Laying the cornerstone of PIH's work to help Haiti build back better

	The construction site of the future National Teaching Hospital at Mirebalais.
	Haitian Minister of Health Dr. Alex Larsen addressing the crowd at the cornerstone laying-ceremony on September 10.
	Father Jean Jeannot of Mirebalais (with shovel) laying the cornerstone with Father Fritz Lafontant (center, in black), the founding director of Zanmi Lasante.

On September 10, in partnership with the Government of Haiti, Partners In Health (PIH) and its Haitian sister organization, Zanmi Lasante (ZL), laid the cornerstone for the $15 million, 320-bed world-class National Teaching Hospital in Mirebalais, Haiti. The new facility is itself a symbolic cornerstone of PIH’s long-term, post-earthquake rebuilding efforts.

"On the seventh day after the earthquake, the best hospital in the country was floating in the harbor on a ship, the USNS Comfort. Is that fair? Is that right?” PIH co-founder Paul Farmer asked the crowd of several hundred people who gathered for the event under a large tent pitched on the site of the future facility. “The answer of course is 'No.' That's why we're here today, to do something unprecedented in our history—to build the finest hospital in the country right here in the center of Haiti."

In addition to destroying many of Haiti’s medical facilities, the January earthquake also demolished the country's nursing school, killing more than 200 students and faculty, and disabled the only public teaching hospital. At a time when Haiti desperately needs skilled health professionals, the country has been hamstrung in its ability to train its own people to fulfill these roles. The new hospital will help teach the next generation of Haitian doctors, nurses, and lab technicians, equipping them to take on the challenges of rebuilding and strengthening the Haitian healthcare system.

"This is not just about a hospital. It's about building back better," added Farmer, who is also the Chair of the Department of Social Medicine at Harvard Medical School, and Chief of the Division of Global Health Equity at Brigham and Women’s Hospital in Boston.

The new hospital was one of the first projects proposed by the Haitian government and officially approved by the Interim Haiti Recovery Commission, a Haitian and international joint effort led by Prime Minister Jean-Max Bellerive and former President Bill Clinton to oversee the national recovery and development plan following the earthquake.

The Haitian Ministry of Health has been an active partner in developing and expanding plans for what will become a flagship public medical and teaching facility. "We don't have the capacity to do this without the Ministry of Health," said Farmer. To symbolize the government’s commitment to the project, Haitian Minister of Health Dr. Alex Larsen and Director General Dr. Gabriel Timothé spoke at the Friday event and took up shovels to help lay the cornerstone.

In fact, the National Teaching Hospital was technically Dr. Larsen’s idea, said Farmer. Before the earthquake, PIH/ZL had originally planned to build a smaller, community hospital at the site. Following the tragedy, the Ministry asked PIH/ZL to revise the project into one with a much larger scope and future impact.

“What Haiti needs now are true partners to help us build back better by strengthening our country's public infrastructure,” said Dr. Larsen in an interview prior to the cornerstone-laying event. “The new teaching hospital at Mirebalais will be a model for our national health system, offering high-quality medical services, a place for our clinicians to study and train, and hope and dignity to all who will seek—and offer—care there. We look forward to building upon our long-standing partnership with Partners In Health/Zanmi Lasante with this desperately-needed facility."

By the first anniversary of the earthquake—January 12, 2011—the seven buildings of the main hospital campus, comprising 180,000 square feet, will be standing, with work on the interiors begun. Plans call for the hospital to be accepting patients by the end of 2011.

In addition to being a major training facility, the hospital will also serve as a central referral center for the country. Mirebalais is located at the intersection of two main roads in Central Haiti that have been major thoroughfares for earthquake survivors fleeing Port-au-Prince.  It’s estimated that 20,000 people have migrated to the area, which means the hospital will immediately serve at least 160,000 residents. To serve such a large population, the hospital will have 320 beds—nearly matching the combined capacity at the 12 facilities now operated by Zanmi Lasante. Estimates of the demand for health care in the area suggest that the facility will serve approximately 450-550 patients per day.

The state-of-the-art clinical facilities will include an intensive care unit and an operating theatre complex with six operating rooms equipped for thoracic surgery—services not yet available at any public site in Haiti. The hospital will also provide comprehensive, community-based primary and prenatal care as well as treatment for TB, HIV, malaria, and malnutrition. In addition, the facility will feature cutting-edge infection control systems, wall-mounted oxygen and medical gases, improved diagnostics (digital x-ray and ultrasound), and solar panels to power the facility.

Partnerships with leading universities and teaching hospitals in the United States, including Harvard Medical School and Brigham and Women’s Hospital, will support the medical training and education of Haitian clinicians, as well as that of visiting international clinicians. Fittingly, a group of residents from the Brigham who were in Haiti for a training also took part in the cornerstone-laying event. The new hospital will also include the technological and logistical capacity to support educational exchanges, distance learning, and remote collaborations.