HIV patient files, Zanmi Lasante, Cange, Haiti. 2007.

HIV patient files, Zanmi Lasante, Cange, Haiti. March, 2007.

My first visit to Zanmi Lasante, in the central Artibonite region of Haiti, was loaded with anticipation. Paul Farmer’s important studies and medical work, and the slightly glossy biography about him, Mountains Beyond Mountains, were all located in this area, and at this particular hospital, run by its parent organization called Partners in Health (PIH) and the Episcopal Church. (PIH has since then shifted most of its physical presence and activities to a much larger facility in the nearby town of Mirebalais.)

Much of the impetus for both Paul Farmer, and his Haitian mentor, Father Fritz Lafontant, was a response to the spread of HIV and multi drug-resistant tuberculosis in this profoundly impoverished area.  What little government infrastructure was largely directed to other parts of Haiti all through the second half of the 20th century, so the spread of these diseases was compounded by a lack of health services, and the iatrogenic effect of non-governmtal organizations providing inconsistent and unregulated health care.

I was not prepared for what seemed like an oasis. The Zanmi Lasante hospital complex was beautifully designed, calm and soothing. It provided and supported an interconnected set of solutions: among them health care of course, but also education, nutrition, employment and training for adults. But the stark reality of the situation became visible when I saw this – a large open storage system for files belonging to HIV patients.

Hasselblad 500C/M, 80mm Planar lens, Ilford HP5 film, processed in Pyro PMK