Overview:

Since November 2016, eight missions have occurred in Haiti as a collaborative initiative between the humanitarian organization Pharmaciens Sans Frontières Canada and the local pharmacy team at Bernard Mevs Hospital (HBM). HBM acts in partnership with MEDISHARE and welcomes various health professionals working as volunteers within the hospital. The hospital specializes in neurology, surgery and orthopedics. All of the initial mission objectives were worked on during the last PSF missions to HBM. Specific short-term projects and objectives were subsequently identified to continue collaboration with Pharmacists Without Borders Canada.

Objectives:

• Develop a severe sepsis protocol for pediatric patients and revise the severe sepsis protocol in adults in collaboration with the local medical team

• Develop a policy for the choice of antibiotics and the duration of treatment, according to the type of infection as well as the time to PO medications (adult and pediatric)

• Start developing a guide for clinical pharmacists

Accomplishments:

Sterile and non-sterile manipulations:

• Organization of the sterile hood

• Organized revision of manipulations with pharmacists and assistant pharmacists during training.

• Completed certification of sterile manipulations of pharmacists and assistant pharmacists and delivery of certificates.

• Completed training on the stability of sterile drugs as well as expiry dates.

• Implemented stability tables (shelf life and target temperature) for the most frequently used injectable drugs and batch preparations in syringes

• Provided training on pharmaceutical calculation methods (electrolyte calculations, infusion and pediatric antibiotics).

• Implemented a register of master formulas of non-sterile magistrals.

Donations of medicines:

• Assisted in the planning of the warehouse triage to separate out-of-date medicines from unused drugs that may be relevant to Bernard Mevs

• Saved as much as possible by making the warehouse functional

• Established a concrete action plan for donations of drugs and equipment

• Created an official form recalling the essential principles of WHO adapted to Bernard Mevs, which includes the expiry date of drugs and a section for monetary donations reserved for the destruction of expired medicines

Hypertension

• Completed a presentation on hypertensives provided to health professionals

• Developed a tool for the substitution of antihypertensive drugs

Antibiotics

• Created a training and self-study program related to antibiotic therapy for the pharmacy team and for some members of the medical team

  • Raised awareness among participants about the phenomenon of antibiotic resistance

  • Reinforced the notions of pharmaceutical calculation applied to antibiotics

  • Strengthened the concept of interprofessional collaboration\

  • Discussed general principles related to antibiotics

  • Discussed the concept of cross allergy

  • Presented the main classes of antibiotics

  • Presentation completed in three sessions to the pharmacy team and some members of the medical team

• Created a knowledge assessment using a quiz done before and after the presentations

• Medical tour completed with the pediatric team to learn about prescribing habits

• Drafted five pediatric antibiotic protocols (pneumonia, bite, cellulitis, urinary tract infection and meningitis

Centre De Sante Notre-Dame de Lourdes

Pharmacists Without Borders (PSF) in collaboration with The Foundation for Economic and Social Development (FODES-5), and the financial support of Pharmaide, have conducted in Haiti a development mission which took place from 2013 to 2015. The Foundation for Economic and Social Development (FODES-5) is a philanthropic private Haitian organization, secular, apolitical and non-profit in four neighbouring municipalities spread over four geographic departments Petit Goave (West), Aquinas (South ), Côtes de Fer (Southeast) and Miragoâne (Nippes). FODES-5's mission is to promote the economic, social and cultural development in its area of ​​intervention by helping local people to develop economic strategies and basic social services to improve their quality of life. The population of the project area is estimated at about 48,000 people.

Objectives:

• Review the role of the pharmacist as a resource person on the proper use of medicines

• Review the good pharmaceutical practice i.e. the right patient, the right medication, the right dose, the right route and the right time to be at the center of decisions making.

• Review the distribution of medicines and pharmaceutical care recognized by the World Health Organization (WHO).

• Optimize patient outcomes through the judicious use, safe, efficient, appropriate and effective medicines.

Gressier Health Center

PSF Canada in collaboration with the Health Center of Gressier Haiti with the financial and professional support of pharmacy students and pharmacists will conduct a development mission in 2016-2018 at the Gressier Health Center and other local Health centers.

Objectives:

• Local personnel training on inventory management and the redesigning of the workflow of the pharmacy. In the health centers, the management of the pharmacy is not always carried out by a pharmacist, the local pharmacy manager must be able to know how to properly manage all inventory of the establishment. PSF Canada will implement the training program for pharmacy managers; and will ensure the theoretical and practical applications in the pharmacy health centers.

• The pictogram project: In an environment where illiteracy affects over 50% adult population and in which there is no universal system for providing medication to patient in place, patient counseling is compromised. The pictograms are small illustrations to explain dosage and the details of pharmacological treatment. This improves adherence to treatment and aims to ensure optimal transmission of information so that the patient takes his medication properly to achieve the desired results.

• Training on health topics to local population: Several trainings can be given to the population, whether with children, pregnant women or villagers. These aim the prevention and treatment of various health problems and health education.

• Training of medical staff: Scientific presentations are also conducted with physicians, pharmacist and nurses in order to discuss the different practices.

• Topical preparations for dermatology: The preparation of topical products by the pharmacy can solve many skin problems. This involves providing tools for developing these preparations and training the local staff.