Two years on from the earthquake that devastated Haiti, physical therapists are still working to rehabilitate people and rebuild services. But it isn’t easy. Haitian physical therapist Ivens Louius is founder of the Haitian Foundation of Rehabilitation (FONHARE). He has been working with WCPT’s North America Carribean Region (NACR) and has participated in the region’s meetings. Here he tells Stacy de Gale, NACR regional Chair, about discriminatory attitudes, resource shortages and lack of professional rehabilitation skills.
Stacy de Gale: What challenges have you faced working as a physical therapist in Haiti?
Ivens Louius: Initially, I had great difficulty getting community leaders involved in organising FONHARE. It has also been difficult to change perceptions about disability. People with disabilities in Haiti have always been excluded from society and there is much work to be done to build opportunities for education and employment.
There are also limited employment opportunities for Haitian physical therapists. In order to work with people in poverty who cannot pay, you must often volunteer your own time, which is what I do.
Another challenge is a lack of materials and equipment to provide the kind of therapy I would like to provide. Also, sometimes patients do not complete their duration of therapy sessions, due to lack of money for transportation.
SdG: Many people admire the tenacity of physical therapists working in Haiti. Why did you decide to stay?
IL: I wanted to be part of the change in Haiti. I wanted to bring my knowledge back and make a difference in people’s lives, particularly in the north of Haiti, where there are very limited rehabilitation options. These are my people and they motivate me to stay with their willingness to go great distances just to receive therapy and with the progress they can make in their health and function.
SdG: Since the disaster of 2010, how has the face of rehabilitation changed in your country?
IL: Many more non-governmental organisations are now attempting to establish physical therapy as a permanent profession. The government is more concerned now with the issues facing people with disability and is promoting initiatives to improve rights, access, and opportunity. Before the earthquake, rehabilitation was virtually unknown, but now more people are hearing and talking about it. Some organisations are attempting to address the need for rehabilitation by training people to become rehab technicians. To me, this is not a positive move – it is not formal training, and long-term I believe it will create more problems.
SdG: Are the rehabilitative needs of the people of Haiti being met?
IL: No. Problems still exist because many disabled people are living in bad conditions and don’t have access to services, and many have accessibility barriers inside their own homes. There are still so few therapists providing rehabilitation and so many more people in need of services, that this will be a challenge for a long time.
SdG: Can you tell me more about the Haitian Foundation of Rehabilitation?
IL: FONHARE is a grassroots organisation that provides both physical and occupational therapy to children and adults regardless of ability to pay. It is the only organisation providing therapy founded and led by Haitians. I am currently the only therapist on staff, but I have a rehab technician who works alongside me, and we are implementing a volunteer programme, so hope to have volunteers helping us throughout the year. We want to get funds so that we can welcome Haitian therapists who are working and studying outside of Haiti to join the FONHARE staff.
There are other physical therapy institutions in Haiti, but they are mainly run by foreigners, and most are concentrated near to Port au Prince. We operate a clinic in Ouanaminthe, and see patients with orthopaedic injuries and deformities, strokes, developmental disabilities, neurological conditions, and general pain and dysfunction. Our approach to creating lasting change for individuals involves implementing special programmes, such as the Independent Life Programme that provides accessibility at home, church, school and public places for people with disabilities. We try and change public perceptions by hosting a weekly radio education programme.
SdG: What are your dreams for physical therapy in Haiti?
IL: My dream is for all Haitian physical therapists to be able to return to Haiti to work in their country and contribute to building the rehabilitation system. I dream of having physical therapy schools in Haiti. I would like to see a Haitian Physical Therapy Association become a member of the World Confederation for Physical Therapy.
You can learn more about these programmes and how to support them at: www.fonhare.org