Malnutrition in the Pine Forest

It is a happy day when we see a child graduate from our malnutrition program.  We get to observe the positive change in health and disposition in a child that has received therapeutic food and medical care. We know that each child that graduates the program will have a decreased chance of growth stunting, xerophthalmia (Vitamin A deficiency that can lead to night blindness), severe infections, numerous chronic health conditions, multi-system organ failure, and death.  They will be able to acquire improved immunity, healthy brain development, and, most importantly, an improved quality of life.

Over the last 10 years, Haiti has made significant efforts to decrease the burden of malnutrition on its citizens, yet 1 in 5 children less than five years old still suffer from being chronically malnourished.  There are of variety of causes including food scarcity, poor education, cultural practices, unclean water, intestinal parasites, and poverty.  Access Health Alliance is striving to decrease the incidence in the Foret des Pins region by treating active cases, educating mothers on the importance of breastfeeding until at least 12 months and up to 24 months, routinely screening all young children to identify cases early, and supplementing at risk families with vitamin and protein enriched rice when it’s available.

Malnutrition in children can present as both chronic and acute onset.  We have two types of acute malnutrition that we treat at the clinic in Foret des Pins, Haiti.  Marasmus is a slow occurring severe deficit of calories, including fats, carbohydrates, and proteins, which presents with our patients appearing starved, having a tiny arm circumference, and diminished body fat stores.  Kwashiorkor malnutrition has a rapid onset, usually weeks, caused by a decrease in protein intake.  These children may have some retained fat stores and present with swelling to their extremities, which may deceptively appear as normal baby chubbiness to the untrained eye.  However, while their appearance may not be as shocking as the child with marasmus, they are still very sick children that need immediate intervention. 

Since opening the doors to the clinic in 2016, we have seen numerous children suffering from malnutrition and knew we needed to do something about it.  Joining with International Medical Corp (IMC) for a 1 year partnership in 2017, we were able learn and implement a protocol that treats children under five years of age with both forms of malnutrition.  Each child diagnosed receives treatment for any underlining cause, ready to use therapeutic food, vitamin A, and albendazole which is a medication used to treat and prevent gastrointestinal parasites.   We have been able to continue this program after our partnership with IMC ended due to our very generous supporters and donations from Operation Blessing, Fonkoze, Vitamin Angels, and the Haiti Ministry of Health.

In 2019 we admitted 135 children and infants to our outpatient acute malnutrition program and another 82 through September of 2020.  It is heartbreaking to continue to find more malnourished children, but we are thankful that we have an established program in place to identify and help these children in need.   We have observed a few barriers to the success of this program that affect the reliability of supplies and the needed commitment of families to achieve discharge criteria.  We are continually seeking solutions to improve our services and the outcomes of these little ones.   

AHA’s malnutrition program would not exist without the ongoing collaboration of other agencies within Haiti and the support of our Alliance.  Thank you!