HOSPITAL HOLY CROSS
MEETING WITH FOREIGN PARTNERS
APRIL 2OO7
In the name of Administration of Holy Cross Hospital, we present our regards and our Christian greetings to the distinguished invitees who have joined together today. We want to once more thank you for all your technical, moral and financial support.
Let us give a short history of Holy Cross Hospital for those who have not yet heard it
The Holy Cross Hospital is an Institution of the Episcopal Church of Haiti concerned with Diocesan Office. It has worked in the field of health since 1968; it passed from the stages of dispensary and health center, to become a Hospital.
Holy Cross Hospital is a non-profit organization. It works in partnership with the Presbyterian Church of the United States of America and the Medical benevolence Foundation (MBF), an agency of the Presbyterian Church, it also receives the support of other churches, and the funds of certain national and international organizations. It generates receipts internally mainly fees charged to the patients.
Holy Cross Hospital is located in Léogâne, a town located in a western department about thirty kilometers from Port-au-Prince, the capital of Haiti. It has as its principal mission “to provide quality health care to the population of Léogâne and its immediate surroundings".
It provides curative and preventive care, works in the field of community health by offering a minimum package of service, does research on the level of certain endemic diseases, trains health agents (agents santé), and midwives.
We must tell you that what was inherited is very grave. From the technical point of view, we found a Hospital whose majority of its equipment is 70%, and broken down; a practically empty pharmacy, no orders in drugs were placed for lack of money, a laboratory and a radiology service which lies idle for lack of materials, three operating rooms and an emergency room to rethink, maternity services, surgery, and internal medicine that have to be revised, an electrical system, plumbing, obsolete air-conditioning, etc.... Thus we have a hospital which cannot fulfill its mission suitably any more. The services offered do not meet the standards governing the operations of a hospital, which has caused a loss of confidence by the residents of Léogâne automatically decreasing the frequency of its use.
From the point of view of administration:
We found Holy Cross Hospital with more than 300 employees drawing a salary against its budget, there are 25 doctors (including 5 generalists, students who did not make their social service yet), 34 nurses, 35 auxiliaries, 3 aides, 1 bacilloscopist, 61 people in maintenance, 5 people in pharmacy, 12 people for radio Holy Cross, 17 laboratory technicians and the remainder in administration. A plethora of personnel is paid without providing actual services.
From a financial point of view:
The Hospital received funds from various Haitian and Foreign partners, but during the year 2006, the funds received decreased considerably involving a loss of earnings for the institution whereas the wage bill increased during this same period by 1,300.000 gourds per month (ref. report of the DAF). Therefore, the Hospital cannot honor its contracts with employees. The payments are 3 months in the arrears, and were being made from the meager internal receipts and the inter funds transactions, which caused the Hospital to have a debt against its projects of about 600,000 gourds, and of 30,500 American dollars and debts of more than one million gourds owed to the Directorate-General of Taxes and ONA (August 2006).
Moreover, the Hospital has 3 generators which consume on average 300,000 gourds per month (ref. report of the DAF) which reflects the situation of the Hospital clearly. The arrival of the new team of management, supported by the executive council, has been put to work.
An elaborate plan of reorganization (see copy detailed in the annex) whose main axes of the system of ideas are:
- The increase in internal receipts of the institution, in other words, it acts to increase in the frequency in use of the Hospital
- Reduction in the expenditures of the institution
- The installation of new structures for a rational and effective management of the funds of the institution
- The installation of new structures allowing self-sufficiency of certain services, the such radio, ophthalmology, the private dental clinic, etc. .
To increase the internal receipts, several actions are considered and carried out, such as:
- To invite the Léogâne doctors to integrate the structure of the Hospital
- To sensitize the population of Léogâne, via the radio Holy Cross, to be a frequent user of the Hospital
- To meet notable people of the city to encourage the population of Léogâne to use the services of the Hospital
- For that, we will improve the reception level of the Hospital, starting with the installation of the reception room and emergency room, of equipping them and of providing them materials necessary for their best operation.
- We also propose to have an effective maintenance service including qualified and motivated personnel while providing them products in time to do their work while taking care to pay them each end of month regularly. Thus linens will be distributed to the patients so that they will have a clean and attractive space.
- We plan to have strictly private rooms, semi-private rooms and common rooms for the patients who cannot pay. These rooms must meet the standards required of all hospitals.
- Like other points considered, we need to improve the quality of the services offered, with that, we need qualified personnel answering requirements established beforehand in our protocol. Thus we will schedule meetings in order to bring back existing personnel and other competencies that will be hired to supplement staff, such as doctors, including a Technical Director, a nurse to manage the service of male nurses, a technician to manage the service of the laboratory. For that, it is necessary to add the refitting of the 3 operating rooms and the laboratory, maternity, pediatrics, etc. . .
- At the same time stocks of products will be made up and managed to avoid any out-of-stock condition preventing the very best operation of the hospital
- Certain broken down equipment will be repaired, machines that cannot be repaired will be replaced. This is the case of the laundry which has 2 washing machines in very bad condition
- The installation of a new structure for the effective, efficient, and rational management of internal receipts.
- It is necessary to note the reopening of the hospital pharmacy thanks to the granting of an interest-free loan by a person from Léogâne. Its management is now ensured by new employees.
Thus to achieve our goals, we need the support of all our Haitian and foreign Partners. This support can be technical, moral and financial, (Technical for the repair of the broken down apparatuses... Mr. Polycarpe, technician for recycling and training of staff, equipment, case in point).
To decrease expenditures several actions are already undertaken such as:
- The reduction of personnel, after study and evaluation of files, of almost 36% (from 265 to 171) in manpower involving a wage cost saving of almost 42% (of 965,000 Gdes of wages to 665,000)
- The reduction in consumption of fuel for the generators by a new form of management, it has reduced usage from 1500 to 1000 gallons on average per month. To mitigate this problem, the use of other alternative sources is planned. A study was undertaken in this direction by an Engineer in order to equip the hospital with solar energy. According to the study report, the savings is estimated at nearly 200,000 gourds, that is to say 5,000 to 6,000 American dollars depending on the rate. It should be noted that the Engineer stated that this system will not be able operate large apparatuses, but the institution will be permanently lighted.
- Like other sources of energy, we also are considering a study of wind systems, we are establishing the contacts. Rational management of expenditures
A new structure is installed for the management of the institution, it includes a system of control for the receiving and the disbursing of funds.
Other provisions are to be taken within the framework of the reorganization
- To block one of the two gates, only one will be open to serve the hospital and the administration. For that, it is necessary
- To arrange for re-entry
- To put an employee at the door of entrance of the hospital
- To place at the disposal of the hospital visitor charts
- To fix the visiting times and to make visitors respect them
- Changes to be implemented within the hospital
- Badge for the employees (lack of funds)
- Uniform for the support personnel (lack of funds)
- Revision of the internal structure
- Preparation of a handbook of administrative and financial procedures
- Preparation and signature of the 2007 contracts by the employees
- Redistribution of functions and tasks
- Preparation of a wage table
To render certain services financially self-sufficient
To render certain services autonomous, as envisaged in the reorganization plan in order to increase the internal receipts by the institution.
The Dental Service
A program of dental care to school establishments is being studied spiritedly; letters will be distributed to the Directors to make them take part in the program.
A program of school insurance is also planned for the next year.
The Ophthalmologic Service
A program in eye care with the schools is envisaged.
The recruiting of a specialist in ORL is designed to reinforce the capacity of the service.
The Holy Cross Radio
The Holy Cross Radio is now entitled to sign contracts under the Supervision of the Administration of the hospital, while respecting its mission.
Conclusion
Distinguished invitees, we say to you that the situation is serious, the task is difficult, there remains to us much to be done to achieve the goal which is to make Holy Cross Hospital what it was twenty years ago, a hospital of reference for the area and the entire country, but we lack the means. Thus we count on the support of each and everyone to help us to go up the slope. We are practically in April and we have not yet paid the wages of January through March 2007 which amounts to nearly 20,000 dollars per month.
May God blesses you!!!
Father Jean Jacques Déravil
Administrator General
Holy Cross Hospital Léogâne
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