Investing social capital  pg. 5

We also had equipment that was necessary to do the tests and the reagents, as well as specific clinical research projects, where you could train a young faculty staff member in the conduct of research. They are the ones who said, ‘Why can’t we apply these same research tools for patient care?’

I think that separating completely research from patient care doesn’t make a lot of sense because research has been instrumental in both training the personnel, because we train them with the results of the research that we conduct on site, and also it has been instrumental to provide the proper care.

What is the most important kind of international support that should continue for your program?

At present because we have very well trained staff, I think the provision of the drugs is essential, as well as the reagents, because the one-year cost for placing a patient on HAART in Haiti is still expensive—around $2,000 a year per patient.

Dr. Pape, are we training enough of the right kinds of researchers to do the studies that need to be done on a global scale?

Clearly, in Haiti, we are not training enough people.

We’ve trained since 1992 over 10,000 health personnel including 2,000 physicians. Unfortunately many of those physicians tend to leave Haiti. We’ve lost over half of them, but we’ve also trained psychologists and trained social workers.

Now what I think is important in a place like Haiti is providing on-the-job training. Training them behind a blackboard is not going to make a difference. We give them very little theoretical training. The majority of the training is done on the job.

What AIDS has done also is created teamwork. It’s not a team composed only of physicians. We also have people living with AIDS who are part of that team, field workers.

Field workers are our extension because people here don’t have phone numbers, so even the best address would not get you close to their home. You need field workers who are able to visit patients at their homes and verify that their address is correct.

Dr. Holtgrave?

Previously I think there was a sense in public health that we needed to bring people together from a lot of different disciplines. But now increasingly there’s recognition that as we train people in graduate programs and even now in undergraduate programs in public health, it’s important to give people a broad array of skill sets.

A special skill in and of itself is how to work together on an interdisciplinary team and how to be appreciative of other disciplines, how to phrase questions in a way to draws out the views of people from other disciplines. More and more we’re seeing people trained to be multidisciplinary themselves as opposed to simply bringing one disciplinary viewpoint to a multidisciplinary team.

That doesn’t mean that you wouldn’t still have teams that included people from a variety of different fields, but it’s important to have people who’ve been trained in how to work in an interdisciplinary way and who themselves have experienced some training in all of the different areas of public health.

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