Patient Cholera Profile: Jacqueline

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Jacqueline*, two-years-old, was admitted to the Rehydration Center at St. Damien Pediatric Hospital for three days after several days of being severely ill at home. She is the only child in her family, living with both of her parents. Jacqueline had several episodes of diarrhea, vomiting and fever when she arrived. When the symptoms first started, her mother brought her to St. Catherine Hospital in Cite Soliel. However, as they are not equipped to take care of these types of cases, the doctor transferred her to St. Damien’s for better care.

According to Dr. Ernestine Ysaac, the lead doctor in the Rehydration Center at St. Damien, “by the time she arrived her condition were very bad. She was lethargy, not able to drink anything due to her severe dehydration and her heart rate was slowing down too. But, the child was quickly treated with IV fluids and in her first night, the child received four bags of IV fluids.” By the next day, Dr. Ysaac assured, the child’s health improved with sign of rehydration and normal vital signs.

Today, Jacqueline is in great health and was discharged to go back home. However, before discharging her, the doctor discovered that the child was also suffering malnutrition. She was referred to our external malnutrition program where she visit regularly for check up’s and to receive special peanut better, vegetables and medication to treat her malnutrition.

Jacqueline’s mother said, “Thank you very much for your generous help that you provided to my child, because without you she might not be here. St. Damien’s was my only chance and I want to thank the staff who were quick in treating and taking the good care of my kid.”

Jacqueline and her mother are now home, happy and healthy!

*Name changed to protect privacy.

Staff Profile: Dolcy’s Caring Heart

Dolcy in front of the Social Services office.

Dolcy in front of the Social Services office.

Dolcy started working at St. Damien in early 2010 as a part of the social work team. Each member of the social work team is responsible for different departments throughout the hospital and since his first day Dolcy has been responsible for the children and families in the cancer ward and the neonatal unit. Dolcy loves his job and is extremely good at it and we are fortunate to have him on our team.

Dolcy explained that even though there are challenges in the job, the majority of the time his experiences are rewarding. He is constantly on the move and crossing items off of his to-do list. On a day to day basis, he checks in on families and children, writes reports, is called into meetings and even has to travel to get passports and visas.

“The most rewarding part of the job,” Dolcy says, “is building relationships with the children and families and being a support for them in their most difficult times.”

In 2012, Dolcy was promoted as the director of the office. He was then managing all of the social workers and overseeing the work done in each department. He was thrilled for the opportunity and took the challenge on with open arms. However, in 2013 there was a restructure throughout the office and a psychologist was hired onto the team and also named director. Dolcy has served as a wonderful mentor for him to fall into the role with ease.

He feels honored to be a part of such a wonderful mission and to be working towards the mission with hands on action. Dolcy said, “we take care of everyone with all of our heart. We try to help everyone and to do all we can do for them.”

One story that with remain with Dolcy forever is about a little boy named Michael*. Michael was a patient in the cancer ward (known as Salon Mango) back in 2010. When he arrived his stomach was swollen and overextended due to the fast-growing tumor. Dolcy recalls that no matter how sick he got, he always danced. He also had no papers, which was a challenge for Dolcy, as many of our cancer patients need to travel to the Dominican Republic after receiving chemotherapy to receive radiation therapy. Dolcy spent six-months, non-stop, on his papers and eventually got them! Michael then went to the Dominican Republic for treatment and Dolcy cannot tell this story with a smile from ear to ear.

Dolcy’s caring heart and determination to complete whatever task is thrown his way is why we feel very lucky to have him as a part of our team. He is a valuable member of the St. Damien family and we don’t know what we would do without him.

*Names have been changed for privacy purposes.

Contributed by Avriel Burlot, former Communication Specialist NPH Haiti

Q2 St. Damien Update

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  • Since last April, we have been facing the Chikungunya epidemic, transmitted by the Aedes mosquito, in Haiti and at St. Damien: up to 114 cases seen during April and May. We envisioned to open a separate room for the children needing hospitalization for  better management, but could not do it for lack of funding. The most severe cases are seen in the infant population.
  • Dr. Elouse Pierre, Mme Adeline Goldman and Dr. Marie Lina Excellent of the HIV clinic, participated in a conference by IHI Institute of Health Improvement conference in Paris, France in April, presenting two quality projects realized in the HIV/AIDS department.
  • Dr. Jacqueline Gautier, Executive Director of St. Damien, participated in the Pediatric Academic Society annual conference, in April in Vancouver, Canada. The topic was how to create global pediatric cooperation projects. Dr. Patricia McQuilkin from University of Massachusetts a member of SCIPH (see below) initiated this workshop that received good reviews from participants.
  • In May, despite all our financial constraints, we made an effort to raise the salary of approximately 100 staff members (a quarter of our personnel). Our support staff members deserved a decent albeit still modest salary. The hospital had not offered a raise for the past four years. We opted for this solution, because we were not able to offer a raise to everyone.
  • The network of six US pediatric academic programs supporting St. Damien, Saint Damien collaborative to Improve Pediatric in Haiti (SCIPH), completed their year of global pediatrics training for 3rd year US pediatric residents in May. Activities of SCIPH will include a six week training in Akron, Ohio, for a multidisciplinary team of physicians, nurses, administrator, pharmacist, and maintenance technician, to improve intensive care at St. Damien. This activity is supported by a section of Rotary International, committed to bringing pediatric cardiac surgery to third world countries. SCIPH will also offer opportunities for the Haitian pediatric residents of St. Damien/Bernard Mevs to have training rotations in the US hospitals during their 3rd year of residency in 2015.
  • In June, Dr. Luterse Dupont, director of the Maternity service, was able to attend a conference in Obstetrics and Perinatology in Florence, Italy. He then stayed to work with Professor Enrico Ferrazzi, OBGYN physician, who helped create the maternity service at St. Damien.
  • Kettia Merveille, microbiologist from St. Damien completed last week a six week training at Rhode Island laboratory in Providence. She is back to work with Mme Elcie Bien Aime, responsible of the microbiology lab to upgrade this crucial service at St. Damien. This is an activity supported by Brown University, member of SCIPH.
  • One physician and one nurse from the neonatology department benefited of one month training last June at Hospital Bambinu Gesu, Italy.
  • Dr. Flaminia from Bambinu Gesu, Rome, Italy, spent 10 days in Haiti in June working with the neonatology staff, offering training in neonatal resuscitation for pediatricians, midwives, nurses and obstetricians.
  • Thanks to Saint Jude Hospital in Memphis, Tennessee, our oncology department was able to install tools for hand hygiene: soap dispensers, paper towels etc., as an effort to prevent infection in this unit. St. Damien improved greatly its performance in oncology in this area although much remains to be done. Also starting in May, three staff members of St. Damien are attending an online course in infection control. St. Damien is hoping to decrease gradually its rate of nosocomial infections. The course will go until next September at which time the participants may go to Mexico City for 10 days training at a pediatric hospital, championing in infection control.
  • On June 17th, St. Damien organized the first meeting to create a foundation to fight pediatric cancer in Haiti. The main objective of this foundation is to support the effort of our oncology service and to educate the population about child cancer.
  • Dr. Marie Lina Excellent, chief of HIV/AIDS at St. Damien, resigned to attend a masters program in public health at UNC North Carolina, USA. Marie Lina completed almost two years of excellent service helping St. Damien uphold its mission toward the families. She was replaced by Dr. Jenny Edouard Pierre Lys, who starts her role today, July 7th, 2014.
  • Two staff members, one from the emergency room, one from the department of archives, participated in a week training about electronic medical record use. Since October 2013, St. Damien is using a free national electronic medical record, for the moment, just for ambulatory patients. Despite some problems linked with poor internet function at times, and not enough computers at the hospital, the new record system facilitates our work.

Contributed by Dr. Jacqueline Gautier, Executive Director – St. Damien Pediatric Hospital

Chikungunya Fever and Baby Jean

Baby Jean and Mother

Baby Jean and Mother

Since late 2013, the Chikungunya outbreak in the Caribbean and Haiti has been gathering momentum. By May 6, 2014, the number of cases rose from one to 15,000. As of June 2014, 27,000 cases were confirmed.

Chikungunya is a viral disease that is transmitted to people by the Aedes species mosquitoes. Symptoms usually begin 2‒6 days after being bitten by an infected mosquito and the most common symptoms are fever and severe joint pains, often in the hands and feet. Chikungunya can cause the appearance of “stooped walking” not only because of the pain, but it also causes fatigue. Rheumatic effects may persist for several months and even years.

There is no antiviral medicine to treat Chikungunya. Treatment is only symptomatic and based on the administration of medicine to help reduce the fever and pain.

At St. Damien Pediatric Hospital, we have experienced an increase of Chikungunya cases because often people are refused at other hospitals, due to the lack of healthcare centers in Haiti. The capacity of the St. Damien emergency room does not allow us to host the increase in positive cases, therefore we are able to provide hydrotherapy and paracetamol (analgesic) before we transfer them, if they can make it to another hospital. Patients that are admitted to our ER, typically have a very high fever and body pain so severe that they do not want to be touched.

BabyJean and cryingBaby Jean*, who was just five days old and born at home, was able to receive care at St. Damien. Chikunguya virus can be transmitted by mother to the newborn if the mother catches the disease perinatally, so Baby Jean could have contracted the disease from his mother, or from a mosquito. A few days after her birth, she started showing signs of a fever. Concerned that it might be Chikungunya, her mother quickly found a motorcycle to take them from Cite Soleil to St. Damien. Baby Jean’s body was pale when she arrived at St. Damien. The nurses and staff quickly attended to her, starting an IV and began treatment by administering paracetamol. With the help of the ER physician and staff, Baby Jean is feeling better, although she does not like to be touched due to her body aching. She will spend another four to five days in the hospital.

An average stay for in-patient care is $52 (per day) $52 x 5 =$260. If a patient is seen in our outpatient clinic, it is a one-time fee of $32.

St. Damien staff also had 100 staff members who became ill with Chikunguya and many had to be temporarily replaced to provide uninterrupted care to our patients.

Since the last week of April, St. Damien has provided care to 112 Chikunguya outpatient cases and hospitalized 14 patients, who stay an average of five days.

We ask for your continued support in caring for these children, to help decrease their suffering and pain.
Please donate.

*Name changed to protect privacy.

Chikungunya Fever: A New Threat:

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Dear Friends,

The rainy season has always brought troubles for the Haitian people: flooding, mudslides, malaria, and in recent years, deadly cholera. Now there’s a new outbreak spreading across the country, Chikungunya fever.

Our St. Damien Pediatric Hospital programs have seen an increase in patients, stretching as usual to meet overwhelming need. Our ability to serve the many seeking treatment depends on the funds to buy fluids and medications, and our ability to maintain these overflowing structures. We wanted you, our friends, to be aware of this great new need.

The name Chikungunya means “to become contorted” or “to bend up” because the pain caused by the virus is so intense that all you can do is hold your aching joints and wait for it to be over. Haitians have adopted the name kraze le zo or “breaking bone” in Creole.

There is no anti-viral treatment for Chikungunya fever, and no vaccine, but one can treat the symptoms. While rarely fatal with proper treatment, many Haitians don’t have access to or can’t afford reliable healthcare, putting them at risk for severe dehydration and chronic pain that lasts for days or even months. It can be particularly dangerous for the very young and the elderly.

Thank you as always for your friendship and support. Please donate, it is a great comfort to know that we can count on you.

With gratitude,

Father Rick Frechette, National Director NPH Haiti