Klinik Fonfred is a 3,500 square foot primary care clinic located in Les Cayes opened in 2015 and is the center piece of our work. The clinic is entirely operated by a Haitian staff including a director, doctors, nurses, clerical and support staff. Klinik Fonfred is able to offer services scarce or entirely unavailable in southern Haiti. We serve a population of about 15,000 people. This includes the village of Fonfred and the immediate area surrounding it. We have digital x-rays and laboratory services that were unheard of except in Port-au-Prince which is 8 hours away.
Klinik Fonfred is open 6 days a week and 30-40 patients are seen each day. Services offered include prenatal care, preventative medical care from birth through old age, acute medical care of illnesses common in the developed countries such as ear infections, pneumonia, vomiting and diarrhea to illnesses common only in third world countries such as Tuberculosis, Zika virus, Malaria, Cholera, and severe malnutrition. Chronic life threatening illnesses never before diagnosed or treated are now managed at the clinic. Some of these illnesses are: high blood pressure, diabetes, acid reflux, and arthritis.
Patients are charged a small amount of money for services provided at Klinik Fonfred. However, no one is ever denied services because they cannot pay. This includes seeing a doctor, receiving medications from our pharmacy, and lab services or x-rays provided at the clinic. There are several reasons why the decision was made to charge a fee for services. The majority of people in Haiti express embarrassment at the need to accept handouts and free services of any kind. There is a certain dignity and improved self-esteem in being able to pay for their medical care. The prices set at the clinic are affordable even in the face of severe poverty. We serve the village of Fonfred and the immediate area surrounding it but since the opening of the clinic people have come from many areas outside of the Fonfred area; Aquin, Camp-Perrin, Torbeck, Port Salut, Chantel,and Ducis to name a few. People are driving from hours away to receive these services. We are able to provide medical care in the face of overwhelming poverty, so people come.
For $20 US we are providing all of the medical care required for a child for an entire year. This includes 1 well visit each year, all required vaccinations, sick visits, medications, and lab and radiology services offered at the clinic. This kind of care is unheard of in this area of Haiti. Down the road from Klinik Fonfred is Loving Shepherds who as part of their good works they provide a home for 200 orphans or children “at risk”. Klinik Fonfred has an agreement to provide the medical care for these children for $20/year ensuring these children get the medical care that they need.
The 2018 operating budget for the clinic $160,000. This cost to run Klinik Fonfred is shared between Forward Health and Gaskov Clerge Foundation (GCF). GCF was planning on building a medical clinic and emergency room just a few miles away from the almost completed Klinik Fonfred. Rather than duplicate services the board of directors of FIH and GCF met and decided it was best to combine efforts and not duplicate services. The two organizations have remained separate but work jointly to operate Klinik Fonfred. Each organization is responsible for half of all costs in running Klinik Fonfred. Each organization is committed to providing the life-saving care at Klinik Fonfred.
THE NEED – Klinik Fonfred Operating Costs
The initial budget for the first year to run Klinik Fonfred was $150,000. As word of the affordable high quality medical care available at Klinik Fonfred has spread, the need to hire additional medical staff has increased our budget. In 2016 a third full time and then fourth part time physician were needed and hired. The success of the clinic, providing life-saving medical care for more and more patients, has required an increase in all expenses from pharmacy to medical supplies.
As modest as a physician’s salary is in Haiti compared to a developed country, currently $10,000-$20,000 per year it is still a lot for us. FIH and our partner supporting the clinic, Gaskov Clerge Foundation are small fish in the world-wide pond of non-profits. The staff for both non-profits in the United States are completely volunteer. No one is paid a salary. The staff in Haiti is as small and lean as possible to still do the required life-saving work. Adding new required staff at the clinic has a significant impact on the budget.
Medications are expensive everywhere. Haiti is no different, and in fact often worse off. Quality medications must be imported from another country which increases the cost. The pharmacy has proven to be a “budget buster”. Initially budgeted at $6,500/year, it was doubled during 2016 prior to the hurricane to $13,000. In 2018 the budget was up to $26,400 for the year for medication. 3/4 of the way through 2018 we found that we were averaging $4,442/month! This is despite efforts to control costs such as buying generic medications whenever available and having a limited variety of medications on hand. For 2018 we have the expertise of a U.S. pharmacist, Amber Suszek, Pharm.D. She is helping to provide accountability and professionalism to the pharmacy.
The philosophy of both Forward in Health and our partners supporting Klinik Fonfred Gaskov Clerge Foundation is to provide a hand-up to the people of southern Haiti working at the clinic. This is one reason why whenever available Haitian’s are hired to staff the clinic. Rather than providing charity we are providing jobs. With that comes the responsibility to provide a wage which allows people to climb out of poverty. They deserve a fair wage. Not only are they providing life-saving healthcare, they are able to support themselves and their families.
Keeping this in mind, both Forward in Health and Gaskov Clerge Foundation understand their responsibility to their donors. Being lean effective non-profits every dollar is accounted for. As opposed to the other massive organizations doing work in third world countries, even small donations make a significant impact helping Forward in Health and the running of Klinik Fonfred.
As funds were raised and made available Forward in Health completed construction of Klinik Fonfred. The same will hold true for construction of Phase 2, an operating room suite. A needs assessment funded by Forward in Health found that the ability to provide surgical care is one of many medical needs identified by the community. Basic surgeries are often unavailable in southern Haiti. Even if available patients must be able to pay in full for all aspects of the operation and subsequent care; the surgeon, nurses, operating room, anesthesia, and all post-operative care including food and medication. As with the medical clinic, Forward in Health would never refuse care because of the ability to pay for it.
Architect Paul Fallon has completed preliminary architectural drawings. The planned operating room suite is approximately 7,500 Sq. Ft. Fundraising is planned to begin in 2018 with construction to begin as funding becomes available.