Strengthening specialty services

The earthquake greatly increased the need for specialized medical services such as rehabilitative medicine and mental health. PIH/ZL has strengthened these services at our own facilities and advised the MSPP (Haiti’s Ministry of Public Health and Population) on a national strategy to improve services nationwide.

Rehabilitative medicine

More than 300,000 people were wounded by the earthquake. Many suffered crush wounds, compound fractures, amputations, and other serious injuries that require ongoing rehabilitation and physical therapy. PIH/ZL is accompanying 50 patients with amputations, partnering with Hanger International and l’Hôpital Albert Schweitzer (HAS) in Deschapelles to provide prosthetic limbs and round out care through home visits. Two of our patients with prosthetic limbs are now members of the ZL rehabilitation team, providing coordination and social support for other patients with disabilities. 

The PIH/ZL rehabilitation team also provides services to Haitians living with disabilities in 10 communities in the Central Plateau. Currently most services are based in Cange, but the rehabilitation team has plans to expand services. Because patients with disabilities are often the least able to access medical care, they are visited in their homes where they are given comprehensive care, including assessment, physical therapy, family and community education, provision of assistive devices such as crutches and wheelchairs, and assessment of the home for barriers to accessibility. PIH/ZL hopes to provide a model of community-based rehabilitation services that can be used throughout Haiti to respond to the MSPP’s call to provide care and integrate Haitians living with disabilities.   

Partnering with Spaulding Rehabilitation Hospital and Partners Harvard Medical International, we will soon break ground for a rehabilitation center at l’Hôpital Saint Nicolas in Saint Marc. This center will provide rehabilitation services for the Saint Marc community and beyond, and also house a program to train rehabilitation technicians. Through these efforts, we hope to increase the quality and quantity of rehabilitation professionals in Haiti. The center will serve as a model of disability-centered design, construction, education, and services created within the public sector.  

Mental health and psychosocial support

PIH/ZL staff recognized immediately after the earthquake that in addition to visible wounds, almost every Haitian had been scarred emotionally by the terror of the experience and the loss of family members and friends. We responded by more than doubling the size of our mental health and psychosocial support team. That expansion included hiring 17 new psychologists, installing one at each of the seven hospitals we operate and deploying eight to settlements around Port-au-Prince. In addition, we trained community health workers in the settlements to identify, refer, and support people suffering from anxiety, depression, and other mental health problems. Through the end of November, our settlement clinics had recorded more than 11,000 mental health appointments. 

PIH/ZL’s mental health and psychosocial team is also supporting the MSPP in its effort to develop a national system of decentralized mental health services. We are collaborating with the MSPP to develop culturally appropriate protocols for care of mental health problems, and building a Mirebalais-based mobile training team that will consult, provide services, and supervise the extended ZL network of social workers, psychologists, and physicians in providing integrated, quality care.