Maternal and Child Survival Program
The Maternal and Child Survival Program is a global U.S. Agency for International Development (USAID) cooperative agreement to introduce and support high-impact health interventions in 24 priority countries with the ultimate goal of ending preventable maternal and child deaths (EPMCD) within a generation. The Maternal and Child Survival Program engages governments, policymakers, private sector leaders, health care providers, civil society, faith-based organizations and communities in adopting and accelerating proven approaches to address the major causes of maternal, newborn and child mortality such as postpartum hemorrhage, birth asphyxia and diarrhea, respectively, and improve the quality of health services from household to hospital. The Program will tackle these issues through approaches that also focus on health systems strengthening, household and community mobilization, gender integration and eHealth, among others.
Global Health Mentor: Bethany Arnold, Program Officer at Jhpiego
As I descended into Port-au-Prince I was filled with excitement and nervousness. From above, the scene was filled with mountains beyond mountains surrounded by ocean. The drive from the airport wound through the streets of the capital city, along unpaved roads, through back alleys, all lined with street vendors and filled with students piling out from afternoon classes. As we approached my soon-to-be neighborhood, the mountains rose in front of us, the mountain faces an image of thousands of tiny cement houses built one upon the other, forming some of the city’s largest slums. This would be the sight from my balcony for the next six months.
While in Haiti I was working with the NGO Jhpiego, on the Maternal and Child Survival Program. Specifically, I was supporting the model referral networks project. The idea of this project is to reinforce the communication, transportation and clinical systems to decrease the delay in emergencies. This is especially important during obstetrical emergencies as a woman hemorrhaging after childbirth can die within 2 hours. My role was to do an in-depth study of each of our three sites to better understand the current referral pathways along with their strengths and weaknesses. This entailed visiting each health facility within our three model referral network sites and interviewing the staff. In addition, I was tasked with the development of a mapping tool that could be placed in each health facility serving as a visual aid when making referral decisions. To accomplish this I took GPS points at each of the facilities and used GIS software to design the maps.
The work was very fascinating and allowed me to be in the field quite a bit. This afforded me the opportunity to see a great deal of the country and chat with locals across the provinces about their health care concerns. There were however a number of challenges as well. Since the 2010 earthquake, Haiti has been inundated with humanitarian and development organizations. Despite these efforts, the country is still facing difficulties across many sectors including health care, agriculture, education, government and general infrastructure. With the involvement of many organizations across all these fields I quickly learned the value of working effectively with partners and stakeholders. At times it was also very frustrating, feeling as though any work we did in the health sector was impeded by the lack of functionality in other sectors. As such, this experience highlighted for me the critical need for global health interventions to be more cross-disciplinary, with creative and integrated solutions to address the issues of today.
On a more personal note, I learned that work alone would not be enough to sustain me so I kept up with my yoga and ukulele playing but I also joined a Haitian Folklore Dance Troupe. Led by our two talented instructors, Réginald and Ricardo, we learned traditional Haitian choreographies to the beat of live drums. While I first thought the benefits of joining would mainly be for the physical activity, it soon became clear to me that this was a unique window through which to learn about the culture in a more intimate way, a vibrant culture of resilience and passion that I have come to love. It is also through this group that I made my closest friends in Haiti.
Throughout this entire experience I have had the opportunity to reassess my future in global health. It has confirmed my desire to work in the field of international maternal and newborn health as I continue to feel passionate about the subject however I now realize that I would like to diversify my skills so that I may help develop interdisciplinary solutions. In addition, this placement highlighted my love for direct interaction with the local population so I must find a role that allows me to do this extensively. Overall, the experience has been an incredible opportunity through which I have gained valuable career skills and learned more about my desired career path and myself.
Two auxiliary nurses I interviewed at Dispensaire Savane au Lait:
The community referral hospital St. Michel de l'Attalaye and their ambulance:
At the end of several days in the field we visited a local attraction, the ruins of King Christophe's palace (Palais Sans-Souci):
A photo taken at one of our Haitian Folklore dance performances:
The Model Referral Network team and I with a nurse who we interviewed at the Fonds Baptiste health center: