The Feats and Future of the University Hospital's New Center for Excellence in Rehab and Education

In 2010, construction began on the University Hospital in Mirebalais (HUM), Haiti. Since the hospital’s opening in 2013, it has served as a model for healthcare in Haiti and other developing nations, as it provides care to 185,000 people in Mirebalais and surrounding communities, serves as a teaching hospital to educate Haitian nurses, medical students, and residential physicians, and is the largest solar-powered hospital in the world. Building on the initial successes of the University Hospital, HUM recently added a rehab center, which was completed in July of 2014. Set to open in September or October of 2014, the rehab center will provide patients with more thorough recovery care than is currently available.

The HUM rehab facility will be the first of its kind in Haiti. As physical therapist Jonah Feldman, an advisor to HUM rehab, explained,  “The goal is that the rehab center will offer a more intense amount of rehab so that [patients] can get better quicker and then go home a little sooner.”  This goal will be met by serving a wide population of patients with musculoskeletal and multi-trauma injuries including those who have suffered from burns, car accidents, stroke, spinal-cord injury, and traumatic brain injury. The rehab center will be able to house 10 inpatients.  Senior Construction Manager Forrest Shroyer pointed out that “patients who in the past would have been discharged early due to massive demand for bed space in the hospital will now have a place of their own to take the time to do proper rehab.” These patients will receive therapy on par with the US standard of at least 3 hours a day. Treatments will typically consist of an hour and a half of physical therapy and an hour and a half of occupational therapy, with speech therapy being offered to those who need it.

Beyond the care that the rehab center will provide, Feldman hopes that it will set a standard of therapy education and awareness throughout the rest of Haiti. As Feldman observes,  “The name of the rehab center is ‘Center for Excellence in Rehab and Education,’ so the key part of that is the education piece for training the Haitian staff in providing rehab care. The goal is eventually to open it up as a teaching environment.  Just as HUM is a teaching hospital, we would be glad to have other folks from different programs around the country come, stay for a week or two, and do some very intense training, so they could go back to their sites with that knowledge.”

In addition to providing training to Haitian medical staff, the construction of the rehab center served to employ and train several Haitian tradesmen. Shroyer believes that the greatest success of the rehab center was being able to “rely less and less on visiting expat tradesmen (carpenters, plumbers, and electricians) and more on Haitian tradesmen through direct training.  This is because every time an expat comes down, his or her skills are passed along to the Haitian tradesmen.  Building the rehab building was so much easier because of the skills and knowledge passed on during the construction of HUM.” For this reason, Shroyer reflects, “ My favorite part about working in Haiti is working with the Haitian tradesmen and laborers.  I've known many of the guys for over two years and it's been great to watch them learn and grow and take on more responsibilities…many of the guys have a strong desire to learn more, and when they do, it makes my job so much easier.”

Feldman, however, believes that the rehab center’s greatest accomplishment is that it is a statement “not just for the Haitian medical system but for the rehab practitioners as a whole.” He attests that rehab practitioners will be “more respected and more integrated into the hospital system.”  The physical location of the rehab center is an integral part of achieving this respect. “Right when you drive into the hospital you see [the rehab center as] the first thing to your left across from the emergency room, so I think that is a big accomplishment just becoming more visible and more respected as a healthcare profession,” says Feldman.  This visibility within the community of Mirebalais is already apparent. According to Feldman,  “The community was curious. They were like, ‘what’s this building going to be about’, so we really liked to engage the people who had questions for us on what we were going to be doing there, so they could understand what rehab is, why it’s important, and why we were building this rehab center.”

 Pictured above (back row, left to right): Max Nerrette, Dr. Jonah Feldman, Rich Lebouf, Stephen ‘Mac’ Davis (Harvard Medical School student doing research on hyperextension), (front row, left to right): General Surgeon Dr. Luther Ward’s daughters- Dakota Ward, Sawyer Ward, and Cassidy Ward

Pictured above (back row, left to right): Max Nerrette, Dr. Jonah Feldman, Rich Lebouf, Stephen ‘Mac’ Davis (Harvard Medical School student doing research on hyperextension), (front row, left to right): General Surgeon Dr. Luther Ward’s daughters- Dakota Ward, Sawyer Ward, and Cassidy Ward

Like the members of the Mirebalais community, Dr. Feldman and Shroyer are anxious for the rehab center to open its doors to patients. Aside from holding an impromptu ground breaking ceremony with three or four other people, Dr. Feldman remarks, “It was funny because [the completion of construction] wasn’t really celebrated at all, and nobody made a big deal of it, but for me it was a big deal, so we had a caution ribbon and did a ribbon cutting. It wasn’t a serious thing. We’re hoping that when it really opens, we can invite our partners and have a grand opening for it to celebrate taking a major step forward in the development of Haitian healthcare.”