In some sense, CDS’s ability to continue in operation speaks for itself. Its been functioning for 34 difficult years. CDS’s longevity is attributable to five core areas of support.
- First, local business leaders started the organization and remain on the board. This has created a base of domestic advice, material assistance, connections and funds that have stabilized the group throughout its existence.
- Second, CDS has formed partnerships with the Ministry of Health. While other private groups spurned any contact with the Ministry, CDS (again, preferring collaboration over rivalry) determined to support to work with the Ministry’s staff, training them and incorporating them into the CDS system. Ministry staff that work in CDS facilities receive their base Ministry salary, which is supplemented by CDS as long as Ministry staff conform to CDS standards. CDS has repeatedly found that many of those involved in corruption and dereliction of duty when working for the Ministry turned into dedicated employees when they joined the CDS system, where they found respect for the ability, recognition of creativity and hard work, and meaning and purpose in their professional lives.
- Third, CDS has asked community members to pay relatively small fees for the curative services they receive. (Preventive care is free, and the CHWs, with their intimate knowledge of the population, identify the poorest members of the community who receive all services for free. No one is turned away.) This practice provides a base of support, and gives the program credibility in the eyes of the beneficiaries, who often reason that services or medicines given away for free cannot be very valuable. More importantly, by paying their own way (at least in part) the recipients earned a measure of self-respect, not an insignificant factor for the downtrodden.
- Fourth, CDS understood that the most reliable means of increasing the economic security of its programs was to increase the economic capacity of the communities it served. Not only would improved economic conditions ameliorate health problems, gradually residents would be able to afford fees that would come closer to covering the cost of CDS services. As a result, CDS launched initiatives aimed at long-term economic development (and sometimes the root causes of poor health, such as poor sanitation):
- • With funds from the InterAmerican Development Bank, CDS built a pipeline system to bring fresh water to all of Cite Soleil for the first time. CDS turned over control of the 77 water outlets to local community groups. (The Bank also loaned CDS funds for an ice factory.)
- • A high quality school in Cite Soleil for 1,000 children. Almost 60% of the graduates pass their baccalaureate exams; the nationwide average is 45% of those who take the exam. The school has one of the only public libraries in all of Haiti that is open to the poor.
- • Three vocational training centers, offering courses in sewing, electronics, computer training, etc.
- • Literacy classes are available to adults.
- • Small loans to struggling entrepreneurs. Training in financial management is given before the loan is awarded. 80% of the loans are given out to small groups, with all members of a group responsible for the debt.
- • A small group of poor women were trained in baking and provided them with a kitchen. CDS turned over the bakery to the women.
- • Seeds were given to rural cooperatives (tens of thousands of farmers) throughout Haiti.
- • CDS ran the sanitation company for Cite Soleil.
- • Following a substantial fire that burned a large section of Cite Soleil, CDS built an apartment complex on top of the scorched earth. It remains the best housing in Cite Soleil.
- Fifth, CDS turned to foreign donors to bridge the gap between its own domestic resources and the financing required to meet its program goals. CDS’s integrity, advanced public health practices, and a documentation system allowing it to demonstrate its accomplishments have made CDS a reliable partner with many foreign organizations.