April 30, 2021
The 2010 earthquake killed more than 200,000 people, devastating the country. The small Caribbean nation then experienced a cholera outbreak that infected nearly 800,000 people. To address Haiti’s fragile public health infrastructure, CDC helped establish the Haiti Field Epidemiology Training Program (FETP-H). This article celebrates the 10 anniversary of this program and its impact on Haiti.
The Growing Footprint of FETP in Haiti
A primary objective of FETP-H is to strengthen the country’s public health system and increase its epidemiology workforce in collaboration with the country’s ministry of health (MOH). Program participants for FETP-H therefore include Haitian Ministry of Health (MOH) employees. In 2011, the FETP-Basic (now called Frontline) and Advanced (similar to the Epidemic Intelligence Service program) were launched. In 2012, the Intermediate program was offered. On this decade celebration of its existence,529 people have been trained through FETP-H—397 in Basic/Frontline, 127 in Intermediate, and 5 in Advanced.
Another important milestone is that from 2011 to 2015, FETP-Advanced produced two cohorts. These residents took courses for the theoretical component of the program at the University Del Valle in Guatemala, staying there for three months at a time, before returning to Haiti for field practice. Upon completion of the program, each resident earned a master’s degree in field epidemiology. The current program consists of FETP-Frontline and Intermediate. Each cohort is a mix of medical doctors, nurses, informaticians, laboratory technicians, statisticians, veterinarians, and surveillance officers.
FETP-H Graduates Lead Haiti’s Public Health Workforce
FETP-H graduates have become the thought and practice leaders in Haiti—their expertise and presence are invaluable. They support the country in all matters related to public health, including outbreak investigations and surveillance, helping to strengthen Haiti’s public health system. Many graduates also hold prominent positions in both governmental and non-governmental organizations. For example, four of the FETP-H Advanced graduates are working in MOH leadership positions. They also mentor FETP-Frontline and Intermediate trainees and serve as facilitators of certain program modules and field supervisors. Some of the most notable FETP-H alumni include the alert and response chief at the Directorate of Epidemiology Laboratories and Research, the malaria coordinator, and the Director of the Health Center in the Artibonite Department (Haiti is divided in 10 administrative subdivisions called Departments).
Wilnique Pierre, MD, MPH, a physician-epidemiologist and an alumnus of the FETP-H, embodies the success of the program. He joined the program at its inception in 2011 and graduated from all three levels. Since then, he has been involved in the program, rising through the ranks to become the FETP-H national coordinator.
“I can attest to the importance of the FETP for the country,” Pierre said. “It was initiated in the face of a glaring lack of epidemiologists who were capable of addressing the major public health problems in the country. After 10years of FETP implementation, many cadres have been trained in the country. FETP contributes to the well-being of the Haitian population and of the whole world.”
FETP-H Contributes to the COVID-19 Response
The importance of FETP-H has also been important during the current pandemic. Most recently, FETP-H graduates and residents have been fully engaged in all activities related to the COVID-19 pandemic response. From a graduate of FETP-Advanced being the incident manager for the COVID-19 response team to graduates and residents providing technical assistance, FETP-H is on the scene. From the beginning, the MOH has used the FETP-H workforce to prepare and respond to the pandemic—even before the identification of the first COVID-19 case in Haiti.
The Haitian MOH prioritizes reaching out to the public through radio and television to provide clear, accurate, and timely information about COVID-19. In support of these efforts, FETP-H graduates and residents help craft messages and manage the MOH hotline, answering questions from the public or transferring them to relevant authorities.
FETP-H residents and graduates also help develop daily situation reports and other tools, such as COVID-19 factsheets, screening sheets used mostly at points of entry, and investigation, contact tracing, and follow-up sheets. They also conductCOVID-19 clinical orientations, provide trainings for the use of personal protective equipment, and support testing and data analytics for health workers at all levels of the health system. Finally, FETP-H alumni helped develop the preparedness and response plan that includes alert and response, investigation, contact tracing, and infection prevention and control components.
10 Years of Positive Public Health Impact in Haiti
In its first decade, FETP-H has impacted how public health surveillance is conducted in Haiti. Now, diseases under surveillance are reported promptly and accurately. FETP-H has allowed for public health data to be systematically collected and analyzed, enabling evidence-based decision making across the country.
With support from FETP-H, surveillance and outbreaks investigation outcomes have significantly improved. For example, situation rooms have been established in most of the country’s 10 departments to discuss surveillance data and activities, allowing pertinent groups to strategize on necessary public health actions. Residents and graduates also produce weekly epidemiological bulletins, which provide a better understanding of the health status of a given department, leading to better care and management of the population.
Sénou Amouzou, MD, MPH, consultant and FETP-H mentor and facilitator, first encountered the program in 2012, when he gave a lecture to the second cohort. He has since delivered more than 200 hours of lectures and mentored more than 40trainees. He shared that his “dream is to have every professional involved in public health action trained in field epidemiology, especially those leading teams. This program should guide us toward acceptance of public health policy, strategy, and actions.”
This type of dedication and enthusiasm for FETP-H is widespread, demonstrating the positive impact of the program in its 10 years of existence. As FETP-H celebrates 10 years of existence, it has solidified its role as a key partner to the MOH as it continues to strengthen the public health system in Haiti.
