Troubleshooting training challenges in Haiti and Rwanda

A training specialist travels from Rwanda to Haiti to foster a cross-site collaboration.

A training session in Haiti, organized by Zanmi Lasante.

by Celia Reddick with Vernet Etienne

It is 6:00am, and I am in search of Vernet Etienne, the Training Coordinator at Zanmi Lasante, PIH’s sister organization in Haiti.

I work for the Department of Medical Education and Training of Inshuti Mu Buzima (IMB), PIH’s sister organization in Rwanda. I’m in Haiti to shadow, collaborate with, and learn from our colleagues in the Training Department here at Zanmi Lasante (ZL).  I’m eager to chat with Vernet about his work, but I have to be quick -- he’s leaving in an hour to facilitate one of many cholera trainings the ZL training team has designed and implemented this past year in response to the cholera outbreak.

	Zanmi Lasante Training Coordinator Vernet Etienne at a recent training.
	Bad roads are one of the many challenges faced by the training team in Haiti.

When I find him, he’s eating breakfast, his suitcase packed for the journey and propped next to the door, but he welcomes me to join him.

I ask him to tell me about his work, and he smiles. “Well,” he says, taking a deep breath, “there are so many projects.” He describes his responsibilities: planning, implementing, and reporting on training initiatives to support ZL’s community health worker program. “It’s the planning that is the hardest,” he explains. “There are so many factors which can get in the way of training. I do my best to make sure everything is set and scheduled, but sometimes, there are things I can’t control.” He lists some of the challenges of working in a rural environment with an unstable infrastructure: rutted dirt roads, unreliable vehicles, sporadic training supplies. I note that the hurdles in Haiti sound similar to the ones the training team faces in Rwanda.

Vernet is animated as he discusses his work. With formal training as a secondary school language teacher before coming to ZL, his presentations skills are excellent. He is now working toward a BA in anthropology and sociology, and hopes to bring this interest to ZL’s fieldwork. In many ways, he already does so. “When you are working with the community, you have to understand the cultural reality of a place,” he explains. “We are working in rural communities where this cultural reality has a big impact on our work.” 

One aspect of this cultural reality has to do with perceptions of training. Vernet and his department support Ministry of Health training initiatives, but often, they come second to participants’ expectations, or to various other ministry or clinical priorities. In Haiti and Rwanda, to implement effective trainings the team must develop thoughtful activities using participatory methods; mentor trainers to use supportive and engaging training styles; and design and print clinically accurate and engaging materials. For most participants, however, training has always been a didactic experience and participants frequently arrive late or choose not to attend because of past experiences with ineffective teaching styles. Vernet compensates with some healthy hounding; as he explains: “Sometimes I send a text, then I call with a reminder, then I call on the day, and then I am there to welcome the trainers to the training site,” he says. “With this strategy I make sure the trainings happen.”

Vernet’s role requires that he maneuver through many political and social levels—many cultural realities—to make sure that ZL implements training to support the Ministry of Health. He communicates with high-level officials from the Haitian Ministry of Health and international funding organizations, local and expatriate staff from ZL and partner non-governmental organizations (NGOs), and community health workers from rural villages. Across all these contexts, he must make a case for participatory learning. His ability to articulate the importance of ongoing education for low-literate adults, and to form bridges between these many worlds have led to his success. 

My colleagues at IMB in Rwanda and I have a lot to learn from Vernet and his team. IMB’s Department of Medical Education and Training is growing to accommodate ever-more ambitious goals from the Rwandan Ministry of Health. As we hire new Training Coordinators in Rwanda, we will benefit from Vernet’s work and experience, and the training implementation systems the Haitian team has developed.

Vernet’s car is waiting for him outside, and he quickly swallows the rest of his breakfast of spaghetti, eggs, and bananas. As he heads outside, we commit to ongoing collaboration between our teams in Haiti and Rwanda. I look forward to sharing our experiences across sites so that the educational initiatives we undertake reflect the nuances of our particular communities, as well as the larger goal of improving health outcomes through capacity building.

Celia Reddick serves as the Curriculum and Training Specialist for Partners In Health in Rwanda. Vernet Etienne serves as the Training Coordinator at Zanmi Lasante, Haiti.