Improving Child Healthcare in Haiti Through Resident Exchange

Haiti is facing big challenges. It's the poorest country in the Western Hemisphere, where about 65% of people live in poverty. Sadly, the country has high rates of infant and maternal deaths, malnutrition, and many who live with HIV/AIDS. One major reason for these health issues is the shortage of healthcare workers. The number of health professionals is low, with only four for every 10,000 people. This shortage makes it hard to provide good care, especially for children.

#St. Damien Hospital

Enter St. Damien Hospital, which is a pediatric hospital in Haiti. This hospital is a hero, providing around 50,000 essential services to Haitian kids each year. After a devastating earthquake in 2010, a group of North American pediatric hospitals joined together to help build healthcare capacity in Haiti. They created the St. Damien Academic Collaborative. In 2013, St. Damien Hospital launched a pediatric residency program. This is a big deal since Haiti has only around 300 pediatricians and three residency programs.

The goal is simple: train more pediatricians and improve child healthcare in Haiti. One cool part of this program is the exchange between Haitian and U.S. residents. They swap places—Haitian residents go to the U.S. to learn, while U.S. residents come to Haiti. This allows everyone to learn in different settings and gain new skills.

#Benefits of the Exchange Program

The exchange program is helpful for both sides. Haitian residents get to learn advanced medical skills in the U.S. that they can bring back home. They see cases that are common in Haiti but rare in the U.S. This exposure is incredibly valuable for their training. On the flip side, U.S. residents encounter unique cases found in Haiti, giving them real-world experience in resource-limited settings.

Over the past ten years, more partnerships have formed between researchers and doctors from wealthier countries and those from places with fewer resources. However, the bidirectional exchange at St. Damien is special—it's a two-way street that allows for mutual learning.

#Study Aims

This study looks at how both Haitian and U.S. residents feel about their experiences in the exchange program. By focusing on what's working well and what can be improved, the goal is to support better partnerships. We hope to learn from their experiences to make training programs even better.

To gather feedback, we sent out unique electronic surveys to residents who took part in the program. We asked for demographic info and insights about their experiences, including what they learned from each other, challenges they faced, and how it impacted their practice after returning home.

#Survey Insights

#Participant Demographics

In total, 14 Haitian residents and 17 U.S. residents completed the survey. Of the Haitian residents, about 86% were female, while around 71% of U.S. residents were female. Most participants graduated medical school between 2012 and 2015. The number of participants from each year didn’t show any significant differences.

Most Haitian residents spent about 1 to 2 months at their rotation site. The U.S. residents had a similar distribution, with the majority spending 1 to 2 months or less at their rotation site. The difference in how long residents spent abroad wasn’t significant.

#Rotation Sites and Subspecialties

Haitian residents could rotate through various specialties in the U.S. Some of the reported specialties included cardiology, hospital medicine, and emergency medicine. Those experiences helped residents learn new skills and understand different Healthcare Systems.

#Interest in the Program

When asked what motivated them to join the exchange, U.S. residents showed more personal interest than their Haitian counterparts.

#General Exchange Experience

Overall, Haitian and U.S. residents reported similar experiences during the exchange. Both groups felt they received enough housing support. However, only 64% of Haitian residents thought the program length was sufficient for learning, compared to 88% of U.S. residents.

Interestingly, Haitian residents valued educational conferences and lectures more than U.S. residents did. They also found core lectures more beneficial than their U.S. peers. On the other hand, U.S. residents thought managing patient care was more helpful than Haitian residents did.

#Challenges Faced

Language was a significant challenge for U.S. residents, while Haitian residents felt observership status was a larger hurdle. This means U.S. residents struggled more with language barriers, while Haitian residents didn’t have as much hands-on experience.

#Teaching and Feedback

Haitian residents felt more encouraged to ask questions during their rotation, which is a positive sign. U.S. residents noticed a shared vision during their rotation, while Haitian residents reported they received feedback in a way that didn’t feel insulting.

As for personal support from clinical teachers, both groups reported positive experiences. Most residents felt they were treated respectfully and welcomed by the teams they joined.

#Benefits After the Exchange

Haitian residents reported that their time in the U.S. helped broaden their understanding of the healthcare system and improve their skills. U.S. residents felt the experience helped them understand the Haitian healthcare system and encouraged them to work with underserved communities.

#Post-Rotation Challenges

Both groups faced difficulties when returning home. Haitian residents noted changes in their goals and priorities, while U.S. residents found it hard to readjust to the practices back home.

#Subspecialty Experience

When asked if programs abroad would lead them to leave their home country, opinions among Haitian residents were mixed. A small percentage felt it might encourage them to leave, while many were unsure. On the flip side, U.S. residents felt the experience influenced their career choices positively.

#The Value of the Bidirectional Exchange

Overwhelmingly, Haitian residents felt that the bidirectional aspect of the exchange was beneficial. They shared lessons learned and continued to communicate with their peers. Many highlighted how this exchange allowed them to learn and teach simultaneously.

#Future Improvements

Residents had ideas on improving the program, including better support, more direct care, and enhanced Collaboration between U.S. and Haitian residents. They also mentioned challenges back home, such as limited resources and the need to convince their peers to embrace new practices.

#Conclusion

The residency exchange program between St. Damien Hospital and U.S. medical centers shows how collaboration can make a real difference. There’s a lot to gain when people from different backgrounds work together and share knowledge. By listening to the experiences of residents and continuing to improve the program, we can train better doctors who will help close the gap in healthcare, especially in Haiti.

This exchange program is a wonderful example of how sharing knowledge and experiences can lead to better healthcare for everyone. We can all learn from each other—and who knows, maybe some day we’ll find a way to better the world together, one residency at a time!