A cholera epidemic, one of the highest malnutrition and maternal mortality rates in Latin America and an ill-equipped health sector are not putting off a new generation of Haitian doctors born and trained in the Caribbean nation.
Dr Mariline Menager is one of 14 people selected from 238 who applied for a place on the medical residency programme at Haiti’s new Mirebalais University Hospital.
She belongs to a new crop of doctors hoping to fill the acute shortage of doctors in Haiti and take the lead in reviving a health sector still struggling to recover from the massive earthquake that flattened the capital Port-au-Prince in January 2010.
“I prefer to be in Haiti than anywhere else in the world. Haiti has more needs and we don’t have enough doctors to cover the health needs of the population,” Dr Menager, a first-year medical resident at the Mirebalais University Hospital, told Thomson Reuters Foundation in a telephone interview.
“We are rebuilding the country, and I can contribute to that. Part of rebuilding is the construction of a health system. Haiti is a country that needs to rebuild in every sense of the word, in terms of education, health,” said Dr Menager from the Mirebalais University Hospital, 30 miles (50 km) north of Port-au-Prince.
With few resources, career options and low salaries, Haiti grapples to attract and retain doctors in its public hospitals. Around 80 percent of all doctors trained in Haiti leave within five years of graduation to practice abroad, often in the United States and Canada, in search of better pay and working conditions and career development opportunities, according to the Boston-based medical charity Partners in Health (PIH).
A survey conducted by PIH on Haitian residency programmes found that 55 percent of residents don’t have Internet access at the hospitals where they work. And most of those doctors who stay in Haiti end up working in Port-au-Prince in private clinics.
Dr Menager, 29, is bucking the trend and doing her bit to reverse Haiti’s brain drain. She and other medical residents at the Mirebalais teaching hospital receive specialised training in pediatrics, internal medicine, and general surgery from Haitian and foreign doctors.
In Haiti, there are only 0.25 doctors for every 1,000 Haitians, while in neighbouring Dominican Republic there are 1.88 doctors per 1,000 people.
The acute shortage of skilled and specialised nurses and doctors in Haiti means the country struggles to deliver even basic healthcare to its population of 10 million.
“In Haiti there’s a lack of nurses and doctors in rural areas and a problem of access to healthcare for people living in rural and remote areas,” said Dr Menager, an internist, who has three years left to complete her residency.
“Haiti also has the problem of infectious diseases, such as HIV/AIDS and tuberculosis, and high levels of maternal mortality.”
The 300-bed teaching hospital, with more than 30 outpatient consulting rooms, and six operating rooms, is a joint project involving PIH and its sister group, Zanmi Lasante, with a $5.5 million donation from the American Red Cross and other NGOs and private donors.
The hospital opened in March and is billed as the biggest reconstruction project in Haiti’s health sector since the January 2010 earthquake, which damaged or destroyed many hospitals, three universities, the country’s main nursing school and midwifery school.
Mirebalais University Hospital aims to provide healthcare to around 185,000 people in the town of Mirebalais and two nearby communities, and offer HIV/AIDS care, prenatal and emergency obstetric care, treatment for malnutrition, vaccines and family planning services, while providing jobs for around 1,000 people. The hospital also serves as a site for clinical rotations for Haiti’s national nursing schools.
It’s also billed as the largest hospital in the world to be powered by solar energy. On most sunny days, its 1,800 solar panels generate more electricity than the hospital needs, allowing the surplus energy to be fed back into the electricity grid. On the roof, reflective white coating keeps the building cooler and makes the solar panels up to 15 percent more efficient, PIH says.
For many, Mirebalais University Hospital represents one of the most tangible improvements since the earthquake, where reconstruction efforts are being led by Haitians.
“The hospital and the training we get there is about Haitians helping their own people, the most vulnerable, and giving them the best care possible and better quality of life,” said Dr Menager.