Nursing student experiences first hand how the Community Health Program is ‘complex and integrated’
By Neekan Aeini
Although I’ve volunteered in the Caribbean before, specifically in Trinidad, nothing could prepare me for what I was going to experience in Haiti. I’ve heard that it is the poorest country in the western hemisphere but it’s hard to put a picture to the description unless you experience it first hand.
Upon arriving in the streets of Thomonde, I could only see the need for adequate health care. After our first orientation, I learned about the community health program which is complex and integrated. Although started by Project Medishare, the organization took a grass-root approach and extended its services by using well respected, local volunteers to be community health agents who educate the community on health issues and disease prevention.
At first I didn’t understand the significance of this approach until we volunteered at our first rally post. We traveled into a remote village where mothers brought their babies to be weighed. They continuously track their growth to make sure they are not malnourished. We also provided vaccinations. While we weighed the babies, the community health agent spoke about how to prevent getting worms by improving hygiene and cooking techniques. This may seem like a typical volunteer event, however; one must travel to these locations to truly realize the lack of resources. There is no constant supply of water, and the water they do have is often contaminated which contributes to high rates of diarrhea and malaria. There are many children with scabies because there is no boiling water for mothers to wash their clothes. Many of the children have discoloration and patches of hair missing which common signs of malnutrition. There are no diapers, baby formula, cleaning supplies, and no nearby hospital. Haiti is filled with these remote villages that often do not have access to these resources. That’s when I realized how thoroughly planned and organized Project Medishare’s community outreach program is.
In a matter of four days, I’ve learned how important and how successful health care can be if it is integrated into the community at its start. This means establishing trust between the health care educator and the community. The surrounding community needs get involved by providing space or additional resources. Also, it is necessary to make sure that services are continuous. I was very impressed when I was informed that the community health agent will know who didn’t show up to the rally post and the next day will do door-to-door visits to ensure all the babies in the local area are vaccinated. I also realized that the only way to control a problem is by addressing it as early in the cycle as possible. The community health program greatly increased the number of vaccinated children by focusing on babies 0-11 months. It was repeatedly stressed that all children in the area are fully vaccinated before reaching 12 months. These efforts were proven with the numerous and continuous rally posts that are held in these remote villages. The root to the problem was identified and all measures were taken, in many directions, fully integrating the people who are most effected.
The Haitian culture has taught me all these concepts that will positively contribute to any future health care endeavors. Again, trust is key. If you don’t trust your provider, then you are wasting resources. It is amazing to me that the village chooses who they believe is most respectable and admired and then the nominee serves as the community health agent. This gives the community a sense of control and accomplishment.
Much time and effort needs to go in to planning a health program. All needy areas must be reached using adequate resources. Those who don’t have money or transportation Project Medishare makes sure they are still accounted for by providing free vaccinations and doing home visits. By identifying the primary problem, investigated and fully addressing it at the start before it further develops ensures the health care is culturally sensitive with the patients. This is the only way to assure compliance and switch from restorative to preventative health care. I will implement this ideal with all my future patients, whether they’re in Miami, Haiti, or anywhere around the world.