15 Years Addressing Health Needs in Northern Haiti

March 12, 2017

Global health funding has plateaued over the past 6-8 years. While the U.S. remains the biggest donor country, its contribution is going down and is expected to decrease substantially under the new administration.  “A big deficiency with global health work today is that too little of it is invested in building and strengthening local health systems for a long-term benefit,” according to Nate Nickerson, Executive Director of Konbit Sante Cap-Haitien Health Partnership, a Maine-based non-profit working in northern Haiti.  Nickerson spoke Saturday at USM on the occasion of Konbit Sante’s 15th years working in Haiti.

Konbit Sante was started in 2001 by Dr. Michael Taylor and his wife Wendy of Portland as an alternative to medical mission trips, and as a way to have a long-term, sustainable impact. According to Nickerson, who has been executive director of the organization since 2005, “Konbit Sante’s approach is to work with and strengthen the local Haitian health system to better meet their own goals.”   “This approach is relatively rare,” he said, “but promoting local capacity to provide care and health services is the best way to assure sustained improvements in health for the community.”

Haiti, once called the “jewel of the Antilles,” is rich in history, including being founded after the first successful slave revolt in 1804. But has since it has been plagued by political instability and poverty. Today, about 60 percent of the population lives on less than $2.50 per day. Forty percent of Haitians have no potable water, and there are no public sanitation systems in the country.  Not surprisingly, health conditions associated with poverty are common in Haiti, including malnutrition and infectious diseases such as malaria, dengue fever, cholera, and other diarrheal diseases. On the positive side, infant and maternal mortality appear to be on the decline, although neonatal mortality hasn’t budged for the past 25 years, according to Nickerson.

In terms of health infrastructure, the differences between Haiti and the U.S. are striking. “Compare our 242 physicians per 100,000 population to Haiti’s 25, or our $9,400 annual expenditure for health care per capita to Haiti’s $61, and you can anticipate the differences in health outcomes between the two countries,” Nickerson noted.  “But I want people to understand that while Haiti has many serious needs, it also has highly educated, dedicated doctors and nurses who work in circumstances that we who work in resource-rich situations would find nearly impossible.”

To accomplish its mission, Konbit Sante provides technical assistance and support for Haitians in key positions and embeds these people within the local Haitian health system. Konbit Sante now supports more than 40 staff in Haiti including community health workers, physicians, nurses, and people who administer supply systems. To further support local efforts, Konbit Sante also provides education to physicians, nurses, and others including lectures, bedside teaching and teaching exchanges. 

Konbit Sante supported health workers focus on women’s health, newborn and child health, TB and other community health issues. So far Konbit Sante has sent 18 containers of critical medical supplies and equipment to support the work of their partners in Haiti. A team of technical professionals works to improve infrastructure such as facilities, electrical systems, x-ray, and water supply.

The organization has a small but highly skilled staff in the U.S. and Haiti and many volunteers including medical people, engineers, public health specialists, and people who just want to lend a hand in the warehouse or office. They are currently looking for pediatric nurses to teach both in Haiti and here at home. The Konbit Sante website provides a list of current volunteer opportunities.

“Solving complex problems and making a real difference is not easy. We constantly reexamine what we do and how we do it,” says Nickerson. “In my opinion, if you approach people seeing their strengths as well as their needs, the outcomes are better. We’re not the all-knowing saviors coming in to tell people how to solve their problems. We’re willing collaborators, working with people we respect and trust to identify problems and come up with the resources to solve them.”

Dr. Youseline Telemaque, a former employee of Konbit Sante who was in Portland for the event, said, “It’s about dignity. They respect your dignity and they respond to your needs. For example, in radiology they fixed and replaced machines and then we made a business plan to keep the unit working.” And Dr. Edris Matthieu, a Haitien pediatrician also visiting for the event added, “Konbit Sante doesn’t try to impose solutions. They take into consideration the cultural aspects. They help find solutions that fit with our reality. And they don’t only give materials, they make sure we know how to use them.”

The name Konbit Sante says a lot. In Haitian Creole, a konbit is a collective work group in which members of the community labor together, particularly when no-one alone has enough hands or other resources to accomplish the task. Sante means health.