ARTICLE - HAITIAN HOSPITALS

HAITIAN HOSPITALS SUFFERING FROM EARTHQUAKE LOSSES

The catastrophic earthquake in Haiti is still leaving victims: private hospitals struggling to stay open.

(Miami Herald) - By Jacqueline Charles

PORT-AU-PRINCE -- One closed its doors, forcing 177 nurses, doctors and staff out of work. Another slashed staff in half. A third resumed charging fees.

Many employees and suppliers haven't been paid since the end of last year.

The hospitals of Haiti are in critical condition, their bottom lines bleeding as patients receive free medical care after the earthquake.

``It's a catastrophe,'' said Dr. Michel Théard, who sits on the board of one struggling hospital, and operates a cardiology practice across the street from another that recently closed.

``A private hospital that now wants to survive is facing [competition from] free medical care, which is OK. But it's a new challenge for survival.''

For months, Haitians in this quake-ravaged capital have received free medical care courtesy of foreign doctors, the government-run hospital and several private hospitals that suspended charging patients after the Jan. 12 quake. The impact is painfully visible in the empty operating rooms and idle equipment at Sacred Heart/CDTI.

``We cannot pay our employees,'' said Dr. Reynold Savain, whose hospital, Sacred Heart/CDTI was the site of Haiti's first organ transplant a year ago and today is the first post-quake hospital casualty.

On March 31, as the last of the foreign doctors packed up, Haiti's most modern hospital shut down.

``Before Jan. 12, we were surviving,'' said Savain as he recounted stepping over crushed bodies in a chaotic scene in his parking lot hours after the quake.

``After the earthquake, we gave free healthcare to everybody who came.''

With the first foreign medical teams still three days away, the 22-bed hospital emptied its supply cabinets and ``gave away everything we had.''

All of the high-tech equipment -- digital X-ray, respirators, sterilization and CT Scan machines -- were put at the disposal of patients. By the time the last team of foreign doctors left, CDTI had treated 12,250 patients and performed nearly 3,000 surgeries -- all for free.

``Everything was financed by the hospital. That means me,'' said Savain, who has unsuccessfully lobbied the U.S. Agency for International Development and various nongovernmental organizations for financial help. ``The foreign doctors came. They gave the medicine. But what about the employees who were working 24 hours, what about the equipment . . . ?

Unable to pay bank loans and three-months of salaries, Savain closed the hospital, which he built to honor his 15-year-old son who died of brain cancer five years ago.

Across town in Pétionville's Frères neighborhood, the 75-bed Haitian Community Hospital remains open -- but barely.

``The only reason we're still operating is because we were able to ask people in the U.S. to donate to our foundation,'' said Josiane Hudicourt-Barnes, whose mother first opened the hillside hospital as an outpatient clinic in 1984.

Recently, a benefactor loaned the hospital $60,000 to pay January's salaries for its 200 staffers. And last week, after painful consideration, operators began charging patients: $3.75 for a doctor's consultation, a bit more for medical care.

``Every time a person is sick in Haiti they have to weigh on their own whether the sickness is grave enough to warrant spending $3.75 for a consultation,'' Hudicourt-Barnes said.

And then there is the increased competition from aid groups. Already luring away Haitian nurses before the quake by offering to double their $350-a-month salary, some are now advertising free care in local newspapers. They are also poised to benefit from nearly $5.3 billion in promised international aid toward Haiti's rebuilding.

Théard, who sits on the board of the 30-bed Canape Vert Hospital, which has slashed its staff from 150 to 75, said the problem is beyond the almost $500,000 that three functioning hospitals estimate they are owed in reimbursements.

``The system can't go back to the way it was before,'' he said. ``The population has no money to go to the medical facilities. The government cannot offer all of the needs.''

Théard fears doctors -- who make $590 a month in public hospitals, and supplement income by working at various private hospitals -- will soon abandoned the private hospitals, or even Haiti.

``They rather be a nurse in the States than a doctor in Haiti,'' he said.

Patients are beginning to feel the impact.

``I went to three hospitals and we could not get treatment,'' said Francoise Jean, who finally got help at Canape Vert Hospital for her husband, who was suffering from high blood pressure.

Dr. Ariel Henry, chief of staff for the minister of health, said officials are looking at a pay-for-services package to help keep doors open, and Haitian medical staff employed. Cost of the program: at least $10 million.

The free medical care and medicine has affected all hospitals, including government-run facilities, which were ordered to remove all fees shortly after the quake, Henry said. The result is that hospital usage has gone up 10 fold.

``That shows money was a barrier,'' said Henry, a Haitian neurosurgeon. ``We have to think about financing the healthcare of the population, and how people can have better access to healthcare.''

Miami Herald special correspondent Jean-Cyril Pressoir contributed to this report from Port-au-Prince.