MASS Design Group (MASS) commits to developing a replicable, integrated approach to water and sanitation at health facilities in Port-au-Prince. Initially, this will be done through the design of ten Health and Hydration Centers (HHCs). These centers would not only respond to needs in Port-au-Prince, but could also serve as a model to prevent and control diarrheal disease across Haiti, the primary cause of child mortality even before the cholera outbreak.
This approach builds on MASS's experience partnering with Les Centres GHESKIO to construct Port-au-Prince's first permanent Cholera Treatment Center, opening fall 2013. The facility presents a new, three-pronged paradigm for diarrheal disease treatment and prevention: 1) a primary healthcare center, 2) chlorinated water distribution, and 3) on-site wastewater treatment facility to prevent recontamination.
Using this facility as a prototype, MASS will develop a plan for citywide replication and envisions partnering with the Ministry of Public Health and Population (MSPP) and others to integrate this model into health facilities. Each building would reflect specific facility needs and could include components such as primary care, water treatment systems, publicly available sanitation blocks, and even small-scale commercial market space for community entrepreneurship opportunities. This HHC model reflects priorities from Haiti's National Plan for the Elimination of Cholera and could nimbly target epidemiologic priority areas with a decentralized network of water and sanitation infrastructure.
MASS plans to strengthen the design of HHCs through carefully monitoring health outcomes and community impact of the GHESKIO Cholera Treatment Center. This research will help ensure that the Health and Hydration Centers provide a long-term solution to cholera treatment but also the long-term infrastructure necessary to combat diarrheal disease.
With a diversified service model, the HHCs could become a civic resource beyond health services, serving as a community hub for market creation, civic space, and the bolstering of long-term Haitian community health.
Fall 2013: Opening of the GHESKIO Cholera Treatment Center
A convening between MASS, GHESKIO, donors, and other key constituents will be held in November as a celebration of the facility's opening and as recognition of the partners' concerted accomplishment. At this event, the vision for the expansion of the CTC's model will be presented and strategies for reaching this goal discussed.
Fall 2013 - Winter 2014: Monitoring and Evaluation
MASS has begun preliminary monitoring and evaluation of cholera treatment strategies and will launch a variety of investigations to track the effectiveness of the GHESKIO CTC's design, programs, and wastewater treatment measures. Research will also include monitoring current studies and predictions for the incidence of the disease over the coming decade.
Winter 2014 - Summer 2015: Needs Assessment for Future Facilities
Backed by ongoing monitoring and evaluation, MASS will lead immersive research with GHESKIO in Haitian communities to inform future phasing and replication of this new prototype. MASS will conduct a needs assessment for a distributed network of 'Hydration Centers' to deliver widespread wastewater decontamination and healthcare access across Port-au-Prince and in Haiti more broadly. MASS will build a coalition with key partners for implementing this model and will develop a budget and strategy for facility replication.
Fall 2015 - Winter 2018: Health and Hydration Center Design
Following completion of an immersive needs assessment that will ascertain the most immediate needs and potential for impact in various communes of metropolitan Port-au-Prince, MASS will design an initial phasing of ten Hydration Centers, to be completed by Fall 2017. Further phasing will continue after the commitment concludes.
Cholera remains a formidable challenge facing Haiti. Best estimates indicate that cholera has killed over 8,000 Haitians, with more than 657,000 reported cases since the epidemic began in October 2010. In other words, approximately one out of every fifteen Haitians (~6.7 percent) has been sickened by cholera in one of the largest cholera epidemics in recent history. Cholera now threatens to become endemic in Haiti and requires a long-term, comprehensive response.
Cholera is an acute diarrheal disease spread through fecal contamination of food and water. It is effectively controlled by: 1) improving primary health care systems, 2) improving sewage treatment systems, and 3) investing in and scaling access to clean water.
In the initial response to the cholera outbreak in Haiti, temporary independently-operated cholera treatment centers were assembled to meet short-term needs. Nearly three years later, however, these facilities remain the mainstays for cholera treatment despite lacking capacity to provide dignified, prevention-oriented, and long-term health care. Many tented cholera treatment centers fail to weather the Haitian climate and rely on manual sewage collection systems that risk water table recontamination. Haiti deserves a more concerted solution, one that integrates cholera treatment into existing healthcare infrastructure while addressing basic water and sanitation needs.
MASS welcomes partners who come from backgrounds that range water and sanitation, public health, entrepreneurial, engineering, and design sectors to help contribute technical expertise, provide unique perspectives, as well as raise awareness and capital.