Logistics: Moving Essential Equipment, Supplies, and Medicines to Northern Haiti

Early on in Konbit Sante’s work in Haiti, it became apparent that the lack of basic supplies, medications, and appropriate and functioning equipment was a serious impediment to our Haitian colleagues’ ability to provide quality care. In 2003 Dr. Steve Larned, one of the organization’s early board members, took the lead in organizing Konbit Sante’s first container shipment to Haiti. The first shipment came together in Amesbury, Massachusetts, former home of International Medical Equipment Collaborative, where volunteers packed materials into a container which was then shipped to Cap-Haitien via New York and the Bahamas.

An early container from Konbit Sante moves out of the port of Cap-Haitien.

In 2009 Konbit Sante became a legally recognized humanitarian organization in Haiti. Just 5% of organizations working in Haiti have this status because the process is very challenging, according to Konbit Sante volunteer and former Executive Director, Nate Nickerson. This status allows Konbit Sante to ship its own containers as well as those consigned by other nonprofit/humanitarian organizations. The contents, which are pre-approved by the Haitian government, then enter the country duty-free.

Fast forward to November 2022. During the past 12 months Konbit Sante consigned 22 shipments of donated essential medicines and medical equipment, including 16 full containers, to Cap-Haitien. Some of the shipments were from organizations including Direct Relief, MAP International, the Dalton Foundation, and Rise Against Hunger. The items that arrive via these shipments have been identified by our partners in Haiti as critical to their ability to provide care.

In addition to receiving donated materials, Konbit Sante helps partners source basic supplies and pharmaceutical products through low-cost options such as the PAHO (Pan American Health Organization) supply chain in Haiti called PROMESS, or through low-cost organizations in Europe such as IMRES. If needed items are available and well priced in Haiti, then our preference is to buy local.

What does shipping cost? A typical 40-foot container, the kind we see stacked up in ports or being hauled by semi-trucks or by rail, costs approximately $10,000 to ship and often contains in excess of $150,000 worth of materials. One example, during the past few years Konbit Sante has imported thousands of new wheelchairs through partners Hope Health Action and The Walkabout Foundation. The wheelchairs are then distributed all over the country to those who need them.

Rob Dalton, volunteer at Hope Health Action, prepares a wheelchair for a patient at the HCBH rehab center.

The Needs

Addressing Cholera ASAP

One immediate need is for supplies to help the communities served by our partners have safe drinking water. To accomplish this, one million Aquatabs water disinfection tablets are being purchased from Medentech in Ireland where they cost one-quarter of what they cost in the U.S. The aim is to have them shipped by the end of the year, and then distributed by a system of community health workers already in place at several partner facilities and organizations across northern Haiti.

Community outreach: A neighborhood hand washing demonstration in 2010.

Keeping Facilities Open with Increased Patient Loads

Because of the lack of electricity, many care providers in the north are currently closed, meaning our partners are treating more patients than usual. Medicines and supplies are among the top needs of our partner facilities, according to Konbit Sante’s Country Manager and Interim Executive Director, Tezita Negussie. For quick response to partners’ immediate needs, needed items will be purchased from pharmacies in Cap-Haitien. Larger quantities for the longer term will be secured abroad and shipped.

The Logistical Options

Moving materials into the country is a challenge during the best of times, but it has become dramatically more difficult due to the country’s fuel shortage and insecurity. The situation is fluid, and Konbit Sante’s program and logistics teams are currently monitoring and evaluating which route is best based on the specific contents and the urgency of each shipment. Here are four options:

• By container to Cap-Haitien is the usual way. This is the least expensive option, and the next container of medical equipment will likely travel this way.
• By container to the Dominican Republic and land transport to Cap-Haitien hasn’t been tried. This route has many unknowns related to customs in the Dominican Republic and possible insecurity of land transport across the border.
• Air freight to Port-au-Prince and then land transport north is the fastest option during normal times but more difficult now due to fuel shortages and general insecurity. For speed, however, the Aquatabs will likely travel this way.
• Air freight to Cap-Haitien via Miami is both fast and secure, although somewhat more expensive. The airport at Cap-Haitien is not currently open for air freight, but this will become an attractive option when they open.

As the situation in Haiti is dire and ever evolving, Konbit Sante’s longstanding relationships and experience position us to continue to make a difference in the lives of the Haitians we serve.