Kay e Sante nan Ayiti | Housing and Health in Haiti


Kay e Sante nan Ayiti (Creole for Housing and Health in Haiti) is an international project aimed at improving health outcomes in the Bois L’État community of Saint-Marc, Haiti. Our goal is to build a long-lasting community-based health transformation, involving both construction and education.

Haiti is one of the poorest countries in the world and the health of its people ranks the lowest in the hemisphere. The country has the highest rates of infant, child, and maternal mortality in the Americas. Additionally, HIV rates in Haiti are the highest in the Western hemisphere and for those living with HIV/AIDS, there is extremely limited access to lifesaving antiretroviral drugs. The diseases that cause the greatest morbidity and mortality in Haiti are those that are most acutely linked to living in poverty. Sadly, of every thousand children born in Haiti, 78 die before reaching the age of 5, most frequently from diarrheal diseases, acute respiratory infections, and malnutrition. Infectious diseases, particularly HIV and TB, are major causes of adult mortality. High maternal mortality rates in the country are largely due to obstructed labor and haemorrhage. Most rural regions in Haiti have no access to basic health care services, leaving residents of these regions extremely vulnerable to otherwise treatable diseases.

ARCHIVE has chosen the rural community of Bois l’État as the site for its pilot health and housing project. The population of Bois L’Etat and the surrounding area:

  • has a higher prevalence of HIV/AIDS than the national prevalence (4.0-4.5% vs. 1.9%, respectively)
  • lives in inadequate and crowded housing conditions
  • lacks access to health care facilities
  • does not have access to clean water
  • has a high prevalence of diarrheal disease and acute respiratory infections, particularly in children under the age of five

In addition to these factors, the Artibonite region, where Bois l’État is located, has experienced a sudden spike in population due to mass internal migrations of displaced persons following the earthquake in January 2010, and has struggled with the devastating consequences of the cholera epidemic beginning in October 2010. These circumstances have resulted in increased pressure on already fragile and limited health care services and intensified the demand for increasingly limited resources. Due to this, the community of Bois L’État was chosen as the focus of efforts directed toward the improvement of health and living conditions.

The Kay e Santé nan Ayiti pilot project strives to improve health outcomes through community-driven, innovative transitional housing design, as well as build awareness in the region of the connection between living conditions and health. During this pilot project, with the help of our partner FEBS, ARCHIVE involves local residents in every stage, in order to ensure that the program is meeting local needs and is viable in the long term. Community engagement turns beneficiaries into actors and fosters a necessary sense of agency and ownership which will ensure that residents use the facilities and infrastructure in a beneficial way.

The project consists of 3 main phases:

Phase 1 – Open Innovation Competition (completed)
In July 2010, an Open Innovation Competition was launched in search of innovative designs that were specifically developed to limit infectious disease transmission in Bois l’État. Drawing nearly 1600 participants across the medical, architectural, and planning professions, the competition gathered innovative designs that used housing as part of a strategy for preventing infectious disease transmission such as tuberculosis, particularly for those most vulnerable.
Phase 2 – Construction (To be completed in December 2014)
Construction of a community health clinic, a dormitory for medical and office staff, a community center, and 18 transitional housing units is expected to be completed by the end of 2014. The structures will be equipped with solar panels for electricity and a water well is being built on the site to provide access to clean water for the new households and the broader Bois l’État community. Use of rain and gray water is also integrated in the community’s design program.
Phase 3 – Institutional Facilities (2015)
Phase 3 of the project will consist of the building of an educational facility that will provide vocational training and other learning activities to adults and children in the Bois l’Etat community. Further research and a needs assessment are to be conducted in order to assess which skills are most in need, develop curricula, and recruit and train staff. Another component of Phase 3 involves the designing of a community home and care program for Orphan and Vulnerable Children (OVC) in the area.

impact chart

Phase One Impact:

The project began with an Open Innovation Competition to raise awareness, and gather research and ideas on the link between housing and health in Haiti:

  • 1600 Design competition participants
  • 150 design submissions from over twenty countries
  • Winners selected by a panel of judges from medicine, public health, sociology, architecture, civil engineering, and planning

Phase Two Impact:

  • Winning designs from Phase One are being incorporated in a community health clinic, a dormitory for medical and office staff, a community center, and a set of 18 transitional housing units for FEBS beneficiaries and their families.
  • The transitional housing and surrounding services will serve as a context of rehabilitation for beneficiaries to adapt to treatment regimens, as well as become economically independent through education and vocational training.
  • Water well and treatment facility to provide clean water for ARCHIVE/FEBS structures along with the greater surrounding community.


Kay e Santé nan Ayiti aims to improve living conditions and health outcomes in the rural community of Bois l’État in the Artibonite region in Haiti.

  • 72 beneficiaries per transitional housing cycle
  • 1,200 direct beneficiaries of access to clean water in Bois l’État
  • 19 workers and their families currently gaining employment on the construction site for Phase 2

The project will have an impact upon both direct and indirect beneficiaries as it continues to develop. Following construction, Bois l’État and the surrounding communities will have access to a much-needed clinic, which will provide access to basic medical services, health education, and employment. A staff dormitory will allow medical professionals to live in quality housing within the community that they are serving, rather than being forced to commute from larger cities or find appropriate housing independently. The community center will provide an adaptable space that can be used as an educational facility and meeting area that can foster a sense of community ownership in Bois l’État.

Health Impact:

Kay e Santé nan Ayiti targets infectious diseases that are responsible for the majority of the morbidity and mortality in the region, specifically respiratory and diarrheal diseases. The 18 homes built in Phase 2 have been designed to reduce indoor air pollution, indoor humidity, and overcrowding, while increasing ventilation and sunlight exposure, which create an environment unsuitable for the transmission of many diseases.

Additionally, the homes will have access to improved sanitation and handwashing facilities, which will allow for the safe separation of waste from the living environment and the opportunity to regularly practice good hygiene habits. A newly constructed well and water treatment station, managed by a community-led water point committee, will provide all residents in the community with regular access to a high quantity and quality of water daily.

Health Goals for the Kay e Santé Project:

  • Reduce indoor air pollution exposure in houses by 60%
  • Reduce 30-40% of tuberculosis infections attributed to high indoor air pollution exposure
  • Provide water access to the community of Bois l’État
  • Reduce diarrheal infections by 30% in children under five years of age

Esther Boucicault founded FEBS in 1996 shortly after she was diagnosed with HIV, having lost her first husband and young son to AIDS. She is credited with being the first person in Haiti to publicly admit to having HIV.

FEBS aims to improve the quality of life for people living with HIV and AIDS in and around Saint-Marc, Haiti by providing quality care and supportive services and reducing stigma and discrimination. Services include up-to-date and appropriate HIV counseling, psychological support, AIDS education and prevention, and grassroots advocacy.