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An Innovative & Effective Model:
Sante Nan Lakou

We focus our disease prevention and health outreach efforts at the level of the lakou, where we can make the most impact and reach those who would otherwise never receive medical care. 

H.O.P.E and A.S.B Hospital have worked together to develop a novel multi-pronged, four-tiered public health model referred to as Sante nan Lakou—“health in the lakou.”  Lakous are the basic social structure in rural Haiti, comprising an aggregation of family members who live together—typically in multiple dwellings—and share responsibility for child rearing, providing food, and familial tasks.  Women and girls are central to the functioning of the lakou and, likewise, are central to our holistic health intervention programs, as is our team of trained community health agents, lab techs, nurses, and doctors. 

Community surveillance and health screening at the lakou level allows us to provide a holistic approach to health, beginning at the grass-roots level and flowing up to Alyans Sante Borgne Hospital.  This four-tier model is our innovation, and it gets proven results.

We wish it were simple to explain what we do!  The truth is, we do a lot, and we do it all “in community” with the residents of beautiful, rural Borgne--a commune in northern Haiti that stretches from the beaches of Fond La Grange to the mountainous communities in Milot. 

A Holistic Community Health Model

TIER FOUR

In The Lakou

TIER THREE

Mobile Health Clinics

TIER TWO

TiBouk Clinic

TIER ONE

Alyans Sante Borgne Hospital

TIER FOUR: In the Lakou

 

Principle: 

Build on existing community networks and social institutions to extend the reach of medical treatment and preventative services for people in rural northern Haiti.

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Programs: 

 

TIER THREE: Mobile Health Clinics

 

Principle: 

Mobilize services and resources to better connect with, and truly understand, the community in the socio-economic context in which people live.

Programs: 

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TIER TWO: TiBouk Clinic

 

Principle: 

Counter the highly centralized nature of Haitian structures.

Program: 

About 10 years into our partnership with the Haitian government, we independently rebuilt a health clinic in the market town of TiBouk, the second largest population center in Borgne.  This secondary level provides the only medical care in the mountainous rural areas of the commune and offers families who live too far from the village of Borgne access to testing, treatment, and vaccines as well as maternal care and nutrition. This clinic serves as a literal and symbolic bridge from the farthest corners of this mountainous commune to the administrative center in the town of Borgne, --which is at sea level and near to paved roads that lead to Cap-Haitien.

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TIER ONE: Alyans Sante Borgne Hospital 

 

Principle: 

Promote a holistic vision of community health by integrating the physical, environmental, social, cultural, psychological, and economic dimensions of community well-being.

Program: 

A.S.B., or the Health Alliance of Borgne Hospital, is a high-capacity, expertly staffed hospital just outside the town of Borgne that H.O.P.E. has built and assumes high levels of responsibility for funding-- in partnership with the Haitian government. The hospital provides basic services, such as an in-patient facility, internal medicine, women's health, maternity, delivery, and prenatal and postnatal services, as well as a dental clinic, TB and HIV/AIDS programs, a lab, and pharmacy. This hospital moves nimbly to respond and provide large-scale interventions from a cholera outbreak in 2012 or a global pandemic in 2021. The medical team who runs this hospital sees over 20,000 patients a year and we estimate that this addresses only about 15% of the medical needs in the commune of Borgne, even as it is the only no-cost health care system in northern Haiti.

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