Award won:

The Global Health Travel Award for Postgraduate Medical Residents

Bio:

I am a PYG-3 in internal medicine based at the Royal Victoria Hospital. What made me want to participate in the McGill Internal Medicine Global Health Initiative in Haiti was the idea of a long-term partnership between McGill and Haitian doctors and of capacity building, rather than a one-time intervention.

Project Overview:

Elise in Haiti

This project is a one-month elective rotation where a team composed of internal medicine senior residents and staff from McGill works at Hopital St-Nicolas (HSN) in St-Marc, Haiti. This involves collaborating with local residents and staff as well as Zanmi Lasante/Partners in Health (ZL/PIH), the largest non-government health care provider in Haiti. The goal of this project is to maintain a partnership with ZL and the family medicine program at HSN (including exchanging knowledge, teaching, mentoring), while developing competencies for McGill residents in global health.

Lessons learned:

Change is so difficult to implement. Last year’s team had tried to implement the concept of a patient list on the ward, using whiteboards where you put the patient age, sex, diagnosis and plan. Unfortunately, the first day we arrived to the hospital, the whiteboards were empty. We re-emphasised this concept and did some positive reinforcement throughout the month, and finally the boards were being used when we left. Our fear was that residents would stop using them after we left, but 1 month later we were excited to learn that they were still in use. Change IS possible! I was sometimes discouraged thinking what we were doing was a wasted effort, that those interventions we were making would not stay. But when I learned that the whiteboards were still in use after we were gone, I suddenly felt like I had done something good and valuable.

Advice:

Students looking for a global health experience need to find a project that involves a long-term relationship with the local workers and try to avoid sporadic interventions. The main reason for that is that the time spent on-site is limited and maintaining the change afterwards becomes the most difficult challenge. One of the terms I learned with this project is “capacity building”, which includes finding ways of making an intervention sustainable.

This experience influenced my future career plans in many ways. I don’t know when I will participate again in a global health initiative, maybe not in the near future, but possibly later in my professional life. One thing this experience did reinforce is my desire to be a teacher. I certainly want to work in an academic setting and teach young people how to become better doctors, in regards to the medicine itself but also the human side of it.

The United Nations cannot claim to address and prevent human rights violations while simultaneously failing to acknowledge the culture of impunity and alarming lack of accountability within the organization. Immunity should exist solely to ensure the security of UN peacekeepers during their missions. Instead, the UN uses absolute immunity as a bureaucratic tactic to avoid responsibility when their soldiers violate the human rights of the citizens they are mandated to protect. The UN continues to hide behind its shield of impunity despite its recent unequivocal violation of human rights in the case of the cholera outbreak in Haiti.

The Artibonite River: the suspected source of the cholera outbreak in Haiti. Source: Kendra Helmer, USAID.

The latest of three class-action lawsuits, seeking compensation and reparations on the behalf of the Haitian cholera victims, was filed against the UN in October 2013. Despite ample, convincing evidence pointing to the UN as the singular cause of this epidemic, the UN Secretary-General Ban Ki-moon, issued a statement saying “the claims are not receivable, pursuant to Section 29 of the Convention on the Privileges and Immunities of the United Nations”. The statement subsequently redirected the narrative to the UN’s commitment to eliminating cholera from the country and strengthening Haiti’s water and sanitation infrastructure (7). The UN leadership blatantly disregarded the rights of the cholera victims to pursue legal action and compensation for the hardship they suffered due to the UN’s gross negligence.

The way the UN has handled cholera in Haiti has not only been a grave miscarriage of justice, but has challenged the very ethos of the organization itself.

In accordance with Article 6, Section 23 of Convention on the Privileges and Immunities of the United Nations, the Secretary General has not only the right but the duty, to waive immunity in cases where it would impede “the course of justice” (13). The way the UN has handled cholera in Haiti has not only been a grave miscarriage of justice, but has challenged the very ethos of the organization itself. The United Nations has undeniably proven that its bureaucratic self-protective instincts painfully outweigh those to protect and uphold the human rights of all.

Madlen Nashis a U3 microbiology and immunology student at McGill University. Her global health interests are infectious disease prevention and diagnosis in high-burden, low-resource settings and health and social justice.

Works Cited

Agreement Between the United Nations and the Government of Haiti Concerning the Status of the United Nations Operation in Haiti. Volume 2271, 1-40460. 261-262. Web. 15 Nov. 2014. http://www.ijdh.org/wp-content/uploads/2014/03/MINUSTAH-SOFA-English.pdf

Carla Ferstman. “Criminalizing Sexual Exploitation and Abuse by Peacekeepers.” Special Report 335. United States Institute for Peace. September 2013. Web 15 Nov. 2014.http://www.usip.org/sites/default/files/SR335Criminalizing%20Sexual%20Exploitatio%20and%20Abuse%20by%20Peacekeepers.pdf

Convention of the Privileges and Immunities of the United Nations. 13 February 1946. 28. Web15 Nov. 2014. http://www.un.org/en/ethics/pdf/convention.pdf

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