Letters to the Editor
To the Editor:
In Haiti, the time for postearthquake emergency relief has long since ended, and Haitians and visitors alike are eager to build a better health system. High-quality medical education is central to this process.1 Administrators at St. Luke Hospital in Haiti have partnered with U.S. academic institutions to offer training for Haitian staff. The hospital’s physicians and nurses see a tremendous array of pathology and have benefited from effective teaching by guest lecturers in recent years. Our experiences with these lecturers prompt us to offer the following advice for medical educators visiting Haiti:
Toss out or revise old PowerPoint presentations. Haiti’s challenges are different enough from the United States’ to make many imported slides irrelevant. Write a new presentation for Haiti, or use a medium that encourages interaction with the audience, such as a chalkboard or whiteboard.
Before your lecture, find out what resources are available at the host institution. Do enough clinical service to observe local challenges. Ban the phrase “I don’t know if you can do this here, but….” Do research in advance to find out whether particular technologies are available, and tailor your lecture accordingly.
Let local experience inform your teaching. Refer to cases of patients that you or your colleagues have treated in Haiti. Review the local literature. Remember that the burden of noncommunicable diseases is considerable here—we recently requested lecturers in neurology to help improve stroke management.
Interact frequently with your audience to break down the language barrier. Many Haitian professionals speak English (in addition to Kreyol, French, and often Spanish), but levels of comprehension can vary. Limit misunderstandings by promoting discussion.
Help mitigate brain drain. Work with host administrators to build incentives for local doctors to stay. Support a culture of academic medicine to make the Haitian hospital a more rewarding place to work. Pledge a lasting educational commitment. Find ways to include Haitian medical students in your training.
Consider a longer stay. More local experience enriches lesson content, and extra time helps build rapport with trainees. If extended visits cannot be scheduled, send the same people on follow-up trips. Better yet, consider moving to Haiti—we have dedicated academic physicians here, but we could use some more.
Margarette J. Blaise, MD
Medical director, St. Luke Foundation, which operates St. Luke Hospital and numerous outpatient clinics in Tabarre, Haiti; firstname.lastname@example.org.
Nicholas H. Carter
Fourth-year medical student, Warren Alpert Medical School of Brown University, Providence, Rhode Island.
1. Archer N, Moschovis PP, Le PV, Farmer P. Perspective: Postearthquake Haiti renews the call for global health training in medical education. Acad Med. 2011;86:889–891