Community Health

Haiti’s Central Plateau

In 1997 a delegation of citizens from the Commune of Thomonde in Haiti Central Plateau arrived unannounced at Dr. Arthur Fournier’s office in Miami. They told him of the desperate health conditions in their commune and invited him to come and see with his own eyes. At that time, Thomonde was one of the most isolated communities in Haiti, requiring an arduous six-hour drive over a dirt road in an all-terrain vehicle.

The health clinic built by the regional Ministry of Health was crumbling in disrepair and have been abandoned. This community of 35,000 people had some of the worst health statistics imaginable – a life expectancy of 47 years, birth to 5 mortality of 20% and a one in 10 chance for women to die during childbirth. Sixty percent of children were clinically malnourished. To the delegation’s surprise, Dr. Fournier accepted their invitation. He was intrigued by the idea that this community had sought him out and so valued health that they were looking for someone to help them.

On his first visit, Dr. Fournier was accompanied by two medical students and met with community leaders. He made a commitment to return with more students on an episodic but regular basis.

Mobile Health Clinic

Mobile clinics frequently see 200 – 300 patients per day.

Since then, Thomonde has evolved from no healthcare through a stage of episodic care delivered by medical student and faculty volunteers to a permanent culturally competent health care delivery system staffed by a Haitian work force. The backbone of this workforce is a cadre of community health workers who serve as peer educators and facilitators. With funding from a Miami foundation, The Green Family Foundation the program expanded in 2004 to include two adjacent communities, Marmont and Casse, caring for a total population now of 100,000 people.


  • Birth to five mortality has been halved
  • Malnutrition is confined almost entirely to the remotest corners of these communities
  • Prenatal care is now available to all pregnant women