In Haiti, an unprecedented expansion in nutrition services for children and women

By Skye Wheeler

PORT-AU-PRINCE, Haiti, 18 January 2012 – In two cramped UNICEF tents in the middle of the General Hospital, Head Nurse Bluette Jean-Louis and Dr. Josiane Andrianarisoa attend to severely malnourished children. Many of them are ill.

“Sometimes you see malnourished babies that get sick. Sometimes the sick ones get malnourished. It’s what we call the vicious circle,” said Dr. Andrianarisoa, who leads Concern Worldwide’s nutrition programme in Port-au-Prince.

Even before the devastating 2010 earthquake, malnutrition had reached crisis levels in Haiti. One fifth of children under age 5 were underweight, and nearly a third suffered chronic malnutrition. But today, two years after the disaster, there has been an unprecedented expansion in preventative and therapeutic nutrition services for children and women.

Creating sustainable solutions

Dr. Andrianarisoa is part of these expanded services, and she is helping make sure these programmes are sustainable.

She spends her days navigating the narrow streets of the capital, moving in and out of Concern-run nutrition clinics and centres, making certain every child under her care is doing as well as possible. And, crucially, she passes on her knowledge to her Haitian colleagues.

At one of the General Hospital tents, Nurse Jean-Louis, Dr. Andrianarisoa and one of the hospital’s local pediatricians evaluated 4-month-old Maya Max Davens.

As the baby squirmed, Dr. Andrianarisoa quizzed the pediatrician on his treatment plan, and then reviewed his paperwork. Helping local doctors refine their abilities will ensure Haiti’s nutrition programmes continue to operate efficiently in the future.

Importance of breastfeeding

“He’s a good baby,” Dr. Andrianarisoa said. “He is not too sick, just malnourished.” She turned to Maya Max’s mother, Marie Louise Surin, and inquired if she had been breastfeeding.

Ms. Surin said she tried for a long time but that Maya Max refused to latch onto her nipple. Eventually, she gave up and began feeding him cow’s milk and ground corn meal.

“This is no good,” Dr. Andrianarisoa said. “You have to breastfeed until at least six months.”

Breastmilk contains all the nutrients infants need, and also provides antibodies to strengthen children’s immune systems. UNICEF and partners are working to promote the importance of breastfeeding around the country, part of broader efforts to address child malnutrition.

Ms. Surin will be shown how to properly breastfeed Maya Max, and in the meantime, the baby will receive F100, a kind of fortified milk full of fat, vitamins and minerals. Fortified milk and other fortified foods, technical support and other resources are provided by UNICEF to many of the country’s clinics and hospital wards.

When they are discharged, Maya Max will receive outpatient care to ensure he continues to improve. Every time a baby leaves it is a triumph for Nurse Jean-Louis and Dr. Andrianarisoa.

“You feel happy when they grow,” Dr. Andrianarisoa said. “I love my job.”

New facilities

The tents at General Hospital are crowded with cribs and cardboard boxes of fortified peanut paste. Doctors and nurses carefully maneuvered around each other and patients.

Between two of the cribs, a mother slept on the ground. The air was thick with humidity, and everyone was sweating.

But nearby is the new nutrition area – not a tent but a large room with new cribs and fans blowing from the walls. On the walls are cartoon murals.

“UNICEF paid for this. It is much closer to the toilets and sanitation facilities, and that is much better,” Dr. Andrianarisoa said.

“We will be able to make more babies healthier here.”