The Problem:

While US medical education is very good and thorough in creating diagnosticians, educating how to treat illness and developing technical skills in its students, it often falls short in teaching compassion for the world as a whole.  Over three billion people in the world today (that is nearly half of the world’s population) live in poverty.   According to UNICEF, 22,000 children die each day due to poverty. And they “die quietly in some of the poorest villages on earth, far removed from the scrutiny and the conscience of the world. Being meek and weak in life makes these dying multitudes even more invisible in death.” (from globalissues.org) 

Those who live in poverty are in fact the sickest, the most vulnerable and have the least access to medical care.  Yet during medical education and in pursuit of medical careers it is rarely an issue or noticed that the medical community is not making efforts to care for the half of the world that needs us the most.  In fact, it is a rare individual that pursues healthcare with devotion to poverty medicine after medical school.   Most healthcare professionals start with a mission to help patients regain health and to reduce suffering.  It is the norm however for western health care providers to get lost in the day to day and now more than ever we are distracted by issues of the finances of medicine, cost of care, insurance companies, electronic medical records, work schedules etc.  In other words, our daily mindset has nothing to do with our original purpose.     And yet in the background “ 1 billion children live in poverty (1 in 2 children in the world). 640 million live without adequate shelter, 400 million have no access to safe water, and 270 million have no access to health services. 10.6 million died in 2003 before they reached the age of 5 (or roughly 29,000 children per day) “ (from web site

globalissues.org)

HEAL’s premise is that it is our most basic human obligation to care for 100% of our planet, and particularly care for the neediest half of our world.  We submit that as health care professionals we have a duty to not only help fight poverty but to treat these individuals with dignity, and with the assumption that health care and well being is equally important to both halves of the world, rich or poor.

HEAL is offering an opportunity to open the eyes of health care students and professionals by using experiential learning as a stepping stone into delivering poverty medicine.  It has developed a model where it exposes medical students early in their training to poverty medicine.  HEAL’s students get to see and live in the developing world that is the sickest, the poorest, and with little and usually no access to health care.

What we do:

Every year HEAL educates US medical students in poverty medicine.  We recruit 11-13 students to volunteer their spring break and join us in traveling to Haiti.   For 6 months prior to the trip the students meet with Dr. Partovi and discuss details of planning the trip as well as anticipating medical treatment plans, learning the history of Haiti and cover a poverty medicine curriculum.  Ideally 2 students from previous years volunteer to join us again and take on a leadership role for the incoming year.  The first time students and also strongly encouraged to take on learning and projects that can lead with each year.  Once in Haiti we partner with US foundation for the Children of Haiti, and based on the foundation’s need and on the direction of HEAL, we provide care in their schools, orphanages, hospital and villages.  In 2015 the HEAL Haiti voyage,  decided to spend the entire focus of care in the small village Mussotte.     

 Accomplished in 2015:

• delivered a year’s worth of hypertension medications to 100s of adults (very prevalent and uncontrolled in Haiti and a major source of morbidity/mortality)
• cervical cancer screening on 150 women
• treated early cervical cancer in a "see and treat” cryo therapy on several women who had abnormal cervices on our direct screening
• treated 100’s of children for worms ( a major source of anemia, poor learning and malnutrition)
• we saw over 1000 patients in just 5 days of clinic treating arthritic pain, rashes, diabetes, H.pylori (a major cause of malnutrition and gastric cancer), anemia, urinary tract infections, pneumonia, asthma, etc.
• strengthened our partnership with the Doctors who live and treat the people of Mussote year round with limited resources
• were able to identify a very sick child and pay for her hospitalization (who would otherwise not have gone)
• helped an elderly man who had an untreated stroke just days before our arrival who went from bed bound and aphasic to sitting in a chair and speaking
• surveyed residents in their home (a project designed by our amazing 4th year student leaders)
• identified a willingness and embracing the idea of a community healthcare worker for the village we treat
• watched the third year medical students grow in their independence, confidence, love of caring for this and other impoverished populations
• watched our fourth year student leaders amaze us with their organization talents, leadership and devotion to making our care sustainable, and deliver good practice in medicine

Presently the most urgent medical needs there are sustained access to medications, particularly for treatment of hypertension in the adults, for worms in the children, prenatal care, treatment for anemia, access to birth control, treatments for acute illnesses such as antibiotics and treatment for burns.  The larger issues that Mussotte is faced with are access to reliable clean water, better nutrition, better education and promotions of small businesses there to boost the economy. 

What occurs while we are in Mussotte, Haiti is incredible.  First, we transform a small church into a clinic.  There are only dirt or cement floor in most of the area that we work, no electricity, no running water.  From our kind donors in the US, We bring suitcases and suitcases full of medications, supplies, condoms, sanitary napkins, and soap.  The churches pews are turned into waiting areas, examination benches, and pharmacy shelves. What feels like the entire town lines up in the courtyard and at this point the full experience begins…  Student’s later comment that they get more hands on experience with patients in Haiti in 3-4 days than they do for they’re an entire year of school.  The students are encouraged to organize and take charge of most of the care themselves thus the autonomy and growth of each student’s history taking, examination, confidence and self reliance is very obvious to the attending / supervising Doctors and practitioners there.  Typically by the end of our time in Mussotte we are exhausted but excited about what has been accomplished, learned and a list forms of what we ran out of, and how can we do it better next year.  It is dusty, dirty, exhausting, frustrating, there is no Wi-Fi, no x-ray, no ability to test more than a hemoglobin or a glucose and vitals, no surgeons, no MRI, no Echo, no sophisticated treatments and it is hopefully the most memorable and most positive experience in our students education. 

HEAL’s goals

For 2015 HEAL has 3 main goals.

1.Our Focus now and the near future will be on helping to transform Mussotte.   Ultimately we would like to help Mussote become a more prosperous village and thus a healthier place to live.  Ideally, they will have a self sustaining system for health care so that they eventually will no longer need us and we can move on to another village who does.

2. Medical students will be inspired to devote some or their entire career to helping the impoverished populations of the world. 

3. Scholarship

a. We will fully fund our scholarship student who intends on completing school in the Dominican Republic and will return as a general surgeon to help Haiti. 

b. In the near future we would like to add scholarships for other Haitians to complete graduate and professional education.

c. Additional scholarships will be formed to financially support the fourth year leadership medical students to cover expenses for travel to Haiti.

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Objectives

1)     Mussotte.

A.    We have committed to visiting Mussotte yearly and are now spending our entire clinical April rotation there. 

B.    We have committed to working out a means so that we can supply year round anti-hypertension medications to the adults who need it.  

C.    We are establishing avenues so that we can purchase the antimalarial and anti parasitic medication in Haiti directly rather than purchasing and transporting from the US to Haiti with each trip

D.    We will create a needs assessment in Mussotte with the April 2015 visit run by the Medical Students

E.    In 2016 We would like to add a second rotation perhaps during December break with students from a different medical school (presently only UCLA medical students attend)

F.     Our contacts and Partners in Haiti and Mussotte:

a.     We partner with US for the Children of Haiti to assist with housing, and attend to their sponsored elementary school there. Gladys Thomas, who is the CEO of USFC, lives in Haiti and has a family home in Mussote. USFCH has created several successful schools, a hospital and 2 or 3 orphanages in Port au Prince and the schools in Mussotte.  Gladys is our main liaison with Haiti

b.     We are partnering with Haitian physicians in Mussote. the 2 sons of the Mussotte Church Pastor Drs. Famfam are Cuban trained physicians and see patients there weekly.  He has helped us in Mussote for the past 2 years and we would like to continue to help supply him with medical support and pharmacy. He provides the continuity of care and helps meet the sicker patients that we find during our clinics in the nearest hospital. 

c.     We are exploring options that would help improve the water purity and supply through our contacts with Charity: Water and their field experts in Haiti

d.     We are exploring the option of supplying cast iron bars that can be used in cooking water to help combat anemia, our contact for this is through Lucky Iron Fish

e.     April 2015 we plan to provide on site Cryo therapy for abnormal Pap smear gyn finding ins as primary care for the women that we see there