Partners In Health (PIH) is an international nonprofit public health organization founded in 1987 by Paul Farmer, Ophelia Dahl, Thomas J. White, Todd McCormack, and Jim Yong Kim.
Partners in Health provides healthcare in the poorest areas of developing countries. The organization builds hospitals and other medical facilities, hires and trains local staff, and delivers a range of healthcare, from in-home consultations to cancer treatments. It also removes barriers to maintaining good health, such as dirty water or a lack of food. The approach trades charity for "accompaniment" which is described as a "dogged commitment to doing whatever it takes to give the poor a fair shake." While many of its principles are rooted in liberation theology, the organization is secular. It forms long-term partnerships with and works on behalf of local ministries of health.Farmer, Paul E., Bruce Nizeye, Sara Stulac, and Salmaan Keshavjee. 2006. "Structural Violence and Clinical Medicine". PLoS Medicine, 1686-1691. PIH holds a 4 out of 4 stars rating from Charity Navigator, a nonprofit evaluator.
History
Partners In Health began in 1987, after Paul Farmer and Ophelia Dahl helped set up a community-based health project called Zanmi Lasante ("Partners in Health" in Haitian Creole) in Cange, Haiti. The organization initially focused on treating people with HIV/AIDS in rural Haiti. PIH now embraces a holistic approach to tackling disease, poverty, and human rights in a variety of countries.
In 1993, Farmer used the proceeds from his John D. and Catherine T. MacArthur Award to create a new arm of Partners In Health, the Institute for Health and Social Justice. Its mission is to analyze the impact of poverty and inequality on health, and to use findings to educate academics, donors, policy makers, and the general public. PIH's Chief Medical Officer, Dr. Joia Mukherjee, directs the institute.
Current work
Partners in Health currently has 18,000 staff members globally and has sites in Haiti, Kazakhstan, Lesotho, Liberia, Malawi, Mexico, Peru, Rwanda, Sierra Leone, and the United States.
PIH collaborates closely with Harvard Medical School and the Brigham and Women's Hospital.
At the invitation of local governments, it strengthens and sustains public health systems in remote, rural areas. It trains and hires local healthcare workers, many of whom actively find patients in their communities and help them get care. PIH also helps local experts conduct academic research that leads to clinical innovation.
Notable supporters include Hank and John Green, Madonna, actor Meryl Streep, Ryan Lewis, Win Butler and Régine Chassagne of Arcade Fire, and Matt Damon.
Haiti Zanmi Lasante is PIH's flagship project. The small clinic that started treating patients in the village of Cange in 1985 has grown into the Zanmi Lasante (ZL) Sociomedical Complex, a 104-bed hospital with two operating rooms, adult and pediatric inpatient wards, an infectious disease center (the Thomas J. White Center), an outpatient clinic, a women's health clinic (Proje Sante Fanm), ophthalmology and general medicine clinics, a laboratory, a pharmaceutical warehouse, a Red Cross blood bank, radiographic services, and a dozen schools.
The organization also works in 11 other sites across Haiti's Central Plateau and beyond. Zanmi Lasante is Haiti's largest nongovernmental healthcare provider, serving 4.5 million. It employs 5,700 Haitians, including doctors, nurses, and community health workers.
Community-based models PIH's community-based model has proved successful in delivering effective care both for common conditions like diarrhea, pneumonia, and childbirth that are often fatal for Haiti's poor and malnourished, and for complex diseases like HIV and tuberculosis. The main key to this success and to the PIH model of care pioneered in Haiti has been training and hiring thousands of accompagnateurs (community health workers). The PIH model of accompagnateur care is outlined in the 5-SPICE framework, a scholarly article detailing the tenets of a successful community health worker program.
The use of accompagnateurs is one of the most effective ways of removing structural barriers to adequate treatment of HIV and other chronic diseases while increasing job growth in communities that desperately require employment to further benefit the community's social structure. Focusing on minimizing the implications of structural violence is the key to the PIH model's success and to the improvement of treatment of chronic disease in rural Haiti.
Expansion in Haiti
As ZL has expanded, it has partnered with other nongovernmental organizations and the Haitian Ministry of Health to rebuild or refurbish existing clinics and hospitals, introduce essential drugs to the formulary, establish laboratories, train and pay community health workers, and complement Ministry of Health personnel with PIH-trained staff. Clinics that previously stood empty now register hundreds of patients each day at twelve sites—Cange, Boucan Carré, Hinche, Thomonde, Belladère, Lascahobas, Mirebalais, and Cerca La Source in the Central Plateau plus additions in the Artibonite region: Petite Rivière, Saint-Marc and Verrettes. In 2008, ZL recorded more than 2.6 million patient visits at clinical sites.HPV vaccine in Haiti Summary, Nov 2011.pdf
https://files.givewell.org/files/DWDA%202009/PIH/HPV%20vaccine%20in%20Haiti%20Summary,%20Nov%202011.pdf
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Response to the Haiti earthquake
When an earthquake struck Haiti on January 12, 2010, PIH/ZL resources were in place to deliver aid. In addition to providing care to the hundreds of thousands who fled to Haiti's Central Plateau and Artibonite regions, ZL established health outposts at four camps for internally displaced people in Port-au-Prince. ZL also supported the city's General Hospital (HUEH) by facilitating the placement of volunteer surgeons, physicians and nurses, and by aiding the hospital's Haitian leadership.
The earthquake leveled most of the health facilities in and around Port-au-Prince, including Haiti's only public teaching hospital and nursing school. In March 2010, PIH/ZL responded to an urgent appeal from the Haitian Ministry of Public Health and Population (MSPP) by announcing the Stand With Haiti campaign, a 3-year, $125 million plan to help Haiti rebuild. The plan included a scaled-up version of an already planned hospital, the Mirebalais Hospital.
Hôpital Universitaire de Mirebalais Before January 12, 2010, PIH had been planning to build a new community hospital in Mirebalais. Less than six months after the earthquake, the organization quickly scaled up plans.
In October 2012, Partners in Health finished construction on the Hôpital Universitaire de Mirebalais in Haiti. The hospital provides primary-care services to about 185,000 people in Mirebalais and two nearby communities. It is also intended to serve most of the country for secondary and tertiary care. The hospital opened its doors in March 2013.
The hospital provides education for Haitian nurses, medical students, and resident physicians. It has telemedicine technologies installed in meeting and operating rooms that link US-based medical professionals to help educate and train students and residents working there. Also, Partners in Health helped to establish an emergency department in the hospital. The organization has incorporated community health workers into their treatment regimen for their patients. Community health workers make necessary house visits to patients, deliver stipends and other essentials for patients' care, and keep record of their patients' progress at the hospital.
Other locations
Perú Since 1996, PIH's sister organization in Peru, Socios En Salud (SES), has been providing medical services in Lima. Based in the northern Lima district of Carabayllo, SES is now Peru's largest non-governmental health care organization, serving an estimated population of 700,000 inhabitants, many of whom have fled from poverty and political violence in Peru's countryside. As a valued partner to Peru's Ministry of Health, SES has also influenced national policies for prevention and treatment of multidrug-resistant tuberculosis and HIV and provides important training and support to help implement those policies nationwide.
SES also provides a variety of services. SES provides food baskets, transportation, lodging and other forms of support for impoverished patients. The project also provides opportunities for income generation projects, job skills training, and small business loans. One example is Mujeres Unidas ("Women United"), a cooperative workshop that participates in crafts fairs in Peru and has sold handicrafts as far as the United States, Japan and Switzerland.
PIH is also affiliated with the non-profit called Advance Access & Delivery in Lima.
Tuberculosis treatment SES has treated more than 10,500 people for multidrug-resistant tuberculosis (MDR-TB) in Lima. SES is conducting the world's largest TB research study, the EPI Project. Funded by a National Institutes of Health grant of US$6 million in 2007, the project seeks to understand how MDR-TB and XDR-TB spreads among people living in close quarters. English
Mexico
Partners In Health, known locally as Compañeros En Salud, began working in Chiapas, Mexico in 2011. The residents of this southern Mexican state, including indigenous populations, have long struggled with poverty, political violence, and inadequate healthcare access. Chiapas has higher tuberculosis incidence and mortality rates than the country's. CES aims to provide a more reliable, community-based alternative by training and employing local community health promoters, called promotores.
El Equipo de Apoyo en Salud y Educación Comunitaria (EAPSEC, The Team for the Support of Community Health and Education) was established in 1985 by a small group of Mexican health promoters. They initially worked with Guatemalan refugee communities in the Chiapas border region, and later expanded their work to other marginalized people in Chiapas. EAPSEC believes that "a life of dignity" is a human right. This includes a strong public health system that responds to the most pressing health needs of the population, and access to high quality health care.
Since 1989, PIH has collaborated with EAPSEC to improve medical infrastructure in the region and to recruit and train hundreds of promotores. Over the past two decades, EAPSEC has partnered with dozens of indigenous and rural communities throughout Chiapas to develop local health capacity. Recent work has focused on a network of communities in the area of Huitiupan in the highlands and around Amatan. EAPSEC is dedicated to helping communities build self-sufficiency and counts many successful community health groups throughout Chiapas among its "alumni."
Russia
Partners In Health's work in Russia has a narrower medical focus over a vastly wider geographical area than any of its other projects. From a base in the region of Tomsk Oblast, Siberia, PIH has been working since 1998, in collaboration with the Russian Ministry of Health, to combat one of the world's worst epidemics of drug-resistant tuberculosis (MDR-TB). As of 2014, 39,000 Russians had the disease. In partnership with the Division of Social Medicine and Health Inequalities (DSMHI) at the Brigham and Women's Hospital, PIH has focused on improving clinical services for MDR-TB patients in Tomsk while undertaking training and research to catalyze change in treatment of MDR-TB across the entire Russian Federation.