Saint Damien Hospital

Mission Statement: The healthcare programs of Nos Petits Freres et Soeurs are motivated by the gospel command to care for the sick and strive to offset the injustices of poverty and unemployment which make healthcare inaccessible for many poor people. Poverty imposes a tremendous burden of sickness and suffering on many children. In an effort to help precisely these children, St Damien Hospital offers both children of poverty, and children of any social level in emergent distress, quality and dignified healthcare. St. Damien always seeks to include the parent participation in this care through ongoing dialogue, on-site opportunities for education, and encouraging any level of material support they can offer for the care of their children.

Background:

The island nation of Haiti is located in the Caribbean and is the poorest country in the Western Hemisphere. Poor sanitation and widespread poverty have led to young children being 15 times as likely to die from diarrhea or pneumonia than HIV/AIDS. Nearly 10% of children die before their 5th birthday, largely of  treatable illnesses. 1 out of 4 children are moderately to severely malnourished, and 138,000 children die of preventable diseases each year. In a population where 1/3 of the population is under 14 years old, improvements in pediatric health are a vital and necessary requirement towards Haiti’s economic, social, and political development.

Nos Pequenos Hermanos, founded by American priest Father William Wasson in 1954, opened their Haiti offices (as Nos Petit Frères et Sœurs (NPFS) or Our Little Brothers and Sisters) in 1988. While the initial goal of NPFS was to build a permanent home for orphaned and abandoned children in Port-au-Prince, the large amount of children dying from treatable illnesses showed a desperate need for a hospital that could treat chronic and other debilitating pediatric illnesses.

Funded through private contributions to NPH worldwide, St. Damien’s provides high quality medical treatment for disadvantaged and sick children in Haiti. More than half of all patients are admitted for an infectious disease such as tuberculosis, malaria, and HIV while twenty-five percent are admitted for non-infectious diseases such as cancer, cardiovascular disease, and kidney infection. Most patients admitted are also malnourished.  The outpatient clinic treats 100 children daily, for acute, parasitic, and bacterial infections. In specialized clinics, chronic conditions such as sickle cell anemia, congenital heart diseases (CHD), tuberculosis and cancer are treated for months or years if needed. St. Damien Pediatric Hospital and associated public health programs of NPFS reach over 30,000 children annually.

Capacity

St. Damien’s Hospital has 120 beds, including an 18 bed emergency unit, 10 bed pediatric intensive care unit (pICU), and 9 bed cancer center.

Human Resources

The hospital is staffed with 18 pediatricians, 50 nurses and 60 certified nursing assistants, as well as 8 lab technicians, 1 x-ray technician and 3 x-ray auxiliary technicians. The hospital pharmacy is headed by a trained pharmacist, whose work is supported by 22 pharmacy technicians and overseen by an international volunteer pharmacist.

Laboratory

The hospital’s laboratory has the capacity to do many essential tests, including malaria blood smears, HIV, and sickle cell.  On average, about 1,500 hematological exams and more than 4000 bacteriological exams are conducted monthly.

Radiology

The hospital has a digital x-ray which performs 400 x-rays a month and is capable of sending images across the internet to an external radiologist in America or Europe. More than 90% of all x-rays are pictures of the chest to exam the lungs for respiratory tract infections.

Pharmacy

The pharmacy is responsible for the drug and medical supplies and items to the patient rooms and out-patients. While some essential drugs are produced and purchased in Haiti, most medications and supplies are imported from Action Medeor, a specialist supplier for charity projects from Germany. A system has been established in the past few years where the hospital pharmacy team receives supervision, support and training from an international volunteer pharmacist from Germany through distant communications and a minimum of three to four annual visits in Haiti.

Surgery

St. Damien’s surgery is composed of two surgical suites, a recovery room, prep room, and a sterile changing area. The staff of 15 includes 2 doctors, 4 nurses, 2 certified nursing assistants, and 3 technicians who were trained in Italy. Around 2,000s surgeries are performed a year including colostomy, hypospadias, hydrochephelus, hernias, and oncology referrals. There are also visiting teams of surgeons who come 4x a year. Patients are referred to surgery from the general clinic and the emergency room, and the chief of surgery consults on 5-7 patients a day (monday through friday) to determine if surgery is needed. Non-emergency surgery is performed Monday through Friday, while emergency surgery is performed 7 days a week.

Pediatric Oncology/Hematology:

The St. Damiens Pediatric Oncology/Hematology Center has been in existence since 2006, and has treated over 140 patients from throughout Haiti.  The Center treats both solid tumor and blood cancers (such as leukemia, lymphoma, retinoblastoma, rhabdomyosarcoma, osteosarcoma, Wilms, Hepatoblastoma, Neuroblastoma, ovarian,
testicular) as well as hematological diseases (such as aplastic anemia). Chemotherapy and surgical interventions are provided on-sight at the St Damien campus in Tabarre, which radiation therapy is provided in Santo Domingo in the Dominican Republic.

The Center currently works closely with St Jude’s Medical Center in the US, and is currently undergoing evaluation to become a St Jude international affiliate. Our head oncology pediatrician is currently spending a year in Guatemala at the St Jude Center there undergoing training. There are also bi-weekly video conferences with St Judes to discuss difficult cases-oncology pathology is also supported by several centers in the US who aid in diagnosis.

Tuberculosis:

The TB Program at St. Damien’s treats both Pulmonary TB and Extra-Pulmonary TB and is for children between 0-14 years of age, divided between children who are under 6 years of age, and those that are between 6-14 years of age.  Those under 6 receive 6 months of treatment while those between 6-14 years of age receive 8 months. Both age groups start with an initial 2 month in-patient treatment and medications are provided by Haiti’s National Program Against TB (PNLT in French). In 2009, St. Damien’s treated 221 patients for TB.

Malnutrition:

St. Damien’s Malnutrition Program started two years ago, in order to combat Haiti’s alarmingly high rate of malnutrition (17,500 children under the age of 5 were reported to be acutely malnourished before the quake). The program runs for 6 weeks, and provides patients with food packages consisting of a combination of F100 (a dried high-energy milk that is fortified with a mix of vitamins and minerals that are designed to counter the specific biochemical effects of malnutrition in children) and Plumpy’Nut (a combination of peanut paste, vegetable oil, powdered milk, powdered sugar, vitamins, and minerals). Children are followed through weekly consultations to monitor progress. HIV tests are offered to those suspected for being at risk for HIV, about a quarter of program participants.

Maternity:

St Damien’s High Risk Maternity Program sees over 1,000 patients a month. The Program has a staff of 56 including 8
obstetrician/gynecologists, 7 anesthesiologist, and 12 midwives. The Program collaborates closely with the St Luc Manitane Pre-natal clinic and St Luc Outreach Clinics in the slums.

Neonatology: 

St Damien’s Neonatology program treats our highest risk newborns, and serves up to 50 patients per month.

Public Health

The NPH St. Damien Pediatric Hospital started a Public Health Program in 2004. One nurse and seven health agents offer education and immunization to approximately 12,000 people living in proximity to St. Damien. The areas are divided into sections and each health agent living in this area work with the leaders to promote community health.

Vaccinations and nutritional assessment are offered in the communities based on a calendar schedule. Immunizations are also performed for children born at the hospital or coming through the general clinic to update their immunization.

Approximately 500 children receive vaccines on a monthly basis. Those living in the target areas complete their vaccination. For the others the information is not available.

About 100 pregnant women monthly receive vaccination to prevent neonatal tetanus.

Children are also screened for malnutrition and receive deworming medicine regularly. Other programs include medication to eradicate filariosis in conjunction with the Ministry of Health.

Education sessions cover nutrition, importance of breastfeeding, sanitation, prevention measures for TB, HIV, malaria, worms, cholera, birth spacing, etc. The public health program participates in vaccination campaigns organized by the Ministry of Health. Health agents joined by others go to most schools to vaccinate children under five years of age.

Next year, we will be able to offer sexual education for youths in the schools located in the community, joining the HIV program in its prevention activities.

HIV Program

The NPH Haiti St. Damien Pediatric Hospital HIV Program began in April 2005 using its own funds to provide care for a few children infected with HIV. The children were identified from where Fr. Rick Frechette was holding an ambulatory clinic in the slums of Cite Soleil and Warf Jeremie. Included in this program were approximately 20 NPH youths living at the St. Helene orphanage in Kenscoff.

In December 2005, St. Damien submitted a proposal to receive funds from the US/PEPFAR program. St. Damien received a grant from the University of Washington, contracting with CDC/PEPFAR in Haiti, to care for children exposed and infected with HIV. With these funds St. Damien was able to hire a multidisciplinary team and started to enroll more children exposed and infected with HIV. The team is made up of one psychologist, two social workers, four physicians including the manager of the program, four nurses, two pharmacists, five field workers, one mid wife, and four administrative staff. The five field agents visit the families to make sure the children receive appropriate care at home, and are compliant to their medication. The field agents encourage the patients to return to the clinic if they miss their appointments.

In 2011, the HIV program, in conjunction with the maternity department added a prevention program for pregnant women infected with HIV to prevent the transmission of the virus to their newborns. Children are screened for HIV along with their mothers at the general ambulatory clinic and then enrolled in our care if they test positive.

Annually, the program screens 10,000 adults and children for HIV ending with 2% being positive. Together with their parents, the children infected with HIV receive psychological follow-up care and medical treatment including anti-retroviral therapy. Social workers assist with coordination of other

PEPFAR or Global Fund programs offering economical help, food, housing, vocational training, micro credit opportunities and academic scholarships).  To date, approximately 900 children are followed, 361 receive anti-retroviral therapy (ART). Sixty pregnant women infected with HIV are followed or have given birth through the prevention program. Often times it is too late for prevention because mothers receive screening only when they come to deliver their babies. The infants then receive prophylaxis at birth.

Other activities

Daily Dental Clinic: Available to Children and Adults, and available 5x a week.

Contact: For any questions, please email the Communications Officer at Co.ht@nph.org.

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