ADULT: HIV AND MICROFINANCE

ILRICK'S STORY:
A mother living with HIV enrolls in Fonkoze’s program for the poorest of the poor in Haiti.

Women who receive microfinance loans enter the local marketplace and earn money to support their families.

If you are walking through the small Haitian village of Bento and find yourself hungry for some bread or cookies, or maybe just some fresh fruit, you may find yourself in front of the home of Ilrick Louis-Fils.

Ilrick sells goods in front of her home.

For just over a year now, Ilrick has sold food and refreshments from a small basket in front of her house. Because she lives on the main path to the nearby market, Ilrick has had no trouble finding customers. During that time she has watched her profits steadily grow. In fact, today she buys food for her two children and pays for them to go to school.

All of this would have seemed unimaginable just a few years ago.

In 2009, Partners In Health’s network of community health workers found an emaciated and sick Ilrick. She was referred to the organization’s nearest medical clinic in Boucan Carré. Tests revealed that she was living with HIV. Within days, Ilrick began taking antiretroviral therapy drugs (ART) and receiving comprehensive care.

As with all PIH patients living with HIV, Ilrick is visited daily by a community health worker. This health worker, a woman from Ilrick’s village, keeps track of the family’s health and works to connect them with psychosocial support programs.

A unique microfinance institution lifts women out of poverty

Thanks to Partners In Health's close partnership with Fonkoze, Ilrick had access to more than just health care. Soon she was a client in the microfinance institution's program for the extremely poor. The largest such organization in Haiti, Fonkoze serves more than 56,000 women borrowers and more than 250,000 savers—all of them poor and all living in rural villages. As of early 2012, Fonkoze’s network of 46 branches cover every region of Haiti. 

A busy market flourishes in Boucan Carré near the new Fonkoze bank (left), the new hospital (center), and the old clinic (right).

Ilrick was enrolled in Fonkoze's Chemen Lavi Miyò program, which translates as Pathway to a Better Life. Chemen Lavi Miyò Director Gauthier Dieudonne describes the women selected for the program as utterly hopeless. They are the outcasts of their communities, often indebted to their neighbors, living in shacks with mud floors and leaking roofs, and without a sanitary place to go to the bathroom. They cannot afford to send their children to school, and they go hungry for days.

"Where they live—some people would not put their animals there. They only live to eat for that day. All their efforts are put into one thing, just to getting the meal for that day."

Born out of a conversation between Paul Farmer and Anne Hastings, CEO of Fonkoze, the program searches out the most destitute women in poor, rural communities and provides them with income-generating assets such as livestock and a stipend to help stabilize their income. It also helps them to start a small business.

Throughout their 18 months in the program, participants receive weekly visits from case managers who accompany them on their journey out of extreme poverty. They counsel the women on family problems, give business advice, and connect them to the health services of Zanmi Lasante, Partners In Health’s name in Haitian Creole.

After participating in the program, they can re-connect with their communities and participate in the economy.

"The transformation is unbelievable," Dieudonne said. "It's not that we provide them with some assets, or provide them a stipend so they can eat better. It's how they feel about themselves. There is this hope in their face. They feel like they are no longer alone. They finally feel like they are somebody."

The birth of an entrepreneur

With money from Fonkoze's Chemen Lavi Miyò program, Ilrick began selling groceries from her home. The program also gave her family three goats. 

She worked as hard as her strength would allow her. Soon she was making a small profit.

Working together, PIH and Fonkoze help patients overcome illness by helping them break the cycle of poverty that keeps them sick. While PIH provides medical care to Ilrick and other women like her, Fonkoze accompanies these women as they enter the local economy, earning money to support themselves and their families.

In fact, two of PIH’s hospitals are located right next to Fonkoze branches. Paul Farmer once explained the partnership by saying that he was tired of watching people recover from illness only to have them suffer from poverty that medicines alone cannot cure. “Good public health requires more than just medical treatment,” said Farmer. “It takes economic development, too.”

From a shaky start, a solid businesswoman emerges

The turning point for Ilrick’s business came when she was able to save 2,000 Haitian gourdes (US $50) and buy a small horse. The horse allows her to make weekly trips to the nearby city of Domon, where she can buy food and liquor for her store at a cheaper price.

Ilrick and her new horse.

Today her weekly sales average about 600 gourdes (US $15), at least half of that is profit. In 2010, the World Bank estimated that the average Haitian family earned US $671. With a yearly takeaway of roughly US $390, Ilrick’s earnings are still far below the national average. But she is thriving. 

"I used to have to beg for something to feed my children every day," said Ilrick. "I had nothing. We didn't even have a dry place to sleep at night." With the help of PIH and Fonkoze, Ilrick has put a tin roof on her wooden house. Healthy and making money, she has a new lease on life.

Ilrick is now planning for the future. She is expanding the number of items she sells. Two of her three goats are pregnant. And she would like to buy a cow. In addition to the milk and the calves it could provide, it would also serve as an insurance policy, an asset that gives her greater leverage in the local economy.

Learn more about Fonkoze.
Learn more about PIH’s work providing microfinance loans in Peru and Malawi.