Saint Damien Hospital

Nuestros Pequeños Hermanos founded by American priest Father William Wasson in 1954, opened their Haiti program (as Nos Petits Frères et Sœurs (NPFS) or Our Little Brothers and Sisters) in 1988.  While the initial goal of NPH/NPFS was to build a permanent home for orphaned and abandoned children, 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 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 and community programs provide over 80,000 services to children and adults annually.

Anesthesiology: The anesthesiology department includes seven anesthesiologists performing mostly cesareans and offers anesthesiology services to the visiting teams of surgeons. Eventually they will also provide service to a regular pediatric surgical service.

Dental Clinic: One dentist and two technicians offer daily services to both adults and children.

High-Risk Maternity: The high-risk maternity program delivers approximately 2,000 babies per year. The program has 15 obstetricians (part and full-time), and eight midwives among other professionals. Each month the program receives two volunteer midwives from Italy. The program collaborates closely with the St. Luke Manitane Pre-natal clinic and St. Luke Outreach Clinics in the slums. In 2015, St. Damien had 4,841 consults, 2,502 admissions and 2,026 deliveries.

HIV Program: 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. With time, some children are referred to new sites open near their homes to improve compliance for families. In 2015 the pediatric cohort was 674 and the pregnant and breastfeeding cohort was 107.

Human Resources

• The hospital is staffed with:
• 389 full time employees
• 60 short term contracts and part time employees
• 9 staff members from St. Luke Foundation, a sister hospital
• 460 total

Among other positions are:

• 11 administrative
• 12 pediatricians
• 40 registered nurses
• 32 nursing assistants
• 41 hiv program
• 1 radiologist
• 7 laundry
• 5 kitchen
• 3 data clerks

Laboratory: The laboratory has the capacity to do many essential tests, including malaria blood smears, HIV, and sickle cell and bacteriological studies. Other tests are done at outside labs.

Malnutrition: Children with severe malnutrition are usually hospitalized for six weeks and are treated based on the national protocol. This department treats children from many areas of the country. Patients first receive a special liquid formula made of mild multivitamins and oligo elements. Fortified peanut butter with added nutritional ingredients is administered at the last phase for rapid treatment. The monthly average of patients is 30 (per 2014 statistics).

Neonatology: St. Damien’s Neonatology program treats our highest risk newborns and serves up to 50 patients per month. The program receives regular technical support from Bambinu Gesù Hospital in Rome, Italy. Pediatricians and nurses receive four week training regularly at this hospital while nurses and neonatologists come for two to four weeks to continue the training onsite. The St. Damien Neonatology unit is one of only five neonatology departments available in the country. Since neonatal deaths accounts for half of the whole pediatric mortality rate, St. Damien is thrilled to bring this invaluable service to the country. Although progress was made in Haiti, cutting by 20% the pediatric mortality rate in the country, the neonatal death rate has remained unchanged for the last 15 years.

Oncology/Hematology: St. Damien’s Pediatric Oncology/Hematology Center has been in existence since 2006 and has treated almost 300 patients throughout Haiti. The Center treats both solid tumor and blood cancers (such as leukemia, lymphoma, retinoblastoma, rhabdomyosarcoma, osteosarcoma, Wilms, hepatoblastoma, neuroblastoma, (ovarian, testicular). Chemotherapy and surgical interventions are provided onsite at the St Damien campus and radiation therapy is provided in Santo Domingo in the Dominican Republic. The Center currently is a site of the international outreach program of St. Jude’s Medical Center from the United States. Two pediatricians out the three working at the department, were trained for one year in Guatemala where an international site for pediatric oncologic training is located, under the supervision of St. Jude Hospital. The physicians have bi-weekly video conferences with St. Jude’s to discuss difficult oncology cases. Pathology is supported by several centers in the US who aid in diagnosis.

Panel physician clinic to screen candidates for US immigration: This clinic opened in February 2014, under a contract with the US embassy and collects a fee from the clients seeking to immigrate to the US. The objective is to generate funds for St. Damien in order to complement money received by fundraising. The fee covers the screening for several diseases including tuberculosis as well as a series of vaccines, based on CDC requirements. One physician, a nurse, and the service of a radiologist and a receptionist, manage the department. The number of clients is increasing monthly.

Pediatric Residency Program: There is a severe shortage for specialty training for medical graduates in Haiti. Only 60% of them have access to a residency program. Furthermore, only 300 pediatricians are in function in a country where 30% of the 10 million inhabitants are children under 15 years of age. St. Damien, with over 20 years experience in managing pediatric healthcare, decided to work at decreasing this severe gap. In September 2013, St. Damien developed a pediatric residency program in conjunction with two other entities: University Notre Dame (a private catholic medical school) and UNDH and Hospital Bernard Mevs/Project Medishare (a private hospital). The program is a three-years and is open to all Haitian medical graduates. The recruitment is based on a theoretical exam and an interview. In October 2014, seven residents entered their second year of training while six new residents started their first year.

Pharmacy: The pharmacy is responsible for drug and medical supplies including items for the patient rooms and for outpatients. While some essential drugs are produced and purchased in Haiti, many medications and supplies are imported from Action Medeor, a specialist supplier for charity projects from Germany and IDA, a similar supplier from Holland. Technical support if offered from the Association of Pharmacists in Italy, assisting with pediatric formulation preparation as well as management of oncologic drug preparation.

Radiology: The hospital has a digital x-ray which performs 400 x-rays a month and is capable of sending images to an external radiologist in the United States. More than 90% of all x-rays are chest exams of the lungs for respiratory tract infections.

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 one consultant pediatric surgeon, four nurses, two certified nursing assistants, and two technicians who were trained in Italy. Most common surgeries performed are colostomy, hypospadias, hydrocephalus, hernias, and oncology cases. Visiting teams of surgeons perform surgeries three times a year. Patients are referred to surgery from the general clinic and the emergency room. The chief of surgery consults five to seven patients weekly, to determine if surgery is needed. Non-emergency surgery is performed Monday through Friday, while emergency surgery is performed seven days a week.

Tuberculosis: The tuberculosis (TB) program at St. Damien’s treats both Pulmonary TB and Extra-Pulmonary TB and is for children between 0-14 years of age. Some cases are hospitalized, but most are outpatient receiving a six-month regimen with close supervision for compliance by two field agents. St. Damien receives free drugs from the National Program (PNLT) against TB. Every year approximately 250 children are treated. St. Damien receives financial support by ACTMON, a Spanish foundation based in Barcelona.