Last Thursday we visited the Medical School of the Aristide Foundation [UniFA] and had the privilege of an audience with former first lady, Mdm Mildred Aristide. She spoke about the history of the medical school which, though it was started in 2002, can be traced back to 1996 when Haiti restored diplomatic relations with Cuba, which had been ‘ruptured’ through the years of Duvalier rule. In 1997, a medical cooperation began between Haiti and Cuba which enabled Haitian students to study medicine. However, President Aristide felt that even more students could benefit from the cooperation if Cuba doctors came to Haiti and trained students in their own country. The school was then established ‘as a cooperation amongst the Aristide Foundation for Democracy, the Haitian government, the Taiwanese government and the government of Cuba. In 2003 there were 247 medical first and second year students.
Following the 2004 US supported coup against President Aristide, the school was completely trashed, shut down, and many students and staff forced into hiding or exile. The school compound was then occupied by the US and used as a military barracks until 2007 when it was finally returned to the Aristide Foundation. Following the coup, many of the staff and students had to flee into hiding or exile for their own safety. Others went to the Cuban embassy and were able to secure passage to Cuba to finish their studies.
After the 2010 earthquake the compound became a refuge for thousands of quake survivors from the neighbourhood of Tabarre where the Foundation is located. The Foundation was able to explain they needed the grounds to rebuild and reopen the medical school and it was on this basis that residents voluntarily left the camp. Prior to returning to Haiti in March 2011, President Aristide reiterated his commitment to working in education, and reopening the medical school was seen as the first step in this direction. The school reopened in September 2011 with the help of Partners in Health and a group of Cuban doctors who remained in Haiti a year after the earthquake. The first intake was an evenly divided 126 women and men, and the school is now in its second year with 254 students. By the second year, realising the school was not a political space where they were able to attract Haitian doctors to the teaching staff, a nursing program with 73 students was introduced. Students are chosen strictly on merit, but recruitment is encouraged from those living outside the capital, particularly in rural areas and from poor families who would otherwise not have an opportunity to study medicine.
Madam Aristide went on to explain that despite the advances made by the foundation, the programme is:
“…Merely a drop in the bucket, because every year Haiti graduates in terms of high school students taking the baccalauréat there are between 55,000 and 60,000 students who pass. But when we look at the number of university seats in Haiti there are maybe 6,000 places available if you include the technical schools, so you can see right there a gaping hole. Again the concentration of university places are in the capital so its a tiny drop and a tiny drop in terms of Haiti’s medical needs when there are only 1.5 doctors to 11,000 people. In terms of the Cuban relationship, since 1997 they have trained about 750 doctors, which is huge….So we have a lot of challenges in the medical sector and we know our contribution is going to be a tiny drop but if we don’t start then further down the road we will face more difficulties.”
She went on to explain that though foreign doctors, who were essential in the post-earthquake period, the solution to a sustainable healthcare program in Haiti is to train it’s own doctors rather than continue to depend on intermittent clinical care from overseas. With this in mind, the school works with, for example, Physicians for Haiti, who provide a rotation of visiting doctors for up to two weeks in a training capacity.
The school also works within the medical school’s immediate community, Tabarre, where there are over 400 schools on education, and on healthcare through programs on Radio TiMoun and a clinic serviced by the staff and students of the medical school. These are some of the Foundation’s contribution to education and healthcare in Haiti where the challenges are huge:
“It’s impossible to think you can construct a country and build and really go forward when you have the youth as a number one goal is to find a foreign visa and travel. But that unfortunately is the reality because of the economic situation. We think we can train these medical professionals to work and stay in Haiti. That is part of the job, the second part is now making sure they will be able to work, and not only in the capital but in the countryside. We also have to work with Haitian society, so these students are not picked up by the US and Canada. We already have an agreement with the new Partners in Health hospital at Mirebalais which is where our students will do their clinical training.”
Just to bring the Haitian healthcare system into perspective, on Wednesday I witnessed a pregnant woman – a mother of 7 children — being carried down the hillside of Jalouzi by two men.
It had earlier taken me over an hour to stumble down the steep, gravel and stone laden path, and only the help of two hands prevented me falling and seriously wounding myself. So I imagine it most have taken them at least half that time if not more. She was then rushed into the SOPUDEP micro-credit store where we immediately laid her on a camp bed and covered the space with a cloth.
Flaurantin Marie Enise of Le Phare, a women’s organisation based in Jalouzi, put on her gloves and proceeded to examine the woman. From that moment, she estimated she had about two hours before the woman would go into the final stages of labour. Flaurantine said she was concerned about whether to try to get her to the MSF hospital, about an hours journey, or to wait for her to go into the final stages of labour. The woman was very weak, but in the end Flaurantine decided there was time for her to get to the hospital and she was carried out on a stretcher up another very steep hill that climbing makes one consider the marvels of gravity, and onto a tap tap to the MSF hospital in Delmas 33. A journey, at that time of the day, of at least one hour on foot and by tap tap. She had a baby boy and he is fine. On the way down Flaurantin had introduced me to the two other women whose babies she had helped deliver.
There are a number of matrons and nurses in Jalouzi, but with a population of about
200,000, it is really only with women helping each other that crisis such as these don’t end up in deaths. I was also reminded of the time my mother delivered a baby after a woman had gone into labour outside our house at Ikeja in Lagos. Someone told my mum what was happening so she went out and brought the woman into the house where she gave birth with Mum’s help. It was a girl and they called her Florence after my mum.
Sokari Ekine is a 2013 IRP New Media Fellow reporting from Haiti.