News from Haiti: MFP opens second clinic, AIDS data released

Dr. Michael Viola announced the opening of second clinic in the community of Descostiere in the Gros Morne area in northwest Haiti. The clinic was built by the Foundation Saint-Dominique, part of the Roman Catholic parish in the community. The clinic will be non-denominational. Both MFP clinics at Descostiere and the mountaintop clinic at Charbes have the capacity to treat most common illnesses of children and adults, and have well-stocked pharmacies as part of the facilities. The clinics will be staffed by a community health worker and by visiting MFP physicians. The clinics perform an important preventative public health function in educating patients about childhood vaccinations and nutrition, reproductive health, prevention of sexually transmitted diseases, and malaria control.

In 2007, MFP, in collaboration with Jacqueline Picard, RN, will hire approximately 50 "agents de sante", community health workers, to perform public health activities in the remote mountainous regions around Gros Morne. Each "agent de sante" will have a portfolio of 200 families for whom they will be responsible to visit once a month. The agents will encourage families to have children vaccinated, receive supplemental feedings at the clinic if children are malnourished, advise women about reproductive health, and treat patients for malaria. The agents will work closely with the MFP clinics and with the Alma Mater Hospital in Gros Morne.

UNAIDS has recently released the "AIDS Epidemic Update 2006", which includes current data on the AIDS epidemic in Haiti. The majority of the 250,000 individuals living with AIDS in the Caribbean are from Haiti and the Dominican Republic. In the Dominical Republic, the highest AIDS infectivity rates are found in Haitian workers living in the batayes, shanty towns housing sugar cane plantation workers. AIDS Infectivity rates throughout Haiti remain high, ranging from 2.2% to 3.8% of individuals infected in different regions. There are slight downward trends in infectivity rates in Port-au-Prince; this could represent real behavioral changes (increased use of condoms by sex workers has been documented), or what has been referred to as "circular migration". The latter refers to the return of AIDS stricken individuals from the city to their homes in the countryside to seek home-based care.

A disturbing aspect of the data from Haiti is the increased sexual activity among younger teenagers, particularly girls, and the practice of unprotected sex in that young age group. Both practices will fuel the AIDS epidemic in Haiti.

Despite, the political and economic problems in Haiti in recent years, there has been a steady increase in the numbers of AIDS patients receiving modern highly active ante-retroviral therapy for AIDS. Approximately 12% of patients who needed AIDS chemotherapy therapy, received it. While, this leaves considerable room for improvement, it does demonstrate that in poor, rural communities it is possible to deliver complicated therapeutic regimens, monitor response to therapy, and assure patient compliance.

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The Mountaintop Clinic at Charbes

The new MFP clinic at Descostiere