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The earthquake that struck Haiti in January left hundreds of thousands of survivors in need of immediate medical attention. The international community responded, with doctors, nurses and medical equipment. The temporary abundance of free care appears to be endangering Haiti’s own health care system. The World’s Amy Bracken has the story.(Photo: Logan Abassi/The United Nations) Download MP3
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DAVID BARON: The earthquake that struck Haiti in January left hundreds of thousands of survivors in need of immediate medical attention. The international community responded with doctors, nurses and equipment. As a result, many Haitians received medical treatment for the first time. Parts of Haiti still have more free health care than ever before. But this has created a problem. The temporary abundance of free care appears to be a factor in the decline of Haiti’s own health care system. The World’s Amy Bracken has the story from Port-au-Prince.
AMY BRACKEN: When CDTI Hospital opened three years ago, it was touted as the best medical facility in Haiti, with CT scanners and other technology rarely seen in the country. The private hospital catered to Haitians who could afford the 25 dollar consultation fee. After the earthquake, it provided round-the-clock free care to anyone who needed it. But today the hospital is quiet, empty, closed. Reynold Savain is a radiologist and the hospital’s director.
REYNOLD SAVAIN: To have a private hospital operating right now, in this situation, it’s not possible.
BRACKEN: Savain says providing free care after the earthquake has driven him deeply into debt. To the bank, to the staffers who worked for months without full pay, to pharmaceutical suppliers whose products he gave away, and to local doctors who invested in the hospital. Savain says he was grateful to the foreign organizations that provided medical staff and supplies after the disaster. But he also needed financial support.
SAVAIN: All these people wanted to give was medicine, medical supplies, and doctors, rotational doctors, and at one point I couldn’t take it any more. So at the end of March I said okay, this is it, everything has to stop.
BRACKEN: And after the emergency phase ended, Savain says his patient base dried up. Many are now going to the free clinics run by international groups. Savain was forced to close down. Other private hospitals fear the same fate. Michel Théard is a cardiologist and board member at Hopital Canapé Vert, just up the road.
MICHEL THEARD: We have an average of 8 to 10 patients a day, which is not enough to maintain the hospital open. And the problem is that the NGOs are working giving the free care, so when they will leave, you will find nothing. The medical condition of Haiti will be worse than before.
BRACKEN: But Hans Van Dillen, Haiti mission chief for Doctors without Borders, or MSF, says aid groups that treat Haiti’s neediest should not be blamed for damaging the private system.
HANS VAN DILLEN: I don’t see MSF being responsible for destroying the private sector as has been said now. Well, not only MSF, of course, but the fact that there is free health care in Port-au-Prince is much more important.
BRACKEN: Still, MSF won’t be around forever. And neither will other aid groups. Earlier this month, another NGO, International Medical Corps, pulled out of Port-au-Prince’s General Hospital. IMC had been running the public hospital since shortly after the earthquake. The Hospital’s director asked them to leave. Jason Erb of IMC says his staff were unhappy about going, but they understood that after the emergency phase, the presence of foreign doctors can be a problem.
JASON ERB: In Haiti before the earthquake, I believe it was less than 45% of people actually had access to healthcare, and that includes private and public. And so we know that in coming in we have provided care to people who maybe never had it before. It’s difficult to stop providing that, but it’s not something that can go on forever. And it’s not something that helps to develop the health care system here in Haiti.
BRACKEN: Before the earthquake, the Haitian government financed the public hospital. Emergency care was free, and the rest was heavily subsidized. But patients had to buy their own medications and bring them to the hospital. And hospital staff periodically went on strike, abandoning patients in their cots, because the government hadn’t paid them in months. Now Haiti’s government is pledging to make health care at the public hospital completely free with the help of international donations. That remains to be seen. But Alix Lassegue, who runs the main public hospital, is still concerned about the state of Haiti’s private health care system.
ALIX LASSEGUE: I think there is a necessity in a country like Haiti to have private sector. The majority of doctors or nurses working in the public sector work also in the private sector because the salary paid in the public sector is not sufficient to take care of the family, all the expenses for the daily life.
BRACKEN: In other words, if private health care in Haiti collapses, it will bring the public system down with it. Lassegue hopes the government will also help private medicine. Others, like Théard of Hopital Canapé Vert, say they’re hoping for a public-private partnership, one that would provide care for anyone, regardless of their ability to pay.
THEARD: I believe the new avenir of the future of medicine in Haiti has to be mixed. Private won’t work any more.
BRACKEN: But in order for a public-private system to work, Haiti will have to rely on international funding for the foreseeable future. For The World, I’m Amy Bracken, Port-au-Prince, Haiti.
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