I have had the privilege of serving on medical teams to Terre Blanche since 2000. I have some sad memories of seeing children in the early 2000’s with severe malnutrition. As a pediatrician, I felt very limited and hopeless in how much we could help these children.
During these years, there were no close hospitals with inpatient nutrition stabilization units and the Clinic of Hope did not exist so there was not a way to have ongoing follow up. We could treat for any acute infection. However, we knew that even if the child survived the current infection then the next time they got sick they would be at high risk of dying.
In 2013, I was part of a medical team to Terre Blanche. By this time, the Clinic of Hope had been fully operational for seven years and our HFH medical teams were working in partnership with the Haitian clinic staff.
On our first day working in the clinic, a mother brought in a very sick toddler, named Anelson. He was severely malnourished. His mid-upper-arm circumference and his weight on the Haitian growth chart put him in the most severe category of malnutrition. We recognized that he had pneumonia based on his breathing difficulty, fever, low oxygen level and physical findings. He was labored with his breathing and too weak to hold his head up or make purposeful eye contact.
Our initial thoughts were to try to get him stable with oxygen and an injection of antibiotics, check his blood sugar, and to give him the electrolyte solution with extra sugar as recommended for malnourished children with dehydration. From the very beginning, the Haitian nurses in the clinic and the nurses on our team recognized how sick this child was and showed great teamwork implementing his initial treatment.
I sought out Pastor Delamy to inform him that we had a child who needed to be transferred to a hospital with a children’s malnutrition stabilization center. Pastor Delamy listened carefully to my recommendations and concerns about how sick this child was. He then told me that he thought it would be best to keep Anelson at the Clinic of Hope. I had been very impressed with Pastor Delamy’s wisdom and prayerful consideration over the years, but I was not sure about this decision.
However, I immediately I saw prayers being answered with this child’s care. One of my initial concerns was not having access to the formulas that are used for severely malnourished children in hospital settings. We called the country director of the Children’s Nutrition Program in Haiti and she immediately emailed recipes for the two formulas needed, along with the feeding schedule and volumes needed.
My next worry was that it may be difficult to get all the ingredients and, even if we had access to the ingredients, how could we prepare the formulas without a special gram scale to measure everything? That worry lasted about five minutes. As soon as I showed the recipes to Linda Markee, she told me she had a gram scale. Then Linda and Pastor Delamy’s wife, Evire, found all the ingredients between the kitchen and the clinic’s pharmacy.
Anelson responded well to the antibiotics and needed oxygen for less than 12 hours. The nurses placed an NG tube and he was given the formulas as recommended per protocol. They also helped Anelson’s mother use a makeshift breast pump to help keep her milk supply up until Anelson was strong enough to breastfeed again.
By the next day Anelson was more interactive and able to hold his head up and within a couple of days he was sitting up and smiling. By the fourth or fifth day he was taking solids and he was enrolled in the Medika Mamba (fortified peanut butter) program.
It was a blessing to see Anelson get stronger and more interactive during the week we were there. By the end of the week, he was able to leave return home and be followed as an outpatient.
In Haiti there is a proverb “Sa se troket la chaj la deyo.” The troket is the scarf that Haitian women place on their head before placing the large baskets on their head. So, the proverb translated is: “This is only the scarf, the load follows.” I think of that week in Haiti where we were able to partner with the Clinic of Hope staff as the scarf, but the most important work that put Anelson on a path to good health occurred after our time in Haiti.
After the medical team left, Anelson was followed closely by the Clinic of Hope nurses and providers over the next year. He received Medika Mamba until his nutrition was stable. His mother received nutritional counseling through the Ti Foyer (hearth) program. Madam Elvire made multiple home visits to make sure that his mother had the needed resources to care for her family.
Each time I have returned to Terre Blanche, I have been able to visit with Anelson and his mother. Seeing him healthy and playing in the courtyard reminds me that prayers were answered and also reminds me of the dedication of Clinic of Hope staff.
Anelson’s care and follow up also reflects the impact the Clinic of Hope has had on this region. The clinic staff, in coordination with the Community Health program, screen many children which allows for interventions prior to them developing severe malnutrition. This is especially important now during this challenging time in Haiti. Pastor Delamy has confirmed that the demand to enroll children in the Medika Mamba program has increased.
Support and prayers to continue this life saving work is more important now than ever. Read about the most recent screening for malnutrition.
by Harold Latta, M.D., HFH board member