By: Dr. Alessandra Maria Martino, Head of Pediatric Department, Tree Top Hospital, Hulhumale, Maldives
The health of a nation is reflected in the wellbeing of its children.
As the Head of the Pediatric and Neonatology Department of Tree Top Hospital, a private tertiary care hospital in the capital of the Maldives, I have the privilege — and the responsibility — of witnessing firsthand the triumphs and challenges in caring for our youngest patients.
One of the most pressing challenges I noticed since my arrival in Maldives in 2018 is not only the growing number of children with complex medical conditions being referred abroad for treatment, but also the number of children traveling abroad on their own expenses to get a professional answer to the most simple complains.
This journey is not only costly and logistically challenging for families but it can also delay timely diagnosis, proper management, treatment, and follow-up.
At Tree Top Hospital, our mission is to reduce this necessity by developing high-quality, specialized pediatric care, ensuring that children can receive the right care at the right time—close to home.
Why Pediatric Health Requires a Unique Approach
One important principle in pediatric medicine is that children are not small adults.
Their bodies, physiology, and diseases are different. From diagnosis to treatment, approaches must be specifically tailored to their developmental stage.
Their physiology, disease patterns, psychological development, and responses to treatment differ fundamentally from those of grown individuals. A child’s liver metabolizes medication differently, a newborn’s immune system responds to infections in unique ways, and a toddler’s lung disease might mask itself in ways we would not see in adults. These differences require a healthcare system that is not only equipped with child-specific infrastructure but also guided by clinicians who understand the nuanced science and art of treating young patients.
The assumption that general practitioners or even adult specialists can adequately manage complex pediatric conditions underestimates both the scientific demands and the ethical obligations of pediatric medicine.
This specialized understanding is why pediatric subspecialists play such a crucial role.
The Burden of Medical Travel Abroad
It is a painful reality that many Maldivian families are forced to seek medical help for their children in hospitals in India, Sri Lanka, or even further afield. These trips are not just financially burdensome—they are emotionally draining and often logistically chaotic. Families must navigate unfamiliar environments, language barriers, and extended periods of separation from their support systems at home. Critically ill children who travel abroad for care often do so after delays caused by financial constraints, visa processing, or lack of referral coordination, which can severely impact outcomes.
More importantly, the cycle does not end with treatment. Follow-up care is frequently disrupted once the child returns home, as the local system may lack the specialists required for continuity. This results in fragmented care, increased risk of complications, and unnecessary suffering.
Tree Top Hospital as a Centre for Pediatric Tertiary care
While general pediatricians and family physicians provide commendable care, they are often unsupported when confronting rare or complicated diseases. The availability of specialized pediatric expertise is therefore essential—not only to improve medical outcomes but also to reduce the emotional, social, and economic cost of overseas referrals.
Our first major step in strengthening pediatric services was the development for the first time in Maldives of a Neonatal Intensive Care Unit (NICU) staffed full-time by neonatologists in addition to general pediatricians. This has allowed us to care for extremely premature babies and severely ill newborns, who would have been previously transferred abroad in many cases. The presence of neonatologists ensures that these fragile patients receive highly skilled, evidence-based treatment around the clock.
On this basis, and recognizing that complex conditions extend beyond the newborn period, we expanded our services by organizing regular visits from a Pediatric Orthopedic specialist and a Pediatric Surgeon. These visiting specialists enable us to address conditions that, until recently, could only be treated outside the country—such as congenital limb deformities, complex fractures, complications of cerebral palsy and surgical conditions unique to children. By scheduling these visits regularly, we ensure that our patients have predictable access to the right expertise without unnecessary delays.
Our vision is to build on this foundation by bringing more pediatric subspecialists to Tree Top Hospital on a regular basis.
Establishing these services locally would not only improve access but also support a multidisciplinary approach—where different specialists, together with our general pediatricians, collaborate closely for each child’s care plan.
Continuity of care is central to this approach. A child’s journey with a health condition does not end with one consultation or procedure; follow-up, monitoring, and coordination between different health professionals are key. Having these services available locally means families can return to the same team, maintaining trust and ensuring that all aspects of the child’s health—medical, developmental, and emotional—are addressed consistently.
Our commitment is to create a pediatric service where Maldivian families can find the expertise they need without the disruption and strain of traveling abroad. By developing specialist pediatric care and fostering teamwork among experts, we aim to deliver care that meets international standards while remaining accessible at home. Ultimately, this will not only improve health outcomes but also give families the confidence that their children’s unique needs are fully understood and managed—here in the Maldives.
Integrated preventive and curative medicine.
Together with the management of acute or chronic complex pediatric diseases, a special mention deserves the Preventive Medicine, which is the cornerstone of pediatric and neonatology care, as it allows us to protect children’s health before illness develops.
Early diagnosis of diseases—through regular check-ups, screening programs, and close monitoring—ensures timely treatment, reducing the risk of complications and improving long-term outcomes.
Equally vital is proper nutrition, as a balanced and age-appropriate diet fuels physical growth, supports brain development, strengthens immunity, and lays the foundation for a healthy adulthood.
By integrating prevention, early detection, optimal diet, and lifestyle recommendation into routine pediatric care, we give every child the best chance to grow and thrive.
The Ripple Effect: Better Child Health Means a Stronger Nation
Healthy children grow into healthy adults. When we invest in pediatric care, we are investing in our country’s future workforce, leaders, and thinkers. The impact goes beyond hospital walls—it enhances education outcomes, reduces poverty cycles related to healthcare debt, and strengthens family resilience.
Moreover, local availability of pediatric super-specialty care can serve as a beacon of trust in our health system. It builds national pride, reduces dependency on foreign systems, and encourages our brightest students to pursue careers in healthcare. It also opens up potential for medical tourism in the long term, with regional patients seeking high-quality pediatric care in the Maldives.
Conclusion
The children of the Maldives deserve nothing less than the best we can offer.
They deserve doctors trained to understand their unique biology, hospitals designed for their needs, and a healthcare system that sees them not as small adults, but as individuals with specific, evolving needs.
We cannot afford to wait for the next generation to build this future. The time to act is now. Tree Top Hospital is committed to developing high-quality pediatric care that is accessible, sustainable, and centered on the unique needs of our children.
When we care for our children, we care for the very soul of our nation.