Five recent medical stories, told by Dr. Tram Jones
A 14-month-old child (pictured above) presented to Lespwa Timoun. Her head was very large and she was clearly suffering from a disorder known as congenital hydrocephalus. This disorder is not uncommon in Haiti; this is due to a variety of factors including brain infections and poor folic acid intake. At six months, her mother took her to an intown hospital. At that time, she was told that a CT scan would cost $300 – far outside the reach of this mother (and of the majority of patients who we see). After eight more months of swelling, the mother brought the child to Lespwa Timoun. Without surgery, her condition would be fatal. Using our network, we contacted a specialized hospital, Bernard Mevs, in Port-au-Prince. They have a special program for children with this disorder and assured us that all care (including surgery) would be free. Our driver took the family to the Hospital two weeks ago and the child had her preliminary scans and consultations in anticipation of surgery. We are hopeful for neurosurgery in the coming months.
A sweet child (pictured above) was brought to Lespwa Timoun from the smaller village of Belle Fontaine. She was accompanied by her mother and father—a sacrifice that rarely occurs as it requires time off work (lost revenue) for both parents and time away from other children. With only a first glance, staff at Lespwa Timoun knew that she required hospitalization quickly as she was massively swollen, from her feet to her neck. This was a classic and severe case of kwashiorkor, swelling brought on by starvation.
The child was driven to the hospital immediately. The families of malnourished children are usually the poorest in our area. A hospital bill that can reach more than $100 for a several-week stay is simply not feasible for them. To ensure we meet our mission of serving those who are most in need, we have arranged a flat rate of care with the hospital for of our malnourished children who we refer; they simply send the bill to us at Lespwa Timoun.
After two weeks (pictured above), the child’s swelling is significantly reduced. While her skin is peeling, she has started to eat again – a promising sign of progress. We continue to hope for this small child and for her mother and father who have remained at her bedside.
At the clinic, we had a mother bring her two twin children to the clinic. At nine months, they both weighed a little over 8 pounds (as reference, many American children weigh more than this at birth). The children were driven straight to the hospital and their hospital bills paid. While the boy twin did well, his sister struggled to gain weight. After two weeks in the hospital, however, both were able to eat on their own. Once discharged from the hospital, the children have continued in our weekly nutrition program at the clinic as part of a longer-term nutrition rehabilitation. They receive fortified peanut paste, Plumpy’Nut, to promote rapid weight gain. The boy is now over 12 pounds and the girl is now over 10 pounds. They still have a long road ahead, but Lespwa Timoun will walk with them every step of the way for the next 6 months.
Last week at the clinic, a tiny child (pictured above) was brought to Miss Jonkat, our community health worker who oversees the Nutrition Program. At six months, this baby weighed nine pounds and was in the 0.1 percentile for weight-to-height. With severe malnutrition, we often see familial issues at play. This particular girl had lost her mother two months before and had only recently found her way to a loving aunt. Her aunt was extremely worried about the child despite having other children to care for. In addition to her low weight, the child had been experiencing diarrhea for the previous 4 days. Her respirations were faint and she was very lethargic. She was brought to the hospital with which we partner and greeted by Dr. Donald Valdema (son of Lespwa Timoun founder, Carmel Valdema) in the Emergency Room. Dr. Valdema is a resident in the local hospital and has been essential in coordinating care for our sickest infants. This child will need all of our hopes and prayers over the next weeks.
Boucan Boyer is a village North of the city of Croix-des-Bouquets (and likely familiar to those of you who have visited Haiti before). In December 2019, our community health worker, Mercidieu (his name means “Thank you God”) was screening in the community for malnutrition and found a severely ill child. She had severe kwashiorkor (pictured above). Her skin was breaking from the level of swelling in her legs. He knew that she did not have long to get to a hospital. He arranged with the family for the child to be taken to the sole children’s hospital in the Port-au-Prince area.
On arrival at the hospital, the child was found to have diabetes and malnutrition, which complicated her case significantly. After a prolonged hospital stay, she returned to Boucan Boyer. Lespwa Timoun has followed her monthly in the nutrition program, and continues to provide nutrition supplements and medical supervision, while St. Damien provides ongoing care for her diabetes in the city.
After a long journey, she has recently graduated from our nutrition programming, returning to the normal strength that a young child deserves (pictured above with a proud dad).
