Since 2006, Ohio State University physician and faculty member Howard Werman, MD, has been bringing emergency health care to Haiti, a nation designated as the poorest in the Americas and the third “hungriest” in the world. Dr. Werman’s most recent visit marked a significant difference in how health care might well be delivered to impoverished Haitians in the future.
“Most of the missions to Haiti since 2006 focused on clinical service,” reports Dr. Werman. “We would go to Fort Liberte´, deliver medication and supplies, set up a clinic and see about 1,000 patients over the course of one week. Then we would return to the states, and I found myself asking, ‘What did we truly leave behind?’”
Dr. Werman is quick to point out that these previous missions were valuable – they provided access to medications for Haitians who otherwise would have had none and exposed his physician colleagues to the seriousness of the poverty and health care shortage in Haiti. But ultimately, they were all finite and episodic missions.
Enter Dr. Ayesha Khan, a former colleague and friend of Dr. Werman at OSU and an emergency physician and current faculty member at Stanford University. The leader of Empower and Advance (www.empowerandadvance.org) – a non profit organization dedicated to empowering impoverished individuals and groups to advance their communities – Dr. Khan refined and elevated the most recent mission to Fort Liberte´.
According to Dr. Werman, “Dr. Khan realized that the cost of our group traveling to Haiti was really dollars that could have been better applied to the Haitian people we were trying to help. So her idea was to train native Haitians to be community health workers to help maintain a medical presence in Fort Liberte´ that endured after our group returned to the states.”
Harnessing the knowledge of Dr. Werman, OSU Emergency Medicine resident Meghan Taylor and two other OSUCOM students, Rogette Esteve and Michael Scott Cardone, along with grant dollars provided by the College’s Alumni Association, the Empower and Advance-led mission focused on implementing Dr. Khan’s model of a sustainable emergency community health worker (eCHWs) program. The program trained secondary school educated Haitians to diagnose and treat acute care conditions in Fort Liberte´. All of the eCHWs underwent comprehensive reading and math testing as well as a series of individual and panel interviews. To solidify their commitment, the eCHWs were required to agree to two years of service to their community, with the specific intent of training the next wave of volunteers to ensure that the program exists in perpetuity.
According to Dr. Khan, the eCHW program has been validated by a number of physicians with global health backgrounds and is certified by the Northeast Province Director of the Ministry of Health in Haiti. Dr. Werman believes that this recent mission is step one in the process of improving the Haitian health care system until it reaches the point of truly being self-sustaining. It also represents a notable change from the previous episodic based mission trips where foreign physicians provided temporary care to a model where the Haitian eCHWs are participating in the delivery of care rather than simply receiving it.
“The new and ultimate goal is to support Haiti until they don’t require our assistance. The eCHW program will equip them with the knowledge base and skills to deliver quality health care. Until that goal is met, groups of physicians, nurses and residents will continue to trek to Haiti to advance Dr. Khan’s Empower and Advance program and vision.”