On the Front Lines of HIV Care, Six Months After Haiti Quakes

July marks six months since the devastating earthquakes in Haiti. At the time of the disaster, I-TECH Haiti employed 36 Haitian staff, working from an office in Port-au-Prince and in nearby health facilities. “We were very lucky—we suffered many tragedies, but all of our staff survived, and our office remained sound,” says Rachel Labbé-Coq, I-TECH Haiti Country Director.

I-TECH clinicians immediately pitched in to support the emergency trauma care that was occurring round-the-clock in Port-au-Prince. Many worked in unimaginable conditions. “Those first days and weeks were indescribably difficult,” says Labbé-Coq. “Finding fuel was a problem, and it was at first difficult for staff to reach the office. Nevertheless, we were able to assist the Ministry of Health to evaluate the public hospital and camps, and to provide services.”  Within a week, members of the team had also returned to supporting HIV care as it resumed out of makeshift facilities and clinics across the Port-au-Prince area.

I-TECH Haiti's Dr. Jean Domercant Wysler provides urgent care to an earthquake victim.

Patients line up outside the makeshift lab at the national hospital, which operated from a tent until recently.

In the period immediately following the earthquake, I-TECH’s Haitian staff, along with the nation, struggled to process the enormity of the disaster. Some team members lost immediate family members and loved ones, homes, and property. Many sheltered in tents near damaged or destroyed homes, with colleagues and friends, in the tent camps, or in vehicles.

Within weeks, an influx of new organizations, new funds, and new challenges led to some restructuring of how HIV care is delivered in public sector facilities around Port-au-Prince, a change that is still in process. However, I-TECH’s central program mandate has remained the same: to mentor clinicians and improve the quality of HIV care, to build strong health informatics systems for patient and laboratory records, and to ensure that ongoing HIV training of health care workers is of high quality.

I-TECH mentor Dr. Reginald Amoux (right) supports HUEH Dr. Mrede David (left) as she sees an HIV patient.

Recognizing that the earthquake and its effects deeply traumatized many Haitians, I-TECH also tapped University of Washington expertise to develop new training and materials on post-trauma psychosocial support. These trainings, delivered by I-TECH, help health care workers recognize and respond to their own emotional needs and the emotional needs of their patients. The trainings also support the psychosocial needs of people living with HIV, many of whom must now manage their health while also facing deep personal loss. Awareness, sensitivity, and structured support are particularly important to help them cultivate hope and continue to adhere to treatment. The second part of this effort, a training-of-trainers course, is scheduled for July of this year, and a pocket guide for clinicians has just been released. (Read more about this pocket guide)

I-TECH pilots a psychosocial support training for clinicians, who also receive a new pocket guide.

The I-TECH Haiti team has also continued informatics work to implement and support iSanté, Haiti’s electronic medical records system. In addition, they have worked to quickly develop tools for monitoring patients as they move between clinics and care facilities, a flexibility that is especially important for  patients displaced by the earthquake.  To continue to support local informatics expertise, I-TECH conducted a Server and Health Information Systems Training Course in June, along with an advanced training on OpenELIS attended by 24 participants from Haiti’s National Laboratory.

This July, as the people of Haiti continue to rebuild, the I-TECH team is also continuing the work they began six hard months ago. They are supporting and extending I-TECH programs, responding to the new needs of Haiti’s health care systems and people, and continuing the long process of personal and national healing.

“In the wake of the earthquake, I-TECH Haiti staff came together as a family and as countrymen and women,” says Labbé-Coq. “These six months have been some of the most challenging times in our lives, but they have also deepened our commitment to improve Haiti and shown the truth in the saying about Haitians: We are like reeds; we will bend, but we will always rise again.”

 

Photos: Laura Hahn, Ben Depp