By Leslee Jaeger, MD
In 2018, I decided to take a three-month sabbatical to do volunteer work in rural parts of Minnesota and to volunteer with HVO. I had already been working in Haiti since 2006, so I wanted to mix it up. I noticed HVO’s project in Hue, Vietnam, and I was able to spend two weeks there, two in Haiti, and then three weeks in rural Minnesota. I wanted to know what retirement might look like for me, but I was also suffering from burnout at work, and I wanted to do something that made me feel like I was giving back. I wanted to remember why I went into medicine in the first place—to help people who can’t help themselves.
There are often organizations or projects that come in and say, “You need to do this,” and then they aren’t successful because the partner doesn’t buy in or doesn’t think the proposed changes are right for them for reasons we might not understand. A willingness to listen to partners and not impose goals on them is important—we want to help them further their own goals. HVO is unique in that they don’t impose. They don’t come in and tell a program, “This is what we’re doing.” They help the hospital determine what they actually want help with. This improves communication and gets things going more quickly.
I was in Guatemala, and it was all American led – physicians, CRNAs, post doc staff – and we essentially took over and did a lot of surgeries and took care of a lot of patients, but there was no teaching involved. That means we have to come back every year to do this, in contrast to HVO, which teaches and involves local staff before moving on to somewhere else.
In November 2024, I traveled to Can Tho, Vietnam to conduct a site visit for HVO to see if we can open a new project there. One important area of focus in terms of teaching during that trip was discussion of how to reduce C-section rates. Right now, about 70% of women who give birth do so via C-section. I came in with the idea that there were a lot of changes we could make easily, but discovered it would not be as easy as it first seemed to me. It made me reflect on the culture and think about why they do things the way they do. For example, I had not thought about the long distances many women have to travel to give birth in a safe location. A scheduled C-section is much easier than coming in weeks early and waiting to go into labor. There are also fewer physicians available to handle the number of deliveries, so scheduling C-sections gets you through the day more easily than having women going into labor at unexpected times. Another issue is that there are not enough postpartum beds for all the C-sections, so we can work together on reducing postpartum stays to help with that, rather than make a change to the number of C-sections being performed.
In these current times, we have to examine our values as a nation. I have always been of the opinion that those of us who have the most resources owe it to the rest of the world to help. Since many of our institutions, like USAID, are going away, at least for the short term, I think we should reexamine our values and help the people who maybe can’t help themselves. Haiti is suffering right now because many products they were using to feed malnourished kids and stock the maternity center were bought from organizations who received funding from USAID. As they say, “A rising tide lifts all boats.” If we can get others to a point where they can help themselves, we will be a much better country.