We are now close to  conclusion of the third out-reach course in
Obstetrical Ultrasound organized by ISUOG ( international Society of
Ultrasound in Obstetrics and Gynecology), at St Damien Hospital, with
the support of Rava Foundation, and generous local staff.

–
Enrico Ferrazzi, MD
Full Professor and Chairman -
Dept. of Obstetrics and Gynecology ICP – Buzzi Childrens’ Hospital
Sacco Clinical Sciences Institute -.
University of Milan -
Milan – Italy

The new operating room was inaugurated last Monday, November 19^th.  Equipped with up-to-date technology and furniture, the room was funded by the Francesca Rava Foundation through NPH Italia.  The first operation to take place in the room was performed by Dr. Jean Edgard Aupont, the Head of the Maternity Ward, Dr Jean Junior Jazon, an attending OBGYN, Anesthesiologists, Drs. Magdala Pavrette and Joanne Duchatelier Domercant.  Assisting the doctors was Head Operating Room nurse,  Mme. Edna Benjamin, and INFs Claudine Beltinoire, Merline Obey, and Louisena Francois. The typical team would comprise four members: one OBGYN, one Anesthesiologist, one operating room nurse to assist the surgeons and one auxiliary nurse. However, for this first case on the very first day of opening, it was necessary to have a back up team to make sure that everything was perfect.

The first C-Section surgery in the new OR

The wonderful staff, who assist in the surgeries, hard at work

To start the ceremony, our beloved Fr. Richard “Rick” Frechette led the attendees in prayer, after which Dr. Jacqueline Gautier, the Executive Director of St. Damien Hospital, spoke directly to the hearts of everyone present while reminding us of the NPH mission – to care for the marginalized children of Haitian society.  Following Dr. Gautier’s eloquent words, Dr. Aupont, the Head of Maternity, complimented and congratulated the entire Maternity Ward team of new and current employees for the strong collaboration and consistent “esprit de corps” that continues to reinforce St. Damien Hospital’s reputation as a pillar in medical care in Haiti.

Opening Prayer

The new facility contains 2 surgery rooms, 1 Scrub Room, 1 Changing Room and 1 office.   Amazingly, with the funding of our supporters and friends, St. Damien Pediatric Hospital was able to hire a team of 11 new employees for the operating room.  The new additions to the team consist of 4 Registered Nurses, 2 Auxiliary Nurses, 4 Orderlies and 1 Sterilization Agent raising the Maternity Ward staff to a total of 27 employees.  In all, there are now 7 Anesthesiologists, 7 Registered Nurses, 4 Auxiliary Nurses and 9 Orderlies.  This amazing team, headed by Dr. Aupont, is committed to raising the standards of medical care to the citizens of Haiti who travel great distances to come to St. Damien for the quality care that it provides free of charge.  According to Dr. Gautier, the staff here is handpicked and forms a cohesive network of highly trained specialists who provide dignified and loving care to the poorest of the poor of the people of Haiti.  In Dr. Aupont’s words “We give our best to every patient.  Each member of the team is vital; without each person doing his/her part, we cannot function.”

Fr. Rick blesses the new rooms

Immediately following the prayer and speeches, Fr., Rick blessed each room of the OR asking God for His divine inspiration and guidance in all procedures that take place there.  Because St. Damien Hospital is known for its reputation of providing quality medical care for extremely high risk pregnancies, 38 year old Mrs. Rosemarie Louis was referred to this hospital during her second pregnancy.  The medical care was provided free of charge to Rosemarie because she cannot afford it.  As a second time mom who is unable to deliver a baby through natural childbirth, she underwent a Caesarean Section to give birth to a very healthy 7 lbs. baby girl.  The baby, known immediately after birth as Baby Louis, was extracted speedily and without incident.  Dr. Aupont explained the necessity of performing a Caesarean Section on Rosemarie to prevent potential complications due to previous surgery for fibroids.  Considering the doctors first had to remove a mass of keloid from Mrs. Louis’ two previous surgeries prior to performing the procedure, the operation was a success.  The team is grateful for the modern equipment that has been donated to the hospital.  As you can see in the pictures, Dr. Aupont is using the electric scalpel to remove the keloid from Rosemarie’s abdomen.  Additionally, the electric scalpel was used to remove multiple layers of scarred tissue before extracting the baby.  Also in the pictures, the Anesthesiologists are using the new machinery to monitor Mrs. Louis during surgery.  The impact of our supporter’s and friend’s contributions will multiply many times over as St. Damien continues to carry out its mission on behalf of Haiti’s poor.

Another baby is welcomed into St. Damien Hospital thanks to the hard work of the team!

Hurricane Sandy leaves people of Haiti in further distress.

The death toll in Haiti reached 51 after three constant days of rain from Hurricane Sandy. Our NPH homes and children withstood the storm and are now trying to clean up and get back to a normal schedule and resume school. But others have not been so lucky. Many of our neighbors and staff have had their roofs blown off and houses flooded. Crops have been destroyed and farm animals washed away.

Bridges washed out from flooding

Fr. Rick Frechette, National Director of NPH Haiti explained, “We have a number of repairs to windows, waterlogged electrical systems, gravel to lay down and trees to replant.

Children Walking Through Flooding

Cholera has gone high from the rains and we need more cots and iv fluids. We need to replace lights and fans that blew up when the generator and electrical lines flooded and shorted. Also it would be nice to help the neighbors with food, roofing materials and clothes.”

River Flooding

Monica Gery

Information Officer

Recently, the St. Damien Pediatric Hospital had the honor of delivering a set of all boy quadruplets. Proud parents, 30-year-old Madonne Laguerre and 34-year-old Gregoire Rigobert have tried for several years to create a family. Married in 2006, this was their first pregnancy. To ensure the safety of both mother and babies, Madonne had to be closely monitored practically her entire pregnancy – about eight months. After a two-week stay in the hospital, mom delivered the babies by caesarean section. The babies were extracted successfully on Tuesday, October 4th; however, the third and largest baby was at risk of lung failure and had to be resuscitated. After such a successful birth, we had to brace ourselves for a most unfortunate circumstance. Much to the parents’ heartache and the staff’s chagrin, little Marving, who had been experiencing tremendous difficulties since birth, died two days later of respiratory complications and anemia. At birth, baby Marvel, weighed 1,230kg, baby Raylanz weighed 1,180kg and little Hendrick 1,380kg. As of the writing of this story, they now weigh 920 gr, 985 gr and 1,380 gr, respectively.

One of the New Quadruplets

While mom has been sent home, the babies are being kept in incubators to allow their lungs to mature, gain weight and become healthier before being sent home. Although they are “not out of the woods yet”, we are all excited and very happy with their progress. The proud papa, exhausted from the daily trips to and from St. Damien, proudly recounts the night that the decision was made to perform the emergency caesarean section on his wife. He had just walked in the door at around 3 p.m. when his phone rang. It was the hospital informing him that his wife was being rushed to the operating room for the emergency operation. He immediately returned to the hospital and by the time he arrived the babies were already born.

One of the Quadruplets welcomed into St. Damien

The couple lives in Cabaret near Tabarre in a three room house which they share with a number of relatives. They were planning to move out on their own. With the babies’ arrival, they are even more determined to be in their own home. Gregoire is currently unemployed and is desperately searching for a job and as soon as is practicable, Madonne will return to work. However, given the state of the economy in Haiti, the future is uncertain. He and his wife are extremely grateful to St. Damien. They have not had to pay for the services, except for providing some of the babies’ needs such as diapers and wipes, milk and water.  A very devout man, he thanks God for bringing them to this hospital.

The couple was prepared for the possibility of complications that come with a multiple birth including the risks of post natal hemorrhage and pulmonary embolism among others. From the beginning of the pregnancy, Madonne, was transferred to St. Damien Hospital for the specialized care that this pregnancy necessitated. In Haiti, St. Damien Hospital specializes in extremely high risk pregnancies. People from all over the country come to St. Damien for the high quality care that it provides free of charge to those in need. It is a full service hospital that provides medical care from pre-natal to birth up to the age of 14. Currently, there is no other pediatric hospital in Haiti that parallels St. Damien.

Two of the Quadruplets staying warm together

From the time Madonne was transferred to St. Damien at 16 weeks into her pregnancy, she was experiencing pre-term labor which is common in such high risk pregnancies. She was followed up regularly until the 28th week at which time she was admitted into the hospital. To diminish contractions, a tocolytic agent was administered and corticoid was given to accelerate the fetuses’ lung maturity. Between 30 and 31 weeks the Caesarean Section was performed on an emergency basis because beyond that the risk of fetal demise greatly increases. Present in the operating room were Drs. Aupont [head of Maternity], Jazon [OBGYN] and Gautier, a visiting 4th year OBGYN resident at Georgia State University,  Lerissont [Pediatrician], Ms. Bazin (neonatologist nurse), the Anasthesiologist and the operating room Nurses. According to Dr. Aupont, Chief of the Maternity Division of St. Damien, everything was “in sync” for this birth. During the stages of pre- and post-surgery, the Neonatology team, lead by Dr. Dorcelus (in the absence of  Dr. Nazaire, head of Neonatology), was present to aid in the delivery and to accept the babies into the Neonatology ward. Although, Neonatology is oftentimes overwhelmed with the responsibilities of that division, they made available three incubators ready and waiting for the babies.

Dr. Aupont, said, “The teamwork was intense because everyone had to react quickly.”  To summarize his sentiments, Dr. Aupont remarks further that the cooperation between Maternity and Neonatology was phenomenal and it “proves what great work can be done at this hospital.” He also commented on the great work the rest of the team does every day because without the members who prepare the beds, sweep and mop the floors to maintain the cleanliness of the hospital; cook the meals, administer the medications to maintain the health of the patients, “we cannot function and I could not do my work”.  An apt statement, in appreciation of teamwork!

While mom was resting from the operations, dad took the opportunity to thank the doctors, nurses and support staff at St. Damien for the excellent care that his wife and children are receiving. Furthermore, he appreciated the kindness in the nursing staff’s approach to new parents.

HIV

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.

Public Health agent visits community patients

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.

The total number served by the St. Damien HIV and Public Health Programs is 22,000.   Click here to view photos of our public health agents working in the community.

Needs

HIV program: Funds and micro loans to help the families of children infected and affected with HIV.  Many times the socio economic problems are profound and as the children improve with medication they need to go to school. Most families cannot afford to send their child to school. Funds are also needed to provide lab tests currently not available in the PEPFAR network but that can be very helpful to improve the care of the children.

Public health program: Three computers to document immunization records. For the moment we only use paper registers. We also need funds to provide air conditioning in the room where we stock our vaccines in two refrigerators, to improve our cold chain. In summer time it is a challenge to keep the required temperature.

Total number served: 22,000

My mother loves the rain. Some of my earliest memories are of her excitedly preparing my sisters and I to venture outside to splash in gutters, jump in puddles, and carelessly kick around as children so naturally do. She’d laugh, she’d skip, and she’d sing, as if teaching us to love the rain was a life lesson of vital importance. As if we were in some way learning to weather storms, take the sour with the sweet, or appreciate the little things. Our dancing around would be followed finally by us entering our dry home, taking turns to have a hot shower, using a soft towel and putting on warm clothes, and then eating a homemade soup prepared by our singing mother. These early child hood experiences conditioned me well to love the rain – The sound of it, the feel of it, and the aftermath of it. Growing older brought new rainy moments and associations. Romantic dinners in dimly lit restaurants in NYC, the sharing of an umbrella with a stranger, and waiting through rain delays to watch the Mets lose again. At worst, a rainy day at the beach forced us to stay indoors to complete puzzles, read books, or watch movies. All of these activities done with warm, dry clothes and without fear, or in fact even any real relation whatsoever, with the rain that fell outside. Rain was something to be appreciated, observed, and occasionally planned for, but very rarely more or less than that.

I have spent the last two years living in Haiti, and the sound of rain is forever changed. Here I have been enriched and inspired by the Haitian people. One cannot spend much time in this beautiful and magical country before being punched in the chest by the strength, grace, and determination of the Haitian people, who are constantly moving, pushing forward and fighting for tomorrow. I have changed and grown as anyone would through the witnessing of new realities, astounding beauty, and an at times deafening amount of misery and pain. Where the sound of rain once brought comfort and quiet reflection, it now brings unease and worry that comes with my intimate knowledge of what rain means these days in Haiti. Mixed in somewhere is a bit of guilt as well, when the first drops fall and my initial and time-imparted positive associations are met head-on by my newer sympathetic response to the sound of rain on tin roofs. This guilt is in no way an indictment or judgment on those who enjoy the sound of rain from their homes. The guilt comes from being part of a world where the luxury of comfort, joy, or at a minimum indifference to the sound of the rain remains foreign to so many whose lives are so brutally affected by it.

My friend Esther is a devoted mother of three, and a smart, strong, and enormously talented woman. She can break your heart with a song, she has a laugh like a firecracker, and she possesses strength and light that is visible from a mile away. She is Haitian, born and raised here, and is what one might refer to as middle class by Haitian standards. She works at the same hospital I do, as does her husband, and she has been an inspiration to me throughout my time as a visitor in her country. As much as my own mother loved the rain, cherished it, and sought it out, Esther worries over it, fears it, and tries (though to no avail) to avoid it.

It is widely known that Haiti experienced two large-scale disasters in the past two years. The earthquake brought an early and unexpected death to 300,000 Haitians, and with it came cameras, attention, newsmen, and a swarm of international volunteers and NGOs (some heroic and many clueless and in need of help themselves). The second disaster was the cholera epidemic, which began in October of 2010 and continues to this day. The miseries that now come with the rains are in fact closely associated with these disasters.

Have you ever stood in a tent holding your several belongings above your head, standing up right, with dirty rain water up to your knees, while your children sit on the highest chair you can find and try not to fall asleep? Have you ever gone to work the next morning leaving all of your kids with a neighbor, only to then repeat the same thing every other night and day for three months straight? I haven’t either. But this is what my friend Esther did when the rains started after the earthquake. She had lost her simple home, as had so many others, and there was nothing to do but put one foot in front of the other, and work, work, work. There was no alternative whatsoever for her and for an entire population of people. There has been progress in Haiti and I believe there is real reason to be hopeful. But two years later there are still people holding their belongings above their heads every night. A legion of mothers standing upright to hold their babies until the day comes.

In October of the same year, cholera entered Haiti for the first time in over one hundred years. The strain of cholera, which is widely accepted to have been inadvertently brought in by Nepalese UN troops, was particularly virulent and spread very quickly. Cholera travels in water and thrives in places with poor sewage and sanitation, and in this sense the conditions in Haiti were akin to lighting a match in a gas soaked room. To date over 500,000 have been infected and over 7,000 have died. Education about the disease has improved and people now know how to quickly recognize symptoms. But poor sanitation and lack of access to clean water have changed very little. As the rains come and the water rises and mixes, so spreads cholera. Many organizations that were initially treating cholera have now left. And though there are noble and worthy efforts being made at vaccination, the conditions in the short term continue to be dire. Herein lies the second reason that Esther hates the rain. In the hospital we work at, St Luke’s, Esther has been working with cholera patients since the very beginning. Since that time we have seen over 20,000 sick come through our gates. The disease is brutally quick and can kill a healthy person in a matter of hours without treatment. Esther and the rest of our staff have saved thousands in the past year and a half, but they have also seen many arrive too late to be saved. Esther has seen families crushed by this second disaster as well, and she now knows well that with the rains comes cholera.

Tucked within the response to these two tragedies there is great deal of hope, and it is found in the example of Esther and the rest of our Haitian team and leadership at St Luke Foundation. There are many organizations, St Luke included, that are doing extraordinary things in Haiti, with many of the most effective among them being led by Haitians. In my experience what the Haitian people need is resources and respect. They will take care of the rest. Progress has been made and will continue if resources arrive. The head of U.N. mission in Haiti is asking publicly for more resources so that the U.N. can ramp up efforts to fight cholera as the rains begin. Many international pledges have not been fulfilled. With financial troubles in Europe and the States, and myriad problems throughout the world, it is an easy time to forget the promises made to Haiti, and an easy time to turn away from the brutal hand that these disasters have dealt the nation.

The important and inescapable fact which is immediately clear to anyone who spends any real time in Haiti is that great and sweeping change is possible and in fact inevitable if a foreign aid that respects the Haitian people’s proper role in their future is brought into the country. As the rains begin in Port au Prince my deepest hope is that the Haitian people be provided the resources to work towards allowing Haiti to become a place where children play in the rain. The strength of Esther and the many other Haitian mothers who have held their children throughout nights and nights of rain is a strength that ought to be harnessed as part of forward thinking plans for the future of the country. The rain should be left for playing in, the nights should be left for sleeping through, and this enormous human energy should be used as fuel for the development of the country. In order for the currently abysmal conditions to change, international investment and support must continue. Promised support should not be delayed or withheld a day longer. Without this support the sound of the rain will continue to bring only fear to the devoted mothers of Haiti.

Wynn Walent is the Assistant National Director at Nos Petits Freres et Soeurs and the St Luke Foundation for Haiti.

Thirty-six year old Velene Victore Liko and her husband, Ernest Liko, are the proud parents of triplets.  Mom and babies are healthy and doing fine.  Baby No. 1, a boy, weighted 750 g (appx. 1 lb and 11 oz); baby No. 2, a girl, weighed 650 g (appx. 1 lb and 7 oz) and baby No. 3, a boy, weighed 850 g (appx. 1 lb and 14 oz).  The first triplet was born on Friday night while the other two were born on Saturday morning.  The babies have not yet been named; however, hospital staff refer to them by order of birth and by weight.  This is the second time triplets have been born at St. Damien Pediatric Hospital and we are excited to share the good news with everyone.

Velene Victore came to St. Damien Pediatric Hospital on a referal from the Manitane prenatal care clinic operated by the St. Luke Foundation.  She was referred to Maritane Clinic after having been to another hospital at Delmas 29 because her pregnancy was a difficult one that required the care of specialists.  Being sister hospitals, St. Luke and St. Damien care for their patients in tandem which is why Manitane Clinic’s “high risk” pregnancies naturally come to St. Damien.  Here at St. Damien, the care ranges from pre-natal care, to birth, through post natal care, and extends beyond until the child reaches the age of 18.

Velene and her healthy triplets

When Velene Victore arrived at St. Damien on Friday, May 4 at approximately 10:00 p.m., she was already in labor at which time she delivered the first baby by natural childbirth.  However, she was experiencing complications pushing the second baby through the birth canal.  The baby’s head crowned but was stuck and its heart rate began to decrease.  Doctors immediately rushed her to the operating room for an emergency Caesarean Section “C Section” to remove the baby.  At that point, it was revealed that there was a third baby ready to be born. Surprise! Surprise!

Velene Victor shares the story of having had sonograms done prenatally that the tests did not show triplets, and she was prepared only for twins.  Since she had to undergo anesthesia she was asleep during the birth of the second and third child.  Much to her delightful surprise, after surgery she received the news that instead of going home with twins, she was now going home with triplets.  Although this mom is overjoyed, she says that she is very worried for her babies because she has given birth to twins before.  That was her first pregnancy 10 years ago, and sadly, one of the twins did not survive.   Velene Victore shared her problem with many fibroids in her uterus which complicated her pregnancies, the births and also caused bleeding during labor.  She fully admits that this time she is “in very good hands here” because St. Damien Hospital’s maternity ward accepts “very high risk pregnancies,” which it is fully and expertly prepared to handle.

Velene holding one of her three new babies

With the babies’ low birth weights, she has no idea when she will be released from the hospital, but for now she feels comfortable and completely satisfied and happy with the care that she is receiving. This kind of care would have cost her a great deal of money which she and her husband could not afford.  She is currently unemployed and unable to work. Her husband, a day worker who is willing and eager to work whenever he is able to find a job, does not make enough money to pay for his wife’s prenatal care nor her hospital stay. In her words, she “has not been asked for any money.” The only cost to them has been the cost of the sonograms. Their BLESSINGS ARE MANY including the safe birth of their triplets, the children’s health, and the excellent free care she has received at St Luke Manitane Clinic and St. Damien Pediatric Hospital.

Dieuveck Rosembert and Peggy Parker
Communication Team, NPH Haiti