Sustainable surgical resource initiative for Haiti: the SSRI-Haiti project

• Published in: Global health action Vol. 16; no. 1; p. 2180867
• Main Authors: Frechette, Richard, Colas, Nathalie, Augustin, Marc, Edema, Nathalie, Pyram, Gerson, Louis, Stanley, Crevecoeur, Carl Eric, Mathurin, Carmeline, Louigne, Raphael, Patel, Bhavesh, Humphreys, Mitchell, Chapital, Alyssa, Martin, Mallory, Ayoub, Qamarissa, Hottinger, Daniel, McCurdy, Michael T., Tran, Quincy, Skupski, Richard, Zimmer, Donald, Walsh, Mark
• Format: Journal Article
• Language: English
• Published: United States Taylor & Francis 31.12.2023; Taylor & Francis Ltd; Taylor & Francis Group
• Subjects: Cholera; Earthquakes; Epidemics; Experiential learning; general anesthesia; Global health; global surgical training; Haiti; Health facilities; Hospitals; Humans; Intensive care; medical missions; Medical personnel; Resource-Limited Settings; Seismic activity; Serotonin reuptake inhibitors; Staffing; Surgeons; Surgery; Surgical procedures; Surgicenters - organization & administration; Sustainability; Waterborne diseases; Haiti; Haiti; global surgical training; medical missions; Surgical procedures; general anesthesia
• ISSN: 1654-9716; 1654-9880
• DOI: 10.1080/16549716.2023.2180867

In response to the 2010 earthquake and subsequent cholera epidemic, St Luke's Medical Center was established in Port-au-Prince, Haiti. Here, we describe its inception and evolution to include an intensive care unit and two operating rooms, as well as the staffing, training and experiential learning activities, which helped St Luke's become a sustainable surgical resource. We describe a three-phase model for establishing a sustainable surgical centre in Haiti (build facility and acquire equipment; train staff and perform surgeries; provide continued education and expansion including regular specialist trips) and we report a progressive increase in the number and complexity of cases performed by all-Haitian staff from 2012 to 2022. The results are generalised in the context of the 'delay framework' to global health along with a discussion of the application of this three-phase model to resource-limited environments. We conclude with a brief description of the formation of a remote surgical centre in Port-Salut, an unforeseen benefit of local competence and independence. Establishing sustainable and collaborative surgery centres operated by local staff accelerates the ability of resource-limited countries to meet high surgical burdens.