Haiti: Orthopedic Surgical Program
Surgical Support Program – Long Term Health Care Capacity Building: August 2016
September 15, 2016
Dr. Patrick Dupont
Summary of Activities
Starting in 2012, the orthopedic surgical support program has been providing complex surgeries and longer term follow-up treatment for children and adults suffering from chronic or acquired orthopedic conditions. These conditions are often extremely severe, ranging from congenital deformities to posttraumatic impairments, in many cases caused by the January 2010 earthquake.
RMF’s surgical program started its first installment with both adults and children, and then refocused its aim toward specialized care only for children and young adults. The patients selected for surgical treatment come from the metropolitan area of Haïti’s capital, Port-au-Prince, but now some patients also come from very remote provincial towns located in the southern and northern departments of the country.
Offers Quality Healthcare
Pétion-Ville and the surrounding communes were home to more than 100,000 displaced persons living in tent communities. This free clinic continued to offer quality health care to patients in need of primary, secondary, and even tertiary care. We were able to provide for more than 1,800 consultations and 450 surgeries over this time frame.
Dedicated Orthopedic Surgeons
Our dedicated surgical team of two orthopedic surgeons and one anesthesiologist performs these specialized orthopedic procedures at the Lambert Santé Surgical Clinic in Pétion-Ville, making it possible for these young patients to regain their ability to walk, to do so proudly, and, most of all, to become free from society’s discrimination toward their visible and incapacitating conditions.
It is our utmost belief that this surgical program is significantly impacting young lives in Haïti. What we are able to provide through this program is, in one word, hope.
(RMF is) benefiting children, teenagers, and young adults who were incapable of enjoying a normal childhood or starting a meaningful young professional life… Our main desired outcome is to optimize each patient’s chance to thrive as an active member of his or her community.
RMF continues our Surgical Support Program in Haïti, providing complex surgeries and longer term follow-up treatment for children and adults suffering from chronic or acquired orthopedic conditions. These conditions are often extremely severe, ranging from congenital deformities to posttraumatic impairments, in many cases caused by the earthquake.
Over the past four years, generously supported by Child Survival Fund, Real Medicine Foundation has been able to provide specialized orthopedic care and follow-up treatment for children and adults who were desperate for relief from their posttraumatic or congenital ailment, which had prevented them from thriving or taking care of responsibilities and their families’ needs.
Public Private Partnership
CENTRE HOSPITALIER DU SACRÉ-CŒUR, HÔPITAL CDTI
RMF’s overall vision for our work in Haïti remains firmly in place: to promote and provide sustainable health care. This vision has been paramount in our efforts to implement a public/private partnership healthcare facility in Haïti available to all patients regardless of their ability to pay: RMF’s CDTI Hospital project (Centre Hospitalier du Sacré-Cœur, Hôpital CDTI).
This flagship facility, as it is envisioned, has the potential to become a game changer in the Haïtian healthcare system, improving access to quality secondary and tertiary care for the Haïtian population and its visitors in an ever developing climate.
In the aftermath of the January 12, 2010 earthquake, in addition to tackling some of the immediate relief needs, RMF moved forward with a comprehensive long-term strategy for sustainable health services development in Haiti to help rebuild its shattered public health system. Six years have passed since most of Haiti’s infrastructure was devastated, and while much progress has been made in rubble clearing and somewhat in rebuilding efforts, there is still much work to be done. Our new Surgical Support program is providing surgeries and follow-up treatment for children and adults in Port-au-Prince, Haiti.
- To provide free clinical services at Hôpital Lambert Santé Surgical Clinic in Pétion-Ville.
- To provide care for patients with severe conditions and deformities, while focusing on improving their overall health, functionality, and optimizing their chances to thrive as active members of their communities.
- To increase overall access to quality secondary and tertiary care for the entire Haitian population.
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We were able to provide for more than 1,800 consultations and 450 surgeries.
In December of 2015, the last selected pediatric patients of this installment were able to be screened again and treated before Christmas, making Christmas more joyful for many of these families, as their loved ones got to see the children’s impairing conditions addressed and corrected.
These 10 new patients had various conditions, ranging from residual developmental lower limb deviations from the normal axis, to Blount’s disease and severe dysplastic lower limb deformities.
Manoach Louidort, is a 6-and-a-half-year-old boy for whom we had done a corrective tibia osteotomy in 2013 for his post-traumatic left tibia injury. Upon noting recurrent bowing after the first procedure, clearly diagnosed at 6 months plus postoperatively at age 4, we decided to perform a temporary growth arrest on the medial side of his femoral growth cartilage during the second half of that same program installment to try and progressively correct the recurrent deviation. We finally had to perform another, more aggressive correction osteotomy this year, in view of lessened but still ongoing deformity 6 months later. Upon the last follow-up, 4 months after his last surgery, his recurring condition appears to have been finally stopped, and now Manoach’s left leg will soon be allowed full weight-bearing, as we will continue to follow his progress.
Pédaline Louis, 13 years old, was first treated by RMF in 2013 for a severe bilateral bowed leg deformity from rickets. She was able to see her life drastically changed by the first surgery on her right leg that year and is now able to benefit from the same surgery to realign her left lower limb to finally match her new appearance and functionality.
Multiple Surgeries Required
Stevancia Dejuste is also a perfect example of this principle, as in 2012, a severe bone growth afflicting her thigh and shin bones resulting in major leg discrepancy was able to be diagnosed as benign through a bone biopsy and pathological exams. This first procedure set in motion a plan to correct her severe condition and restore a more satisfactory level of ambulation and function to her lower limbs. She has been part of all three installments of the surgical program, and after another surgery in 2013-2014 to correct the severe lateral deviation of her knee and shin bone, a lengthening procedure was last done in 2015 to try and decrease the remaining leg discrepancy. The remaining 8 patients suffered from a variety of orthopedic conditions of congenital, developmental, and post-traumatic origins afflicting their knees and/or their overall lower limbs.
First Corrective Surgery
Medgine Olivier displayed bilateral dysplasia of her skeleton resulting in a severe bowing deformity of both her lower limbs. A combination of nutritional and growth disturbance factors is probably to blame for her condition. Medgine, who has been in the care of a local NGO-supported orphanage and child support services for very low or no income families in the rural Port-au-Prince area, was brought to our attention after word of mouth information spread from the satisfied families from previous surgical program installments. Medgine will undergo her first corrective surgery in July 2016, and we anticipate very good postoperative results.
Second Limb Surgery
Richardson Edouard suffered from Blount’s disease, a developmental growth pathology very common in the Haïtian population, and incurring moderate to severe bowing at the knee level to the point of limited walking capacity. Richardson underwent his first corrective procedure in 2012 as one of the first patients of RMF’s pilot surgical program, which addressed one lower limb and required monitoring to evaluate and follow the progressive correction of his condition. The second limb surgery was finally done this past year, concluding his treatment.