For me ok as join the stream most people in haiti lack access to Adequate Health care so what can be done to resuscitate the countrys medical system to join the conversation is really easy you can tweet us at a stream or jump into our live you choose chat as youll also be in the street. 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 all but destroyed the countrys 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 with the chatty hope for haiti she has one reason why you want your movie thanks 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 wont be able to receive help the hospital doesnt have the supplies available to help the person thats the biggest problem we have in the Health Care System in haiti the state doesnt provide the materials for you if your doctors to care for the patients in the way youre supposed to. Joining us to talk about haitis Health Care System in Port Au Prince shes head of mission to haiti for Doctors Without Borders also in Port Au Prince news hes the president of private Hospital Association of haiti and informed. Hes a doctor and director general for haiti operations at some point to face hospital hello everybody its good to have you here. I am thinking back 10 years ago. Frank this is what you look like im just going to share with you what you look like but that. And you were chatting and you were talking about the emergency situation what you remember about the sky what is the searing memory for you in haiti about that earthquake 10 years ago from go ahead yes hello good morning everybody hello what do you remember frank we see you here there are tents behind you as an emergency situation what do you remember what to say remember you remember. It was basically a nightmare for every single asian Family Living in the metropolitan area i can tell you that there at that time i was just. Hired by care he is to become. Helpful to have the head of the Health Program for 80 at that time and it was my 1st mission trip i wasnt going to have a 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 live this kind of things and i did not know whether or not my wife my kids passed away because of that theyre 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 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 haiti today in terms of health care. I believe i can say that the sudden start happening from going to share that question because we have a few other people in the conversation you can stand by for a moment of an artist in a bag and a better head ok so you know as you and i had. Yes so as you put it. Right actually more have to structure infrastructures were destroyed. During the quake and it are actually not more. Because its actually a population thats been growing since then and we have more and more people who are with you know im 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 the outbreak because you know what has asked for denies our system why the 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 myself saw for ted talks about what is and what he be thinking about im looking here at the reports 10 years on and then looking at the Health Care System actually even doesnt hold up as a Health Care System sanjay what can you tell us about whats happening right now and i think if youre sick how do you get treated yes thats a good question access to health care is a daily struggle for the patients we need i can it is share some examples that may illustrate the situation better than statistics last tuesday so its less than a week ago we received a pregnant mother you know. The Health Center that we support in the south of the country in the background of this and there was a complication for this woman so we had to refer her to a Public Hospital located 2 hours away which we did and so we arrive in this retro hospital at 8 a m. And everyone tells us something grander so its ok it 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 that nothing had been done for her so we had to give a couple of bunco to really i would say as it faced our needs 1st and make sure that she would receive them some parents she was afraid to go on at 10 30 pm. In other instances we receive specialists in this movie sleepy that we refer to a 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 dont have blood available. And as the previous reporters that you just showed mentioned in many patients and caretakers need to purchase the gloves bandages and simple medical supplies themselves in private. Pharmacies outside of the hospital they want to have a chance of being taken care of this this is so important im wondering from this idea of the having to bring your own medical supplies to be treated was this the case before the earthquake it was now when just as quite fit into the situation where if you dont go to the to the clinic or the hospital with your meds they dont have a really difficult time trying to treat you front when. It when it comes to the journalist done for instance an order because you do sure. That 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 investment in have care facility that comes from the outsource. And. The government in israel is investing in very very little to for the for servicing the patients what you need to understand is that when you take the Public Services the Public Hospitals 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 im not so im so glad you said that because were looking at pictures of hospitals and im seeing equipment i would expect to see 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 theyre from 2010 they have been Additional Health care facilities that they 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 i let frank how type from a result in about why thats a new host or new hospital in Port Au Prince if it finishes in the head no not initially on the type of the hospital. Yeah it depends on the of that magnitude you know call complexity. A big thanksgiving thank. You bending was it was forecast to be finished last year in actually in 2018 its not that into the ice and 14 so basically 2 years. On the combat action so its still there and it would absolve a lot of need for that medical treatment area or so far you know like centers like this and manifest in that its obvious you know out or doing their work got. In a in of amps ive said that if youre cutting it. Youre cutting in and out and people have to appreciate that in haiti connectivity is not always smooth 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 smile its like it was a very knowing smile what was going on there we thank you i was thinking that of course it its 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 its the top of the iceberg if you dont have money and qualified staff to run this what so isnt this absolutely its 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 its only 4 or 4 and a half per cent of the National Budget that if your health care and health is not try to revive by the government its 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 this facility. Im just wondering frank as. People watching this thinking there are such a huge response to haitis earthquake ever so much money being 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 im talking about n. G. O. S im not even talking about large with 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 were talking about i believe the 1st the 1st year it was around 2000000000. 00 that the that the 80 receiving terms of the nation 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 the 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 dont have and the right amount of funding how do you even Practice Medicine youre working or. Yeah im working that bright at the hospital or working in this souths so our or Management System is a bit different done the public os that woods so what weve been there were all in a for more done 30 years providing health care at to dip must go no of are interested and thence an 80 so i to be weve the in all go well year after a year wed patience you known date ed basically we patients coming from that bought a brents area and or dare way to beat rian lot of i ns and fund at me like in this out because or little ron dewhurst they has no major medias of cohen im so bottle done work got 3 do so we really strive to do them was that we can in the very difficult and by juan meant because we need to address problems that should be address by god if i send it is i think him a lot how do you move that will stripes to the best we can dont give me an example he can striving everyday yeah for example oh out every that we would want to your at 20 bet hospital as by that we had been saying i bow the 1000 patients every day and an a the accessed lower hospital because we out working in the bear we will area we dont have like at would would to our hospital and many people all show off on the daily basis to war to our would lauras but we cant basically turn any to patient will way because we know if we turnt patients a way then wouldnt have access to the basic care that they need so we need to do all it done we should because access and options up in we need made it i mean has some of the conversation found have within you and in a battle from pets wow the happening on your champ and i think mean up back in full for about who is responsible emery says all of what the guests are talking about boils down to a failure of governance where we havent talked about 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 dont have enough money to live and the health of the public of course is very very Important Role of that sounded i dont 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 youre right 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 yet in 2010 but also i would say took a lot of efforts 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 2001000 the been a lot is that when you have barricades everywhere it makes things worse for access to health care because patients cannot move out to not go to the house the citys 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 some healths gas facilities 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 were in in january 2020 it remains closed so the only way through to i actually really appreciate was when dr chair say because we work in a small village in the sands 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 has been so i mean there are 456 different hospitals between the 2 more where we work and theres somebody thats also but with someone you trust is the only one being able to operate quality of care and as dr pierce said they accept everyone so theyre really grateful for the work youre doing and i mean i wish there were more hospitals such as yours suggest. Let me know you know america they did that for get the go ahead go have felt and then i want to bring in some other comics people watching and they wanted to ask you questions so the place that can get to the questions they want to talk to god let me just add to that that 111 point one very important point. To make about the Health Care System is as you said. The governor thought the system and in its entirety. I believe one of the main problem of. Freight in terms of health care in this is not just walk out. When it comes to social services its leadership in general public contrie but also the leadership of the sector actually. The Health Care System in. Health care for this is this is just one turn of the so this is not right at the public front im going to push you i was going to push you 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 with 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 her. People who live in these communities find it very difficult to find health care when they are sick for this reason in 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 zones 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. So i guess another push i want to call this the speed round i want an instant reaction to this frank you stop so if youre looking for unique solutions to the Health Care Issues of haitians name one thing wow ok thats fantastic because i have wi proposal that the i. I put on my note to share with your family the one you could have most about ready for it one i wanted to catch to touch it was the community a friend and when i talk about community have child like to remind the fire that in 2016. When they relieved the last. Policy National Policy for hair like remember that is the speed round make it quick so that if initial the point so yes it does help with consider what causes the bad blood of the u. C. You have got them that they dont want to put in place and the minute he does get back i want to share this with your colleagues in a better immediate so if you think you know from the work that youve done what is it for healthcare how do you help how to get votes and 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 dont have this system yet so we need to begin with so obviously yes when you say its 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 hadnt defined a key players and were responsibility is clearly defined. And. People are countable because rand resigning us to say exist around in a bad thank you thank you so much so i know youve had plenty of time to think instant go for that where do you and youve been in haiti for a very long time so you must obviously see how to do this better name one thing training. Their training and i want to name one Success Story its actually in about as there is a University Hospital run by own doctors ship the government and haitian american organizations and partners in health and theyve just started saying last week i think International Recognition and certification from the trainings 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 to live in a back to frank and also to sandra i going to leave you on 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 who we will jump into the life you choose chat it is curated we are there as a stream team and we will let you know about all of the guests various different organizations so that you can trust them to help patients with the health care guests thank you very much youve inspired after us he will end the conversation i will see you next time on the street they carry. The bag to. To to. To to. They join one of the worlds most notorious ahmed groups. But found a way out rebuild their lives and now help us. A tale of course for crude and child soldiers and the horrific exploitation of women daughters are. Part of the radicalized series on aljazeera. The latest news as it breaks this bushfire season is far from over but its caused so much devastation across a strain. With detailed coverage. On the streets of paris and feel as journalism senators are preparing for a briefing on the u. S. Military strike and whatever response it may break. When a french soldier was murdered in a socalled terrorist attack. His mother retaliated with a love. Speaking out against intolerance and alienation. She travels the world with the result of a grieving mother who lost a son but adopted a generation. A witness documentary on aljazeera we understand the differences and similarities of cultures across the world so no matter what we do to the news and Current Affairs that matter to you. Hello im Maryam Namazie in london with a quick look at the headlines now at least 2 people have been killed in baghdad after Iraqi Security forces used tear gas and live ammunition to break up antigovernment protests meanwhile in the south of the country hundreds of demonstrators there blocked main roads in several cities iraqis are continuing to say the Prime Minister has not fulfilled his promises and they are calling for an overhaul of the political system imran khan reports now from the capital. In one of the main squares in central Baghdad Police and protesters confront each other it began in the early hours of my