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Even before the devastating earthquake in 2010, Haiti's public health care system was perhaps the worst in the Western Hemisphere. Then the quake knocked down clinics, killed medical workers and severely damaged the General Hospital in Port-au-Prince, the capital.
Now, the Boston-based group Partners in Health has set out to build a world-class teaching hospital in what used to be a rice field in the Haitian countryside.
Amid much talk about the slow pace of recovery, the hospital is a concrete sign of progress. The project is also being touted as a possible model for international aid in the developing world.
Dr. David Walton is overseeing the construction of the National Teaching Hospital, about 35 miles outside the capital in the small city of Mirebalais.
Walton is a physician with Brigham and Women's Hospital in Boston, but on a recent day he looks more like a construction foreman. He says this hospital, which will be part of the public health care system, will provide services and a level of care that is light years ahead of what is currently available in Haiti.
For instance, the hospital will be wired with a fiber-optic data connection.
"We'll have cameras in the operating room in the lights so that you can see surgery from anywhere," Walton explains. "That will allow surgeons in whatever country to comment on and assist in the technical details of surgery that's being done right here in Haiti ... leveraging technology to improve care here."
Outstanding Infrastructure, Low Cost
When it opens this summer, it will be the largest hospital in the country — with six operating theaters, an emergency room and a neonatal intensive care unit. It will be the only public facility in Haiti with a CT scan machine.
In Boston, Walton says, a single hospital is likely to have 12 CT scan machines. In Haiti, the entire country has only four — three of which are in the private sector. The fourth, which will be at the new teaching hospital, will be "for the people of Haiti," he says.
The roof will be covered in solar panels, which allow the facility to run entirely on solar power on sunny days.
Partners in Health's budget for this massive, 320-bed, 180,000-square-foot facility is $16 million.
Walton notes that the group has received another $4 million worth of in-kind donations, mainly medical equipment and construction supplies. The final price tag for this new national teaching hospital will be less than 1 percent of the billions of dollars in international aid that were pledged to Haiti in the aftermath of the earthquake.
"One of the lessons this hospital can provide is how to provide really outstanding infrastructure and construction practices at a fraction of what it may cost in other settings," Walton says, "and I would argue at a fraction of what it may cost versus other projects that are being done here."
The Canadian government this month pledged $20 million just to move squatters out of a huge tent encampment in front of the National Palace.
Looking around Haiti, this hospital is one of the few solid examples of post-quake reconstruction. There are private projects to build new hotels. The cellphone company Digicel rebuilt the historic Iron Market in Port-au-Prince. But the National Palace is still awaiting demolition. Many of the cholera clinics that have sprung up are in tents or temporary shelters.
Serving Multiple Purposes
At a dedication for the hospital just before the second anniversary of the earthquake, the Haitian minister of health, Dr. Florence Guillaume, said that for her, this project is a dream come true.
"I'm really proud, almost crying this morning. It's really this type of assistance that we need," she said.
Guillaume says this hospital will help bolster the entire public health care system in Haiti in several ways.
First, other clinics and hospitals will be able to refer patients there for more complicated procedures and tests.
Second, as a teaching hospital it will help train more Haitian doctors and nurses. And by providing a better work environment, she hopes it will help stem the exodus of Haitian medical professionals who so often decamp for the U.S. or Canada.
Paul Farmer, the co-founder of Partners in Health, says he views this hospital project as a model for effective international aid.
"The amount of money either pledged or flying around out there is substantial," Farmer says. "If it were marshaled into a coherent system of hospitals, health posts, you could see some big, big improvements in health indices in Haiti, and that's what we expect to happen."
The National Teaching Hospital still faces big challenges. Construction is on track but still not complete. At first, the Ministry of Health and Partners in Health will be running the facility together, but eventually the Haitian government needs to come up with an operating budget to keep the hospital running for the long term.