I wish I could say that I'm trying to give her a run for her money with two back to back posts!! Yeah me!! But that would be a lie. Truth is. Jenn saved you all from one, ridiculously long, single post. She pre-read my "favorite moments" and suggested that I cut them in two. You can thank her later.
Opening Thoughts
We've had moms and babies at the land for just about 10 days now. These women and their children are what busy me most during the day. The four moms that have spent time at Second Mile in the last 10 days have all had one thing in common: they have no other children. The child in their arms is their first and only. We always ask how many times have you given birth and how many living children do you have and I always get the chills when they reply, "only this one."
Since it is so common within the most impoverished parts of Haiti for a family to lose one or more children to malnutrition and preventable illness (like diarrhea), receiving a mom and her very first child feels kind of like we get to challenge those statistics. It's like, boom, take that "statistics," this mom doesn't have to lose this child or any child, ever.
And on that note, I give you a few more of my favorite moments.
saturday entertainment provided by jenn.. the moms stick close to their one and onlies
Not everyone stays.
It's important to tell you that some of the hospitals and clinics have a service called PTA, which is a French acronym that means "outpatient treatment program" for malnutrition. Sites with PTA programs use the same wonderful product we use which is called Plumpy'Nut, or Medika Mamba. The children come in once a week to be weighed and to receive their weekly ration of the specially formulated, vitamin packed, peanut butter goodness. These are great programs and help save thousands of lives in Haiti. I'm sure that as more and more facilities obtain funding for PTA programs Haiti will begin losing less and less children to malnutrition each year.
All that to say, whenever I speak to the staff of these programs I'm careful to state that our facility doesn't aim to replace the work they are doing. Rather, we're on standby. If the staff sees fit, they can refer children who aren't progressing, cases where the caregiver can't afford to travel to the clinic once a week, and cases of repeat severe malnutrition where we might be able to help identify and address the underlying problems faced by the family.
I received a phone called on a Wednesday, the day after our little field trip.
"You have case for me?" I asked the nurse over the phone. Her response was, “Se pa yon, non. Gen plizye.” Not one, but several. Since this particular facility had a program like the ones I just described, I knew that her having “several cases” meant that she hadn’t fully understood what I was sure had been a brilliant explanation of what we do. Oops.. Kerline headed out to site to get to bottom of it.
I had explained to the nurse that if the family had the means to travel once a week for Plumpy'Nut and if the child was improving then there was no need for referral. These kids were already on the path to recovery through the hospital’s own programs..
..but alas, there were 15 kids waiting when Kerline arrived.
Some were just moderately malnourished.
Some were accompanied by a sibling or a friend of the mother's so no decision could be made about coming out to Second Mile.
Other moms just declined the offer. They either had too many other children at home or had obligations like selling food in the market.. or washing clothes...
Kerline spoke with all of them. She took particular note of two children she thought probably didn't need to come to Second Mile. They looked to be in pretty good shape. She wrote down their weights and ages though so that she could check the growth charts when she got back. Sure enough, these kids were fine. Just slightly underweight.
Today, one of those babies showed up.
Kerline received them at the gate, wide-eyed. Another oops... She'd forgotten to call the mom.
We brought them in for an evaluation anyway and I liked this woman instantly. This 12 month old baby was her only child. You could tell she would do anything for him. She was still breastfeeding which is such a good sign! She came with soup she had prepared for him that morning. She had listened to Kerline’s instructions at the clinic, packed everything she would have needed to stay. She showed incredible effort. She even brought his vaccination card which is another sign that this mom has it together.
The vaccination card was particularly telling. It showed that she routinely brought her son to the clinic for check ups. There was a weight listed for every month of his life. It showed that he had been progressing normally from ages 0 - 10 months. Only recently had it taken a slight dip. The family lived within walking distance from the clinic that was already providing him with nutritional supplements.
There was no reason for them to stay.
I took the liberty of chatting with the mom about nutrition anyway since they were going to wait for our midday meal and a ride back to town. She couldn’t initially define “malnutrition” nor was she familiar with the 3 food groups we talk about in Haiti. But after I walked her through the types and causes of malnutrition and gave her examples of the food groups she was able to rehearse them back to me with shocking precision. She would have been our star pupil.
But that’s the beauty of it. Not everyone needs to stay. :)
Watching a baby’s butt heal. (a much shorter story)
Clearly we believe in Haiti’s health system and we wish for people of all ages to be able to make use of its services, but frankly not everyone can. Without going into the many complexities, I will say that simply not every one has enough money to pay for transportation to their nearest facility, or to pay the visit, lab, and medication fees once they arrive. As was the case of a boy named Anderlin. Anderlin is 21 months old and was born with spina bifida. He was referred to us by our friends at Children of the Promise who helped save his life (literally) by taking him to get surgery in the Dominican Republic shortly after he was born. I don't know his life history, but he looks great! The surgery and recovery must have gone well because Anderlin is a healthy and happy boy.
Expect for his bum.
Recently he sat on something scalding hot. The result was three small, pressure sore-like wounds on his der·ri·ère. To make matters worse, he has a very itchy skin infection around his buttocks, legs, and his back.
His sixteen-year-old mom doesn’t have a dollar to her name. She could not afford to travel to the closest clinic for dressing changes. Quite perfectly, Anderlin and his mom live en-route to our facility. I pick them up each morning and they ride back with me in the evening. Anderlin gets all the nursing care he needs during the day. His mom gets to participate and gets all the benefits of the health and hygiene classes and the time they spend at the land falls across two meal period. Because Anderlin is not malnourished they really don’t need to spend the night. I think it is a win-win for everyone.
My favorite part of this arrangement is watching the wounds heal. I love wound care. I love it. There’s nothing better than watching a wound get better. Expect maybe watching malnourished babies get better...
***To the COTP staff involved in getting surgery for Anderlin, I commend you. He's a big healthy boy. What a miracle.