The Medical Visitor Program

Hôpital Sainte Croix

Léogâne, Haiti


Visiting Haiti


Hopital Sainte Croix (Holy Cross Hospital), a 120 bed general hospital in Leogane, Haiti, receives help from many volunteer physicians, dentists and other health professionals from abroad. Medical visitors assist in specialty care, consult with Haitian medical staff, hold continuing medical education conferences, and support and encourage the hospital staff as it seeks to develop a high standard of medical care in the hemisphere's most needy nation.

The full-time Haitian medical staff provides inpatient care and specialty clinics in medicine, pediatrics, obstetrics-gynecology, general surgery, and anesthesia. There is part-time medical staffing in radiology, clinical and anatomic pathology, orthopedics, urology, ophthalmology, and dentistry. There is a 24-hour emergency room. There are four operating rooms in a recently expanded surgical suite.

Medical Visits

Medical visitors may come as individuals or in teams. A team might consist of physicians and/or other professionals from various specialties, for example colleagues from a hospital or a church; or it might be a self-contained surgical team consisting of surgeon, technician(s), and anesthesia personnel. Visitors are met at the airport, and are housed and fed in secure and comfortable visitor quarters on the hospital grounds. Because of the very limited financial resources, visitors must pay their own air transportation and a small per diem fee for room and board (currently US $ 25).

The political and civil situation has been stable following restoration of the Aristide presidency in October 1994. The language of the people is Haitian Creole; the administrative language is French. Most administrative and professional staff also speak English. Translators are provided as necessary.

For more information, contact:

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Planning the Medical Visit

For scheduling of visits, or information about current needs, contact Dr. Jack G. Lafontant at the address above. Linda Markee, Presbyterian mission coworker, helps coordinate scheduling of visitors and consultants (same HSC address).

Medical visits typically last one week. Especially for surgical teams, it is desirable to schedule well in advance. The hospital medical staff will then arrange appropriate cases for surgery and/or consultation. Visitors would make rounds with their local colleagues, attend conferences, and hopefully provide a continuing education conference on a topic of general medical staff interest.

Timing of visits is based on hospital needs and the limited size of the visitor quarters (four double rooms). Scheduling is done directly with the hospital administration, based on current needs.


Supplies: The hospital welcomes the needed specialty items which many teams have brought. If you have special items you would like to bring, please check with the hospital before departure to coordinate supplies with needs, and to plan proper transportation from the airport. Due to government regulations, do not import outdated medications.

Hospital economics: As a mission hospital, Hopital Sainte Croix tries to provide care to all who seek it. There is a standard fee schedule for those who can pay. Decisions about who pays and who is eligible for non-reimbursed care are complex, and are best left entirely to the local hospital officials.

Credentials: Professional visitors are asked to send copies of their current licenses and a short CV to the hospital before arrival, in accordance with Haitian regulations.

US Tax information: The expenses of volunteer medical service visits may be deductible. Well in advance of departure from Haiti, request from the Director's office a letter stating that your trip was a direct contribution to Hopital Sainte Croix, Episcopal Diocese of Haiti; also keep the receipt for your room and board expenses. Consult your tax advisor for current regulations.

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Travel to Haiti

Obtain a passport well in advance. An advance visa is not required. Make your air reservations as soon as possible to insure space and obtain the best rate. Be sure that you have notified the hospital of your arrival date/time and flight number.

Baggage: American Airlines strictly limits carry-on bags. Any excess must be checked at the gate. Expect a crowded flight and an extremely congested baggage claim area. When looking for checked luggage, be aware that attendants may pull bags and boxes off the small conveyor belt and distribute them to one side. Medical or other items of checked baggage must be very carefully packed; plan ahead for opening and re-sealing boxes at customs.

Immigration: Fill out the immigration card in flight. Pass through the immigration line and obtain a passport stamp. Retain a stamped copy of your immigration card throughout your visit. It must be surrendered on departure.

Customs: After clearing immigration and after finding your checked luggage, proceed through one of the customs lines. Inspection practices vary widely.

Arrival: After customs clearance you will be deluged by drivers offering their services. Say no, and wait outside where you can be seen. The hospital driver is usually identified by a Hopital Ste.Croix sign. If you don't see it, wait until the driver finds you. Many people will offer to help with your luggage; if you need and accept luggage help, keep an eye on every item at all times. Note the following.

Handouts: Decide in advance what will be your policy about people who beg. Many who beg around the airport (and elsewhere) are very persistent, with well-developed stories. Unquestionably the needs in Haiti are great (that's why you're there), but remember you can't help all who ask. If you do help, be very discreet.

Currency: The conversion rate printed on Haitian notes is 5 gourdes to US$ 1. The five-gourde note is commonly called a Haitian "dollar"; but the exchange rate floats, so do not exchange a Haitian "dollar" for a US dollar. (During visit 24-29 June 98 it varied from 15 to 16.5 gdes/$) In dealing with vendors, be sure you understand which dollar is being discussed. Because of the exchange problems, you are urged to change your US dollars at the hospital, and then deal locally in gourdes. However, gourdes cannot be converted into US dollars. Part of the departure tax must be paid in gourdes, but otherwise gourdes are not accepted from visitors paying the airport departure tax. Be sure to save enough US cash to pay the departure tax!

Emergency numbers: Hopital Sainte Croix: 87-0746 or 87-0749. If for some reason you could not get in touch with the hospital, you might call the Episcopal Diocesan office in Petionville 57-1624 for advice, or Ecole Saint Vincent, Port-au-Prince 22-5844 (an Episcopal Church facility). If you become stranded in Port-au-Prince overnight, call Hotel Montana 57-1920 for accomodations. International direct dial prefix from USA to Haiti is 011-509-... AT&T USA- Direct number from Haiti is 001-800-872-2881.

What to bring: The climate is quite warm. Wear cottons, not blends. Bring "sensible" shoes. The dress code in town and at the hospital might best be described as "modest tropical casual" Be aware that Haitians have a highly developed sense of style, dignity, and appropriateness; even the very poor dress nicely for school and church. Bring beachwear, beach towel, surf shoes or sturdy sandals, and a hat. There is snorkel equipment available at the visitor quarters. Bed linens and towels are provided in the guest quarters (but bringing your own and leaving them as a gift would be welcome). Bring special professional items, such as your own scrub clothes, stethoscope, lab coat, etc. as necessary; and your personal medications and toiletries. Laundry facilities are available. Electrical current is 110 volt.

Health: Malaria and dengue are endemic. Short term visitors staying in the visitors quarters or other screened sleeping areas and who use mosquito repellant are at little risk. Chloroquine or Aralen prophylaxis is optional. If you take it, follow through with the full six weeks course upon return. Hepatitis immunization is a good idea for all health workers, in any case. Review and assiduously follow universal precautions in all clinical work. The hospital water supply (deep well) and the food preparation there have been quite safe. However, triple-sulfa prophylaxis is a consideration if you go to the beach or eat out. Use sun glasses, hat, and at least SPF-30 sunscreen. Risk of vehicle accidents is increased at night.

Leisure Activities: Take the opportunity to walk around Leogane, noting especially the market area, Episcopal church and school grounds (adjoining the hospital grounds), Catholic church, large crucifix, varied architectural styles, park with its memorial to Anacoana, cemetery, soccer stadium, central market. Usually there will be opportunity to see something of the immediate environs as well, such as the Community Health Center at nearby Darbonne, or the boat-building area at Ca Ira, or to check on construction progress for the new Nursing School complex (groundbreaking 28 Jun 98). The hospital administration wants your visit to be fun and interesting, as well as productive, and will try to provide a weekend beach visit if desired, depending on vehicle availability. Hospital needs must, of course, take precedence. Bring a book! Stay flexible!

In Port-au-Prince: If your schedule permits, try to see the inspiring murals at Ste. Trinite Episcopal Cathedral, the Haitian art museum, and the statue of the "Unknown freedom fighter" near the National Palace, and catch a performance of the Ste. Trinite Philharmonic Orchestra. Shopping at the Iron Market is a memorable experience.

A philosophical note: It helps to remember that the Medical Visitor Program is not designed to change Haiti; it is intended to help support the Haitian hospital staff in their desire to provide the best medical care that circumstances allow. Be aware of the concept of "appropriate technology." Most American expectations of "quality medical care" are based on a multiply-redundant supply system. What works at home may not at all be appropriate in Haiti. For prescriptions, stick closely to the hospital formulary.

What to bring home: some Haitian art (painting, iron sculpture, carving, ceramic, etc.); perhaps some rum, coffee, and/or vanilla concentrate; the ability to greet, thank people, and smile in Creole; the memory of Haitian drums and singing, of the brilliance of hibiscus and flamboyant, and of the swaying of the cocoyer (palm trees, symbolic of Haiti's freedom); a renewed appreciation of your ability to adapt to varying conditions; an appreciation of the hard work and courage of Haitians in living in difficult circumstances; and deeper insight into your own spirituality and professional calling. You will find that even though you left Haiti, Haiti did not leave you.

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Departure from Haiti

Reconfirm your return reservations 72 hours in advance: American Airlines 46-0100. The hospital office will help you do this by telephone from Leogane. The airline recommends arriving at the airport three hours before departure. Expect extreme crowding and delays. Bring a book !

Food: if you will need lunch and snacks, bring them from the hospital. Due to the heat and delays, it is a good idea to travel with a personal water bottle.

Checklist: Before leaving the hospital, and again before entering the departure area at the airport, be sure you have the following: (1) US$ 25 cash -- not checks -- for departure tax; (2) Ten gourdes for gourdes portion of the departure tax; (3) passport and immigration card; (4) airline ticket; (5) all luggage items together, well identified as yours; (6) film in xray protective bag it will get at least two xrayings before leaving Haiti, and again when you make flight connections in USA.

An airport newstand and bookshop are outside the departure processing area; if interested, visit them before beginning departure processing.

Departure processing:

a. Enter the first xray-inspection check. All luggage (carry-on and checked) must be processed.

b. Enter ticket-agent area (there is usually another passport and ticket checkpoint at the beginning of the check-in line). Check-in your baggage, get seat assignment, boarding card, and baggage claim check.

c. Pay the airport departure tax, in two portions, at a special desk: (1) US dollars cash only -- In June 98 this was US$ 25; and (2) Gourdes (ten gdes, Jun 98) which presumably is an incentive for visitors to exchange $ to Gdes. (It is prudent to check on the current fees upon arrival.) Be sure you have the tax receipt to show at every subsequent step until you are airborne.

d. Go to Immigration at Departure gates 5,6,7.

e. At Immigration, show passport; surrender immigration card.

f. Show passport and ticket again before going through scanner just beyond Immigration.

g. Carry-on luggage is xrayed again.

h. At departure-tax desk show passport (again!) and departure tax receipt.

i. Enter waiting area; keep watch; don't rely on gate announcements. Visit the duty-free shops upstairs; use up your gourdes!

Note: Do not import plants or fresh foods into USA.
(Prepared food products such as coffee, vanilla concentrate, marmelade, etc. are acceptable.)

Note: All checked baggage must be claimed and all personal items submitted to customs inspection upon arrival in USA; checked baggage must then be rechecked with airline agents just beyond the customs area exit.

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