CMMB leaders: Haiti initiative's success depends on community involvement

May 1, 2014


In some international aid circles, Haiti is becoming known as the "land of the NGO," with nongovernmental organizations of all stripes from around the world swooping in periodically to try to solve the many, deeply entrenched problems of the Caribbean nation.

But there's frequently a lack of coordination between the incoming organizations and the Haitian people, and so aid efforts often fall flat, said Erin Snyder Ulric, regional manager of Latin America and the Caribbean for the New York-based Catholic Medical Mission Board, an international medical charity.

Catholic Medical Mission Board officials and Cotes-de-Fer community members involved with the Children And Mothers Partnership program view the future site of the Cotes-de-Fer hospital and health center.

Snyder Ulric said CMMB's approach to advancing a women's and children's health initiative in Haiti's poverty-stricken Cotes-de-Fer will be different from many other organizations' aid attempts because "we are really setting up a community participatory approach, and engaging" Haitians in the work.

Lara Villar, CMMB senior vice president of strategy and organizational measurement, said the initiative, which includes the construction of a small hospital, has received generous support from Cincinnati-based Catholic Health Partners.

CMMB will be helping Haitians "to be more proactive, because if they are not proactive, this (work) will not be sustainable," she said.

Villar said impoverished Haitians have had trouble taking the first steps to improve health care access in their communities in part because they had grown accustomed to NGO-directed aid programs, and the locals had no direct contact with people and organizations that could help them begin to take initiative and ownership of improvement initiatives.

CMMB plans to help the Cotes-de-Fer community to create and execute a community-conceived strategic plan for improving health care access. It will do so in part by brokering relationships and in part by mentoring and encouraging Haitians to become actively engaged in efforts they will be able to sustain. "We plan to empower the community to be at the center of this effort. We're a convener," linking the community to influential organizations and people, Villar said. "We're developing tools so they can help themselves. They decide what the problems and solutions are, we provide the technical expertise."

Rooted in the community
CMMB plans to conduct a three-month community assessment to identify or better understand local health conditions, community partners, cultural factors and the socioeconomic environment in Cotes-de-Fer, said Sr. Kathy Green, RSM, CHP senior vice president of mission and values integration. This "community engagement is an integral component" of the effort, she said.

While CMMB has not yet identified the community members and organizations it will involve in the Cotes-de-Fer effort — that will happen during this summer's assessment — Villar said the list likely will include community leaders, ordinary citizens, and health care providers. CMMB will seek commitments from individuals on how they will contribute to the health initiative.

The Haiti effort is the first implementation of the CMMB-led approach called CHAMPS — the acronym for Children And Mothers Partnerships. Through CHAMPS, CMMB is collaborating with community members in-country as well as with donors, agencies, community groups, Catholic health care providers and others in the U.S. and globally to focus significant resources on achieving lasting change in targeted communities overseas.

Villar said CHAMPS is a departure from CMMB's usual approach to aid work. Until recently, the organization engaged in isolated aid projects involving medical supply donations, placement of medical volunteers and the administration of grant-funded projects, including U.S. government grants. CMMB is continuing those methods of aid, but now is also "using greater focus, identifying sustainable funding models, measuring impact, and starting to work on an integrated way to address issues," said Villar.

Under the new approach, CMMB has held discussions and forums with hundreds of people including international aid experts in the U.S. and community members in parts of Africa, Latin America and the Caribbean, regions where CMMB already has a presence, to learn where the highest levels of need are and to determine the best approach to address those needs. This strategic planning process was used to identify goals and CHAMPS project sites in Haiti, Peru, Zambia, South Sudan and Kenya.

CHP is providing a $2 million matching grant for the Haiti CHAMPS effort. Sr. Green said CHP is investing in CHAMPS in Haiti in part because the approach incorporates and builds upon interventions that have been successful in other aid programs.

Hard slog
According to the Central Intelligence Agency World Factbook, Haiti is the poorest country in the Western Hemisphere, with 80 percent of Haitians living under the poverty line and 54 percent in abject poverty. The fact book says the country's economic growth has been hampered by poverty, corruption, Haiti's vulnerability to natural disasters and low levels of education among the population — issues exacerbated when the 2010 earthquake destroyed much of the country's infrastructure, especially around its capital, Port-au-Prince.

Bruce Compton is CHA senior director of international outreach. He said aid efforts in Haiti often are difficult to execute because of the lack of consistent access to resources in the country, especially medications, technology and staff. Villar said even when a community has a health care facility — Cotes-de-Fer currently has one small clinic serving an area of about 55,000 people — the community often does not have the funds to maintain staff, equipment and services.

Villar said many citizens in Haiti "believe they have to be paid to be involved" in a project. Or, "When you ask them what they're able to commit to a project, their mentality often is 'I'm here to receive.' But if you start to walk away, they often change, and start to raise their hands to contribute," she said.

But, CMMB believes its strategy of deeply involving the community will help it overcome these barriers. Villar added that Haitian women will get involved once CMMB makes clear "the effort is for the well-being of their children."

Dr. Dianne Jean-Francois, CMMB's country director for Haiti, said that the mindset of Cotes-de-Fer residents "has already started to change." The community donated land for the new hospital and citizens are participating in community meetings regarding hospital planning and construction, health education programming and water system sustainability.

CHAMPS commits to women and children

Announced last year, the Catholic Medical Mission Board's women's and children's health initiative in Haiti represents a 15-year commitment to work with the Cotes-de-Fer community on aiding women and children, the groups that are most vulnerable to sickness and death in Haiti, according to Lara Villar, CMMB senior vice president of strategy and organizational measurement.

The six goals of CMMB's Children And Mothers Partnerships are: saving children from life-threatening conditions like pneumonia and malaria, saving mothers from complications of pregnancy and childbirth, saving women from potentially fatal chronic diseases, improving nutrition, increasing safe water and sanitation and increasing access to medicines.

Plans include the construction of a 30-bed health center and an accompanying guest house. The Haitian Ministry of Health has committed to help staff the health center. The ministry runs and funds most of the health care facilities in the country. Erin Snyder Ulric, CMMB regional manager of Latin America and the Caribbean, said it has been difficult for health care facilities in Haiti to maintain staff, equipment and services; and it has been hard to get a remedy for such problems from the health ministry; but, the memorandum of understanding signals the potential for a different outcome for this project.

The Filles de la Charite de Saint Louis, an order of women religious from Canada that already is serving in Cotes-de-Fer, plans to take over administration of the health center from CMMB.


Copyright © 2014 by the Catholic Health Association of the United States
For reprint permission, contact Betty Crosby or call (314) 253-3477.

Copyright © 2014 by the Catholic Health Association of the United States

For reprint permission, contact Betty Crosby or call (314) 253-3490.