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Photo of Joia Mukherjee by Matthew Lester.
Having seen more than 800 patients on her first day in Haiti, Joia Mukherjee, MD, MPH, knows how dire the immediate needs for medical care and supplies like food and water are. The BWH physician and medical director of Partners In Health (PIH) also is stressing the importance of a long-term plan to provide continued support to the people of Haiti—and the use of a strong community health model in doing so.
“We expect the needs to escalate—as people live in close quarters, diseases spread,” said Mukherjee, of the Division of Global Health Equity, who just returned to Boston after 10 days in Haiti. “We’d like to think of a model for relief that addresses immediate needs and long-term needs.”
Immediately following the Jan. 12 earthquake, BWH was part of a coordinated response with MGH and Partners to assist PIH by deploying surgeons, surgeons, nurses, anesthesiologists and other care providers to the island to aid in relief efforts. Those efforts have continued, with a team of BWH nurses heading to Haiti this weekend, followed by a multidisciplinary team next week.
During a conference call Tuesday for local and national media, Mukherjee explained that a two-pronged approach necessary for meeting the country’s long-term needs involves supporting the Haitian government’s ability to provide health services and mobilizing grass roots community efforts to participate in health programs.
Photos sent by David Walton, MD, of Partners In Health and BWH's Division of Global Health Equity, who is caring for patients in Haiti.
Mukherjee and her colleagues, who partnered with Haiti's Ministry of Health to get 20 operating rooms functioning and fully staffed in the days following the earthquake, also set up tents in communities to provide first aid, medical care and orthopedic triage.
“In my view, going to the Haitian communities is still critical. As you can imagine, it’s a minority of people who have been able to reach hospitals,” said Mukherjee, who plans to return to Haiti in the next week. “The community-based efforts need to be expanded.”
At its core, the Partners In Health model focuses on partnering with communities and hiring health workers from those communities to provide health information, refer people to clinics and report their medical needs to clinic staff.
“A key part of our strategy is to hire more Haitian community health workers, which will allow them to support their families in this desperate situation and strengthen the on-the-ground Haitian response,” Mukherjee said.
Community health workers will be integral in meeting the needs of some 7,000 pregnant women in Haiti. “The community health model will be important in finding women who are pregnant in communities and helping to ensure they receive care and have a plan for delivery,” Mukherjee said.
PIH has been focusing on the needs of pregnant women in the aftermath of the earthquake by ensuring OB/GYN physicians are available for emergency C-sections and routine deliveries. “Haiti has suffered high maternal mortality for a long time due to lack of services,” Mukherjee said. “Even normal deliveries are going to have difficulties now.”
Another issue that must be addressed is the resettlement of people displaced by the earthquake. “There’s nothing for them to go back to in Port-au-Prince,” she said. “There is a great need for tents, and we’re working with mayors and local officials who have asked us for thousands and thousands of tents to house refugees flooding out of Port-au-Prince.”
When Port-au-Prince does begin to rebuild, Mukherjee spoke of the need to consider access for the many people disabled by the earthquake. “A lot of the injuries were crush injuries, and many Haitians are amputees,” she added. “There will have to be some vision of what it is going to be like to have a nation with many disabled people.”
PIH, which coordinated aid resulting in 47 planes and 170 medical teams arriving in Haiti in the last 12 days, is doing all it can to help the nation it has served for more than 20 years.
“Partners In Health expects to be working to support the people of Haiti for many years and generations to come,” said Ted Constan, chief program officer for PIH.
Visit BWHPikeNotes.org/Haiti for employee resources and updates from staff on the ground.
Comment online: Share your support for those affected by the earthquake and those involved in relief efforts.