Wednesday, November 16, 2011

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.

Monday, November 14, 2011

Little lives

I am always overwhelmed by the littlest lives.
We had quite the day today. In the NICU there are two babies who are in the 700 gram range (that's about 1 and a half pounds.) It is an attestment to the amazing work of the doctors and nurses here. They have limits to the resuscitation measures, labs, diagnostic tests, and medicines, yet they have kept these two fragile little lives going strong. The babies themselves are Haitian through and through- beautiful, brave, resilient, right from the first moments of their lives.
I also spent time on the malnutrition wards. Even after many trips to many poor countries, and taking care of these kids day in and day out, something about them still grabs me. I see babies who have thin, bony limbs where they should have cherubic limbs with roly-poly thighs and dimpled knees, and something gets stuck in my throat. Every time. There is a deep, intrinsic drive to FEED the baby that pumps through me when I see them. They inspire me to continue to tell their stories, to continue to work for the change that would allow them secure access to food. I try my best to take care of them in the short term. I worry about them once they go home, whether they will continue to grow, if they will have the strength to fight off infections, how they will do their first year in school.

The toddler ward
I brought the first batch of coloring books to the wards; they were a huge hit. Thank you to everyone who contributed to that project!

Sunday, November 13, 2011

Heroes in Haiti

I have arrived safely in Haiti. The trip was unbelievably smooth. The 5 hour layover in Miami was tough- getting in at 11 pm and having to be back in the airport at 4 am was almost ridiculous.The man who worked the desk at the airport hotel said, "What's the point of checking into this hotel?" Wise man.
 I arrived Saturday morning. I met my host family, two wonderful Haitian doctors. They are amazing people: bright, engaging, and gracious. I am so lucky to have the chance to meet them.
I am here with a neonatologist, Alan Picarillo. We went to the hospital today for rounds, and a teaching session. Rounds was somewhat abbreviated as it is Sunday. I was very nervous about teaching. Pediatric rheumatology is a subject that can be difficult to teach. English is not the first language of most of hte residents, and my Haitian creole is getting stronger by the day, but still not up to lecture giving performance level. But the teaching was great. The residents were engaged and interested. They asked so many great questions and kept the talks going with their enthusiasm. I am so excited to teach the rest of the week. We have already had a few challenging cases presented to us. we are working hard to try and help take care of these beautiful children.
I spent most of the day with a pediatrician. She has worked in Haiti her whole life. We spent a lot of time talking about our work, and what drives us. We had a lot of shared passion for serving underserved populations, working in situations which challenge us, and providing social justice. These doctors could choose to leave Haiti. They could head to the States and live a protected and comfortable life. But they work tirelessly every day to improve the health of Haitian children. Their dedication blows me away. There are angels on this earth, and sometimes you find them in the most unlikely places.

Alan teaching the residents-I can't make it upload in the correct orientation. 
I like this picture of the smushed mosquito on my journal article. Stamping out malaria, one mosquito at a time.