Early lessons from Haiti in global health

Doctors, nurses, ministers, first-responders and many individuals have interrupted their daily lives for weeks and months at time to lend a helping hand. To show solidarity communities have thrown parties, organized fundraisers and joined with relief organizations. “Text for Haiti” became a popular way to make individual contributions through mobile phone text messages as many leaders urged financial contributions over direct donations of foodstuffs, clothes and other supplies. Early indications show a real boost in this approach to philanthropy, which etymologically means “the love of humanity.”

The aftermath of a 7.3 magnitude earthquake two years ago in Haiti left more than 250,000 dead; 300,000 suffering with illness and/or injury; 222,000 homes were destroyed and communities were devastated leaving 1.5 million displaced people living in temporary housing – one inconceivable moment has lead to an intense international call for a movement to help and heal Haiti.

Sustaining support in Haiti is remarkably visible in a complex web of celebrity, global leadership, governments and institutional partnerships working to build new infrastructure, distributing resources and reclaiming hope for renewal in the nation.  Widespread humanitarian responses addressed the immediate need for potable water, food, temporary shelter and medical treatment. Those pitching in with Haitians to address rebuilding plans for the nation of Haiti continue to work.   Doctors are also on the ground mobilizing efforts aimed at health care and health.

The difference between addressing short-term needs and development (long-term strategic approaches) required to rebuild the Haiti and other places in ruin like the city of New Orleans demands a humanitarian response from architects, planners, engineers and educators who are moved by innovation, collaboration and technology. Furthermore, matching human capital and financial investment with a commitment to transparency and governance is key for future progress. This is an opportunity to build a new nation with a vision for a healthier society. The Haitian Ministry of Health is working with the Pan-American Health Organization (PAHO) a division of the World Health Organization (WHO) along with formidable world health leaders to shape a strategic plan. Haitians especially young people complement the expertise available as PAHO/WHO recognizes the power of enabling indigenous populations to shape their future.  In these efforts we also find new ground to apply the principles of the social determinants of health by developing an equitable and sustainable environment.

While many phases of planning were taking shape a cholera epidemic emerged in the aftermath of the earthquake in Haiti. By December 2011 more than 7,000 died and over 550,000 cases were reported. Rapid public health surveillance on the ground in Haiti has been enabled in part by social media with Ushahidi’s innovative crowdsourcing tool that allow individuals to report outbreaks using of mobile phones. Health Map is driven by this real-time aggregate data for the deployment of essential resources related to water, health, cholera and other emergency services.  A new global campaign now calls for the elimination of cholera in Hispaniola (Haiti and the Dominican Republic) by pushing for continued investment in the infrastructure for safe drinking water and sanitation throughout the region. The potential to reduce other waterborne illnesses and improve rates of infant and child mortality would also improve along with indicators of health.

Any efforts at relief, recovery, reconstruction and renewal will see setbacks, complications and struggles. Progress is not impossible.

In the two years since Haiti’s earthquake there is striking evidence of significant improvements.  More clean water is available now than before the earthquake. WASH (Water, sanitation and hygiene) is the first public health lesson in global health. Another health lesson comes with understanding nutritional needs and food security.  U.S. AID Administrator Dr. Rajiv Shah reports collaborations with local farmers are yielding new crops of rice, grains and corn to feed 10,000. Furthermore, classrooms are open for more than 250,000 children and the economy is on the upswing with 6.5% growth in gross domestic product, an indicator of a country’s standard of living.

Health professionals and other volunteers are still needed on the ground in Haiti as well for global health. Dr. Natasha Archer a Harvard trained Haitian physician and her colleagues also call for more formal opportunities in global health training. Medical schools and academic medical centers are challenged to consider offering dedicated time, financial support and mentoring with the development of relevant curricula in rotations, tracks and/or pathways as well as fellowships. Large scale disasters draw willing volunteers including doctors and health professionals who may be trained in specialties, but may not have experience in health care delivery in resource-limited settings, lack an understanding of historical and cultural context of the regions or expertise with the clinical manifestations of illnesses and diseases in such settings.  More and more encounters in global health are encouraged as globalization shapes our world.

I’ve spent time in southern Africa and other regions of the Caribbean working on health-related projects these experiences have helped to shape my view of medicine and health. We should do what we can with what we have to give. If we are moved to do more then training and opportunities should be within reach to improve the capacity for health around the world.

Katherine Ellington is a medical student who blogs at World House Medicine.

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