a couple of you know we meet with newsmakers and tweet about the stories that matter. i'm femi oke a and join the stream most people in haiti lack access to adequate health care so what can be done to resuscitate the country's medical system to join the conversation it's really easy you can tweak that age a strain or jump into a live you cheap shot and cure oh say industry. it has been 10 years since a massive earthquake struck haiti killing hundreds of thousands of people and leaving more than a 1000000 homeless the quake what destroyed the country's health care system a decade later it remains in ruins with an estimated 40 percent of the population still lacking access to care dr myleene they need with the challenge the hope for haiti she has one reason why you might. imagine a state hospital in order to receive care they send you away to go purchase medical supplies that means a person can come in with an emergency and without anyone and they won't be able to receive help the hospital doesn't have the supplies available to help the person that's the biggest problem we have in the health care system in haiti the state doesn't provide the materials for you if your doctors to care for the patients and the way you're supposed to. joining us to talk about haiti's health care system in port au prince she's head of mission to haiti for doctors without borders also in port au prince news he's the president of private hospital association of haiti and informed that long in a pair pierre he's a doctor and director general for haiti operations and support offis hospital hello everybody it's good to have you here. i am thinking back 10 years ago. frank this is what you look like i'm just going to share for you what you looked like back then and you were chatting and you were talking about the emergency situation what you remember about the earthquake what is the searing memory for you in haiti about that earthquake 10 years ago. from go ahead. really hello what do you remember from we see you here there are less tense behind you there's an emergency situation what do you remember was the searing memory you remember. it was basically a nightmare for every single asian family living in the metropolitan area i can tell you that they are about time i was just. hired by a kid i hate these to become. helpful she said i have the head of they have program for k.g. time and it was my 1st mission trip i was in good i have quick quick quick hit the country and for 26 hours i was unable to talk with my family and this was something that was the 1st time i had to leave this kind of things and i did not know whether or not my wife my kids the way because of their quick and this is pretty much what the almost everybody else remember from the 10 years the fact that people are living in port au prince was in despair people living outside of the of port au prince has a lot of questions that was on answered and it was very stressful so in a big you went from an emergency crisis situation 10 years ago to a health care system today which is what how would you describe how you think about in terms of health care. i believe i can say that the saudi happening frank i'm going to show that question because we have a few other people in the conversation you can stand by for a moment of an officer in a bag in the back go ahead ok so yes no i was you and i said yes so as you put it. right after the launch of our captain structure infrastructures were destroyed. you know quite an editor actually not more. because it's actually an operation has been growing since then and we have more and more people who are with you know i'm very very noble situation showing up to our doors on the daily basis so the challenge is i can say denise is it in years later. or before you wait because you know what has asked for if you're not our system. why needs to have to agree let me just bring sandra into the conversation this is a this is a an idea that looking at this decade since the earthquake that i sense a flip ted doc snap what is and what he be thinking about i'm looking here at the reports 10 years on and then looking at the health care system actually even doesn't hold up as a health care system sanjay what can you tell us about what's happening right now and i think if you're sick how do you get treated yes that's a good question access to health care is a daily struggle for the patients who need i can it is share some examples that may illustrate the situation better than statistics last tuesday so it's less than a week ago we received a pregnant mother you know. the health center that we support in the south of the country and background of this and there was a complication for this woman so we had to refer her to a public hospital or paid to 2 hours away which we did and so we arrive in this retro hospital at 8 a m. . and everyone tells us some ground it's ok that was a character we need and she had to wait for over 14 hours before being operated on so we got a call in the evening from the caretaker of the patient telling us but nothing had been done for her so we had to give a couple of phone calls to really i would say as it faced our needs 1st and make sure that she would receive them some parents she was operated on. send 30 pm. you know there are instances we receive specialists in this move us military that we refer to public hospitals but they ask us to bring the oxygen they ask us to bring for up to 6 takers to donate blood because they don't have blood available. and as the previous reporters that you just showed mentioned in many patients and because they care they need to purchase the gloves bandages and simple medical supplies themselves in private. pharmacies outside of the hospitals they want to have a chance of being taken care of this this is so important i'm wondering from this idea of having to bring your own medical supplies to be treated was this the case before the earthquake is it was now well just as quite fitting to the situation where if you don't go to the to the clinic or the hospital with your mates they don't have a really difficult time trying to train you fuck. up when it comes to the journalist done for instance an order because she too should. the situation became i consider became worse in terms of what the population needs to invest to receive care. year after year. the contribution of the of the household is becoming greater in the health care system so right now what you have you have. about one 3rd of the point of the investment in have care facility that comes from the outsource. and. the government in is it is investing very very little to do for the for servicing the patient what you need to understand is that when you take the public services the public as it does what you can see you can see even though the beatles are here physically present you are not certain that the services are available yes i'm not so i'm just glad you said that because we're looking at pictures of hospitals and i'm seeing equipment that i would expect to seen in most hospitals anywhere but what about i can tell you even more than that yeah. we myself and. we just said that there the situation is getting worse but when you look at the data you can see that they from 2010 there they have been additional health care facilities that the government will build you can also see that there are many other actions that was taken in the health care system. many things has been done have been done and including many things including a situation that was built and equipped but when it comes to make them to turn them into operation are in a situation you do not have results from the form from what you have why do they have that front how tight from it is are in about why there's a new store new hospital in port au prince if it finishes in the head no you're not finished how long the take the hospital. yeah it depends on the of that magnitude you know call complexity. theory dating thanks but that bending was it was forecast to be finished last year in actually in 2018 it's not that into that's been 14 so basically 2 years. on a combat mission so it's still there and it would absolve a lot of need for that medical treatment area or so far like centers like this and manifest in that it's obvious you know out or doing the work that. in a in of amps i've said that if you're cutting. you're cutting in and out and people have to appreciate that in haiti connectivity is not a way smith's apologies about that in a bear which is going to jump out of here just for a moment santa when i asked why the general hospital in port au prince was not finished you smiled slightly as a very knowing smile what was going on there we thank you i was thinking that of course it's it's a pity that the construction is not finished but i mean beyond the construction there has been a lot of focus on reconstructing rebuilding the infrastructure after the earthquake which was obviously highly needed but it's the top of the iceberg if you don't have money and qualified staff to run this what so isn't this absolutely it's not going to work what is really i think painful to observe is that. maybe 15 years ago in 2006 the part of the national budget that was there to get you to health care was over 16 percent of the national budget and today it's only 4 or 4 and a half per cent of the national budget that if your health care and health is not prioritized by the government it's underfunded and so even if we finish the construction of the general hospital. which nobody really knows when this will happen you will still have problems to make sure that someone can actually run dismiss realty. i'm just wondering frank as. people watching this thinking there are such a huge response to haiti's earthquake ever so much money they in pumped into haiti why are you not the switzerland of health care right now because there was so much money coming to haiti that initial year 2 years after the earthquake people around the world wanted to help you what happened. the 1st thing you need to remember to remember that most of the money did not necessarily go into the health care system to the health system as a whole you had you had a very large part of this money that went directly to n.g.o.s and when i'm talking about n.g.o.s i'm not even talking about large was with consequential just like doctors without borders you had a lot of the money that was used by people. we can call volunteers on the field and we're talking about i believe the 1st the 1st year it was around $2000000000.00 that the that the 80 receiving dems are going ation and all together but they will do that very little as little as one or 2 percent came to the system so it was not very much money that they was helping to to to build that to build back our health system we tried to actually have a plan the country tried to have that by 2012 and it is not before 2000 tour in 2015 that the country was able to release a documented form or document as a as a national health policy so this money came along but we cannot say that the use of this money was one flight in terms of rebuilding our system in a bad how do you practice medicine under this kind of situation if you have a limited amount of medicine the patients are bringing that you don't have and the right amount of funding how do you even practice medicine. working or. yes i work in that private hospital working in this silence so our management system is a bit different done the public asteroids so we've been there on a for more than 30 years providing health care to the moscow know of are interested in finance and. so. we've been all going well year after year we'd patience you know basically we patients coming from the port au prince area and are there way to be degree and a lot of violence and find everything in this out because or little rock there is no major medias occur and i'm so proud of the work that we do so we really strive to do them was that we can in a very difficult and by one event because we need to address problems that should be addressed by our defense and it is i think a lot how do you mean that will strike to the best we can don't give me an example where you can striving every day yeah for example every day 120 bed hospital is about we have been saying about 1000 patients every day and then the access to our hospital because we are working in the better we will area we don't have like it would to our hospital and many people and show off on a daily basis. to our doors but we can't basically turn any patients away because we know that if we turn patients away they wouldn't have access to the basic care that they need so we need to do more than we should because access and options up and we need it and we share some of the conversation found with iran in a battle front as well. the happening on the and. there's a been a back and forth about who is responsible emery says all of what the guests are talking about boils down to a failure of governance what we haven't talked about are the protests the protests and bubbling up of the last couple of years and some of it is about corruption some of it is about we just don't have enough money to live and the health of the public of course is very very important role of that sounded i don't we take a political position but governance is that government is the difference between haiti succeeding right now in sailing in terms of health care. yes you're right it's governance is definitely part of it and good also maybe if i can go back a little bit we all need to remember that in 2010 we estimate that 60 percent of the health system in the house facilities were destroyed so the reconstruction would have been a huge effort anywhere else and to add to this the problem is that we also had successive health care emergencies in the country and we had the cholera epidemic in the same yairi in 2010 but also i would say took a lot of effort for the father already damaged health system to be able to cope with this and then there was the hurricane matthew and then more recently the political and social situation that you are describing i mean not commenting on the on the reason for the demonstrations which we understand perfectly but the problem with the strategy that was adopted especially at the end of 200-1000 the big a lot is that when you have barricades everywhere it makes things worse for access to health care because patients cannot move out cannot go to their house the city's health facilities themselves have not been able to receive fuel to make sure they can run the o.t. they were not able to receive oxygen basic supplies blocked so this created a lot of problem for the population not to mention that somehow it's got to cities where attacks the general reference hospital for the department of the south was attacked and looted twice the blood bank of the south department was also looted and and today we're in in january 2020 it remains close so the only way through to i actually really appreciate was when dr care say because we work in a small village in the south which is located 5 hours away so the somebody has hospital but very frequently and more and more we need to a driver. this 5 hours to get through somebody 1st off before which should not be a record last night so i mean there are 456 different hospitals between the team or where we work and there's somebody that's also with somebody 1st is the only one being able to operate quality of care and as dr pierce said they accept everyone so they are really grateful for the work you're doing and i mean i wish there were more hospital such as yours suggest. let me know you know that they did that for the go ahead go have found i'm not i want to bring in some other comics people watching and they want to ask you questions so the place that can get to that question i want to talk to get let me just add to that that 111 point one very important point. to make about the health care system is. the governor thought the system and in its entirety. i believe one of the main problem of. operates in terms of health care and this is not just washed out. when it comes to social services it's leadership in general contrie but also the leadership of the sector actually. the health care system in. health care for everything this is a good one ter so this is not right at the public front i'm going to put it to you i was going to push it because we spent way too much of this program talking about all of the problems and not enough talking about how to solve them which is probably the issue of waves with haiti anyway so many problems and not enough solutions let me bring in clothing for us watching as a community health program coordinator she is thinking about haitian solutions for haitian issues have a listen to. this people who live in these communities find it very difficult to find health care when they are sick for this reason our program where we have mobile clinics where we travel to find people in these communities so we provide health care also we have community health workers and the zone's who work with children in schools where they do sanitation education with the children and they have 1st aid kits so when they are sick they can have access to 1st aid and we train the community health workers on their medications and materials so they are ready to provide 1st aid so when people are sick they can find 1st aid in the meantime before they go to the hospital. to get another push i want to call this the speed round i want an instant reaction to this frank you stop so if you're looking for unique solutions to the health care issues of haitians name one thing wow that's some drastic because i have we hope also that the i. i put on my note. to share with your family that when you could have just about ready for it one i wanted to. touch it while i mean it you know if and when i talk about community as i would like to remind the fire that in 2016. when they relieve the last. police ignition of policy for hair like remember that is the speed round make it quick so before if initial did so yes it could help with confident what could be the bad blood that you see you have that they don't want to put in place and even if he does get back i want to share this with a colleague in a bad immediate solution that you know from the work that you've done what is it for health care how do you help how to get votes in haiti yes i think we need to build this system we have doctors we have to have infrastructures we have nurses we have many things but we don't have this system yet so we need a system with certain obviously yes when you say it's so obvious is it even possible that how do you build a system from scratch so i think 1st we need to outline and then make sure that we hadn't defined the key players and we're responsibility is clearly defined. and. people are combo because rand presenting us exactly as i you know beth thank you thank you so much so i need had plenty of time to think instant. where do you know and you've been in haiti for a very long time so you must obviously see how do we do this better name one thing training definitely training and i want to name one success story it's actually a ballet there is a university hospital run by doctors ship the government and haitian american organizations and partners in health and they're just over saying last week i think international recognition. and certification stronger training they are providing is a huge success story and we should all replicate more of it and this is what will so we tried to do. as we go. thank you thank you 2 in a bad to frank and also to sandra i believe you have a comment here on each face says is there something i can do to help the health care crisis in haiti from here in america here in the states that we can put pressure on who should i donate to we will jump into the live chat it is curated we ar