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Holy Name Medical Center President and CEO Michael Maron clearly recalls the pivotal meeting he had about a dozen years ago with the leadership of Hôpital Sacré Coeur in Milot, Haiti, to launch the New Jersey medical center's partnership with that North Haiti hospital.

Holy Name's foundation had just taken over sponsorship of the struggling Haitian hospital, and Maron was telling the leaders there about Holy Name's vision for how the transition would take place.

His speech was met with blank stares.

When he asked why everyone was so disengaged from this fresh start, a surgeon spoke up, noting that Maron was just the latest in a long procession of "blancs" — or foreigners — who had swooped in from the U.S. to tell the Haitians how to do things. They were sure Maron would disappear just as quickly as so many of the other interlopers had.

Maron assured the group he was a man of his word, and he promised them that Holy Name would be different. He said Holy Name would be a true partner to Hôpital Sacré Coeur, continually seeking the staff's perspective, respecting their input and working closely with them to improve health care access in North Haiti.

For its success in keeping this promise, Teaneck, New Jersey-based Holy Name has earned CHA's 2024 Achievement Citation, the association's recognition of innovative programming that changes lives.

Surging volumes
The Montreal province of the Brothers of the Sacred Heart founded the 10-bed Hôpital Sacré Coeur in 1968 on land that the Catholic Archdiocese of Cap Haitien owned in Milot. In 1986, at the Cap Haitien archbishop's request, the Brothers' Center for the Rural Development of Milot, or CRUDEM Foundation, assumed financial and supervisory control of Sacré Coeur.

When a 7.0-magnitude earthquake ravaged Haiti's capital and most populous city, Port-au-Prince, in January 2010 and when cholera broke out about 10 months after the quake, Sacré Coeur experienced large surges of patients. Milot is about 120 miles north of Port-au-Prince.

Holy Name obstetrician Dr. David Butler already had been traveling to Sacré Coeur as a medical missionary for about a dozen years when he journeyed there in 2010 to provide medical aid to quake victims. He was so distressed at the conditions he witnessed that upon his return to New Jersey he pleaded with Maron to help solve one of the Milot hospital's greatest concerns: regularly running out of oxygen. Without oxygen, doctors could not perform lifesaving surgeries.

Maron coordinated the purchase and transport of an oxygen generator then traveled to Milot to ensure its safe delivery and installation. That 2010 visit inspired Maron to engage Holy Name leadership and clinicians in increasing involvement in the Haiti hospital. This included Holy Name providing bridge loans to shore up Sacré Coeur's finances as it strained to respond to ongoing patient surges.

By 2012 it had become clear that the hospital was in such dire financial straits that without even more help, it would close, leaving the approximately 250,000 people in the region around Milot with no hospital. Holy Name agreed that year to sponsor Sacré Coeur.

Evolution
As sole sponsor of Sacré Coeur, which now has about 230 inpatient beds, the New Jersey hospital foundation has provided tens of millions of dollars in funding since 2012 as well as administrative, technological, operational and clinical support. Holy Name also has coordinated dozens of meal packaging events in the U.S. over the past five years. The medical center has shipped more than 1 million of those packaged meals per year to Haiti for distribution to malnourished people in the Milot region.

Butler says under the Holy Name–Sacré Coeur partnership, the Milot hospital has become a smoothly functioning facility with a healthy supply chain, a growing capacity to offer health and social services, and a strategic plan for additional growth. All these feats are extremely difficult to accomplish in a country plagued by natural disasters, poverty, civil unrest and gang violence. Sacré Coeur has become an economic powerhouse and lifeblood of northern Haiti, Butler says. He is chair of the board of Haiti Health Promise — the Holy Name affiliate that fundraises for Sacré Coeur.

Holy Name Executive Vice President of Operations Steve Mosser has coordinated many of the capital projects, construction work and operational work at Sacré Coeur under Holy Name's sponsorship. He attributes the Haiti hospital's success to Holy Name and Sacré Coeur's commitment to the spirit of partnership that Maron established in 2012.

Mosser says Holy Name and Sacré Coeur have continually evolved their relationship. Before Holy Name became sponsor, he says, the usual way of doing things was to have a different team of medical missionaries from all across the U.S. come to the Milot hospital about every week to perform surgeries and other skilled procedures, with those clinicians often bringing family members along. The visiting clinical teams normally would bring medical and other supplies with them. Dr. James Morgan, medical director of Haiti Health Promise, says under this approach, it was nearly impossible for the Haiti staff to have continuity and to systematically address root causes of hospital issues. Plus, with the "drop-in" medicine, there was very little preventive or follow-up care or social services available to patients, so it was difficult to promote healthy outcomes over the long term.

Over time, Holy Name has been cutting back on the use of drop-in medical missionaries, and clinicians who do come must have multiple medical skill sets. They no longer can bring family members who essentially had been like missionary tourists. The focus over the decade of Holy Name's sponsorship has been on having the U.S. clinicians educate and train Haitian clinicians so that the Milot team can increasingly take over the medical procedures. The goal is to continually build capacity and eventually hand off all the work to the Haitian staff.

Cedar Wang, Holy Name vice president of nursing operations, has supported the Milot staff's professional development by building up a comprehensive training and education program that includes simulations and role-play scenarios in the Sacré Coeur staff's native languages, Haitian Creole and French.

Community building
Just as Holy Name has been seeking to hand as much clinical control as possible over to the staff, it also has been seeking to "localize" the hospital's supply chain and operations.

For the past decade, the Holy Name–Sacré Coeur team has been aiming to use Haitian laborers working with Haitian raw materials to the extent possible when constructing new facilities, or to at least have the on-site workers train Milot-area workers in their trades.

As much as possible, Holy Name also has been aiming to use local food suppliers for staff and patient nutrition.

Through these efforts, Sacré Coeur has increased its capacity over the last decade-plus to provide emergency, maternity, pediatric, dental, prosthetic, laboratory, pathology, HIV/AIDS and a variety of other services, plus it has built up a strong community health outreach team. It also has strengthened nutrition, housing and education in the surrounding community.

Pervasive threats
Despite all that has been achieved, further progress at Sacré Coeur is under constant threat, say the Holy Name leaders. Southern Haiti — and in particular Port-au-Prince — is experiencing great upheaval, extreme civil unrest, poverty and gang takeovers. Northern Haiti is not immune from the reverberations. Sacré Coeur staffing, supply lines, hospital safety and resources are continually at risk.

The Holy Name leaders say they and their colleagues remain committed to Northern Haiti and they have hope the momentum that Holy Name and Sacré Coeur have built up is not in vain.

Butler says the Haitian people have a persistence that is remarkable — and that bodes well for the long-term success of Sacré Coeur.

Wang says the camaraderie that has grown among the Holy Name and Sacré Coeur staffs has made them all feel like one big team, pursuing one mission, and that puts them in a strong position to take on the challenges.

"This relationship has grown and deepened," says Morgan.

Mosser says: "It feels like the Hôpital Sacré Coeur staff are extended family."