From Pittsburgh to Haiti: A Lasting Gift
Founded by an heir to the Mellon fortune and still partially supported today by Pittsburgh donors, the Hôpital Albert Schweitzer Haiti celebrates 60 years of providing health care in a rural region while standing at the forefront of efforts to limit the impact of the Zika epidemic.
William Larimer “Larry” Mellon Jr. and his wife, Gwen Grant Mellon
photos courtesy Hôpital Albert Schweitzer Haiti
For six decades, there has been a place in Haiti’s Artibonite Valley serving as a source of comfort and compassion in the midst of unimaginable adversity. It has stood through health crises and natural disasters. Now it stands in the face of a new disease threatening the youngest among its population.
This place, though 1,500 miles away, can trace its story back to Pittsburgh, where a community of donors and supporters continues to help advance its mission today. Hôpital Albert Schweitzer Haiti, the brainchild of Larry and Gwen Grant Mellon, provides effective and efficient medical care in an area where such services are extremely limited. The hospital celebrated its 60th anniversary in June during a year also marked by the emerging threat of Zika virus in the country and the world.
“It’s hard for a lot of people to understand how little health care there is in Haiti,” says John Walton, chair of the HAS board of directors. “This 131-bed hospital with 14 doctors responds to all of the medical needs for a population of 350,000 — roughly the population of Pittsburgh. It’s a real shock to go to such a place and realize health care is just not available.”
In 1947, William Larimer “Larry” Mellon Jr., a Pittsburgh native and an heir to the family’s banking and industrial fortune, was living as a cattle rancher in Arizona when he read a magazine article about medical missionary Dr. Albert Schweitzer. The man’s dedication to showing compassion and respect to all humans impacted Mellon so deeply that, at age 37, he decided to become a physician himself and open a hospital in an area in need. With his wife’s support, Larry Mellon reached out to Schweitzer and began their journey. He earned his medical degrees from Tulane University in New Orleans, while Gwen Grant Mellon studied there to become a medical laboratory technician.
A friend in New Orleans encouraged the Mellons to visit Haiti, where they found an impoverished population in desperate need of medical care. The nonprofit Hôpital Albert Schweitzer Haiti opened on June 26, 1956; the couple dedicated the rest of their lives to its operation. Larry Mellon died in 1989, and Gwen Grant Mellon’s death followed in 2000. They are buried on the hospital grounds, and their legacy remains as an invaluable resource for hundreds of thousands of Haitian people.
“There really is no equivalent institution in Haiti that’s been there for 60 years providing the care it does,” says Dr. Scott Dowell of Seattle, an HAS board member.
Hospital medical director Dr. Herriot Sannon, who is among the 98 percent of HAS employees who are Haitian, says the same importance founders placed on providing quality services remains a priority today.
“Even when care is free or low-cost, if it is not good people will not come for it,” he says. “The founders also made community relations, activities and community health a priority, which means the local community has been engaged since the beginning.”
The HAS U.S. Administration Office, located in Pittsburgh, is devoted to its ongoing operation. Despite its own stability, the hospital must continue to function in an incessantly unpredictable environment. The hospital is 40 miles north of Port Au Prince in a rural area where the population is dispersed and there are few jobs outside of farming. The hospital is one of the region’s largest employers.
The hospital generates its own electricity and treats its own water. Some patients drive hours to get there as Port Au Prince’s hospitals are mostly private or lack adequate staff. Due to its own funding needs, HAS is not able to provide CT scans, MRIs, expanded laboratory services or dialysis, so patients requiring such special services must be referred elsewhere.
Yet the hospital always has been viewed as an asset by the community because of its “willingness to take on the challenges of the day, whether that be flood or food shortage,” says Walton, who is Larry Mellon’s great-nephew. It treated many patients during the 2010 earthquake and thousands more during the subsequent cholera outbreak. Chikungunya, a virus transmitted by mosquitoes resulting in fever and joint pain, has sickened thousands of Haitians in recent years as well.
After the earthquake, improvement to infrastructure and roads led to an explosion in the number of motorcycles on the island, and with that came an increased number of injuries due to crashes, Walton says. The hospital also is seeing an emergence of chronic diseases such as diabetes and hypertension, as the average life expectancy in Haiti has jumped from 42 in 1960 to 63 in 2011.
One of the biggest concerns today is infant and mother mortality, Walton says. It’s common for Haitian women to forgo hospital births and deliver at home with midwives, despite increased risks for both mother and child.
“There are very few families with a single child so when they have a baby, there is another child at home,” says Walton. “If the mother dies, it’s like the tentpole disappearing from the tent. It really fractures the whole structure of the family.”
Through word of mouth, more women are coming to understand the benefits of delivering in a medical facility, Walton says. HAS saw a 34 percent increase in the number of hospital births in the past year alone.
Now the hospital is responding to combat the impact of Zika, which is yet to be fully seen, Walton says. Zika is spread by mosquitoes and can be passed from a pregnant woman to her fetus, resulting in microcephaly, eye defects, hearing loss and impaired growth, according to the U.S. Centers for Disease Control and Prevention. There is no vaccine.
In an approach that hospital leaders anticipate will be emulated elsewhere, the hospital is at the forefront of monitoring the symptoms and spread of the virus. In a unique attempt to spread information as quickly and efficiently as possible, the staff works with a community of more than 300 Haitian birth attendants who travel throughout the region, report back on all pregnant females with symptoms of Zika and help those affected to seek medical care.
Walton says once Zika began to emerge as an international issue, HAS staff felt strongly that it would come to Haiti and began educating the community immediately. Because symptoms of the virus — fever, rash, joint pain — are so mild, many Haitians who develop them do not seek treatment. Therefore, the virus’ scope remains unknown.
“It’s hard to quote statistics,” Walton says. “There are hundreds and hundreds of patients we suspect are Zika, and we’re certain it’s there. But because the symptoms are so vague, it’s not something you can diagnose without a blood test that’s been properly analyzed, and that’s not something we can do on-site. It requires a very sophisticated lab.”
To minimize the virus’ impact on newborns, the community health workers are arming the population with information, encouraging increased birth-control efforts and recommending that women avoid pregnancy until the virus passes its peak.
“One approach is to vigorously avoid being bitten, but these are domestic mosquitoes that bite day and night,” says Dowell. “The alternative is to not get pregnant during the time Zika is at its peak.
“Peak Zika lasts six months to one year, but you need someone to tell you when it’s peaking,” he says. “The hospital is tracking the epidemic and reaching out to the population to inform them.”
Most pregnant women who contracted Zika did so during the country’s wet season in late spring through fall, meaning the cases of babies born with its effects will start to climb this fall and winter, Walton says.
“So far, we’ve not seen any evidence, but we know a great number have contracted it,” he says. “We have to wait and see.”
Pregnant women are advised to come to the hospital or its community health centers for a consultation if they have Zika symptoms.
The hospital has established a comprehensive three-year prevention plan, but it still is seeking funding for a full-scale response that would include community mobilization, family planning and surveillance, Sannon says. “Zika will be with us for a long time, and we have a lot of work to do.”
Securing the necessary funds to meet patient needs and address operational requirements is a constant challenge, board members say. Because there is little government or institutional funding available, donor support remains critical to HAS’s continued presence in a country desperately dependent on its services. The hospital also is facing an anticipated spike in waterborne disease following Hurricane Matthew in early October.
“Without the generous support of our donors, there simply wouldn’t be a hospital,” Walton says. “Many of them are in the Pittsburgh area. They’ve been extremely generous in providing the fuel for us to continue our mission. We don’t know what’s around the corner. An earthquake? Another natural disaster? We have to be prepared and ready to respond.”