ANNUAL
REPORT
2020
Celebrating
10 years
in Haiti!
O U R V I S I O N
F O R H A I T I
A world where vulnerable
families have access to
sustainable, high-quality,
primary health care
services.
While this past year was challenging for everyone around
the globe, it was especially difficult for Haiti for so many
reasons. In addition to the pandemic, it is still dealing with
waves of civil and political unrest, high rates of inflation and
unemployment, food insecurity, and fuel shortages.
In a country with a fragile health system and national
infrastructure, building high-quality and sustainable health
care is of the utmost importance for the people of Haiti.
Despite the challenges, our priority was to keep all of our
clinics’ doors open to serve the communities that depend
on us. Our slogan “Sante w se Pwiyorite” (“Your Health is Our
Priority”), explains how we believe healthcare should be.
MESSAGE FROM
OUR LEADERSHIP
C2C
Annual Report 2020
We are excited to share with you the milestones and successes we experienced this year. In this
report, you will learn more about our programs, our dedicated staff, our patients, and everyone
who has contributed to work through the difficulties of this past year. Thanks to your support, we
celebrate how far we have come in a decade. We are so proud to operate seven successful
community clinics that offer care to over 250,000 people.
I would like to thank you for believing in C2C and in the important work we are doing in Haiti. We
have done incredible things together and I firmly believe that the example of C2C’s work can
serve as a model for primary care delivery in Haiti and elsewhere.
Dear friends of C2C,
It would be an understatement to say that 2020 was a year unlike
any other in our lifetime.
Healthcare has been on all of our minds this year as we are living
through a global public health crisis. We learned quickly that the
strength and resilience of a nation is calibrated directly to its
healthcare system.
I am humbled by and grateful for the steadfast support of the C2C
community and for our extraordinary clinical team, who remained
committed to our patients every day and in the face of great
uncertainty. Without them, C2C would not have been able to fulfill our
promise to our patients.
Over a decade ago, we founded C2C in an effort to find a new and sustainable way to deliver
primary health care to the people and families who need it most, where they need it most. Good
health is the bedrock of society. If your health is compromised—or if you’re worried about catching
a deadly disease—it’s hard to concentrate on anything else, whether you live in the United States
or Haiti.
For us at C2C, our work to deliver essential health services to the people of Haiti has never been
more important. Even in the face of the pandemic, I am so proud that we have been able to
continue in strength, ensuring that our clinics are vibrant community resources for the families we
serve.
We cannot continue to do this important work without the incredible staff, advisors, Board of
Directors, supporters, and friends of C2C. In the pages that follow, you will read more about what
we have accomplished during this past decade and, in particular, this past year despite the
challenges. Thank you for helping us to shape the future of healthcare in Haiti!
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C2C transforms the lives of vulnerable
people by providing curative care,
promoting good health, and ensuring
sustainable access to health services
In partnership with the government of Haiti,
we save lives by increasing access to
primary care services and improving the
quality of care at public clinics in a
financially sustainable way which ensures
long-term availability of essential health
services.
We set ourselves apart by our commitment
to higher-quality, patient-centered care
that working families need. We work with our
communities to address their health
concerns and offer health care services
based on their needs. We do this through
our one-stop-shop model, that provides all
of our services in one place, from a doctor
consultation, lab work and picking up
medications.
WHAT
WE DO
ONE
STOP
SHOP
DOCTOR
CONSULTATION
ON-SITE
LABORATORY
ON-SITE
PHARMACY

A D E C A D E
O F
P R O G R E S S
2010 - 2020
The Savanette clinic is the furthest clinic site from our
headquarters in Cap-Haitien by approximately 3
hours. It has a population of 30,657 people. The
public clinic was originally closed for 3 years and the
community is very happy to have a high-quality
clinic close to home.
The Cité Chauvel clinic is our busiest clinic, located in
the only peri-urban community we serve, near Cap-
Haitien (Haiti’s “second city”). Residents of the
community do have access to other health care
options, but they like that our clinic offers them low-
cost, high-quality primary care all in one location.
C2C was first founded by Elizabeth Sheehan as a relief
organization in response to Haiti's devastating
earthquake. At the time, our containerized clinic model
served over 40,000 people in Port-au-Prince until 2013,
on the grounds of a local hospital that had lost more
than 80% of its infrastructure in the destruction.
After our partnership with the hospital was completed,
we deployed our innovative clinic facility to the
community of Acul du Nord. Thanks to a dedicated
group of Holy Cross Alumni, the clinic opened its doors
and currently serves a community of 50,000 people. In
addition to primary care services, we also provide
maternal health services at this clinic.
We formalized a public-private partnership with the
government of Haiti to rehabilitate underperforming
public clinics and to enhance patient outcomes by
improving the infrastructure, service quality, and
operational excellence of these existing clinics.
We launched this partnership by rehabilitating the
Sinek clinic, located in the community of Bas-Limbé,
and opened another clinic months later in the
community of Bayeux. It was successful start to the
partnership, leading the way to replicate this model
throughout Haiti.
We opened the newest clinic of the C2C network
through our partnership with Haiti's government in
Roche Plate. This public clinic is the only health care
option in the area to serve the community of 8,439
people.
2010
With our partners and patients, we learned about the
persistent challenges of supply chain maintenance,
human resources for health, and financial sustainability
in Haiti. We opened our second clinic in Camp Coq, a
small community with a population of 20,000 people in
the northern region of Haiti. Our clinic offers the only
doctor for many miles. In addition to primary care, we
also provide maternal health services for expectant
mothers and their babies.
A DECADE
IN REVIEW
2013
2015
2017
2018
2019
2020
THEN
7 community-based clinics
Public-Private Partnership with
Haiti's government
53,000+ patients served annually
Primary Care
Comprehensive Women's Health
Community Health
Child Malnutrition
Sexual and Reproductive Health
Vaccinations
Sustainability
Earned clinic revenue
100 employees
Social Service Program
Quality of Care Clinical Protocol
Electronic Medical Records
Main Office in Cap-Haitien
Solar Energy
PORT-AU-PRINCE
1 container clinic
Post-earthquake relief response
10,000 patients served annually
Primary care, focusing on women
and children
Completed partnership with Grace
Hospital in 2013 after it was rebuilt
NOW
CAP-HAITIEN
MEASURING
PROGRESS
HAITI
From our founding days through today, we have believed in a simple powerful premise: that
health is human right. And that a strong, effective, durable national healthcare system, is the
way to ensure that right is realized. Thanks to generous friends and partners like you, we are
closer to that goal more than ever!
2010-2020
(cost recovery is
at clinic unit level)
Despite all the challenges this past year due to the COVID-19 pandemic, and ongoing
civil and political instability, our clinics have stayed open to serve our patient
communities through it all. We are so proud of to share our work and the growth we
experienced during an incredibly difficult year for Haiti.
2020
IN NUMBERS
82%
53,942
2,359
100
11,005
PATIENTS REACHED
THROUGH COMMUNITY
HEALTH ACTIVITIES
16,820
TOTAL PATIENT VISITS
IN ALL CLINICS
48% increase in one year
AVERAGE
COST-RECOVERY
PRENATAL VISITS
LOCAL STAFF
VACCINES
ADMINISTERED
"Often times, when we had a problem, we had to go all
the way to the next town. But now that we have the clinic
here, we can get treated here, and if necessary get a
referral to a hospital. I’m very happy for that."
-Judith, C2C patient and resident of the Savanette
community
In May 2019 and in partnership with Haiti's government, we opened the most remote clinic from our Cap-
Haitien headquarters. Located in the community of Savanette, this public clinic was closed for three years
due to lack of funding.
As we explored the renovation of the clinic, we found a strong interest in the community to reopen it for two
reasons: Since it is the only health facility in the community, patients would not have to pay transportation
fees to go somewhere else that happens to be further, and they would not lose a day just to see a doctor for
basic services.
Shortly after the clinic opened its doors to the community, we saw an average of 7 patients per day. Only one
year later and despite a global pandemic, the number of patients visiting the clinic has increased fourfold.
The community of Savanette has been very happy to have a functioning and high-quality clinic back in their
very own community.
We are thankful to report that neither COVID-19 or the civil and political unrest has affected the community.
We kept the clinic’s doors open throughout the year, despite the challenges that Haiti has faced in 2020, and
continues to face currently.
CLINIC OF
THE YEAR
Savanette
Average patient
visits quadrupled
in 2020!
Meet Dr. Wilnick Richard, our Chief Medical Officer who manages
C2C's doctors and nurses to provide safe, effective medical services
to our patients, while developing and training staff on our medical
protocol to keep current on changing medical regulations.
Dr. Richard is from Cap-Haitien and is one of nine children in his
family, to which he credits for his passion to study medicine. He was
a natural caregiver and is drawn to care for people by way of using
his intelligence, skills, and character to make them feel better. He
joined C2C as a resident doctor in our Cité Chauvel clinic. Before
long, he rose through the ranks of senior doctor to his current role.
"I believe C2C is a unique healthcare provider because we place
patient satisfaction and quality of care very high. A measure of care
quality, patient satisfaction gives providers insights into various
aspects of medicine, including the effectiveness of their care and
their level of empathy.
One of my priorities as Chief Medical Officer is to lead the training
of our staff on quality of care. Medicine is a field that needs to
consistently involve training and learning to make sure that patients
receive the highest quality of care. In Haiti, if patients are treated
well, they will refer others, they will come back, and they adhere to
their treatment."
OUR GROWING
TEAM
100
employees
in 2020!
We take pride in having locally-staffed clinics and we are proud to grow our team of
100  talented  and  dedicated  staff  in  Haiti!  Our  staff  are  the  heart  and  soul  of  our
clinics  working  through  daily challenges  to  provide  the  very  best  quality  of  care  to
the  communities  they  serve.  Dr.  Wilnick  Richard  and  Edelie  Jean  Pierre  are  leading
C2C's mission in Haiti!
Meet Edelie, born and raised in Cap-Haitien, and a member of our
clinical team. Since 2016, she has worked in a range of positions
from a malnutrition nurse to the supervisor of our community health
program, and most recently, as Clinic Manager. As our mission
focuses on providing high-quality care, Miss Edelie shares her view
on the work we do and what it means to her to be part of C2C.
"One of the most interesting parts of working for C2C is the quality
of care offered to the Haitian community, as well as the strive to be
up-to-date with new technology and concepts to make our services
and programs accessible to all Haitians. I have always wanted to be
part of a team in which I can put my knowledge and my know-how in
nursing at the service of people where innovation, creativity, and
focus on patients are at the center of everything we do.
While the year 2020 has been difficult for everyone between the
pandemic and political instability, I have always done my best to go
to work every day. The only difficulty I have encountered is often the
inability to find an efficient means of transport to get to work
because of the recurring scarcity of fuel and the insecurity causing
roadblocks. Despite everything, patients still need us and we are
there to serve them to keep them safe and healthy."
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Here’s what Dr. Richard has to say about what makes C2C different!

Small island nations like Haiti are particularly vulnerable to climate change and prone to environmental
disasters. With electricity either unavailable or unreliable, all our clinics have to rely on gas or diesel generators
for operation. Not only is this an unhealthy and inefficient way to produce energy, it is also an unreliable power
source due to the country's instability and fuel shortages.
As healthcare providers, we make every effort to keep our clinics open to our patients who depend on us for
care. In 2020, three of our clinics were outfitted to run on solar energy and we are in the process of converting
most of our clinics to be solar-powered by the end of 2021.
Solar power is a promising source of renewable energy for Haiti. The island is sunny most of the year, making
solar energy a reliable source of electricity, especially in rural areas. With the help of our partners at the IZUMI
Foundation and The Pfizer Foundation, we are able to bring solar-powered healthcare to Haitian communities.
We build our clinics to be sustainable in every sense – providing care long-term, operating self-sufficiently,
and reducing environmental impact!
Most of our clinics also have
solar-powered refrigerators
in order to provide routine
vaccinations for children and
families regardless of the
state of Haiti’s fuel supply,
infrastructure, or instability.
GREEN
ENERGY
In partnership with
The Pfizer Foundation and IZUMI Foundation
We strive to provide high-quality, affordable,
patient-centered primary care to communities
in Haiti. Here is what we accomplished in 2020:
EVERY DAY
CARE
Primary Care:
Community Health:
Community health education and outreach are
central to our model. As an extension of our
clinical services, our community health workers
make home visits, convene health screenings,
and work with communities to promote health,
nutrition, and vaccination.
53,942 44%
FIRST-TIME
PATIENTS
127
AVERAGE
DAILY
PATIENTS
TOTAL
PATIENT
VISITS
Primary health care is the most efficient and
effective way to achieve health for all. Most of
what communities suffer from could be treated
at the primary health care levels in a more
cost-effective way.
11,005
2,785
225
PATIENTS REACHED
IN THE
COMMUNITY
FOLLOW-UP
HOME VISITS
EDUCATION &
SCREENING
ACTIVITIES
This past year, we expanded our community
health program as part of our COVID-19
response in our clinics and in the communities
we serve. Preventive education became a
priority and, with the help of our community
health workers, we focused on delivering
accurate messaging about preventive methods
to mitigate the spread of COVID-19 and protect
the lives of our patient communities.
Haiti has the lowest health outcomes for
pregnant women and newborns in the Western
Hemisphere. We provide specialty antenatal
care services to mothers and their babies
through the first year of life.
SPECIALTY
CARE
2,359
NEW
PROGRAM
PRENATAL
VISITS
We launched this new initiative in our patient
communities as an education program targeting
young women in Haiti who are vulnerable to
adolescent pregnancy and subsequent poverty.
This after-school course will cover a variety of
topics to address myths about sex and sexuality
that are prevalent in Haiti, giving girls the tools
they need to prevent early, unwanted pregnancies.
Maternal Health:
Sexual & Reproductive
Health:
Only 40% of children in Haiti are fully
vaccinated and some of the leading causes
of child mortality include entirely preventable
and treatable conditions like pneumonia and
diarrhea. We address the prevention of early
childhood infectious disease by covering all
recommended pediatric vaccinations
administered in the first year of life, delivered
at no-cost to families.
One in five children in Haiti are malnourished
and one in 14 will die before age five. As part
of our maltutrition program, children are seen
once per week for up to 12 weeks and receive
a ration of Ready-to-use Therapeutic Food,
antibiotics and medicine (as needed), health
and nutrition counseling for the parent, and a
transport subsidy to alleviate the costs of
going to and from the clinic every week.
Vaccinations
Child Malnutrition
15,641
CHILD
VACCINATIONS
ADMINISTERED
321
CHILDREN
SCREENED
In partnership with
the IZUMI Foundation and Vitol Foundation
In partnership with Together Women RIse (formerly Dining
for Women) and Conservation, Food & Health Foundation
In partnership with
Haiti's Ministry of Health and Vitamin Angels
In partnership with
Clif Bar Family Foundation
C O V I D - 1 9
R E S P O N S E
In March 2020, the first COVID-19 case was
confirmed in Haiti. As a primary care provider, we
focused on protecting our staff and patients, while
educating our communities about practicing
preventative measures, while treating mild to
moderate cases, and identifying and referring
severe cases when necessary. We also provided
more than 50 hand-washing stations that were
placed at churches, school entrances, and in areas
with a high population density. As we continue to
fight COVID-19, our mission is to ensure that
vulnerable communities in Haiti have access to
high-quality care to safeguard the health of
themselves and their families.
Thank you to everyone who supported our COVID-19 Response.
Our work would not be possible without your generosity!
increase in
earned clinic
revenue in
one year
26%
We are so proud to share our accomplishments of 2020 with you, such as our almost
doubled patient volume and the 26% increase in earned revenue. At the same time, we also
reflect on the difficulties this past year presented on our clinics and programs. COVID-19
significantly affected our patient volume during the first few months of the pandemic due
to cultural stigma and misinformation but gradually began to increase in after the country
lifted its restrictions this past summer. We finished the year on a strong note and are
pleased to report that our clinical programs and services are back to schedule.
2017 2018 2019 2020
$400,000
$300,000
$200,000
$100,000
$0
FINANCIALS
Programs
82.9%
Fundraising
10.1%
General & Administrative
7%
Foundations & Corporate Funders
56.9%
Earned Revenue
25.7%
Individual Contributions
15.9%
In-Kind Gifts
1.5%
84%
10%
6%
26%
16%
57%
P
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s
G
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&
A
d
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a
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&
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o
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o
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s
$1,416,320
$1,176,558
2017 2018 2019 2020
60,000
40,000
20,000
0
increase in
patient volume
in one year
48%
Patient Volume
Earned Clinic Revenue
We are grateful for our donors and partners for standing with us as we navigate through
the pandemic and civil unrest to provide quality care for the people that need it the most.
E
X
P
E
N
S
E
S
R
E
V
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N
U
E
*cash basis
I
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-
k
i
n
d
G
i
f
t
s
1%
For more information, email us
at info@care2communities.org
24 School Street
Second Floor
Boston, MA 02108
Thank you for helping us shape
the future of healthcare in Haiti!
Photos by C2C Staff & Team BWB
Learn more at
www.care2communities.org
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