Although the concept of a social enterprise is still fairly new in Haiti, we have seen the rise of market-based solutions take root, nurtured by organizations like Yunus Social Business, to demonstrate that an aid culture of free and subsidized goods and services may not be the most favorable strategy for building long-term economic growth and vitality in the country.

At C2C, we agree that this type of market-based solution is often more sustainable than traditional aid. Regardless of the number of existing barriers to success, we believe that a social enterprise approach in Haiti can work (specifically in health services) and that the challenges inherent in the market are surmountable.

James Ellsmoor recently profiled ten Haitian entrepreneurs who are taking the country’s narrative into their own hands by “creating opportunity in this Caribbean island nation to uplift Haiti’s environmental, economic and social landscape.” Learn more about who these are and what they’re doing to invest their talents into rebuilding their home country:

Dr. Samuel Bernard leads a training session with the new cadre of C2C Community Health Workers

Dear Friends,

As you know, we opened our fourth clinic last month as part of our formal collaboration with the Haitian Ministry of Health to create a public-private partnership (PPP) to rehabilitate existing public clinics to achieve high benchmarks of service delivery and quality.

We know that rehabilitating clinic buildings and ensuring that doors are open to patients each day doesn’t necessarily improve the health of a community. Poor families need support to be able to consistently access care and to be empowered with the health education they need to make healthy choices. That’s why we pair our clinical services with community health programming: services that complement clinic-based care with community-based screenings, home visits, and education opportunities.

Earlier this year, we overhauled the scope of our existing community health programming by hiring a new cadre of 8 Community Health Workers (CHWs) devoted solely to home-based follow-up to the clinic experience. CHWs can close a critical gap in the continuum of care, helping to ensure measurable clinical improvements for patients. It’s an exciting evolution for our organization and we want to be able to offer this level of accountability to our key stakeholders: our patients.

The New Community Health Initiative:

Program Highlights:

• Each C2C clinic is now staffed with two clinical personnel devoted solely on home-based and community-based care and follow-up: one Community Health Nurse and one Community Health Agent.
• CHWs conduct home visits, provide education at churches and schools, and convene free health screenings each week to educate community members about the most common threats to health: unclean food and water, poor hygiene, chronic conditions, nutrition, the importance of childhood immunizations, and sexual health.
• This initiative targets some of the most common illnesses we treat in our clinics: acute respiratory infections, anemia, typhoid, and hypertension.
• CHWs are assigned to follow-up at the household level for every patient diagnosed with these illnesses to ensure that the continuum of care is complete and that our patients are not just receiving services, but that they are getting well.
• CHWs will bring with them the necessary medication or follow-up diagnostics or monitoring tools to the patient’s home, such as tablets, blood pressure cuffs and pneumonia monitors to assess and record the health profile of a patient at home or in the community.

CHWs are a vital link between clinic and patient. This level of service delivery is unprecedented in Haiti and we believe that we can demonstrate significant gains against baseline data, proving that the CHW model for follow-up care is measuring improved health outcomes.

One month after the grand opening of the Sinek clinic and, though its impact isn’t fully defined yet, we can clearly see that the community is happy to see its doors open. We began to experience a daily high volume of patients right on opening day. Sinek, the 4th clinic in C2C’s growing network of community clinics, is surrounded by a population of nearly 20,000 people. Prior to its re-opening, the community lacked access to reliable, high-quality medical services.

We recently sat down with C2C’s Chief Operating Officer, Dr. Samuel Bernard, to reflect on the journey of re-opening the Sinek clinic, its success in such a short period of time, and to discuss C2C’s model evolution towards a Public-Private Partnership (PPP). Dr. Samuel told us that he was very excited about C2C’s partnership with Haiti’s Ministry of Health (MSPP) and, in particular, the renovation of failing public clinics. This partnership gives us the ability to breathe “new life” into these existing clinics. Dr. Jasmin, the Director of the Northern Department at the Haitian Ministry of Health, was just as thrilled as we were to embark on this mutually-beneficial journey.

Dr. Bernard shares his reflections about embarking on the PPP journey that begins with the grand opening of Sinek:

Addressing Concerns:

We knew Sinek was the right place to start, considering the clinic wasn’t functional: patients never saw a doctor- only a nurse assistant and did not have any meds, exams, or lab tests to offer. At the same time, we knew we had to tackle a mountain of challenges before opening day. Despite the best efforts of the government to staff and equip a public clinic in Sinek, there simply was not enough public funding to pay salaries, secure the supply chain, or provide electricity or running water.

In order to tackle the internal issues and operations of the clinic, we had to address the many external challenges, such as:

• Sourcing construction materials that weren’t available in Haiti
• Assessing the community and understanding what types of services they need
• Educating the community about C2C’s model and how it differs from the public clinics

Grand Opening:

Community members were excited and happy to see the changes to the clinic.
The Ministry of Health was glad to see that the clinic was supporting the community and that we wanted to include their input throughout the re-opening process. We had an overwhelming amount of feedback stressing that this is the only clinic that the community has and that they so are glad that they can depend on it to stay open and functional. The renovations to the clinic (from the inside and out) showed that our partnership with the government was headed in the right direction and it gave people hope that the Public-Private Partnership was indeed a winning model.

C2C Model Evolution:

Since the early years in Haiti, C2C developed methods for community-based market research, established key partnerships, built a local brand, and iterated core operating protocols (staffing, task-shifting, electronic medical records, quality standards). We believe that our model, having demonstrated both health impact and business traction, is ready for replication to new communities.

C2C is growing its network in northern Haiti. We now operate 4 clinics with plans to open another 6 clinics in the next two years, reaching 50,000 people annually by 2020. We have always worked in close collaboration with the Haitian Ministry of Health, offering national priority programs like immunizations and antenatal care free-of-charge. Starting with Sinek, we have begun to formally expand our collaboration with the Ministry to a public-private partnership (PPP) model, rehabilitating existing public clinics to achieve high benchmarks of service delivery and quality, by adopting the C2C model for clinic management.

Sinek patients have welcomed C2C with open arms and are happy that the clinic is clean, safe, professional, and trustworthy. This successful start to the partnership gives Haiti’s government hope that replication in other communities is possible and on a path to transforming healthcare in Haiti.