Thoughts from my first months as a Dimagi Field Manager in Haiti

The following blog post is by Matt Levasseur, a Dimagi Field Manager who is based in Haiti. In Haiti, Matt is working directly with the Pathfinder International team to develop a CommCare system for the Services de Santé de Qualité pour Haïti (SSQH) project, which aims to increase access to and use of quality healthcare services in Haiti’s Central and Southern regions. This system will eventually be deployed to 2,500 Agents de Santé Communautaire Polyvalents (ASCPs).

We’ve been back in the US for a little while now, and it’s a good time to start writing about what we’ve been doing in Haiti with Pathfinder International on the SSQH-CS project.

Last week and this, our first cadre of Community Health Workers (CHWs) were trained to use the CommCare app we developed for (and with) them. Then they began practicing in the field on their own. Our baby is starting to walk.  There is never a more exciting moment.

Over the last few weeks, we have focused our efforts on testing the app, arranging and conducting trainings, managing the logistics of the mobile phones, training on the ground staff to use CommCareHQ to build their own apps for other projects, and troubleshoot upcoming problems.

We’re also lucky to have a very experienced cadre of CHWs to launch our app with. They work out of a well-regarded charitable hospital in the mountains outside of Port-au-Prince, and bring many years of experience to the project. They have been invaluable in developing the most effective possible application- but who would know better than CHWs themselves how the app should work?  Every day they trek for hours in the mountains visiting each lakou (a yard often shared by multiple families and houses), diligently tracking their activities and health indicators collected by the Haitian Ministry of Public Health and the Population (MSPP in Haitian Creole.) They know their clients well and their clients know them well.

It is thrilling to work on the start-up of a large scale, historic public health project that has received tremendous support from the Haitian and US governments, international organizations like Pathfinder International, a great number local partners, and vitally has attracted buy-in from community level workers as well.

In thinking about this project, I decided to write out five interesting memories from our first trip to Haiti:

1. In the beginning we were all staying in a hotel, working late into the night on various plans and presentations.  We would stop working for an hour or two after a full day of meetings and presentations, and sit down to prepare more for the following day or following week.  Gradually during this period the enormity of our endeavor sunk in: very little in the project was going to be simple, and we needed to draft detailed plans and implement them in the chaotic environment that Haiti often is.  We drafted and reworked several plans for the first year, and as we began implementing elements of the project the team developed the flexibility to respond to urgent demands while not losing track of longer-term goals.

2. Another memory, and perhaps our trial by fire, was the very rapid development and deployment of an Emergency Medical Services app for Haiti’s annual Carnival.  In the span of a few tremendously busy weeks, we built, tested, iterated, and deployed a set of 3 apps at Carnival in Gonaives.  In Jacmel the week before, we tested our first prototype; I found myself observing in the Emergency Department of a local hospital, watching the ambulances come rolling in, the nurses using tablets to record patient information.  In Gonaives, I spent several nights doing the same- at a first aid post, observing the use of the app and answering questions.  Nothing quite compares to the memory of sitting in very well equipped first aid station at the very heart of this massive party, at 4:00 AM, watching entries arrive on CommCareHQ with our project partner, while the parade- a sea of people and music trucks- carried on until early morning (for 4 nights).

3. Contrasted to the chaos and energy of Carnival, there are many peaceful memories as well.  We ate a meal high up in the mountains above Port-au-Prince, looking down at the lights of the city below.  We swam in the warm Caribbean. We had a day off here and there. I learned to drive a motorcycle and went for a cruise up a gorgeous coast highway in the south.  We went dancing.

4. Some of my favorite parts were the days we spent with Community Health Workers, accompanying them as they made their rounds.  We got to spend time with them and their patients, we got to spend time with their supervisors, and the managers above them.  Everybody offered us enthusiasm, and a few skeptics offered helpful advice. Ultimately seeing is believing for everybody: nothing explains CommCare like a demonstration, and nothing provides information on which to improve an application like doing home visits with CHWs.

5. Last but not least, is the memory of meeting the First Lady of Haiti, Sophia Martelly.  We received the same gracious support as we had from nearly everybody, but the First Lady’s enthusiasm was naturally all the more exciting and gratifying.  Amazingly our project has spanned from the lowest rungs of Haitian society, from the slums of Port-au-Prince, to the highest echelons of power in Haiti: the national palace and the First Lady.