As a pediatrician, I work towards helping families raise healthy children every day.

A home of many of the Haitian children.

In Haiti, the challenge of this is great. There is so much working against the health of the children here. It starts with maternal health. The mothers of these babies have poor access to care, medicines, food and water. They may deliver at home, and the child may be sick for a long time before they come to the hospital. Once in the hospital, all of the major illnesses, such as pneumonia, diarrheal illness, and malaria, are much harder to control and cure in a severly malnourshed child. When I think about a typical well child visit in the US, I remember asking about childproofing, locking away medicines, keeping water temperatures safe. When I drive by tent cities, and see dangers at every turn. There are long iron rebars coming out of the ground and rubble. There are large piles of garbage and refuse adjacent to most tent cities. The government has crews constantly out working to collect and contain the trash, but it is a losing battle. There are open fires right next to the tents. When I first saw these things, I was shocked. When I saw two youngs boy splaying soccer, kicking a ball back and forth between piles of trash, it really hit me: this is their home. They have been here for so long, this is their average, day to day reality.

Beginning to work to fix these problems is hugely complicated, and I am certainly glad it is not my job. When I see healthy children in their school uniforms walking down the street, I marvel at the miracle. "How did you make it through, little one?" I ask, silently yet incerdulously. When I see the effects of these living conditions, such as babies with such severe malnourishment that their little bellies are round and swollen, and their skin begins to breakdown, I get motivated to do more. We cannot forget about Haiti. The journalists have moved along, the cameras have stopped rolling, but the need for help remains. I am very happy to be part of an ongoing effort to help make a difference in the lives of these kids. There is no quick fix here.

I continue to be impressed by the work of the Haitian physicians. November 12 was world pneumonia day. They organized many efforts to help the parents of Haiti prevent pneumonia, and seek treatment quickly if it does arise. One powerhouse pediatrician created "The 10 commandments of pneumonia " for mothers. She and her colleagues developed 10 basic tenets, including using clean water, getting immunizations, and recognizing respirtory distress. It is a very clever outreach model in an almost enitrely Christian nation.

On a personal note, I have been so blessed on my trip here. The Haitian family I am boarding with has been overwhelmingly gracious. On my first trip here, it was during the elections, and there was a lot of concern about political violence. I did not leave the clinic compound except for one day when I drove to get a cell phone. This trip has been like a sneak peek into Haitian culture. They present me with a new Haitian food to try each and every meal. For those of you who have traveled with me, you know I love nothing more than to sample the wacky and the weird. I have had my favorite from my last trip, soup joumou, or pumpkin soup. The peanut butter I have with breakfast is manba avec pimien, or with hot peppers. I don't think I will ever be able to go back to plain peanut butter again. And yes, concerned readers, I have been avoiding the street food.

The side of a tap tap- Haitian public transportation. They often have Jesus and Beyonce hanging out together, amid the bright Haitian paintings.