In 2018, NPH continued to provide quality healthcare with a child-centered approach in countries where the basic human right of access to healthcare is quite difficult to accomplish. Our medical programs strive to provide the best care possible for populations of children living in NPH homes and for those in the surrounding communities. Medical Services uses an integral, holistic, and comprehensive approach that takes into consideration environmental, psychological, preventive, and curative factors. Each regional medical coordinator assists in monitoring children with chronic conditions, delivering vaccinations, coordinating therapies and annual well-child checkups, ensuring the appropriate use of cost-effective drugs, procuring specialized medicines, and implementing public health interventions.
The NPH Medical Services’ motto is “what would you do if this patient were your own child?” The answer is obvious. Even if the necessary treatment can only be found abroad, NPH will do it! For the past 10 years NPH has sent nine children to Italy and Spain for difficult surgeries or treatment, among them kidney transplants, congenital heart diseases, leukemia, oncology diseases, and severe orthopedic problems. All of this is possible thanks to the surgeons, hospitals, airlines, and NPH fundraising offices. What we can do working together as a team has no limits.
The NPH healthcare programs reached many milestones in 2018 that are aligned with the U.N. Sustainable Development Goals and with the international standards of well recognized healthcare organizations.
Zero Hunger – Sustainability Goal #2
NPH’s food menus have improved substantially, providing children with the necessary micronutrients and vitamins to grow healthy and happy. Nevertheless, Latin American children overall continue to show a high percentage of chronic malnutrition, an invisible condition that is identified through consistent measurement of growth and development.
Chronic malnutrition in children inhibits growth as a result of deficient nutritional intake. Long-term deficiencies can have grave consequences, affecting lifelong physical and cognitive development. These children will have difficulty understanding lessons in school leading to high dropout rates, which, in turn, can lead to low levels of job skills and a lifetime of low-paying employment.
Global leaders in chronic malnutrition are some of the countries where NPH operates—Guatemala, Honduras, Nicaragua, Mexico, and Peru. Of the 200 million children worldwide who live with chronic malnutrition, 25% or 50 million are in Latin America.
Good Health and Well-being – Sustainability Goal #3
Fortunately there were no major vector-born epidemics (dengue, the Zika virus, chikungunya, or malaria) thanks to the strengthening of preventive measures, like mosquito nets and regular fumigation. Only a few homes reported chicken pox cases, which is quite common in settings where a high number of children live together. NPH maintains an average 85% vaccination rate according to the ages of the population. Our goal is 92%, which has been achieved in previous years with additional funding sources. The World Health Assembly Global Vaccine Action Plan calls on all countries to reach 90% coverage with all vaccines by 2020.
Clean Water and Sanitation – Sustainability Goal #6
Water is life. It is also the source of many diseases, if not properly treated, thus making clean water a priority in all NPH homes. NPH Haiti formed a partnership with a team from the United States and used funds from Europe to improve water service for the flagship property located in the mountains of Kenscoff. This project has brought hot water to the property, a change welcomed by the children and caregivers given the cold and foggy climate of the region.
Chronic Conditions and Children with Disabilities or Special Needs
The prevalence of children with chronic conditions is quite high in NPH countries as a result of inadequate prenatal care, teenage pregnancy, and environmental factors. Almost half of the population in some NPH countries has some sort of chronic condition and 20% have disabilities, which means higher healthcare expenses and more follow up care.
In 2018 Medical Services developed and presented first at the medical services workshop in April and then again at the psychology workshop in October, “Sex Education Guidelines for Children with Disabilities,” which will be implemented in each NPH home in 2019.
Expanding Programs and Community Outreach
Medical Services has developed cost effective and impactful healthcare initiatives for our expanding programs. With the increase in the number of adolescents in the population, we have restructured our programs to adapt to this change. These initiatives include health school programs for children of all ages from pre-K to high school. The program also includes health monitoring for children in community centers run by NPH, for children in transition homes, and for NPH OneFamily.
Mental health in vulnerable communities demands a professional and multidisciplinary approach to evaluate needs and provide integral, specific support for the healthy development of the individual and the benefit of the community.
A multidisciplinary approach is applied case by case for effective evaluation, treatment, follow-up, and staff training and advice. For staff, empowerment and training in trauma-informed practices is a requirement, as most of the NPH population has suffered an adverse childhood experience (ACE). In our efforts to comply with UNICEF guidelines and accepted children’s rights practices, we provide age-appropriate sex education based in human and spiritual values. Among the most common diagnoses are post-traumatic stress disorder (PTSD), attachment, depression, attention deficit hyperactivity disorder (ADHD), and adverse childhood experiences (ACE).
Health Education for Local Staff and Clinicians
Medical Services delivers continual on-site training and hosts an annual medical workshop. We develop healthcare policies, manuals, guidelines, protocols, and procedures based on international standards and best practices, using evidence-based medicine.
University of Pennsylvania School of Nursing senior Alaina Hall was among the nine winners of a $100,000 prize in funding for Penn seniors to design and undertake post-graduation projects that make a positive, lasting difference in the world. Hall’s nonprofit project – Healthy Pequeños (Healthy Little Ones) – is a nurse-led multi-interventional health-promotion effort that aims to address the global health problem of infectious disease in children. Working in partnership with NPH Mexico, Hall is working to improve health education for children and their caregivers, strengthen infection screening and identification processes, and reduce exposure to infection-causing pathogens by providing filtered water and repairing damage to local sewage structures.
The World Health Organization (WHO) defines health as, “a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity.”
NPHI Medical Services On-site Visits
– One per year to each NPH Home
– Regular monitoring of core programs
– Annual evaluation of country-specific healthcare goals
– Ensure adherence to NPH healthcare policy, quality standards, and global health indicators
On behalf of the NPHI Medical Services team, we express our deepest gratitude to all the professionals and teams, and all of those who have provided us with continued support in 2018.
Pilar Silverman, MD
NPHI Medical Services Director