Pediatric Diabetes Program at Hôpital Sacré Coeur Milot, Haiti

Created nearly 3 years ago, the Pediatric Diabetes Program at Hôpital Sacré Coeur is the only program in northern Haiti providing comprehensive, free care to children and young adults with type 1 diabetes. The program is directed by HSC pediatrician, Dr. Marc-Mesadieu Exavier.

Without treatment (i.e. multiple daily insulin injections) insulin-dependent, or Type I diabetes mellitus, is uniformly fatal. Type 1 diabetes is a very different disease from the more common type 2 diabetes in that it primarily afflicts young people and is caused by autoimmune destruction of the pancreatic beta cell which produces insulin. Diet and exercise do not help prevent the disease.

The health crisis that results from a lack of insulin in a person with type 1 diabetes is marked by severe dehydration and metabolic derangements that lead inexorably to death. As a result, the prevalence of pediatric diabetes in Haiti is difficult to establish as innumerable children with this disease perish with unrecognized or undiagnosed disease—and certainly without treatment.
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Since its creation in 2013, the HSC PDP has grown from a handful of patients to its current level of 55. The children receive all of their diabetes care at HSC. Dr. Exavier hosts a monthly clinic at HSC during which time he evaluates the patients, reviews blood sugars, and distributes the necessary supplies, including insulin, syringes, glucometers.

Despite the many patients whose lives have been saved by this program, there are heartbreaking stories. In July, a young teenage boy arrived at HSC in coma due to the severe dehydration caused by prolonged high blood sugar. With rehydration and insulin therapy, he quickly improved.

Unfortunately, his loving parents believed that evil spirits were the cause of his diabetes and that local alternative therapies instead of insulin would restore his health.

They removed him from the hospital, and four days later he died at home. Unfortunately, this is not an isolated case.

Right now, Dr. Exavier and Antonio, a dedicated social worker, run this program but they are in desperate need of a diabetes nurse educator to provide ongoing education and support to these families. This is an exceptionally difficult disease to manage in the US, let alone in a resource poor country like Haiti.

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The mission of the type 1 diabetes program at HSC is to treat and educate these patients and their families until they have the knowledge, education and income to care for themselves.

Currently, per patient, the program costs roughly $50/month or $600/year. The program is funded by private donations through The CRUDEM Foundation. In addition, the program provides ongoing medical education and support from CRUDEM volunteers such as Drs. Michael Canarie (a pediatric intensivist at Yale) and Nancy Dunbar (a pediatric endocrinologist at Connecticut Children’s Medical Center). In addition to volunteer trips to HSC, they hosted Dr. Exavier in Connecticut last year for 2 weeks to increase his knowledge of the diabetes and its management by observing the diabetes clinic at Connecticut Children’s Medical Center.

If you would like to help support this important and life-saving program, please consider making a tax-deductible donation on behalf of HSC pediatric diabetes.

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