Justinian University Hospital

Hôpital Universitaire Justinien (Justinian Hospital) is a 250-bed teaching hospital operated by the Haitian Ministry of Health. The hospital is the largest health care provider in northern Haiti and serves an estimated 825,000 people. Its residency programs include medicine, pediatrics, general surgery, OB/GYN, family practice, and schools for nurses and laboratory technicians.

There is no clean, potable water in most of the hospital. Open-air wards make control of infectious diseases very difficult. Electrical surges and lack of grounding damage delicate medical equipment and pose a threat to patients and staff. The only public bathroom facilities are sub-standard pit latrines. Because preventive care is largely unavailable, patients are often very sick when they come to the hospital. Doctors and nurses work long hours, and with few resources.

The Clinic at Fort St. Michel

In 2003, Konbit Sante expanded its work to the clinic at Fort St. Michel. This well-organized public clinic is under equipped and under staffed to serve the needs of this impoverished neighborhood of 40,000 people on the edge of Cap-Haitien. There is no electrical service or safe drinking water in Fort St. Michel. Most homes are very fragile dwellings constructed on refuse and vulnerable to flooding. Tuberculosis is the leading infectious cause of death in the Fort St. Michel neighborhood.

PROGRAMS

Much of our initial work has focused on Hôpital Universitaire Justinien (Justinian Hospital), the Fort St. Michel clinic on the outskirts of Cap-Haitien, and the surrounding neighborhoods. Some of our work to date includes:

Ongoing Education: Providing education and support in nursing, internal medicine, pediatrics, OB/GYN, family practice, urology, psychiatry, dermatology, and public health.

Pediatrics: Hiring and supporting two highly qualified Haitian pediatricians and a pediatric nurse educator to improve education and quality of care in pediatrics at Justinian Hospital. This work is partly funded by a grant from the United States Agency for International Development (USAID–MSH/SDSH-PWOJE DJANM), with additional support from the SG Foundation. We have built a new pediatric outpatient facility at Justinian Hospital and have helped re-establish the inpatient feeding program for severely malnourished infants. In 2006 we installed a system to deliver pediatric-dose oxygen to patients in the ward. The latest additions to our pediatric team in Haiti are two agents sante (community health worker) who follows the progress of children at home after discharge from the inpatient malnutrition program. Now, thanks to the Dorothea Haus Ross Foundation, we are building a pediatric emergency room and water cistern.

Internal Medicine: Hiring and supporting a highly qualified Haitian internist to provide education for residents and medical students and to improve patient care in the adult wards at Justinian Hospital. We have also created and furnished a teaching space in medicine.

Tuberculosis: At the Fort St. Michel clinic, working with the Ministry of Health, International Child Care (ICC), and clinic staff, Konbit Sante has supplied critical support for TB detection, treatment, and risk reduction. We employ six agents sante (community health workers) and provide emergency supplies for the TB program. We have also made some facilities and infrastructure improvements at the clinic. This work is also funded by USAID/MSH.

Women’s Health: In 2006 Konbit Sante conducted a community-wide study of women’s health needs in Cap-Haitien. This study was funded by a grant from the Conservation, Food & Health Foundation. A combined team of US and Haitian physicians, nurses, and community-based women’s health organizations organized by Konbit Sante are implementing programs to make the hospital easier to navigate and welcoming to women. Most recently, with USAID funding, we have hired an OB/GYN with whom we collaborated on our study of women’s health needs to provide care for the women in the area served by the Fort St. Michel clinic.

Infection Control: Konbit Sante is developing a program to reduce the spread of infections within the Justinian University Hospital. This two-year program is funded by a grant from the Pan American Health and Education Foundation (PAHEF). The desired outcome is improved infection control at Justinian and also development of a sustainable model that may prove particularly useful in hospitals with limited resources.

Hookworm Treatment: Konbit Sante has introduced a hookworm treatment program in the Fort St. Michel neighborhood to improve the anemia status of women of reproductive age, thus improving the quality of their daily lives and improving maternal and birth outcomes. The program will also build a sustainable, community-directed mass distribution system to improve the public health system’s capacity to provide other interventions. This work is funded by a grant from the Conservation, Food & Health Foundation.

Infrastructure Improvements:

Water Program: A major project has begun to improve the quantity, quality, and distribution of water within the Justinian Hospital. This work involves adding a second well, improving ability to pump and store water, and installing new piping to various parts of the hospital campus in order to provide more and better water for staff, patients, and their families. This work is partially funded by generous donations from GlobalGiving.com and Rotary International.

Communications: We have installed computers and a satellite-based internet connection at Justinian Hospital to improve communications and access to up-to-date medical information. Konbit Sante is grateful to Northern Data Systems for their support of this work since its inception.

Electrical and Mechanical Improvements: Initial much-needed improvements to the hospital’s fragile electrical system have been made. More work is needed in this area to protect people and medical equipment. In addition, Konbit Sante technicians deliver, repair, and train hospital staff in use of specialized medical equipment. Konbit Sante is developing a system for ongoing troubleshooting for medical, electrical, and computer systems using part-time Haitian consultants.

Equipment and Supplies:

To date, Konbit Sante has delivered nine 40-foot sea containers of essential medical equipment and supplies and has worked with the hospital management to develop a central system for inventory and distribution.

Community-to-Community Relationships:

In 2003 Konbit Sante initiated a Sister Cities relationship between the City of Portland, Maine and Cap-Haitien, Haiti, based on the belief that broadening community support and involvement will have an important synergistic benefit for the people of both communities. We continue to encourage non-clinical, community-to-community relationships that focus on improving health.

 

Photo Credit: top photo taken by: Nathan Broaddus