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Striving for Equity in Surgical, Anesthesia, and Obstetric Research in Haiti: A Multi-Partner, International Research Training Collaboration
Poster Title: Striving for Equity in Surgical, Anesthesia, and Obstetric Research in Haiti: A Multi-Partner, International Research Training Collaboration
Submitted on 09 Nov 2019
Author(s): Dr. Jean Alouidor*, Dr. Frédéric Barau Déjean*, Dr. Louis-Franck Télémaque, Dr. Ronald Eveillard, Dr. Laëlle Mangurat, Dr. Isaac Martineau, Dr. Chartelin Jean Isaac, Dr. Darlène Rochelin Paultre, Carine Réveil Jean-Baptiste, Dr. Lucile Louis Riché, Dr. Jordan Pyda, Rolvix Patterson III, Dr. Blake Alkire, Dr. Eunice Dérivois-Mérisier (*Co-First Authors)
Affiliations: State University Hospital - Haiti (HUEH) / Continuing Medical Research and Education Unit (UMREP)
This poster was presented at Social Medicine Consortium Annual Conference 2019 :June 1, 2019 • Jaltenango de la Paz, Chiapas, Mexico
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Abstract: n low- and middle-income countries (LMICs), surgical, anesthesia, and obstetric (SAO) research capacity is often limited and thus performed in collaboration with high-income country (HIC) researchers. These partnerships are characterized by unequal agency due to disparities in funding, academic time, and training available to HIC researchers vis-à-vis LMIC colleagues. This asymmetry is apparent in myriad ways and results in projects where the clinical problems faced by local LMIC researchers are not prioritized, their contributions on collaborative projects are under-recognized, and reinforces the structural violence inherent in excluding LMIC clinical researchers from the published results of their own work, especially when pertinent to the care of their own populations.e Centre d’Information et de Formation en Administration de la Santé (CIFAS) of the Haitian Ministry of Health (MSPP), together with the Continuing Medical Research and Education Unit (UMREP), INFO-Chir medical journal, and Les Hôpitaux Universitaires d'Haïti (HUH), have partnered with Narayana Health (NH) in Bangalore, India to create an advanced SAO research training opportunity for Haitian clinicians. Facilitated by Harvard’s Department of Global Health and Social Medicine and Boston Children’s Hospital, this research equity collaborative supports the training of Haitian SAO physicians in clinical research methodology to advance equity in global health.

Three recently trained Haitian surgeons are participating in a three-month course designed to achieve competency in epidemiology, biostatistics, research design, and scientific writing. A concurrent global health equity module contextualizes research within the wider global health and social justice movements. Faculty from CIFAS/MSPP, UMREP, HUH, Narayana Health, and Harvard worked together to develop and implement this module-based curriculum prioritizing equitable research practices.

Our pedagogical approach is founded upon bi-directional accompaniment, team-based learning, communication, and humility to provide a comprehensive introductory research experience. Students develop and conduct a research study culminating in a manuscript submission to a peer-reviewed journal. Self-confidence and competency in research methods are evaluated by structured exams. Course content and faculty performance is evaluated via multiple anonymous surveys.

Our pilot effort has used Narayana Health’s clinical excellence and volume to provide an unparalleled research milieu in which the equity-oriented educational imperative of CIFAS/MSPP and UMREP can take root. Initial impressions include the novel clinical research opportunities of working in non-local resource-impoverished settings. Challenges include time-zone and language differences, and diverse didactic methods. Next, we will transform this international experience into sustained institutional accompaniment supporting the training efforts of CIFAS/MSPP, UMREP, and HUH in Haiti.
Summary: Striving for Equity in Surgical, Anesthesia, and Obstetric Research in Haiti:
A Multi-Partner, International Research Training Collaboration
References: 1. Hedt‐Gauthier BL, Riviello R, Nkurunziza T, Kateera F. Growing research in global surgery with an eye towards equity. BJS. 2019;106(2):e151–5.
2. Elobu AE, Kintu A, Galukande M, Kaggwa S, Mijjumbi C, Tindimwebwa J, et al. Evaluating international global health collaborations: Perspectives from surgery and anesthesia trainees in Uganda. Surgery. 2014 Apr;155(4):585–92.
3. Chattopadhyay S, Myser C, Moxham T, Vries RD. A Question of Social Justice: How Policies of Profit Negate Engagement of Developing World Bioethicists and Undermine Global Bioethics. Am J Bioeth. 2017 Oct 3;17(10):3–14.
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