From Innovation To Transformation 2011 Annual Report Director’s Message
Dear Friends, As 2011 draws to a close, Partners In Health is approaching several major milestones. On January 12, we will observe the second anniversary of the devastating earthquake that destroyed Haiti’s capital and killed over a quarter million people. Six months later, we will celebrate the opening of the 320-bed, national referral and teaching hospital we have been building at breathtaking speed in Mirebalais. Around the same time, we will spend the last of the tens of millions of dollars we received after the earthquake, fulfilling the commitment of our Stand With Haiti plan to invest it all in emergency relief and long-term reconstruction over a 30-month period. On my first visit to Haiti following the earthquake, I observed, “Haiti’s catastrophe will forever divide its history into before earthquake and after.” I also realized, although I didn’t say so at the time, that the earthquake would demarcate PIH’s history as well. In the two years since the earthquake—with the support of so many of you who have rallied to our side—our Haitian colleagues have truly performed miracles. They have worked tirelessly to provide lifesaving medical care to tens of thousands of people affected first by the earthquake and then, less than a year later, by a deadly outbreak of cholera that has now killed more than 6,500 people and sickened nearly half a million. They have reinforced our own services and supported national initiatives to strengthen rehabilitative medicine, mental health, and other specialties that had always been weak in Haiti and were even more desperately needed by a population scarred physically and emotionally by the back-to-back disasters. And they have managed to push ahead with major initiatives to rebuild Haiti’s public systems for health and education of health professionals. Mirebalais Hospital is not just the biggest reconstruction project undertaken anywhere in Haiti since the earthquake. When it opens it will stand as the finest hospital in the country, as a center of excellence for education of the next generation of Haitian doctors and nurses, and as a beacon of hope for the people of Mirebalais, the Central Plateau, and the entire nation. Even as we have necessarily focused attention and resources on Haiti, our projects in 11 other countries have not only maintained and strengthened their existing services but have managed to innovate game-changing approaches to maternal mortality, cancer, and other intractable and neglected conditions among the poor. Complications of pregnancy and childbirth still kill nearly 1,000 poor women a day. Over the past two years, our Lesotho team has pioneered and rapidly scaled up an innovative program that has already recorded significant increases in women receiving pre- and post-natal care and delivering their babies at health centers in some of the world’s poorest and most isolated communities.
Pediatric ward at Rwinkwavu Hospital, Rwanda Credit: Bill Campbell Director’s Message (continued)
Cancer is among the diseases that have been largely neglected in developing countries. Even though developing countries bear 80 percent of the world’s burden of cancer, they receive only five percent of the resources devoted to prevention, treatment, and palliative care. Nearly 2.5 million cancer deaths a year in developing countries could be averted using prevention and treatment interventions that are widely available and readily affordable, according to a report published recently by a global task force PIH helped form and lead, along with our partners at Harvard Medical School and Brigham and Women’s Hospital. The report highlights PIH projects in Rwanda and Haiti as pioneering initiatives to prevent and treat a variety of cancers, including cervical cancer and Burkitt’s lymphoma, a deadly but treatable disease that is the most common malignancy among children in Africa. In 2012, together with the Rwandan Ministry of Health, the Jeff Gordon Children’s Foundation, and the Dana-Farber Cancer Institute, we will open the first pediatric cancer center in rural Africa at the new Butaro District Hospital in Rwanda. These and similar innovations at all of our sites testify to our unyielding commitment to provide the highest quality care to the 2.4 million poor people we now serve directly, even when that means defying conventional wisdom and prevailing policies. They also speak to our dream of transformational change that will make the world a healthier, more equitable place. As we have shown with treatment for multidrug-resistant tuberculosis and HIV, one can lead to the other—well-documented local success to global change of direction, innovation to transformation. Perhaps our proudest accomplishment over the past year has been our ability to come together, from projects in 12 countries on four continents, to map out a strategy to keep our commitments and further our dreams. At the heart of our strategy is a rededication to the research, education, and training that are essential to our mission—to improving the quality of our work; to creating the evidence base needed to leverage changes in global health policies and priorities; and to building the capacity of individuals and institutions to plan and implement programs that truly benefit the poor. Our strategic discussions took place in the shadows of the enormous responsibilities we have shouldered since the earthquake and of the daunting fundraising task that looms when our Stand With Haiti Fund is exhausted in mid-2012. I draw profound inspiration from my colleagues who, even as we face the challenge of providing more and better services with fewer resources, have embraced an ambitious strategy: we will continue to meet the needs of the communities we serve, and build on that work with new research and training efforts that will help catalyze policy changes and strengthen the movement for global health equity and social justice. With that kind of selfless dedication to the greater good, and with your continuing support, I am confident that together we will be able to rise to the challenge, to fulfill our commitments, and to realize our dreams.
Ophelia Dahl Executive Director, Partners In Health The vegetable market in Neno, Malawi 1 Our Mission Our mission is to provide a preferential option for the poor in health care. By establishing long-term relationships with sister organizations based in settings of poverty, Partners In Health strives to achieve two overarching goals: to bring the benefits of modern medical science to those most in need of them and to serve as an antidote to despair. We draw on the resources of the world’s leading medical and academic institutions and on the lived experience of the world’s poorest and sickest communities. At its root, our mission is both medical and moral. It is based on solidarity, rather than charity alone. When our patients are ill and have no access to care, our team of health professionals, scholars, and activists will do whatever it takes to make them well—just as we would do if a member of our own families or we ourselves were ill.
Inauguration celebration for new hospital in Butaro, Rwanda
2 Table of Contents Director’s Message______i Our Mission______2 Table of Contents______3 From Innovation to Transformation______4 Year in Review______10 Haiti______10 Peru______12 Rwanda______14 Lesotho______16 Malawi______18 Russia______20 Kazakhstan ______21 USA (PACT)______22 Mexico______23 Guatemala ______24 Medical Informatics______25 Training______26 Advocacy and Policy______27 Research______28 Selected publications ______29 Finance & Governance______30 Financial Review______31 Thank You to Our Supporters______36 Officers and Boards______55
3 From Innovation to Transformation
Partners In Health was founded nearly 25 years ago by a handful of people who shared three things: an unflinching, narrowly focused commitment to a single destitute community; grand, wide-angle aspirations to change the world; and the core concepts of what has proved to be a powerful strategy for change.
They were committed to improving the health of some of the world’s poorest and most vulnerable people—several hundred displaced peasant families living in a squatter settlement in Central Haiti. Their aspirations were to help bring about a seismic shift in policies, priorities, and resources that would save and enrich lives not just by the hundreds but for the hundreds of millions of poor people around the world who are denied access to fundamental rights and basic necessities—health care, food, clean water, education, adequate housing, and opportunities to earn a decent living. And the keys to their emergent strategy for change lay in their commitment to building partnerships, starting with their connections to a major research university (Harvard) and teaching hospital (Brigham and Women’s). It worked. Over the quarter-century since PIH was created, we have managed to fulfill and expand our fundamental commitment. Working in partnership with local communities and governments, we have succeeded in providing universal access to quality care—not just for the squatter community where we began but for a combined population of more than 2.4 million people served by 76 health facilities in 12 countries. Our pioneering efforts have helped overturn global policies that had deliberately denied treatment to the poor for drug-resistant tuberculosis and HIV. The partnerships with Harvard and Brigham and Women’s have steadily evolved and strengthened, enabling us to constantly improve our work and expand our influence through monitoring and evaluation, rigorous research, informed and inspired teaching, and advocacy that is both impassioned and evidence-based. The combination of service, training, research, and advocacy has become a powerful engine for change—for strengthening entire health systems as we treat the individual patients within them; for revitalizing one destitute community, and using what we learned there to help shift national and global priorities; for moving from innovation to transformation. Community health worker makes home visit in Rwanda Credit: Matthieu Zellweger
4 From Innovation to Transformation (continued)
Through our example, backed by solid evidence of its impact, we have also helped change policies and mobilize resources for the innovation that has been central to our success—building a platform for high-quality, comprehensive care on the foundation of networks of trained, supported, and paid community health workers.
The use of community health workers (CHWs) is widespread. Systems for training, supporting and supervising, and paying them, however, are not. In many places, the poor are expected to serve as health volunteers in their own impoverished communities, often working without either support or compensation. We insist that poor people must be paid for their labor, and employ community health workers—or accompagnateurs—as the foundation of an integrated health system, with training and support from local health centers and connections to a nearby referral hospital. This health system is an unparalleled platform for delivering comprehensive, high-quality health care to the poor. Together with our partners, we have conducted the research to prove it. With patients suffering from drug-resistant tuberculosis and HIV, research at multiple PIH sites has documented the impact of daily visits from community health workers who deliver medicines and provide emotional and social support. We have been able to demonstrate that more patients adhere to their treatment regimens and fewer are lost to follow-up than in many programs here in the United States. In Rwanda, with support from the Doris Duke Charitable Foundation, we are documenting the impact of accompaniment from community health workers on delivery of primary health care in an impoverished rural setting. And in Boston, we have shown that CHWs can both improve health outcomes for the most vulnerable HIV patients and dramatically reduce the costs to the health system for emergency room visits and hospitalizations. Over the past several years, our example and the research demonstrating its impact have helped move paid CHWs to the forefront of global strategies for improving health care and addressing a desperate shortage of health workers in poor countries. The World Health Organization issued guidelines endorsing the vital role of CHWs in HIV programs and explicitly calling for them to receive “adequate wages and/or other appropriate and commensurate incentives.” Earlier this year, a coalition of organizations including the Earth Institute, UNAIDS, and the UN Surveying socioeconomic Secretary General’s Office launched a campaign to train and recruit one million additional CHWs in Africa as a needs of HIV patients in Malawi key to achieving the Millennium Development Goals.
5 From Innovation to Transformation (continued)
PIH co-founder Paul Farmer refers to the essential role of research and training in strengthening our delivery of care as a “feedback loop,” borrowing a term from microbiology and systems science. Others have called it an “amplification loop” or an “engine of change.” Whatever term we use, the integration of research, training, and advocacy with our healthcare delivery has been essential both to maintaining the quality and success of our programs and to extending their impact far beyond the communities we serve.
Over the past two years, we have backed up our relentless commitment to providing the highest standard of care for our patients by making strategic investments to reinforce our capacity and partnerships for research and training. Some of our key accomplishments and plans include: • Strengthening our monitoring and evaluation capacity, both at our headquarters in Boston and at our project sites. The increased focus on monitoring and evaluation included development of a standard set of cross-site indicators to facilitate more consistent reporting and analysis and to foster quality improvement by highlighting strengths and weaknesses in our programs. • Implementing research projects, documenting, among other things: the impact of accompaniment on the delivery of primary health care in an impoverished rural setting in Rwanda; the impact of shifting tasks among doctors, nurses, and community health workers in Haiti; the dynamic feedback between poor health and poverty; and whether and how constructing a new hospital and strengthening the health system stimulated economic development in a poor and isolated rural district in Malawi. • Addressing the need for more advanced post-graduate medical training in Haiti by collaborating with the state university to create the country’s first residency program in family medicine. The program will train six residents a year at the public hospital Zanmi Lasante operates in St. Marc. • Building and strengthening cross-site quality improvement teams drawing on the clinical, research, and mentorship skills of our partners at Harvard Medical School and Brigham and Women’s Hospital to improve our services, build local capacity and document our work in specific program areas.
Newborn baby rests in • Constructing major teaching hospitals in both Rwanda and Haiti. Butaro Hospital in Rwanda opened Butaro hospital in Rwanda
6 From Innovation to Transformation (continued)
in January 2011. More than half of the construction of Mirebalais National Teaching Hospital in Haiti has been completed since ground was broken in June 2010. When the hospital opens in 2012, it will create a standard of excellence for the education of nurses, medical students, residents and other health professionals in Haiti. • Expanding the scope of our training curriculum for community health workers. Available in five languages (English, Haitian Creole, Kinyarwanda, Sesotho, and Chichewa), the curriculum originally focused primarily on training CHWs to accompany HIV and TB patients. Twelve new primary health care modules are now being developed, covering topics such as family planning, reproductive health, malnutrition, and vaccinations. • Launching the Programs in Global Health and Social Change at Harvard Medical School with a mission to advance the evidence base for effective health care delivery for the poor and to link this research to medical education and practice. The programs include six that focus on clinical specialties—infectious disease, mental health, newborn health, primary care, noncommunicable disease, and surgery—and three devoted to medical education, public policy, and health system strengthening. • Publishing the Program Management Guide, a compendium of lessons and strategies drawn from over 20 years of experience that have helped PIH implement and improve our programs—from planning the layout of a health facility, to working with the public sector, to procuring medicines and supplies, to hiring local residents. Advocacy Our Care & Innovation & Policy Service & Evidence Theoryof Evaluation Teaching Pediatric TB & Scale-up patient in Lesotho Change & Quality
7 From Innovation to Transformation (continued)
Strengthening the feedback loop of research and training is absolutely essential both to fulfilling our commitments to the communities we serve and to leveraging their example to help advance our mission of health and social justice for the poor on a world scale. Over the past two years, staff and partners from all of our projects have engaged in an intensive effort to focus our strategic vision and programmatic priorities.
This initiative has mapped out a strategic framework to inspire and guide our work—four overarching transformative goals; seven strategic objectives that will help us advance those goals over the next two to three years; and to reach each of those objectives, one or more transformative projects. Our transformational goals are broad and ambitious: 1. comprehensively lessen the burden of disease among the poor; 2. build the capacity of individuals and institutions to deliver the highest standard of health care to the poor; 3. break the cycle of poverty and disease; and 4. build a movement for social justice that universalizes the notion that the poor deserve quality health care. For each of these goals we have identified ways of measuring progress and have specified objectives and transformative projects with clearly defined targets for the next several years. Take goal number one. Lessening the burden of disease among the poor means nothing less than reducing, and ultimately eliminating, the deadly disparities in health between and within countries. A child born in one of the world’s poorest countries today can only expect to live around 50 years. In developed countries, average life expectancy is closer to 80. The gap in life expectancy between rich and poor within countries is also wide. In most African countries, the wealthiest fifth of the population lives 20 to 50 percent longer than the poorest. Achieving our goal requires first eliminating these disparities within the countries where we work, and then, building on our example and partnerships, substantially reducing disparities between rich and poor countries worldwide. To get there, we have committed ourselves to several medium-term objectives: to strengthen and document our integrated healthcare model; to demonstrate the value of community health workers to solve a variety of health problems, both in poor countries and with vulnerable populations in the United States; to pursue innovations in health for the poor focused on specific clinical services, such as treatment for MDR-TB, maternal and neonatal health, cholera, Hiking to the health center mental health, and cancer and other non-communicable diseases; and to build capacity of local health-related in rural Lesotho practitioners through high-quality, service-based education and training.
8 From Innovation to Transformation (continued)
From innovation to transformation, via projects, objectives, and goals—an example illustrates PIH’s theory of change in action. The project is the Maternal Mortality Reduction Program in Lesotho. The objective is to tenaciously pursue and prove innovations in health for the poor, led by a focus on specific clinical services integrated into a strengthened health system. The overarching goal is to lessen the burden of disease among the poor.
In Lesotho, one out of every 62 women can expect to die from hemorrhage, obstructed labor, or other complications of pregnancy and childbirth. In the rich, industrialized countries, the risk of pregnancy-related death is vanishingly small: one in 4,300. Overall, more than 99 percent of the nearly 1,000 maternal deaths that take place every day worldwide occur in developing countries. And virtually all of these fatalities are what PIH co-founder Paul Farmer has called “stupid deaths”—deaths that could easily be prevented with proven interventions that are routinely available in rich countries. This grotesque injustice—death by lottery, by the accident of being born poor in a poor country— is what we are determined to change, in Lesotho and around the world. Since it was launched in 2010, PIH-Lesotho’s Maternal Mortality Reduction Program (MMRP) has trained and employed more than 600 women—many of them traditional birth attendants who had formerly helped women deliver their babies at home—to locate all expectant mothers in their villages, accompany them to regular pre- and post-natal visits, and bring them to the clinic to deliver their babies with the help of a doctor or nurse-midwife. The target of the MMRP is clear and simple—zero preventable maternal deaths in Lesotho. Progress toward that goal is being monitored meticulously. The program is overseen by the nurse who heads PIH-Lesotho’s Monitoring and Evaluation team. And we are using our Electronic Medical Records system and Geographical Information System technology so that we can map the locations of all pregnant women and maternal health workers and overlay information about visits to the health center, complications, deliveries, and health outcomes. Lessons extracted from this information through analysis and research will be used to strengthen the project and to advance our strategic objective of proving the impact of innovations in specific clinical services built on our integrated platform of care. And that, in turn, will help us mobilize support for changes in policies and priorities that could Maternal health reduce maternal mortality, lessen the burden of disease, and increase life expectancy for the poor worldwide. workers in Lesotho
9 Haiti/Zanmi La sante
Continuing to rebuild from the unimaginable disaster of the January 12, 2010 earthquake, Zanmi Lasante (ZL) provided urgent care and ongoing community outreach in response to widespread cholera outbreaks, continued constructing a state-of-the-art hospital in the Central Plateau, and strengthened specialized services.
Highlights of the Year Responded to the cholera epidemic: Since the first cases of cholera were confirmed by the Haitian Ministry of Health in October 2010, ZL worked tirelessly to treat over 75,000 cases, conduct community education and outreach, and strengthen the infrastructure necessary to provide clean water and basic sanitation for Haitians most vulnerable to the outbreaks. On the international stage, PIH/ZL advocated for a comprehensive, community-based strategy for prevention and treatment—including oral vaccination campaigns and attention to the structural causes of cholera, such as improved water and sanitation infrastructure. Thanks to funding from the US government and the World Bank, ZL was able to build and operate cholera treatment facilities and oral rehydration posts, train additional community health workers, and provide mental health and psychosocial support to cholera survivors. Completed over 50 percent of construction on Mirebalais Hospital: By May 2011, construction teams had already completed more than 50 percent of construction of a flagship national referral hospital and teaching center in Mirebalais. The 180,000-square-foot, 320-bed facility will change the face of public health care in Haiti by providing Cholera patient receives intravenous rehydration 10 Haiti/Zanmi La sante (continued) By The Numbers
comprehensive clinical services, many of which—such as neonatal intensive care and thoracic surgery—are not currently available at any public facility. When the hospital 2.8 million total patient becomes fully operational, it will be the largest functioning hospital in the country, with encounters (all services included) the capacity to treat upwards of 500 patients per day and provide high-quality education for nurses, medical students, and resident physicians. 13,784 children received educational assistance Provided mental health, psychosocial support, and rehabilitative services: Since the earthquake in January 2010, ZL’s Mental Health and Psychosocial Support team 53 houses constructed or repaired has more than doubled the number of psychologists, social workers, and community health workers trained to 6,268 HIV-positive patients on identify, refer, and support people suffering from myriad mental health problems. The services provided, such treatment as the treatment of depression, anxiety, post-traumatic stress, and psychosis, have been integrated into the comprehensive system of care at all ZL sites to better support the 482 TB patients treated mental health needs of all our patients. Approximately 75,000 cholera ZL also trained seven rehabilitation educators to provide specialized rehabilitative patients treated accompaniment to an estimated 225 patients, many of whom were injured in the earthquake. In addition, plans were completed for Haiti’s first wheelchair-accessible 9,780 children treated for moderate or severe malnutrition public sector rehabilitation center at the hospital ZL runs in partnership with the Ministry of Health in Saint-Marc. This facility will provide rehabilitation services and be the site for a nine- 25,269 active users of modern month Rehabilitation Technician Training program. contraception methods
Cared for children with physical and developmental disabilities: Zanmi Beni, Creole for “Blessed 98,735 pregnant women seen Friends,” is home to 50 unaccompanied minors and vulnerable children with physical or developmental in antenatal clinic disabilities, abandoned in the crumbled pediatric ward of Port-au-Prince’s General Hospital in the days following the earthquake. In April 2010, ZL purchased land in a quiet neighborhood of Port-au-Prince to build what is now a safe haven and caring Staff: home providing the children an educational and loving environment in which to 1,192 medical thrive. Zanmi Beni strives to reduce the stigma and discrimination faced by children 1,841 non-medical with special needs, and has already become a model center for addressing special needs in resource-poor settings. 2,378 community health workers
The Year In Review 11 Peru/Socios En Salud
On July 9, 2011, Socios En Salud (SES) celebrated 15 years of providing high-quality treatment and support for tuberculosis and HIV patients in some of the poorest areas of Peru. This year, SES continued to grow, increasing social and economic support for patients, conducting advocacy initiatives to increase public awareness of TB and HIV, and engaging in research and trainings to inform the clinical management of both illnesses.
Highlights of the Year Provided socioeconomic support to patients with MDR-TB and HIV: Patients receiving treatment for TB and HIV need to have sufficient food and housing to ensure a sound recovery. This year, in partnership with the Peruvian Ministry of Health, SES continued to provide multi-drug resistant tuberculosis (MDR-TB) and HIV patients with the nutritional support, transportation, and pre-constructed, well- ventilated houses that allow patients to recover at home with their families while reducing the risk of transmission.
Scaled up outreach and training for TB control and prevention: As part of national efforts to scale up TB prevention and early diagnosis efforts among general and high-
A community health worker delivering a food package 12 © SES 12 Peru/Socios En Salud (continued) By The Numbers
risk populations, SES trained university educators and administrators in TB prevention, and began studies in indigenous communities in Peru related to risk Treated more than 10,500 factors and vulnerability for TB. In addition, SES collaborated with the Ministry MDR-TB patients to date with a of Health to provide training on MDR-TB treatment and prevention to doctors, % cure rate—the highest nurses, and community health workers in Lima and the southern Pisco region. 75 in the world At the national level, SES reached more than 7,000 university students with TB health campaigns on campuses across the country, and ran mass media campaigns university staff trained in estimated to have reached 1.5 million people. 150 TB prevention
Contributed to research on MDR-TB and HIV: SES provided oversight and research capacity for Approximately 800 MDR-TB the EPI project: a study of the transmission dynamics of MDR-TB, enrolling and HIV patients received 4,000 patients and 20,000 of their household contacts. SES and the Ministry of socioeconomic support Health will use the results of this research to reinforce early detection efforts and improve coverage by the national TB strategy. And in a study that seeks to 2,063 MDR-TB patients show the impact and cost-effectiveness of community-based intervention in HIV and 6,413 contacts enrolled in treatment, SES worked in 92 health posts to enroll patients living in extreme TB transmission research study poverty who had recently begun treatment but were at risk of non-adherence. More than1,800 food baskets Provided patients with options for sustainable income generation: SES’s distributed income generation project offers interest-free loans to TB and HIV patients and their families to start small businesses, helping them gain economic independence, improve self-esteem, and reignite their will to recover from their disease. This Staff: year SES provided in-house training, small loans and staff accompaniment to 97 111 medical current and former patients to start or expand small businesses including a taxi service, a juice stand, and a curtain-making enterprise. Within a year the average 195 non-medical per capita household monthly income of those patients more than doubled—from $48 to $114. 174 community health workers
The Year In Review 13 Rwanda/Inshuti Mu Buzima
By collaborating with the Rwandan Government on a variety of projects—building a hospital in a previously underserved rural region, creating a district model that can be scaled up nationwide, and constructing new homes for a historically marginalized community—Inshuti Mu Buzima (IMB) helped to transform the health system in three districts of rural Rwanda. Highlights of the Year Opened state-of-the-art hospital in rural Burera district: Inaugurated in January 2011, Butaro Hospital now brings high quality medical care and serves as a flagship center for medical education and innovation for the entire east Africa region. In addition to the four basic services—maternity, internal medicine, surgery, and pediatrics— the new hospital includes an emergency department, full surgery ward with two operating rooms, intensive care unit, neonatal intensive care unit, outpatient ophthalmology and gynecology services, and significantly expanded laboratory capabilities. Constructed in partnership with the Rwandan Government, which is supporting more than 40 percent of the operating costs, the facility features modern measures for infection control, including natural cross- ventilation reinforced by large ceiling fans and ultraviolet lights, secluded patient wards around courtyards, and an effective spatial triage system allowing for separation of patients based on their condition. Newborn twins in Butaro Hospital Credit: Matthieu Zellweger 14 Rwanda/Inshuti Mu Buzima (continued) By The Numbers
Under-5 Deaths in Burera District Expanded services from seven to 22 health centers in the Eastern Province: 600 With support from the Doris Duke Charitable Foundation, IMB expanded to 15 new health centers in Southern Kayonza and Kirehe Districts. With the addition of these 400 facilities, IMB now covers all health centers in the districts. The major components of 200 this project include social support programs, increased human resources and service 0 delivery support, constructive nursing supervision, and an enhanced network of 2008 2009 2010 community health workers. IMB’s research and monitoring and evaluation programs will document this strengthened healthcare system, allowing other districts to scale up and replicate the model. Malnutrition Cases in Burera District 1500 Supported Rwandan Government in cervical cancer screening, treatment, and training: Beginning in August 2010, PIH worked to enable Butaro, Rwinkwavu, and Ruhengeri Hospitals to offer cervical cancer 1000 screening. Combined, the hospitals provided screenings to more than 1,200 women, and 500 treated 56 with cryotherapy. In June 2011, IMB organized a three-week training on quick 0 and low-cost approaches to screening for cervical cancer. This training is part of PIH’s 2008 2009 2010 collaboration with the non-profit PATH and the Ministry of Health to support Rwanda’s National Cervical Cancer Plan. The plan includes HPV vaccination for adolescents, 660,137 total patient visits screening for HPV and cervical cancer using Visual Inspection with Acetic Acid, and 5,910 HIV patients on treatment treating precancerous lesions with cryotherapy. 19,759 babies delivered in health Provided social and economic support for a marginalized community: In facilities partnership with the local community, and as part of the Rwandan Government’s 107,980 patients tested for HIV initiative to eliminate grass-roofed houses, IMB constructed 39 houses for families health centers supported from the marginalized pygmy community in the remote hills of northern Rwanda. 37 Replacing leaky, grass-thatched huts, the new houses were built with sturdy walls 554 secondary school students and metal roofs, ensuring equity while complying with district housing standards. received tuition coverage In addition to housing, IMB and Burera district officials provided a full package of 37,200 people received mutuelle support to the pygmy community, including mutuelle health insurance subscriptions health insurance coverage for every family, agricultural and food support, and school support for every child, Staff: including the costs of uniforms, shoes, notebooks, and other fees. 865 medical 1,146 non-medical 3,313 community health workers The Year In Review 15 Lesotho/ Bo-Mphato Litšebeletsong tsa Bophelo
In the five years that PIH has been working in Lesotho, we have expanded comprehensive health care services to seven health centers and one hospital in the mountainous, rural areas. This year PIH-L continued to provide comprehensive services at the community level— sending community health workers to the homes of pregnant women and patients with tuberculosis and HIV—and in clinics, focusing on providing safe deliveries and high-quality pre- and post-natal care.
Highlights of the Year Expanded rural healthcare support: In March 2011, PIH-L expanded its network of supported health facilities in the rural mountain districts to include Mamohau Hospital. When PIH-L removed user fees at the hospital in April, the number of patient visits more than tripled. Working with the Ministry of Health and Social Welfare and the Christian Health Association of Lesotho, PIH-L is providing training for staff and community health workers, medical supplies and equipment, and improved infrastructure. In addition to increasing the number of people in the mountains who are receiving high-quality health care, Mamohau will serve as an emergency referral facility for all PIH-L clinics, providing emergency obstetric services and serving as a base for training and research activities. With the addition of Mamohau, PIH-L now serves an estimated 235,000 people in rural Lesotho. An HIV patient with her children 12 Credit: Ilvy Njiokiktjien 16 Lesotho/Bo-Mphato Litšebeletsong tsa Bophelo (continued) By The Numbers
Scaled up Maternal Mortality Reduction Program: PIH-L scaled up a successful pilot program to improve access Patients Receiving Antiretroviral for women in the mountains of Lesotho to comprehensive pre- and post-natal care, and Therapy 5000 to delivery at health facilities with a skilled nurse-midwife. This year PIH-L added 450 3750 community health workers trained to educate women about the importance of facility- 2500 based care during pregnancy, and accompany them to health clinics. PIH-L also built maternal waiting houses at six clinics, where pregnant women who live far from the health 1250 0 facility can stay to ensure they are close by for delivery. By connecting women and children 2008 2009 2010 to the health system at a critical time, this program is also increasing the number of HIV- positive women who receive services to prevent transmission of HIV to their children, the 14,771 patients tested for HIV, number of children who receive vaccinations and are screened for malnutrition, the number of HIV-positive women of whom 1,269 (8.6%) tested positive screened for cervical cancer, and the number of women who receive family planning. 777 patients newly enrolled on ART Spearheaded MDR-TB treatment and training: PIH-L began treating drug-resistant tuberculosis in 2007. Since then, PIH-L has led the national program for multidrug-resistant tuberculosis (MDR-TB), with over 200 437 new TB patients, of which 148 trained community health workers helping patients take medications and cope with had drug resistance and 256 had side effects and socioeconomic challenges. The Lesotho MDR-TB program has treated HIV co-infection more than 600 patients to date and has gained international recognition as a model for 76,954 outpatient visits community-based care. This year, the program hosted 50 visiting health professionals from countries including Zambia, Ethiopia, Zimbabwe, and Swaziland, and ran a 14,933 total food packages distributed to patients training program for doctors on treating MDR-TB in areas of high HIV co-infection. 1,922 prenatal care visits Provided social support to vulnerable patients: In addition to improving access to medical care, PIH-L continued to support the social and economic needs of our patients. The program 456 deliveries at clinics to support orphans and vulnerable children now provides more than 75 children with services that include total immunizations food packages, school fees and psychosocial support. Partnering with the World Food Program, PIH-L also 12,631 provided food packages to pregnant women and children at several clinics, with the goal of improving nutrition 10,474 total family planning visits and health outcomes for this vulnerable group. Additionally, PIH-L began supporting a community-run pre-school in Nkau, where children too young for primary school can play and learn. The school has been so Staff: successful that the community is building a larger space to accommodate more children. 79 medical 133 non-medical 1,745 community health workers The Year In Review 17 Malawi/Abwenzi Pa Za Umoyo
By providing equipment previously unavailable in Malawi, promoting women’s health and disease prevention, and supporting community programs, Abwenzi Pa Za Umoyo (APZU) continued to make strides to improve public health infrastructure and services in rural Neno District.
Highlights of the Year Opened Malawi’s first rural microbiology laboratory: In September 2010, APZU inaugurated a new microbiology lab at Neno District Hospital, making it the first district hospital in Malawi able to perform routine blood cultures, a vital diagnostic tool for detecting life-threatening infections ranging from typhoid to sepsis. The lab was opened through a partnership between APZU, the Malawian Ministry of Health and the Centers for Disease Control and Prevention. Before the lab opened, doctors had to send samples to a lab in the capital city of Lilongwe and wait weeks for results. Now, clinicians can have answers and prescribe treatments for their patients within just 48 hours. Prevented malaria through distribution of bed nets: Each year, Malawi’s people endure millions of cases of malaria and mourn the death of thousands—most of whom are women and young children. To help fight malaria in Neno District, APZU partnered with Together
Mother and 12 child in Malawi 18 Malawi/Abwenzi Pa Za Umoyo (continued) By The Numbers
Against Malaria to provide long-lasting insecticide-treated bed nets to pregnant Patients Receiving Antiretroviral women, new mothers, and their newborn children. These nets offer important Therapy advantages over nets traditionally available in Malawi, as they last up to five years 3500 2800 and do not require recipients to treat them again with insecticides. Provided at the 2100 district’s prenatal clinics, ART centers and maternity wards, the nets encourage 1400 women to seek primary healthcare services and complement APZU’s existing work 700 with the Ministry of Health to distribute nets at the community level. To date, over 0 2008 2009 2010 2011 400 women and newborns have benefited from the program.
Promoted women’s health through screening and treatment for cervical cancer: Rarely encountered 379,171 outpatient visits across 12 in rich countries and entirely preventable with vaccinations, proper screening, and removal of precancerous APZU facilities lesions, cervical cancer kills over 1,500 women in Malawi each year. In partnership with the Malawian Ministry of Health, APZU scaled up a successful cervical cancer-screening program across 10 health facilities 1,419 children received nutritional and educational support in Neno District. The program uses Visual Inspection with Acetic Acid to identify precancerous lesions and a liquid-cooled probe to freeze and remove them (cryotherapy). Over the last year, more than 400 women 740 patients received socioeconomic were screened for cervical cancer and dozens were treated effectively with cryotherapy. support in kind, cash, and housing
Fought malnutrition in a new nutritional rehabilitation unit: On May 26, 2011, Neno District Hospital 14,505 community members admitted its first patients into a new Nutritional Rehabilitation Unit (NRU)—the first of its kind in the enrolled in the Neno Community district. In Malawi, 20 percent of children under the age of five are moderately or Support Initiative severely underweight, and over half suffer from moderate or severe stunting due to 2,856 food packages distributed chronic malnutrition. Supported by a partnership between APZU, the Malawian to HIV and TB patients Ministry of Health, and the Clinton Health Access Initiative, the NRU provides specialized care to dangerously malnourished children. The NRU is part of APZU’s 61 hospitalized patients provided comprehensive community-based nutrition program, which identifies and treats with financial and material support malnourished children under the age of 12 in the district, as well as pregnant women and new mothers. Staff: 175 medical 490 non-medical 691 community health workers The Year In Review 19 Russia/ Партнеры во имя Здоровья
PIH-Russia celebrated its tenth year treating patients with multidrug-resistant tuberculosis in Tomsk Oblast in Siberia. The program has expanded out of Tomsk to five additional regions, and continues to improve care for tuberculosis patients through research and comprehensive, patient-centered treatment.
Highlights of the Year Celebrated 10 years of treating multidrug-resistant tuberculosis (MDR-TB): When the treatment of multidrug- resistant tuberculosis with second-line drugs was adopted by the World Health Organization, it was called DOTS Plus— projects implemented in addition to standard Directly Observed Therapy (DOTS) aimed at treating drug-resistant TB patients. In 2000, PIH brought DOTS Plus to Russia, choosing Tomsk as the first Russian site to implement the international standards. Now, 10 years later, Tomsk’s MDR-TB project has treated more than 2,100 drug-resistant TB patients, and cut the TB mortality rate by more than 60 percent. Expanded community-based care to additional regions: In October 2010, PIH-Russia received a $1.5 million grant from USAID to create Patient Centered Accompaniment (PCA) projects— expansions of the existing Sputnik project in Tomsk—in five new regions in Russia. The PCA projects provide care at home or in the community for patients who have difficulty making daily visits to a health facility for the intensive treatment regimen needed to cure MDR-TB, especially patients affected by homelessness, poverty, alcohol and substance abuse, HIV, and previous incarceration. The PCA projects enrolled approximately 700 high-risk patients and will screen up to 10,500 of their contacts (people who may have been exposed to TB or MDR-TB) over the next five years. Continued MDR-TB training and research projects: In collaboration with Harvard Medical School and Brigham and Women’s Hospital, PIH-Russia conducted three workshops on MDR-TB, providing specialized training to doctors and program managers from 25 territories to improve the quality of services they provide. In June 2011, PIH-R concluded a six-year clinical trial that incorporated treatment for alcoholism—a condition present in more than half of all TB patients in Tomsk district—into standard TB care. Preliminary results show that this intervention is highly feasible as an integrated component of TB care, and has been widely endorsed by providers and patients. TB Mortality in Tomsk 25 (per 100,000 population) Staff: 20 800 TB and MDR-TB 629 HIV- 11 9 HIV patients 15 patients received daily positive at risk of co-infection 10 food packages in order patients enrolled on preventive 7 medical to stimulate adherence to screened TB treatment, of whom TB patient receiving 5 15 non-medical medicine and a food package 0 the treatment provided. for TB 90% completed the full 2000 2002 2004 2006 2008 2010 course of treatment. Kazakhstan
Due to the success of the PIH-Russia program in treating multidrug-resistant tuberculosis (MDR-TB) for the past 10 years, the government of neighboring Kazakhstan invited Partners In Health to provide technical assistance in Karaganda and Pavlodar Oblasts, two regions bordering Siberia where these drug-resistant strains of tuberculosis are quite prevalent.
Highlights of the Year Expanded services, opened new office in Kazakhstan: In April 2010, PIH opened a new country office in Almaty, Kazakhstan. The PIH program in Kazakhstan (PIH-KZ) scaled up TB coverage by adding three patient-centered accompaniment teams in Karaganda and Pavlodar Oblasts, treating TB and MDR-TB patients in the civilian and prison sectors. Since opening, PIH-KZ has provided several monitoring visits and organized trainings for more than 250 participants to learn about tuberculosis detection, treatment, and follow-up. Introduced a new training initiative for TB treatment: Setting out to improve patients’ adherence to treatment, PIH-KZ collaborated with teams from PIH-Russia to develop and introduce a new training initiative for TB treatment. It focuses on TB nurses, enabling them to act as TB counselors or supporters to patients during the entire course of their treatment. The training contains 10 modules on various aspects of TB treatment, including information on patients’ rights, social support, and adherence. To date, PIH-KZ has delivered the training to 107 TB nurses from the public and prison sectors of Karaganda and Pavlodar. Influenced national TB policies: PIH-KZ plays a leading role in improving the management of drug-resistant tuberculosis at the national level. In the last year, PIH-KZ contributed to the development of the National Decree on MDR-TB and the National Guidelines on Medical Management of MDR-TB, both of which were approved by the Kazakh Ministry of Health for further implementation. These policies will increase access to adequate treatment for patients across the country who are suffering from drug-resistant TB.
511 drug-resistant TB 255 TB doctors 54 TB patients Staff: patients enrolled in DOTS- received intensive received patient- Plus treatment, with 217 training on Medical and centered accompaniment 7 medical patients in Karaganda and Program Management at home. non-medical A nurse visiting a Pavlodar prisons. of MDR-TB. 2 patient at home 21 USA/PACT
This year, the Boston-based Prevention and Access to Care and Treatment (PACT) project became further integrated into the Boston healthcare system, refreshed its strategic planning efforts, and made new connections with US healthcare policymakers. PACT also invested in refining its HIV program to better serve Boston’s at-risk HIV/AIDS patients.
Highlights of the Year Received federal funding to improve HIV care for Boston’s at-risk HIV population: This year, PACT received a five-year federal grant through the Ryan White HIV/AIDS Program, the largest funder of HIV/AIDS care in the US. This marks the first time the organization has awarded a grant to a community health worker (CHW) program in Massachusetts. Working in partnership with the Massachusetts Department of Public Health, PACT will use this funding to continue providing care to Boston’s most vulnerable HIV-positive patients. Completed strategic planning to impact US health care: PACT received strategic planning support from the Harvard Business School Community Action Partners (CAP) to improve PACT’s focus and develop a plan to achieve the greatest possible impact on the domestic healthcare system. As a result, PACT integrated its clinical and training leadership staff into the primary care transformation efforts of the state’s largest hospital network—Partners Healthcare. PACT provided training and technical assistance for their two most innovative care delivery models: Brigham and Women’s Hospital’s medical home project and Massachusetts General Hospital’s care management program for high-risk Medicare patients. Developed relationships with federal and state healthcare policymakers: The PACT team developed many new relationships in the Boston statehouse and on Capitol Hill, meeting frequently with policymakers to enhance their knowledge of the PACT community health worker model and its potential for systemic change. Supported by these new connections, PACT has submitted proposals to the Center for Medicare and Medicaid Services (CMS) Innovation Office and identified opportunities to participate in Massachusetts’ patient-centered medical home (PCMH) transformation efforts. 85 patients Approximately More than 300 Staff: served in HIV 5,160 health healthcare providers project. promotion and trained on 1 medical PACT patient taking DOT home visits. PACT model. 12 non-medical medicine for HIV 9 community health workers 22 Mexico/Eapsec
In addition to their continued support and training of community health workers (promotores), Equipo de Apoyo en Salud y Educación Comunitaria (EAPSEC) worked to improve TB care and provide social support for women in the state of Chiapas.
Highlights of the Year Hosted a forum on the right to health and tuberculosis in Chiapas: EAPSEC, together with other members of the Citizens’ Observatory for the Exercise of the Right to Health (OBCIUDES), convened and organized the “Forum on the Right to Health and Tuberculosis in Chiapas.” Epidemiologists and researchers discussed the state of the TB epidemic, including evidence suggesting that many children with TB go undiagnosed. The forum also served to review the state TB program from the perspective of civil society, highlighting the challenges community members face when trying to get TB care. To help address these challenges, the forum featured a nurse from PIH’s partner organization Socios En Salud who shared successful TB management strategies employed in Peru. Focused on supporting and empowering women: EAPSEC facilitated a process of reflection for women’s groups in the town of Siltepec in southern Chiapas, identifying ways for them to better exercise their rights. Groups addressed topics such as identity and self-esteem, how to make nutritious meals using local foods, the production of edible mushrooms, bread-making, and utilizing nutritious edible plants often mistaken for weeds. It is difficult for women to participate in such programs, due both to a heavy workload at home and to attitudes that discourage women from being active outside the home. Despite these difficulties, the program has achieved a high participation rate and has served 154 women to date. Provided community validation of forthcoming edition of “Where There Is No Doctor”: As a result of EAPSEC’s strong community relationships and decades of experience, the Hesperian Foundation asked EAPSEC to coordinate a process of community validation of several chapters of the new version of the book Where There Is No Doctor. EAPSEC facilitated the participation of 12 promotores, all with several years of experience as local trainers, to review the chapters related to parasitic diseases and disease prevention. Where There Is No Doctor serves as a reference tool for promotores in Chiapas and for other community health worker programs across the globe. Staff:
1 medical non-medical A community health 4 worker on a home visit 23 Guatemala/ETESC
With initiatives in environmental health, improved capacity for cancer screenings, and outreach projects advocating for the rights of indigenous communities, Equipo Técnico de Educación en Salud Comunitaria (ETESC) continued to work toward better health and human rights in the rural communities of Huehuetenango, Guatemala.
Highlights of the Year Launched Environmental Health Program in indigenous communities: ETESC helped 175 vulnerable families address the root causes of harm to both health and the environment in their communities. The families received training on environmental health issues, then selected an activity to address their top concern. They unanimously chose to install improved wood-burning stoves manufactured by HELPS International. By cutting indoor smoke from open cooking fires by up to 90 percent, these new stoves will decrease the serious risk of respiratory diseases such as pneumonia, asthma, and emphysema. They will also decrease the amount of wood fuel used by as much as 50 percent, helping preserve local forests and avoid erosion and landslides. Collaborated with clinics to stop cervical cancer deaths: Despite being one of the most preventable cancers, cervical cancer is the leading cause of cancer death among women in Guatemala and many other poor countries. This year, ETESC collaborated with a local government health post and a private women’s clinic to improve access to screening and treatment for cervical cancer. Traditional prevention requires multiple patient visits—a chain of care that is easily broken when time and transport costs present barriers to women. ETESC’s new program introduced the screen-and-treat method, which allows women to receive results—and when necessary, treatment— in just one visit. Four clinicians received instruction in this method from master trainers, as well as crucial equipment and supplies. In the first three months of the program, more than 300 women were screened. Advocated for an indigenous voice in development: Due to insufficient land rights and worker and environmental protections, large-scale projects such as mines and highways often harm local communities. Guatemalan law holds that indigenous communities must be consulted before such projects are undertaken—a process often glossed over or ignored altogether. ETESC has been a leading voice in a coalition of civil society groups that proactively advocates for and implements such consultations. This year, intending to give this mechanism more weight, ETESC conducted advocacy campaigns to give official legal status to these consultations. Staff: 10 non-medical Women with improved wood-burning stoves 24 Medical Informatics
The Medical Informatics team facilitated the routine collection and use of data as a core part of PIH activities, used to improve quality and access to care, program and supply-chain management, and research. The team continued to contribute as one of the leading developers of OpenMRS, an open- source Electronic Medical Record (EMR) system pioneered at PIH sites and now used in 49 countries.
Highlights of the Year Expanded the scope of data captured in OpenMRS: In Malawi, PIH expanded HIV EMR coverage from six health centers to 13. In Rwanda, new modules for chronic diseases such as hypertension and diabetes were added, and infrastructure was deployed to allow remote data entry in all supported districts. PIH also streamlined the MDR-TB records system in Haiti for entry of essential reporting and patient monitoring data. Built capacity for OpenMRS in Rwanda: PIH supported the Government of Rwanda’s national rollout of OpenMRS through training, mentoring and capacity building. PIH developers worked closely with our Rwandan counterparts, trained in a PIH eHealth course, to develop the required software. A major milestone was the deployment of OpenMRS at Musha Health center, the first of four Phase I sites chosen for the national rollout. Piloted new software for inventory and supply-chain management: The Medical Informatics team continued work on new, open-source software for inventory and supply chain management, aiming to prevent stockouts of essential drugs and medical supplies by providing PIH with real-time inventory levels and streamlining the process of requesting and shipping new stock. PIH built and tested new features for inventory management and shipping at warehouse sites in Miami and Boston. Deployed innovative point-of-care EMR systems: A point-of-care system for collecting and accessing primary care data was piloted at Rwinkwavu Health Center in Rwanda. The system uses touchscreen computers to capture patient demographics and essential visit information in real time, eliminating time-consuming data entry and providing immediate access to patient information. PIH registered 7,365 patients at Rwinkwavu Health Center with this new system. In Malawi, PIH continued to collaborate with Baobab Healthcare on a point-of-care system for HIV data, expanding the software to capture new data required as part of Malawi’s revised HIV program guidelines.
Collecting GPS data in Rwanda The Year In Review 25 Training
PIH’s training department works to strengthen training programs and systems in our project sites through standardized, culturally sensitive curricula and dedicated training teams focused on local capacity building. This year we developed new curricula, supported clinical and community health worker training programs, and provided materials and technical support across PIH sites. The training department also serves as a resource for organizations around the world to build capacity and maximize the impact of services.
Highlights of the Year Enhanced training, mentoring, and supervision of clinicians: The training department supported the launch of Mentoring and Enhanced Supervision at Health centers (MESH), a new initiative implemented in two districts in Rwanda focused on clinical training of health center nurses, their ongoing mentoring and support, and program monitoring for quality improvement. MESH targeted four key aspects of clinical care: women’s health, pediatric care, acute adult care, and infectious disease. Across these topics, 142 nurses, 27 social workers, and 12 health center directors received training. Additionally, 563 doctors, nurses, and social workers in Rwanda received training on a range of topics, from malnutrition and neonatal care to pharmaceutical management and family planning. Trained community health workers in active case finding and primary health care: With the support and collaboration of the World Bank and the Haitian Ministry of Public Health and Population, the PIH training department contributed to efforts to control the cholera epidemic in Haiti. The training department developed and produced a training unit on cholera, coordinated the training of 90 trainers and 350 community health workers (CHWs), and will provide a second round of training for 3,000 CHWs in the coming year. Developed and disseminated training curricula for CHWs, clinicians, and program managers: In partnership with the World Bank and with local ministries of health, PIH began development of 12 primary health care modules for CHW training, covering topics such as family planning, reproductive health, malnutrition, and vaccinations. This year, 1,600 CHWs in Rwanda and 1,000 in Haiti received training in HIV/AIDS, TB, and primary health care topics such as malnutrition and vaccinations. The Program Management Guide was developed with support from the Bill & Melinda Gates Foundation to provide a PIH model for program planning and implementation. The guide was completed and launched on an interactive online platform in 2011. PIH also developed a training for maternal health workers, forming the basis for a program aimed at stemming maternal mortality rates across our Lesotho sites. Training for 26 mothers in Lesotho 26 Advocacy & Policy
The Institute for Health and Social Justice (IHSJ) team continued to promote PIH’s human rights-based approach to health and development with advocacy and policy-change strategies to increase funding for global health, improve socio-economic conditions in Haiti, and promote food security and health system strengthening.
Highlights of the Year Exposed the inadequacy of food aid in Haiti: The IHSJ team co-authored Sak Vid Pa Kanpe: The Impact of U.S. Food Aid on Human Rights in Haiti, with the Center for Human Rights and Global Justice at the NYU School of Law, the RFK Center for Justice and Human Rights, and Zanmi Lasante. The report shows that while food aid provides partial nourishment to many people without reliable food sources, the way in which it is procured, delivered, and administered often interferes with basic human rights and erodes long-term food security. The report also recommends ways to improve US food aid to Haiti, including involving Haitians in the planning and implementation of aid programs, and increasing Haiti’s capacity to produce food locally. Continued building a movement for social justice and affecting policy change: IHSJ leadership gave over 75 talks, lectures, and presentations to educate and engage different communities around the globe. In addition, the team met with Congressional staff and members over 40 times in the past year to inform and influence global health policy. Co-hosted events to highlight important healthcare issues: With resources swallowed by the fight against infectious diseases, the world’s poor are often left to fight non-communicable diseases (NCDs) such as diabetes, heart disease, and cancer on their own. In March 2011, PIH and our partners at the Harvard Medical School Department of Global Health and Social Medicine organized and participated in a conference on the often-neglected non-communicable or chronic diseases of the world’s poorest citizens. The conference was convened to raise awareness in advance of a high- level United Nations meeting on NCDs in September 2011. Published a landmark article on women and structural violence: PIH staff authored an article detailing how reducing structural violence against women would improve progress in meeting the United Nations’ Millennium Development Goals related to women’s health and education. With examples from our Haiti and Lesotho projects, the article clearly demonstrates how women’s lives can be saved and transformed by programs that combine quality health care with determined efforts to uproot structural violence and the social determinants of disease, especially poverty, sexism, and gender-based violence.
Solidarity celebration for Haiti one year after the earthquake The Year In Review 27 Research
To strengthen and leverage our community-based approach, PIH conducts rigorous research that can be used both to identify and remedy weaknesses and to prove its effectiveness and impact. This year, with our partners at Harvard Medical School (HMS) and Brigham and Women’s Hospital (BWH), PIH published a variety of research including articles on cholera, tuberculosis, and the advantages of the community health worker model.
Highlights of the Year Focused on cholera in Haiti: Researchers at HMS and BWH described the emergence of cholera in Haiti, and proposed a series of interventions to reduce its spread and impact. Led by members of PIH’s Haiti team, this work led to the publication of a joint statement on cholera prevention and care that was endorsed by a global panel of experts. In ongoing work, Louise Ivers, a BWH physician and PIH’s Senior Health and Policy Advisor, partnered with a team of cholera researchers to seek funding for continued research into the epidemiology and management of cholera in Haiti. Studied the impact of innovations in care delivery at PIH sites across the globe: Louise Ivers described the impact of shifting tasks among doctors, nurses, and community health workers in Haiti. Rwandan Minister of Health Agnès Binagwaho and collaborator Paulin Basinga evaluated the effect of performance-based financing of primary health care in Rwanda. Jen Furin described the role of traditional healers in caring for HIV patients within the PIH sites in Lesotho. Sonya Shin and others focused on the impact of microfinance programs for impoverished persons living with HIV in Peru. Paul Farmer led a group of experts that called for an expansion of cancer care and prevention to developing countries. The group highlighted PIH programs in Haiti and Rwanda. Continued to study the transmission and treatment of multi-drug resistant tuberculosis: Mercedes Becerra of HMS described the burden of drug-resistant TB within households of patients in Lima, Peru. Ted Cohen and Sonya Shin of BWH developed tools to track and predict the spatial spread of drug-sensitive and resistant TB. Sonya Shin also studied the impact of a targeted drug-resistance testing strategy for multidrug-resistant tuberculosis detection in Lima.
Researchers from a tuberculosis study in Peru 26 © SES The Year In Review 28 Selected Publications
Books Ivers LC, Farmer P, Almazor CP, Léandre F. Five complementary Bukhman G, ed. The PIH Guide to Chronic Care Integration for Endemic interventions to slow cholera: Haiti. Lancet. 2010 Dec 18; 376(9758):2048-51. Non-Communicable Diseases. Boston: Partners In Health, Harvard Medical School, Brigham and Women’s Hospital, 2011. Ivers LC, Jerome J-G, Cullen KA, Lambert W, Celletti F, Samb B. Task Shifting in HIV Care: A Case Study of Nurse-Centered Community-Based Care Farmer P. Haiti After the Earthquake. New York: PublicAffairs, 2011. in Rural Haiti. PLoS ONE. 2011 May 6; 6(5) Keshavjee S, Farmer PE. Picking up the pace—scale-up of MDR tuberculosis Articles treatment programs. N Engl J Med. 2010 Nov 4; 363(19):1781-4. Basinga P, Gertler PJ, Binagwaho A, Soucat AL, Sturdy J, Vermeersch CM. Lim Y, Kim JY, Rich M, Stulac S, Niyonzima JB, Smith Fawzi MC, Gahire Effect on maternal and child health services in Rwanda of payment to primary R, Mukaminega M, Getchell M, Peterson CW, Farmer PE, Binagwaho A. health-care providers for performance: an impact evaluation. Lancet. 2011 Apr Improving prevention of mother-to-child transmission of HIV care and related 23; 377(9775):1421-8. services in eastern Rwanda. PLoS Med. 2010 Jul 20; 7(7). Betancourt TS, Rubin-Smith JE, Beardslee WR, Stulac SN, Fayida I, Safren Mukherjee JS, Barry DJ, Satti H, Raymonville M, Marsh S, Smith-Fawzi MK. S. Understanding locally, culturally, and contextually relevant mental health Structural violence: a barrier to achieving the millennium development goals for problems among Rwandan children and adolescents affected by HIV/AIDS. women. J Womens Health (Larchmt). 2011 Apr; 20(4):593-7. AIDS Care. 2011 Apr 23; (4):401-12. Shin S, Muñoz M, Caldas A, Ying Wu, Zeladita J, Wong M, Espiritu B, Farmer P, et al. Meeting Cholera’s Challenge to Haiti and the World: A Joint Sanchez E, Callacna M, Rojas C, Arevalo J, Sebastian JL, Bayona J. Mental Statement on Cholera Prevention and Care. PLoS Negl Trop Dis. 2011 May; Health Burden Among Impoverished HIV-Positive Patients in Peru. J Int Assoc 5(5) Physicians AIDS Care (Chic). 2011 Jan-Feb; 10(1):18-25. Franke MF, Robins JM, Mugabo J, Kaigamba F, Cain LE, Fleming JG, Shin SS, Mathew TA, Yanova GV, Fitzmaurice GM, Livchits V, Yanov SA, Murray MB. Effectiveness of early antiretroviral therapy initiation to improve Strelis AK, Mishustin SP, Bokhan NA, Lastimoso CS, Connery HS, Hart JE, survival among HIV-infected adults with tuberculosis: a retrospective cohort Greenfield SF. Alcohol consumption among men and women with tuberculosis in study. PLoS Med. 2011 May; 8(5) Tomsk, Russia. Cent Eur J Public Health. 2010 Sep; 18(3):132-8.
Furin J. The Role of Traditional Healers in Community-Based HIV Care in Surkan PJ, Mukherjee JS, Williams DR, Eustache E, Louis E, Jean-Paul T, Rural Lesotho. J Community Health. 2011 Mar 4. Lambert W, Scanlan FC, Oswald CM, Fawzi MS. Perceived discrimination and stigma toward children affected by HIV/AIDS and their HIV-positive caregivers in Ivers LC, Chang Y, Gregory Jerome J, Freedberg KA. Food assistance is central Haiti. AIDS Care. 2010 Jul; 22(7):803-15. associated with improved body mass index, food security and attendance at clinic in an HIV program in central Haiti: a prospective observational cohort study. Waters E, Rafter J, Douglas GP, Bwanali M, Jazayeri D, Fraser HS. Experience AIDS Res Ther. 2010 Aug 26; 7:33. implementing a point-of-care electronic medical record system for primary care in Malawi. Stud Health Technol Inform. 2010; 160(Pt 1):96-100. Above the mountains in Lesotho 29 Finance & Governance Tree planting at Mirebalais construction site 30 Financial Review As we approach the twenty-fifth anniversary of our founding, we reflect with a great deal of humility on the tremendous progress we have made accompanying the poorest of the poor in 12 countries. Along the way we have learned many lessons, formed valuable partnerships, increased our supporter base, and extended the depth of our programmatic efforts. Our work in fiscal year 2011, as reflected by our financial performance and position, was no exception. In fiscal year 2011, we generated revenues of $88 million, representing a $24 million or 18 percent compounded annual increase compared to normalized revenues of $63 million in fiscal year 2009. Partly supporting this growth were 15,000 individuals who became new PIH donors during the most recent fiscal year. This base of new donors alone outpaces the total number of donors in fiscal year 2009, reflecting the benefits of our careful decision to bolster investments in development. Even with this increased investment in development efforts, the vast majority of our funding continues to directly support program activities; administration and development account for just 6 percent of total expenditures. We ended fiscal year 2011 with $117 million in expenses, creating a deficit for the year of $28 million. The deficit was intentional and part of our plan to spend down in fiscal years 2011 and 2012 the $58 million remaining as of June 30, 2010 that we received to support rebuilding efforts in Haiti following the devastating earthquake in January 2010. We have made a number of investments in Haiti—including construction of a public teaching hospital highlighted in this report—that we believe will generate lasting benefits for our patients and partners. We expect to draw down on remaining Haiti funds of $30 million, included in our net assets of $62 million, by the end of fiscal 2012. Looking forward to fiscal year 2013 and beyond, after the additional funds for Haiti are expended, we plan to reduce overall spending to levels consistent with anticipated normalized revenues. While this will require difficult decisions, we remain committed to acting responsibly and strategically—keenly mindful of our moral and medical obligation to those we diligently serve. In addition, we will strive to ensure that our precious financial resources continue to reach the intended beneficiaries as efficiently and effectively as possible. This critical objective is reinforced by a recent internal change initiative that includes strengthening internal control processes and formalizing belief and boundary systems. Thank you for continuing to stand with us and making our work possible.
Chief Financial Officer
Since 2003, Partners In Health has consistently earned Charity Navigator’s highest rating, certifying our commitment to accountability, transparency, and responsible fiscal management. Only 1% of charities have received this distinction for eight consecutive years, placing Partners In Health among the most trustworthy charities in America. We are deeply committed to being good stewards of our donors’ dollars, with 94 cents of every dollar donated going directly to our programs—directly to saving lives.
31 Financial Review Statement of Activities Revenue by Source FY2011 (dollars in thousands) For the year ended June 30, 2011 2010 2009 Gifts in kind Revenue and other income 5% Contributions, grants and gifts in kind Individuals and Governments and family foundations Individuals and family foundations $39,956 $83,546 $32,311 27% multilaterals 45% Foundations and corporations 19,900 46,039 14,915 Foundations Governments, multilateral & research institutions 23,220 17,428 14,468 and corporations 23% Gifts in kind and contributed services 4,450 4,770 1,523 Other income 351 175 152 Total revenue 87,517 151,958 63,369
Expenses Program services 109,642 86,237 60,118 Program Costs FY2011 Development 3,793 3,042 1,590 2% 3% 3% Administration 3,153 2,507 2,227 1% 3% Total expenses 116,588 91,876 63,935 5% 6% Excess/(shortfall) of revenue over expense (29,071) 60,082 (566) Haiti 53% Rwanda 14% Investment income/(loss) 1,446 569 (3,324) 6% Change in net assets (27,625) 60,651 (3,890) 1% 3% Currency translation adjustments 101 56 (59) Net assets at beginning of year 89,434 28,727 32,676 Russia and Haiti 53% Cross-site activities 5% Kazakhstan 3% Net assets at end of year 61,910 28,727 89,434 Communications Rwanda 14% Administration 3% and advocacy 1% Note: Just 6% of total expenditures in FY11 went toward administration and Lesotho 6% Development 3% USA/PACT 1% development, with the vast majority of funding going directly to program activities. Peru 6% Malawi 3% Other 2% Finance & Governance 32 Expenses, 2006-FY2011 (dollars in millions) Administration $120 Development
$100 Other PACT (Boston) $80 Malawi
Russia and Kazakhstan $60 Peru $40 Lesotho
Rwanda $20 Haiti $0 2006 FY2008 FY2009 FY2010 FY2011
Note: Other includes academic initiatives, medical informatics, training, monitoring and evaluation, communications, advocacy, as well as cross‐site clinical staff and procurement. In 2007, PIH changed from a calendar year end to a fiscal year ending June 30. As a result, we have excluded 2007 due to only 6 months of operating results in that fiscal year. Revenue by Source, 2006-FY2011 (dollars in millions) $160
$140
$120 Other income $100 Gifts in kind and contributed services $80 Governments, multilaterals $60 and research institutions Foundations and $40 corporations $20 Individuals and family foundations $0 2006 FY2008 FY2009 FY2010 FY2011
Notes: Revenues in FY10 reflect generous donations for Haiti earthquake relief. In 2007, PIH changed from a calendar year end to a fiscal year ending June 30. As a result, we have excluded 2007 due to only 6 months of operating results in that fiscal year. Through 2004, PIH relied almost solely on one major foundation grant and a single major gift benefactor. In FY2011, PIH received gifts from Nurse consults patient 170 foundations and corporations and over 45,000 individual donors. records in Lesotho
33 Financial Review
Balance Sheet as of June 30, (dollars in thousands) 2011 2010 2009 Assets Cash and cash equivalents $7,899 $4,476 $5,218 Contributions receivable 825 2,106 2,362 Grants and other receivables 7,687 11,687 5,199 Prepaid expenses and other assets 535 311 142 Investments, at fair value 46,971 71,510 15,649 Property and equipment, net 2,886 3,047 2,725 Total assets 66,803 93,137 31,295
Liabilities and net assets Liabilities Accounts payable and accrued expenses 4,380 3,312 2,322 Amounts owed – fiscal agencies 513 391 246 Total liabilities 4,893 3,703 2,568 Net assets Unrestricted Currency translation adjustments 399 298 242 Undesignated 8,165 9,687 7,093 Thomas J. White Fund 17,374 15,382 13,641 Total unrestricted net assets 25,938 25,366 20,976 Temporarily restricted 35,972 64,068 7,751 Total net assets 61,910 89,434 28,727 Total liabilities and net assets 66,803 93,137 31,295
Digging the foundation for Mirebalais Hospital Finance & Governance 34 Earthquake relief and reconstruction in Haiti The earthquake in January 2010 was a transformative event that continues to require an equally impactful and comprehensive response. In our deep commitment to the people of Haiti, we have responsibly exhausted much of the funds donated in response and expect to complete spending by the end of fiscal year 2012. Following the devastating earthquake and the outpouring of support from generous donors, our intentions have been clear: leverage two decades of experience and existing infrastructure (e.g., hospitals, health centers, and a trained, dedicated workforce that now numbers over 5,400), expand current services complementary to the response and recovery, strengthen the public health system, and accelerate relevant new projects. While these efforts are ambitious and challenging, we have made substantial strides. Due to the significant overlap of our core Haiti operations with the earthquake response and recovery efforts, disentangling spending for the earthquake alone is not an easy task. However, the graph below provides a constructive view of how the reach and depth of operations expanded in response. As the graph shows, through fiscal year 2011, we have spent $60 million above the spending level in fiscal year 2009, and this will increase to over $90 million through fiscal year 2012. More specifically, and consistent with the parameters we set for ourselves last year, we have provided much needed care in settlement camps, increased rehabilitative medicine and mental health services, and accelerated and expanded our plans for a national teaching hospital in Mirebalais. The hospital, scheduled to open in 2012, is the cornerstone of our efforts to rebuild Haiti’s systems for public health and the education of health professionals. Spending in Haiti, FY2009–FY2011 (dollars in millions) $70 Cholera Medical services within settlement camps and $60 support for Port-au-Prince general hospital Mirebalais hospital construction $50 Emergency staff support $40 Rehabilitative care $30 Mental health and psychosocial services Agriculture and water $20 Education, housing and social support $10 Clinical infrastructure Earthquake amputee with 0 Hospital and health center operations FY2009 FY2010 FY2011 prothesis participates in rehabilitation program 35 Thank You to Our Supporters
Pygmy children receiving school supplies in Rwanda
36 Thank You to Our Supporters Partners In Health would like to thank each and every one of our supporters, without whom our work would not be possible.
Samantha, Becky, Mark Foundation Hokies United Estate of Al Kenneth Starr Thomas F. Bumol Individuals, Southtech Orthopedics Hope for Poor Children Foundation Mary Ellen and Mark Stinski Clay and Janet Bunch Charitable Fund Family Foundations, St. Cecilia’s Parish Hurvis Charitable Foundation Mary Stobie Richard A. Busemeyer Atheist and Organizations Union for Reform Judaism Innovate Family Foundation Lise Strickler and Mark Gallogly Foundation Waterfall Foundation Louise C. Ivers Sunstar Americas, Inc. Paul and Catherine Buttenwieser Founders Circle Deone Jackman Ker and Michael Thompson C. Callander & M.C. Callander Trust ($1,000,000 and Above) Sustainers Circle Chandra Jessee Angelo J. Tomedi, M.D. Calvert Social Investment Foundation Anonymous ($25,000 – $100,000) Dr. Edward Jervey Trinity Building Corporation Cambridge Health Alliance Bob and Mary Grace Heine Anonymous JP/HRO John Weldon Kathleen Camuso Al and Diane Kaneb The Stuart and Jesse Abelson Foundation JustGive.org Christopher Wheat Canadian Council for Reform Judaism Herbert and Charlotte Wagner Trust Keefer Family Charitable Trust Tom* and Lo-e White Elizabeth and Nathaniel Carr Aid for Africa Lesley and William King Daniel and Brienne Wright Stanley Case and Mary Warren Visionaries Circle AIG Foundation Barbara Kravitz Ashley Younger John Cawley ($100,000 – $1,000,000) Nathaniel Back Christian Lambertsen The Cedar Street Foundation Anonymous The Cameron and Jane Baird Foundation Lang Foundation Advocates Circle Change the World Kids Jim and Karen Ansara The Baobab Fund Albert Lawrence ($10,000 – $25,000) Gary Choy Arcade Fire Estate of Macky Bennett The Frances Lear Foundation Anonymous Henry D. Chu, M.D. Robert and Anne Bass Brad and Terrie Bloom Leaves of Grass Fund Anonymous Fund in the Community Holly and Andrew Clubok Joshua & Anita Bekenstein Charitable Carole and Lloyd Carney Ledgeways Charitable Trust Foundation of North Texas Martin Cobb Fund, a Donor Advised Fund of Cathedral of the Sacred Heart of Jesus Legacy Venture Member American Association of Collegiate Matthew Cohen Combined Jewish Philanthropies Christ Church of Greenville Richard and Terry Lubman Registrars and Admissions Officers Hewitt Coleman & Warne Family The Blue Foundation Corporacion Dominicana de Empresas The Lucretia Philanthropic Fund, Inc. Jody Adams Emmett Coyne Charina Endowment Fund, Inc. Electricas Estatales Malcolm and Dana McAvity Mitchell Adams and Kevin Smith Gerald Curtis Melissa Cole Moira Cullen Elizabeth McCarthy and Brian O’Leary AFYA Felicity Dahl Jack and Eileen Connors Ophelia Dahl and Lisa Frantzis Medshare International Peter C. Alderman Foundation Phillippe Daniel and Martha McGaw Thomas and Line Corcoran Anita Davidson and Robert Friedman Midler Family Foundation Bill and Lauren Anderson Dartmouth College Crown Family Philanthropies DeLaCour Family Foundation Mission Relief Services Aqua-Flo Supply Dartmouth-Hitchcock Medical Center Annie Dillard and Bob Richardson Kristin Dornig and Tony Krantz James and Lisa Mooney Benjamin Auspitz Sallie and Bernard DeBar Direct Relief International The Stanley and Fiona Druckenmiller Elizabeth Moran The George & Dorothy Babare Family Paul and Mary Ellen DeNoon Eric and Barbara Dobkin Fund Patrick and Christine Murray Foundation Tom and Linda Dickey Wes and Lynn Edens Elisabeth Dudley James Nachtwey Ernest Bachrach DMMN Foundation Samuel and Maryann Ellsworth David R. Ferry Scott Nathan and Laura DeBonis Steven Backes Do A Little Fund The Episcopal Diocese of Upper South Finnegan Family Foundation Network for Good Simon Baker and Rebecca Rigg J. Peter and Marcia Dowd Carolina The Flatley Foundation Mr. and Mrs. Denis O’Brien Matthew and Margaret Balitsaris Nicola Drago FACE AIDS Floor Family Charitable Fund Mary O’Neill and Duncan Dee John and Beverly Barry Kate Duffield The Estate of Robert Fehribach Jascha Franklin-Hodge Population Services International Kimberly Bayless Mary and Robert Eccles Harrison Ford and Calista Flockhart Robert Friede The Replogle Family Foundation Marc and Alicia Belton David Edwards GreaterGood.org The Furman Family Fund Rhode Island Hospital Bergen Foundation Evangelistic Mission of Greek Evangelical Glenn Hadden Gansett Foundation Gardner Russo & Gardner and Semper Tim Bilmanis Church of Boston Harvard University Getinge USA, Inc. Vic Partners Susan Black R. Bradford Evans Hershey Family Foundation Neil Greene Pablo J. Salame Jennie Weiss Block Paul and Didi Farmer Family Howard H. Hiatt, M.D. The Greenwoods Academy Daniel Sanders Dr. Sally Blower and Dr. Nelson Freimer Foundation Inc. Joanna and Jonathon Jacobson Frederic and Jeanne Groos Satter Foundation Joshua and Amy Boger James Feldman and Natalie Wexter Robert and Ardis James Foundation Michael Haddad Family Foundation Kenneth and E. Pixley Schiciano Philip and Maureen Bonanno First Presbyterian Church of Greenwich Kirk Humanitarian Daniel Haines Steven Seidel Byron Bostic Leslie Fleming Scott and Laura Malkin Noble and Lorraine Hancock Family John J. Shaughnessy Boston University Friedman Family Charitable Fund, Pamela and Pierre Omidyar Fund The Shifting Foundation Sarah and Rod Bourgeois an advised fund of the Silicon Valley Ted and Karen Philip Harry Potter Alliance The Spector Fund at the Boston Robert and Nancy Boye Community Foundation River Street Development Foundation Barry Hayes Mutt Fund Foundation The Gracey Luckett Bradley Charitable Donald B. Fries Michael and Maureen Ruettgers The Hess Foundation Stephanie H. and David A. Spina Family Lead Unitrust Maxwell Fritz Rupert the Wonder Dog Foundation James and Anna Hoag Fund Foundation Jennifer Bruder Lavin and Edward Lavin Mr. and Mrs. Robert W. Geyer
This list reflects contributions at $1,000 and above made during Partners In Health’s 2011 fiscal year, from July 1, 2010, through June 30, 2011. Finance & Governance 37 Thank You to Our Supporters (continued)
Chris and Susan Gifford Ira N. Langsan & Lillian Langsan Jaimin Rangwalla Ken and Audrey Weil Gil Besing GlobalGiving Foundation Philanthropic Fund of the Jewish Nina and Lawrence Restieri Paula Weil Elsie Bickford GlobalGiving UK Communal Fund Rachel and Travis Rhodes The Donald and Elaine Weill Family Becky Bilodeau-Dewey The globalislocal Fund Gladys & Ralph Lazarus Foundation The Ripple Foundation Fund Black Dog Foundation Robert and Francine Goldfarb Lear Family Foundation Anthony and Kyra Rogers Welcoming Center for New Robert and Jane Blauvelt Gary Gottlieb and Derri Shtasel David and Anne Lee David Romeo Pennsylvanians Veronica Blette Barbara Greenewalt Paul Li Robert and Betty Romer Mary White Jill Block and Wade Rubinstein Lisa Gregg The Llewellyn Foundation The Rosenthal Family Foundation Michael and Elizabeth White Boy Scouts of Westwood and West Maggie Gyllenhaal and Peter Sarsgaard Mary Lyons Dr. Shelley Roth and Dr. Jed Weissberg Ann Wiedie and Keith Hartt Roxbury Eugene and Nancy Haller Charitable Gift Macalester College The Jim and Patty Rouse Charitable James Williams Thomas and Elisabeth Boyle Fund James and Heather Magliozzi Foundation The Wooden Nickel Foundation John Brannen Melissa and Frank Hanenberger Des Magner Saint Nicholas Fund World Exchange for Health and Human Timothy Broas Rick Hayman Jonathan Mark and Donna Sakson Fund David and Yolande Salter Charitable Fund Services Rick and Betsy Bronson The Hellman Family Foundation Tristin and Martin Mannion Haun Saussy and Olga Solovieva Xaverian Brothers USA, Inc. William and Josefa Buckingham Julie and Bayard Henry Thomas Martin Scriptograph, Ltd. Megan Zorn and Ulrich Mok May Bystricky Karen Hescock Orin McCluskey Seeds of Love for Errol Martha Zornow Dyami and Heather Caliri Hitz Foundation Denise and Mike McFall Stephen C. Senna Luis Camilleri Terrer Alan and Christine Huber The Christopher McKown and Abigail Wendy and Frank Serrino Leadership Circle Mark Campisano The Hunter-White Foundation Johnson Fund Margarita Shannon Rashida Caraway Mr. and Mrs. J. Atwood Ives John and Margarete McNeice Susan Shaw ($5,000 – $10,000) Carfagna Family Foundation The Richard & Natalie Jacoff Foundation, Medical Students United for Haiti Ben Sigelman Anonymous Peter and Rita Carfagna Inc. Mark and Goldi Miller Silver Mountain Foundation for the Arts 2004 Carita Foundation Ellie Carmody Madeline Brandt Jacquet MissionFish Elizabeth Skavish and Michael Rubenstein Patricia Allen Tim Caro and Monique Mulder The Grace Jones Richardson Trust 1993 Irrevocable Trust of Bette D. Deborah Evans Skidmore Thomas and Donna Ambrogi Karl Case Jumo International Moorman Joel and Deborah Skidmore Victor Ambros and Rosalind Lee Sean and Amanda Cassidy Roger and Dawn Kafker Dan Morrill Ida Burnis Smith Americans for Philanthropy Jack and Margaret Caveney Neerja and Hemant Kairam Harold and Julie Morse Martin Smith John and Virginia Andelin Joanne Chang The William Kaiser Family Foundation Richard and Claire Morse Rachael Solem Chris and David Anderson Thomas W. Changaris Foundation Matthew and Kathryn Kamm Joia S. Mukherjee Finnegan Southey The Anglo-American School of Moscow Chase Family Philanthropic Fund Jeffrey R. Kaplan Charitable Fund Mushett Family Foundation, Inc. The Spurlino Foundation Arcturus Fund John Chaves, MD and Karen McIlvena, Kaufman Family Foundation Laurie Weiss Nuell Spurlino Family Fund IV Katherine B. Arthaud MD Michael and Rosalind Keiser New England Council Of Carpenters Christopher and Anne Stack Jonathan Atkeson David Franklin Chazen Foundation The Kerrigan Family Charitable New Settlement Apartments The Stahl/Kim Family Fund Joseph Azrack and Abigail Congdon Bryan Chen Foundation Howard and Patsy Norton Margaret Stavropoulos Martha Baer and Sara Miles Children’s Hospital Boston Rae Jeanne Kier The Peter and Kristan Norvig Family Eugene and Marilyn Stein Bainbridge Community Foundation Timothy Chow Mr. and Mrs. William B. King, The King Fund Jim and Debby Stein Sharpe Chris Baio Mary Chowning Family Advised Fund of the Community Noteworthy, Inc. Alexandria Stewart and Michael Altman Dexter F. and Dorothy H. Baker The Judith and Edwin Cohen Foundation Fdn of Middle Tennessee Elias Nyberg Trevor and Anne-Marie Strohman Foundation Alison Cohen Janet Kinnane and Conrad Smith Susan O’Connor Stephen Sullivan and Helena Taylor Vernon and Theresa Baker Gary and Lori Cohen The Kirby Family Foundation Rowan T. O’Riley Family Foundation Syron Family Charitable Fund of the Bank The Balch Family Fund William and Marjorie Coleman Sid Knafel and Londa Weisman Mary Pope Osborne of America Charitable Gift Fund Edith Baldinger Charitable Lead Annuity The Edward Colston Foundation, Inc. Thomas and Mary Ann Kofler Pamela Parker Ramie Targoff Trust Community Foundation of Eastern Pamela Kohlberg and Curt Greer Antonella Pavese Robert E. Taylor William & Karin Banks Foundation Connecticut David and Ginger Komar PCL Concerts I The Captain’s Rest Tres Chicas Sundance Banks and Claudia Dierkes- Loring and Louise Conant The Komera Project Hilary Peattie Trinity Church Banks Cooper Surgical Clare Koontz Revocable Trust Teresa Perkins Unbroken Chain Foundation Lisa Barrett Brian Cooper and Marguerite Murphy Stan and Susan Krcmar Petunia Foundation University of Massachusetts, Amherst Donna Barry Beverly Cowart Emily Kunreuther Timothy and Katherine Philip University of Miami Gordon and Kathy Bechtel Vicki and David Craver Eileen Laber Dayton Pickett The Valley Fund Mehdi Behmard Dan Crawford John Lamonica The Joan and Lewis Platt Foundation George Waechter Memorial Foundation Eric Berger Craig and Mariko Creasman Mark Landesman Timothy Powers Dilip Wagle and Darshana Shanbhag Matthew Berger Irene and Charles Creecy Anna Lane Prince Charitable Trusts Guillaine and Charles Warne Karl Berggren Crowdrise PS 89 Liberty School George Wasserman Family Foundation Peter and Gayle Bergmann Pamela L. Crutchfield Ann and Robert Quandt Susan Weatherley Berkeley High School Diane Currier and William Mayer
Partners In Health would like to thank our legal counsel, Schulte, Roth & Zabel LLP, and Fragomen, Del Rey, Bernsen & Loewy LLP, for their voluntary support of our mission. Finance & Governance 38 Thank You to Our Supporters (continued)
Gerald R. Curtis and Jeanne M. Curtis Eric Gutstein Richard and Kathryn Kimball Christopher and Robin Miller Nina Ritter Fund Haitian American Students Association Peter King and Tara Morgan-King Kaia Miller and Jonathan Goldstein John Jefferson Rix The Dallas Foundation The Hallett Family Charitable Fund Teresa Kinsella Nicholas and Renee Miller Robert and Catherine Miller Charitable Murray Dalziel Hamill Family Foundation Jill Kirshner The Miller-Wehrle Family Foundation Foundation Lee Dawn Daniel Keith Hammonds Kittay Foundation, Inc. Milton High School Steven Robinson Morgan Debaun Linda M. Hanson Sissel Kjelstrup, M.D. MKM Foundation Rockridge Chorale Mark F. Dehnert Monie T. Hardwick John Knight Leo Model Foundation, Inc. Clark B. Rollins, III Alan Del Castillo, M.D. John Hart Ann & Lance Krafft Charitable Lead Trust Peter Model Liz Romney Dies Family Foundation, Inc. Meryl Hartzband Roger and Belle Kuhn Sung and Carolyn Moon Joseph Rondinella Dolphin Capital Foundation Amy Haynes William Ladd and Robyn Churchill Judith Moore 1950 Trust Jeremy Ronge Doylestown United Methodist Church Dr. Gil Hedley Kevin and Lisa Lange The Gene S. Morse Fund Richard Rosenstock and Mary Frei The Ducommun and Gross Family Hollis Heimbouch Richard and Abigail Lanoix Michael S. Morton The Marcia and Philip Rothblum Foundation Kenneth and Linda Heitz Sandra Larson William Mosakowski Foundation Advised Fund at Aspen Robert and Lynn Ducommun Edward Heumann and Clara Baur Christopher Le Mon and Rachel Taylor Thomas and Judith Munzig Community Foundation Catherine Dunlay Paul and Melissa Hewett-Marx James and Katherine Ledwith New York University Keith and Laura Rothman The Daniel E. Eisenbud Charitable Fund Andrew and Patricia Higgins LeFort-Martin Fund at The Chicago Evelyn B. Newell The T. Rowe Price Program for Charitable The Elias Foundation Cyrus and Anna Highsmith Community Trust The Newport Family Foundation Giving Jorge Espinosa Ceron Philip & Rebecca Hochman Foundation Catherine Lego Northwest Presbyterian Church Rutgers Presbyterian Church Fagen-McCleary Family Charitable Fund John Hodge and Stacey Keare Thomas A. Lehrer Molly Norton Suzanne Rutkowski Mary Falls Leonard and Jean Holder Gordon and Jennifer Levering Leon and Helen Oliver Thomas and Marianne Saccardi David and Joan Fay Robin and Brad Holmgren Stuart Licht Jane S. O’Neal Saint Joseph’s Abbey Michael Federico Leora Horwitz and Derek Kaufman Lincoln Sudbury High School Silvia Ortiz and Emilio Rodriguez Alex San Filippo-Rosser Jeremy Feigelson Bryan Hotaling Michael and Eileen Lindburg Pacific Crest School Cherylann Schieber and Alan Barton Linda Felver Robert & Lyn Houk Charitable Fund James and Margie Lindsey Randall Palmer Walter and Leona Schmitt Family J. Edgar and Veronica Fennie Robert Houk Lise and Myles Striar Charitable Fund P. William and Julie Parish Foundation Carol Fier, RN, MSN James C. Hudspeth Anthony and Mary Lopresti Brian and Erin Pastuszenski Seattle Theatre Group Heike Fischer and James Washburn Kimberly Hult and Robert Pasnau The Edward C. and Elena E. Lord Matthew D. Pearson Sequoia Philanthropic Fund Ned Forrester Helen Hunt Bouscaren Charitable Gift Fund Nancy Peery Marriott Foundation, Inc. Frederick Seykora The Foundation for Enhancing Richard M. and Priscilla S. Hunt David Lowe Christina Pehl and Mark Headley William Shafarman and Judith Schneider Communities Charitable Lead Annuity Trust Robin Macilroy and William Spears Peil Charitable Trust Sameer Shamsuddin Frankel Family Foundation Susan Hunt Hollingsworth Don and Mary Macune Jacques Perold and Amy Boesky Scott Shane and Frances Weeks David Frankel Diana Hunt Terry and Martha Maguire Foundation Mark Shannon and Cynthia Kerr Peter Frankel The Hunter Family Fund Tom and Nancy Maher Allen Perrel Shawkemo Fund at the Boston The G.D.S. Legacy Foundation The Charles Jacob Foundation James Maier Donald S. Pettit Foundation Gaba Family Foundation, Inc. Todd and Tatiana James Maimonides Medical Center Dept. of pH Fund Marina Shevelev Gators United for Haiti The Peter Jennings Foundation, Inc. Obstetrics and Gynecology Piedmont Community Church Short-Dooley Family Foundation Beverly Gee The Jockey Hollow Foundation, Inc. The Mamdani Foundation, Inc. Christopher and Lindsay Pike The Sidman Family Foundation Anthony Genovese Fund The Matthew and Donna Johnson Barbara Manger Cecilia Plum Scott and Shana Silveri Thaly Germain Charitable Fund Marr Scaffolding Emanuela Popa-Radu Sarah L. Singh Michael Gerstenzang Philip Johnston Jerry and Elizabeth Mason Janine Poreba James Slavin and Monica Mottolese Matthew Giere Arthur M. Kaplan Foundation Darrin and Shaula Massena Dr. Robert T. Porter John and Jean Smith Fund Arthur Gleckler Arthur M. Kaplan & R. Duane Perry The Mayer Daniel Fund, an advised fund Price Family Charitable Fund Alice Smith The Jackson and Irene Golden 1989 The KASTIA Foundation of Silicon Valley Community Foundation Princeton Regional Schools Cherida Collins Smith Charitable Trust Rick Katz Judith Mazo and Andrew Seidman Steve and Carolyn Purcell’s Donor John and Jean Smith Janet Lynne Golden and Eric Schneider Derek and Leora Kaufman Charitable The Thomas C. McConnell and Latricia Advised Fund at Silicon Valley Edward Snowdon Jeffrey Goldfaden Fund Turner Fund at Vanguard Community Foundation Soaring Apple Foundation Steven Goldstein The Keare/Hodge Family Foundation Nancy McCormack Sara Rappaport Somanautics Workshops, Inc. Wendy Gordon Elizabeth Keeley Jon and Ann McGee Jake Rattner Hans Spiller Juraj and Eva Gottweis Jeffrey and Sandra Keenan Katherine McGregor Polly C. Rattner State of Washington Gray MacKay Family Fund Keller Family Fund, an advised fund of Mark and Katherine McHugh Redlich Horwitz Foundation Christopher Staudt Green Standards Ltd. Silicon Valley Community Foundation Joseph McIntyre Walter and Judy Rich Theodore E. Stebbins Fund Alva Greenberg John Kern and Valerie Hurley Peter and Betty Michelozzi Kristen Richardson and Sinclair Smith The Stebbins Fund, Inc. Greens Farms Academy Jean Kershner The Midvale Foundation Eric and Maria Rieders Anne Stetson Tracy Grinnell Scott Keske Henry and Beatrice Miller Fund of The Edward and Ted Riley Caroline Stewart Suzanne Grosso Farhad Khosravi Foundation for Enhancing Communities Joshua Ring Philanthropic Fund Donald Stirling and Mary Sundberg Richard Grudzinski Soyeon Kim on behalf of Linda Miller Robert Ritchie Stirling Finance & Governance 39 Thank You to Our Supporters (continued)
Mickey and Leila Straus Ka-Ping Yee Jonathan and Susan Britt John Cook Richard Flaster and Alice Mead Diana Strumbos The Eli and Edyth Broad Foundation Julie Cook Mary Fleming Eleanore Sturgill James and Barbara Bross Lisa Coplit Lindsay Flynn Christopher Suozzo Solidarity Circle The Brouhard Family Foundation Charles and Sarah Cottle Sallie Foley Sutter Healthcare ($2,500 – $5,000) Broward Healthcare Judy and David Covin Fortress Investment Group, LLC Sweeney Family Foundation Anonymous Michael Brower Caroline Crawford Kessel-Frankenburg Family Fund Ann B. Swett Charitable Invester Fund at Adil Abdulali Anna Brown and Eric Hale Neil Crawford Barney & Eileen Freiberg-Dale Fund Rochester Area Community Foundation Mary Louise Alley-Crosby Robert Brown Michael Crowley John and Gioia Frelinghuysen Dennis and Susan Talbot Ambos Mundos Dan Buckley and Johanna Kelly The Diane L. Currier Fund James French William L. Taylor Amer/Manning Fund Jarrod Buckley Allerton Cushman, Jr. Ms. Anne Kiehl Friedman Darren Thomas Amherst College Bucknell University Carolyn Dagres Tom and Clare Friedman David Thompson and Judy Jesiolowski Mary and Thomas Amory Ethan Bueno de Mesquita and Rebecca Bradley and Donna Dahl Evelyn Frost Tides Foundation, advised by Ms. Judith an anonymous donor of Community Bueno De Mesquita Milder Dana Farber Cancer Institute David Fuhr Weiss Foundation Sonoma County Mary Bunting Tobias Danforth The Fund for Mercer County of the TJ Family Fund Jana Andersen Carola Cadley and Margaret Lange Michael Davidson Princeton Area Community Foundation James Tobias Katherine and Dyche Anderson Kathryn Caldwell Douglas and Dorothy Davis Anita Gajdecki and Stephen Blyth John Tocci Nathalie and James Andrews Foundation Craig Calhoun Michael and Sheryl DeGenring John Galvin Kim Triedman Dr. Molly E. Andrews Wendy Calhoun Michael Deich Thomas Gamble TSU GlobeMed Elizabeth Good Angle and Frank King Dyami Caliri Lulu Delacre John Gershman and Deborah Yashar Ullmann Family Foundation Nilgun Antmen Michael and Ronda Callister Alfred DeMaria and Susan Case John and Pamela Gerstmayr United Way of the Columbia-Willamette Bennett Applegate Daniel Capshaw Carolyn Deodene Gloria Gery University of California, Los Angeles Arnow Family Fund, Inc. James Carey The Dhammayut Order in the United John Giuliani University of Notre Dame Ted and Penny Ashford Lisa and J. Richard Carlson States of America Give Green Fund Mark and Karen Vachon Charitable Bailey’s Crossroads Rotary Club Eleanor and Charles Carr Juan Diaz-Laviada Glasgow Middle School Giving Fund Nick and Maura Balaban Ellen Carr Dickey Fund Gomez Family Charitable Fund Tricia Vanacore Alan and Philip Balson Tom and Ann Carr Digital Fusion Creative Technologies, Inc. Gabriel Gomez Verizon Wireless Amphitheatre Encore Christopher Baltus and Banna Rubinow Cars4Charities Kendra and Paul Dipaola Sally and Michael Gordon Park Bank of America Charitable Gift Fund Frances Carter Directions For Rural Action Fund Goucher College Village Community School Bonner Barnes Jaime Carvajal Debra Donaldson and Brian Kelley GRAM Charitable Foundation The Paul and Susan Vogel Charitable Gift Tanya Barnett and Jay Geck Kristin Carveth Elisa Dooley The Grammar School Fund Barrette Family Fund of the New Bonnie Cashin Fund Steven Dorfman The Greater Boston Concierge Assoc. Philip Vogelzang and Kathleen McCoy Hampshire Charitable Foundation G.Thomas Cator Kurt Dorschel Joyce Green Family Foundation Jane Waldfogel Dieter Bauer Richard and Nancy Celio Dougherty Family Fund John Green Katharine Wallace Charles and Denise Bavier The Norman and Heewon Cerk Gift John and Michelle Driscoll Greenway Manor Jane Wang Catherine Beattie Fund Michael Drobac David Guy and Gemma Galli Faron and Jill Webb Justin Beeber Thomas Cerny Mary B. Dunn Charitable Trust Christopher and Sherrie Hall Elizabeth Webber John and Mary Ann Bellanti Elizabeth Chace Christopher Duskin Kimberly Halley Irene and Lynn Weigel Albert & Pamela Bendich Charitable Trust Phyllis Chock Joan Enoch Nicolas Hamatake The Emanuel and Anna Weinstein Pamela and Albert Bendich Youngme Chung Bonnie, Kate and Bill Ewall William Hannigan Foundation Bergen County United Way’s Charitable Carmine and E. Eileen Civitello Adam Ezra Group Elizabeth Harper David and Sherrie Westin Flex Fund Dr. Cheryl Clark John Failor Michael Harris The Stephen F. White Fund Philip Berkowitz and Mary Ann Quinn David Clark Debra Farb Janet and Richard Hart Stephen and Melissa White Nancy Bernstein and Robert Schoen JoAnna and Samuel Cline Farber Fund Harvey Family Foundation Donald and Mary Wieckowicz Channing and Marie Bete Clovis Foundation The Howard and Barbara Farkas George and Marina Hatch Fund Dr. Abby Shuman Margaret Beyer Ellen Codd and Vincent Aloyo Foundation, Inc. Eliza Hatch David Winner Uppanda and Dileep Bhat Lawrence Cohen Daniel Feinberg and Holly Scheider HBS Section F - Class of 2011 The Richard and Elizabeth Witten Francis and Jennifer Blesso Sanford Cohen Gary and Elizabeth Felicetti Health Initiative Abroad, Inc. Charitable Fund Laird and Sara Bloom Douglas Coker Fife Cragin Charitable Trust Heart To Heart International Joel Wittenberg and Mary Ann Ek Paul and Katherine Blount Rebecca Cole and Peter Jhon Marcia Findlay Neil and Renee Hecht Judith H. Wofsy James Bolton Howard P. Colhoun Family Fund Jon Finkel Geoff Heekin Wonder Fund of The Community David Bor and Henrietta Barnes Suzanna Collerd First Congregational Parish Church Broderick J. Hehman Memorial Fund Foundation Serving Richmond and Carolyn Bottomley Claire Collins First Fenway Cooperative Angela and Thomas Heigle Central Virginia Jane Brady Commonwealth of Massachusetts First Reformed Church of Schenectady Joanne Hemenway Barbara E. Workman Steve and Marijo Brantner Concern/America Linda Fisher Scott Hempling and Margaret Flaherty World Union for Progressive Judaism Charles Breunig David Cone and Kellie Stoddart Milton Fisk Lucia Henderson The Worrall Family Charitable Fund Susan Breyer Ted Constan and Alison Franklin Constan Edmond Fitzgibbon Gerald Hershkowitz Patrick Briody Finance & Governance 40 Thank You to Our Supporters (continued)
Alec Higgins Stephen Langdon Wanda McGraw Beatrice Plasse Seevak Family Foundation David and Margaret Hirsch Roger Langsdorf Sally and Matthew McShea Poly Prep Country Day School Peter Senter Christopher Hoffman Christian Lassonde Sam McVeety Portland State University Seton Hall University Drs. Mike and Donna Hoffman Debra and Daniel Laufer Leila Meghji John and Susanne Potts Robert and Anne Shapiro Richard Hoffman Reet Lawhon Celene A. Menschel Fund Dr. Fredric Price and Ms. Ellen Wilson Robert and Barbara Shaw William Hoffman John Lechner and Mary Higgins Marvin and Margaret Menzin Thomas Prichard Clifford Shedd and Michelle Miller Christina Holt William Lehrer Charitable Fund Toby Merk Jairaj Puthenveettil Shrigley Family Foundation Holy Trinity Episcopal Parish Suzanne Lerner Cecile Meyer Lisa Quane Jerry Silbert Homestead Foundation, an advised fund Jaime Lester Talia Milgrom-Elcott Queen’s University Paul Singh of Silicon Valley Community Foundation Margaret Lester Leslie Miller Susan and Carl Racine Medha Sinha and Arthur Epker Brian Houser David Levine The Milner Family Foundation Anastasia Raczek Mary R. Sive Fund Edward W. Hoyt Howard Lewine and Susan Evans Gale Mondry and Bruce Cohen Maria and Frederic Ragucci Austin Smith James Huber and Deborah Clarke Kirk and Carol Lider Monika Morali-Efinowicz Krishna Rangarajan Cheryl Snyder and Scott Newman Joel and Barbara Huber Gabriel Ling Gwynne Morgan Ann and Don Rathjen Linda Snyder and Steven Kadish Lam Hui and Shuk Lee David Link and Margaret Ross Stephen Morris and Julie Kelman Brian J. Ratner Philanthropic Fund St. Anne’s-Belfield School Humanitarian Organization of Latin The Linville Family Foundation Mount Holyoke College Brian and Tawny Ratner St. Timothy’s Episcopal Church American Students Kathy and Bill Linville Dana Mulhauser John Raveret Starr Hill Presents, LLC Barbara Humphreys Sheree Lipton Martin Murphy The Rawlings Family Charity Griff Steiner Zita Hung Abe Littenberg Foundation, Inc. Music for Relief Joseph Reddy Andrew and Joy Stillman Jane Hurt Laura Livesay Elizabeth Myers Jeremy Reff Brian Stoler Ali Husseini James Lockard Stephen Nathan The Reiger Fund John and Lou Stolzenberg Fund Robert and Christine Husson Charles Logan National Association of Black Accountants George and Marina Reiser Jerry and Dianne Straus Sybill Hyppolite Jean Lootz Steven and Susan Naum Sarah Remes Andrew and Thelma Strauss Rosemary Hyson Timothy Loper Elizabeth Needham and Peter Mark Rice University Kate Strully Bill Iorio-Ronek Martin and Cheryl Luchtefeld New England Inpatient Specialists LLC Wendy Riches Janet Stull Baumgartner Foundation, Almon and Marjorie Ives Timothy P. Lundergan Fund New Society Fund Marian and Michael Rieders an advised fund of the Silicon Valley Jain Chem Ltd. Ali W. Lutz New York Blood Center Richard and Nancy Riess Community Foundation Massoud Javadi The Lynton Starfish Fund Lanny Newell Rivanna Community Church The Stutzman Family Foundation Jewish Federation of Cleveland Richard Lynton Jeffrey Newton Robert and Elisabeth Riviello Alan Su Marie A. Johantgen David Mackay Scott Nitowski Heidemarie Rochlin Karen Sundin John Hancock Financial Services The Maitri and Vivek Fund Elaine Nonneman Roger Williams University Swarthmore College Jason and Helen Johnson Stuart and Kathryn Malcolm Nonprofit Knowledge Network Rosalind Franklin University of Medicine Alexandra & Martin Symonds Foundation, Kevin Johnson and Barbara Miner Martha Man Northwestern University and Science Inc. Francine Johnston Manhattanville College Kathleen and James Nulty Lorraine Rose-Lerman Symonds Foundation Jaffe Jorgensen Family Charitable Fund The Mann Family Foundation, Inc. Travis Nutzman Debra Rosenberg David and Peggy Tanner Philanthropic JWT Family Foundation Marina Bay Skilled Nursing Facility and John and Anne O’Gorman William and Sandra Rosenfeld Fund Max Kagan Family Foundation Rehabilitation Ctr David Ogrin and Vicki Cherkas Elizabeth Ross Everett and Lora Tarbox Ed and Ann Kania Mark Family Fund Martin Okun Richard Ross Ben & Kate Taylor Charitable Foundation Kaplan-Nelson Fund Shirley Markey John O’Laughlin The Rothwell Foundation, Inc. Marie Taylor Arnold Kas Thomas Marsden and Julie Thompson Marion Olena Dana and Cheryl Rowan Ron and Mary Tecklenburg The Kaufmann Foundation William and Amy Marshall Antonio Oliver Angelyn Royce James Terrell Priscilla Kersten Mr. and Mrs. Scott B. Martin Fund Tamara Olsen Anastasia Rudman Liz Terry Kessel-Frankenburg Family Fund Carolyn Mason Bonnie Orlin Barbara Rylko-Bauer and Daniel Bauer Foster Goss Family Michael Kilcran Mass Audubon Society Duncan and Christine Orr Sanford and Susan Sacks Patricia and Mark Thompson Charles and Nancy Killeen Massachusetts General Hospital James O’Shaughnessy Safeway Inc. Meghan and Andrew Thornton Owen Kim Barbara Massey O’Toole Reetz Family Fund Saint Andrew’s Church Helen Torelli Hunter King Judith and Michael Mayer Our Lady of the Mississippi Abbey Keith Salvata The Touma Family Foundation Mary King and Drew Devereux Larry Mayer Pajwell Foundation Julia Satriano William Trimble and Anna Margolis Judith and Donald Kinley McCaffrey Family Foundation Penanhoat Family Fund Paul and Carolyn Sax Trinity College Christina Kirk Michael McCally and Christine Cassel Penn State Berks Curtis and Susan Sayers Tubercle.org Katherine Klein and John Gomperts Larry McClung Penn State, Associated Students Activites Anthony and Deborah Schiro Nicholas Turner Trude Kleinschmidt Ashlie and Steven McConnell Martha Pentecost Thomas Schorr Morris Tyler Joann Koonce Anthony McCook Richard Petersen Frank and Ruah* Schwamb The U.S. Charitable Gift Trust Angela Kopp Thomas McDonald Doantam Phan Timothy and Brigitte Searchinger Ingeborg and Arthur Uhlir Doug Kreeger Thomas McDougal and Sarah Duncan Pierce School PTO Sed Ministrare Umma Fund of the Maine Community Susan Kroll Meg McGarvey Pilgrim Congregational Church Seekers Church Foundation Finance & Governance 41 Thank You to Our Supporters (continued)
United Way Capital Area Partners Circle Elizabeth Apfelberg John E. Barnes Patricia Benoit and Lewis Kornhauser University of Florida Barbara Appel Kenneth Barnes and Carmen Madriz- John D. Benson University of Wyoming ($1,000 – $2,500) Luci and Alberto Aran Barnes Richard and Barbara Bentz Andrea and Michael Urban Anonymous Esther Aranda Mark and Kristine Barney Christopher Bentzel Shalini Vajjhala Daniel and Stacey Abbis Joshua B. Arend Amy Pitser Barnhardt Michael Benz Rachel and Bettylou Valentine Pauline Abernathy and Bill Craig Neil E. Aresty Brian and Dianne Baroody Donald and Louise Berdahl Vassar College Donald-Bruce Abrams and Roberta Rubin Leigh Armstrong Jerome and Peter Barrer Daniel Berg Julia and John Ver Ploeg Carol Achtman and Paul Armel Mary S. Armstrong John Barrett Peter Berg Michael and Helen Vlasic Actions for Boston Community Ramsey Arnaoot Jane Barry and Patrick O’Kane Ronald Berg The Theodore A. Von Der Ahe, Jr.Trust Development, Inc. 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The Bill & Melinda Gates Foundation Firelight Foundation African Health and Hospital Foundation Finance & Governance 52 Thank You to Our Supporters (continued)
Firland Foundation Horowitz Associates, Inc. Livenation Finland Nelson Capital Management Robert F. Kennedy Center for Justice & The Flora Family Foundation HSBC Philanthropic Programs Living in the Garden New Balance Human Rights FM Global Foundation HST, LLC Louis Vuitton New England Health Care Employees Rochester Area Community Foundation Ford Foundation Hubbard-Hall Inc. Lumalier Corporation Union Rockefeller Foundation Forester Capital, LLC The Humphreys Group, LLC Lundin Family Foundation New York Blood Center Roll Global Forester Community Education Fund Hybrid Apparel Lynch Foundation The New York Community Trust Rose & Ivy Floral Design Fortress Investment Group, LLC I G Prod Inc. M-A-C AIDS Fund Nina Abrams Fund Ross Sinclaire & Associates, Inc. Foundation for the Carolinas iContact Madison Tyler, LLC No Frills Foundation Rowland Coffee Roasters, Inc. Foundation of Philanthropic Funds IMEC Maine Community Foundation Norcross Wildlife Foundation, Inc. S.J.M. Limited The Frederick and Margaret L. Incept Corporation Mains’l Services, Inc. Novartis The San Damiano Foundation Weyerhaeuser Foundation Institute of Mosaic Art Marc Haas Foundation Oak Foundation The San Francisco Foundation Free The Children Interactive Sciences Inc. Mariel Foundation Odyssey America Reinsurance San Luis Obispo County Community The Friedland Foundation Intermune, Inc. Marietta Surgery Center Corporation Foundation The Friendship Fund Intuit Marin Community Foundation Odyssey Enterprise, Inc. Sanofi Pasteur Biologics Company Fresenius Medical Care Irene S. Scully Family Foundation Marin Software Ogilvy & Mather Santa Fe Community Foundation FXB USA It’s My Amphitheater Inc. Marr Scaffolding The Oliver Group, LLC SAP Matching Gift Program G-Star Izumi Foundation Mass Audubon Society OneXOne Schulte Roth & Zabel, LLP GAP Inc. J.C. Cannistraro Massachusetts General Hospital Open Society Institute Schwab Charitable Fund General Electric Co. J.P. Morgan Chase & Co. Maverick Capital Foundation Operation Blessing The Seattle Foundation Geometric Marine Services, Inc. Jain Chem Ltd. McCarthy Properties, LLC Oracle Corporation Sensortech Services Gilead Sciences, Inc. Jam Productions McCue Corporation The Oregon Community Foundation The Seth Sprague Educational and GlaxoSmithKline Jeff Gordon Children’s Foundation McCullough, Campbell & Lane, LLP Orthopaedic Associates of Michigan Charitable Foundation Goldman Sachs Gives Jewish Communal Fund MCD Productions, Inc. Ottawa International Airport Authority SG Foundation Goldman, Sachs & Co. Jewish Community Federation of San The McGraw-Hill Companies The Overbrook Foundation Sg2, LLC Google Inc. Francisco McKinsey & Company The Pasculano Foundation Sheng-Yen Lu Foundation Grand Rapids Community Foundation Jewish Community Foundation San Diego Medimmune Paula + Martha, LLC Silicon Valley Community Foundation Grandchildren’s Fund at the Goldman Jewish Federation of Metropolitan Medshare International, Inc. Peace Development Fund Sinauer Associates, Inc. Fund Chicago The Medtronic Foundation Peak Entertainment, LLC Skoll Foundation Grasshopper, Inc. John Moriarty & Associates, Inc. Memphis Development Foundation Penguin Group (USA) Inc. Skoll Global Threats Fund The Greater Cincinnati Foundation Johnson & Bell Ltd. Mendes & Mount, LLP Pentair Foundation SL Green Management, LLC Greater Kansas City Community Johnson & Johnson Meng-Hannan Construction Company, Perry Capital, LLC Somanautics Workshops, Inc. Foundation Journey Charitable Foundation Inc. The Peter and Carmen Lucia Buck Soros Fund Charitable Foundation Greater Saint Louis Community Joy Foundation The Mennonite Foundation, Inc. Foundation, Inc. Southboro Medical Group Foundation Juniper Network, Inc. Merck & Co., Inc. Pfizer, Inc. Southwire Maxis The Green Mango Foundation Juniper Networks Foundation Fund, a MFI Engineered Components, Inc. Philip Johnson Associates, Inc. Spectrum Sign Company Green Mountain Coffee Roasters Community Foundation of Silicon Valley Microsoft Pilar’s Tamale and Catering Spectrum Sign Company Green Standards Ltd. Kai Pono Builders, Inc. The Millrace Foundation Plaza Medical Group SpineNevada, Ltd Greenway Manor Kaiser Permanente The Minneapolis Foundation Plaza Medical Imaging Square One Foundation, Inc. GS Gives Annual Giving Fund The Kalamazoo Community Foundation Mold-Rite Plastics, Inc. PopCap Games, Inc. Stanley Black Family Fund of the Triangle Guilford Publications, Inc. Karl Storz Endoscopy-America, Inc. Mold-Rite Plastics, Inc. Portsmouth Brewery, Inc. Community Foundation H.E.L.P. Foundation, Inc. Keystone Construction & Maintenance The Moeller Foundation Positive Action for Children Fund Starr International Foundation H.J. Promise Foundation Services, Inc. Molly Moon’s Homemade Ice Cream Postfontaine Consulting LLC State Street Matching Gift Program Hachette Book Group Matching Gift Keystone Group, LP Monitor Company Group, LP The Potts Memorial Foundation Sterling Stamos Capital Management LLP Program King County Employee Giving Program Monqui, Inc. Project 7 International, Inc. Stichting Flowfund Hard Rock Hotel & Casino Las Vegas Kirkland & Ellis Foundation Montague-Betts Company Pyramid Sound, Inc. The Sullivan & Cromwell Foundation Hasbro, Inc. Knightsbridge Surgery Center, Ltd. Morgan Stanley The Quaker Hill Foundation Summer Star Foundation for Nature, Art Healthcare Charities, Inc. The Kresge Foundation Morgan Stanley Smith Barney Global Razoo & Humanity, Inc. Heart To Heart International Laird Norton Company, LLC Impact Funding Trust, Inc RecycleBank, LLC Sunspring Heartland Charitable Trust Lance Armstrong Foundation Motorola Matching Gifts The Red Cabin Foundation Surdna Foundation, Inc. Heath Concerts Larry Weaner Landscape Design Mozza, LLC The Red Hot Organization Surgery Center of Reno, LLC Henry Schein Cares Foundation, Inc. Levin Capital Strategies, LP MTV Networks International Regent Surgical Health Surgical Notes MDP, LP Hewlett-Packard Company LFA Group The Nathan Cummings Foundation, Inc. The Rhode Island Foundation Susie Tompkins Buell Foundation Hinckley, Allen & Snyder LLP Liberty Mutual National Philanthropic Trust Rialto Restaurant Sutter Healthcare Hogan Lovells US LLP Lindholm & Associates, Inc. Navigant Consulting Rick Dutka Memorial Fund of Tides Synthes Usa Home Depot Little Bear, Inc. NCCPA Foundation Foundation Synthes Usa The Horace W. Goldsmith Foundation Live Nation Nelco Foundation Inc. The Rita Allen Foundation, Inc. T & J Meyer Family Foundation Limited Finance & Governance 53 Zanmi Beni’s blessed friends share a joke with Bill and Daisy Thank You to Our Supporters Helman and Paul Farmer (continued)
Takeda Pharmaceuticals North America, The Wyomissing Foundation Inc. The Yawkey Foundation ThermoFisher Scientific Yileen Press Thomas & Betts Young & Rubicam Brands The Timberland Company ZBI Employee Allocated Gift Fund Tingle Productions, Inc. Zinnia, Inc. TOMS Shoes ZJL, Inc. Total Health Care, Inc. Towers Watson Government, Transatlantic Reinsurance Company Triskeles Foundation Multilateral and Trocaire Other Grants Truist Centers for Disease Control Tumi, Inc. The Global Fund to Fight AIDS, Turner Construction Tuberculosis and Malaria Twin Cities Christian Foundation Global Health Corps Inc. U.S. Bancorp Indiana University Regenstrief Institute, Unilever Inc. Union Bank Employee Workplace International Development Research Campaign Centre United Jewish Foundation of Metropolitan Irish Aid Detroit Jembi Health Systems United Way of New York City National Institutes of Health United Way of Rhode Island Partners HealthCare System, Inc. UPS Rwanda Health Education and Urban Zen Foundation Information Network (RHEIN) USG Foundation, Inc. Russia Healthcare Foundation Vanguard Charitable Endowment U.S. Agency for International Program Development (USAID) The Vermont Community Foundation U.S. Civilian Research & Development Veris Wealth Partners Foundation Vertex Pharmaceuticals, Inc. U.S. Department of Health & Human Voxiva Services, Office of Minority Health W.K. Kellogg Foundation United Nations Children’s Fund W.S. Badger Company, Inc. (UNICEF) W.T. Rich Company, Inc. United Nations Population Fund Walden Asset Management (UNFPA) Walkabout Foundation University Research Corporation, LLC Wall Street Services, Inc. World Bank Warburg Pincus Partners, LLC World Food Programme (WFP) Warby Parker Eyewear World Health Organization (WHO) Waters Corporation Wayside Glass & Mirror Weatherspoon Charitable Foundation Weil, Gotshal & Manges Foundation Inc. Wells Fargo Westchester Community Foundation Weyerhaeuser Family Foundation Whittier Trust Company Wichita Falls Area Community Foundation Wilmington Trust Windover Construction LLC The World We Want Foundation
Finance & Governance 54 Officers & Boards Officers Ophelia Dahl, President and Executive Director Paul E. Farmer, Chief Strategist Joia Mukherjee, Chief Medical Officer Ted Constan, Chief Operating Officer Cynthia Maltbie, Chief Human Resources Officer Donella Rapier, Treasurer and Chief Financial Officer Susan Sayers, Chief Development Officer Paul Zintl, Deputy Director Cassia Van der Hoof Holstein, Chief Partnership Integration Officer Diane Currier, Esq., Clerk Board of Directors Ophelia Dahl, Chair Lesley King Jack Connors, Jr. Jim Yong Kim Paul English Todd H. McCormack Paul E. Farmer Dan Nova Gary Gottlieb Ted Philip Robert Heine Bryan A. Stevenson Albert Kaneb Charlotte Wagner Diane E. Kaneb Advisory Board John Ayanian Fr. Fritz Lafontant Jaime Bayona Anne McCormack Rose-Marie Chierici Patrick Murray Marie-Flore Chipps Guitèle Nicoleau Fr. Julio Giulietti Haun Saussy Jody Heymann Amartya K. Sen Malawian mother receives Marie-Louise Jean-Baptiste Loune Viaud school supplies for her children Philip Johnson
55 Thank You Patient at Rwinkwavu Hospital in Rwanda
56 2011 Annual Report
Cover Photos: Front left: A former HIV patient, now 888 Commonwealth Avenue, 3rd Floor • Boston, MA 02215 a PIH motorcycle messenger 617-998-8922 • Fax 617-998-8937 • www.pih.org Front right: Construction workers building Mirebalais National Teaching Hospital PIH is a 501(c)(3) nonprofit corporation and a Massachusetts public charity Back: Patients waiting at Mamohau Copyright 2011 © Partners In Health. All Rights Reserved. Hospital in Lesotho