Abstract: SA-PO923

Developing Partnerships to Advance Renal Care and Ameliorate “Brain-Drain” in Haiti

Session Information

  • Educational Research
    November 04, 2017 | Location: Hall H, Morial Convention Center
    Abstract Time: 10:00 AM - 10:00 AM

Category: Nephrology Education

  • 1301 Educational Research

Authors

  • Remillard, Brian D., Dartmouth Hitchcock Medical Center, Lebanon, New Hampshire, United States
  • Cleophat, Philip C., Hôpital Universitaire de Mirebalais, Mirebalais, Haiti
  • Brown, Robert S., Beth Israel Deaconess Medical Center, Boston, Massachusetts, United States
Background

Immediately following the earthquake in Haiti (Jan 2010), BR provided acute hemodialysis (HD) for several patients with acute kidney injury (AKI). This involved major support and equipment from the Dartmouth community and Partners in Health/Zanmi Lasante. Once the earthquake crisis ended, we recognized that it would require a concerted effort and multiple partnerships to bring ongoing renal care to Haiti. Furthermore, despite Haiti investing years of free training of health care professionals, over 80% leave the country creating a “brain-drain” due to lack of jobs, low pay, little ongoing medical education and few resources to provide adequate patient care.

Methods

Two academic institutions, DHMC and BIDMC, have established partnerships with Bridge of Life, Sustainable Care Kidney Foundation, Partners in Health and Zanmi Lasante and our new charity, TORCH, along with NxStage Medical, Inc, to initiate treatment of AKI with HD at HUM. We have effectively used teleconferencing between DHMC and HUM to provide education, biomedical support, train staff, and build relationships. We subsequently have developed a “mini” fellowship program inviting Haitian physicians and nurses to DHMC and BIDMC for short (2 week) training venues to provide specific skill development and ongoing mentoring.

Results

With the help of our partners, nurses and residents came from HUM to the USA for specific training in HD, central line placement, urinalysis, AKI diagnosis, echocardiography, and peritoneal dialysis treatment and complications. Teleconferencing has been used to provide ongoing contact and reinforce training. Since 2014, 41 patients with AKI have been treated with HD at HUM with 25 patients surviving.

Conclusion

The development of industry/academic/NGO partnerships was able to build a successful program for treating AKI. Long-term relationships with nurses and residents at HUM via teleconferencing and “mini” fellowships has advanced renal patient care, supported the physicians and nurses at HUM, and may provide a partial answer to the problem of “brain-drain” that impairs Haitian medical care.

Funding

  • Private Foundation Support