A New Paradigm for Health In Haiti
If you’ve never seen it, Hôpital Universitaire de Mirebalais (HUM) is a marvel to behold. Run by Partners In Health and nestled in the hills outside Haiti’s capital of Port-Au-Prince, the large 350-bed hospital campus bustles with activity. Over 1.7 million patients have been seen here since the doors opened — all the more impressive given that the hospital opened less than seven years ago.
Designed and built in the wake of the 2010 earthquake, HUM was the project that first brought me to Haiti, introduced me to David Walton, MD MPH, and ultimately launched Build Health International’s. As David put it to NPR while the hospital was being built, our hope was “to create a new paradigm for health care delivery in [Haiti].”
Healthcare is a big challenge in Haiti. Annual government spending on health is just $13 per capita. There is only one doctor for every 5000 people. Haiti’s neighbor, Cuba, spends $781 per capita and has 41 doctors for every 5000 people. The issue in Haiti is not, however, a lack of medical schools or graduates, but that a staggering 80 percent of all medical students in Haiti leave within five years to practice medicine abroad. Of those who stay, half are generalists who have completed medical school and a year of social service, but have no specialty training. There simply aren’t enough residency programs and teaching hospitals; Haiti graduates 3x more doctors from medical schools than there are residency positions available. The country needs every one of these doctors, but it also needs for them to be able to be able to work at their full potential, with robust training, reliable equipment, and dignified spaces for care. HUM is proving this is possible, and putting Haiti’s medical future first.
HUM’s first class of 14 residents started in October 2013, training in pediatrics, general surgery, and internal medicine. Today, HUM also offers residencies in obstetrics and gynecology, neurology, nurse anesthesiology, and emergency medicine. Two residence dorms enable medical residents from across the country to live on-site and focus on their studies. For many residents, working at HUM will be the first time they have access to facilities and equipment that you or I would consider standard for any hospital — fully equipped operating rooms, an electronic medical record system, a CT scanner. HUM’s Oncology Center is the first and only in the public sector able to offer comprehensive cancer care, including chemotherapy, surgery and counseling. It is supported by Haiti’s first and only pathology lab, built by BHI in collaboration with the Dana Farber Cancer Institute, which has significantly improved diagnostic times and enabled treatment protocols that were previously unavailable anywhere in Haiti.
You could say I’m biased because I’ve been helping design and build this hospital with BHI since it was just a rice field. But no one can dispute the fact that, today, HUM is one of the top teaching hospitals in Latin America and the Caribbean. Earlier this month, HUM received accreditation from ACGME-I, the international arm of the US-based Accreditation Council for Graduate Medical Education — the accrediting body for the vast majority of teaching hospitals in the US. Haiti now joins seven other countries with ACGME-I accreditation across the world. This accreditation demonstrates that HUM meets global standards for institutional, foundational, and advanced specialty education, a great achievement and a testament to the great work that our partners at PIH continue to do.
To date, HUM has graduated 123 residents, with an additional 116 residents currently enrolled. As importantly, 98 percent of graduates have stayed in Haiti, many continuing to serve in rural hospitals where the needs are great and available services often scarce. St. Boniface Hospital’s Surgical Center, built by BHI in 2016, is southern Haiti’s most extensive surgical facility. They perform over 300 surgeries a month. The Surgical Center is run by Haitian surgeons, trained in Haiti at HUM. This is the new paradigm for health care delivery in Haiti.
