C2C RESPONDS TO CIVIL UNREST IN HAITI

Photo Courtesy of The New York Times

Today is the celebration of Carnival in Haiti. The Carnival of Haiti (otherwise known as “Mardi Gras” or “Kanaval” in Creole) is one of the most anticipated events in the country. This cultural event kicks off the day before Ash Wednesday to usher in the season of Lent, with colorful celebrations throughout Haiti. But, unfortunately, this year, Haiti’s Minister of Culture has announced that official carnival celebrations have been canceled in light of recent protests and unrest across the country.

Photo Courtesy of Associated Press News

As you may have heard from the news or from personal connections in Haiti, major demonstrations have been occurring across the country since February 5, when citizens and opposition politicians began to demand the resignation of President Jovenel Moise.

That same day, our clinic managers were leaving our Cap Haitien clinic to attend a staff meeting at our Acul-du-Nord clinic when they were stopped on National Road 1 due to political unrest demonstrations. They tried to urge the demonstrators to allow them to cross the road to get to the clinic but there was no way convince demonstrators to allow them to pass the road blocked with cement blocks. Our staff from other clinics also were forced to cross the roadblock zone on foot to get home. The following day, the road was cleared and the staff was able to get to work easily. Unfortunately, the demonstrators blocked the road again later in the day, and, again, the only way the staff could pass through closures was on foot.

On February 7, due to the rising unrest (protests, huge roadblocks and barricades, and burning tires), we were forced to close our clinic network to protect our staff and the patients. Our staff in Haiti stayed in communication at all times to evaluate the situation in order to make a decision regarding the opening or closure of the clinics. For two weeks, our HR manager would send a message to all the staff every morning to instruct them to stay home if the roads and conditions did not allow travel. For most of this time however, one of our more remote clinics remained open and continued to serve the community since it is located in an area away from the political unrest and most of the staff lives in the same community the clinic serves. We also made a conscious effort to try and keep our main clinic in the center of town (Cap Haitien) open to patients who needed timely access to care.

Beyond the demonstrations, another challenge has been lack of fuel, which has made traveling difficult not only for our staff but patients too. Transportation prices have more than doubled to account for the shortage of fuel options in the country.

Encouragingly, in the last week, things have started to return to normal, but the political and economic situation in Haiti is still delicate. There is no telling whether or not the protests will restart. So, there will certainly continue to be challenges but this is what encourages us to keep doing the work we do. We hold on to (and continue to be energized by) the fact that we are providing vital healthcare services to communities that need them desperately.

Thank you for your continued support and, as always, onward!

C2C OPENS SECOND PUBLIC-PRIVATE CLINIC IN HAITI’S NORTHERN DEPARTMENT

C2C recently held a grand opening to celebrate adding a new clinic to our network as part of our expanding Public Private Partnership (PPP) with the Haitian Ministry of Health in northern Haiti. This newly upgraded clinic opened its doors to treat vulnerable families who live or work in Bayeux and its surrounding communities. This is the 5th clinic in C2C’s growing network and the second clinic we have rehabilitated and re-opened in partnership with Haiti’s government. We collaborate closely with the Ministry to improve patient outcomes, service quality and operational excellence across all C2C clinics. The partnership is thriving in the northern department and will soon expand to other regions in Haiti.

We kicked off Opening Day at Bayeux by offering free immunizations for infants at the clinic which was met with enthusiasm and a large participation from families in the community. We also invited local government leaders and representatives from the Northern Department at the Haitian Ministry of Health. All attendees got the opportunity to take a tour of the clinic and learn about its new and wide-ranging services.

Community members gather to celebrate the grand opening of the Bayeux clinic

Patients wait in front of the clinic for immunizations and physician consultations

Stay tuned as we bring you more information about the Bayeux clinic’s progress and patient stories! In the coming months, you will also learn more about how C2C plans to add more PPP clinics to our growing network of clinics in Haiti.

C2C IS SELECTED FOR INNOVATIONS IN HEALTHCARE 2019 COHORT

Dear Friends,

We are excited to kick off the new year with a announcement that C2C is selected as one of ten organizations to be part of the Innovations in Healthcare 2019 Cohort!

Innovations in Healthcare (IiH) is a nonprofit organization hosted by Duke University and founded in 2011 by Duke Health, McKinsey & Company, and the World Economic Forum. They aim to improve healthcare worldwide by supporting the scale and impact of promising innovations. Every year, they dedicate a substantial amount of time and resources to source, scout, and recruit the best healthcare organizations from around the world.

As members of this year’s select cohort, IiH will work to support and strengthen the work we do at C2C, and we couldn’t be more excited for a year of learning and increasing our impact through this collaboration!

Stay tuned to learn about how this partnership will help C2C to drive impactful work that ensures vulnerable communities have access to affordable, high-quality care.

Social Entrepreneurship is on the rise in Haiti

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:

A letter from Executive Director Scott Schroeder

Dear Friends of C2C,

It’s been a whirlwind of a first month as Executive Director at C2C. I participated in my first Board meeting, represented C2C at a global conference in Mexico and, most importantly, visited our staff and clinics in Haiti for the first time.

Prior to joining C2C, I was attracted by the extremely positive “ingredients” the organization had – visionary founders and passionate Board members committed to taking on one of the planet’s biggest challenges (access to quality primary healthcare, particularly in the developing world), a social enterprise-based earned revenue model that ensures long-term sustainability, a partnership with the Haitian Ministry of Health that opens a path to significant scale, and a passionate and committed Haitian staff in our offices and clinics. These last ingredients I knew about “outside looking in” before I joined but, as is so often the case, what a completely different experience it was being there!

Sure, there were some challenges that come to life in a whole new way when you are in-country such as: very difficult roads that can quickly become impassable with anything more than a brief tropical shower; generators that break; solar panels installed in the shade; more patients than doctors and nurses to serve them at times. But, our incredible team on the ground takes these challenges (and many more) head-on every day and they deliver! The new clinics we have opened in our partnership with the Ministry of Health have seen morale and quality measures double since C2C’s involvement. Our doctors and nurses are happier, patients are getting a far higher quality of service and are saying so in surveys, and our revenue model establishes over 80% ongoing expense recovery within just a few months of operations. It’s a very exciting picture that has enormous potential for expansion in the coming year and beyond.

My goal is to take the C2C footprint from 5 to 15 clinics by 2020. I also believe that our model (and our expertise) can be applied in many other developing countries down the road. The challenges will be many and it certainly won’t be easy, but in just one month, I am even more convinced that C2C can deliver high quality primary healthcare in a sustainable way throughout Haiti and (ultimately) the globe. I’m excited to get to work and tackle the challenges I mentioned so that C2C can achieve the potential of the wonderful ingredients we have assembled.

Most importantly, and finally, we could not have reached this point of amazing potential without the support of all of you. You all should feel great about what you have enabled and the potential that lies before us – thank you so much and onward!

With best regards,

Scott Schroeder
Executive Director

Introducing C2C’s new Executive Director!

Dear Friends and Supporters,

We are kicking off the fall season with some exciting news. On behalf of the team and board at C2C, I am delighted to announce that a new Executive Director, Scott Schroeder, will lead C2C into a new era of growth.

Scott is a development and management professional with broad experience spanning NGO leadership, small business development, marketing and strategy. He began his career in the financial services industry before transitioning into the nonprofit sector. He was the Chief Marketing Officer at Plan International, where he led the organization to raise over $30 million in revenue. He also led new campaigns and developed new development products aimed at issues facing women and girls (Because I am a Girl). After leaving Plan, he served as the Vice President of External Relations at Pathfinder International, where he was responsible for fundraising, partnership development, public relations and communications. Most recently, he served as the Chief Development Officer at the Maven Project, a start-up telemedicine non-profit that matches specialist volunteer physicians with underserved clinics.

Scott brings his experience in global development and business to leads the strategic growth of C2C and optimization of its social business model. He is dedicated to setting a clear and bold vision for C2C’s future.

As we welcome Scott, we also would like to express our utmost gratitude to Allison Howard-Berry. Allison played a critical role in designing and executing the C2C model. She and I worked side by side for over a decade and has served as the Executive Director for the past two years.

Through her leadership and dedication to the organization, she helped to transform C2C from its infancy into the social business it is today. Her vision of leadership for developing our community-based clinic network formed the foundation that shapes the C2C’s mission and values. All of us at C2C are eternally grateful for the opportunity to have worked with Allison and are privileged to be able to carry on the efforts she helped start. We are happy to announce that Allison will continue on with C2C as Strategic Partnerships Advisor to the Board of Directors.

Many of you have been great friends and supporters over the last decade. Please know that we deeply appreciate your support, encouragement, and investment in making this transition such a positive one. I hope you’ll join me in giving Scott a warm welcome. As always, we welcome any questions you might have and please stay in touch with us about the exciting work we will be kicking off under Scott’s leadership!

Sincerely,

Elizabeth Sheehan
Founder and President

C2C clinics receive high scores for quality by the Haitian Ministry of Health

A study published last year in the Bulletin of the World Health Organization found that while 91% of Haitians lived within 5 kilometers of a health facility, only 23% lived within 5 kilometers of a high-quality health facility.

Low quality clinics and hospitals across Haiti are contributing to the poor health status of millions of vulnerable people. At C2C, we’re changing that by transforming public clinics into thriving, well-resourced, high-quality health centers.

Here are our results from the 2018 evaluation by the Haitian Ministry of Health:

C2C Overhauls Community Health Program

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.

Reflections on Opening the Sinek Clinic & the start of a Public-Private Partnership

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.

Clinic Launch Series: Part 1 of 5- Transforming the Pharmacy

Dear Friends,

Last week, we announced that C2C will officially open the doors of a new clinic in Sinek, northern Haiti, next month. This will be the 4th clinic in our growing network of community clinics. The community of nearly 20,000 lacks access to reliable, high-quality medical services. Despite the best efforts of the government to staff and equip a public clinic in Sinek, there simply isn’t enough public funding to pay salaries, secure the supply chain, or provide electricity or running water. C2C is proud to partner with the Haitian government to give the Sinek clinic a “new life” and to serve the community in perpetuity.

Step One: Guarantee a reliable supply chain for essential medicines.

Under government management, the Sinek clinic is able to stock only 6 to 8 different medicines and regularly experiences stock-outs because of failures up the supply chain. Under C2C’s model, the Sinek clinic will stock over 35 medicines. Reliability is a fundamental brand attribute of C2C clinics: we promise our patients that the medicine they need will always be in stock. We’ve developed an inventory and supply chain system that leverages efficiencies across the clinic network.

See our “before and after” photos below! The transformation of the Sinek pharmacy is well underway and we cannot wait to welcome our first patients to the revitalized public clinic in April.

BEFORE:

AFTER:

Stay tuned as we bring you more information next week about how the clinic is transforming. But first, a CALL TO ACTION! We would appreciate if you could take just a moment to do the following:

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We want to build our community of supporters and advocates far and wide so that the community of Sinek and the new clinic know that we are following their success!