News Report / Profile
Children's Day
Children’s Days are days of devotion.
We have to devote our lives to the construction of a culture of the child for the child.
Only this can be our major investment as citizens and professionals caring for or looking after the inalienable higher interests of the child.
There can be no place for mistakes, for ambiguities, for rites of passage.
There may be those who say that it is an affront to speak in the name of a child.
I would say that it is a challenge. An enormous and total challenge that forces us to delve into the identity of each child-person, into the individual discovery of each one, into the mystery of each constructed link and each shared relationship.
Risk, however, is now looking at the destiny of our children.
What is in fact happening in our society is that the threshold of child adaptability in relation to disrespect, to family dysfunction and violence, that threshold, as I was saying, is being surpassed.
We have called our investment in development, in child behaviour and in family intervention in the first “touchpoints” of life the “New Paediatrics”.
The Declaration of the Rights of the Child, rights consecrated by the convention, is the moral doctrine that is obligatory for all.
In paediatric correspondence the evolution of knowledge cannot have limits, just as there can be no reticence in relation to the support we have to guarantee to the education services, in primary prevention and in overall care to guarantee when risk makes the child sick and, in fact, makes them need to stay in hospital.
In the Department of the Child and the Family we seek to correspond to the demanding needs of the child.
Today we have a Primary Immunodeficiency Centre with collaboration protocols (HSM/IMM/FMUL)(1) in which one of our sick children with a FOXN1 deficit underwent the world’s first thymus transplant, which cured the problem. We have an excellent Cystic Fibrosis centre integrated within a European Clinical Testing Network (ECFS – CTN) in articulation with the adult Pneumology Service and with the Dr Ricardo Jorge Higher Institute of Hygiene. We have a Nephrology Unit, the first paediatric renal transplant centre in the south of the country, which to date has performed sixty-six kidney transplants (14 in 2008), with one being a living donor.
We have an excellent Child Neurotrauma centre, and we are now available to start follow-on consultation in this so prevalent area in terms of demand for care in our Paediatric Emergency unit, and we have a Haemoglobinopathy centre corresponding to a programme in which research is promoted in articulation with the Dr Ricardo Jorge National Institute genetic Medical Centre.
We have a Metabolic Illness Unit, a part of the Molecular Pathogenesis Centre – a centre of excellence for patients identified in neo-natal analysis as having metabolic diseases.
We have an excellent consultation unit for Low Stature, and perhaps also the first national pole of assistance for child obesity.
We have a Paediatric Gastroenterology Unit with the up to date development of several different technologies for the functional study of the digestive system.
We have a centre for Respiratory Function Studies – sleep and ventilation, currently forming an exclusively paediatric Respiratory Function Laboratory.
We have a Mobile Domiciliary Support unit (UMAD) which provides support for patients with chronic pneumological, nephrological and gastroenterological problems, coupled with neo-natal support.
We have a Development Unit that guarantees specific support spread over twelve consultations under protocol, and we have a Mental and Youth Health Unit (proposed future service) which provides continued psychological support to all the children referred to the several different in-patient sectors.
We have a General Paediatrics Unit that guarantees support consultations to Health Centres, District Hospitals and private paediatric units, we have a differentiated techniques unit where digestive endoscopies and other diagnostic assessments are carried out, as well as bronchial endoscopies and respiratory capacity tests, among others. We have a dynamic Day Hospital organised by sectors, and all that remains is to set out the space it needs so as not to encroach on the in-patients area.
We guarantee about fifty different out-patient consultations, which, as unique references in Portugal, promote the continuous training of specialists and interns from all the hospitals in Portugal.
One of these consultations is the Adolescent Consultation, and educational reference for professionals training in this area.
We have an Emergency Unit that is in constant growth, supported by na Intensive Care Unit that supports the whole of greater Lisbon and the south of the country, receiving patients from all the other health units and providing cutting-edge care with multi-disciplinary interventions.
We have a Paediatric Pneumology Unit that has gone beyond the barrier of the classic in-patient system to become a unit that, although maintaining acute patients, has stood out in terms of its transition and house-bound patients. It is one of the three major Portuguese centres of domiciliary support for children with chronic illnesses and depending on technology.
Due to all of this, our indicators of production and quality justify a special place among paediatrics services.
I would also state that it something that transcends statistical profitability.
Over the last five years we have had about a dozen cutting-edge research projects, forming the basis of at least five PhDs.
Some of our interns have received study grants and have entered PhD programmes where they are guaranteed shared science, multi-systemic teaching, differentiated training and, above all, a fraternal atmosphere.
In Paediatric Medical Education, as we are the responsible authority, we provide teaching-learning centred on the child from the 1st to the 6th year of the Medicine Course.
In the 1st year we teach “Being a Child” alongside “Being a Doctor” and “Being a Patient”.
In the 2nd year we teach Introduction to Child and Family Medicine.
In the 3rd year we teach “Child and Education”, “Touchpoints” and neuro-behavioural development; in the 4th year we teach Semiology inspired by a relational model.
We have a Brazelton Centre, where we have already trained about 400 professionals from several different areas in “Touchpoints” and in “NBAS” and “NBO” Assessment of the New-born Child, which may guarantee that when we reach a thousand trainees we will have an effective change of the inspiration model in our hospital assistance.
Everything that has been stated is the work of all the professionals from over ten different areas who work in the Department of the Child and the Family.
All of them do this with devotion, wearing the uniform of the institution in accordance with that which is our goal – an unequivocal moral demand, inspiring each intervention, whether this is of care or of teaching.
João Gomes-Pedro
Department of the Child and the Family
217805202
gomes.pedro@hsm.min-saude.pt
___________________________
(1) HSM - Santa Maria Hospital; IMM - Institute of Molecular Medicine; FMUL - Faculty of Medicine of the University of Lisbon
We have to devote our lives to the construction of a culture of the child for the child.
Only this can be our major investment as citizens and professionals caring for or looking after the inalienable higher interests of the child.
There can be no place for mistakes, for ambiguities, for rites of passage.
There may be those who say that it is an affront to speak in the name of a child.
I would say that it is a challenge. An enormous and total challenge that forces us to delve into the identity of each child-person, into the individual discovery of each one, into the mystery of each constructed link and each shared relationship.
Risk, however, is now looking at the destiny of our children.
What is in fact happening in our society is that the threshold of child adaptability in relation to disrespect, to family dysfunction and violence, that threshold, as I was saying, is being surpassed.
We have called our investment in development, in child behaviour and in family intervention in the first “touchpoints” of life the “New Paediatrics”.
The Declaration of the Rights of the Child, rights consecrated by the convention, is the moral doctrine that is obligatory for all.
In paediatric correspondence the evolution of knowledge cannot have limits, just as there can be no reticence in relation to the support we have to guarantee to the education services, in primary prevention and in overall care to guarantee when risk makes the child sick and, in fact, makes them need to stay in hospital.
In the Department of the Child and the Family we seek to correspond to the demanding needs of the child.
Today we have a Primary Immunodeficiency Centre with collaboration protocols (HSM/IMM/FMUL)(1) in which one of our sick children with a FOXN1 deficit underwent the world’s first thymus transplant, which cured the problem. We have an excellent Cystic Fibrosis centre integrated within a European Clinical Testing Network (ECFS – CTN) in articulation with the adult Pneumology Service and with the Dr Ricardo Jorge Higher Institute of Hygiene. We have a Nephrology Unit, the first paediatric renal transplant centre in the south of the country, which to date has performed sixty-six kidney transplants (14 in 2008), with one being a living donor.
We have an excellent Child Neurotrauma centre, and we are now available to start follow-on consultation in this so prevalent area in terms of demand for care in our Paediatric Emergency unit, and we have a Haemoglobinopathy centre corresponding to a programme in which research is promoted in articulation with the Dr Ricardo Jorge National Institute genetic Medical Centre.
We have a Metabolic Illness Unit, a part of the Molecular Pathogenesis Centre – a centre of excellence for patients identified in neo-natal analysis as having metabolic diseases.
We have an excellent consultation unit for Low Stature, and perhaps also the first national pole of assistance for child obesity.
We have a Paediatric Gastroenterology Unit with the up to date development of several different technologies for the functional study of the digestive system.
We have a centre for Respiratory Function Studies – sleep and ventilation, currently forming an exclusively paediatric Respiratory Function Laboratory.
We have a Mobile Domiciliary Support unit (UMAD) which provides support for patients with chronic pneumological, nephrological and gastroenterological problems, coupled with neo-natal support.
We have a Development Unit that guarantees specific support spread over twelve consultations under protocol, and we have a Mental and Youth Health Unit (proposed future service) which provides continued psychological support to all the children referred to the several different in-patient sectors.
We have a General Paediatrics Unit that guarantees support consultations to Health Centres, District Hospitals and private paediatric units, we have a differentiated techniques unit where digestive endoscopies and other diagnostic assessments are carried out, as well as bronchial endoscopies and respiratory capacity tests, among others. We have a dynamic Day Hospital organised by sectors, and all that remains is to set out the space it needs so as not to encroach on the in-patients area.
We guarantee about fifty different out-patient consultations, which, as unique references in Portugal, promote the continuous training of specialists and interns from all the hospitals in Portugal.
One of these consultations is the Adolescent Consultation, and educational reference for professionals training in this area.
We have an Emergency Unit that is in constant growth, supported by na Intensive Care Unit that supports the whole of greater Lisbon and the south of the country, receiving patients from all the other health units and providing cutting-edge care with multi-disciplinary interventions.
We have a Paediatric Pneumology Unit that has gone beyond the barrier of the classic in-patient system to become a unit that, although maintaining acute patients, has stood out in terms of its transition and house-bound patients. It is one of the three major Portuguese centres of domiciliary support for children with chronic illnesses and depending on technology.
Due to all of this, our indicators of production and quality justify a special place among paediatrics services.
I would also state that it something that transcends statistical profitability.
Over the last five years we have had about a dozen cutting-edge research projects, forming the basis of at least five PhDs.
Some of our interns have received study grants and have entered PhD programmes where they are guaranteed shared science, multi-systemic teaching, differentiated training and, above all, a fraternal atmosphere.
In Paediatric Medical Education, as we are the responsible authority, we provide teaching-learning centred on the child from the 1st to the 6th year of the Medicine Course.
In the 1st year we teach “Being a Child” alongside “Being a Doctor” and “Being a Patient”.
In the 2nd year we teach Introduction to Child and Family Medicine.
In the 3rd year we teach “Child and Education”, “Touchpoints” and neuro-behavioural development; in the 4th year we teach Semiology inspired by a relational model.
We have a Brazelton Centre, where we have already trained about 400 professionals from several different areas in “Touchpoints” and in “NBAS” and “NBO” Assessment of the New-born Child, which may guarantee that when we reach a thousand trainees we will have an effective change of the inspiration model in our hospital assistance.
Everything that has been stated is the work of all the professionals from over ten different areas who work in the Department of the Child and the Family.
All of them do this with devotion, wearing the uniform of the institution in accordance with that which is our goal – an unequivocal moral demand, inspiring each intervention, whether this is of care or of teaching.
João Gomes-Pedro
Department of the Child and the Family
217805202
gomes.pedro@hsm.min-saude.pt
___________________________
(1) HSM - Santa Maria Hospital; IMM - Institute of Molecular Medicine; FMUL - Faculty of Medicine of the University of Lisbon