Partners In Health has often been discussed as the NGO that has one of the most successful models, but by looking at its shortcomings it paints a more realistic picture of the challenges in delivering health to peoples in developing worlds. Seeing its development and its efforts to expand demonstrate the moral obligation many feel towards providing adequate healthcare to all people, despite the dangers and unanticipated consequences as seen in their intervention in Sierra Leone.
Drawing back to the three core principles of Belmont Report, PIH has been successful in giving back dignity to impoverished people. Instead of focusing solely on the “zoe,” which groups like MSF are only equipped to do, PIH attempts to make humanizing people a goal. This is why I found the events in Ebola particularly shocking in regards to the Sierra Leone health worker. Health workers contracting a disease is probably one of the most feared unanticipated consequences of global health interventions. Out of the two health workers who contracted ebola, the one from Sierra Leone faced the most difficulty in being transported to a proper facility. Shouldn’t there be a moral obligation to protect health workers whether or not they are the “white savior” or a member of the local population. This brings up a question of valuing one life over another. Is the life of a foreign NGO worker more valuable than a community volunteer?
PIH has been greatly successful in delivering AIDS and tuberculosis treatment in Haiti and Rwanda, which is by no means a small feat, so its understandable why many other NGO’s would follow their model. By focusing closely on partnerships with the community, PIH manages to develop more effective treatment plans that combat low retention rates produced by structural violence. Both Zanmi Lasante in Haiti and Inshuti Mu Buzima in Rwanda demonstrate PIH success at forging community partnerships and the effectiveness of adding horizontal measures to improve vertical approaches. By giving incentives like food and transportation they improve the quality of life for people while at the same time serving more people. By removing some barriers caused by structural violence more people are able to in treatment longer.
While it’s nice to think that Paul Farmer has all facets of global health figured out, when looking at PIH’s ebola intervention there are issues in their approach. It brings into question why their model works in some cases but not in others. It’s necessary to develop programs “that are appropriate to the needs of the population” (Farmer 217). What differences are there in treating HIV/tuberculosis and ebola? How should PIH adapt their model to successfully treat ebola safely? In Haiti, PIH was able to forge strong community partnerships and train local people to be health workers which is an approach that successfully integrates the community into their intervention and gets them invested in the future. It allows for some growth in the health care system. For example after the 2010 earthquake in Haiti, Haitian doctors and nurses that were supported by PIH were able to respond to the disaster (WGBH). Vanessa Kerry, the CEO of Seed Global Health tries to implement PIH’s model and seeks to train skilled doctors and nurses in Haiti. In an interview she describes how 42 Americans were able to train more than 4,000 medical professionals in Africa. The PIH model realizes the need for extensive follow-ups that go beyond the immediate crises that organizations like MSF deal with, however this seems problematic in areas in immediate crisis. How can PIH hope to make long lasting change in more dangerous situations like Sierra Leone?
What approach should have Partners In Health should have taken in Sierra Leone? What are possible unanticipated consequences?
How can PIH form equal partnerships with governments and have effective leadership in their interventions?
Farmer, Infections and Inequalities, Ch. 8
Farmer et al textbook, Ch. 6
Fink, Sheri. “Pattern of Safety Lapses Where Group Worked to Battle Ebola Outbreak.” New York Times 12 Apr. 2015: n. pag. Print.
Ross, Elizabeth “Beyond Ebola: Boston Physicians Lead Global Effort To Prevent The Next Pandemic” WGBH News 28 Oct. 2015