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Sharing Life Saving Knowledge via Tele-Education

A lot can be learned from Haiti, as well. They’ve been able to do incredible things with very few resources and that’s something that we need to integrate more into our health care system.

Brian Remillard, M.D.
Photo: Nephrologist Brian Remillard, MD, gives a virtual lecture via the Haiti Medical Education Project.

It’s akin to distance learning, or medical grand rounds. The new vision for medical education in Haiti involves videoconferencing. Doctors at Dartmouth-Hitchcock (D-H) entered the picture early and remain committed. Born out of crisis, the education program for displaced medical students has since evolved into a virtual community with multiple partners. And, it’s not a one-sided equation. What we learn in Haiti, say D-H physician educators, will help us with what we’re doing here.


Narrator: In the 2010 earthquake that rocked Haiti–all but one of the island nation’s medical schools were destroyed. But, even before the disaster, Haiti faced an acute shortage of trained medical personnel.

Brian Remillard, MD/ D-H section chief of Hypertension & Nephrology: It’s pretty sobering when you see the problems that clinicians face in Haiti every day.

Narrator: Along with triage in the days following the quake, nephrologist Brian Remillard, MD, spent time mentoring medical residents in Haiti’s field hospitals.

Dr. Brian Remillard: They have this intense interest in medicine and I was just a teacher for them. I wanted to continue that link when I came back.

Narrator: The need to help train and retain physicians in Haiti, where they’re desperately needed, led to the creation of the Haiti Medical Education Project.

Galit Sacajiu, MD, MPH / medical director, Haiti Medical Education Project: When you teach medicine it’s teaching the knowledge, but also teaching the profession.

Narrator: Launched in 2010, the weekly tele-education program is a virtual lecture hall with an international team of medical experts, including Remillard, sharing their knowledge.

Dr. Brian Remillard: The French, well my father was one of seventeen children from a big Quebec family.

Dr. Galit Sacajiu: The fact that he is fluent in French is very essential for this program because all the lectures are given in French or we have a direct translation right on the spot.

Dr. Brian Remillard: I’ve had to translate. It may not be perfect, but I think it works.

Narrator: Thanks to donated software, Haitian medical students and physicians are able to connect via iPads and portable devices–even in rural areas with limited connectivity.

Dr. Brian Remillard: We were able to use software called ‘Vidyo’ and to leverage that into video conferencing within the country and basically across the world.

Narrator: Rather than traveling to Haiti for two weeks for a ‘limited engagement,’ the technology allows Remillard’s team to be permanent consultants; permanent colleagues.

Dr Brian Remillard: Philip, I’d like to present Miriam Dowling.

Narrator: Dowling will be working with nurses at the just completed 300-bed hospital in Mirebalais – a modern, state-of-the-art facility which accommodates high-speed internet lectures.

Miriam Dowling, MS, AGNP-C, CCRN/D-H clinical specialist: They really want to start a critical care unit at this hospital in Mirebalais. They have the opportunity to create an entirely new institution after the earthquake.

Narrator: To help nurse and physician teams deal with complications of chronic renal failure, Dowling and Dr. Remillard will also be providing some on-the-ground training.

Dr. Brian Remillard: I left a dialysis machine there after the earthquake and we’ve been able to get that machine to Mirebalais. We’ve been able to show that it’s still functional. I was able to get supplies from the NxStage company for at least a few months of dialysis and catheters; all the infrastructure we need to do acute dialysis.

Miriam Dowling: So, what we’re going to do in Haiti is an interesting hybrid of outpatient dialysis and acute inpatient dialysis.

Narrator: The goal is to eventually facilitate kidney transplants in Haiti, what surgeons describe as life-saving as well as cost-saving procedures.

David Axelrod, MD/D-H section chief, Transplantation Surgery: From a surgical standpoint it’s something we could certainly pull off. It’s been done in various third world environments. In global health, the real challenge is not to jump in--do a few procedures and jump out, but to really build an infrastructure within the host country that allows the procedures to go on into the future.

Dr. Brian Remillard: I’ve spent a tremendous amount of time on the phone with non-profit organizations trying to get support for dialysis supplies and equipment. Of course, that’s a temporary fix.

Narrator: Money is always a hurdle. The biggest challenge is how to make all this sustainable to ensure that the next generation of Haitian doctors are trained and ready to care for their own and in the end….

Dr. Brian Remillard: Create an environment that gives them hope they can move into the future.

Dr. Remillard, who has worked extensively with the Haiti Medical Education (HME) project and their educational initiatives, is now the chair of the HME Advisory Board. His efforts to provide renal failure/dialysis and transplants at Hopital Universitaire de Mirebalais recently received a $10,000 grant from the Haiti Relief Fund.

To learn more about the Haiti Medical Education Project, click here.

In the words of the late Nelson Mandela: “Education is the most powerful weapon which you can use to change the world.”