These last four months regarding the public health program were busiest for the community health nurses who were further editing the manual and putting together power-point presentations and skits for the public health lessons and also for Patrick, the programs director and Sarah, the new country director in training at Hope for Haiti. The two of them, did the logistical planning for the PH program including the selection of the public health students from each school. They helped in the editing process, put together skits and put together a 2-day program along with the nurses that flowed flawlessly. It was wonderful to see that what started with a simple lesson on bed bugs living at the Espwa orphanage has grown to be a model education and training program being used to train leaders from 12 schools and villages around southern Haiti. We are now training community health workers ranging in ages 21-42, bringing health education lessons to thousands of children who would otherwise not receive the life-saving training. The importance of these programs is seen most dramatically in our recent cholera outbreak that has now spread to all regions of Haiti and claimed the lives of over 1,600. Nearly 20,000 are thought to be infected. The incidence of cases is thought to have skyrocketed in the last few days because of the large groups of people who were congregated together all over the country for this weekend's presidential elections. It is believed that the prevalence of the disease will be 200,000 by the time we are able to put a stop to the spread, treating those who are infected. This will prove most difficult in the rural villages of Haiti that are not easily accessible by medical personnel and where clinics are not easily accessible by the people. This highlights the importance of our training programs on the ground now.
This past Thursday and Friday we began the 1-year training program with our 24 newly selected leaders from 12 rural communities who have been nominated by the school directors in their villages as ideal candidates to become community health workers (CHWs). The 2-day lesson which included 16 hours of lessons, skits, activities, presentations, demonstrations and songs focused on the first four chapters of the public health training program; Communication, Nutrition, Bodily Hygiene and Oral Hygiene. The six module-training program is designed to teach one module every two months over the span of one year. Every 2 months, the 24 CHWs in training return from their villages to the HFH office in Charpentier for an intensive 2-day training module. Each of the participants take a pre and post test and must all pass in order to have successfully completed the module. In the two-month period in between the training modules they must conduct a minimum amount of school-based lessons per month at their school and complete all relevant reporting forms. They are expected to maintain a positive working relationship with the school director in their community in creating a safe, cohesive learning space for the students at their school. Each are equipped with CHW training kits with supplies that they can use to teach their lesson plans.
The program’s goal is for each child in the pilot program schools to receive one hour of Public Health instruction per week. This is a minimum standard. If they wish to teach more sessions per week, they are strongly encouraged to do so. Each time they teach a lesson, they record details about the session on the School Lesson Reporting Form, which they and their School Director will sign. They have two months to teach all of the themes in each Module to the school. They are asked to teach at least one activity along with each theme. The lessons take place during school hours, during the school week. There is no need to teach lessons on the weekend or when school is not in session.
For now, the program will only teach children attending the Hope for Haiti supported partner school in each target community. No formal health lessons are approved to be given to anyone other than the children attending this partner school. However, they are encouraged to share information with their friends, families and neighbors, as this is an important part of making community health promotion successful. The starting stipend for the CHWs is $25/month but this may go up as we continue to define the responsibilities and duties of the CHWs.