A Ray of Hope in Haiti

After the quake hit, Haitians began streaming to Paul Farmer's medical complex. Michelle Goldberg on how the public-health crusader’s team could help blunt the aftershocks of disease.

AP Photo

Here is one tiny mercy amid the hell that’s befallen Haiti: Zanmi Lasante Hospital is mostly undamaged. Even before Tuesday’s earthquake, Zanmi Lasante was the most important medical complex in Haiti, and a model to healers worldwide. Now, with hospitals in Port-au-Prince leveled, aid workers killed and a public health catastrophe brewing, it would be impossible to overstate Zanmi Lasante’s importance. It may turn out to be a good thing that Hillary Clinton wasn’t able to get the hospital’s founder, Paul Farmer, to run USAID – now, at least, he can focus all his attention on doing what he does best, healing people in the world’s most unforgiving circumstances.

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It’s easy to see why Clinton wanted Farmer to run America’s dysfunctional aid agency: he’s a rock star in the world of public health, widely hailed as a saint and a visionary. He founded Zanmi Lasante in the 1980s, while he was still at Harvard Medical School, eventually building it from a two-room clinic into a full-service hospital with a network of satellite clinics and home health visitors. Altogether, it serves more than two million people. Haiti is the poorest country in the Western Hemisphere, and Cange, the town where Zanmi Lasante was founded, is one of poorest parts of Haiti. Yet the care provided at the hospital is, by all accounts, excellent. It is also largely free. No one is turned away for lack of funds; support comes from Partners in Health, the Boston-based NGO that Farmer co-founded. As he told The New York Times, “For me, an area of moral clarity is: you're in front of someone who's suffering and you have the tools at your disposal to alleviate that suffering or even eradicate it, and you act.”

The Daily Beast’s full Haiti coverageIn his book Mountains Beyond Mountains: The Quest of Dr. Paul Farmer, a Man Who Would Cure the World, Tracy Kidder describes first seeing Zanmi Lasante. It felt, he wrote, like encountering a miracle. “[H]ere, in one of the impoverished, diseased, eroded, and famished regions of Haiti, there was this lovely walled citadel, Zanmi Lasante. I wouldn’t have thought it much less improbable if I’d been told it had been brought by spaceship.” It includes, in addition to a fully equipped 104-bed hospital, schools and women’s literacy programs. Besides treating patients, it does pioneering public health work: It cleaned up the water supplies in its region and staved off a typhoid epidemic. It was one of the first places in the world to distribute anti-retroviral drugs for HIV free of charge. Wrote Kidder, “In Haiti, tuberculosis still killed more adults than any other disease, but no one in Zanmi Lasante’s catchment area had died from it since 1988.”

This kind of public health work is going to be especially necessary now, because, after the initial cataclysm of the earthquake, Haiti is likely to be hit by aftershocks of disease. As Alana Sheik wrote at UN Dispatch, “If stringent controls are not put in place, the combination of displaced people and damaged infrastructure will lead directly to epidemics of diarrheal disease over the next few months. In the case of Haiti, the risk is typhoid. It’s already present in the country, and it could spread rapidly if people are crowded together drinking contaminated water. We could also see spikes in dengue fever and malaria if people are living in temporary shelters with little protection from mosquitoes.”

Zanmi Lasante could help spare Haiti some of these agonies. It is located just over two hours from the country’s capital, and injured people are already making their way there. Meanwhile, people from Partners in Health are working on setting up field hospitals in Port-au-Prince. “We have about 100 doctors and 600 medical personnel in Haiti itself, and we’re working to get those team members into Port-au-Prince and set up some kind of temporary emergency care facility,” says Partners in Health staffer Wendy A. Mayer.

Naturally, they need money, badly. On the Partners in Health website, there’s an email that the group’s clinical director, Louise Ivers, sent from Port-au-Prince. “Port-au-Prince is devastated, lot of deaths. SOS. SOS... Temporary field hospital by us at UNDP needs supplies, pain meds, bandages. Please help us." If you’ve been watching this crisis unfold and wondering if there’s something you can do, there’s no better place to start.

Michelle Goldberg is the author of The Means of Reproduction: Sex, Power and the Future of the World and Kingdom Coming: The Rise of Christian Nationalism. She is a senior correspondent for The American Prospect, and her work has appeared in The New Republic, The Nation, the Los Angeles Times, Glamour, and many other publications.