Improving access to essential medicines in rural Haiti

Blog post by Plan International of Canada

Medicines save lives but in rural communities access to medicine is a significant barrier to receiving adequate treatment. Existing health facilities often experience a shortage of essential medicines and equipment needed to respond appropriately, especially to reproductive health needs. This leaves adolescent girls and children in a precarious and vulnerable position.

According to UNICEF, Haiti has the highest maternal mortality rate in the Americas. In North-East Haiti, complications from pregnancy and childbirth are a major cause of death for adolescent girls – approximately 18% of them are mothers.

In response to the poor access to essential medicines, Plan International has partnered with Health Partners International of Canada* (HPIC) to arrange donations of essential, life-saving medicines to Haiti. With the support from HPIC and their generous donors, Plan International will be able to provide antibiotics to treat infections that women or young children can contract and oxytocin, an essential medicine used to prevent post-partum hemorrhage, which is among the leading causes of maternal death.

In Haiti, Plan International Canada will also work with Plan International Haiti, the local government and NGO partners to implement a multidimensional project. It will target the most marginalized and vulnerable women, adolescent girls and their children in hopes to reduce maternal and neonatal mortality.

Working to improve quality of care 

Health facilities in North-East Haiti face a number of challenges. There can be a lack of space, often times, the staff are tired and overworked, and patients are not always received in a friendly environment. Additionally, many of the facilities lack essential medical equipment and supplies needed to provide quality health services.

Plan International will focus its work on improving the quality of care that is provided to patients by making medicines and equipment available. And by working with health providers to reinforce their capacities to provide services that are adolescent friendly and that are responsive to the unique health needs of women and girls.

Hope for the future

“For having participated in many meetings, I believe that this project will be useful to the community…” -Mimose Alfred. (Fort-Liberté health center staff)

Although this project is only in its beginning stages, people at the health facilities are optimistic about the changes that Plan International and its partners can bring to the area. They believe the project will encourage community members to return to the hospitals.

Together, we are working to make sure that everyone and especially girls, women and children can exercise their rights to access quality health services without discrimination.

Our generous partners

The work we are doing would not be possible without our partners in Canada, namely HPIC and pharmaceutical donor companies including AstraZeneca Canada, BD, Fresenius-Kabi, Henry Schein, Hospira, Johnson & Johnson Inc., Pfizer Canada Inc., Pfizer Consumer, Pharmascience Inc., Teligent, and Teva Canada Limited, as well as government partners, and our local partners in the very communities we work with.

*Health Partners International of Canada is an independent Canadian charity dedicated to increasing access to medicine and improving health in the most vulnerable communities. HPIC works with Canada’s pharmaceutical and healthcare industry to treat about 1 million people in 50 countries every year through a well-established network of Canadian volunteers and global partners. HPIC equips medical mission teams, stocks clinics and hospitals in impoverished communities, mobilizes medical relief during emergencies and builds local capacity.

Help #ChangeTheBirthStory

Plan International Canada in partnership with the Government of Canada is supporting women, men, girls and boys to change the birth story in many remote communities across Ghana, Haiti, Nigeria, Senegal, Tanzania, Mozambique, Malawi and Bangladesh.

Kenyan health facility serving Maasai gets a boost from HPIC

You have probably heard of Kenya’s Maasai people, perhaps the most well-known ethnic group in Africa thanks to their proximity to the big game parks and all the related tourist activities, colourful dress and nomadic lifestyle. Perhaps you don’t know that the traditional Maasai who live in the most remote areas of Kenya have lost many mothers, babies and young children because some do not get to clinics and access treatment.

The Maasai and other people living in the area of Narok did not have a hospital and needed a community health facility. The Nturumeti Dispensary was built to serve an area covering eight villages. In November the dispensary received a shipment of medical relief from Health Partners International of Canada (HPIC). This was part of the first provision of medical aid through HPIC’s Pamoja Project in partnership with Anglican Development Services Kenya (ADSK), a key partner in the delivery of healthcare to vulnerable communities in Kenya.

The medicines were “a boost to the facility,” reported Anne, the dispensary nurse. The facility, officially supported by the Ministry of Health, has had many challenges due to a poor supply of medicines. She has a tough time getting enough medicine with her modest budget.

“I appreciate the supply of infection control items such as waste bins, wet wipes, sharps containers, disposable gowns,” she says. “This has improved our infection control measures, especially in our maternity and wound dressing rooms.”

The women accessing the maternity services are especially grateful for the items they receive to improve their hygiene during and after childbirth. Anne believes that the number of patients is increasing thanks to greater access to medicine.

The nurse noted that the antibiotics for children were very effective. As stated by one of the beneficiaries, children are recovering well thanks to the donated medicines: “We are happy for the new drugs; they are causing our children to recover very fast.”

HPIC is currently planning the next shipment for the Pamoja Project, slated to leave in August.

About the project
Pamoja, which means “together” in Swahili, is in partnership with ADSK.

Like many African nations, Kenya relies on health services provided by faith-based organizations to care for more than 60 per cent of the population. Many women and children have little or no access to essential medicines or basic health services. As a result, the annual death rates remain far too high. Every year 8,000 mothers and over 7 million children five years old and younger die. Most of these deaths can be prevented through greater access to care and effective treatment.

HPIC’s Pamoja project aims to be part of the solution. Providing necessary medicines and supplies is one part of the project. And the other innovative component of the project involves training and mobilizing leaders as communications channels to transmit key health messages to communities and mothers. The hope is that more women will know about available health services, why and when to consult. To save the lives of mothers and young children, women and their partners need to consult before treatable complications and diseases go too far.

Partner highlight: HPIC is grateful for the partnership of Pfizer Canada, a donor of antibiotics to this shipment to Kenya. Pfizer Canada has been a partner since 1994 and was a top donor in 2016.


Volunteers pack “health and hope” throughout the year

Did you know that Health Partners International of Canada benefited from over 1,300 volunteer hours given by about 500 volunteers last year? And that is not even counting the Izzy Doll knitters and crocheters!

Almost every week teams come in to pack medicines at our distribution centre in Oakville, Ontario. Every Humanitarian Medical Kit is packed with care by a volunteer team. They sort the medicines and pack the kits that bring healing to the most vulnerable people in 50 countries every year.

“We love welcoming the volunteers to our distribution centre!” says Wes Robinson, HPIC’s Director of Operations. “It is a great way to share our mission, especially with the employees of companies that donate medicine. And when they leave, they know they are helping thousands of people access essential medicine and care.”

Other volunteers across Canada devote about 40,000 hours every year knitting or crocheting Izzy Dolls. The first task of these dolls is to protect the medicines packed in our Humanitarian Medical Kits. Their most important job is to bring joy and comfort to children seen at clinics and hospitals.

And there are more volunteers who offer their time and expertise to help HPIC with specific projects to advance the mission to increase access to medicine for the most vulnerable.

On the occasion of National Volunteer Week, we wish to offer our thanks to all our volunteers! Thank you!

And our partners in program delivery and the patients who benefit join us in thanking you:

“Thanks so much. There is no way we would be able to get access to these drugs or be able to afford them even if we could.”

“Thank you so much. We would not have any medicine if it were not for this Humanitarian Medical Kit!”

“The patients were very grateful that there are people who would care enough to donate these medications.”

“The medications facilitate my work. I am able to give more effective treatments than I would otherwise be able. Patients are happy to know someone cares about their wellbeing and is willing to help them. It makes them feel valued.”

Thanks to the companies that provide volunteers:

Astellas Pharma Canada, Inc.
AstraZeneca Canada
Bayer Inc.
Eli Lilly Canada
GlaxoSmithKline Inc.
Johnson & Johnson Inc.
LEO Pharma Inc. Canada
Pfizer Canada Inc.
Teva Canada Limited

“Surely these kits saved lives in Syria”

Healthcare practitioners in Syria have the capacity to save lives in one of the worst conflicts afflicting the world today thanks to a provision of medical relief from Health Partners International of Canada. Program partner Global Medic reported to HPIC about the distribution of 100 Humanitarian Medical Kits earlier this year. This was enough donated medicine to treat an estimated 25,000 Syrian kids and adults.

HPIC’s partner is Global Medic, a Canadian organization that provides short-term, rapid response in the wake of disasters and crises in Canada and overseas. Both HPIC and Global Medic have been responding to the Syrian crisis since 2011.

“The impact of the donation was truly maximized by serving a high-risk population that is not easily accessed by international aid efforts,” wrote Matt Capobianco, Global Medic’s Deputy Director and coordinator of their Syrian relief projects, in the report to HPIC.

“The conditions in the healthcare facilities in the region are deplorable – with immense gaps in essential medicines and supplies – yet the need for medical service in the region is at an all-time high,” Matt wrote. “The support that these centres received was essential in ensuring that physicians and health practitioners had access to essential medicines and supplies in order to continue treating patients. The importance of receiving these medical supplies cannot be overstated.”

Undisclosed facility 

The kits arrived in Syria at an undisclosed health facility and are currently being used to care for an extremely vulnerable population.

The kits arrived in Turkey by air freight, Matt reported, and then were delivered to their local partners. “Despite medical professionals fighting to continue providing critical medical care to vulnerable civilians, access to even basic medicines and supplies is highly restricted at a time when they are at greatest risk.

“Surely these kits saved lives in Syria,” Matt said. “This response is restoring a sense of security for beneficiaries as they are accessing the care and treatment they need. Men, women, children, infants, the elderly, and those with disabilities are included in the scope of targeted beneficiaries.”

Since this is an active combat zone, Global Medic cannot divulge the names of hospitals, partners or doctors dispensing the medicines. “I can tell you that I I am in frequent contact with the field,” Matt told HPIC.

Health concerns 

“The primary health concerns and medical issues were specific to war-related traumas, which are the main cause of death in the targeted region, as reported through mortality surveys conducted by the World Health Organization,” reported Global Medic.

“For example, nearly 27,000 war-related trauma cases were treated in November 2016 alone. Idlib Governorate remains the primary destination for citizens fleeing other parts of the country, including more than 36,000 in December 2016 alone. This led to an influx of patients requiring care from hospitals and mobile clinics in Idlib. This movement has also led to increased cold exposure and risk of hypothermia due to poor living conditions and an influx of internally displaced persons. Individuals in this specific context are succumbing to curable diseases and ailments simply due to a lack of access to essential medicines. Communicable diseases including influenza-like illness (ILI), severe acute respiratory infection (SARI), as well as diarrheal diseases and leishmaniasis are among the most prevalent.”

“These kits delivered truly powerful and meaningful impact for the Syrian families seeking medical care in Idlib Governorate,” the report concluded.





Video tour of the ward at HEAL Africa, D.R. Congo

Imagine that a town the size of Baie Comeau, Quebec or Gravenhurst, Ontario only had one doctor on duty.

That is the situation of people living in the Democratic Republic of the Congo where the healthcare system has still not recovered from years of conflict and chaos.

HEAL Africa is located in Goma, a city in the eastern lakes region of the country known for bandits, rebels and an active volcano. In this difficult setting, HEAL Africa is a place of hope and healing.

Their hospital located in Goma in the Democratic Republic of the Congo is a regional centre that attracts people from quite far away in the vast and troubled country it serves.

Women who have survived horrific assaults and need surgery and rehabilitation find hope here and a new beginning.

Children with congenital problems and birth defects come here to receive appropriate care by trained professionals and they get a new start at life.

And all kinds of other Congolese children and adults come to the hospital and its associated clinics and receive life-changing care.

One patient who benefitted in 2016 is Kashama Mayaya, a 16-year-old student living in Tshibala, Central Kasai province. From the hospital’s report: “He was born with a cleft lip. From his birth, he felt stigmatized by society. In September 2016, the HEAL Africa team repaired his cleft lip for free thanks to the HPIC donation.”

Another child treated was Lucien Widuhaye, a two-month old baby with hydrocephaly. He was rescued by the HEAL Africa team as well last year.

For more than a decade, Health Partners International of Canada has been sending containers of medical and surgical supplies to help the hospital help these people.

“Getting drugs and supplies is difficult,” writes the organization in their most recent report to HPIC. Having greater access to medicines helps the hospital help the most vulnerable patients.

“Without donations, the hospital could not operate,” they wrote in their report.

HPIC would like to acknowledge the contribution of two organizations whose support has made this project possible: Medtronic Canada, which is the major donor of products to HEAL Africa since the beginning of the project, and Unifor Social Justice Fund, which has sponsored this project since 2005.

HPIC has a liaison in country, Connie Smith, who took us on a video tour of some of the wards:

And Dr. Sylvain, staff doctor, wanted to thank HPIC’s donors and the patients wanted to send their blessings in this video:



Their names are Nita, Chhea and Teurng

And these three young children in Cambodia survived thanks to donations from AstraZeneca and the Ptarmigan Foundation that funded and supplied an HPIC project to bring specially requested medicines to a pediatric hospital in Cambodia.

“When we developed this plan, we knew it would save the lives of children,” said Denis St-Amour, President of Health Partners International of Canada (HPIC). “Now we know the stories of three of the little patients.”

Angkor Hospital for Children in Siem Reap, Cambodia requested a donation of powerful antibiotic Merrem (meropenem) from Health Partners International of Canada last year. In September they received 1,500 doses of Merrem, a broad spectrum antibiotic that can treat a wide range of infections.

Around 500 kids visit the hospital every day and “many have undeveloped or compromised immune systems, leaving them vulnerable to infection.” More than 25,000 kids were treated at the hospital in the quarter the Merrem was delivered.

One of the kids who was saved is Teurng, a nine-year-old farmer’s daughter. She had always been a healthy child but got quite sick suddenly. Teurng’s symptoms included fever, shortness of breath and abdominal pain. “Her parents gave her fever reducing medicine thinking it would help her, but she continued to get worse,” stated the hospital report to HPIC.

Her mother decided at that point to take her to the emergency department at Angkor Hospital for Children in mid-January 2017. By then Teurng’s condition was severe and she was seen immediately. Lab results and x-rays determined that she had an infection and she was treated as an in-patient with a full course of Merrem.

Teurng stayed at the hospital for two weeks while the team managed and monitored her infection. The cause of the infection was never found but with access to care and treatment provided by HPIC through AstraZeneca and Ptarmigan, the little girl made a full recovery.

Chhea and Nita, two babies, also were saved by having access to Merrem treatment. Chhea’s parents now realize they could have lost their son and are extremely grateful: “If it wasn’t for the hospital, I could have been sitting here watching my son die in front of my eyes. This hospital provided my son a second chance at life.”


Lessons learned in Guatemala help students become better nurses and paramedics in Canada

Humber College believes that a project in its third year for students in nursing and paramedics can transform their students’ perspectives on providing care for diverse and multicultural communities in Canada.

This February a team of students will once again leave for Guatemala. Equipped with their training and with four Humanitarian Medical Kits from Health Partners International of Canada, they will bring health care to children and adults who have very little access.

A major goal of the project is to learn “cultural humility”. The college produced a great documentary video of last year’s trip that is recommended viewing for anyone planning a medical mission trip. In the video they describe the concept as fostering “a commitment to listening, observing and learning with the understanding that I do not know everything from the perspective of an individual or a culture.”

The students will provide health assessments for all children living at Valle de los Angeles, a boarding school for kids aged 6-16 years old from impoverished areas around Guatemala City.

Bringing health to slums and schools 

They will also visit two schools in the slums to set up a clinic as well as at a church in the rural area of Solola.

“This is such a beautiful gift to us,” says the school’s director Franciscan priest Michael Della Penna. “This (project) gives us the opportunity to identify the problems.”

One of the places they visited in 2016 was the Guatemala City dump, the largest in Central America and home to 3,000 families and many children with sad stories.

Anyone can be taught how to take vitals and do assessments, but nothing prepares you to meet these children, one student said.

Courtesy: Humber College

Courtesy: Humber College

Another said she just wanted to do as much as she could to help. And a paramedic student said he was inspired by the positivity and tenacity exhibited by these children.

In all, 216 children were treated last year at the school and hundreds more at the other clinics- some communities had never had access to care prior to the team’s visit.

“Without the medications (from HPIC), we would not be able to deliver comprehensive care,” wrote Professor Frankie Burg-Feret, the organizer, in her report to HPIC. “The families living in under-resourced areas would not be able to afford to purchase medication or vitamins.”

This extraordinary experience at the beginning of their careers taught them to be open to learning from people they are working with so they can give the best care.

“If I don’t, who will?” 

In the Humber video it was noted that: 17,000 children under five years old die every day due to poverty and they die quietly in some of the poorest villages on earth, far removed from the scrutiny and the conscience of the world. (UNICEF Progress of Nations report 2013).

These Humber students feel they are helping to make a difference even if it is limited. “If we don’t help, who will?” one student said.

Many children will lead healthier lives after receiving preventive care and being introduced to some basic healthcare, such as brushing teeth.

Humber College is sending another team Feb. 14-27.

Last year the Humber students brought four Humanitarian Medical Kits, including Ciprofloxacin, an antibiotic donated by Bayer Inc. Bayer has been supporting the work of HPIC with donations of funding and requested products since 1995. In 2016 Bayer was a significant sponsor of our mission. It is estimated that over 800,000 people have been treated with medicine donated by Bayer to HPIC over the course of the partnership.

Documentary video of 2016 trip to Guatemala





Delivering health where no cars can take you

This area in the mountains near Cap Haitien had never had a visit from a medical team.

Health Partners International of Canada (HPIC) partner Becky Munnings and part of the team of 11 healthcare workers from Harvest Bible Chapel in Oakville had quite a journey to get to this village.

“We drove as far as we could and two doctors, a nurse, a pharmacist and translators hiked in another half mile. The rain was constant and water rose as we crossed over three rivers. Despite the weather, people waited for seven hours to be seen. 175 people were seen that day. A return visit was needed as we couldn’t see everyone who came. A total of 1,200 people were seen during our mission. Many thanks to HPIC for your help.”

It is suggested that 71% of people in this area live on $2 a day and that 47% lack health care.

The team put together a slideshow video to put faces to the people they treated at various clinics in and around Cap Haitien in November 2016. They were equipped with $60,000 worth of medicine packed into Humanitarian Medical Kits from HPIC.

Watch video here 



A dentist’s career highlight in Haiti

When Dr. Carrie Hui met Nelson in 2014 during a dental mission trip to Haiti, he was 11 years old and had two badly decayed teeth that needed to be extracted.

“We had a very difficult time with him as he was uncooperative and cried the entire time we were working on extracting a molar,” Dr. Hui recalled in her report to HPIC. “Once we successfully extracted the first molar, we were ready to dismiss him as we didn’t want to proceed with the second molar. However, he tapped me on the arm and pointed to the other side. He likely realized that if he didn’t have the infected tooth extracted, he would have to live with the pain and discomfort until another dental mission visited the area.”

Nelson after being treated by Dr. Hui in 2014

Nelson after being treated by Dr. Hui in 2014

Impact on Nelson
When she returned in 2015, Nelson remembered them but did not interact much with Dr. Hui and her team. On the last trip in 2016, he was able to speak French and so could speak to them and accompanied the team for much of their mission this past year.

Nelson shared that he was brushing his teeth twice a day and taking good care of them and he revealed his dream to become a dentist one day. Nelson helped them by reassuring patients.

One of the most touching moments of Dr. Hui’s career came when Nelson helped to cover the eyes of a patient receiving anesthetic. “It was touching to see that he appreciated and remembered what we did for him two years ago, and here he was reassuring other patients!” she wrote in her report to HPIC.

Nelson helps Dr. Hui with a patient undergoing a procedure with anesthetic

Dr. Hui brought 2 Humanitarian Medical Kits for dental care provided by Health Partners International of Canada to Haiti in 2016 to provide dental care to a community that has a chronic lack of access. She and her team treated 200 patients.

Tremendous relief 
Most of these patients experienced tremendous relief when she extracted teeth that had become infected. Others had preventive work done. An additional 500 children under the age of 14 years old received preventive treatment, including scaling to remove calculus build up, prophylaxis, application of topical fluoride varnish and oral hygiene instruction.

Dr. Hui would like to relay her thanks to HPIC’s donors, especially Patterson Dental, a donor that makes the dental care kits possible:

“Thank you for your continued support and generosity. It is only with your contributions that we are able to carry out dental and medical missions. Your donations allow us to provide much needed care to patients around the world who are not as fortunate as we are and have little access to these services. The patients are grateful and appreciative for what we are able to bring to them. You can only imagine living with a toothache and not having anyone and anywhere to go for it. Thank you very much.”

Dr. Hui leaves for Haiti again this week with a team and a Humanitarian Medical Kit for dental care.

How a man named “Rubbish” encouraged us

Sometimes we hit obstacles when planning a project that make us wonder if we are ever going to be able to pull it off.

When HPIC’s Pamoja project for Mothers and Children in Kenya was in the concept stage, our Kenyan partner sent us the most moving email message to encourage us:

Why the project matters in our partner’s words
“The Lord God will provide the funds,” wrote Rev. Philip Makokha, a priest who was the assistant to the Anglican Primate of Kenya at the time. “This project will save the lives of mothers and children.

“My parents lost many children before and after I was born. At birth I was thrown on a foot path and picked up by an old woman. The woman gave me back to my mother and named me MAKOKHA meaning rubbish* so that I could survive!

“When I bury babies and mothers who die in childbirth, I pray to God to help the remaining mothers and babies. You are on the right course.”

First shipment arrived
We remember these words and his determination that it would work out and give thanks for the first provision of medicines and supplies for the Pamoja project that arrived in Nairobi, Kenya in November.

“Thank you for this precious support for the women and children and the community in general,” wrote local project co-ordinator Bwibo Adieri. “To all who worked so hard to make this come true, I say Asante (thank you).”

This shipment of medicines and supplies is providing treatment for an estimated 9,000 women and children. The first community to benefit was the Kibera slum in Nairobi, home to about 1 million people living in extreme poverty.

Backgrounder on the project
Pamoja, which means together in Swahili, is a project that was requested by the Anglican Primate of Kenya (most senior leader of the church in the country) in 2015 and is implemented in partnership with Anglican Development Services Kenya and the Anglican Church of Kenya. Kenya, like many African nations, relies on health services provided by churches to care for more than 60 per cent of the population.

Many women and children around the world still have little or no access to essential medicines or other basic health services.

Every year Kenya loses 8,000 mothers and over 7 million young children under 5 years old. Most of these deaths can be prevented. HPIC’s Pamoja project aims to be part of the solution.

More mothers and kids will live  in five targeted communities 
The project will provide shipments of essential medicines and medical supplies to five of the Anglican health facilities: Holy Trinity Clinic in the Kibera slum in Nairobi, Butonge Dispensary in Bungoma County, Maseno Mission Hospital in Kakamega County, Mount Kenya Hospital in Kirinyaga County and St Luke’s Hospital Kaloleni in Kilifi County.

Increasing the availability of medicines and supplies means that more mothers and children will receive quality healthcare during pregnancy and after childbirth. Over time, this will encourage more women to attend the clinics. In the targeted communities, mothers will be alive to care for their kids and young children will grow up.

The prayers of many are being answered, just as our partner assured us.

*Note about Kenyan naming practices:

When parents produce children who die immediately after birth, a ceremony known as ‘khuboelela’ is carried out to stop evil spirits from killing babies. It is carried out after parents have lost hope after so many children have died at a very tender age.

Immediately after giving birth, the baby is neatly dressed and taken to a path/ road side near the home. A humble blameless old woman is instructed to go and pick up the baby from the road side and bring it to its parents.  On reception of the baby, the parents will pretend the baby is not theirs but they are just to take care of it. Names given to a baby girl after this ceremony include Nabangala, Nang’unda, and boys names are Kundu, Kuloba, Makokha, Namunyu and Wenani.

Sometimes, if a child is born and dies and it is believed in that family that the death was caused by the spirits, in order to deceive them, a newborn child is given a name that is supposed to deceive or scare the spirits.