Tuesday, March 29, 2016
As the poorest country in the Western Hemisphere, Haiti systemically struggles with debilitating infrastructure shortcomings, low literacy rates and poor health care. The latter issue is one likely linked to health estimates that put a Haitian’s life expectancy at about 63 years. Even more dismal are the maternal death rates, and the mortality rates for children.
A woman in Haiti has a one in 90 lifetime risk of dying during childbirth, 16 times higher than a woman’s risk in the United States. And, out of every 1,000 children born in Haiti, 59 will die before their first birthday. In the U.S., that number is just five, according to national health data.
Such jarring numbers are the impetus behind a partnership between the Virginia Commonwealth University Institute for Women’s Health and the Richmond-based Midwives for Haiti, a nonprofit organization working to end preventable maternal and infant mortality in Haiti. Janett Forte, assistant clinical professor in the VCU Institute for Women’s Health and a licensed clinical social worker, recently returned from a seven-day trip to Hinchi, Haiti, with a group of students. In the past two years, eight VCU students participated in the project through funding from the Global Education Office. Students shadowed health care providers, clinicians and Haitian students, and they participated in mobile clinics and provided clinical assessments and prenatal health education for pregnant patients.
Such partnerships create outreach, research and service opportunities for VCU to collaborate with other groups, share expertise and continue to position itself on the front line of global health issues, Forte said. The Institute for Women’s Health formally partnered with Midwives for Haiti in the winter of 2014 to develop a sustainable connection to their global women’s health program.
“This partnership allows for ongoing student study abroad opportunities, faculty support and mentoring of students interested in maternal health,” Forte said. “We served as volunteers, which meant that depending on our professional background and credentials, we supported the program in a variety of ways and also had opportunities for cultural immersion-type experiences.”
The trip offered students an opportunity to increase knowledge and skills, collaborate across disciplines, increase self-awareness and promote an understanding of advocacy needs for the underserved. Additionally, students were exposed to the harshness of rendering medical care in nontraditional, resource-poor settings.
There were stark differences between the facilities and resources available to medical practitioners in the U.S., and those working in Haiti.
“There were stark differences between the facilities and resources available to medical practitioners in the U.S., and those working in Haiti,” said Hannah Samuels, a VCU nursing major who recently participated in a trip. “The clinics I helped with were set up on front porches, in chapels and sometimes just under a covering of trees — wherever there was shade.
“Many of the medications and services that we were able to offer would be considered easily accessible in the states, but medications as basic as antacids or prenatal multivitamins were gratefully accepted by the pregnant mothers, who would not have had access to them otherwise. Pre-eclampsia and postpartum hemorrhage are deadly for Haitian women, who often give birth at home without access to skilled birth attendants.”
Team members had an opportunity to develop relationships with Haitian physicians, nurses, midwives, administrators and patients, using translators to communicate information. VCU medical professionals from the fields of epidemiology, social work and health psychology previously have taken trips with the Institute for Women’s Health. Those trips have proven mutually beneficial and produced follow-up initiatives strengthening the partnership with Midwives For Haiti.
“A number of the VCU team folks have been involved in the development of a prenatal group care curriculum based on the Centering Pregnancy model of care,” Forte said. “We have developed an educational curriculum based on this model, provided in-country training during our June 2015 and March 2016 trips, had it recently translated into Creole and are seeking feedback from the mobile clinic midwives and the students on the content and usability of the materials and activities.”
Team members have also provided Haitian mobile clinic midwives with a photo book of images, based on the curriculum for the midwives, for use as an educational tool at prenatal clinics. The curriculum information and activities are arranged into four educational topics: “Staying Healthy in Pregnancy,” “Sexually Transmitted Infections and Family Planning,” “Preparing for Labor and Birth” and “Keeping Mamas and Babies Healthy After Birth.”
Samuels was encouraged by the trip.
“The work that I got to see — local nurses being trained as midwives and then sent out to work among their own — was encouraging and inspiring,” she said.
Forte said, “We hope to continue to build our relationship with Midwives for Haiti and encourage more VCU students to join the institute as we share resources and expertise with our partners working to improve maternal and infant health in Haiti.”
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