OT faculty member brings help to Haiti through Fulbright program

Patty Coker–Bolt, Ph.D., OTR/L, associate professor in MUSC's Division of Occupational Therapy, has been traveling abroad on medical mission trips for more than a decade, conducting research and building partnerships in Ethiopia, Uganda and elsewhere.

In June, she added Haiti to the list. Coker–Bolt is currently pursuing two projects in that country. One, funded through the Fulbright Specialist Program, will allow her to help build Haiti's first in–country Occupational Therapy (OT) and Physical Therapy (PT) Programs. The other, funded through a grant from MUSC's Center for Global Heath, will bring sustainable feminine hygiene products and menstrual education to women and girls in Haiti.

The Fulbright Specialist Program, sponsored by the U.S. State Department, is a prestigious and competitive national grant that provides specialists in their fields with the opportunity to travel abroad to provide training and education to their counterparts at host institutions overseas.

As a Fulbright Specialist, Coker–Bolt will work with the rehabilitation program at the Episcopal University of Haiti to build that country's first OT–PT rehabilitation program.

“They've already gone through the first year of their curriculum, which is very general,” she said. “It's not until the second, third and fourth years that they begin to offer more specialized training, and that's where I come in.”

Coker–Bolt said she was contacted by the dean of the rehabilitation program at the Faculté des Sciences de Réhabilitation de Léogâne to help match international rehabilitation specialists with the university's approved curriculum. The goal is to determine how the specialized content from international experts can be delivered more effectively in an innovative hybrid format combining in–person and distance learning.

“How can we have an expert who lives in the U.S. or Canada deliver content on rehabilitation that's culturally sensitive and meaningful to therapy students in Haiti?” she asked. “Providing stroke rehabilitation education just like we do in the U.S., where we have the best equipment and technology at our disposal, may not be relevant to therapists in Haiti. That's my project in a nutshell: to go down there, learn about their curriculum, and try to tailor content from international specialists to meet the needs of Haitian therapy students.”

There is no shortage of international specialists willing to offer their expertise to help build Haiti's OT–PT educational program. There will be plenty of challenges, however, in getting them all on the same page and finding an appropriate online learning system to deliver the instruction.

“We need to make the decision about whether the content can be delivered online or not,” Coker–Bolt said. “Can we offer an online or distance learning program with discussion boards and chats with our international specialists? Or do we actually invite the specialists to deliver lectures in person in Haiti or use a hybrid version of both online and in–person instruction? Working with each individual faculty member’s schedule can be complicated. It will be difficult to alter the curriculum sequence just to meet an expert faculty member’s schedule, so how can we meet the needs of both the educational program and the international specialist?”

Once Coker–Bolt helps to work the kinks out of Haiti's program, she hopes the curriculum can be adapted to other these countries. “It's very hard to find experts to deliver instruction in these countries for lots of reasons,” she said. “There may be very little funding available for educational programs abroad. But, by developing virtual lectures and e–learning modules, the content developed from the project in Haiti could be adapted and used by many rehabilitation educational programs in low–resource countries.”

Medical care and medical education in Haiti have been very limited in recent years, with the country relying far too heavily on short-term medical mission trips. “That's just not sustainable,” Coker-Bolt explained. “That's why this OT–PT educational program is so needed.”

Her other project, which she said is just as necessary, is an innovative feminine hygiene initiative called Days for Girls, which she will launch in Haiti and study as it expands in that country.

“In many low-resource countries, women — especially young girls — have no way to manage menstruation and personal hygiene,” Coker–Bolt explained. “They may have to miss an entire week of school every month, which puts them at a severe disadvantage compared to their male classmates.”

The Days for Girls International program teaches seamstresses in poor communities how to sew reusable feminine hygiene products and create simple kits, bringing both higher standards of living and sustainable jobs. “Local seamstresses will learn to make the kits, which will provide them a way to make money,” she said. “They'll sell the kits for about $10 U.S., which is a lot for Haiti, but the kits are reusable for up to three years. Women who learn to use the Days for Girls kits will also lessen the waste products accumulated from traditional feminine hygiene materials. This is especially critical in Haiti, which is known for having problems with waste management and disposal.”

The Days for Girls program has been used in many developing nations around the world, but it has never before been studied in depth. Coker–Bolt hopes that this research study, funded by the MUSC Center for Global Health pilot grant program, will change the way menstrual education and feminine hygiene needs are met in Haiti.

Projects like these, she said, underscore the importance of collaboration and global thinking in solving the health challenges of the 21st century. “Even though we may have different cultural beliefs and societal needs, we have to find ways to work successfully to solve global health’s most pressing issues.”