FEJ Children’s Medical Center for HIV & Malnutrition
Summary
In 2020, Fondation Enfant Jesus (FEJ) committed to establishing a children’s medical unit focused on the treatment of HIV and malnutrition at the Fondation Enfant Jesus Children’s Center. As the poorest country in the Americas, Haiti is especially vulnerable to a myriad of health issues, particularly HIV and malnutrition. Children with HIV experience a significant gap in access to treatment, as only 40% receive treatment. Similarly, 22% of children under five suffer from chronic malnutrition. These challenges are worsened by the stigma that surrounds HIV and malnutrition. FEJ’s initiative will provide treatment, food supplements, physical therapy, and access to social services for at least 50 Haitian children with HIV and malnutrition. Through this initiative, FEJ will train medical professionals, expand the intensive care unit at the WJC Children’s Center, and implement a life skills training program for 25 mothers of children receiving care.
Approach
Fondation Enfant Jesus (FEJ) and partners commit to establishing a children’s medical unit focusing on the treatment of HIV and malnutrition at the Fondation Enfant Jesus Children’s Center. Through the program, at least 50 Haitian children living with HIV and malnutrition will have access to important medical treatments and services, including HIV medications, food supplements, and physical therapy, as well as access to social services.
In order to achieve these goals, FEJ and partners will hire and train doctors, nurses, nutritionists, cooks and other ICU support staff (24 medical staff and 3 operational staff) . They will also provide necessary renovations to the building and procure materials (milk, food, propane) , medical equipment, and medications through in-kind donations and purchase. Finally, for on-going training and improvements, partners will utilize telemedicine to enlist the involvement and expertise of other medical facilities.
The program will also procure an additional 15 beds for their intensive care unit (ICU) to increase availability of temporary on-site housing to 25 children living with HIV who require 24/7 care. Once a child is stabilized, they will be returned to their families or to a qualified Haitian orphanage.
Additionally, a life skills training program, called Chache Lavi, will be implemented for mothers with children receiving care in the HIV unit. The program will be used to prepare approximately 25 mothers to better care for their special needs children. The program will raise awareness of the impacts of HIV and aim to improve family health and nutrition. Given the economic impact of caring for a child with special needs, the Chache Lavi program will also provide financial training designed to encourage financial empowerment and small business development among the women.
Action Plan
Phase 1: Zero – Six months:
FEJ will announce the launch the HIV and malnutrition services program at the WJC Children’s Center and begin the procurement of supplies and medications, as well as the hiring and training process for staff to provide services. It will also utilize existing ICU beds to accommodate 5 to 10 children for short-term housing and treatment at the FEJ facility.
Phase 2: Six months – 12 months:
This phase will launch the telemedicine services from the University of Virginia School of Medicine and other medical facilities in Haiti to provide the best possible care for children with complex health problems. Renovations of certain portions of the center and the procurement of additional supplies and equipment will take place throughout this phase.
Phase 3: 12 months – 24 months:
The program will then procure 15 additional ICU beds to expand to a maximum of 25 children being accepted for short-term housing and treatment at the facility. Staff will begin recruitment of mothers caring for children living with HIV for the Chache Lavi program in the community.
Phase 4: 24 months – 36 months:
The Chache Lavi program will launch and begin trainings for women in the community. On-site housing and treatment will be available for 25 children. Staff will continue trainings and information sharing with technical experts through telemedicine.
Background
Haiti is the poorest country in the Americas and one of the poorest in the world. Fifty-nine percent of the population, approximately 6 million people, lives below the national poverty line of US$2.41 per day. Nationwide poverty is compounded by the persistent risk of natural disasters, political instability, and poor infrastructure, which threaten both food security and the availability of medical services throughout the country and continue to make Haiti’s population vulnerable to myriad health issues, including HIV and malnutrition.
Outside of sub-Saharan Africa, the Caribbean region has the highest adult HIV prevalence rate in the world, and Haiti has the highest adult HIV prevalence rate among all Caribbean countries. Although the prevalence of HIV in Haiti has decreased slightly in recent years, difficulties in further progress are due in large part to the lack of availability of HIV treatment, such as antiretroviral treatment (ART) . Access to HIV treatment is a particular challenge for children living with HIV in Haiti. Only 40% of children aged 0–14 years living with HIV are receiving treatment.
In Haiti, 22% of children under 5 years, suffer from chronic malnutrition (stunting or low height-for-age) and 66% of children under 5 years, suffer from anemia. In addition, about one fourth of all children were born with low birth weight. Malnutrition in childhood has many adverse consequences for child survival and long-term well-being.
Even when treatment is available, children living with HIV and malnutrition also face the effects of stigma and discrimination as they are often denied access to hospitals and thus denied medical treatment. Those children who are admitted to hospitals usually receive inadequate services due to the lack of knowledge and the fear of treating children with HIV. These children need proper medical treatment and these children should be treated within a caring environment.
Progress Update
Fondation Enfant Jesus (FEJ) intensive treatment UNIT project achieved several milestones in 2023, including screening 105 children for malnutrition and treating 73.2% of admitted patients, although the goal for the malnutrition screening clinic was not fully met. Medicine adherence in HIV/malnourished patients reached 100%, but discharge without medical advice remained at 15.5%, higher than the 2% target. For 2024, the objectives remained focused on screening more children, treating all malnutrition cases, and improving medicine adherence while reducing abandoned treatments. Challenges persisted, such as equipment shortages, power problems, delayed lab reports, and security issues impacting admissions. Adjustments are needed to address these challenges and maintain progress towards the project’s goals.
As part of their commitment to establishing a children’s medical unit focused on HIV and malnutrition treatment at the Fondation Enfant Jesus Children’s Center in Haiti, significant progress has been made, although challenges persist.
In 2023, FEJ’s achievements included screening 105 children for malnutrition in the outpatient clinic, treating 73.2% of admitted patients, and maintaining a medicine adherence rate of 100% for HIV/malnourished patients. However, they faced challenges with the malnutrition screening clinic, achieving only 50% of their target.
Moving into 2024, Fondation Enfant Jesus objectives remained focused on screening 200 children annually for malnutrition, treating 100% of admitted malnourished patients, and improving medicine adherence rates while reducing abandonment to 2% per year. Unfortunately, due to ongoing challenges such as equipment shortages, electricity/power issues, delayed lab reports, and heightened insecurity in the operational area, FEJ faced setbacks. The admissions and outpatient clinic visits decreased, impacting their ability to meet the screening goals and overall patient care.
Despite these challenges, FEJ commitment to providing comprehensive care, including medical treatments, food supplements, and access to social services, remains steadfast. They continue to train medical professionals, expand facilities, and support mothers in the life skills training program. While their project extends beyond the initial commitment period, ongoing efforts are required to overcome obstacles and achieve goals in addressing HIV and malnutrition in Haiti.
Partnership Opportunities
FEJ is seeking to identify and engage partners to provide funding, equipment and supplies, elevation through networks, and technical expertise to support the programs. The specific financial support needed is identified in the budget section and includes financial resources to cover operational costs and the implementation of the Chache Lavi program. To procure additional equipment and supplies, FEJ is seeking both funding and in-kind donations from partners. Lastly, FEJ is hoping to elevate their mission through partners’ media support and to engage technical experts to advise on medical treatments, holistic care, and micro-business and micro-financing., FEJ offers expertise in HIV treatment and pediatric healthcare to other organizations, particularly those in Haiti. FEJ also offers the physical infrastructure to facilitate life-saving medical care. This program will enable FEJ to share and develop best practices with other Haitian (and global) NGOs regarding HIV treatment and pediatric healthcare. In addition, FEJ will be positioned to share its data for future research regarding pediatric HIV treatments. FEJ will also have an opportunity to engage various telemedicine doctors for research and training opportunities, which will be made available to other organizations as well. And of importance to the Haitian community, FEJ will offer mentoring/coaching to other Haitian NGO leaders performing similar child welfare work. In addition, FEJ will offer an educational component to medical students attending the two major universities in Haiti.