One starfish at a time

Today I had a moment of victory in the hospital.  Malnutrition is a big problem for Haitian kids, and can be serious enough to require hospitalization.  We have a great nurse who runs the outpatient malnutrition program, giving moderately malnourished kids Nourimanba and special fortified milk so that they stay well enough to avoid hospitalization,  and she also treats the hospitalized patients who have severe acute malnutrition.

I have met a few malnourished kids already.  The toughest ones are the ones whose mothers have either died or are sick, so breast feeding – a cost-free and nutritionally sound feeding method – is not an option.  One of those babies is 5 months old and weighs 3.3kg (7 pounds 4 oz) – about as much as a newborn baby should weigh.  His mother has died, and his grandmother cannot afford to feed him.  On the day I met him I’d asked why we weren’t providing him treatment for his malnutrition (i.e. food!) and I was told that the malnutrition program only treats patients who are at least 6 months old.  From my reading of the protocol mentioned above, I knew there was a whole chapter devoted to patients under 6 months old – a minority of malnutrition patients, for sure, and one that requires some slightly different care.

We first discussed treating this patient’s malnutrition on Friday, when the grandmother told us she didn’t have anything to feed the child.  I felt powerless and really discouraged to hear the answer – we can’t do anything.  He’s too young.  We don’t give out formula.  So I went home and did my research, found that protocol, and brought a copy with me to the hospital.  Today I saw the malnutrition nurse and asked if she’d see my little patient.

She agreed, and came over to see him, but frowned when she heard he was only 5 months old – too young to fall under her care.  I mentioned to her, in Creole, that there is a protocol, and asked if she would look at it.  I ran off to get that protocol, and showed it to the skeptical-looking nurse.  She gave it a glance, jotted down the numbers that she’d need to calculate how much formula to give to my baby, and quickly agreed to treat him.  I was thrilled!

He’s only one patient in a sea of malnourished Haitian children, but he’s one patient.  One patient who I helped today.  I can feel good about that.

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  1. the DAd

     /  January 25, 2012

    ok Dr Dooooooooooooo Gooder. Good Job. so in a country where education is next to non existance you were able to use the rules to accomplish the task. How sad you had to resort to that. Have you run this up the flagpole and let your boss know that the b.s. is happening. So today 1 kid, tomorrow the world.

    is that little practice in benecia and the apt over the starbucks with the view of water starting to sound better each day

    Love ya

    the DAd

  2. Thanks Dad. I love you too!
    I think the nurse just hadn’t known that the country had guidelines for how to treat the youngest kids. She was very willing to help once she knew how to do it. I have a second 5-month-old who I’m going to be referring to her tomorrow. I’ve got the protocol in my bag in case she has any other questions.
    I do have a view of the water from the hospital here, but no Starbucks and no Benicia. Maybe some day…


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