People were sleeping outside the Haiti hospital — on the ground.
“Why are they sleeping outside?” Antoinette Hays, RN, PhD, asked her hosts at Clinique Bon Saveur in Cange, Haiti.
They replied that the campers were patients who had traveled at least a day by foot or vehicle on Haiti’s broken roads for their next day’s appointment. The staff would see them in the morning, and then the patients would travel at least another day home.
“I left Haiti completely changed,” said Hays, dean of Regis College School of Nursing and Health Professions in Weston, Mass. On her visit to Haiti in 2007, Hays met with the Ministry of Health and deans of Haiti’s schools of nursing to begin creating a master’s program for Haitian nursing faculty.
Hays describes Haiti as a forgotten country. It is one of the poorest nations in the world with the worst healthcare indicators. The per capita income is less than $600 a year, and one out of eight children die before age 5, according to the U.S. Agency for International Development. Only $2 a person is spent on healthcare annually, reports Partners In Health.
Regis is collaborating with PIH, an international charity organization headquartered in Boston. Along with its sister organization in Haiti, Zanmi Lasante, and the Haitian Ministry of Health, PIH builds and staffs clinics and hospitals in Haiti, Lesotho, Malawi, Peru, Russia, Rwanda, and the United States. PIH’s motto: “Whatever it takes.”
The collaboration between Regis and PIH began when Regis awarded an honorary degree to Ophelia Dahl, PIH co-founder and executive director. “As far as I’m concerned, Dahl is a living saint, and Dr. Paul Farmer (PIH co-founder and executive vice president) is the male version of Mother Teresa,” Hays says. “I was so inspired by their work that I asked Ophelia how Regis could help their mission.”
Hays’ offer caught the attention of PIH because it was a request to serve, not improve her college’s profile, says Donna Barry, NP, MPH, PIH policy and advocacy director.
“The goal of this collaboration is to improve nursing care in Haiti,” Barry says. “Over the last 20 years, we have made huge gains in medical care and medical education at our sites. Now we must emphasize the role nurses and nursing education plays in every context of care.”
Creating Master’s-Prepared Faculty
It will take time to raise the nursing standard of care to that of a first-world country, Barry says, but one road to progress is raising the level of education of Haiti’s nursing faculty, many of whom have only an associate’s degree or diploma.
Regis will provide free teaching and curriculum materials for 12 Haitian nurses to receive a master’s degree in nursing leadership and education, beginning in January 2009, in coordination with the University of Port-au-Prince, which will issue the degree.
The students will use curriculum from Regis’ Upward Mobility Program, which takes nurses from an associate’s degree or diploma certificate to a master’s degree in three years. The Haitian nurses will travel to Regis to receive orientation and to take the first two courses; then they will continue the program via online distance learning. In addition, Regis nursing faculty and doctoral students will travel to Haiti three times a year to teach intensive classes. The Haitian nurses will return to Regis in the summer for classes and residency at Boston-area hospitals.
PIH/ZL and Regis piloted the exchange program in May when four Haitian perioperative nurses left their families and jobs at PIH/ZL Ministry of Health clinics in rural Haiti for six weeks to expand their perioperative skills.
PIH paid for translation, course materials, travel, and food, while Regis offered its Introduction to Perioperative Nursing summer course gratis. The Haitian nurses lived in the Regis dorms and shadowed OR nurses at Boston Medical Center, which employs a high number of Haitian-American nurses.
Barry says the perioperative nurses returned to Haiti with exposure to, and experience with, technologies and OR nursing processes and specialties they had only read about in books. “They are much better prepared to organize an OR and practice more efficiently,” Barry says. “The success of the pilot is a good sign for the future of academic collaboration to bring much-needed resources to Haiti.”
The Road Ahead
One challenge is finding perioperative textbooks in French. Most of the Haitian nurses can read and understand basic English but it is not their first language, nor do they speak it well.
“Can you imagine taking an intensive six-week course in another language, in another country, and passing? They are so eager and so hard-working,” Hays says.
It was still chilly in the spring when the Haitian nurses arrived in Boston. Their first stop was the Regis bookstore, where Hays bought them sweatshirts. Hays, whom the Haitian nurses call “Mom,” already is collecting coats, hats, and gloves for the Haitian nurses who arrive this winter.
Winter clothing is the least of Hay’s fundraising efforts. She estimates Regis’ costs to provide master’s degrees to the 12 Haitian nursing faculty will be about $100,000 per year, primarily for textbook translation and travel expenses for Regis faculty, who have offered to teach unpaid while in Haiti. PIH and ZL will host the Regis faculty in Haiti.
Seed money from the Virginia Pyne Kaneb Faculty Scholars Grant is helping Regis kick-start the master’s program for Haitian nurse faculty, and an anonymous company donated laptop computers for Regis faculty in Haiti.
“I have no anxiety about this anymore,” Hays says. “We know this is the right thing to do, and the money will come.”