County to recognize Haitian hospital with Pittsburgh origins
Hôpital Albert Schweitzer didn't have enough beds to meet demand before a catastrophic earthquake rocked Haiti on Jan. 12, 2010, killing more than 220,000 people.
But with most hospitals in Port-au-Prince destroyed, droves of survivors made the three-hour trek from the capital to the unscathed hospital in Haiti's Artibonite Valley, an institution with Pittsburgh origins and Strip District-based administrative staff.
Police officers turned pickups into ambulances. Survivors carried the injured on top of old doors, on mattresses and in wheelbarrows. Patients lay on the hospital's hallway floors.
“Amputations were the rule rather than trying to do anything more sophisticated,” said Dr. Bill Swartz, a plastic and hand surgeon at Veterans Affairs Pittsburgh Healthcare System's Oakland campus. He has visited Haiti twice annually since the disaster.
Search teams spent weeks rescuing survivors and recovering bodies trapped under the tons of rubble the 7.0-magnitude earthquake left behind.
Five years later, Allegheny County Executive Rich Fitzgerald is holding a proclamation ceremony Monday morning to honor the life-saving work of Hôpital Albert Schweitzer, which opened 60 years ago as the brainchild of public health pioneer and Pittsburgher Larry Mellon.
Yet, the work to rebuild Haiti's health care system — sparse and ill-equipped even before the earthquake — is in its infancy.
“We can't just focus on the next 12 months,” said John Walton, Hôpital Albert Schweitzer's board chairman. “We have to think in terms of five years and 10 years.”
Donations are drying up as the worst earthquake to hit the country in 200 years fades from public memory.
Strapped hospitals are struggling to come up with revenue streams that would ensure long-term sustainability.
That's the top concern for Andrew Mayo, CEO of the Texas-based Medical Benevolence Foundation, the primary supporter of Léogâne's Hôpital Sainte Croix, a 60-bed facility rebuilt in September 2010 with the help of the Pittsburgh-based Brother's Brother Foundation.
“Even though people gave money, like for instance to rebuild this hospital, there really are no funds for ongoing administration and training and equipment,” Mayo said.
“Here's this great building, but now, you're trying to run it, and lots of people can't afford to pay the bill.”
Political instability underpins the litany of problems in the poorest country in the Western hemisphere. If politicians fail to vote by Monday on holding elections, Haiti will fall into a one-man rule by decree under President Michel Martelly.
“We think it's better if all three branches of government are existing and functioning, and so we think there's a fair chance that they can reach that kind of agreement by Monday,” Thomas Adams, the Department of State's special coordinator for Haiti, said Thursday on a call with reporters. “We're certainly urging them on.”
The Red Cross raised $1.2 billion worldwide, and Congress appropriated $4 billion toward Haiti relief, but Adams acknowledged that the level of donations anticipated “did not materialize.”
Much of the aid that did pour in didn't filter down to where Haitians needed it most, amid the lack of proper infrastructure to get it there, said Kathleen Hower, CEO of Global Links, a Green Tree-based medical relief organization that has supported 26 hospitals in Haiti since 2010.
“People have great intentions, but these aren't simple things,” Hower said.
“You have to support the physicians that are there,” she said, “and train people in the context of their culture — you can't come impose it.”
Mayo is concerned about the impact of Doctors Without Borders closing a key facility later this year. Hospitals like the one he supports in Léogâne will have to take on its patients, accustomed to free, high-quality care.
“They're going to lock it up and leave,” Mayo said.
“It's one of those situations where you really have to think through how you equip people and how you help them, because sometimes helping can be worse than the original problem.”
Swartz, a University of Pittsburgh professor, said each time he travels to Haiti, he's impressed by the planeloads of volunteers. But the relief effort's heavy reliance on outside support raises concerns.
“The government doesn't have to provide those services if (non-government organizations) are coming down to do it,” Swartz said, “so it kind of gets them off the hook, or it undermines the necessity of government doing those things.”
Progress has been made on several fronts, Walton said, such as increased prenatal screenings and more patients getting preventive care.
The cholera epidemic that killed more than 8,000 Haitians seems to be under control, though it could resurface the next rainy season. In 2011, the peak of the outbreak, Hôpital Albert Schweitzer had 4,677 cholera admissions. Last year, it treated 36 cases.
The 131-bed hospital has nearly 100 percent Haitian medical staff and serves a 610-square-mile district, roughly the size of Houston, including about 350,000 people, or slightly more than the population of Pittsburgh. Last year, its occupancy rate hit 106 percent. The U.S. hospital bed occupancy rate averages around 61 percent, Becker Hospital Review data show.
Haiti's lack of traffic safety enforcement and basic pedestrian features, for instance, means that newly paved roads have led to an alarming uptick in trauma injuries.
Surgery volume at Hôpital Albert Schweitzer is up 25 percent since 2010, up to nearly 2,000 major surgeries annually. About half are trauma surgeries.
Sterility at the hospital measures up to Pittsburgh facilities, but “the instruments are poor,” Swartz said. “It's things we take for granted, like an X-ray machine in the operating room.”
Swartz takes comfort in the individual lives he's affected. He recalls a 14-year-old boy, for instance, with a tumor on his jaw so enormous he could not open his mouth.
Swartz helped remove the tumor and rebuild the child's jaw using a bone from his leg, sewing together blood vessels using magnifying glasses because microscopes were not available.
“It's a lot of pressure,” he added, “but we do it knowing that there's no alternative for these people.”
Natasha Lindstrom is a staff writer for Trib Total Media.