PORT-AU-PRINCE -- For years, the low-lying slum along the bay and the AIDS clinic across the street lived in separate worlds, a one-way relationship where the sick shuffled out but healthcare providers didn’t dare go in.
Then Haiti’s massive Jan. 12, 2010 earthquake and subsequent cholera outbreak crumbled the barriers.
“We didn’t ask for any of it,” Dr. Jean William Pape, founder of GHESKIO, Haiti’s leading HIV/AIDS clinic and research center, said about the disasters. “But now we got them. What are we going to do with them?”
For all the devastation and death both catastrophes unleashed, they also stirred hope of a healthcare turnaround for the most destitute of Haiti’s poor.
For the past year, a small army of community healthcare workers has quietly ventured beyond the clinic’s front gate to confront some of the stumbling blocks that have long made providing quality healthcare in the developing world challenging.
On any given day inside Port-au-Prince’s slum-by-the-bay, T-shirt clad health workers and physicians can be seen handing out buckets of chlorinated water and other cholera treatment, supervising community clean-ups and stepping into humble homes to deliver primary care.
The intense focus on Haiti’s slums come as an increasing number of Haitians leave tent cities for crowded ghettos, triggering fears of a deepening public health catastrophe in a country where people already contract tuberculosis at a higher rate than anywhere in the hemisphere — except for Peru — and many children never make it to their third birthday because of any number of illnesses, including 21 waterborne diseases.
It also comes in a country with one of the hemisphere’s highest rates of HIV, the genesis for the founding of GHESKIO, the Haitian Group for the Study of Kaposi’s Sarcoma and Opportunistic Infections.
But the current mission has little to do with AIDS treatment. Rather, the focus is on improving the lives of the poor in a nation where clean water and sanitation are luxuries, and where the government is struggling to raise $2.2 billion to eradicate a cholera epidemic that has claimed 8,048 lives and sickened 650,218, according to Haiti’s Health Ministry.
“When I look at old Paris, old Rome, those were all slums that they improved. So why can’t we improve these slums?” Pape said. “If you provide them with the tools, they’ll get there.”
Twenty years ago, Pape could look out across a busy Harry Truman Boulevard and see the pristine blue ocean hugging Port-au-Prince’s bay. Today, the ocean is murky, its shallow bay waters filled with trash to create the Village of God and various communities of ramshackle concrete block shanties that make up the City of the Eternal.
It’s a place where gangs and disease run rampant, where the rain brings down topsoil and human waste, and where residents are more likely to go to the bathroom in plastic bags than outhouses.
But treating disease inside the slums, a refuge of warring gangs and kidnappers, has long been a challenge — even for the clinic.
“My staff was very reluctant,’’ Pape said. “This is a very dangerous area where people are killed all of the time.’’
The first opportunity came with the quake, which forced fleeing residents to set up a tent city in the clinic’s parking lot. Then cholera hit.