The Chicken Coop

New development in the ladies dorm this past week – one of the many chickens roaming the compound has been coming into our room and laying eggs next to Amelia’s bed.  When in Haiti!

So this past week, we went into the field for two days as usual.  The second day, Shelley and I got absolutely mobbed by a crowd of parents and children constantly shoving forward to try to get their child measured, plus other people in the village shoving closer to see what we were up to.  The curiosity is understandable, but trying to work in a square foot of space in the middle of a mob for an hour and a half gets overwhelming!  “Fè ba! (get back!)” works for about 3 seconds. 

Wednesday, Shelley and I went to Cap Haitien to meet with the director of Meds and Foods for Kids, an organization in Haiti that manufactures therapeutic nutritional foods for malnourished children.  We were so fortunate to meet the team at MFK soon after we arrived at the beginning of June and tour the factory, and now it was terrific to sit down with the director and just chat openly and honestly about child malnutrition in Haiti.  The organization is doing terrific work in an extremely challenging environment.

Friday morning, Shelley and I led a workshop on Child Nutrition for the community health workers that work for the hospital here in Milot.  This was the last of a five-part series of workshops that the med student organized on different health topics.  We had a lot of fun putting on the workshop, even though there is always so much to talk about when it comes to nutrition – our favorite topic of course – and so little time.  Promoting public health through community health worker education – check!

We’ve been checking in on the Nutrition Center as usual in between field visits and meetings.  Not surprisingly, once one severe case is resolved (temporarily, at least), there are always more to follow.  Just the week after little J went to the infant care center, we discovered two more difficult cases of malnutrition at the nutrition center.  And the more you talk to their parents, the more you unravel layers of their story that brought them to this severe state.  In the first case, we have an adorable little baby – we’ll call her Linda – who you can usually find sitting on a mat, looking around taking the world in, smiling once in a while.  She loves to be picked up, and she’ll just lay her head on your shoulder.  If she didn’t have the reddish hair and the infections on her skin, you might think she was a pretty good size 6-month-old baby.  But she’s actually 19 months old and a year behind in development. And if you didn’t talk to her mother (who appeared unusually old to have such a young child at 50+ years old), you wouldn’t know that she was actually a foster mother who rescued Linda when her own mother threw her in a dumpster at 5 months old.  Linda has had a very difficult health history since, and has been in and out of the hospital with different illnesses.  I had a visiting pediatrician come to take a look at her, who also realized that in addition to multiple nutrient deficiencies she had pneumonia and potentially scabies.  She went into inpatient treatment for a few days and was released early last week, but the last I heard was that her mother could not afford her medicines.  It is hard to predict how Linda’s childhood will pan out in the next few years.  It would be a triumph if we could get her to attempt crawling before we leave, but that may be hoping for too much.

In the second case, a mother started coming in to the nutrition center two weeks ago with a beautiful tiny baby - we’ll call her Rosie.  At 7 months, she is almost the size of a newborn, weighing just 9 lb.  She has a cleft lip and cleft palate, which causes milk to come out of her nose when she drinks.  A craniofacial surgery team came earlier this year and operated on her lip, but it is not clear when they or another team will return for follow-up surgery, and she may still be too young to receive surgery for her palate.  At first, we assumed that she is severely malnourished because she cannot eat and drink properly, so we have requested that a volunteer team coming this weekend bring special bottles designed for cleft palate babies.  This is definitely a large part of the problem, but another looming issue is food insecurity at home.  We realized last week that sometimes she can drink properly from a regular bottle if sitting upright, but also that she is the youngest of seven children and hardly eats anything after noon and on the weekends when she’s not at the nutrition center.  She needs to be on a diet of concentrated infant formula to build back her energy, but infant formula costs the same price here as it is in the US – which is expensive by US standards and thus completely unaffordable for most people here.  I’ve been in contact with the pediatrician who was visiting, and we are trying to figure out how best to help this baby.  In the meantime, it’s hard to come up with effective, sustainable solutions when I’m leaving in 2 weeks.  When I went by the nutrition center on Friday, Rosie wasn’t there, but her mom had heard that I was looking for the baby, so she actually came by our residence compound on Saturday to see me.  I had told her that the baby needs to go to the clinic because she is also sick with a fever and needs medicine, and that the baby ultimately needs infant formula to regain her strength, which was of course in vain because I know the mother cannot afford to buy it.  I said that I would keep trying to help her.  I don’t yet know how.

This past weekend was the last in Haiti for the med students, who leave Wednesday.  I spent most of Saturday on the compound, except for when I went for a walk with another visiting volunteer to visit a family that she knows in the village with a bunch of cute little children.  I tried to give out some nutrition advice in my broken Creole to the mothers with young children.  In the afternoon, after a fruitless quest to find affordable infant formula in town, I went to visit a post-surgery patient in Milot that a couple of the med students have been monitoring, since I’ll be checking in on her after they leave.  Sunday, we went to the coast for one last trip to lovely Cormier Beach.  And then at night, one last night out at the roofless dance club before the med students take off.

Just a couple more weeks now for Shelley and I to furiously collect the last of our data, write up our report, and wrap things up here in Haiti!