This has undoubtedly been a difficult year for people everywhere, and Haiti is no different. In addition to the COVID-19 pandemic, Haiti has experienced widespread political unrest, persistent inflation, continued depreciation of its currency, fuel shortages, and a rise in unemployment. High rates of serious malnutrition, low access to basic sanitation, and weak health systems are a dangerous combination in Haiti.
We are doing everything possible to sustain our daily operations in Haiti and provide critical health services to our communities. Now, more than ever, our community needs us. And we need you.
From now through GivingTuesday and until the end of the year, you have the opportunity to make a positive impact on vulnerable communities in Haiti by giving a gift from our 2020 Holiday Catalog. Here are some examples of the life-saving gifts you can choose from:
$10 supports sexual and reproductive health education for young women
$50 provides free first aid services at one C2C clinic
$100 purchases necessary lab equipment
This holiday season, help us share the gift of health and hope. Your generosity is needed now more than ever!
The Foundation to COVID-19 Recovery and Building Healthy Communities
Two years ago, world leaders met at the Global Conference on Primary Health Care in Astana, Kazakhstan, and marked their commitment to strengthen primary health care (PHC) as the cornerstone of resilient health systems and the most effective pathway toward health for all.
Today, the COVID-19 pandemic has made acting on those commitments more urgent than ever. According to an article in the British Medical Journal, this pandemic is officially “the most disruptive event for health systems across the world in a century. It has forced health systems to tackle a new infectious disease, protect health workers and patients, and figure out how to still deliver essential health services.” It has had a dramatic effect on people’s lives globally and has preyed on the most vulnerable among us.
The Primary Health Care Performance Initiative advocates that “high-quality primary health care, guided by evidence and data, can be a robust first line of defense against disease outbreaks while maintaining essential health services in times of crisis and in calm.”
Combatting COVID-19 and future health crises depends on high-quality PHC as the first line of defense against outbreaks. Worldwide, we must place stronger PHC at the center of COVID-19 recovery plans and long-term approaches to health security, and urgently recommit to building a foundation of strong PHC systems to become resilient against future disease threats and ensure that health care is accessible for all.
C2C’s mission to bring high-quality PHC in rural Haiti is at the front line of this mobilization. Our founding vision hinged on the fact that primary care is consistently neglected, while it should be the core of a national health care system. In an under-resourced country like Haiti, we have always been working to address the most cost-effective opportunity in improving health outcomes. The answer has always been: access to quality PHC.
There are many lessons learned from this pandemic that we must apply as we emerge from this global challenge. The principle lesson is to prioritize and invest in health systems to build healthy and resilient communities. Strong PHC systems can help to diagnose, track and stop the spread of local outbreaks while providing essential lifesaving health services.
While the global COVID-19 pandemic has presented many challenges, it has also been a stark reminder of just how important vaccines are. Preventative medicine, like vaccines, is critical for healthy communities, but often we take these life-saving innovations for granted.
Ensuring that routine vaccination is maintained or reinitiated during the COVID-19 pandemic is essential for protecting communities from vaccine-preventable diseases and outbreaks. Routine vaccination prevents illnesses that lead to unnecessary medical visits, hospitalizations, and further strain the healthcare system.
Typically, in the US and other developed countries, vaccines are easy to access and often even required; however, in places like Haiti, getting vaccinated is not a simple task.
In Haiti, even if there is an adequate supply of vaccines, logistics can often present major obstacles to distribution, especially refrigeration options for transporting and storing the vaccines (known as cold chain). The ideal temperature for vaccine storage is between 35°F and 46°F (2°C and 8°C) at all times. A 2018 article from New York Magazine further highlights this issue: “long distances, poor roads, hot weather, and unreliable electricity […] make deployment even more difficult.” Indeed, getting vaccines where they need to be is extremely challenging in a country with a high disease burden, and with 50 children dying per day due to vaccine-preventable illness, this has had severe consequences.
Exacerbating the issue is the fuel required to transport vaccines. In 2019, Haiti faced waves of political unrest and violence due to a countrywide fuel shortage. The crisis, sparked by low fuel supply, low cash reserves, and high debt, affected nearly every person across the country. Road blockades and demonstrations made travel dangerous if not impossible; even many schools and hospitals were forced to close for weeks at a time.
Luckily, with sunshine 90 percent of the time, Haiti is ripe for solar energy. The Ministry of Health is committed to increasing vaccination rates and is working on installing solar refrigerators in all public clinics. C2C currently has solar panel fridges at our clinics in Sinek, Bayeux, Savanette, and Roche Plate. Through a partnership with a solar company in Port-au-Prince (contracted by UNICEF), we will be installing a new solar-powered fridge at our Cap-Haitien clinic this month. Before we had solar energy, our fridges ran on propane tanks 24/7 and we needed to make sure that we kept a reserve tank in case one ran out. This was both costly and inefficient. Our new solar fridges are more cost-effective, environmentally-friendly, and easier for staff to use and maintain. This option is also more reliable than fuel, especially due to the increase in insecurity and lack of propane at certain times of the year. With solar fridges, C2C is able to provide life-saving routine vaccinations to children and families under our one-stop-shop model regardless of the state of Haiti’s fuel supply, infrastructure, or political climate.
C2C is celebrating World Sexual Health Month by introducing our newest initiative: a sexual and reproductive health education program targeting young women in Haiti who are vulnerable to adolescent pregnancy and subsequent poverty. This after-school course will cover a variety of sexual health topics and address myths about sexuality and gender that are prevalent in Haiti, giving girls the tools they need to prevent early, unwanted pregnancies and STIs and to feel empowered in their bodies and their relationships with others.
Before we begin to implement this program, we first need to assess the needs, thoughts, and opinions of the different communities in which we work. Sex education is not commonly offered in Haiti, especially not in classrooms and definitely not in rural areas. Our approach to combine a participatory approach with the view to community ownership is community capacity building, which is an essential approach for health promotion. We interviewed key community leaders, pastors, priests, school directors, and teachers, as well as parents of adolescent girls. We also consulted with some of our staff members who have been working in these communities for a long time. We asked them questions about problems young girls face in their communities, the consequences of the lack of sex education, and about their fears or objections to the implementation of this program.
We learned a lot from our interviews that helped inform our curriculum make-up. Young girls today face multiples challenges and all groups we interviewed believe that they could greatly benefit from having better access to sex education classes. Not only is this topic not discussed in classrooms, it is also avoided at home. Many parents are afraid that talking about such subjects will actually motivate their children to engage in sexual behaviors, but this has been disproven according to a position paper published in the Journal of Adolescent Health. Parents often aren’t sure how to approach their children to discuss subjects related to sex and sexual health and they typically don’t have the facts to guide the conversation. Since most mothers in Haiti typically have kids at a young age, they don’t have much information about the menstrual cycle or family planning, creating many misconceptions and myths for young girls. Adolescents of all genders face a great deal of economic insecurity. Young people and their families often do not have any type of revenue-generating activity. Girls in particular are at risk and when they get pregnant at a young age, it often means never going back to school and facing issues specifically related to their gender such as power imbalances in relationships, violence, sex trafficking, sexual abuse, and rape.
Overall, the community’s response to our proposed sex education program was very positive. They all welcomed and understood the importance of this program. The issues that were raised during our discussions highlighted the fact that we need to remain collaborative with parents and community members as we implement it in the communities we serve. This way, we can reduce and resolve the fears and misconceptions about talking to adolescents about sex and sexuality.
As we prepare to launch this program, we are also working on building the curriculum for the classes. As part of the curriculum, we are including a handbook with many visual components for each young girl to write in, bring home, and keep at the end of the course. As a next step, we will be hiring and training staff members to administer the program in time to recruit young girls to start the first pilot of the class in January 2021. We are looking forward to continuing to update you about the progress of this new and exciting program!
Global hunger has increased over the past five years, and because of the novel coronavirus pandemic, an additional 83 to 132 million people around the world are expected to plunge deeper into food insecurity by the end of the year.
Food insecurity has grown worse in Haiti in the past year due to many factors, some of which include the closure of the border with the Dominican Republic, persistent inflation, the continued depreciation of the local currency, a rise in unemployment, and the effects of COVID-19.
Here at C2C, we currently operate a malnutrition program at our Acul du Nord clinic site. The program started four years ago to treat moderate and severe malnutrition in children between 6 months of age to 5 years old. Since its launch, we have treated over 350 children. However, with the magnitude of difficulties that are on the rise in Haiti, there is a higher prevalence of malnutrition in rural areas.
All across our clinics, we are seeing more and more malnourished children. The population that is most vulnerable to malnutrition come from lower-income households. These families have a hard time meeting the nutritional needs of their children, in terms of quality and quantity, which causes acute or chronic malnutrition. The majority of the children enrolled in C2C’s malnutrition program come from single mother-led families. Many of the mothers are unemployed and hope for financial support from the fathers. Some work in local markets selling diverse goods in an effort to sustain their families. To make matters worse, due to the devaluation of the local currency (gourde), basic staples such as rice, oil, beans, fruits, and vegetables are rapidly becoming more expensive. Just a year ago, 77 gourdes was equivalent to one US dollar. Now, one US dollar is worth 122 gourdes and is steadily increasing, which negatively impacts families that are getting less for their money. Children are eating fewer portions or being fed less healthy food that happens to be more affordable but without any nutritional value to reach satiety.
The increase in unemployment in Haiti has also been directly affected by COVID-19. While populations worldwide have suffered a plunge in the global economy, every household has certainly felt the effects of COVID-19 in Haiti, which is already the poorest country in the western hemisphere. The border to the Dominican Republic has been closed since March, reducing trade between the two countries, while the lack of tourism has affected tens of thousands of people. Due to the decrease in demand for services in Haiti, many businesses have been forced to lay off employees which also increases malnutrition cases due to less income generated per capita.
In addition to the increasing insecurity, inflation, and unemployment, many families worry about providing for their own as the government does not provide reliable electricity and the majority of households do not have refrigerators to store food. This means that they cannot buy in bulk and resort to buying food every day, which isn’t always a possibility when COVID-19 safety measures make it difficult to move around.
The World Food Programme estimates that the number of people in severe food insecurity in Haiti could rise from 700,000 to 1.6 million. With hurricane season in the Caribbean from June to November, there is an additional risk for which Haitian families need to prepare.
C2C plans to expand its malnutrition program and services to all of our rural clinics to reduce the burden on the communities that are facing severe food insecurity and are unable to meet their basic food needs, especially for their children.
Stay tuned to hear more updates about the expansion of the malnutrition program, our COVID-19 efforts in our clinics, and more!
On March 20th, 2020, Haiti recorded its first confirmed case of coronavirus. As of July 29, Haiti has recorded 7,371 official cases and 158 deaths, although because the country has not been doing sufficient testing, the actual figures are likely much higher. Unfortunately, Haiti’s Ministry of Health lacks the resources to adequately respond to the virus. A 2017 report from the World Bank found that the government spends just $13 per capita annually on health services, much lower than neighboring countries such as the Dominican Republic ($180 dollars) and Cuba ($781 dollars) and the Latin American and Caribbean region as a whole, which has a per capita public expenditure of $336 dollars. Of the few funds allocated to the health system, 54% of the government’s expenditure is allocated to curative care (38% to hospitals) with only 19% directed towards preventive care.
Needless to say, the Haitian government was ill-prepared to take on the COVID-19 pandemic. As wealthy, developed countries such as the US have struggled to contain the spread, COVID-19 has also resulted in a health and economic crisis in Haiti. As C2C is the primary partner of the Ministry of Health in the north of Haiti, health officials have relied greatly on our organization to slow the spread of the virus, mainly through community education activities.
“For us, the main way to deal with the pandemic in Haiti is prevention,” says C2C’s Chief Operating Officer Dr. Samuel Bernard. At first, our staff found it challenging to convince people to follow best practices for virus mitigation. “People didn’t want to hear about [the virus] because they didn’t trust that it was real,” reflects Dr. Bernard. “Asking patients to wear masks, washing their hands before entering our clinics was a fight. But, by providing education many times a day in the clinics [and the communities], our patients finally understood that they should follow the protocol to avoid being infected.”
We are collaborating closely with the Ministry of Health on education activities, keeping people updated on the state of the epidemic in Haiti and how they can protect themselves and their families. Although the government has not been able to provide much support for these activities, C2C is grateful to our generous supporters for allowing us to continue our COVID-19 response.
At the onset of COVID-19 in Haiti, C2C set critical overarching goals, objectives, and activities for our clinic network and have continued to adjust our plans and priorities as the crisis continues to evolve.
Mitigate the spread of the coronavirus infection in our region of Northern Haiti
Treat any patient suspected of having coronavirus
Educate the communities we serve in virus mitigation best practices
Prepare and train staff to provide education to our communities on coronavirus
Secure equipment needed to face an epidemic
Enhance the capacity of the clinics to quickly identify any suspected case of coronavirus
Enhance the capacity of the clinics to care for any possible case of coronavirus infection
Sample of Clinical and Community Activities:
Training of staff on COVID-19 and means of prevention: prepare and disseminate training materials about COVID-19 to give to staff; supervising doctor ensures that all clinical staff are trained properly
Provide, improve, and resupply hand washing stations at each clinic and encourage increased handwashing among patients and staff
Radio and TV announcements weekly from C2C medical staff; hire a local “mobile” (a pick-up truck with large speakers in the bed) to drive through communities and broadcast the Haiti Ministry of Health’s taped message on COVID-19 prevention
Clinicians provide up-to-date information on COVID-19 during regular patient consultations; nurses hold education sessions in waiting room of clinics to inform patients how to protect themselves and their families
Increase collaboration with peer organizations and the Ministry of Health to scale communications, education materials, outreach, and training
We’re excited to share some news! C2C has been evaluated by Charity Navigator through their revolutionary Encompass Rating System and received a 100 out of 100 rating!
The Encompass Rating System is a comprehensive evaluation tool that analyzes nonprofit performance based on four key indicators. In July 2020, Charity Navigator released the first indicator, Finance & Accountability, to highlight nonprofit organizations demonstrating fiscal responsibility.
This milestone achievement for C2C couldn’t have happened without you and your support. Thank you for being part of our family as contributors, funders, and fervent advocates. Your trust in us is what makes the difference to us and the communities we serve.
Until recently Haiti seemed to be fortunate regarding COVID-19, with reported numbers barely registering on the global radar screen. We are now however beginning to see the kind of spike in cases we have long feared.
While the daily new cases reported count is now in the hundreds, we know (and the World Health Organization (WHO) confirms) that the true case count is far higher due to logistical challenges and continued shortages in testing kits. With cases now spiking, the next likely crisis will be severe with illnesses flooding a healthcare system that is significantly under-resourced. The WHO warns that the combination of COVID-19 shutdown-induced economic shock and patients over-burdening the health system could trigger a terrible humanitarian catastrophe in a nation where half the population (six million people) lives below the extreme poverty line of $2/day.
At C2C, we began urgent preparations for the onset of COVID-19 in mid-March and we have been improving and reinforcing our capabilities constantly since then. At all of our clinics we have:
Dedicated isolation areas where patients suspected of COVID-19 can wait to be screened.
Equipped all employees with N-95, surgical and reusable marks, as well as face protectors.
Ensured all clinic staff wear gloves and added hand sanitizers for staff and patient use.
Added temperature screening and hand-washing stations for all patients upon entry
Implemented daily morning COVID-19 educational talks with patients providing detail on symptom awareness, hygiene best practices, and the importance of wearing a mask and maintaining social distancing whenever possible
COVID-19 in our clinics:
We have now seen COVID directly impact our staff. A cluster in one of our clinics yielded 6 positive tests but thankfully none had severe illness (3 were asymptomatic and 3 experienced only mild symptoms). We are glad to report they are now back to work serving our patient communities.
Starting in April, we began to see a drop in patient volume as patients began to fear seeking care due to the perceived higher risk of COVID in clinics. This is a phenomenon that has occurred worldwide but is a concern because it means our regular patients are deferring critical care.
Unfortunately, this crisis in Haiti is far closer to the “end of the beginning” than the “beginning of the end”. We will continue to keep you apprised of our efforts to take on this monumental challenge in the communities we serve. Thank you so much for supporting our work, none of these efforts would be possible without our incredibly generous supporters and partners.
In this time of uncertainty, there’s a fundamental truth that gives us hope – that together we can do extraordinary things. Over the past few weeks and months, the entire world has been coming together to stand up, help out, give back, and heal. Whether that’s through donations to community organizations, celebrating doctors and nurses at shift changes, or reaching out to a neighbor to help with groceries, generosity has been helping the entire world get through this global pandemic. Together.
C2C is participating in #GivingTuesdayNow, a global day of unity and giving. As you may already know, we are raising a COVID-19 Response Fund to equip our staff and facilities with essential equipment and supplies that will help to slow the spread of the virus in Haiti and save lives.
But we can’t do this without you!
Not only do we need your support, we need your help to spread the word. Please tell your friends and family why you believe in our work and encourage them to support us too!
Join the movement! Click to learn about ways you can participate in the #GivingTuesdayNow movement and don’t forget to share this with someone today.
C2C is proud to announce that we have been selected by global giving circle Dining for Women as a featured grantee for 2020! The funds that Dining for Women raises on behalf of C2C will go towards implementing a sexual and reproductive health education program for young girls and women in the communities we serve in Northern Haiti.
Dining for Women is a non-profit giving circle dedicated to empowering women and girls living in extreme poverty. Care 2 Communities will be its featured grantee for the month of December 2020. We are very excited for this new partnership and are grateful to Dining for Women for supporting our essential work to serve vulnerable women in Haiti and ensure they have the education they need to make informed decisions about their health.