A hospital for 250,000 people, with electricity for half a day

Can there exist a hospital with electricity for only half a day and no equipment to take x-rays? Yes and is operational in Jean Ravel (Haiti), a town an hour away by Jeep from Mare Rouge. I went there this morning accompanied by Madda, parish helper that takes care of the disabled. He introduced me to the director of the hospital, Blanchè, and together we made a tour of the facility. Through the eyes of a European, the situation is dramatic for several reasons: it is the only hospital in the Northwest of Haiti, it serves over 250,000 inhabitants, has no financial support from the State and the patients must pay for the care. I underline, through the eyes of a European it is a dramatic situation, but the local people are grateful for having a hospital, even if it takes hours to reach on foot.
In the structure there are four doctors interns, a gynecologist, a surgeon, eight nurses and approximately twenty trainees. There are 35 beds and there are “departments”; General Medicine, surgery, radiology, dentistry, laboratory analysis, Pediatrics and Gynaecology. “The situation is difficult,” the director tells us, “We do what we can with the resources we have. People arrive from the whole area, even from far away and in emergencies we try to help them, either with payment in instalments or in serious cases exemption.”
The hospital is not large: it is spread out on two floors and the departments are simple rooms. Conditions may seem bad, but Madda ensures us that “it is much better than some time ago”. It is now much cleaner and the Director has managed to create a real working team of doctors and nurses.
However, there are many problems. I ask the Director (pictured) if in future there is a possibility to buy a radiological equipment and he is very clear: “Before this we would like to be able to have light and electricity for 24 hours a day. Now at night time we no longer have lighting and for a hospital it is really problematic to continue under these conditions. “
The healthcare facility in the area relies on dispensaries, the surgeries: aren’t always open, but when the heads of clinics are located in front of a patient who, even with fewer resources, don’t manage to heal them, they are referred to the hospital. And the patient most times doesn’t go; they don’t have the money to pay. We cannot do otherwise,” explains the Director, “This is a state structure for the sanitary programmes and protocols, but we must be independent. But we never leave anyone on the street, a solution we almost always find. But in these conditions it is almost impossible to perform preventive care.”
The Director shows us the rooms of the structure. He doesn’t hides anything, he is proud. He’s been there for just over a year and shows the many changes that he has done. From cleaning to the organization. He lets us photograph everything. “We need a lot, even medicinal products,” he concludes, “After the earthquake of 2010 we had enough medicines thanks to humanitarian aid received from all over the world. Now the support is greatly diminished, it is a problem finding many drugs. Here we are doing miracles and it often happens that even doctors and nurses organise collections to support a patient’s care, **but more than that we do not know what we can do**.”