Curbing AIDS in Haiti
Driven by a passion for providing health care to the poor, Antoine Augustin, MD ’72, MPH, has dedicated more than 25 years of his career to the non-governmental organization he created to help the people of Haiti. He founded Management and Resources for Community Health (MARCH) in 1985 for the purpose of providing medical care to those in the Caribbean nation limited by income barriers.
“Medical care for the poor is expensive, even in poor countries,” Dr. Augustin said.
MARCH is designed to bring health services to urban and rural populations in Haiti. What began with the opening of four urgent care centers during a period of two years has evolved into an association of four entities, including a network of hospitals and urgent care centers, youth centers, a health policy research organization and a nonprofit hotel/conference center. The organization specifically seeks to provide general health care and reduce the prevalence of HIV in Haiti.
Currently, the MARCH Foundation is working with a number of donors to provide comprehensive HIV services to women, especially expectant mothers, in an attempt to avoid transmission of the virus to their unborn children. Together, the organizations expect to reach 100,000 women. The project is designed to address the gaps in service using a community-based approach to lower the HIV incidence in Haiti, which has one of the highest HIV infection rates in the Western Hemisphere.
Dr. Augustin primarily oversees the work of the managers of each of the four divisions in the organization. He also provides technical assistance in Haiti and overseas, carries out research, and is active with various commissions in Haiti that coordinate efforts to bring health services to the public. He also serves as a consultant for several international entities including the U.S. government the World Bank, and UNAIDS, which all work to bring health care to underserved areas and to decrease the prevalence of HIV/AIDS.
As a medical student at The Medical College of Wisconsin, Dr. Augustin was among those who operated a free clinic in Milwaukee, which is what helped inspire him to provide health care to the poor. Later, he volunteered at a center in New York that provided services for runaway adolescents, which he said sparked the idea to set up youth centers in Haiti.
He furthered the interest while earning his MPH from Harvard University.
“I met a lot of interesting people who were pioneers in what was then called population-based health systems,” said Dr. Augustin, who was awarded the Harvard Alumni Award of Merit for his work. “This is an approach where an entire population is registered and followed to determine who has, and who has not, received health services. I applied many of these principles to my work.”
He said the biggest challenge in his work is sustainability. Simply for the centers to break even financially is a challenge, he said, and after the 2010 earthquake in Haiti, the challenge worsened. Dr. Augustin believes a potential solution would be to make insurance available to low income individuals, which Haiti’s government is working to accomplish. He credited organizations such as World Bank, UNICEF, the U.S. government, and the World Health Organization with providing assistance now.
“The poor have the same medical needs as the well-to-do,” Dr. Augustin said. “Cheap medical care is an oxymoron.”
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