The Haiti Project
Family Medicine Training in Haiti: A partnership between the Haitian Ministry of Health and the University of Miami School of Medicine
Since 1999, a Family Medicine Program has been established in Cap Haitien, Haiti, to train Haitian family physicians. Despite difficulties inherent to the introduction of a new medical specialty, and the harsh socio-political climate, the Program has graduated 27 residents, 25 of them practicing in the country. In addition, 4 residents will graduate in October 2009. While the curriculum developed remained faithful to the tenets of Family medicine – emphasis on ambulatory care, continuity of care and a biopsychosocial approach, provisions were allowed to equip the trainees to address the Haitian health challenges.
The program, known at UM as the Haiti Project, is located in the Justinen Hospital in Cap- Haitien, the second largest city in Haiti and has expanded to two satellite centers in the North department. After ten years of operation, the teaching program is now staffed with Haitian physicians, fully trained in Family Medicine. The University of Miami provides a close administrative and academic supervision, through a liaison Faculty member, Dr Andre Vulcain, who shares his time between Miami and Haiti and several visiting UM faculty members. The Haiti Project is administered by the UM department of Family medicine and directed by Dr. Michel Dodard.
Emphasis has been placed on maternal and pediatric health, general preventive health, and advanced surgical skills, including C-sections. In the Family health Center of the Justinien Hospital, the faculty and residents in family medicine now care for 25,000 patients, and more than 100,000 visits have been logged.
The Family Medicine residency has raised the level and quality of medical services and has been used as a launching platform for several other clinical services and training programs, benefiting the whole local health system. Of note is the development over the last five years of an extensive HIV/AIDS service, providing specialized, up to date care to 3,000 patients, with 800 patients receiving triple drug therapy. Upgrades in different clinical departments of Justinien have taken place either through direct efforts of the Haiti Project, or other organizations attracted to the Hospital by a structured teaching program and a health force with ties to a major University.
The Haitian health system has benefited from the Haiti Project in several ways;
- Creation of a primary work force.
- Training of several hundreds of nurses, allied health staff, and community health workers in HIV care.
- Provision of preventive, curative and palliative care through an innovative service education model.
- Demonstration of a successful experience to stop the current medical brain drain.
The Ministry of Health has expressed several times its wish to extend the Haiti Project model to other hospitals in Haiti, as funding becomes available.
Recurrent funding challenges and uncertain sustainability remain potential threats to the growth and expansion of Family Medicine training. Predoctoral teaching in Family Medicine in all three Haitian medical Schools as well as an active Ministry of Health support will be necessary to pursue the development of the discipline of Family Medicine in Haiti.
There is an urgent need to secure funding for the present training program, and an ever present need to extend its model to serve a larger population.