Haiti after the quake: Telemedicine remaking healthcare in one of the world’s poorest countries

The telemedicine clinic in Haiti has provided healthcare to more than 10,000 Haitians. The founder of LifePaths Global Alliance, Elaine Knight, is third from left.

PORT-AU-PRINCE  –  Out of sight, out of mind, the familiar proverb goes. The people of Haiti know this; they live this. After the 2010 earthquake that decimated the country, killing some 316,000 Haitians and leaving some one million homeless, an influx of outside aid poured into the country. Today, much of that promised money has yet to materialize, and most aid groups have vacated. Haiti still remains the poorest and most disease-ravaged country in the Western Hemisphere.

By establishing telemedicine clinics and extending care to Haitians in the most rural and forgotten areas, the endeavors of one group seek to put Haiti back into sight and back into minds  –  for good.

Elaine Knight, founder and chair of LifePaths Global Alliance (LGA), an organization seeking to sustainably help disadvantaged communities, both locally and internationally, decided to act.

In 2010, Knight helped establish a telemedicine clinic based in L’Estere, Haiti  –  two hours north of Port-au-Prince. Two years later, the telemedicine clinic has provided healthcare to more than 10,000 Haitians and has helped decrease malaria, sexually transmitted diseases and basic infections by 30 percent.

Knight says the efforts began after the 2010 earthquake, when she decided to take a group of physiotherapists down to help the inordinate number of amputees.

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When the group arrived, Knight says, “We found very quickly that we couldn’t find a lot of the amputees, and the amputees couldn’t really find us because they were in tent cities and were dispersed all over the place.”

It was then the group decided to connect with Joseph Prosper, Haitian doctor and telemedicine clinic medical director, who conducted rural mobile health clinics across the country.

“We didn’t just come here for the earthquake, and we won’t leave when it is forgotten,” says Prosper in a 2010 NJ.com article.

Knight recalls the story of a young pregnant woman who needed emergency medical care, but because of her rural location, there was absolutely no place to take her. Eight hours later, the woman died. Tragedies like this are everyday facts of life, Knight says somberly. “Had someone showed up an hour after the accident, many of those people would still be alive.”

“I quickly decided that the best solution to the problem in Haiti would be the basic healthcare,” she says. In Port-au-Prince, “Everybody was trying to help with the earthquake, but what was really important, I thought, was to bring services out to the rural areas.”

January 2011, Knight’s group went full-on telemedicine. “On Wednesdays and Saturdays we would hold clinics, and people would come into our clinics, and we would hook them up by video to our doctor in Port- au-Prince, and he would talk to them about what problems they were having.”

There would be one agent with the patient, and the doctor would discuss among the three of them what the symptoms were and what he thought would be the best method for treatment. The doctor would then authorize the agent to write out a prescription to take to LGA’s free pharmacy. Some 100 patients per week were given primary care this way.

Knight explains that 99 percent of the patients come for primary healthcare, like infections, malaria and cholera. “We were there when the big cholera outbreak happened, so we helped a lot with that by doing IVs and hydrating people.”

One thing Knight seeks to do differently from other groups that have come and gone is to make the telemedicine clinic sustainable. For this reason, only Haitians are trained as nurses, doctors and telemedicine agents, she explains.

“It’s great if we can bring boatloads of doctors and nurses, but they’re there for two weeks, and they leave,” she says. “Our plan isn’t just to flat down help and take off, but it’s not to stay there and run a clinic for the rest of our lives either. It’s to teach these skills, set up programs that can help sustain the clinic, and then use that as a model where we could go somewhere else in Haiti.”

LGA has also created a clothing boutique, a rice project and a computer school/Internet cafe, where all the profits go back into the clinic.

“It’s slow, and the money’s dribbling in,” Knight says. “But now the rice is ready to harvest; the boutique is at the point where we’re starting to see a profit.”

The clinic’s ongoing expenses are pegged at $2,500 per month, which includes the doctor, telemedicine agents, medications, the facilities and the service. As the initial funding begins to evaporate, the group is looking to other corporate donors and partnerships to further sustain the clinic’s efforts.

“All this existed before the earthquake. [Haitians] don’t want a handout, but they do want a hand up,” Knight says. “And they’re capable of doing these things on their own; they just need some encouragement and help from people.”

“Utilizing telemedicine in remote areas of Haiti has changed many lives, especially mine,” says Prosper. “This is my dream come true.”


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