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May 4, 2010

Funding drop threatens UCMC's Haiti operations

The Haitian field hospital where University Medical Center staff treated patients in the wake of the January earthquake is now struggling with funding issues and faces possible closure.

The Fond Parisien Disaster Recovery Center (DRC), located in the small town of Fond Parisien near the Domincan border, was established soon after the earthquake. Since its inception, the DRC has been run collaboratively by the University of Chicago, Harvard, and several NGOs.

The hospital has treated over 1,200 patients to date, but it may close soon. DRC administrators have applied for funding from the United Nations and the United States Agency for International Development’s Office of Foreign Disaster Assistance, but have been caught up in bureaucratic red tape, repeatedly being asked to resubmit their application.

“The reason the hospital is closing is due to funding constraints,” said Vincenzo Bollettino, director of Programs and Administration at the Harvard Humanitarian Initiative (HHI), which founded the hospital and displacement center. “The real thing that has kept us alive through this is individual donors. The U of C was a life saver because they provided some crucial initial funding,” Bolletin said.

University of Chicago’s support on the ground was mainly channeled through the Medical Center's Global Health Initiative (GHI)—aimed more at research, teaching, and clinical work abroad, rather than disaster relief—but its assistance seems to be nearing an end. “We’ve been scaling down for the past three weeks or so, and many patients have been discharged,” said Mélodie Kinet (A.B. ’08), a GHI coordinator.

“We are still talking with University leadership about the role that the University of Chicago is going to be playing in Haiti,” Kinet said, although not on behalf of the GHI.

The instability of the post-disaster environment in Haiti, as well as funding uncertainties, have made the decision-making process difficult. “The University won’t make a sound commitment about exactly what it will do, because that doesn’t make sense due to the conditions on the ground,” she said.

The U of C and Harvard have shared the burden of directing the hospital, with different physicians holding the position as they have flown in and out of the country. “We have alternated leadership the whole time based on who is available,” Bollettino said. “There is a very organized method of signing off to each other. The people who have led the operation so far have all worked together previously.”

The hospital has been directed by U of C physicians Christian Theodosis and Chrissy Babcock, but was placed back under the leadership of the HHI April 21, when Harvard’s Dr. Hilarie Cranmer returned to Fond Parisien for her third tour of the hospital. Cranmer has been involved in the hospital since its instantiation, founding the project in January.

A message on the HHI website calls for “urgent financial support” on behalf of the Fond Parisien DRC. “We would like to be able to reduce the number of patients, but a little more slowly. We would prefer to downsize over the next six months rather than the next six weeks,” Bollettino said.

While the overall environment in Haiti may be unstable and the leadership ever-changing, the Fond Parisien DRC “has been pretty-user friendly,” Bollettino said. “It’s safe, it’s clean, a lot of people know each other, and we have decent resources,” Bollettino said.

The program even has a Humanitarian Studies group, so that people come understanding principles of humanitarian assistance in addition to their own area of expertise, he said.

While speculation circulates, Bollettino foresees some type of continued presence in Haiti. “It has been a great project; it has just been a challenge because of funding constraints,” he said. “It’s likely that we’ll have a role in the medical treatment; it will just downsize.”

The project may shift away from a clinical presence toward support of other NGOs already working in and around the camp, Bollettino said. “The American Refugee Committee runs a family camp nearby, and housing is such a huge need,” he said. Other NGOs involved in the project include Love-A-Child Orphanage, which owns the land, and Operation Smile, which performed reconstructive surgery in the camp.

As programs such as 24-hour surgery fade, the hospital’s aims may shift toward case management and less intensive forms of care. “Getting people into their own homes or transitional homes instead of sitting in a hospital bed is important,” Bollettino said.

While the University of Chicago has not decided what its future involvement in Haiti will be, continued partnership with HHI and other NGOs on the ground in Haiti is a possibility. “We’ve had a really close partnership with U of C, and they’ve been amazingly dedicated in pushing this thing forward,” Bollettino said.

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