Welch Shaping Next Generation of Global Anesthesia

​Haitian anesthetists in training practice treatment
of anesthesia emergencies during their first simulation session.
John Welch, CRNA, spends his time between two worlds. He spends about 25 percent in Boston working as a staff CRNA for Boston Children’s Hospital. The rest of his time is spent in rural Haiti, where he’s been working with Partners in Health, an organization that strives to bring the benefits of modern medicine to those in need, supporting nurse anesthetists at a new, 300-bed hospital, the University Hospital of Mirebalais.
During nurse anesthesia school, Welch described himself as “always [having] an interest in global health and social justice.” So the pairing with Partners in Health, which has been working in Haiti since the 1980s, was a good fit.
“We, as highly trained, well-funded healthcare providers, have a just cause to provide care for the world’s poor and underserved people,” said Welch.
Beginning as a volunteer, he participated in the organization’s mission of “accompaniment,” which is not just performing medical duties, but being there for the Haitians in all capacities. His duties ranged from simply standing side-by-side with the Haitian nurse anesthetists to introducing them to new technology.
As the hospital grew, Welch’s responsibilities began to expand. Partners in Health’s sister organization in Haiti, Zanme Lasante, will begin a nurse anesthesia program at the University Hospital of Mirebalais.
“It really never worked on this scale before,” Welch said of hospital that was continuing to open new facilities. Part of his duties became developing curriculum for anesthetists that had a wide range of experience.
“Some have lots of experience. Others have virtually no experience,” he said. Without anesthesia, there can be no surgery, and, since Haiti has only about 35 anesthesiologists in the country, the need for nurse anesthetists has never been greater.
“Many of our patients have been walking for days to arrive at the hospital,” said Welch. In order to support the expanding facilities and training program, he’s taken to wearing many hats, from curriculum planning to evaluating methods to creating clinical rotation schedules.
“In global health, one person is doing the job of many people,” he said. When in Haiti, Welch stays in facilities provided by Partners in Health. Since the organization has a history in the country, it’s been able to provide safe accommodations for its volunteers.
Surprisingly, Welch says his biggest challenge in establishing viable healthcare in Haiti doesn’t come from governments or outdated technology, but instead from the people back home.
“[The biggest challenge] is to convince U.S. colleagues that, not only is it possible to provide world-class healthcare to a place like Haiti, it’s necessary,” he said.
Welch hopes to continue working with Partners in Health in Haiti, something he’s able to accomplish due to the flexibility of Boston Children’s Hospital.
“They’ve been so incredibly generous to give me this time,” he said.
The plan is always to continue strengthening the Haitian healthcare workforce, with the goal of Haitian independence in the provision of its healthcare.
CRNAs who are interested in learning how they can be involved with Partners in Health in Haiti can visit www.pih.org or email Welch at john.welch2@childrens.harvard.edu.