Dr. Plourde examining a patient in clinic.
Dr. Pierre Plourde is a Medical Officer of Health with the Winnipeg Regional Health Authority. Since 2004 he has also been an EMAS Canada Team Leader for an annual mission to Haiti where he first made trips as a medical student, intern, resident and physician starting in 1982. This year he led an amazing team of young healthcare volunteers who helped assess and manage over 600 patients in a community clinic supported over the years by Dr. Plourde’s teams. They saw over 300 children in that clinic, none of whom were severely malnourished due to a 20-year feeding program for destitute neighborhood children. Over the past five years, Dr. Plourde at the urging of a friend and colleague, has also included a short visit to the hospital for sick children in Port-au-Prince, run by the Missionaries of Charity sisters, simply to volunteer and to offer social human interaction to severely malnourished and neglected children.
I was handed an apron by the nun and a bowl of porridge by the nursery attendant as she pointed to crib #13, silently asking me to feed the youngster who was laying waiting for breakfast. This child was one of about two-dozen in this nursery who needed to be fed, washed up, socialized with, and fed again before we would be asked to leave at noon
The sisters take after their founder, Mother Teresa, very strong minded with a will not take “no” for an answer attitude when advocating for the poorest of the poor. They are pleased if all you have available to give the children in the nursery is love. And of course, no photos allowed!
The little guy in crib #13 was a beautiful child. He didn’t show obvious signs of severe malnutrition. His hair wasn’t red and coarse. His skin looked good. His eyes didn’t show any hint of vitamin deficiencies. He wasn’t wasted (a sign of marasmus) and didn’t have the typical bloated appearance of Kwashiorkor (severe protein-calorie malnutrition). I took out my stethoscope and, listening to his lungs and heart, they sounded fine. I had to prop him up, for he was unable to sit up by himself—he seemed “floppy”. I looked at his ankle bracelet—the name was completely smudged and unreadable. I guessed he had been at the hospital a long time. I could barely make out an age of “7 months”, not knowing if that was his current age or, probably, the age at the time of his admission. Regardless, he should have been able to sit up on his own.
He was a slow eater! Really slow! So slow that by the time I finished feeding him breakfast, other volunteers in the nursery had fed two or three infants each, making me the subject of a little ridicule—the father of two children who had forgotten how to feed a baby.
When I finished feeding #13, I waited for his gastrocolic reflex—the one responsible for the urge to defecate following a meal. His was a strong reflex! I was glad I had accepted the full body apron that the nuns had handed to me. I decided I’d show my fellow volunteers that if I’d lost the knack of feeding a little one, I certainly hadn’t lost my legendary skill of the “rocket” diaper change. My little #13 was very pleased with the prompt, efficient and rapid diaper change service offered to him that day. His broad smile showed me that he was able to socialize somewhat. Too bad I couldn’t take a picture. Maybe I should have made an effort to find out what his name was!
Over the next couple of hours, while I was attending to other needy children, I noticed that #13 wasn’t drawing much attention from any of the other volunteers. Despite all the crying and fussing from other infants begging to be picked up and cuddled, he remained silent but seemingly attentive.
Was his silence due to lack of connecting with his outside world? Or was he truly laid back and relaxed? Was he resigned, already giving up on a world that had been cruel to him? There was no way to tell. He did manage to take a nap amid all the hustle and bustle.
When parent visitation time came, he seemed to be one of the very few infants who didn’t receive a visit from his mother. One mother that I observed was so detached from her child that she seemed totally unmoved and almost dismissive of her child’s pleas for her to stay when visitation time was over. Maybe denial is the best way to cope sometimes when life gets desperate.
At lunchtime I was again handed a bowl of food—rice with mashed soy-based protein-rich something. Although #13 didn’t look too malnourished, by the looks of the infants in neighboring cribs I could just imagine what he might have looked like when he was admitted. And his lack of ability to sit up gave away his developmental delay. In another crib I noted a chubby girl with red hair who looked to be four years old, whose bracelet gave away her true age of seven! Her chubby appearance had nothing to do with fat – on the contrary it betrayed the classical appearance of Kwashiorkor with massive fluid shift into her tissues due to dangerously low levels of protein in her blood. But at least she was able to sit up and feed herself.
I managed to get lunch into #13 in the time it took the other volunteers to feed three or four children. As a result, I got to spend a fair amount of time with him, probably a good two of the three hours. The nuns ask volunteer helpers to leave at noon. Maybe I should have made an effort to find out what his name was!
And so I said “so long” to my little #13, knowing that I will likely never see him again, and even if I do, how will I know? And I’m sure he completely forgot about me the next day. I left the nursery with so many questions.
- What impact did I have on #13’s life? He sure had an impact on mine!
- How does he bond if his mother doesn’t visit, and he meets a different volunteer every day? I sure felt a special bond with #13 during our short time together!
- What did he get out of my visit? I was certainly blessed by the privilege of sharing my love with him!
- What are the chances that he will make it to the age of 5? The worst thing that happened to me before the age of five was probably measles and chicken pox!
- What is his life expectancy? Mine is about 80 years (vs. about 60 years in Haiti)!
Maybe I should have made an effort to find out what his name was!
I want to wish #13 a healthy, fulfilled, prosperous life; but I am afraid that I may be wishing through rose colored glasses. I was told there were at least two other nurseries—one for infants who were recently admitted with severe forms of malnutrition and one for infants who were doing better and close to being well enough for discharge home.
I think #13 was close to being transferred to the pre-discharge nursery. I wondered what “home” he would be discharged to. Was he going to be sent home to worse conditions than crib #13? It was hard to imagine him being sent home to a dreadfully poor setting where his mother could be unemployed and reduced to begging and vulnerable to worse abuses; where his father could be non-existent, having abandoned a family he cannot support on an annual income of $900-$1200 if he is fortunate enough to have a job. These are the harsh statistics of Haiti.
But #13 was not a statistic—he was right in front of me. He put a real face on a bunch of numbers and realities that I have come to know about life in Haiti over the last 32 years. Maybe I should have made an effort to find out what his name was!
I only spent three weeks in Haiti on this trip, but those three hours in the sisters’ hospital intermediate nursery are imbedded in my mind. I think #13 might have a chance to flourish if he lives in a neighborhood blessed with a community development program that provided free primary education and free primary health care, where he can receive at least one good meal a day. Is it really just the luck of the draw that determines whether a child lives or dies? Or can I make a difference?
Maybe I should have made an effort to find out what his name was!