World Health Day is celebrated every year on April 7. This year, the World Health Organization designated the theme for 2021 as “Building a fairer, healthier world,” encouraging leaders to monitor health inequities and ensure that all people can access quality health services when and where they need them.
The world looks very different today from how it did over a year ago, just before the first cases of COVID-19 were reported to the World Health Organization (WHO). The pandemic has changed the lives of everyone around the world. It has affected our physical and mental health but, more than that, it also highlighted the barriers and health inequities that have long existed, especially in vulnerable communities.
“COVID-19 has shown that universal health coverage, strong public health systems and emergency preparedness are essential to communities, to economies, to everyone.” -António Guterres, the Secretary-General of the United Nations says.
Here at C2C, we are ensuring that equity is at the heart of everything we do to improve health and lives. All people throughout the world deserve the chance to live dignified lives free from the burdens of poor health. This starts with quality, accessible primary care.
We stand together with leaders, partners, supporters, and advocates to build fairer, healthier communities by creating access to care in communities that have typically been ignored. Health is a right, not a privilege, and no one should be left behind.
Today, C2C recognizes World TB Day. This global day of observance occurs each year on March 24 and commemorates the date Dr. Robert Koch announced his discovery of the bacterium that causes tuberculosis (TB).
This year’s theme for World TB Day is “The Clock is Ticking”—referring to the commitments made by global leaders to end TB and the urgency still needed to act on this goal. This is especially critical in the context of the COVID-19 pandemic, which has put TB progress at risk, and in ensuring equitable access to prevention and care. Globally, many people still suffer from TB. Here at C2C, we are committed to finding and treating cases of active TB disease, testing and treating latent TB infection to prevent progression, and helping to make TB elimination into a reality.
Part of the solution to this crisis is increased TB education and outreach to healthcare providers, healthcare agencies, and community organizations, especially those serving populations disproportionately affected by it—such as the ones we serve in Haiti. TB is still a life-threatening problem, and it impacts many of our vulnerable communities in Haiti. TB knows no borders, and people all across the world are suffering from it.
This year for World TB Day, we are sharing a Q&A from our Managing Director, Racha Yehia. Racha is deeply involved in the development and implementation of C2C’s programs and knows firsthand the importance of TB education and medical care.
Q: How does C2C screen for tuberculosis in its clinics?
A: We screen anyone for TB that has had a cough for more than two weeks. We take a sample of three sputum specimens to determine whether the test is positive or negative for TB.
Q: Who takes care of the patients?
A: Our team works together to ensure proper care of TB patients. From the doctor that does the initial screening and explains the disease, to the lab technician that performs the analysis, to the nurse that explains the medication treatment, to the community health worker that goes to the patient’s home to check on their health status—it is all about teamwork!
Q: Can you explain what TB treatment looks like?
A: The duration of treatment and the types of drugs administered depends on the status of the patient. If it is a new case (a person having tuberculosis for the first time) the treatment will last 6 months, if there is no issue with the protocol or relapse. Anti-TB drugs are used as a treatment: RHEZ (Rifampicin (R), Isoniazid (H), Ethambutol (E), and Pyrazinamide (Z)). The treatment regimen consists of 4 months of RHEZ followed by 2 months of RH. If the patient has multidrug-resistant tuberculosis (MDR-TB), another treatment protocol will be used, which will last between 9 to 12 months. The lab material and medication to diagnose and treat TB patients are all provided for free by the Ministry of Health. Along with malaria and HIV/AIDS, TB is one of the three diseases for which treatment is fully subsidized by the government.
Q: Can anyone get TB?
A: Anyone can catch TB, but the majority of cases we encounter are people that have an underlying disease such as diabetes, respiratory problems, asthma, HIV/AIDS, or malnutrition. Also, people with poor personal hygiene habits have higher chances of getting TB.
Q: How is TB viewed in Haiti?
A: It is considered the disease of poor people and has several Creole nicknames: maladi ti kay, maladi kenhenk kenhenk, maladi touse, maladi zepol kare. People with tuberculosis are stigmatized, especially by those around them. Many hide the fact they have TB from the community they live in or go to other neighboring regions to be treated so they are not recognized. Despite the TB treatment being free of charge, there is still a lot of stigmatization towards the disease. Patients have a hard time accepting they have the disease and following the TB protocol. Most prefer ignoring their diagnosis, not taking their medication, and letting their health worsen. Our biggest challenge at C2C when trying to fight TB is to bring awareness and educate the population on the disease in the different communities we serve, which helps reduce stigmatization, as well as ensuring that our TB patients adhere to the regimen of taking their medication for the required duration. With the regular home visits that we have as part of our community health program, we do our best to ensure their full recovery.
Two years ago, life in Haiti seemed normal yet still consisted of many struggles, from poverty and lack of education & healthcare, to political uprisings and a continuously crashing economy. Fast forward to 2020, and still the same struggles endured amid a global pandemic. The unknown loomed in a country with clustered public transportation, where pickup trucks are often filled with 20+ people packed together. How do people practice social distancing in such an environment? Well, they simply cannot. Out of necessity, life had to continue without the possibility of precautions for the masses. A lucky few could afford social distancing—which remains a luxury.
Today, one year since the first cases of COVID-19 were recorded in Haiti and the first wave began, the country has somehow been spared the worst. In a population of almost 12 million people, less than 13,000 positive cases have been confirmed and 250 deaths. In contrast, Haiti’s neighbor, the Dominican Republic, has faced 247,000 positive cases and more than 3,000 deaths. The reason for this drastic difference remains unknown. We can speculate that it is due to Haiti’s very young population, where fifty percent are under 23 years of age. We can make guesses that herbal medicine has treated unknown cases or we rapidly reached herd immunity. We can continue to speculate but the truth is that we still do not know.
Luckily for us at C2C, we do have the resources to keep our staff and patients safe. We are able to provide an environment where social distancing is practiced, hand-washing stations are available, and educational material on prevention and mitigation of COVID-19 are shared. Within the past year, behavior towards the virus has gone from people instigating violence or harm towards individuals who admitted to having symptoms and institutions trying to protect the population from the spread of the virus, to people believing that there is no more COVID-19 in Haiti. All of these thoughts and ideas were driven by lack of knowledge about the virus. From day one, C2C has worked to bring awareness to the issue and educate our patient population on the precautions that should be taken to reduce the spread. We know that health education plays an important role in fighting the COVID-19 myths that erode trust in healthcare. For that reason, we continue to educate our patients and the communities we serve until this day.
During the summer of 2020, the government lifted all restrictions related to the virus and the country got back to ‘normal’ life. However, at C2C we felt that we needed to continue to provide the necessary resources to reduce the spread of COVID-19. Together, we worked with our community leaders to create a safer environment for our patient population when it came to their daily routines. We provided more than 50 buckets to be used as washing stations that were placed at churches, school entrances, and in areas with a high population density. As part of our continued campaign to reduce the spread of COVID-19, we are currently still installing more than 100 tippy taps in the communities we serve.
The reality is that we are still going through a global pandemic and no matter what the data says, precautions still need to be taken daily. We have come a long way since the first case was reported in the country exactly a year ago and we are proud to have kept all our clinic doors open to serve the communities that need it the most.
As we continue to fight COVID-19, our mission remains unchanged. We will continue to ensure that vulnerable communities in Haiti have access to high-quality care to safeguard the health of themselves and their families.
Thank you to everyone who has supported C2C during this difficult time. Our work would not be possible without your generosity! To learn more about how your donations are protecting our communities against the threat of COVID-19 and to continue to help us do this necessary work, click here!
March 8th is International Women’s Day, and all month long we are celebrating the contributions that women have made, both in our clinics and throughout Haiti’s history. This week gives us a chance to reflect on the ways that all of our lives have been shaped by the actions of women, as well as an opportunity to expand our knowledge. Women have been at the forefront of countless struggles for hundreds of years, but their contributions are not often proportionally recognized. We’d like to take this opportunity to celebrate the women shaping Haiti’s history and invite further engagement with the wealth of wisdom that Haitian women have to offer.
Women are the backbone of Haitian society and the lifeblood of its economy. Two-thirds of Haitian women participate in the workforce, working hard to build better lives for their families and their communities. The work that women do is integral to the Haitian economy, both for farmers producing goods and consumers buying food. Women involved in the agricultural supply chain, called madan saras, purchase food from farmers and sell it in markets. Madan saras work cooperatively with family members and distribute their earnings for the betterment of their community. Their work is not supported or protected in any official capacity. But without them, Haiti’s agricultural supply chain would not function.
In addition to their central position in the economy, women have spearheaded movements for the betterment of Haiti since its inception. Adbaraya Toya (later known as Victoria Montou) was a member of an all-women military regimen in Benin before she was abducted and enslaved in Saint-Domingue, now Haiti. She lived on the same plantation as Jean-Jacques Dessalines (leader of the Haitian Revolution and the first ruler of Haiti), and she taught him and many others combat skills and commanded her own brigade in the Revolution. Countless other women played important roles in the Haitian Revolution, a revolt that had rippling impacts throughout the world, weakening the global system of slavery.
As women were so central to Haiti’s foundation, it makes sense that the country would later have a strong feminist movement. This movement began in the 1930s and was shaped by brilliant writers, suffragists, and activists. Alice Garoutte was a suffragist and women’s rights advocate who formed a book club that became a political organization. The group fought against the United States’ soldiers’ use of gender-based violence as a weapon of terror against Haitian women. Yvonne-Hakim Rimpel founded Haiti’s first feminist organization and first feminist newspaper.
Women are trailblazers across sectors of Haitian society, entering new spaces to advocate for their rights and communities. Ertha Pascal-Trouillot was the first woman to serve as a Supreme Court Justice in Haiti before serving as the country’s first woman as provisional president in 1990. Haiti has also had two women serve as prime minister. In the medical field, Yvonne Sylvain was the first woman in Haiti to become a medical doctor in 1940. Driven by her desire to serve her country, she studied obstetrics and gynecology and delivered healthcare to Haitian women throughout her life.
Women’s movements in Haiti have experienced disruptions and destabilization, both from natural disasters and political opponents. Many feminist writers and scholars were exiled during the Duvalier dictatorship or endured retaliatory brutality for their criticism of the dynasty, including Yvonne Hakim-Rimpel and Maryse Vieux-Chauvet. The 2010 earthquake in Haiti claimed the lives of prominent women’s rights activists, including Magalie Marcelin, Myriam Merlet, and Anne Marie Coriolan. Any catastrophe will reveal and exacerbate the inequities that are already present in a society, and the earthquake was a prime example of this. The earthquake jeopardized women’s financial security, as many women are involved in the formal economy and experience greater economic instability than men. Women were also more likely to seek refuge in internally displaced person camps, where they are at risk for gender-based violence.
Still, Haitian women continue to organize for justice and collective liberation in Haiti. The #PetroCaribeChallenge, a social media movement, is a great example of this. Countless Haitians, including women, stood against corruption and misappropriation of aid funding. It is important to remember, especially as political turmoil continues in Haiti, that what outsiders may see as unending unrest is an organized rebellion by Haitian people for self-determination and a better future.
In addition to being activists, scholars, and businesswomen, women are the foundation of public health in Haiti. We’ve long understood a mother’s health as one of the primary influences on a child’s health. Mothers in Haiti face high rates of maternal and infant mortality due in large part to the inaccessibility of perinatal care. The impacts of poor maternal health ripples throughout populations and generations, influencing public health outcomes and economic potential.
We focus on women’s health at C2C to improve life and generational health outcomes in the communities we serve. Our community clinics directly address the needs of women and their families through our vaccination, malnutrition, and maternal health programs. Often, mothers are the ones bringing their children to our clinics and taking an active role in protecting their child’s health. We are also committed to women’s empowerment through our community and reproductive health education programs. These programs give women the tools to make empowered, informed choices about their life and health outcomes. We strive to provide holistic healthcare and health education to women in Haiti to improve their lives and the lives of their families in the long term.
As an organization operating in Haiti, it’s important we learn this history and acknowledge the ways in which Haitian women set the groundwork for our organization and continue to make our work possible. Haitian women are the backbone of our organization. They are the midwives caring for pregnant women, the community health workers educating their communities, and the medical professionals who make our daily operations possible. The women who give care in our clinics save lives every day with their unique contributions to our organization. Our work stands on the shoulders of the countless women who have fought and organized, won and lost.
We honor the contributions that women make to C2C by engaging women in leadership at all levels of our organization. Our clinics create stable, well-paying jobs for women in rural areas. A number of our leaders began at C2C as nurses or staff members and advanced to leadership positions in clinic management with their initiative, talent, and passion. We facilitate professional development whenever possible and encourage the talented women on our staff to advance their skills and careers.
Our celebration of women’s history and contributions will not end this week or this month. We are working to expand our maternal health program to other clinics this year so that Haitian mothers can get the prenatal and infant care that they deserve. We are promoting women to leadership positions and working with our staff and communities to better serve women and children. Our goal is not just to create representation but to facilitate meaningful involvement from those most closely impacted by health disparities in Haiti, and those so often on the frontlines fighting for a brighter future.
Click here to learn more about our plan to support even more women in our communities by expanding our maternal healthcare program.
C2C is growing and we seek to hire a Director of Operations who will be responsible for all aspects of C2C’s service delivery model by managing the daily clinical operations that drive health impact. This role sets the standards for operational excellence at every level and then ensures that those high standards are met. The Director of Operations has primary responsibility for both people and process management related to core service delivery. Furthermore, the Director of Operations ensures the development of long-term operational strategies, setting strategic goals, always looking for innovative ways to improve our services and model. The Director of Operations collaborates closely with a local team of managers to set, meet, and exceed C2C’s promise of exceptional health service delivery.
You can access the position description in full here.
Please note: The position will be based in the Northern Department in Haiti and requires frequent travel to clinic sites which are mostly located in rural areas.
How to Apply: Please email your CV and cover letter, along with the name and contact details of three references to [email protected] by Friday, February 19th.
It is truly my pleasure to wish you a happy and healthy start to the New Year. 2020 was such a difficult year for everyone and I want you all to know how much we appreciate the inspiring and vital support that our stakeholder community provided as we navigated challenging circumstances for C2C’s healthcare operations in Haiti and — crucially — for our patients.
2020 was one for the history books. It was a year that demanded adaptation, innovation, and resolve. In Haiti, as everywhere else, the COVID-19 pandemic presented a looming health threat for a nation with very little adequate healthcare infrastructure. Haiti also faced fallout from widespread economic and political instability. The impact of the global economic slowdown and interruptions in trade have been devastating for an island country that depends heavily on imports. Many necessities are scarce and livelihoods are increasingly threatened.
Still, the 95+ staff members of C2C worked hard to meet the challenges of the moment and we are so proud of all that we have accomplished together this past year: serving over 50,000 families with essential primary care, ensuring that our specialty care for women and children continued uninterrupted, and strengthening our partnership with the Haitian government.
We are kicking off the New Year with some exciting and hopeful news. I am honored to introduce Racha Yehia, who will be leading C2C into the future as our new Managing Director! Racha, a leader of unique talent and vision, exemplifies the values that are at the core of our shared efforts together: a deep commitment to expanding health access for families; a sophisticated view on how we work to ensure that our services are sustainable and impactful in the future; and a creative and tenacious spirit that keeps us all focused on what is possible. Based in Cap Haitien, Racha will lead our talented and dedicated team as we grow the organization toward deeper and broader impact.
We look forward to a bright and hopeful 2021 and offer our gratitude for your ongoing support.
As the second wave of COVID-19 cases surges in the U.S. and other countries brace themselves for an increase in cases this winter, we are seeing and hearing better news in Haiti. Haiti’s latest totals reveal less than 10,000 cases and 300 deaths in all.
Due to its very poor health infrastructure, we were expecting much higher numbers since our neighboring country, the Dominican Republic (DR), was reporting a high case count and now has 139,000 cases and 2,300 deaths.
When the first case was reported in Haiti on March 19, there was a lot of stigma associated with COVID-19. People burned down health centers because they didn’t want this virus in their area or were physically violent to Haitians showing symptoms of the virus. This kind of attitude, caused by fear and misinformation about COVID-19, made mitigation and control of the spread difficult in Haiti. Many people hid their symptoms, afraid of being targeted or isolated by their communities. At C2C, we focused on educating our patients and communities as part of our COVID-19 mitigation protocol. We showed informational videos in our waiting rooms, our nurses informed patients about COVID-19 symptoms and best practices upon arrival to our clinics, and our community health team traveled to remote areas to educate communities about how to reduce the spread of the virus.
From the beginning of the pandemic, we have put in place a protocol that outlines the steps to take when we have a patient showing signs and symptoms of COVID-19. We also worked closely with the Ministry of Health and scheduled testing for a patient whenever we encountered a suspected case. Although we were unsure how the pandemic would affect Haiti, we made every effort to keep all of our clinics open. We required (and still do) that all patients wear a mask at all times upon entering and while inside our clinics. We designated a quarantine site at each of our clinics where patients would be isolated if they showed signs or symptoms of COVID-19. We put a handwashing station at the entrance of all our clinics so that every patient coming in or leaving our clinics can wash their hands. We took the temperature of every person that entered the clinic. We also ensured that our staff is equipped with personal protection equipment (PPE), even though it costs three times the price to buy PPE and hand sanitizers in the country. Although we have not seen many COVID-19 cases at our clinics, the virus has affected our work significantly. Our patient volume greatly declined during the first few months of the pandemic and has started to slowly increase since September.
There are many theories as to why Haiti was not hit as hard as expected during the pandemic in comparison to other countries. For one, medical experts agree that half of the population is made up of young people who typically only develop mild symptoms or are asymptomatic. Some believe that the tropical Caribbean climate of Haiti played a factor in reducing the cases, as well as casualties. But most importantly, since the beginning of the pandemic, Haiti was issued a Level 4 travel advisory warning, its border with the DR has been closed, and all flights were halted which reduced the number of people entering the country and likely reducing the number of reported cases.
At C2C, we remain cautiously optimistic. Second waves in Europe and the U.S. have presented a stark reminder of just how important it is to continue to take this pandemic seriously. While it’s been admittedly difficult to adjust to this “new normal,” we cannot let our guard down and must continue to adhere to virus mitigation best practices. We continue to do our best to ensure that our clinics, staff, and the communities we serve are protected and supported.
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.