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Partners In Health

From Wikipedia, the free encyclopedia
Non-profit health care organization
Not to be confused withPartners HealthCare.
Partners In Health
Founded1987
FoundersPaul Farmer;Jim Yong Kim;Ophelia Dahl,Thomas J. White; Todd McCormack
FocusHumanitarian
Location
Area served
Worldwide
Key people
Sheila Davis, CEO
Employees18,000
Websitewww.pih.org
A family receives medical attention at one of PIH's Port-au-Prince-based clinics after the 2010 earthquake.

Partners In Health (PIH) is an internationalnonprofit public health organization founded in 1987 byPaul Farmer,Ophelia Dahl,Thomas J. White,[1] Todd McCormack, andJim Yong Kim.[2][3]

Partners in Health provides healthcare in the poorest areas ofdeveloping countries.[4] The organization builds hospitals[5] and other medical facilities, hires and trains local staff, and delivers a range of healthcare, from in-home consultations to cancer treatments.[6] It also removes barriers to maintaining good health, such as dirty water or a lack of food.[7] The approach trades charity for "accompaniment" which is described as a "dogged commitment to doing whatever it takes to give the poor a fair shake."[8] While many of its principles are rooted inliberation theology, the organization is secular.[9] It forms long-term partnerships with and works on behalf of, local ministries of health.[10] PIH holds a 4 out of 4 stars rating fromCharity Navigator, a nonprofitevaluator.[11]

History

[edit]

Partners In Health began in 1987, after Paul Farmer and Ophelia Dahl helped set up a community-based health project calledZanmi Lasante ("Partners in Health" in Haitian Creole) inCange, Haiti.[12] The organization initially focused on treating people withHIV/AIDS in rural Haiti. PIH now embraces a holistic approach to tacklingdisease,poverty, andhuman rights[13] in a variety of countries.[14]

In 1993, Farmer used the proceeds from hisJohn D. and Catherine T. MacArthur Award to create a new arm of Partners In Health, the Institute for Health and Social Justice. Its mission is to analyze the impact of poverty and inequality on health, and to use findings to educate academics, donors, policy makers, and the general public. PIH's Chief Medical Officer,Dr. Joia Mukherjee,[15] directs the institute.

Current work

[edit]

Partners In Health collaborates closely withHarvard Medical School[16] and theBrigham and Women's Hospital.

At the invitation of local governments, it strengthens and sustainspublic health systems in remote,rural areas.[17] It trains and hires local healthcare workers,[18] many of whom actively find patients in their communities and help them get care.[citation needed] PIH also helps local experts conductacademic research that leads to clinical innovation.[19][20][21]

Notable supporters includeHank and John Green,[22]Madonna,[23] actorMeryl Streep,[24]Ryan Lewis,[25]Win Butler[26] andRégine Chassagne ofArcade Fire,[27] andMatt Damon.[28]

Haiti

[edit]

Zanmi Lasante is PIH's flagship project. The small clinic that started treating patients in the village ofCange in 1985 has grown into the Zanmi Lasante (ZL) Sociomedical Complex, a 104-bed hospital with two operating rooms, adult and pediatric inpatient wards, an infectious disease center (the Thomas J. White Center), an outpatient clinic, a women's health clinic (Proje Sante Fanm),ophthalmology and general medicine clinics, a laboratory, apharmaceutical warehouse, aRed Crossblood bank, radiographic services, and a dozen schools.[29]

The organization also works in 11 other sites acrossHaiti's Central Plateau and beyond. Zanmi Lasante is Haiti's largest nongovernmental healthcare provider, serving 4.5 million. It employs 5,700 Haitians, including doctors, nurses, and community health workers.[30]

Community-based models

[edit]

PIH's community-based model has proved successful in delivering effective care both for common conditions likediarrhea,pneumonia, andchildbirth that are often fatal for Haiti's poor and malnourished, and for complex diseases likeHIV andtuberculosis. The main key to this success and to the PIH model of care pioneered in Haiti has been training and hiring thousands ofaccompagnateurs (community health workers). The PIH model of accompagnateur care is outlined in the5-SPICE framework, a scholarly article detailing the tenets of a successful community health worker program.[31]

The use of accompagnateurs is one of the most effective ways of removing structural barriers to adequate treatment of HIV and other chronic diseases while increasing job growth in communities that desperately require employment to further benefit the community's social structure.[citation needed] Focusing on minimizing the implications ofstructural violence is the key to the PIH model's success and to the improvement of treatment ofchronic disease in rural Haiti.

Expansion in Haiti

[edit]
After the earthquake in Haiti, PIH sent hundreds of volunteers to the island nation and mobilized an existing staff of nearly 5,000 Haitians.
After theearthquake in Haiti, PIH sent hundreds of volunteers to the island nation and mobilized an existing staff of nearly 5,000 Haitians.

As ZL has expanded, it has partnered with other nongovernmental organizations and theHaitian Ministry of Health to rebuild or refurbish existing clinics and hospitals, introduce essential drugs to the formulary, establish laboratories, train and pay community health workers, and complement Ministry of Health personnel with PIH-trained staff. Clinics that previously stood empty now register hundreds of patients each day at twelve sites—Cange,Boucan Carré,Hinche,Thomonde,Belladère,Lascahobas,Mirebalais, andCerca La Source in the Central Plateau plus additions in the Artibonite region:Petite Rivière,Saint-Marc andVerrettes.[citation needed] In 2008, ZL recorded more than 2.6 million patient visits at clinical sites.[32]

Response to the Haiti earthquake

[edit]

When anearthquake struckHaiti onJanuary 12, 2010, PIH/ZL resources were in place to deliver aid. In addition to providing care to the hundreds of thousands who fled to Haiti's Central Plateau and Artibonite regions, ZL established health outposts at four camps for internally displaced people inPort-au-Prince. ZL also supported the city's General Hospital (HUEH) by facilitating the placement of volunteer surgeons, physicians and nurses, and by aiding the hospital's Haitian leadership.[citation needed]

The earthquake leveled most of the health facilities in and around Port-au-Prince, including Haiti's only publicteaching hospital and nursing school. In March 2010, PIH/ZL responded to an urgent appeal from the Haitian Ministry of Public Health and Population (MSPP) by announcing theStand With Haiti campaign, a 3-year, $125 million plan to help Haiti rebuild. The plan included a scaled-up version of an already planned hospital, theMirebalais Hospital.[33]

Hôpital Universitaire de Mirebalais

[edit]

Before January 12, 2010, PIH had been planning to build a newcommunity hospital inMirebalais.[34] Less than six months after the earthquake, the organization quickly scaled up plans.[34] The Haitian Ministry of Public Health and Population (MSPP) and PIH/ZL broke ground on the world-class national referral hospital and teaching center.[citation needed]

In October 2012, Partners in Health finished construction on theHôpital Universitaire de Mirebalais in Haiti. The hospital providesprimary-care services to about 185,000 people in Mirebalais and two nearby communities. It is also intended to serve most of the country for secondary and tertiary care. The hospital opened its doors in March 2013.[35]

The hospital provides education for Haitian nurses, medical students, andresident physicians. It hastelemedicine technologies installed in meeting and operating rooms that link US-based medical professionals to help educate and train students and residents working there.[36][37] Also, Partners in Health helped to establish anemergency department in the hospital.[38] The organization has incorporated community health workers into their treatment regimen for their patients. Community health workers make necessary house visits to patients, deliver stipends and other essentials for patients' care, and keep record of their patients' progress at the hospital.[39]

Other locations

[edit]

Perú

[edit]

Since 1996, PIH's sister organization inPeru,Socios En Salud[40] (SES), has been providing medical services inLima. Based in the northern Lima district ofCarabayllo, SES is now Peru's largestnon-governmental health care organization, serving an estimated population of 700,000 inhabitants, many of whom have fled from poverty and political violence in Peru's countryside. As a valued partner toPeru's Ministry of Health, SES has also influenced national policies for prevention and treatment of multidrug-resistant tuberculosis and HIV and provides important training and support to help implement those policies nationwide.[41]

SES also provides a variety of services. SES provides food baskets, transportation, lodging and other forms of support for impoverished patients.[42] The project also provides opportunities for income generation projects, job skills training, and small business loans.[41] One example is Mujeres Unidas ("Women United"), a cooperative workshop that participates incrafts fairs in Peru and has sold handicrafts as far as theUnited States,Japan andSwitzerland.

Tuberculosis treatment

[edit]

SES has treated more than 10,500 people for multidrug-resistant tuberculosis (MDR-TB) in Lima.[41] SES is conducting the world's largest TB research study, the EPI Project. Funded by aNational Institutes of Health grant of US$6 million in 2007, the project seeks to understand howMDR-TB andXDR-TB spreads among people living in close quarters.[43][44]

Chiapas, Mexico

[edit]

The residents of the southern Mexican state ofChiapas, including millions of indigenous Maya, have long struggled withpoverty,political violence, and dismal health conditions.[citation needed] Chiapas has extremely high rates ofmaternal mortality,infant mortality, and tuberculosis compared to other states in Mexico.[citation needed] Partners In Health, known locally as Compañeros En Salud, began working inMexico in 2011.[45] CES aims to provide a more reliable, community-based alternative by training and employing local community health promoters, calledpromotores.

El Equipo de Apoyo en Salud y Educación Comunitaria (EAPSEC, The Team for the Support of Community Health and Education) was established in 1985 by a small group of Mexican health promoters. They initially worked with Guatemalan refugee communities in the Chiapas border region, and later expanded their work to other marginalized people in Chiapas. EAPSEC believes that "a life of dignity" is a human right. This includes a strongpublic health system that responds to the most pressing health needs of the population, and access to high quality health care.[citation needed]

Since 1989, PIH has collaborated with EAPSEC to improve medical infrastructure in the region and to recruit and train hundreds ofpromotores.[citation needed] Over the past two decades, EAPSEC has partnered with dozens of indigenous and rural communities throughout Chiapas to develop local health capacity. Recent work has focused on a network of communities in the area ofHuitiupan in the highlands and aroundAmatan. EAPSEC is dedicated to helping communities build self-sufficiency and counts many successful community health groups throughout Chiapas among its "alumni."

Community Health Workers, Yadira Roblero and Magdalena Gutiérrez, walk down the mountain side to complete their home visits in Laguna Del Cofre, Chiapas, Mexico, on March 11, 2016.
Mirebalais Hospital
Many of the women took images of family members, but a surprising number were of stoves, kitchen shelves, and wells.
Mirebalais Hospital
See more images here:https://www.pih.org/article/women-in-chiapas-mexico-document-their-lives-advocate-their-concerns

Russia

[edit]
A patient living with MDR-TB receives care in Russia.
A patient living with MDR-TB receives care in Russia.
This section needs to beupdated. Please help update this article to reflect recent events or newly available information.(October 2024)

Partners In Health's work inRussia has a narrower medical focus over a vastly wider geographical area than any of its other projects. From a base in the region ofTomsk Oblast, Siberia, PIH has been working since 1998, in collaboration with the Russian Ministry of Health, to combat one of the world's worst epidemics of drug-resistant tuberculosis (MDR-TB).[46] As of 2014, 39,000 Russians had the disease. In partnership with the Division of Social Medicine and Health Inequalities (DSMHI) at the Brigham and Women's Hospital, PIH has focused on improving clinical services for MDR-TB patients in Tomsk while undertaking training and research to catalyze change in treatment of MDR-TB across the entire Russian Federation.[citation needed]

Partners In Health began working with local clinicians to improve treatment of MDR-TB in Tomsk in 1998. The joint effort got a major boost in 2004, when a five-year, $10.8 million grant was secured from theGlobal Fund to Fight AIDS,Tuberculosis andMalaria for efforts to improve prevention, diagnosis and treatment of TB and MDR-TB. Key components of the clinical effort include improving diagnostics in order to detect cases earlier, developing a comprehensive strategy to promote adherence among patients, improving infection control in hospitals and clinics and decreasing transmission of TB to HIV-positive patients. Work in Tomsk also encompasseshealth education for the public and clinical and program management training for medical personnel in Tomsk.[47][48]

Partners In Health operates in two other regions in Russia,Voronezh Oblast andKarelia, where technical assistance is provided to regional tuberculosis services.

Community Health Workers in Lesotho receive monthly trainings.
Community Health Workers in Lesotho receive monthly trainings.

Lesotho

[edit]

Bo-Mphato Litšebeletsong tsa Bophelo/Partners In Health inLesotho was PIH's second project in Africa and the first in a country with extremely high prevalence of HIV.[49] Approximately one quarter of Lesotho's adult population is HIV-positive and life expectancy in the country is 55 years for women and 52 for men.[50] In addition, the Basotho people are being ravaged by atuberculosis epidemic.[citation needed] Lesotho's TB rate is among the highest in the world,[citation needed] and TB spreads rapidly and is particularly deadly where many people's immune systems are weakened by HIV.[citation needed] The PIH project in Lesotho was launched in 2006 following an invitation from the Lesotho's Ministry of Health and consultation with the Clinton HIV/AIDS Initiative (CHAI, now known as theClinton Health Access Initiative) about where to replicate that model elsewhere in Africa.[51]

An aerial image of PIH's new Butaro Hospital, the largest public facility in Rwanda.
An aerial image of PIH's newButaro Hospital, the largest public facility in Rwanda
Rwandan President Paul Kagame and PIH's Paul Farmer at the Butaro ribbon cutting ceremony in 2011.
Rwandan PresidentPaul Kagame and PIH'sPaul Farmer at the Butaro ribbon cutting ceremony in 2011

Rwanda

[edit]

Partners In Health/Inshuti Mu Buzima (IMB) has been working inRwanda since 2005. In partnership with the Government of Rwanda and the Clinton Health Access Initiative (CHAI), IMB's work supports the Ministry of Health to comprehensively strengthen the public health system in rural, underserved areas of the country. Initially, PIH and CHAI began by implementing a pilot project in two rural districts,Kayonza andKirehe, in Rwanda's Eastern Province.[citation needed] Building off of PIH's approach in Haiti, the project was designed as a comprehensive primary health care model within thepublic sector. The approach used HIV/AIDS prevention and care as the entry point to build capacity to address the major health problems faced by the local population. Haitian physicians, nurses, and managers traveled to Rwanda extensively in the early years of the program to provide training and program design assistance.[citation needed]

Inshuti Mu Buzima-supported facilities

[edit]

In January 2011, PIH supported the Ministry of Health of Rwanda in the opening ofButaro District Hospital.[52][53][54] The hospital, located inBurera district, has 156 beds.

University of Global Health Equity

[edit]

In September 2015, Partners In Health inauguratedUniversity of Global Health Equity, a non-for-profit organization offering a two-year part-time master's degree in Global Health Delivery.[55] Construction began in September 2016 on the first phase of a campus located in Butaro.[56] The new campus officially opened in January 2019.[57]

Malawi

[edit]

In early 2007, Abwenzi Pa Za Umoyo (APZU; Partners In Health in Chichewa), started treating patients and training community health workers in the southwestern corner ofMalawi, one of the poorest and most densely populated countries in Africa.[citation needed]

The Clinton-Hunter Development Initiative (CHDI) targeted Malawi as a country desperately needing a rural health project to address the devastating HIV/AIDS epidemic in the region. About 14 percent of Malawi's adult population is infected with HIV and hundreds of thousands of children have been orphaned by the disease.[citation needed] CHDI asked Partners In Health to replicate the rural initiative programs that have proven so successful in delivering HIV treatment and comprehensive primary health care inRwanda andLesotho.[citation needed] The Malawi Ministry of Health directed PIH and CHDI to the impoverished rural area of Neno.

In 2010, APZU tested 17,606 patients for HIV. The organization clinics logged 332,619 patient visits. APZU supported 889 children, allowing them to attend school and receive food.[58]

Ebola response in West Africa

[edit]

In late 2014, PIH heeded calls from the governments ofLiberia andSierra Leone, and other international partners, to join the fight against Ebola inWest Africa.[59] Although PIH is not an emergency response organization, they felt the moral obligation to join the response, given the unprecedented nature of the outbreak in West Africa.

Sierra Leone

[edit]
A maternity hospital in Sierra Leone being built with support from Partners in Health.
A maternity hospital in Sierra Leone being built with support from Partners in Health

PIH arrived in Sierra Leone at a time when the situation was worsening. The organization sought to quickly respond to the outbreak. They began inPort Loko District at the Maforki Ebola Treatment Unit[60] and scaled up from there to provide clinical care at 16 facilities across 4 districts at the peak, while managing a network of Ebola response community health workers, providing surveillance, support and referrals in rural communities.

The organization took a health systems strengthening approach and aimed to work together with government entities to support the response to the outbreak.[61] As Ebola was brought under control, PIH shifted to support the Ministry of Health in rebuilding its health system.[62] Today PIH's Sierra Leone program is focused on raising the standard of care through programs in Kono and Port Loko Districts, with a focus onmaternal health, HIV/TB and Ebola survivor care. PIH currently supports six health facilities across three districts in Sierra Leone.

Liberia

[edit]

PIH began work inLiberia in November 2014, focused on responding toEbola inMaryland County, a 20-hour drive south from the capital of Monrovia. They supported two Ebola treatment units and three community care centers, and taught teachers and community members new techniques to slow the spread of infections. Since Ebola came under control in Liberia in March 2015, PIH has focused on helping rebuild the health system, primarily for a population of roughly 100,000 inMaryland County.[63]

Kazakhstan

[edit]

Since 2009, PIH has worked inKazakhstan with the Ministry of Health to provide services treating MDR-TB.[64]

United States

[edit]

PIH launched its U.S. arm in May 2020 in response to theCOVID-19 pandemic.[65]

Partner projects

[edit]

PIH also supports partner projects in the following countries:

  • Africa: Project Muso inMali; Tiyatien Health inLiberia; Village Health Works inBurundi
  • Asia:Possible Health inNepal
  • Central America: Equipo Técnico de Educación en Salud Comunitaria in Guatemala

PIH also previously worked in the Dominican Republic.[citation needed]

References

[edit]
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