Title: Community first responder training

Date: November 9th-12th, 2021

Location: DEP, Pacot, Port au Prince

More training sessions will be announced soon...

Event: Community first responder training for university students and staff

Location: Port au Prince, Haiti

Date of Training: 10/14/21-10/15/21

The power of our philosophy at work. Because of the pandemic, our US based volunteers have not been able to make it to Haiti. Some of lhe local healthcare providers trained by us, under the supervision of our local coordinator have put together a community first responder training for university students and staff. The next training will take place in November.

Centre Médical Béraca de Lapointe, Hopital Immaculée Conception de Port de Paix

Training Trip: January 21-24, 2020

Post Visit Summary

Primary Care Haiti Team Members:

• Kissinger Goldman, DO.MBA - ER Physician, Co-Founder, Chief Strategist
• Jennifer Goldman, DO.MBA - Family Physician, Co-Founder
• Evelyne Moise, MD.MBA - Internal Medicine Physician, In-Haiti Coordinator
• Claudy Lemene, MD, Internist, In-Haiti Coordinator
• Christ-Ann Magloire, MD - OB/GYN
• Catherine Voltaire - Ultrasound Course Director
• Francesca Onyejuruwa, Nurse, RN, NRP Instructor
• Margalie Mathurin, Nurse, RN
• Jonathan Munoz, Medical Scribe
• Lucas Delicio,Medical Scribe
• Dilraj Cambow, Medical Scribe
• Sindala Martinez - Medical Scribe
• Philip Villar - Medical Scribe
• Rodrigue Junior Joanes - Photographer

Courses Taught:

Adult Emergency Courses:

• Triage training
• Arrhythmia recognition
• Mass casualty event management
• Basic life support (BLS)
• Advanced cardiac life support (ACLS)
• Choking management

Pediatric Emergency Courses (PALS):

• Pediatric airway management
• Pediatric cardiac arrest management
• Pediatric arrhythmias diagnosis and treatments
• Pediatric cardiac medicines
• Choking management

Neonatal Intensive Care Unit (NICU)

• Nursing care in the NICU
• Nursing documentation
• Neonatal Intensive Care Unit (NICU) medical equipment utilization
• Neonatal Resuscitation Program (NRP)

Gynecology

• Cervical cancer screening training in visualization and inspection with acetic acid (VIA) and Lugol’s iodine solution (VILI)
• Mobile colposcopy training
• Mobile thermocoagulation training to treat Cervical Intraepithelial Neoplasia (CIN), all classifications (1-3)
• Mobile colposcope and thermocoagulator donated to Centre Médical de Béraca to build cervical cancer screen and treatment program in northwest Haiti

Courses Taught (cont’d):

Ultrasound

• Machine basics and maintenance
• Obstetrics 1st, 2nd and 3rd trimester
• Focused assessment with sonography in trauma (FAST)
• Abdomen (liver, pancreas, gallbladder, aorta)
• Upper and lower extremities venous
• Hysterosonography
• Pelvic/transabdominal

Train-the-trainer

• How to effectively transfer what you have learned to others

Patients Treated (by our students, under trainer supervision):

• 150 colposcopies
• Fourteen patients had positive test results
  • Five patients received treatment for cervical cancer (thermocoagulation) Eleven patients scheduled a cervical biopsy with gynecologist

Donations (with contractual agreement):

• Hopital Immaculée Conception de Port de Paix
  • 1 ultrasound machine
  • 1 adult and 1 pediatric EMS training mannequin
  • 2 backboards
  • ancillary gynecological medical supplies (speculums, gel, gloves, cotton swabs)
• Centre Médical Béraca
  • 1 ultrasound machine 1 Thermocoagulator 1 Mobile ODT Colposcope 2 backboards were donated
  • 1 adult and 1 pediatric EMS training mannequin More items were donated and are listed on document: Attachment 1

Attendees:

• Total number of attendees: 378
• Attendees came from more than 11 different Regions of Haiti, including Port au Prince, Cayes, Mole St Nicholas, Bassin Bleu, Jean Rabel, Bombardopolis, La Pointe, Saint Ange Sonia, Port de Paix, and Iles de La Tortue
• Number of attendees in each course taught:
  • EMS Courses (ACLS, BLS, PALS): 77 Physicians, Nurses
  • Cervical Cancer: 21 Physicians and Midwives
  • Ultrasound Course: 14 Physicians and Midwives
  • NRP Hands on Training: 18 Nurses
  • CPR for Nursing Students: 248 Nursing Students

BLS, ACLS and PALS Follow up:

• Conduct adult and pediatric ‘mock’ codes monthly
  • Keep attendance and save attendance sheets in central location.
  • Keep a log next to all equipment. Document the date that all equipment is checked and tested.
  • Initiate allergy bracelet protocol (sample shared).
  • Create a code sheet to be using during resuscitations (sample shared).

Cervical Cancer Screening and Treatment Protocol:

Taught 21 physicians, nurses, and midwives in screen and treat protocols to diagnose and treat cervical precancerous lesions. Followed the World Health Organization’s International Agency for Research on Cancer’s training protocol. Trained nurses and midwives on Visual Inspection with Acetic Acid (VIA) and Visual Inspection with Lugol’s Iodine (VILI) to diagnose cervical precancerous lesions at the point of care. Trained physicians on mobile colposcopy to further differentiate precancerous lesions as well as on the use of thermocoagulation to treat precancerous lesions. Note: Since the mobile colposcope and thermocoagulator are both battery-powered, they can be used in mobile clinics and in very rural areas even without electricity.

The physicians, nurses, and midwives saw a total of 150 patients. Of these, 14 cases screened positive for precancerous lesions. Five were treated with thermocoagulation and the rest were biopsied for further cytological information.

Centre Médical de Béraca in Lapointe and Hopital Immaculée Conception in Port de Paix have both pledged to begin a cervical cancer screening program run by nurses and midwives every Friday, with positive cases to be sent to physicians for colposcopy and treatment as indicated. The mobile colposcope and thermocoagulator were donated to Centre Médical de Béraca to support this screening program. The hospital signed a contract agreeing to provide data on the number of women screened per month, the number who screened positive, the number of women treated with thermocoagulation, and the number of women sent for biopsy and treated with other modalities.

Future Plans & Training Sessions

• For Hopital Immaculée Conception and Centre Médical Béraca
  • We have left our training equipment in Haiti, as described above in “Donations.”
  • We will return to Hopital Immaculée Conception de Port de Paix and Centre Médical Béraca in June 2020.
  • We will donate an ultrasound machine one other hospitals in the south: Port Salut.
  • We will donate another ultrasound machine to Centre Médical Béraca.
  • We will donate another ultrasound machine to Hopital Immaculée Conception de Port de Paix.
• Generally, for PCH operations
  • We would like to establish a paid monitoring staff in Haiti to help plan future trainings and ensure sustainability of past trainings.
  • We will be purchasing a bus that will remain in Haiti to help in country transportation.
  • We will be purchasing more thermocoagultors and mobile colposcopes to continue our commitment to our (contractual) donation program.
  • We will be purchasing more training mannequins and ancillary training equipment.
  • We will be purchasing two more projectors.
  • We will be purchasing a portable/mobile ultrasound device.

Volunteer Feedback and Testimonials

"Good morning everyone. I want to share how fortunate I feel for being part of this incredible team, this last trip. This experience has humbled my character and shown me the real power of knowledge. The Haitian culture is something I had never experienced before and I am blessed to have joined them these last few days. I will never forget those smiles and their gratitude. A new passion has awakened in me and I can’t wait to do more in the future. I want to personally thank everyone who made this mission possible. Outside the program, this team shared laughs and joy. It was nice hearing the word “sacrifice” in the moments of appreciation by the Haitian physicians/nurses/EMTs but in reality I feel they are the real heroes for choosing to learn more and share later on. I want to thank the memorial team for sharing your years of expertise and guiding the CPR team in some instances. The teamwork was phenomenal!"

"No words to describe the Goldmans, they are real role models and I can’t wait to continue learning from them!"

"Dr. Moise’s leadership is indescribable and I am very thankful to have been part of her team."

"I am very great full for this opportunity and you all deserve a huge round of applause. God bless you all! - Lucas Delicio, Medical Scribe"

"Good morning PCH. I finally have a moment since we’ve returned to talk about our time in Port-De-Paix last week. I could not have asked for a more incredible and rewarding experience with such a dedicated and hard working group of health care professionals. As I said on the first night, you all inspire me to be a better future physician. I hope I can one day continue this work as a physician alongside you all and do more for the people of Haiti. The incredible organization of this trip made it easy to arrive and perform our duties seamlessly. My peers and I had an amazing time teaching BLS to eager students who will be sure to utilize and spread what they learned. I hope I am able to participate in future trips and will do my best to spread the word about the amazing work PCH does. Lastly, it was a privilege to learn about Haitian culture, experience amazing food, and meet everyone who keeps PCH moving forward. Thank you all! - Jonathan Munoz, Medical Scribe "

Participant Feedback and Testimonials

"I have the honor to participate in your training on emergency care which was held within the Béraca Lapointe Medical Center. Sincerely this training allowed me to consolidate my knowledge and increase my passion for this noble profession. I thank your enriching contribution in the beginning of my professional career, a thank you to all the team especially to Dr. Goldman for his professionalism and his method of transmission of his knowledge. It was very profitable for me and goes to help me to excel throughout my career.I want to inform that primary care Haiti has a place in my heart., with all my gratitude, receive my best regards - Joseph Mewaldin, MD (Port de Paix, Haiti)"

"I have just participated in a high level training with Primary Care Haiti. Words fail me to thank the team of trainers for the sacrifices made, leave their job, their family and come to the North West / Haiti to share their knowledge with us. We will give better quality services to our community, so we will replicate these training courses to have a critical mass of people trained in these fields. Thank you PCH, we are waiting for you for other modules - Dr. Andremene Vilton from Béraca"

Primary Care Haiti’s Impact: Post-Training Successes

The photos below show a follow up BLS Training at Centre Medical Beraca, La Pointe. This course was taught by PCH-trained healthcare providers immediately following our departure in January 2020. They trained an additional 42 healthcare providers using PCH-donated mannequins. PCH will receive a full training report.

Another phenomenal Primary Care Haiti training trip to Haiti! We worked at L’Hospital Immaculee Conception in Les Cayes in the South of Haiti.

Training Mission Highlights

• Emergency Care Course
• Ultrasound Course
• Cervical Cancer Diagnosis and Treatment screening using the WHO recommended “see and treat” method (thanks to the colposcope from MobileODT)
• Pharmacy Course
• IT Training
  • Adult and pediatric neonatal resuscitation techniques

Training Sessions Summary

• Triage
• BLS (Basic Life Support)
• ACLS (Advanced Cardiac Life Support)
• PALS (Pediatric Advanced Life Support)
• Mass Casualty Management

• Obstetrics & Gynecology
• Echocardiography
• Abdomen (Gallbladder, pancreas, Liver, Kidneys, Aorta, Spleen)
• Thyroid
• Upper Extremity Venous and Arterial
• Lower Extremity Venous and Arterial

• More than 290 Haitian physicians, nurses, midwives, and nursing students from 7 regions of Haiti!
• Extra training provided to representative from HAS who would be in charge of training other healthcare providers who were not present at our training sessions

• More than 500 patients screened for cervical cancer
• 3 diagnostic ultrasounds performed
• Thermocoagulation performed on patients who screened positive for cervical cancer

This trip was dedicated to the memory of Dr Michaele Gedeon, former Minister of Health of Haiti, who dedicated her life to improving health care in Haiti. One of Dr Gedeon’s goals was to expand the work of Primary Care Haiti to the south of the country and to train more health care providers in emergency response. We are proud to have accomplished her goal and we look forward to continuing our training trips in the future. www.primarycarehaiti.com

Training Mission Highlights

• Emergency Care Course
• Ultrasound Course
• Cervical Cancer Diagnosis and Treatment
• Pharmacy Course
• IT Training

Training Sessions Summary

• Triage
• BLS (Basic Life Support)
• ACLS (Advanced Cardiac Life Support)
• PALS (Pediatric Advanced Life Support)
• Mass Casualty Management

• Obstetrics & Gynecology
• Echocardiography
• Abdomen (Gallbladder, pancreas, Liver, Kidneys, Aorta, Spleen)
• Thyroid
• Upper Extremity Venous and Arterial
• Lower Extremity Venous and Arterial

• Mobile Colposcope use & training
• Thermocoagulation training
• Over 500 women screened for cervical cancer

• Common side effects from commonly used antibiotics in Haiti
• Importance of dispensing and timing of medications
• Medications used in the management of diabetes
• Medications used in the management of hypertension

• Trained the IT staff on proper computer network configuration and presented them with certification certificates
• Complete rewire of the internal network
• Removed all existing network cat5 cable replaced with cat6 weatherproof cable
• Installed network switches and designated zones throughout the campus
• Set up workstations in the library and connected to fiber optic internet and shared internal network
• Installed hard wired networked routers in the conference room and dorm
• Connected all printers throughout the campus to a central network share
• Installed network cable in the new Church building

• More than 60 healthcare providers from various regions of Haiti
• Nurses, Doctors and Ancillary staff
• Extra training provided to representative from HAS who would be in charge of training other healthcare providers who were not present at our training sessions

• More than 500 patients screened for cervical cancer
• 3 diagnostic ultrasounds performed
• Thermocoagulation performed on patients who screened positive for cervical cancer

Training Mission Highlights

• Ultrasound training
• IV training
• EKG training
• Mobile colposcopy training and implementation of one visit cervical cancer screening, diagnosis, and treatment

Training Session Summary

• BLS
• ACLS
• IV Access using Ultrasound
• Management of shock

• PALS
• Foreign Body removal
• Management of shock

• Nursing care in the NICU
• Nursing Documentation
• NICU Medical Equipment utilization

• OB Ultrasound course
• Mobile Colposcopy use with acetic acid and lugol’s solution to screen for cervical cancer
• Mobile thermocoagulation to treat CIN 1-3

• IT staff training
• IT infrastructure setup and update
• Internet optimization
• New AV system set setup
• Wireless network optimization

• 60 colposcopies
• 25 OB Ultrasounds
• 2 C-Sections
• 1 vaginal Delivery
• Thermocoagulation treatment of cervical cancer: 10

• 50 Nurses
• 20 Doctors
• From 7 different regions of Haiti

Training Mission Highlights

• ACLS (Advanced Cardiac life support) training for nurses and doctors
• BLS (Basic Life Support) training for nurses and doctors
• Cervical cancer screening training for nurses and doctors (including pap smear and mobile colposcopy training)
• Over 600 patients treated
• Thousands of dollars worth equipment shipped and donated
• Electronic Medical Record setup and training, made possible thanks to donated computers
• Training provided in all aspects of patient triage, taking vital signs, and keeping accurate medical records
• Community education training on breast cancer and cervical cancer

•   ACLS Training by Emergency Physician Kissinger Goldman, Pignon, Haiti: 6, 2017
•   BLS Training by BLS Instructor Reggie, Pignon, Haiti: 6, 2017
•   Pap Smear Training by Dr Jennifer Goldman, Pignon, 6, 2017
•   Medical Training Sessions in Hopital Bienfaisance Pignon, Haiti
•   Nurses in Pignon discussing what they learned about intubation

Training Mission Highlights

• 900 patients seen
• Cervical cancer screening training for nurses and doctors
• Training provided in all aspects of patient triage, taking vital signs, and keeping accurate medical records
• Basic Life Support Training for nurses and doctors

Training Mission Highlights

• 900 patients seen
• Cervical cancer screening training for nurses and doctors
• Training provided in all aspects of patient triage, taking vital signs, and keeping accurate medical records

Education

Training Mission Highlights

• Lack of access to quality education is a known social determinant of health. This is why Primary Care Haiti commits to improving the school systems in the areas we serve. We accept donations of new or gently used school supplies, including pencils, crayons, notebooks, soccer balls, basketballs, hula hoops, art supplies etc. For more information on how you can help, please contact our education coordinator, Sandra Mahoney, at education@primarycarehaiti.com.