How Grace Children’s Hospital Was Able to Overcome the Challenges That Allowed It to Continue to Provide Care to Patients

The following piece was originally published in the American Academy of Pediatrics: Section on Global Health Fall 2024 Newsletter (Vol. 5 No. 3). It was written by GCH staff - Dr. Rony Derius, Dr. Josette Bijou and Mdm. Jocelyne Arnoux.

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Original Text:

How Grace Children’s Hospital Was Able to Overcome the Challenges That Allowed It to Continue to Provide Care to Patients

Dr. Rony Derius, Dr. Josette Bijou, Mdm. Jocelyne Arnoux

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History of International Child Care / Grace Children's Hospital

International Child Care/Grace Children's Hospital (GCH) is anon-profit philanthropic organization that has been operating in Haiti for nearly 60 years. The physical structure of this hospital was destroyed by the terrible earthquake of12 January 2010, and since then it has been largely operating in temporary shelters. It currently has 20 pediatric inpatient beds, an eye clinic where young ophthalmologists are trained, and outpatient clinics in various specialties, especially supporting care for children and women.

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GCH's Mission

In response to Christian principles, International Child Care works in a spirit of care and sharing, to promote the overall health and well-being of the poor, especially children.

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The political situation in Haiti from January to June 2024

• The political situation has deteriorated considerably over the last 6 months. Haiti continues to suffer from chronic political instability.

• The capital is besieged by gangs and their violence is growing at an alarming rate

• No government for more than 2 months (March – April –May...)

• Total closure of the airport of the capital "Maïs Gâté"

• More than 15,000 people have abandoned their homes in the capital to go to the provinces or take refuge in tents in public squares.

• The increase in violence has led to the death of many people, including a doctor at the hospital and in the street.

• Roads are closed by barricades.

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Impact of the political situation on health

The health system is already shaky in Haiti and is collapsing. It is becoming increasingly difficult for the majority of the population to access health care. Lives continue to be lost in Haiti as vital health services risk being paralyzed by:

• Unavailability of essential medicines and daily medicines for the treatment of chronic diseases.

• Closure of several health institutions in the metropolitan area, including the Asile French hospital, Bernard Mevs...including the HUEH, the largest public hospital, besieged by bandits.

• Reduction in medical staff due to gang violence. Medical personnel are forced to either stay at home or turn back when roads are blocked by armed bandits or take refuge in the provinces.

• Difficulty accessing a hospital when the streets are barricaded, sometimes even by ambulances.

• Inability to guarantee continuity of care for a patient due to a lack of equipment, blood, medicines, doctors, nurses and others.

• Inability for dialysis patients, cancer patients, decompensated diabetes, etc. to go to treatment. They sometimes die at home due to a lack of access to care.

It is in this deleterious environment that GCH had to continue to offer its services to the population but was forced for a few weeks to close the hospital section (pediatric hospitalization) because of shortages of drugs and inputs and also under the demands of parents who claimed their children to take them to the provinces.

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Impact of the political situation on the economic situation

Haiti faces a persistent political, economic, and institutional crisis that has been aggravated by extreme gang violence. The economic potential of the inhabitants has decreased considerably. Nearly half of the population faces endemic food insecurity.

• Several employees with their families found themselves homeless, fleeing their residential area. Some have taken refuge in GCH because they have no other shelter.

• Difficulties in transporting agricultural products from the Province to the capital, the main access routes are controlled by bandits

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A resilient team forced to adapt to continue

At Grace Children's Hospital, we are a multidisciplinary team. With the economic and political crisis, the ever-increasing violence, and the failing health system, the needs of the Haitian population are great and urgent. The ICC/GCH team, aware of this reality, has done everything possible to try to maintain and adapt its services as best as possible according to its capacities despite the insecure conditions. A contingency plan had to be developed and executed. Results:

• Medical, administrative and support staff sometimes had to get around obstacles despite heavy fire to come to work

• In emergency cases, employees who live in the area surrounding the hospital have willingly agreed to come to work outside of their time slot

• Special shifts are established for staff.

• Distribution of anti-tuberculosis drugs and ARVs for patients has been maintained, sometimes at home and also on weekends as soon as passage is possible

• Close contact between managers and meetings outside the work environment for the smooth running of the hospital

• Utilized our stockpile of lab inputs and medicines during 2 months of total shutdown of the country to treat patients on an outpatient basis.

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Conclusion

The political situation in Haiti greatly affects the ability of the health service to provide quality care. The functioning of the health system is hampered by the current insecurity, but the situation is not hopeless, although it is overwhelming. Actions need to be taken to ensure that the entire system is properly rehabilitated and access to care is strengthened. At GCH, the challenges are great. We hope fora sharp and rapid improvement in the situation for the establishment of a less precarious and safer environment for both patients and staff.

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References (for photos)

• fchhaiti.com (Photos)

• wordpress.com (photos)

• gazettehaiti.com

• https://gchhaiti.org/about-us

• Pinterest.com

• la1erefrancetinfo.fr

• www.gracechildrenhaiti.com