LOOKING FORWARD 2013 ANNUAL REPORT
A Partners In Health community health worker uses a GPS device to map coordinates of remote villages in Neno, Malawi.
CONTENTS 06
08
10
WHERE WE WORK A look at Partners In Health and our mission partners at work around the world
ACCOMPANIMENT A few words about how we approach our work with the poor
FEATURED PIH SITES Stories that highlight the care we provide at the community level and in clinics and hospitals at our sites
OUR SUPPORTERS
16
Acknowledging the many friends, family foundations, and organizations that make our work possible
21
GOVERNANCE
22
FINANCIAL REVIEW
A summary of our finances in fiscal year 2013
2
Our board of trustees and officers
Front cover: Partners In Health community health workers, such as Shareen Iman in Malawi, use GPS mapping devices to capture locations of villages. Photo by Alexandra Rose
Our mission is to provide a preferential option for the poor in health care. By establishing long-term relationships with sister organizations based in settings of poverty, Partners In Health strives to achieve two overarching goals: to bring the benefits of modern medical science to those most in need of them and to serve as an antidote to despair. We draw on the resources of the world’s leading medical and academic institutions and on the lived experience of the world’s poorest and sickest communities. At its root, our mission is both medical and moral. It is based on solidarity, rather than charity alone. When our patients are ill and have no access to care, our team of health professionals, scholars, and activists will do whatever it takes to make them well—just as we would do if a member of our own families or we ourselves were ill.
Above: Dr. Dayo Fadelu, head of oncology at Butaro Hospital in Rwanda, helps a young woman who is arriving for treatment. Photo by Rebecca E. Rollins
3
FORGING INNOVATIVE HEALTH CARE SOLUTIONS THROUGH PARTNERSHIPS In addition to donor support, global health education—including medical training and research— plays a key role in sustaining the high quality of patient care at our sites. Our efforts to prepare the next generation of global health providers are strengthened by partnerships with Brigham and Women’s Hospital and Harvard Medical School, two extraordinary, world-class institutions. Working collaboratively with our partners to serve the sick in settings of extreme poverty, we are redefining the limits of what is possible in delivering health care to the poor—and inspiring others to do the same.
4
Above: A colorful mosaic welcomes visitors to University Hospital in Mirebalais, Haiti. Thanks to hundreds of supporters who donated time, money, and gifts in kind, the hospital opened in March 2013. Photo by Rebecca E. Rollins
EXECUTIVE DIRECTOR’S MESSAGE
and Kerling Israel launched medical residency programs at University Hospital in Mirebalais. In the U.S., this type of training is the norm; in Haiti, the residents in Mirebalais are among the first to have access to hands-on training supervised by seasoned mentors in well-equipped teaching facilities.
Dear Friends, As I look back across the achievements of our collective in 2013, which include the opening of our most ambitious facility ever, University Hospital in Mirebalais, Haiti, I’m struck most of all by the breadth of our accomplishments, spread across geographies and disciplines. Partners In Health’s mandate is not only to deliver quality health care to the poor, but to teach others to do the same. And last year, with your support, we were proud to do a great deal of both, from the mountains of Chiapas to the pages of key medical journals. The years I’ve spent with our colleagues in places such as Rwinkwavu and Carabayllo and Neno, in the impoverished communities where PIH works, have taught me that no temporary intervention can take the place of expertly trained local clinicians caring for patients in well-equipped medical facilities. Training the next generation of health providers—from community health workers to the clinicians who staff our clinics and referral hospitals—is essential to breaking the cycle of poverty and disease.
No temporary intervention can take the place of expertly trained local clinicians caring for patients in well-equipped medical facilities. In every setting in which PIH delivers services, we are ensuring that this work strengthens—and is strengthened by—training and research efforts designed to increase the capacity of local providers, improve outcomes, and add to our shared store of knowledge. In Haiti last year, building on a pilot program established in the wake of the devastating 2010 earthquake, my friends and colleagues Drs. Michelle Morse, Paul Pierre,
These residency programs will have an amazing ripple effect. In addition to treating thousands of their fellow citizens, graduates will be equipped to train future generations of clinicians to deliver compassionate, high-quality care to the poor and marginalized. They will improve not only the individual lives of patients and their families, but also the health care system of an entire nation—an achievement we can replicate in other countries with increased support. As we look forward toward the next decade, and beyond, I have drawn energy and inspiration from projects such as the new residencies, our successful maternal mortality reduction program in Lesotho, combined clinics for HIV-positive mothers and their babies in Rwanda—and especially from the dedicated and visionary colleagues who are building them. And, as ever, I am inspired and encouraged by the partnership, the solidarity, and the extraordinary generosity of PIH’s remarkable supporters. As you read about the work you’ve supported, and about the people whose lives have been transformed by it, I hope that you, in turn, will find it inspiring. On behalf of my colleagues, our patients, and the communities we serve, mesi anpil. Thank you very much. Warm regards, Ophelia Dahl Executive Director, Partners In Health
Above: Dr. Michelle Morse with Dr. Bregenet Lamour, a Haitian physician enrolled in University Hospital's new residency program. The program aims to strengthen the capacity of Haiti's health care system. Photo by Jonathan Lascher
5
WHERE WE WORK "Our goal is nothing less than the refashioning of our world into one in which no one starves, drinks impure water, lives in fear of the powerful and violent, and dies ill and unattended." - Dr. Paul Farmer
6
NAVAJO NATION
MEXICO
HAITI
PIH supports the Community Outreach and Patient Empowerment (COPE) Project, which works to improve health in the sovereign Navajo Nation. COPE accompanies Navajo Community Health Representatives, helping to build local capacity, and improving access to healthy foods. COPE's activities aim to eliminate health disparities among Navajo.
Compa単eros En Salud (CES) is revitalizing rural clinics in the mountains of Chiapas to bring primary health care to marginalized people. CES pays community health workers to actively seek out patients suffering from chronic diseases, and recruits new Mexican doctors to provide care and receive training in global health.
Zanmi Lasante (ZL) welcomed its first class of medical residents at University Hospital in Mirebalais. Built in partnership with the Ministry of Health, the hospital aims to build sustainable health infrastructure and human resources in Haiti. ZL also continues its work preventing and treating malnutrition and cholera across central Haiti.
Above: Dr. Paul Farmer sees patients at Neno District Hospital in Malawi. Photo by Rebecca E. Rollins
RWANDA
RUSSIA
Inshuti Mu Buzima (IMB) continues to advance its work in HIV treatment and non-communicable diseases, particularly cancer. Staff inaugurated the Butaro Ambulatory Cancer Center in 2013. Rwandanled research is also a growing component of IMB's work, as are its social support services.
PIH/Russia scaled its multidrugresistant tuberculosis program in Tomsk, bringing treatment, social, and psychosocial support to prisoners and other vulnerable people. Staff train tuberculosis health providers from across Russia in multidrug-resistant tuberculosis care, and actively find patients who are at risk of dropping out of treatment.
8
COUNTRIES
13,600 98%
STAFF
OF STAFF ARE FIELD-BASED
PERU
LESOTHO
MALAWI
Socios En Salud (SES) supports the government in providing treatment for multidrug–resistant tuberculosis in poor communities. Staff recently piloted a program to treat extensively drug-resistant tuberculosis. SES conducts worldclass research programs, runs mass community education efforts, and provides support to tuberculosis patients in the slums of Lima.
PIH/Lesotho provides services for HIV, tuberculosis, and maternal and child health to eight communities in Lesotho. PIH/Lesotho also manages the national program to treat multidrug-resistant tuberculosis, which it continues to expand in partnership with Lesotho's Ministry of Health.
Abwenzi Pa Za Umoyo (APZU) continues to scale its work in HIV, noncommunicable diseases, tuberculosis, and maternal and child health in the district of Neno. APZU employs more than 800 village health workers who identify and treat patients and renovate houses to improve their living conditions.
Dark blue dots: Our mission partners work to implement the PIH model across the globe, bringing high-quality health care to rural and marginalized areas: Burundi/Village Health Works; Liberia/Last Mile Health; Madagascar/PIVOT; Mali/Project Muso; Nepal/Nyaya Health.
8
Our approach to fighting poverty and disease is based in our ethos of accompaniment. We accompany the people we serve—we are present in their lives and we challenge ourselves to provide what they need. In homes and communities, with health workers, nurses and physicians, and local governments, Partners In Health shares in the struggle to build health care where it is needed most. The following stories show our philosophy of accompaniment at work.
Above: PIH/APZU Clinical Officer Atupere Phiri evaluates an elderly stroke victim during a home visit in Nsambe, Malawi. Photo by Rebecca E. Rollins
9
BRINGING HEALTH CARE TO THE Making home visits is a crucial part of the work of PIH and its Malawian sister organization, Abwenzi Pa Za Umoyo (APZU). No one understands this better than Charles Phiri, an HIV treatment coordinator for PIH/APZU, whose work focuses on identifying and meeting with HIV-positive patients who have stopped taking their antiretroviral therapy.
In Neno, one of the most remote and rural districts in Malawi, getting from one place to another isn’t easy. Villages are scattered, the terrain is mountainous, and the majority of roads consist of packed dirt and rock.
“I visit patients at least three times a week,” says Phiri. “I talk to them about their lives, why they’ve stopped their treatment, and the consequences of stopping. These patients would die if there were no one to visit them and encourage them to get back on treatment.” To help community health workers like Phiri reach out to high-risk patients, PIH/APZU partnered with the nonprofit organization Riders for Health to secure a number of dirt bikes. In addition to
10
Above, large: PIH/APZU Coordinator Sam Msiska arrives at a patient's house in Neno, Malawi. Photo by Alexandra Rose Above, small: Clinical Officer Atupere Phiri visits a patient at her home to deliver treatment in Neno, Malawi. Photo by Victoria Smith
A ROADMAP FOR MALAWI: REDEFINING HIV TESTING AND TREATMENT POPULATION:
16 MILLION LIFE EXPECTANCY AT BIRTH:
50 YEARS “These patients would die if there were no one to visit them and encourage them to get back on treatment.” - Charles Phiri, HIV treatment
MALAWI
ADULT PREVALENCE OF HIV:
1 IN 10
IS HIV-POSITIVE
coordinator for PIH/APZU
COMMUNITY being better suited for cross-country riding, the bikes are cheaper to obtain and more fuel-efficient than the four-wheel vehicles in PIH/APZU’s limited
PIH RETENTION OF HIV PATIENTS IN TREATMENT:
fleet. Most important, they help community health workers cover more ground—roughly 4,000 miles each month—and support more patients as a result. Other tools PIH/APZU uses to strengthen its care delivery model are Geographic Information Systems (GIS) to map locations of remote villages. (Handheld GPS devices like the one featured on the cover of this report are used with these systems.) A recent mapping project identified the precise
MORE THAN
90
%
locations of villages where patients live and their proximity to the nearest health center, pinpointing areas where care is least accessible and where outreach is needed most. Equipped with this information and better transportation, community
NATIONAL RATE: LESS THAN 80%
health workers can do even more to accompany patients to better health—one home visit at a time. Above: The mountainous terrain of rural Malawi. Photo by Rebecca E. Rollins
11
ACCOMPANYING MOTHERS TO As a mother of five who is enrolled on antiretroviral therapy, Malineo Sethobane intimately understands the hopes and concerns of the HIV-positive women she accompanies as a maternal health worker for PIH/Lesotho.
Since 2010, Sethobane has accompanied women during their pregnancies and made hundreds of home visits to expectant mothers in the rural village of Lipeneng. When her own daughter became pregnant, Sethobane was there to support her—not just as a mother but as a trained maternal health expert. She advised her daughter on antenatal care and helped arrange her delivery at the Nohana Health Center, one of the eight health facilities pioneering PIH/L’s Maternal Mortality Reduction Program (MMRP).
12
PIH is committed to addressing the vulnerability of women in childbirth and launched the program in 2009 in response to Lesotho's dismal maternal mortality ratio, a measure of how many maternal deaths occur per 100,000 live births. Lesotho had one of the worst ratios in the world, at 1,155 per 100,000— 55 times higher than in the U.S. “There is no reason a woman should die during pregnancy or while giving birth,” says Dr. Hind Satti, executive director for PIH/L. “We all started with that spirit, and the entire community—from village leaders to mothers to midwives— has been committed to seeing the program succeed.” At 600 strong, maternal health workers (MHWs) are the undisputed backbone of the MMRP. In addition to monthly door-to-door visits to identify pregnant women, MHWs educate expectant mothers about antenatal care, facilitate their appointments, and accompany them to the nearest health facility when it comes time to deliver. MHWs also serve as a conduit to other health services, such as HIV testing and programs for preventing mother-to-child transmission of HIV. “Addressing maternal mortality is a gateway to addressing women’s health, more broadly” says Dr. Satti. “The MMRP not only helps women with pregnancy and delivery issues but also with family planning, their children’s health, and their relationships with their partners and their community.” Working with the government of Lesotho, PIH/L hopes to ensure that every woman in Lesotho has access to a clinic where she can safely deliver her baby.
Above, small: PIH/L Maternal Health Worker Malineo Sethobane helps mothers deliver their babies safely at Nohana Health Center in Lesotho. Photo by Rebecca E. Rollins
LESOTHO & RWANDA
RWANDA
LESOTHO:
100% OF BIRTHS IN THE VILLAGES WE SERVE TAKE PLACE IN OUR CLINICS, COMPARED TO 10% IN 2009.
LESOTHO
RWANDA:
CLINICAL CARE Rwanda is on track to become one of the first countries in sub-Saharan Africa to eliminate mother-to-child transmission of HIV, thanks to an innovative care delivery model spearheaded by PIH, its sister organization Inshuti Mu Buzima, and the Rwandan Ministry of Health.
TRANSMISSION RATE OF HIV FROM MOTHER TO CHILD IS AS LOW AS 2% IN OUR SUPPORTED DISTRICTS
of mother-to-child HIV transmission is as high as 25 percent. “This model is one of a kind in the region and shows that integrating many services into one point of care is, in fact, possible,” says Dr. Neil Gupta, deputy clinical director of PIH/IMB. Given how successful the combined clinics have been in the three rural districts where PIH/IMB works, the Rwandan government is looking into implementing the model nationwide.
At PIH/IMB’s combined health clinics, HIV-positive mothers receive comprehensive care for themselves and their infants during the same appointment. When mother of eight Christine Niyonsaba makes her monthly visit to the Karama Health Center in eastern Rwanda, for example, a nurse measures her CD4 count and other indicators to check the effectiveness of her antiretroviral therapy. The nurse then evaluates Niyonsaba's baby girl, Iratuzi, to make sure she’s developing properly and receiving her daily medication that reduces her susceptibility to HIV transmission from her mother. This one-stop model is convenient for mothers because it reduces the time and money spent on traveling to medical appointments each month. It also yields exceptional health outcomes. PIH/IMB's combined clinics serve over 700 motherinfant pairs, and the most recent comprehensive study showed that the clinics had achieved a very low mother-to-child HIV transmission rate—under 2 percent. Globally, the average rate
“Together, PIH/IMB and the Rwandan Ministry of Health are showing that elimination of mother-to-child transmission of HIV—and an AIDS-free generation—is possible,” adds PIH/IMB Clinical Director Dr. Felix Rwabukwisi Cyamatare. “And for mothers like Niyonsaba, that possibility is already becoming a reality.”
Above, large: A healthy baby boy is delivered at Nohana Health Center in Lesotho. His mother was accompanied to the clinic by a PIH maternal health worker. Photo by Rebecca E. Rollins | Above, small: Christine Niyonsaba and her baby girl, Iratuzi, make their monthly visit to Karama Health Center in Rwanda. Their treatment regimen ensures HIV is not transmitted from mother to child. Photo by Aubrey Davis
13
FROM HERE ON: WORLD-CLASS As the first patient to undergo surgery at University Hospital, Bazard experienced a new era of health care in Haiti. Never before in the country’s history has such advanced care been available at a public facility. For cancer patients like Bazard, this unprecedented offering is nothing short of a lifeline in the face of a disease that has been a death sentence for many Haitians.
“It’s hard to believe that in a hospital this big there are doctors who really understand people,” says patient Isemelie Bazard of her experience at Hôpital Universitaire de Mirebalais (University Hospital). The state-of-the-art teaching hospital in Mirebalais, Haiti, is built and operated by PIH and its sister organization Zanmi Lasante (PIH/ZL) in collaboration with Haiti’s Ministry of Health. “The doctors listened to me, they did surgery for me, and they really looked after me.” 14
Bazard first sought care in March at the PIH/ ZL cancer clinic in Cange. After examining a lump in Bazard's left breast, PIH/ZL Director of Oncology Dr. Ruth Damuse ordered a biopsy, which was diagnosed as breast cancer at Brigham and Women’s Hospital in Boston. Damuse then worked with an oncology team at the Dana-Farber/Brigham and Women's Cancer Center to develop a treatment plan that included a mastectomy and follow-up chemotherapy.
Above, large: Doctors Angela Jaques and Mirrielle Bien-Aime staff the emergency room at University Hospital in Mirebalais, Haiti. Photo by Rebecca E. Rollins Above, small: Isemelie Bazard was the first patient to undergo surgery at University Hospital. Photo by Rebecca E. Rollins
“I've learned to care for patients better, and with all our capacity and materials in the hospital, we are more comfortable in our diagnostic ability." - Dr. Mirrielle Bien-Aime,
A VISION UNFOLDING: DELIVERING ALL LEVELS OF CARE ACROSS CENTRAL HAITI
University Hospital Emergency Department
CENTRAL HAITI
DOMINICAN REPUBLIC
PIH-SUPPORTED HEALTH FACILITIES
H
«
H University Hospital PIH-Supported Facilities Other Referral Hospitals
« Port-au-Prince
CARE IN HAITI On May 23, 2013, two surgeons at University Hospital—Dr. Michelson Padovany, a native of Mirebalais, and Dr. Ainhoa Costas, a Harvard Medical School Paul Farmer Surgery Fellow— performed surgery on Bazard. The historic event also marked the first time many of the hospital’s departments—from nursing to anesthesiology to housekeeping—were up and running as a cohesive unit. “Surgeons cannot do surgery by themselves,” says Costas. “It’s a collaborative effort, with a lot of little pieces coming together and functioning as one.” The roles of University Hospital as both an advanced care facility and a teaching hospital are equally important. PIH/ZL is partnering with leading medical programs and institutions around the world to establish the hospital as a worldclass clinical training destination for Haitian health professionals. The first group of Haitian medical residents began training in October 2013.
EXPERT CARE, SERVICES, AND TRAINING AT UNIVERSITY HOSPITAL
1 FIRST ONLY
TO PROVIDE FREE COMPREHENSIVE CANCER CARE IN HAITI'S PUBLIC SECTOR CT SCANNER AVAILABLE IN THE PUBLIC SECTOR
TECHNOLOGY PLATFORMS FOR REAL-TIME, LONG-DISTANCE LEARNING FOR PHYSICIANS
H
ACCESS TO COMPLEX CARE FOR 3.4 MILLION PEOPLE
Above: University Hospital in Mirebalais Photo by Rebecca E. Rollins
15
THANK YOU to OUR SUPPORTERS Partners In Health would like to thank each and every one of our supporters who make our work possible. Individuals, Family Foundations, and Organizations $1,000,000 AND ABOVE
Reid Hoffman and Michelle Yee
Jan and Larry Birenbaum
Chris and Susan Gifford
Rob and Lyn Houk
Jennie Weiss Block
Gary L. Gottlieb and Derri Shtasel
Thomas Hsu
Timothy Broas
GreaterGood.org
Lesley and William King
Catherine and Paul Buttenwieser Foundation
Marc Haas Foundation
Theo and Wendy Kolokotrones Legacy Venture Member Richard and Terry Lubman
Kathleen Byers and William Farr * The Lloyd and Carole Carney Foundation
Linda Hanson and Jon Wallach Monie and Chan Hardwick Bambi Hatch
Anonymous (3)
Scott and Laura Malkin
Artists for Haiti
Open Road Alliance
Josh and Anita Bekenstein
Maureen and Michael Ruettgers
Marjorie Benton Michael Chastain
Samantha, Becky, Mark Foundation
Bob and Mary Grace Heine
Erv and Kathy Sauer
Barry and Connie Hershey Al and Diane Kaneb
The 11th Hour Project a program of The Schmidt Family Foundation
Charlotte and Herbert Wagner
Ker and Michael Thompson
DeLaCour Family Foundation
The Jaharis Family Foundation, Inc.
The Wooden Nickel Foundation
Mary Ellen and Paul DeNoon
Jewish Communal Fund
Annie Dillard and Robert Richardson
JustGive.org
$100,000 TO $1,000,000
$25,000 TO $100,000
Anonymous (8)
The Carob Tree Fund, a Donor Advised Fund of Combined Jewish Philanthropies of Greater Boston, Inc. Christ Church of Greenville Ann Marie and Richard Connolly Ophelia Dahl and Lisa Frantzis Phillippe Daniel and Martha McGaw
Stephanie Dodson Mary and Robert Eccles
Anne T. and Robert M. Bass
Anonymous (17)
Ecosystems Technology Transfer, Inc.
Brian and Karen Conway
Rob Abbot and Claire Cifaloglio
The Edgerley Family Foundation
Pierre Crémieux and Denise Jarvinen
Jesse Abelson
Patrik Edsparr
Mitchell Adams and Kevin Smith
Cummings Foundation, Boston
Joan Egrie
AJG Foundation
Eric and Barbara Dobkin
Sophie Engelhard Craighead
American Academy of Orthopaedic Surgeons
The Charles Engelhard Foundation
Jim and Karen Ansara
The Evans Family Foundation
Robert and Michelle Atchinson
Fred Eychaner
The Cameron and Jane Baird Foundation
Paul and Didi Farmer Family Foundation, Inc.
The Baobab Fund
Jacob Friedman Charitable Fund
Sheldon Baskin and Judy Wise/ Baskin Family Foundation
Drs. Kristy Gammon and Steve Ferracuti *
Wes and Lynn Edens The Episcopal Diocese of Upper South Carolina FACE AIDS Global Impact The Horace W. Goldsmith Foundation Hess Foundation
James and Anna Hoag Hope for Poor Children Foundation Hurvis Charitable Foundation The InMaat Foundation Irene Diamond Fund The Richard & Natalie Jacoff Foundation, Inc.
Jill Kirshner The Komera Project Barbara Kravitz The Frances Lear Foundation The Lester Fund Jay and Tammy Levine Michael and Suzanne Masters Malcolm and Dana McAvity Elizabeth McCarthy and Brian O’Leary The Christopher McKown and Abigail Johnson Fund Elizabeth Moran Christine and Patrick Murray National Philanthropic Trust Network for Good Laurie Weiss Nuell
This list reflects contributions of $10,000 and above made during Partners In Health’s 2013 fiscal year, from July 1, 2012, through June 30, 2013.
16
* PIH Canada Donor
The O’Connor Family Foundation
John and Beverly Barry
Ralph E. Ogden Foundation
Maile and John Bay
Martha and Mark Pentecost
Tim and Elizabeth Beeton
Phish Associates
Janet Birdsall
Daniel E. Ponton Fund for the Neurosciences at Brigham and Women’s Hospital
Dr. Sally Blower and Dr. Nelson Freimer
Ann and Rob Quandt The Rathmann Family Foundation Red Mountain Fund Martha Rogers * The Ryan Charitable Trust
SUPPORTER SNAPSHOT
C.D. and Nicole Boothe The Boye Foundation, Inc. Frank Brenninkmeyer Bresky Foundation Art and Barbara Bryant
Sanders Family Foundation
Richard A. Busemeyer Atheist Foundation
Haun Saussy and Olga Solovieva
Elizabeth and Nathaniel Carr
SD Trombetta Foundation
Patrick and Carolyn Carr
Barbara and Edward Shapiro
Karl Case
Michael Sherman
Sara Case
The Shifting Foundation
John and Sara Cashion
Elizabeth Skavish and Michael Rubenstein
“PIH is there for the long haul, staying with the country and committing to the health of the people.”
Cathedral of the Sacred Heart of Jesus
- Emerson and Judy Robinson
Spector Fund at the Boston Foundation
The Cedar Street Foundation
Stevie and David Spina The Spurlino Foundation St. Cecilia’s Parish Stiller Foundation Drs. Mark and Mary Ellen Stinski Valerie and Paul Street Lise Strickler and Mark Gallogly Dan and Junko Thomas David and Leslie Weiland The Williams Foundation
Child Relief International/ Andrew and Bonnie Weiss
The Echo Street Foundation
Henry D. Chu, M.D.
David B. Edwards
City Arts & Lectures
Michael and Barbara Eisenson
Colorado School of Public Health
Elmo Foundation
Dr. Judith Hellman
Kevin Eng
Julie and Bayard Henry
Episcopal High School
Helena Hermes
Brian Cooper and Margueritte Murphy
James Feldman and Natalie Wexler
Karen Hescock
Emmett Coyne
Frank J. Flaman Foundation *
Hitz Foundation
Theodore Cross Family Charitable Foundation
Elizabeth Flemer
Virginia and James Hoeck
Beth Floor
Alan and Christine Huber
Connaughton Charitable Fund at the Boston Foundation
Moira Cullen
$10,000 TO $25,000 Anonymous (27) Aid for Africa Patricia Allen Alexandria and Michael Altman
Diane Currier and William Mayer Anita Davidson and Robert Friedman The Thomas R. and Deborah A. Davidson Foundation Carolyn Deodene DMMN Foundation
Foster Goss Family Libby and Peter Fozzard Sarah and Michael Gerstenzang GlobalGiving Foundation Robert and Francine Goldfarb The Richard W. Goldman Family Foundation
Maggie Gyllenhaal and Peter Sarsgaard Gene and Nancy Haller
Hilltop Foundation
James C. Hudspeth, M.D. Helen Hunt Bouscaren The Hunter-White Foundation Joanna and Jonathon Jacobson Robert Jin Matthew and Kathryn Kamm
Robert Goodlatte
Ed and Ann Kania
Anna Goodman
Kaufman Family Foundation
Steven Dorfman
Renee and Nathaniel Goodspeed
Steven and Kathryn Keefer
Marcia and J. Peter Dowd
Juraj and Eva Gottweis
Michael and Rosalind Keiser
Doylestown United Methodist Church
The Michael T. Gregg Charitable Fund
The Kerrigan Family Charitable Foundation
Matthew and Margaret Balitsaris
The Ducommun and Gross Family Foundation
Guilford Fund
Steve Kessel and Sibyl Frankenburg
Lisa Barrett
Michael and Kate Duffield
Victor Ambros and Rosalind Lee
Ray and Dagmar Dolby Family Fund
American Heart Association Mary and Thomas Amory The George & Dorothy Babare Family Foundation Steven Backes
Maria Gutierrez and Gabriel Orozco
Tracy and Frances Kidder
Above: When Emerson and Judy Robinson (far right and far left, respectively) first came to Haiti, they saw a country that struggled with poverty and disease. They soon began supporting Partners In Health with generous monthly donations, providing PIH the steady, ongoing support it needs. Photo courtesy of the Robinson family
Janet Kinnane and Conrad Smith
Mushett Family Foundation, Inc.
Marilyn and Eugene Stein
Thomas and Mary Ann Kofler
Karen Nelson and Daniel Greenberg
Jim and Debby Stein Sharpe
David and Ginger Komar Betsy Krieger
Donald Nicholson
The Barbara and Mark Kronman Fund of Tides Foundation
North Carolina School of the Arts Foundation, Inc.
Emily Kunreuther
Howard and Patsy Norton
G. Barrie Landry
Noteworthy
Anna Lane
J.M. and Jane O’Neal
The Randi and Clifford Lane Foundation, Inc.
Rowan T. O’Riley Family Foundation
The Margaret P. Langlykke Fund within the Community Foundation of Tampa Bay
Mary Pope Osborne
Ira N. Langsan & Lillian Langsan Philanthropic Fund of the Jewish Communal Fund John Lazarus David and Anne Lee Paul Li Michael and Margaret Lynch Paul Maeder and Gwill York James and Heather Magliozzi Des Magner Amrita & Ashok Mahbubani The EKTA Foundation
Parish of Christ Church Pamela Parker
Mary Stobie John and Lou Stolzenberg
Adolf H. Lundin Charitable Foundation American Endowment Foundation
Donald R. Straus
American Jewish Joint Distribution Committee
Maxwell and Ann Sturgis
American Jewish World Service
Jean C. Tempel
American Red Cross
Raman Tenneti
Avon Foundation for Women
Angelo Tomedi and Margaret M. Wolak
BCBSMA Foundation
Lee and Joanne Travers
Boston Scientific Foundation, Inc.
Trinity Cathedral
California Community Foundation
Trinity Church
The Boston Foundation
The Aber D. Unger Foundation, Inc.
Carabo Capital
V-Day
Teresa Perkins
Citizens Bank Foundation
Vampire Weekend
Petunia Foundation
CKEW Foundation
Tricia and Mark Vanacore
Ted and Karen Philip
The Clinton Bush Haiti Fund
Brian and Jennifer Vosburgh
Romany and Robin Redman Rachel and Travis Rhodes
Georg Waechter Memorial Foundation
Community Foundation for Southeast Michigan
Walter and Judy Rich
Mary Warren and Stanley Case
Nina Ritter
George Wasserman Family Foundation
Antonella Pavese Eric Penanhoat
The Ritter Family Charitable Trust
Chicago Community Foundation
Community Foundation of Tampa Bay Covidien The Crown Family
John and Susan Weatherley
Deerfield Partnership Foundation
Thomas West and Wendy Mezilis
Delany, Siegel, Zorn and Associates, Inc.
Robert and Betty Romer
The Betty L. West Mending Fund of Tides Foundation
Digicel Haiti Foundation
Nancy Peery Marriott Foundation, Inc.
The Thomas A. and Georgina T. Russo Family Fund
Kevin and Eileen White
Disney Club Penguin
Richard E. and Nancy P. Marriott Foundation
The Saint Nicholas Fund
Michael and Elizabeth White Stephen and Melissa White
Doris Duke Charitable Foundation
Ann Wiedie and Keith Hartt
E D & F Man Relief Fund
The Greg Wilkins-Barrick Chair in International Surgery, Dr. Mark Bernstein Chairholder *
ElectricAid
Karen Wisniewski and Robert Boucher
Elton John AIDS Foundation
Peter and Isabel Malkin Tristin and Martin Mannion Jonathan Mark and Donna Sakson
Massachusetts Medical Society Christopher and Kathy McCormack
Emerson and Judy Robinson David Romeo
Paul and Martha Samuelson Linda Schejola The Scoob Trust Foundation
Tim and Kay McDonald
James and Paula Shaud
Sally and Matthew McShea
Jack Shaughnessy
Maurice Meslans and Margaret Holyfield
Silver Mountain Foundation for the Arts
Owen Messac
The Skyemar Foundation
The WRG Foundation
Linda and Michael Mewshaw
Ida Burnis Smith
Daniel and Brienne Wright
Joyce Millen and David Harrison
Nancy and George Soule
Julia Zhou and John Gu
Mark and Goldi Miller
Finnegan Southey
The Miller-Wehrle Family Foundation
Dr. George Spellman and Ellen Spellman
Kenneth and Harle Montgomery Foundation
Marc and Diane Spilker Family Foundation
James and Lisa Mooney
Christopher and Ann Stack
Dr. Brian Morris *
Thomas Stahl and Bo-Kyung Julie Kim
Richard P. and Claire W. Morse Foundation MPD Higgins Foundation
18
* PIH Canada Donor
World Central Kitchen
CORPORATIONS AND FOUNDATIONS Anonymous (12) Abbott Abbott Fund
Margaret Stavropoulos
AbbVie Foundation
Brian and Maria Steck
Abundance Foundation
Discovery Life Sciences, Inc.
The Eli Lilly and Company Foundation Fidelity Charitable Gift Fund Flora Family Foundation Fortress Investment Group, LLC The Friedland Foundation The Fund for New York City Health and Hospitals Corporation Girl Rising Fund Giving Assets, Inc. GlaxoSmithKline Goldman Sachs Gives Google Inc. Grasshopper, Inc. Green Mountain Coffee Roasters, Inc.
PLANNED GIVING
SUPPORTER SNAPSHOT
TOM’S CIRCLE For more than 20 years, co-founder Tom White supported Partners In Health and created a lasting legacy for this organization. While he is no longer with us, our work remains as a testament to his belief in “a preferential option for the poor.” Therefore, it is our pleasure to recognize the individuals below as members of Tom’s Circle. Like Tom White, they are helping to ensure that future generations will be equipped to fight disease and poverty. Members of Tom’s Circle support the continuation of our work by naming PIH in their wills, retirement plans, life insurance policies, or through other planned gifts. For more information about leaving a legacy gift to PIH, or if you should also be listed among the members of Tom’s Circle, please contact us at plannedgiving@pih.org or (617) 998-0182. Anonymous (8)
Irene Guman
Donna Pignatelli
Barbara Ann Banoff
Sherrie G. and Christopher L. Hall
Mary Rafferty
Gene Bernardi
Robin Hanes
Asenath S. Blake ◊ Linda Brandenberger Allan Brender * Ellen Bush
Reid Hoffman and Michelle Yee
Ingrid Christiansen Marian Clarke ◊
Diana I. Rigg
Jack Hicks Tamara Keta Hodgson
John and Sara Cashion
Louise Richman ◊
Alexandra M.C. Hansen ◊
Peter H. Burian
Liz Rantz
Annie Scarff Gayle and Peter Schack Jack Shaughnessy
Cleopatra ◊ and Dr. Ashraff Hosein ◊
Rev. Thomas R. Smith Taimoon and Robert Stewart
Emily Dalgarno
Walter Johnson and Joanne Leslie
Beverley Davis
Grace Kelly
Bernice Decowski ◊
Robert Kruse
William and Annriette Stolte
John Di Stefano * ◊
Katherine and Benjamin Lacey
Deanne Stone
Merle J. Dimino ◊
Drs. Mark and Mary Ellen Stinski
Elaine LaChapelle
Denise Szabo and Thomas Booth
Howard and Irene Levine
Kenneth Tager
Leslie Fleming
Carolyn and Robert Lohman
Zoe Taylor
Kara Flyg
Barbara Lovett
Dayve Forman
Rebecca Lowe and Sam Bertron, III
Lee and Carolyn Engdahl George and Mary Ferger
Don Foxworthy and Sharon Siwiec John and Gioia Frelinghuysen Emily Garlin William Garmany Mr. and Mrs. John A. Gilmartin Jim Goodridge and Joan Riley The Gracey Luckett Bradley Charitable Lead Unitrust * PIH Canada Donor
◊ Deceased
Allan J. Taylor ◊ John and Gayle Thompson Jennifer Tiffany
Susan Lucas
Flo M. Triendl
Andrew Ludolph
Linda Umans
Jennifer Mackey
Beth and John van Bladel
Wendy and Stanley Marsh
Gretchen Van Gessel
Barbara and Stephen Massey
Dan and June Walcott
Ann McDonnell, African Gems Travel
Karin Whittemore
Maurice Meslans and Margaret Holyfield
Emerald Young
Hollace Westfeldt Priscilla Wilson
Above: Taimoon and Robert Stewart chose Partners In Health for its holistic approach to health care. Photo courtesy of the Stewart family
A friend gave Taimoon Stewart Mountains Beyond Mountains by Tracy Kidder and told her, simply, “read this.” Once she delved into the book’s contents—which shares the story of Dr. Paul Farmer’s work—Stewart was overwhelmed by the bravery, commitment, and perseverance of those bringing health care to the poor. “My husband and I felt very strongly that we should help the poor and vulnerable, and not simply turn a blind eye,” she said, explaining their choice to first contribute in 2010, before starting monthly contributions two years later. “Partners In Health’s work is outstanding because of its holistic approach to poverty alleviation, delivering not only health care, but targeting the roots of disease.” Later, when it came time for Stewart and her husband, Robert, to prepare their wills, they quickly agreed to leave a sizeable share of their estate to charity. When they parsed their list of deserving organizations, they didn’t hedge. “We didn’t even debate it,” she said. “We went straight to PIH.” To donors weighing a planned gift, but nervous about their finances, Stewart suggests leaving a percentage of their estate—not a dollar amount—for peace of mind. “There’s a lot of injustice in the world,” Stewart said. “But I have confidence that my money will be used in the most constructive ways possible.”
Marian Parmenter Tom's Circle members as of June 30, 2013
19
Greif Packaging Charitable Trust
The Springfield Foundation
Harvard University
Bonnie Kaiser
GSDR Foundation
Starr International Foundation
Partners HealthCare
Shelly Kreyks
HP
Summer Star Foundation for Nature, Art & Humanity, Inc.
The International Foundation Irene S. Scully Family Foundation Izumi Foundation J.C. Cannistraro, Inc. J.F. White Contracting Company Jeff Gordon Children’s Foundation Jewish Community Foundation San Diego Johnson & Johnson The Kalamazoo Community Foundation
T&J Meyer Family Foundation
IN-KIND GIFTS
The TripAdvisor Charitable Foundation
Abbott
The True Colours Trust and The Diana, Princess of Wales Memorial Fund, as part of the Waterloo Coalition
Afghan Scholars Initiative
The United Nations Foundation
Arkadia Miami
The U.S. Charitable Gift Trust
Aventura Mall
Vanguard Charitable Endowment Program
BD
Westwood Holdings Group
LIVESTRONG Foundation
W.K. Kellogg Foundation
Lynch Foundation
W.T. Rich Company, Inc. ZBI Employee Allocated Gift Fund
M∙A∙C AIDS Fund McCarthy Properties, LLC McCue Corporation Medtronic Philanthropy Microsoft
GOVERNMENT, MULTILATERAL, AND OTHER GRANTS
The New York Community Trust
AIDS United
NRG Energy, Inc
Centers for Disease Control and Prevention
Open Society Foundations Partners HealthCare The Peter and Carmen Lucia Buck Foundation, Inc. Positive Action for Children Fund Random House, Inc. Renaissance Charitable Foundation, Inc. Robert Wood Johnson Foundation Rockefeller Foundation The Rogers Foundation * Ronald McDonald House Charities ® The Ruth and Hal Launders Charitable Trust
The Global Fund to Fight AIDS, Tuberculosis and Malaria Global Health Corps Grand Challenges Canada Health Resources and Services Administration
Schwab Charitable Fund
Jennie Weiss Block Blue State Digital Lori Buswell Children’s Hospital Boston Citrix Corwin & Corwin, LLP Country French, Inc. Covidien Currier Law Office The DAK Foundation
McKesson Corporation Kathleen Murphy NetSys Computers Limited Jeremy Neuringer Sue and D. Alan Nichols Laurie Weiss Nuell Tom O’Connor Peace Love World, LLC Pecan’s Day Spa Ted M. Philip Roche Laboratories Inc. Nicole Rosenbaum Alice R. Rosenberg Royal Caribbean International Schulte Roth & Zabel, LLP SeaWorld Orlando Southern Nevada Public Health Laboratory Sunspring Innovative Water Technologies
DePuy Orthopaedics, Inc.
Surgical Implant Generation Network
Direct Relief International
Nancy Tella
Embassy Suites
Thomas Jefferson University Hospital TOMS Shoes
Faxitron Bioptics, LLC
Translators without Borders
National Institutes of Health
Fragomen, Del Rey, Bernsen and Loewy, LLP
Travizon
Qatar Haiti Fund U.S. Agency for International Development
Fujifilm SonoSite
World Bank
Kate Gelman
World Health Organization
Gradian Health Systems, LLC
The Furniture Trust
Robert M. Heine
KEY INSTITUTIONAL CONTRIBUTORS
SG Foundation
Dana-Farber/Brigham and Women’s Cancer Center
* PIH Canada Donor
Christopher Block
Masimo Corporation
International Development Research Centre *
Brigham and Women’s Hospital
20
Bingham McCutchen LLP
Mariana F. Martinez
Emory University Hospital
The Segal Family Foundation
Skoll Foundation
Big Ass Fans
Margaux Interiors
Inter-American Development Bank
The Seattle Foundation
Silicon Valley Community Foundation
Aragon 101
Map International
Emory University School of Medicine
Santa Barbara Foundation Schulte Roth & Zabel, LLP
Anita International Corp
Boston Medical Center
The Minneapolis Foundation
OneXOne *
Mad Style
Henry Schein Cares Foundation, Inc. The Herbie Fund Hilton Orlando Bonnet Creek The Hospital for Sick Children HP
Dana-Farber Cancer Institute
ICA Foundation
Harvard Medical School
InPro Corporation
ThoughtWorks, Inc.
United Airlines Alexandra Van Romondt Vidacare Walt Disney World Wolters Kluwer Health
SUPPORTER SNAPSHOTS
GOVERNANCE OFFICERS Ophelia Dahl, Executive Director Paul E. Farmer, Chief Strategist Jennifer K. Brown, Chief Engagement Officer Ken Himmelman, Chief Program Officer Ted M. Philip, Chief Operating Officer
Arcade Fire celebrates with Partners In Health at PIH's 25th anniversary event in New York City. Arcade Fire has been an ardent supporter of PIH since 2006, raising funds at its concerts around the world.
Cynthia Maltbie, Chief Human Resources Officer Joia Mukherjee, Chief Medical Officer Cassia van der Hoof Holstein, Chief Partnership Integration Officer Ann Quandt, Vice President of Finance David Whalen, Chief Development Officer
Photo by Johnny Arguedas
Diane Currier, Esq., Clerk
BOARD OF TRUSTEES
Community volunteers in Bainbridge Island, Wash., organized an event at their school in support of Partners In Health. PIH | Engage teams are forming across the country.
Photo by Claire Lunzer
A student tries on a new pair of TOMS shoes at his school in Neno, Malawi. Since 2009, TOMS Shoes has donated thousands of pairs of new shoes to children through PIH programs, such as this malnutrition screening event in Malawi. Photo by Alexandra Rose
Jody Adams
Jonny Dorsey
Anne McCormack
Joelle Adler
Lynn Edens
Todd McCormack *
José (Joe) Almeida
Paul English
Elizabeth G. Nabel
Karen Keating Ansara
Paul E. Farmer, Chair *
Dan Nova *
Marika Anthony-Shaw
Gary Gottlieb *
Ted M. Philip *
Bob Atchinson
Danny Greenberg
Steve Reifenberg
Anita Bekenstein
Antoinette Hays
Joe Rhatigan
Marjorie Craig Benton
Robert Heine *
Lawrence N. Shulman
Donald Berwick
Howard Hiatt
Bryan Stevenson *
Timothy Broas
Joanne Kagle
Jeffrey Swartz
Paul Buttenwieser
Albert Kaneb *
Rien van Gendt
Edward Cardoza
Diane Kaneb *
Loune Viaud
Carole Carney
Tracy Kidder
Charlotte Cramer Wagner *
Régine Chassagne
Lesley King *
Chelsea Clinton
Fr. Fritz Lafontant
Jack Connors, Jr. *
Becky Levin
Pierre Crémieux
Mark Levin
Ophelia Dahl *
Scott Malkin
Stephanie Dodson
Michael Masters
* Governors
E
E
David Walton * E
Emeritus Members
As of January 2014
21
FINANCIALS Partners In Health finances returned to expected levels this past fiscal year following three years of intensive work in Haiti responding to the 2010 earthquake and subsequent cholera crisis. With funds donated in response to the earthquake, we completed the building of University Hospital in Mirebalais to replace and increase health care capacity in the country. Even with such organizational focus on Haiti, we expanded our health care facilities and programs in Rwanda, Malawi, Lesotho, Peru, and Mexico, thereby bringing greater hope and care to more people in need.
DOLLARS IN THOUSANDS FOR THE YEAR ENDED JUNE 30,
STATEMENT OF ACTIVITIES
REVENUE
2013
STATEMENT OF FINANCIAL POSITION
2011
Contributions, grants, and gifts in kind: Individuals and family foundations Foundations and corporations Governments and multilateral organizations Gifts in kind and contributed services Other income TOTAL REVENUE
52,831
42,861
39,596
15,224 20,220 4,262
27,806 25,365 4,462
19,900 23,220 4,450
1,162
612
1,898
93,699
101,106
89,064
90,697
112,896
109,642
3,719 2,938
4,172 3,806
3,793 3,153
OPERATING EXPENSES Program services Development Administration TOTAL OPERATING EXPENSES
97,354
120,874
116,588
INCREASE (DECREASE) IN NET ASSETS
(3,655)
(19,768)
(27,524)
2013
2012
2011
25,725 1,929 7,947 4,471 2,118 2,563
13,766 2,556 5,475 2,215 20,650 2,934
7,899 825 7,687 535 46,971 2,886
TOTAL ASSETS
44,753
47,596
66,803
TOTAL LIABILITIES
6,266
5,454
4,893
47 11,192 15,431
3 12,893 13,970
399 8,165 17,374
TOTAL UNRESTRICTED NET ASSETS
26,670
26,866
25,938
Temporarily restricted
11,817
15,276
35,972
TOTAL NET ASSETS
38,487
42,142
61,910
44,753
47,596
66,803
As of June 30,
ASSETS Cash and cash equivalents Contributions receivable Grants receivable Prepaid expenses and other assets Investments, at fair value Property and equipment, net
LIABILITIES AND NET ASSETS
NET ASSETS Foreign currency translation adjustments Undesignated Board-designated: Thomas J. White Fund
TOTAL LIABILITIES AND NET ASSETS
22
2012
Revenue includes contributions to PIH Canada, an organization established in Canada in 2010 to support the movement for global health equity.
REVENUE: EXPENSES BY PROGRAM
In fiscal year 2013, Partners In Health received $93.7 million in revenue. Of this, $52.8 million came from generous individual donors, a 23 percent increase over last year. Revenue from foundations and corporations declined from $27.8 million in fiscal year 2012 to $15.2 million in fiscal year 2013 due to significant funding received for University Hospital construction in fiscal year 2012. Similarly, public sector funding in fiscal year 2013 fell from $25.4 million in fiscal year 2012 to $20.2 million in fiscal year 2013 due to emergency cholera funding received during fiscal year 2012. We are very grateful to the many individuals and organizations who believe in our mission and enable us to deliver quality health care to many who are suffering.
FY2013
15%
14%
44%
6% 5% 4%
EXPENSES:
3% 3%
Partners In Health expenses declined 19 percent in fiscal year 2013 as compared to fiscal year 2012, from $120.9 million to $97.4 million, primarily due to the completion of University Hospital construction in fiscal year 2012. In fiscal year 2013, 93 percent of funds expended were for direct program costs, and less than 7 percent went to fundraising and administration. PIH is committed to maximizing value for our patients through careful financial management and strong stewardship of our contributions.
1%
4%
1%
Haiti
Peru
Malawi
Rwanda
Russia/Kazakhstan
United States
Other
Development
Mexico/Guatemala
Lesotho
Administration
REVENUE BY SOURCE
TOTAL REVENUE AND EXPENSES
FY2013
FY2009 - FY2013 (DOLLARS IN MILLIONS)
Individuals and family foundations 56%
Governments and multilaterals
200
22% 150
100
50 Foundations and corporations 16% Gifts in kind and other income 6%
FY09
FY10
FY11
Total Revenue
FY12
FY13
Expenses
Charity Navigator is America’s premier charity evaluator. Since 2003, Partners In Health has earned Charity Navigator’s highest rating, certifying our commitment to accountability, transparency, and responsible fiscal management. Only 1 percent of rated organizations have received this distinction for over eight consecutive years, placing Partners In Health among the most trustworthy nonprofits in the United States.
23
2013 ANNUAL REPORT 888 Commonwealth Avenue, 3rd Floor Boston, MA 02215 617-998-8922 Fax 617-998-8937 www.pih.org PIH is a 501(c)(3) nonprofit corporation and a Massachusetts public charity. Copyright 2013 Š Partners In Health. All Rights Reserved.