Social medicine in Haiti: DO students join immersive program

A passion for caring for patients in rural and underserved areas led Dimitri Tito, OMS II, to enroll in medical school at the West Virginia School of Osteopathic Medicine. Earlier this year, he had the chance to explore his passion even further by participating in a three-week immersive social medicine course in Haiti’s Central Plateau.

“I thought traveling to Haiti would help me learn more about what patients in underserved areas need,” he says.

Tito defines social medicine as the practice of exploring social factors or determinants that affect a patient’s health in conjunction with examining a patient’s physical and mental health. Social factors include religion, community, finances, cultural practices and family dynamics. The “whole system” approach of social medicine aligns closely with the osteopathic philosophy of taking care of the whole patient.

About the course

The AOA sponsored two DO students’ participation—Tito and Taisha Destin, OMS II—in Equal Health’s Social Medicine Course in Haiti this past July. Four additional osteopathic medical students also joined the course, which is conducted in French and pairs 10 international medical/health students with 10 Haitian medical/health students for cultural exchange and social medicine training. Students from China and Rwanda joined the course alongside the American students.

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The students spent three weeks exploring Haiti’s health care landscape and public health system. They visited hospitals and health clinics and accompanied social workers to patients’ homes. They went to the compound where cholera was inadvertently introduced to Haiti in 2010 following a major earthquake. They met with different NGOs and public-sector organizations to learn about and discuss the circumstances that affect health in Haiti. They also interviewed patients from different walks of life to begin piecing together how a person’s environment, economic situation and community can impact his or her health.

“The program exposed the students to situations they’d never studied or dealt with before,” says Amy Byerwalter, AOA associate vice president of international affairs. “It gave the students experiences that will really help them take the whole-patient approach to the next level as they now have a heightened sensitivity to the complete range of factors affecting patients’ physical, spiritual and mental health.”

From Haiti to West Virginia

Tito recalls interviewing a woman at a hospital in Mirebalais, a small city in central Haiti northeast of Port-au-Prince.

“Just hearing about her experience with the health care system was really eye-opening,” he says. “She had recently been diagnosed with advanced-stage breast cancer and had a lumpectomy and lymph node treatment. She was expected to survive. But the cancer was discovered at a later stage because she’d had trouble getting a diagnosis. She lived two hours from the hospital and hadn’t been able to get a mammogram or an MRI, because the technology wasn’t available.”

Tito is hoping the knowledge he gained from the social medicine program will assist him in treating underserved patients stateside in the future, especially in West Virginia.

“West Virginia has a lot of underserved areas, and there’s also a big opioid epidemic here,” he says. “Looking at the social factors and stressors that lead to addiction–and trying to assist patients with addressing them–might be a way for physicians to more effectively help their patients who are struggling with addiction.”