACCESS Program
continues to train health care providers at Maternité Isaïe Jeanty (MIJ), the second largest
maternity hospital in the country. Located in Port-au-Prince, Haiti's heavily populated
capital, MIJ has seen a slow down in activity over the past year. "Some physicians and
residents were coming in, but not on a regular basis," explains Country Representative
Dr. Lucito Jeannis, adding that the "demand for services also lessened." Finally, MIJ
staff were moved to the Hôpital de la Paix, another large maternity hospital in Port-au-Prince.
Given such ongoing challenges, ACCESS has had to find creative ways to
carry out the ACCESS Program’s agenda in Haiti, which is to improve the quality of
prevention of mother-to-child transmission (PMTCT) of HIV and a range of reproductive
health services. Amy Kleine, Program Officer for ACCESS/Haiti, talks about the challenging
"duality" of programming in Haiti during these difficult times: "If we pull out because of
the dangers posed by the political conflict, we ignore another set of dangers faced by
women and children who are still in need of services." And, according to recent
statistics, this need is dire. An estimated 11,300 HIV-positive women deliver each year
in Haiti, and approximately 30% of their babies will contract HIV. In addition, the rate
of maternal mortality and percentage of unmet need for family planning remain high among
Haitian women.
One way ACCESS has been able to move forward is to remain flexible and open
to alternatives. For example, recent trainings on PMTCT and counseling and testing (CT)
that were supposed to be held in Haiti were held instead in the Dominican Republic.
"Working with our contact at the USAID/DR Mission," Amy says, "we arranged for our Haitian
participants to travel to Santo Domingo by bus." To maximize the impact of the event, the
training was offered to both health care providers and trainers, so that, immediately upon
return to Haiti, PMTCT/CT services could be offered at key sites while training was
replicated with more service providers. The training sessions also acted as an
orientation for several policymakers from the Ministry of Health. According to
Lucito, the event was a huge success: "The 10 trainers trained at the event have
already trained more than 100 providers, and more trainings are scheduled."
Because of travel restrictions, the Baltimore office has also had to rely more
heavily on the Haiti office. For example, when a consultant who was supposed to
oversee implementation of the PMTCT program was unable to travel there, the
responsibility was given to Dr. Pascale Merlet, a Haitian ob/gyn, who is now
conducting the activity in Haiti's main teaching hospital, l'Hôpital de
l'Université d’Etat d’Haiti (HUEH). "By conducting more activities, local
staff have increased their in-country capacity," Amy points out, "and are able to
function more independently."
Lucito cites "belief in what we are doing" as an essential component
in the success of the ACCESS Program in Haiti, despite these ongoing challenges. And
new hope comes in the form of the Ministry of Health's decision to reinstate services
at MIJ now that the presidential elections are over. There, "we will once again be
able carry out our work," says Lucito—continuing to build a brighter future for
women and children throughout Haiti.
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