ARTICLE - CORNELL - GHESKIO REBUILDS CLINIC

CORNELL CLINIC IN HAITI REBUILDS FROM RUBBLE
(Cornell Daily Sun) - By Tajwar Mazhar

Although much work remains, Cornell’s GHESKIO clinic in Haiti has rebuilt most of its buildings that were destroyed by the earthquake in January 2010, according to Dr. Daniel Fitzgerald, co-director of the Center for Global Health, a division of Weill Cornell Medical Center that works with GHESKIO.

Burdened by the death of four of the clinic’s staff members and the destruction of 70 percent of its buildings, GHESKIO also had to treat more patients than normal due to the devastation caused by the earthquake, said Dr. Vanessa Rouzier, head of pediatrics at the clinic.

“Initially after the earthquake, we spent the first two months seeing patients in the yard, but now, logistics are much better,” Rouzier said. “The earthquake has required GHESKIO to go beyond their previous mission, but we haven’t withdrawn HIV/TB care ... We have opened up to new categories and more community services.”

The clinic, which collaborates with WCMC, was established in 1982 as the first institution worldwide fighting HIV/AIDS and tuberculosis. In addition to HIV/AIDS and tuberculosis treatment, GHESKIO provides counseling for the families of those infected with these diseases, according to Fitzgerald.

Located in Port-au-Prince, the clinic has continued its free medical aid and expanded services and outreach to the local community since the earthquake, Fitzgerald said.

Not only has GHESKIO hired unemployed Haitians staying in the organization’s refugee camp to complete reconstruction on its buildings — of which they have rebuilt at least eight — but it has also started vocational education classes to help prepare adults in the community for employment, according to Fitzgerald.

GHESKIO has also had to cope with the resurgence of cholera in the country. In October 2010, Haiti saw its first case of cholera in decades, and as of January, there have been more than 4,000 deaths and 250,000 cases, according to Fitzgerald.

“Cholera had not been reported for 50 years. So, if a new disease is introduced, it is very dangerous. No one had immunity. [They are] very, very highly susceptible,” Fitzgerald said.

Although the clinic saw a slight decline in cholera cases last month, Fitzgerald said that the communicable disease will spread through water contamination in the upcoming rainy seasons.

Apart from HIV/AIDS and tuberculosis, GHESKIO provides clean drinking water and sanitation to more than 100,000 people in its surrounding area, Fitzgerald said.

In the wake of the earthquake, the clinic has concentrated on establishing greater community outreach — an effort that was “very different before the earthquake,” according to Elizabeth Fox, GHESKIO nutrition training coordinator, who arrived in Haiti days before the earthquake.

One of these outreach programs is a program that provides nutritional guidance to new mothers, some of whom have HIV positive children, according to Fox.

“Starting in summer of 2007, we began laying the groundwork for an infant and child feeding intervention among HIV-exposed children of HIV-infected moms. ... The intervention was successful, reduced risk of malnutrition at 12 months, so we took that basic strategy and scaled it up to all zero- to two-year-olds at the clinic,” said Rebecca Heidkamp grad, who began her dissertation research in GHESKIO.

Following the earthquake, GHESKIO extended the program to include more of the affected population, according to Heidkamp.

“Now we have more than doubled our capacity, irrespective of HIV status,” Rouzier said.

Before the earthquake, GHESKIO had limited interaction with Haitians who lived across the street in an impoverished neighborhood, known as “City of God,” according to Fitzgerald.

Many community members moved into GHESKIO’s compound following the earthquake, providing the opportunity for GHESKIO to collaborate with people from “City of God,” Fox said.

GHESKIO has recently opened an elementary school to make free education available to the refugee camp local community, according to Fox.

“There is a great energy in the compound with kids coming in their uniforms,” Fox said.

Haiti has a law preventing older children without prior education from attending public schools. GHESKIO is offering evening classes for these students, according to Fox.

“This has been a really inspirational experience,” Fox said. The Haitians “are working for and with their people. It’s a refreshing place to be.”

Numerous organizations, ranging from the Clinton Bush Haiti Fund to MAC Aids Foundation, have donated money GHESKIO. GHESKIO has also received thousands of dollars from the Cornell community, Fitzgerald said.

“Cornell has been great to collaborate with,” Rouzier said. “It would be difficult to come out of the rubble without help from abroad. … We really are grateful.”

The organization received funding to develop two long-term initiatives: the creation of an inpatient hospital for tuberculosis patients and the opening of a new nutrition center, according to Fitzgerald.

GHESKIO created the inpatient hospital in response to the increasing population of Haitians suffering from drug-resistant strands of tuberculosis. The reported number of cases of tuberculosis, a disease which is transferred through the air, has doubled over the past year, Fitzgerald said.

The maternal care center will provide growth monitoring and long-term care to the surrounding population of Port-au-Prince, Fitzgerald said.

“The socioeconomic aspects still remain difficult,” Rouzier said. "Children are not growing or thriving as well as we would like. We have a lot of our families still living in tents,” Rouzier said.