Haiti UQ-OCS Global Health Experience

4:53 PM JANUARY 12, 2010 IS A DATE FILLED WITH PAIN AND AGONY.

A 7.0 magnitude earthquake (“Goudougoudou” as Haitians call it) shook the Caribbean nation of Haiti resulting in one of the worst natural disasters seen in the Western Hemisphere. The world watched in horror at the apocalyptic scenes that were being show on the television.

The tragedy hit close to home as the images of Haiti reminded many in New Orleans of the devastation caused by Katrina. With the support of the Ochsner leadership we were able to provide health and humanitarian assistance directly to the victims of the earthquake. Ochsner’s involvement in the relief efforts in the aftermath of the earthquake was our largest international relief effort to date. The Ochsner leadership also realized that this was also an opportunity to provide our trainees in our newly formed UQ/Ochsner Clinical School a global health experience while also fulfilling our mission to serve, heal, educate and innovate on a local and global scale.

The Haitian experience in the aftermath of the Earthquake in 2010 led to the incorporation of the annual Haiti trip as part of the Medicine in Society Rotation. Medicine in Society(MIS) elective course provided the perfect curriculum for fourth year students to gain first hand clinical experience and to understand the challenges and benefits of clinical practice amongst population groups and or communities that face access and equity challenges associated with health service delivery and poverty.

This global health rotation provided students a global view of clinical medicine from a holistic biopsychosocial lens which contextualizes how factors such as poverty, education, neo-colonialism, geographic isolation, socio-economic status, religion, culture, ethnicity, structural racism as well as political matters can adversely impact the health of individuals and populations. The students emerge from these rotations with a deeper understanding of the social determinants of health both on a local and global perspective.

DID YOU KNOW?

Toussaint L'Ouverture - a Haitian general and the most prominent leader of the Haitian Revolution.

Before Haiti established itself as the first free independent black republic in the new world in 1804, Haiti ranked as the world’s richest and most productive colony.

Haiti was the first nation in the world to abolish slavery and that Haitians fought in the American War of Independence against the British in the Battle of Savanah in 1779.

Haiti has the worst health indicators in the western hemisphere. The Human Development Index(HDI) ranks countries in human development based on life expectancy, education and per capita income indicators. Haiti scores “low” on the HDI and is in the lowest quartile of development globally. It therefore provides a unique opportunity for the study, practice and research of global health under the supervision of both Ochsner and Haitian physicians.

The UQ-OCS Global Health Experience is a mutually beneficial and respectful partnership. There is a great emphasis on respecting and understanding the local communities that we partner with by allowing them to prioritize their needs and concerns. We realize that we benefit far more from the experience and the exchange by being exposed different challenges not commonly faced while practicing or rotation in the United States. However we still hold ourselves to the the highest ethical standards of practice and quality of care.

2020 Hurricane Recovery - Dr. Yvens Laborde

“We will not be indifferent to the suffering of our fellow human beings”- It is this simple principle which is at the core of our CEO Warner Thomas', Chief Academic Officer Leonardo Seoane's and the Medical Director of Global Health Education's belief that "Global Health is Local Health”. We believe that diseases and disasters do not respect borders and that we must prioritize improving health and achieving health equity for all.

It is this visionary approach that allowed us to better understand very early on the critical importance of ensuring the equitable distribution and access to the vaccines would be critical to our ability to effectively curtail the epidemic.

Our Vaccine Task force did an incredible work in devising innovate and non traditional ways to connect with our vulnerable communities through trusted community leaders and partnerships to drive vaccinations in all our diverse communities.

This commitment to “not be indifferent to the suffering of our fellow human beings” was again in full evidence when at 8:30am Saturday August 14, 2021, when we got two frantic and panicked phone calls from our FONDYLSHAHH Ochsner Partners in Aux Cayes and Jeremie, Haiti that they were experiencing another severe earthquake in Western Part of the Island in Haiti where we have previously intervened after Hurricane Mathew in October 2016.

When I approached our CEO and President Warner Thomas and our Chief Academic Officer with this disastrous news and the devastating death toll and damage that was to follow, their response was ”how can we help?”

This response is even more amazing given the fact that we at Ochsner Health were engulfed in a devastating 4^th surge of COVID 19 that was overwhelming our health care system and our resources.

Our team of health care heroes quickly mobilized and in short order working with Regine Sylvain, Dawn Pevey, Debbie Simonson, Maida Glover, Michael Guillot, Mark Dupuis with guidance from our FONDYLSAHH partners on the ground in Haiti to initiate a relief mission to the victims of the disaster.

When the Ochsner Health system decided to partner with the University of Queensland in Australia, one of the leading medical schools in the world, to create the UQ Clinical School it was with the vision that physicians and health care professionals of the future would need to have a more global view of health in order to effectively face the many health related challenges of the 21^st century.

This global perspective has allowed us to have a better understanding of the COVID-19 pandemic and the steps that we needed to take very early on in order to better manage and mitigate its propagation.

With the support of Leonardo Seoane our Chief Academic Officer we were able to very quickly use our experience from previous interventions to put a mission in place with a focus on getting medical supplies and medicines to the areas that were in greatest in need. Our relationships with the ministry of health and local relationships allowed us to transport the medications.

We were able to travel to port au prince Haiti on Tuesday August 17^th to port au prince Haiti and then met with our contacts on the ground to ensure security for travel and also met with an elite Colombian Urban Rescue Team for a debrief and planning.

We traveled to Aux Cayes on Wednesday morning and met with the team at Aux Cayes General Hospital where we distributed medications and supplies and worked with the team to assist with triage and logistics for the Aux Cayes Hospital.

We were able to establish nutritional and financial support program for family members of patients in the hospital who had virtually lost everything in the earthquake.

Worked in the ED triage and medicine ward with Haitian phyisican partners

Mobile clinic with FONDYSAHH partners on the ground with Amiva at Camp Gambion

Met with Former First Lady and President Marthelly during work at Hospital

Met with Dr. Geder-The hospsital director to discuss further plans for future collaboration and need for more effective COVID 19 protocols and vaccination program for the facility.

Food distribution and financial support directly to victims of the quake at hospital general and ofatma

Meeting with MSSP director at OFATMA

Flew Back to Port au Prince met with director at vaccine administration site and reviewed protocols and procedures and provided some guidance and expertise

Met with Dr. Jean Hughues Henrys’ The President of the Haitian Medical Association and Advisor to the Prime Minister and Minister of Health

Returned to New Orleans early Saturday morning on the last flight to become part of Team A to support our efforts to care for our patients and staff during Hurricane Ida.

Ochsner Health continues to be committed to its mission to serve, heal, lead, educate and innovate to improving health and achieving health equity for all people locally and globally.

Ochsner doctor heads home to Haiti to help with earthquake recovery efforts WDSU6 News

US Doctor aids in Haiti earthquake recovery CTV News

2018 Hurricane Recovery

In 2018, the Ochsner team, comprised of a primary care physician, urogynecologist, pelvic reconstruction surgeon, infectious disease physician, and 4 medical students went to Moron, Haiti. This small commune in Jeremie Arrondissement, in the Grand’Anse department of Haiti has a population of 250,000 people. With limited access to electricity, adequate plumbing, sanitary living conditions, clean drinking water, and food, most of the living infrastructure, agriculture sector, and health center was damaged by Hurricane Matthew. Prior to the week trip to Haiti, the team collected basic medical supplies to be used in the clinic. On average, the team saw 90-100 patients a day in the clinic and were able to provide IM pain medication, anti-hypertensive, analgesics, and reflux medication. Unfortunately, lack of access to women’s health and STI prevention education was noticeably apparent with amount of STI’s. Although the team was able to treat many acute conditions, the biggest goal was to provide better quality care in the clinic beyond this one -week visit.

2017 Disease Education

Medicine in Society Health Project: Five Students' Journey to a Resource-Limited Clinic in the Haitian Countryside

Since education was not equal in this patient population, pictures were used to help patients understand disease better.

2016 Enhancing the EMR

Last years group established an electronic medical record (EMR) equipped with patient’s name, medical record number (MRN), and information from their visit. However, patients did not have MRN numbers given to them when leaving and a lot of patients did not know their birthday. So, the only way to look up patients was via their names, a difficult task because of language barriers. In order to overcome this inconsistency, Photo ID cards with MRN’s were given to each patient.

This year’s group was able to provide more continuity of care. The EMR system lacked information pertaining to patient’s history and physical exam findings for each visit, so we began to attach electronic scanned copy of the medical record to each patient’s chart, paving the way for true sustainable tool for continuity of care within the clinic in La Victoire, Haiti.

2015 Patient ID Cards

Each trip students build upon advancements made by previous trips. During this trip students were able to create Patient ID cards and pharmacy cards that could be scanned by the pharmacy in order to dispense medications. However, even this project had its limitations. Since camera’s were too expensive, pictures were not included. Also, since the clinics in Mayaya La Victoire, Haiti did not have continuous internet, the ID cards could not be constantly updated.

Students and faculty also participated in daily clinics. Dr. Obinna Nnedu, an infectious disease specialist, mostly saw patients with reflux, osteoarthritis, headaches, and fever. Dr. Leise Knoepp, an OBGYN physician, saw patients with vaginal discharge, pain, and amenorrhea. The medical students were also able to perform minor procedures such as: wound debridement, lipoma removal, and fracture splinting. Overall, the most common condition seen was Gastroesophageal reflux disease (GERD), most likely because of the low caloric intake of the area resulting in an increase in acid secretion.

Images used on ID cards so patients can understand their medications based off of pictures

2014 EMR Database

Starting 2014, 4th year Ochsner medical students and faculty went to Haiti during their Medicine in Society rotation. The main goal was to create an EMR database of every patient seen by the visiting medical team in the Fondylsahh clinic in the remote village of Mayaya La Victoire, Haiti. The group succeeded in creating a database that provided continuity of care, identified the main health issues in the population and treatment plans, and allowed future students and physicians to use this data to better prepare for future trips. Using the EMR, the top diagnoses were identified as: as musculoskeletal pain, vaginitis, Gastritis/GERD, UTI, and headache. This provided good insight into the health disparities of the population and how closely they are linked to their environment.

Students training with the i-STAT blood analyzer

2013 Clinical Activities

After the government of Haiti and Ochsner Health System signed a memorandum of Understanding (MOU) in late 2012, the first official inaugural mission was conducted. The aim of this program was to provide an elective experience for UQ students who were interested in international health. The goal is to educate students abroad and domestically so they can become better physicians. According to a Ross Hoffman, previous student, “The poverty I saw in Haiti pervaded many aspects of life, most notably health, the economy, and education. Any approach to serving Haiti’s future must address all three areas in combination. He also felt that “ Having the opportunity to see and interact with patients within the community, and in this particular setting, was certainly eye-opening”.

I took this photograph as our group was walking through the village on the second afternoon we were in Mombin. Taking this opportunity to fully immerse ourselves amongst the community, explore the town and interact with the local population in this manner was enchanting. - Emily Sineway

2012 Clinical Activities

Students and faculty participated in daily clinics. Dr. Obinna Nnedu, an infectious disease specialist, mostly saw patients with reflux, osteoarthritis, headaches, and fever. Dr. Leise Knoepp, an OBGYN physician, saw patients with vaginal discharge, pain, and amenorrhea. The medical students were also able to perform minor procedures such as: wound debridement, lipoma removal, and fracture splinting. Overall, the most common condition seen was Gastroesophageal reflux disease (GERD), most likely because of the low caloric intake of the area resulting in an increase in acid secretion.