Care 2 Communities (C2C) operates a network of primary care clinics in northern Haiti. We are different from traditional aid models because we have a public-private partnership (PPP) with Haiti’s government—rather than building new clinics, we work with the Ministry of Health to rehabilitate existing public clinics, improving the quality of primary care services offered and increasing access to care for poor and low-income people, empowering families to lead healthier lives.
We have been working in Haiti for over ten years and the West Foundation has supported us through most of that time during our growth. From one clinic offering primary and antenatal care services in the rural town of Camp Coq, to now seven clinics across two regions of Haiti and a formal partnership with the Ministry of Health, the support of West has been transformative in helping improve the healthcare system in the communities we serve.
As the newest program offering in our clinics, we are excited to announce that we have launched a new comprehensive sexual and reproductive health education course for girls ages 13-18 in our communities. Girls in Haiti, like in many places around the world, are not empowered to make decisions about their sexual health or take ownership of their own bodies. This systemic gender inequity has led to many issues in the country. It is well known that early unwanted pregnancy is linked to poverty. At C2C, 15% of the patients in our maternal health program are under 18. We see girls coming in for prenatal visits who are 18 or 19 and in their fourth pregnancies, with children from different partners. Not only do these girls not finish their education, they cannot provide for their families. We also see this through our child malnutrition program, where the same girls often return to our clinics with their children who are suffering medically because they are underweight and not getting the appropriate nutrition. We help them by giving them a nutritional supplement for the child and take the opportunity to educate the mother on healthy and nutritious foods. We offer our clinical services to treat these specific issues, but our overarching goal is to address the root causes. Comprehensive sexual and reproductive health education seemed like the natural and best place to start.
We chose to design our own curriculum, working with a Haitian-American psychologist with years of experience in Haiti, because we wanted to make the course fit the context in which we are working. There are many myths and misconceptions that are prevalent in Haiti when it comes to sex—for example, if you have sex in the ocean you cannot get pregnant, if you drink a beer after sex you won’t get pregnant, if you have sex with a person with a disability you will get rich, and so on. These myths are harmful and promote risky sexual behavior that harm girls and others.
We also felt that it was important to engage the girls in a way that gets them interested and excited about this information, so that they can take their knowledge and apply it to their lives and share with others as well. In one section, the course covers Rabòday, a popular genre of music in Haiti with lyrics that are very degrading towards women. The class looks at some of the lyrics and discusses common themes, how men and women are described in the songs, what stereotypes this genre conveys, and the type of dangers it perpetuates. We hope that by learning about how sexism plays into every facet of their lives, they will become more aware of it and work to change it, starting with their own lives and the choices they make.
Before we start any new program, we take the idea to the community first. For this course, we conducted a feasibility study and interviewed many community leaders—government officials, pastors, teachers, parents, and our own staff. The responses were overwhelmingly positive, even from the church, which is very influential in Haiti. While many may hold traditional values, they see the negative consequences that the lack of sexual education has on the women in their lives. They were eager to have us begin the program. Many of the people we talked to wanted to educate their children on these subjects, but they didn’t know how and many did not have that knowledge themselves.
We created our own curriculum tailored specifically to the girls in our communities, the barriers they face to reproductive health, and their interests. We were fortunate enough to work with Dr. Elizabeth Louis, a Haitian-American counseling psychologist who helped us in writing the curriculum. We also hired one nurse and one social worker to teach the course, since we thought it was important to have young female professionals teach as a team to make the young women feel comfortable with the material and to address any and all questions that the students might have.
We then spread the word about the program in and around our clinics and through our community health workers. Once all of the participant spots were filled, we held an education session for the parents of the girls so that they could learn more about the curriculum and to ask questions and raise concerns. After that, it was time to launch the course.
While the first classes just began, we are already excited about the future of this program. For the first year of the program, we plan to reach girls ages 13-18. Next year, we will adapt the curriculum and add a second, separate class for boys ages 13-18, ensuring to keep the classes separated so that everyone feels comfortable and safe to ask questions and share their thoughts. For the third year, we plan to separate the groups further by age—one class for girls ages 10-14 and another for girls 15-18, and the same for boys. In the fourth year, we hope to pilot the course at a local high school in an attempt to integrate this program into the school curriculum, which has never been done before in Haiti. Once we have several years of data, we will pitch the course to the Ministry of Education with the goal that one day the course will be taught in schools throughout Haiti.
We are so excited about the potential of this program and are grateful to The West Foundation for its ongoing support of our work in Haiti!