INTEGRATED ACTIVITY FLAG:

Improvement of healthcare facility infrastructure is critical and is closely linked with activities in several

program areas such as the blood safety, antiretroviral (ARV) services, basic palliative care, prevention of

mother-to-child transmission (PMTCT), tuberculosis (TB) /HIV, and laboratory programs. Blood banks,

clinics, pharmacy, out-patients services, in-patients wards, all tiered levels of laboratories (national,

regional, district, and healthcare centers), and all auxiliary services including, administrative, face serious

obstacles in Haiti due to the unreliable power supply. Distributed (onsite) energy generation technology,

including renewable and hybrid systems, are viable solutions to the energy problems and are applicable to

all of these critical facilities.

SUMMARY: The activities in this narrative seeks to improve the operations of healthcare facilities that

provide clinical and laboratory services to persons living with HIV/AIDS (PLWHAs) by retrofitting facility

infrastructure at three selected centers of excellence (COE). These COEs are at departmental hospitals.

BACKGROUND: Shortage and fluctuation of electrical supply across the country is one of the major

barriers to improve healthcare capacity in Haiti. Quite often, PEPFAR ARV hospital sites still rely on

generator provided electricity. Fuel is extremely expensive in Haiti, thus the cost to operate fuel generators

is extremely high and nearly unsustainable. Laboratory services offering CD4 enumeration, blood chemistry,

hematology analysis, and other tests are disrupted on a daily basis because of the lack of electricity despite

provision of inverters and batteries. Automated expensive laboratory instruments are constantly burnt out

due to electrical surges despite protection by UPS. Refrigerators used to store drugs, vaccines, and

laboratory reagents commonly function poorly. The temperature is often not within the acceptable

temperature range (4-12C). In short, the integrity of vital healthcare products used for patients in Haiti is

compromised. Activities enumerated in this narrative are past of ongoing efforts to improve the

infrastructure of healthcare facilities across Haiti. Specifically, these activities will address a serious barrier

to the effective operation of ARV sites in Haiti: lack of adequate and reliable energy services to provide

clinical services to PLWHAs, to run diagnostic equipment, air conditioning, refrigerators, and provide

adequate lighting.

ACTIVITIES AND EXPECTED RESULTS:

In Fiscal Year 2008, the partner will undertake the following activities to improve the infrastructure of three

ARV centers of excellence and the national public health laboratory (NPHL):

Activity 1: Implement the recommendations that come out of an assessment of the ARV sites and the

NPHL that is carried out in November 2007 to a) determine the total - both current and projected - energy

demand profile of each facility and the current cost and reliability of existing energy supply; b) identify

alternative electrical resources appropriate for healthcare facilities in Haiti; c) design an optimized energy

generation system to meet the current and projected needs of the whole facility in a sustainable and cost

effective manner;

Activity 2: Procure, install, secure, and set up systems for maintenance of the recommended energy

solutions at three departmental ARV sites and the NPHL so that those facilities will have a constant

electrical supply;

Activity 3: Implement a training program to ensure that technicians are available who can properly maintain

these systems; and,

Activity 4: Implement a program to ensure that funds will be available to purchase replacement parts when

necessary.

This program will provide three ARV sites and the NPHL with the sufficient and reliable power supply

necessary to provide efficient clinical and laboratory services. In order to ensure the sustainability of this

project, consultants will provide training and on-site follow-up to ensure that local technicians are properly

trained in the maintenance of the energy generation technologies and that replacement parts are available.

It is anticipated that this activity will directly increase the number of people receiving ARV services.

TARGETS:

-Three service outlets providing anti-retroviral treatment (ART) with secure, continuous energy supply.

EMPHASIS AREAS:

-Infrastructure

-Needs assessment

-Training

TARGET POPULATIONS:

-Lab workers

COVERAGE AREAS:

-National