The project delivers care to vulnerable patients and supports the delivery and accreditation of a residency in internal medicine at the University Hospital of Mirebalais, Haiti. Haiti suffers from a shortage of physicians and other healthcare providers, with a ratio of only 0.64 healthcare providers (doctors, nurses and midwives) per 1,000 people, which is well below the World Health Organization’s recommendation of 4.5 providers per 1,000 population. Physician shortages are even graver (.25 per 1,000); only half of these physicians have any specialist training beyond medical school and they tend to be concentrated in the capital of Port-au-Prince. Many Haitians who do train in health care move abroad because of Haiti’s economic circumstances and insufficient opportunities in the country for ongoing training, mentorship and support. Internal medicine physicians specialize in the internal organs, including the heart, kidney, liver and lungs, and have expertise in managing diseases of these and other organs. As a result, their expertise is especially essential in managing such non-communicable diseases (NCDs) as cardiovascular disease (the #1 cause of mortality in Haiti), diabetes (#5), chronic respiratory disease (#8) and other non-communicable diseases (#10). Haiti’s disease burden is high, and the demand for this specialist knowledge is great, especially in areas outside of Port-au-Prince. Every year, of the roughly 200 new residency admissions in Haiti, an average of 17% are in internal medicine. According to the Paquet Essential de Services , Haiti would need at least 60 internists by 2030 to meet the basic staffing needs of existing primary and secondary healthcare facilities, as recommendations call for a department hospital serving a population of between 450,000 and 550,000 to have at least three staff internists. By assuring that internal medicine residents are available on a 24/7 basis in the impoverished, rural area where UHM is located – while also building platforms for health professional retention – PIH/ZL is strengthening the healthcare system for some of the most vulnerable populations in the country.
