The improbable journey from the worst to the first health system in rural Haiti’s North.
Since its launch in 2006, Alyans Sante Borgne, or ASB, has become a powerful new model for health in a remote seaside/mountainous community on Haiti’s North Shore in the Commune of Borgne. To this day it still amazes me that what was basically a dream-out-loud vision was born and has grown into a far-reaching health network in this community of 80,000. Sharing this story is one way that we can change the narrative of “Hopeless Haiti” into a story of meaningful progress against the odds. I was there from the beginning and this is how it happened.
Back in 2005, I was still a neophyte in the world of community development, a tech entrepreneur reaching for meaningful ways to contribute to the world. I was accompanied by my daughter who was already deeply engaged in Haiti, and by Dr. Rose-Marie Chierici who was the co-founder of a small community development program named H.O.P.E. It was a whirlwind introduction to a world I could not have imagined. The visible poverty and government neglect were shocking beyond my already low expectations. The little H.O.P.E. clinic with solar power and clean water for basic nursing care was a bright spot, but was limited in its reach and capacity. To my horror, a pregnant mother who had been carried for several hours on a door to the defunct community hospital in town died in childbirth along with her baby. I would never erase that sorrow, and it literally became the crucible moment for ASB in my own mind.
Fast forward three months. Rose-Marie and I are sitting on the concrete ledge of an unfinished building overlooking the sea, taking a moment’s relief from the noise and chaos of market day in the village below. We have a strong budding friendship and complement each other well – a pure field anthropologist and a systematic business leader. Thinking out loud, we create a vision of a true health system for this community – one that is modeled after Paul Farmer’s Partners in Health (PIH) work in Cange, Haiti. As a friend and advisor, Rose-Marie has access to Polo (his nickname) and we decide to ask for his help. That works.
A few months later I travel solo to Cap Haitian to meet Dr. Hugo Jerome, PIH’s medical director from Cange, to learn how to form a critical partnership with Haiti’s Ministry of Health (MSPP). Hugo and I travel to Borgne so that he can help us to assess and document the major needs. He explains to me how the aid system for Haiti works, and we lay out the plan to engage in that complicated process. Basically, we need to gain access to MSPP aid channels, staff, and support; and we need to reopen the hospital and expand the health network across the entire commune. Hugo, Rose-Marie, and I make contact with Dr. Ernst Jasmin MSPP’s Director for the North Department and he turns out to be another key to our future. Dr. J. tells us that Borgne is by far the worst health system in his coverage area, and he is motivated to open the channels that we need to augment our own limited resources. In January 2006 we meet at the Roi Christophe Hotel in Cap Haitian to bring the three key partners or MSPP, H.O.P.E., and MSH (USAID’s partner for Haiti Health) together to form ASB. Roles are defined and we launch ASB.
Looking back, I am amazed that it worked. We had so many setbacks and challenges that I can’t even remember them all. In Haiti, this is the norm as it goes in the saying “Deye Mon Gen Mon”, or “Behind every mountain is a mountain”. It’s true. Each obstacle that we overcome is met by another one. This is the work of community development in Haiti. Here is the real magic of ASB. At the same time that we were dreaming and formulating this plan, a young doctor recently graduated from medical school and returned to his hometown to change the world of health.
Meet Dr. Thony Michelet Voltaire. Just as we felt that we were almost hopelessly against the odds, Dok Thony inspires us to better understand how to build a community-based health model that reaches the entire commune. He is a brilliant and tireless worker who sparks not only our own contributions but also engages with the community to build the best rural health model in the north of Haiti. We are truly partners. The rest of this story is visible everywhere you look in the commune of Borgne. We capture snippets in our own H.O.P.E. communications and social media. When we are there it is palpable. It is my greatest gift that I have been able to be part of this story.
