Field Notes from Haiti Part II

Konbit Sante board member and pediatrician Dr. Adam Silverman recently returned from a trip to Haiti. He visited Justinien University Hospital (JUH) to reconnect with colleagues, observe the renovated pediatric ward, and assess how Konbit Sante can best strengthen pediatric care in northern Haiti.

Leadership on the Ward

Adam spent time rounding with Dr. Muscadin, JUH’s Attending Faculty Pediatrician. Her role is enormous: supervising dozens of learners, managing a high-volume service, and doing it all while working only part-time hours at the hospital.

Her teaching style is decisive yet encouraging, grounded in respect and responsibility. Adam described her as “a true servant leader”. Her request for his next trip is clear: a structured training program to help staff respond more effectively to critically ill children.

Adam and Country Director, Tezita Negussie, are now planning an ETAT (Emergency Triage, Assessment, and Treatment) course for nurses and residents—a proven WHO framework that strengthens rapid response for acutely ill pediatric patients.

A Ward Transformed—and a Team Rising With It

Since Dr. Silverman’s last visit, the pediatric ward has visibly changed: bright rooms, colorful murals, proper seating, and a general sense of warmth and order. But what stood out most wasn’t the infrastructure—it was the people.

“The senior residents are deeply invested in improving pediatric care not just in the hospital, but across the north,” Adam reflected. “They’re trying to build something despite every obstacle.”

They’re skilled, motivated, and eager to serve. Yet without available salaried positions, many face the prospect of completing their residencies with no income and no role—an enormous loss to Haitian healthcare.

In this context, Konbit Sante’s steady presence matters. Adam described us as the organization residents trust when they need guidance, advocacy, or simply someone to back their ideas.

Ingenuity in a System Without Enough

Resource limitations mean the clinical team must improvise. Adam documented several examples—creative, practical, and sometimes troubling because they underline how thin the margins are.

• Oxygen access: Without adequate regulators or tubing, clinicians devised a way to split oxygen flow to two newborns using stethoscope tubing. Ingenious, yes—but ultimately unregulated and inadequate.
• Space constraints: With too few beds, babies are sometimes placed two to a crib or laid on tables.
• Basic identification: Without infant ID bracelets, staff improvise with medical tape.

Two infants sharing a single bed in the JUH pediatric ward due to limited space.

These workarounds are snapshots of the reality clinicians face daily. They also point directly to the kinds of modest, high-impact support that donors make possible—items that are routine in U.S. hospitals but transformative in Cap-Haitien.

Why This Matters Now

The pediatric service at JUH is now viewed as a model of academic medicine in northern Haiti. Not perfect. Not fully resourced. But transformed—and continuing to evolve—because of sustained partnership.

As Adam put it:

“Within the hospital, pediatrics is what everyone points to as the example of what’s possible.”

That progress didn’t happen by accident. It happened because donors like you chose to stay committed to Cap-Haitien year after year, even when headlines made Haiti feel distant, inaccessible or, to some, irredeemable.

A Note for Our Annual Campaign

We are in the final weeks of our annual campaign, and this work depends directly on the generosity of our community. Each gift—large or small—helps ensure that JUH’s pediatric service continues to advance and it helps Konbit Sante remain the constant partner our colleagues count on. If you are able, please consider making a year-end gift to sustain this momentum.

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