Community health workers strengthen responses to HIV and COVID-19 – Haiti
In 2001, Micheline Léon felt bad. The then 33-year-old mother of three traveled from her home in the small town of Corporand in central Haiti to a clinic in Cange. There she was diagnosed with HIV and tuberculosis.
Fortunately, three years earlier, an organization called Zanmi Lasante, Haitian Creole for Partners in Health, had launched the HIV Equity Initiative. (Zanmi Lasante is the sister organization of the US-based nonprofit healthcare group Partners in Health.) This was one of the first projects in the world to effectively deliver antiretroviral therapy in poor rural settings.
Twenty years later, Ms. Léon is one of the 2,000 community health workers called guides of the Zanmi Lasante network. Versatile teams of support staff form the link between patients and healthcare establishments. They are also part of all discussions of the HIV Equity Initiative regarding patient care, treatment and social support.
Community health workers live in the areas where they work. They help ensure that patients recover and stay healthy. Their main roles include distributing medicines and making home visits, as well as connecting people with care. They accompany patients to clinics and monitor those who have missed their appointments. During the COVID-19 pandemic, caregivers have been key to Zanmi Lasante’s care and treatment work. Home care and contact tracing skills refined in response to HIV are now used for COVID-19.
Zanmi Lasante has a holistic approach to care that includes social services such as accommodation, food and transportation. Community health workers help coordinate any support needed. They also serve the community at large by organizing education campaigns on topics such as mental health and sexually transmitted infections.
Critically, coaches empower and inspire people to take charge of their own health. Mme Léon is a model at hand. Since starting treatment, she has stuck with it and her HIV viral load has remained undetectable since she started having viral load tests in 2017. She owns a small fruit and poultry business and occasionally spends time. in Port-au-Prince, where she has a new grandson. . She participates in various group activities at the Zanmi Lasante site in Cange, including support groups, viral load classes and mothers’ clubs.
“The psychosocial support I received from Zanmi Lasante made me realize that my diagnosis was not a death sentence and that I could go on and live a healthy and fulfilling life,” said Ms. Léon.
Another Haitian HIV program uses a community health approach. GHESKIO, the Haitian Study Group on Kaposi’s Sarcoma and Opportunistic Infections, was founded in 1982, the year before the official discovery of HIV. It is the oldest HIV organization in the world and has conducted research and provided clinical care for the past four decades.
GHESKIO leveraged a community model to help Haiti respond to HIV and other public health crises. When the COVID-19 pandemic hit the country in March 2020, GHESKIO strengthened an existing program – Community ART Distribution – to ensure clients living with HIV receive a three-month supply of drugs. From a small room of the National Association of Solidarity (ASON), a team wraps drugs in plastic bags and adds to their list of clients. If a person cannot pick up their medication, they will receive a home delivery.
GHESKIO has also strengthened training activities for its versatile community health workers. In this way, they provided social support to patients as well as home care for cases not requiring hospitalization.
“Our community unit has played a vital role in the acceptance of new COVID-19 treatment centers in impoverished and overcrowded slums,” said GHESKIO program coordinator Patrice Joseph. “Together with the Ministry of Health, we have strengthened contact tracing, case investigation and management of COVID-19 outbreaks. “
One of the more recent community health workers is CV, a 35-year-old mother of three from Village de Dieu, a slum south of Port-au-Prince. She herself is a COVID-19 survivor. When she started to feel sick, a community health worker accompanied her to get tested. After five days at the COVID-19 hospital in GHESKIO, a community team made home visits to ensure his full recovery.
Now she works as a hostess at GHESKIO. She is also a GHESKIO community health worker, encouraging patients to come to scheduled visits. CV supports community awareness around COVID-19 prevention by promoting sanitation and educating people about the importance of COVID-19 vaccination.
“I don’t take a day for granted,” she said.