Zanmi Lasante history

1956 - Haiti's largest river, the Artibonite, is dammed as part of an international development project, causing area farmers to lose their land, livelihoods, and homes and to move further up the mountain.

1962 - Father Fritz Lafontant and his wife Yolande start working in the village of Cange to address community health needs and to provide schooling for the children of displaced peasants.

1981 - The Lafontants establish a primary grade school in the area, Ecole Bon Sauveur.

1983 - A group of community activists, including Paul Farmer and Ophelia Dahl, mobilize around health issues in the Central Plateau of Haiti and form a group called Zanmi Lasante ("Partners In Health" in Haitian Kreyol).

	Thomas J. White and Pere Lafontant

1985 – The Clinique Bon Sauveur is founded by Zanmi Lasante, with generous and unwavering support from Thomas J. White, the wealthy owner of a Boston construction company. It becomes the departmental hospital for Haiti's Central Department (population 500,000) and the hub of ZL's expanding activities, providing outreach through bimonthly mobile clinics and a cadre of 200 health care workers who perform health promotion and disease prevention activities. ZL constructs a major hydraulic system to bring clean water to the village of Cange, eliminating child deaths caused by diarrhea in the village.

1986 – Zanmi Lasante documents the first known case of AIDS in Haiti’s Central Plateau. Voluntary counseling and testing is offered free of charge as ZL focuses its efforts on HIV prevention and education during the early years of the epidemic.

1987 – Partners In Health is established in Boston.

1989 - ZL initiates a community-based, directly observed therapy program for treating tuberculosis, which is the leading cause of death among HIV-positive people worldwide.

1990 - ZL launches a comprehensive women's health program, Proje Sante Fanm, to provide family planning, prenatal care, and treatment for sexually transmitted infections.

1992 – ZL launches an AIDS education project called Une Chance à Prendre. Local patients and activists produce Chache Lavi, Detwi Lavi (Looking for Life, Destroying Life), the first candid film portrayal of AIDS in Haiti.

1993 – ZL opens its first inpatient facility. More than 40 percent of patients are found to be HIV-positive.

1995 – A two-year study reveals that more than half of HIV-positive patients at ZL also have active tuberculosis. ZL becomes Haiti’s first clinic to offer the antiretroviral drug zidovudine free of charge to all HIV-positive pregnant women to prevent mother-to-child transmission of the virus. The availability of treatment dramatically increases uptake of voluntary counseling and testing for HIV among pregnant women and lowers the rate of vertical transmission in the catchment area.

1996 - ZL begins using highly active antiretroviral drugs (HAART) in conjunction with directly observed therapy (the combined therapy was named DOT-HAART). Clinique Bon Sauveur opens its operating room and performs the Central Plateau's first surgical procedure.

1998 – ZL acquires small amounts of the three antiretrovirals needed to provide the drug cocktail known as "triple therapy" and begins a pilot program to treat 50 patients suffering from advanced AIDS.

1999 - The Thomas J. White Center, a 30-bed infectious disease treatment center, is built and designated by the Haitian Ministry of Health as the primary MDR-TB referral site for the country.

2000 – Encouraged by the remarkable return to health of patients in the pilot AIDS treatment project, ZL launches the HIV Equity Initiative to expand treatment to as many patients as possible. Drawing on PIH’s experience treating multidrug-resistant tuberculosis in Peru, the HIV Equity Initiative codifies clinical criteria for beginning AIDS therapy; trains community health workers to deliver antiretroviral drugs under the same model used to treat tuberculosis in Haiti and Peru; and negotiates for preferential pricing and generic medicines on the international market, thereby decreasing the average annual cost of treatment from over $10,000 to $325 per patient. An ophthalmic clinic is built in Cange.

2001 – On August 24, more than 2,000 healthcare providers, patients, and social justice activists who have gathered for the annual human rights symposium at our hospital in Cange issue The Cange Declaration on health and human rights. "We have a message for the people who are here and for those who are able to hear our plea," the Declaration states. "We are seeking your solidarity. The battle we are engaged in -- to find adequate care for those with AIDS, tuberculosis, and other illnesses -- is the same as the combat that has been waged by other victimized people over time so everyone can live as a human being." A group of about 60 patients living with HIV had met in the days prior to the symposium to prepare a declaration regarding the right of poor people with AIDS to modern, effective therapy.

2002 – In a strong endorsement of PIH's community-based approach, Haiti receives one of the first grants from the Global Fund to Fight AIDS, Tuberculosis, and Malaria, thus enabling ZL to expand comprehensive medical services, including AIDS treatment, across the Central Plateau and revitalize the public health sector. New funding from the U.S. Centers for Disease Control and Prevention (CDC) and the President's Emergency Plan for AIDS Relief (PEPFAR) supports further expansion of HIV treatment and prevention efforts.

2003 – PIH opens clinics in four new locations in the Central Plateau: Lascahobas, where we inaugurated rural Haiti’s second fully outfitted AIDS clinic; Boucan Carre, where we renovated and equipped an abandoned hospital; and Belladere and Thomonde, where we opened or refurbished clinics. ZL is selected as the site for the CDC’s new initiative to establish a Caribbean training center for AIDS care and treatment. By the end of 2003, ZL is monitoring more than 7,000 HIV-positive patients; of these, more than 700 receive supervised antiretroviral therapy.

2004 – PIH/ZL’s first site in Cange now houses a sprawling sociomedical complex boasting a full-service hospital (Clinique Bon Sauveur) with 104 beds and two operating rooms, adult and pediatric inpatient wards; infectious disease, ophthalmology, and general medicine clinics; and a women’s health center. ZL records an average of 350 patient visits per day in Cange, where it also operates a dozen schools, a Red Cross blood bank and housing, social services, and community health programs. Growth continues at our satellite sites as well. Patient visits reach 150 per day In Belladère, after we refurbish a Ministry of Health hospital, build an operating room and establish mobile clinics to address the needs of the migrant population. Boucan Carré records another 250 patient visits per day, many of them at a new 12-bed public hospital constructed and inaugurated in collaboration with the Ministry of Health. Other new initiatives in Boucan Carré include construction of a 14-room staff dormitory and operating room and the launch of a nutrition program, a bakery and a reforestation project.

2005 – ZL continues its expansion across Haiti's Central Plateau and beyond. A new hospital opens in Cerca La Source, complete with two large wards, a pharmacy, a drug warehouse, a laboratory, x-ray equipment and offices. ZL enrolls its first patients for antiretroviral therapy at two clinics in the neighboring Artibonite region. The number of patient visits at all ZL clinics and hospitals increases to more than 1.1 million, not including an estimated 1.4 million home visits by accompagnateurs.