Being the social scientist that I am, I am fascinated and always amazed at the environments the kids in my student learn in. Like most developing countries – there are the standard crowding, lighting and circulation issues, but each school has these issues in so many different ways. To illustrate, I’ll compare our two mamba schools; Henri Christophe (HC) and Oasis.
First, what these schools have in common. Every student in every school wears a uniform. Each school in Cap-Haitien has a different one in order to tell which kid goes where. The uniforms for HC are blue checked shirts with blue pants. Oasis has orange pants and beige shirts. The school day starts at 8 am and goes until 12 pm. There is one recess. Subjects taught include geography, science, math, French, Creole and history. Three times a year students take week long tests. The grades they receive on these tests dictate whether or not they pass and move onto the next grade. This is for all schools. Now onto the differences.
Oasis is one of our largest schools in terms of enrollment. There are roughly 600 students in the school with just over 300 participating in the study. Each grade has two classes and there are also the preschool and kindergarten versions. Every class has between one and two teachers, plus there is two administrators and two groundskeepers.
The school is private, part of Baptist church in the area. This means that families pay a larger tuition for kids to attend. While almost all schools will have a tuition, private schools are more expensive but often offer better teachers or other perks like sports, school lunch, English classes, etc.
The school is located just on the outskirts of downtown Cap-Haitien. It’s on a busy road that leads to the market so there is always traffic. Just outside of the school are vendors selling snacks, food and other household items. There are three buildings which make up the school. Two are within the school’s gates and one is on the other side of the road. There is electricity, a water pump, and three flush latrines for the students to use. The classrooms are decorated with paintings and posters.
HC on the other hand is a public school located in Petit-Anse, a low-income neighborhood on the outside of town. There is no tuition for students at this school because it qualifies for a new government program in an effort to start free education nationwide. There are just 140 kids in the school – 110 are in the study. There are five teachers and one administrators for six grades. There is also a groundskeeper who will help out with repairs around the school.
Here’s the kicker. HC is a modern-day one room school house. The entire school is open to each other so there are no barriers between the classes. There is no water source and there is a hole in the back corner for kids to use for their latrine. The front of the school is a bridge over an open sewer. And there isn’t much in front of the school and only one lady selling any sort of snack or food for the kids.
So there’s some huge differences. Oasis is adequately staffed and HC isn’t. Oasis has separate rooms for classes while HC has every class hearing every other class, causing huge distractions. One of schools has water – for drinking (especially when schools get hot) and washing their hands and one doesn’t. There are latrines at Oasis so students are able to go to the bathroom cleanly while HC basically uses a spot in the back of the school. Not sanitary. One school benefits from being in a high-income area while the other is in the middle of one of the poorest areas within the metro area. Big differences.
While all of the schools in my study are lacking many things that ‘we’ (North Americans) think are vital to have in order to have a positive, effective, nurturing school environment they don’t have them here and still kids learn. And they love learning and they love being in school. I guess I am just amazed at the resilience of these kids and that they will sit in a hot, crowded, noisy room every day without eating or drinking anything just to learn some grammar.
Friday, April 12, 2013
Out of Our Control
There are many barriers to implementing and research project. In studies such as the one I am working on, you want to be able to control for as many things as possible. Control basically means keeping things as equal between the groups as possible. This includes factors inside and outside the school; number of students at the school, economic position of the students’ families, number of boys vs. girls, ages of the students. But in real life, there is very very little you have control over in your own life and even less in a study such as this. Take a little thing like Mother Nature…
Snow days. Every child’s fantasy once that temperature goes down and the days get shorter. For kids up north, hardly ever realized because as much it may snow, there exists plows, salt, and the infamous two hour delay. But every once and a while, out of sheer volume of blizzard-like proportions there’s a snow day. Here in Haiti, it’s rain.
And not just your lazy Sunday morning rain, sip a pot of coffee all day long rain, read a few chapters, knit a few scarves rain. No. More like monsoon rain. I’m talking rain that pours and pours and pours for hours on end. Rain that creates flash floods, mud slides, gorges down the mountains. Lots of rain. And what happens the next day? Cap-Haitien literally becomes an island in itself. There’s nowhere for the water to go except downstream. But what happens when that stream gets back-up or cut off from the ocean because of construction, trash and debris? It floods roads and more importantly, people’s homes. They can’t go anywhere or do anything until the water eventually recedes. This can take days.
And schools close. If teachers don’t want to brave the flooded roads – or can’t find transportation to take them through the flooded roads, they can’t teach. If parents can’t – or won’t send their children out into the flooded street to go to school, they can’t learn. If the school itself is under water, creating a breeding haven for mosquitos (which carry malaria, dengue and other horrible shit) it can’t be open.
This doesn’t just happen once or twice a year, but drastically affects the amount of school days that are actually open. Haiti has two rainy seasons. The big one is in October/November and comes with hurricanes. This school year, for nearly two months the kids had maybe a week or two of school because there was just that much rain. Which seriously hindered our ability to begin our project and in fact, delayed the start of the distribution until after Christmas break. This shortened the project from the original length of the school year (none months) to just five. Ugh. Now, April and May – the second rainy season. Although smaller, the rain is now unpredictable. It can come at any time and no one knows for how long it will rain. It could be for twenty minutes like two nights ago. Not a big deal. Or, it could be for four hours like this past Saturday, flooding everything. A big deal.
Again, it’s unpredictable so some schools on Monday could still be flooded and others not at all. And rather than a school district deciding whether to close all schools in an area, it’s up to the school director to decide. So if you happen to go to a school with a not so passionate, actually kinda lazy director you won’t have school and you won’t get mamba and you won’t be learning the same amount as other kids.
As you can imagine, this is a much larger problem than just for this study. But for us, it’s frustrating. We want the kids to be eating the mamba as much as possible – but in order for that to happen, they have to be in school. And we want every kid to be eating the same amount as any other kid, aka we want ALL the schools to be open when ALL the other schools are. When they’re not, the kids aren’t benefiting from getting an extra food source and it makes the data we collect harder to show an impact. We could have a great product here; it could be an amazing program that can seriously impact child micronutrient deficiencies. But we may also never know that because there are so many things out of our control that keep the kids from getting those benefits. A big hurdle that we have no control over what-so-ever. So while you have to accept Mother Nature’s wrath or blessing, you also have to realize what you’re giving up.
On an unrelated note, this March my study had some great visitors from Edesia, the company that makes mamba. They were able to come and visit the schools, hang out with the kids and watch as we collected our midline data. If you're interested in seeing some of the great shots their photographer snagged, check out the link to their Picasa page. Also, check out their website to learn more about mamba and other products that they make. Great people, great work and a pleasure to have worked with them.
Pictures: https://picasaweb.google.com/EdesiaGlobal/EdesiaVisitToHaitiMamba#5859271158546230594
Website: www.edesiaglobal.org
Snow days. Every child’s fantasy once that temperature goes down and the days get shorter. For kids up north, hardly ever realized because as much it may snow, there exists plows, salt, and the infamous two hour delay. But every once and a while, out of sheer volume of blizzard-like proportions there’s a snow day. Here in Haiti, it’s rain.
And not just your lazy Sunday morning rain, sip a pot of coffee all day long rain, read a few chapters, knit a few scarves rain. No. More like monsoon rain. I’m talking rain that pours and pours and pours for hours on end. Rain that creates flash floods, mud slides, gorges down the mountains. Lots of rain. And what happens the next day? Cap-Haitien literally becomes an island in itself. There’s nowhere for the water to go except downstream. But what happens when that stream gets back-up or cut off from the ocean because of construction, trash and debris? It floods roads and more importantly, people’s homes. They can’t go anywhere or do anything until the water eventually recedes. This can take days.
And schools close. If teachers don’t want to brave the flooded roads – or can’t find transportation to take them through the flooded roads, they can’t teach. If parents can’t – or won’t send their children out into the flooded street to go to school, they can’t learn. If the school itself is under water, creating a breeding haven for mosquitos (which carry malaria, dengue and other horrible shit) it can’t be open.
This doesn’t just happen once or twice a year, but drastically affects the amount of school days that are actually open. Haiti has two rainy seasons. The big one is in October/November and comes with hurricanes. This school year, for nearly two months the kids had maybe a week or two of school because there was just that much rain. Which seriously hindered our ability to begin our project and in fact, delayed the start of the distribution until after Christmas break. This shortened the project from the original length of the school year (none months) to just five. Ugh. Now, April and May – the second rainy season. Although smaller, the rain is now unpredictable. It can come at any time and no one knows for how long it will rain. It could be for twenty minutes like two nights ago. Not a big deal. Or, it could be for four hours like this past Saturday, flooding everything. A big deal.
Again, it’s unpredictable so some schools on Monday could still be flooded and others not at all. And rather than a school district deciding whether to close all schools in an area, it’s up to the school director to decide. So if you happen to go to a school with a not so passionate, actually kinda lazy director you won’t have school and you won’t get mamba and you won’t be learning the same amount as other kids.
As you can imagine, this is a much larger problem than just for this study. But for us, it’s frustrating. We want the kids to be eating the mamba as much as possible – but in order for that to happen, they have to be in school. And we want every kid to be eating the same amount as any other kid, aka we want ALL the schools to be open when ALL the other schools are. When they’re not, the kids aren’t benefiting from getting an extra food source and it makes the data we collect harder to show an impact. We could have a great product here; it could be an amazing program that can seriously impact child micronutrient deficiencies. But we may also never know that because there are so many things out of our control that keep the kids from getting those benefits. A big hurdle that we have no control over what-so-ever. So while you have to accept Mother Nature’s wrath or blessing, you also have to realize what you’re giving up.
On an unrelated note, this March my study had some great visitors from Edesia, the company that makes mamba. They were able to come and visit the schools, hang out with the kids and watch as we collected our midline data. If you're interested in seeing some of the great shots their photographer snagged, check out the link to their Picasa page. Also, check out their website to learn more about mamba and other products that they make. Great people, great work and a pleasure to have worked with them.
Pictures: https://picasaweb.google.com/EdesiaGlobal/EdesiaVisitToHaitiMamba#5859271158546230594
Website: www.edesiaglobal.org
Thursday, March 21, 2013
A Coordinated Effort
These past two weeks have been more than busy for me and my team. We just finished with our midline data collection! In other words, we just measured, weighed, conducted BIA and hemoglobin tests for 1167 kids. Oh yea, and we did it in nine days. It may not sound like much of a feat but let me explain the events leading up to these whirlwind weeks.
Midline was originally scheduled for two weeks; the 11th through the 22nd. Then we found out from the schools that Easter break was actually starting March 15th, moving everything up a week. No problem, we thought. It’s still two weeks and it’ll give us plenty of time. Then we realized—the kids don’t go to school all day. The Haitian school system is set up so that most schools are actually two schools in one. There is a morning school from 8-12 that has students, staff and administrators. Then, from 1-5 a completely different set of students, staff and administrators come and have their classes. So we actually only had 4 hours everyday to measure our kids, not 8. Yikes.
Then, quelle surprise, we find out that the week before break is the testing week for schools. Again, a difference between Haitian and US schools- kids take a series of three exams during the school year. These tests determine if a child passes or fails. While students get homework, this isn’t graded and the culmination of grades isn’t from assignments, it’s these tests. Three times a year (December, March and June) students take a week long exam which compiles their grades. So this week was not only important for us because we were collecting our data – it was more important for the children as it decides whether or not they pass their grade. As a result, we realized that while testing was going on, we wouldn’t be able to measure the students. (It would be counterproductive in the grand scheme of things to pull a child out of the most important test of the year to get weighed and measured.) So our second week, 4 hour work days suddenly became 2 hour days. Needless to say I was beginning to get nervous.
So March 4th rolls around (oh yea- we only measure during school days; Monday through Friday) and we begin. To my absolute delight, we completely measure 175 kids. 175 out of 1167 done just like that. Things were looking up. And, to my absolute delight again, my team didn’t let up. The eleven of us were able to hunker down and get all of our kids done in nine days, giving us a day off. I was completely blown away by their ability to focus on the tasks at hand, find a rhythm and rock it. Everyday there was a team leader and that leader was in charge of organizing the kids, setting people’s tasks, and keeping the momentum going.
We had two teams so that we could do two schools at once. We started with the larger schools in order to cause the least amount of disruption during testing. We also tried to coordinate schools by area so that teams worked in schools closer together, allowing less travel and driving around. And it worked. While the teams worked, my counterpart Windy and I drove around making deliveries, bringing supplies, and making sure everything was going smoothly. It was one of the best coordinated efforts I have seen in my limited international work and I was truly impressed. Everyone knew they were part of a team, knew the mission, and worked to get it done.
That’s not to say we didn’t have our hiccups. In the developing world, there are always hiccups and usually these hiccups are chronically occurring. They’re always happening so you have to learn to adjust and work around them. And we eventually did. The biggest bump in the road, besides the crappy road to one of our schools was the testing. Because it was testing week, we started our measurements later, giving the students time to take their tests. However, tests were only an hour or so long. After that, teachers let the kids go home. This meant we had a precious window to catch kids that needed to be measured and quickly get them done. I mean, what kid is going to want to sit around and wait to get prodded and pricked while they have basically a day off of school? As a result, we were always searching for students and always missing some at the end of the day. How did we solve it? Classroom games.
To their credit, most of the teachers at these schools are very helpful. Most. After finishing exams, we were able to get teachers to play games with their students until we were ready for them. Hangman, guessing games, math games – whatever worked. And it did. Kids want to be in school, they like learning and they especially like learning in a way that’s fun and not the standard repetition. I loved it for many reasons; kids were engaged and enjoying themselves, they were staying at the school longer, we got our measurements done, and the schools were involved. A win for everyone.
Yep, our two weeks of measuring was a success. And to end it, we took a staff day to the beach. Granted, it happened to be on a day that was a complete downpour, but once we got over the mountain framing the city, the rains stopped and we were able to enjoy ourselves. The perfect ending to a hard-working week.
Midline was originally scheduled for two weeks; the 11th through the 22nd. Then we found out from the schools that Easter break was actually starting March 15th, moving everything up a week. No problem, we thought. It’s still two weeks and it’ll give us plenty of time. Then we realized—the kids don’t go to school all day. The Haitian school system is set up so that most schools are actually two schools in one. There is a morning school from 8-12 that has students, staff and administrators. Then, from 1-5 a completely different set of students, staff and administrators come and have their classes. So we actually only had 4 hours everyday to measure our kids, not 8. Yikes.
Then, quelle surprise, we find out that the week before break is the testing week for schools. Again, a difference between Haitian and US schools- kids take a series of three exams during the school year. These tests determine if a child passes or fails. While students get homework, this isn’t graded and the culmination of grades isn’t from assignments, it’s these tests. Three times a year (December, March and June) students take a week long exam which compiles their grades. So this week was not only important for us because we were collecting our data – it was more important for the children as it decides whether or not they pass their grade. As a result, we realized that while testing was going on, we wouldn’t be able to measure the students. (It would be counterproductive in the grand scheme of things to pull a child out of the most important test of the year to get weighed and measured.) So our second week, 4 hour work days suddenly became 2 hour days. Needless to say I was beginning to get nervous.
So March 4th rolls around (oh yea- we only measure during school days; Monday through Friday) and we begin. To my absolute delight, we completely measure 175 kids. 175 out of 1167 done just like that. Things were looking up. And, to my absolute delight again, my team didn’t let up. The eleven of us were able to hunker down and get all of our kids done in nine days, giving us a day off. I was completely blown away by their ability to focus on the tasks at hand, find a rhythm and rock it. Everyday there was a team leader and that leader was in charge of organizing the kids, setting people’s tasks, and keeping the momentum going.
We had two teams so that we could do two schools at once. We started with the larger schools in order to cause the least amount of disruption during testing. We also tried to coordinate schools by area so that teams worked in schools closer together, allowing less travel and driving around. And it worked. While the teams worked, my counterpart Windy and I drove around making deliveries, bringing supplies, and making sure everything was going smoothly. It was one of the best coordinated efforts I have seen in my limited international work and I was truly impressed. Everyone knew they were part of a team, knew the mission, and worked to get it done.
That’s not to say we didn’t have our hiccups. In the developing world, there are always hiccups and usually these hiccups are chronically occurring. They’re always happening so you have to learn to adjust and work around them. And we eventually did. The biggest bump in the road, besides the crappy road to one of our schools was the testing. Because it was testing week, we started our measurements later, giving the students time to take their tests. However, tests were only an hour or so long. After that, teachers let the kids go home. This meant we had a precious window to catch kids that needed to be measured and quickly get them done. I mean, what kid is going to want to sit around and wait to get prodded and pricked while they have basically a day off of school? As a result, we were always searching for students and always missing some at the end of the day. How did we solve it? Classroom games.
To their credit, most of the teachers at these schools are very helpful. Most. After finishing exams, we were able to get teachers to play games with their students until we were ready for them. Hangman, guessing games, math games – whatever worked. And it did. Kids want to be in school, they like learning and they especially like learning in a way that’s fun and not the standard repetition. I loved it for many reasons; kids were engaged and enjoying themselves, they were staying at the school longer, we got our measurements done, and the schools were involved. A win for everyone.
Yep, our two weeks of measuring was a success. And to end it, we took a staff day to the beach. Granted, it happened to be on a day that was a complete downpour, but once we got over the mountain framing the city, the rains stopped and we were able to enjoy ourselves. The perfect ending to a hard-working week.
Sunday, March 17, 2013
a little bit of my haiti
just a little snapshot into my first couple of months here. the mountains of cap-haitien, scome of the school kids i work with, and the beaches where i get to relax. life. is. good.
Thursday, February 28, 2013
When things work out
Today while visiting the schools in preparation for our mid-line measurements starting next week, my team got a great surprise. My first week in Haiti at one of the schools I spotted a severely malnourished boy. Not only was he extremely stunted (about the same height as a two year old child), his skin was loose and had a ashy color, his energy level was non-existent (what kid doesn’t at least get up for recess?) and he had a fever. All of these are signs of some sort of micronutrient/nutritional problem but put them together and they indicate a possible larger problem of severe micronutrient deficiency.
In other words, this kid was stunted because he didn’t get enough calcium and vitamins a-c-d-k when he was an infant and young child. This could be because his mother stopped breastfeeding before six months or introduced food too early or didn’t watch him eat when he was old enough to eat without assistance or any combination. His skin – the most important barrier in preventing foreign objects like germs, parasites, infection into your body – was poor because he hasn’t had enough vitamin a & c as well as zinc over the years to the point where this barrier is easily broken. Dehydration also impacts the skin. His energy level was low because not only was he not getting enough food, he wasn’t getting enough of the right food such as fruits and vegatables. The Haitian diet is largely made up of rice, corn and beans. Vegetables like carrots, tomatoes, and pumpkin can be bought, but they can get expensive and are not always in the best condition. The fever that he had was most likely due to the fact that he had several infections that hadn’t been treated. These could have come from simple scrapes or mosquito bites or whatever. Your body needs vitamin a and others to fight of infections. When you have little to no vitamin a guess what – you get sick easily.
Besides all of these visible signs that I noticed right away he also likely had others. Diarrhea is common in undernourished children because they are dehydrated, have chronic infections and other illnesses and live in poor living conditions. The water quality in Haiti is also poor – it’s full of ecolli, giardia, amoebas, and other parasites besides dirt, shit and trash. If you drink it, you bet – diarrhea becomes pretty normal. Similarly, sanitation is also more than lacking. The neighborhood this boy lives in is one of the poorest in Cap-Haitien. Many families don’t have latrines (pit toilets you squat to use) and in fact share a common block toilet. (Imagine sharing two or three toilets with your fellow neighbors up and down the street. Now imagine you all have diarrhea and still can only use those latrines. Think they are adequate? They’re not.
So why the digression from nutrition to water and sanitation? Well, they’re intimately connected. You could be the most well-nourished person in the world but if you get diarrhea and don’t treat it, all those vitamins and minerals go out the um, well you know...back end. So while it’s important to be well-nourished, getting enough vitamin a,b’s, c, d,k and minerals like iron and zinc into your system, it’s just as important to be able to ensure they get used by your body and not flushed out.
An over-simplification of micronutrients, but hopefully you understand the complexity of this boy’s situation. He’s been chronically undernourished his whole life and his living conditions are setting him up for chronic illnesses that prevent him from absorbing the things he needs to get better. So he’s sick. And when I spotted him, the team realized that we needed to do something.
While part of the study is to monitor attendance and the health of the participants, there is also a line which we cross if a child is particularly in need of attention. For example, a child misses two days of school because he has a bad stomach ache. We make a note of it but we don’t call all hands on deck. However, a child has shown signs of malaria and has been absent for two weeks. That is more likely to get our attention and we’ll act by taking him to the hospital one way or another (either our nursing team will, school staff, parents, etc). This kid fell into the latter category – he needed to be seen by a doctor and treated right away. So the very next week, one of our fabulous and amazing nurses took him to the hospital where he was diagnosed as malnourished (he was in the 2% for children age 3. This child happened to be SIX YEARS OLD. That malnourished.) as well as having severe infections. He was given antibiotics and his parents were instructed to feed him a specific diet which included meat, dairy products, eggs, and vegetables.
Chances are, the whole family is undernourished. He has three older brothers at the same school as well as four younger siblings. It’s a lot of mouths to feed no matter what country you live in. In Haiti, getting adequate amounts and qualities of food is especially challenging. So, educating parents as well as kids is important. That’s what our nurse did. She talked with the parents and told them what the boy needed in order to get better. And although the parents have hardly any disposable income (really, none at all) they began sending 10 Gourd to school with the boys to buy snacks while at school.
Since these boys are already in the study and are receiving the fortified peanut butter (one of the experimental groups if you remember a previous post) this money can be spent on additional snack food. The nurse in charge of this school – being proactive and diligent noticed this and pulled the oldest brother aside to instruct him what to buy. 5 Gourd is to be spent on bread so that they can put the peanut butter on it (making it more filling) and the remaining 5 Gourd is spent on frozen milk or something similar which is mostly eaten by the youngest brother (the malnourished one). This happened within my first two weeks of being in Haiti.
Having been here for over a month now, I have gotten pretty busy and the little boy, though never completely out of mind has been pushed aside for other things. But today, as I was visiting the school early in the morning before it started I could see three boys running late. I yelled for them to hurry up and as they got to the school I noticed that it was the little boy and two of his brothers. Quelle surprise! The boy was running! A normal thing for a kid to do, but for a little boy who two weeks ago didn’t even get up for recess but preferred to sit this was a sight to see. His whole demeanor was different – he was smiling, talking and engaged.
It was so good to see and got me and my two colleagues pumped up for the rest of the day. Granted, we didn’t do much for him besides get him to the hospital, the fact that he has changed since going to the hospital is encouraging. The school staff, especially the director has been supportive of our project and has begun improvement to the school such as purchasing a water pump and filter for drinking and handwashing (with clean water!), the parents are sending extra money for a mid-day snack for their kids, the nurse is ensuring that he eats the whole peanut butter packet – all of these things are giving him a chance to get better. I can’t wait to see him again.
In other words, this kid was stunted because he didn’t get enough calcium and vitamins a-c-d-k when he was an infant and young child. This could be because his mother stopped breastfeeding before six months or introduced food too early or didn’t watch him eat when he was old enough to eat without assistance or any combination. His skin – the most important barrier in preventing foreign objects like germs, parasites, infection into your body – was poor because he hasn’t had enough vitamin a & c as well as zinc over the years to the point where this barrier is easily broken. Dehydration also impacts the skin. His energy level was low because not only was he not getting enough food, he wasn’t getting enough of the right food such as fruits and vegatables. The Haitian diet is largely made up of rice, corn and beans. Vegetables like carrots, tomatoes, and pumpkin can be bought, but they can get expensive and are not always in the best condition. The fever that he had was most likely due to the fact that he had several infections that hadn’t been treated. These could have come from simple scrapes or mosquito bites or whatever. Your body needs vitamin a and others to fight of infections. When you have little to no vitamin a guess what – you get sick easily.
Besides all of these visible signs that I noticed right away he also likely had others. Diarrhea is common in undernourished children because they are dehydrated, have chronic infections and other illnesses and live in poor living conditions. The water quality in Haiti is also poor – it’s full of ecolli, giardia, amoebas, and other parasites besides dirt, shit and trash. If you drink it, you bet – diarrhea becomes pretty normal. Similarly, sanitation is also more than lacking. The neighborhood this boy lives in is one of the poorest in Cap-Haitien. Many families don’t have latrines (pit toilets you squat to use) and in fact share a common block toilet. (Imagine sharing two or three toilets with your fellow neighbors up and down the street. Now imagine you all have diarrhea and still can only use those latrines. Think they are adequate? They’re not.
So why the digression from nutrition to water and sanitation? Well, they’re intimately connected. You could be the most well-nourished person in the world but if you get diarrhea and don’t treat it, all those vitamins and minerals go out the um, well you know...back end. So while it’s important to be well-nourished, getting enough vitamin a,b’s, c, d,k and minerals like iron and zinc into your system, it’s just as important to be able to ensure they get used by your body and not flushed out.
An over-simplification of micronutrients, but hopefully you understand the complexity of this boy’s situation. He’s been chronically undernourished his whole life and his living conditions are setting him up for chronic illnesses that prevent him from absorbing the things he needs to get better. So he’s sick. And when I spotted him, the team realized that we needed to do something.
While part of the study is to monitor attendance and the health of the participants, there is also a line which we cross if a child is particularly in need of attention. For example, a child misses two days of school because he has a bad stomach ache. We make a note of it but we don’t call all hands on deck. However, a child has shown signs of malaria and has been absent for two weeks. That is more likely to get our attention and we’ll act by taking him to the hospital one way or another (either our nursing team will, school staff, parents, etc). This kid fell into the latter category – he needed to be seen by a doctor and treated right away. So the very next week, one of our fabulous and amazing nurses took him to the hospital where he was diagnosed as malnourished (he was in the 2% for children age 3. This child happened to be SIX YEARS OLD. That malnourished.) as well as having severe infections. He was given antibiotics and his parents were instructed to feed him a specific diet which included meat, dairy products, eggs, and vegetables.
Chances are, the whole family is undernourished. He has three older brothers at the same school as well as four younger siblings. It’s a lot of mouths to feed no matter what country you live in. In Haiti, getting adequate amounts and qualities of food is especially challenging. So, educating parents as well as kids is important. That’s what our nurse did. She talked with the parents and told them what the boy needed in order to get better. And although the parents have hardly any disposable income (really, none at all) they began sending 10 Gourd to school with the boys to buy snacks while at school.
Since these boys are already in the study and are receiving the fortified peanut butter (one of the experimental groups if you remember a previous post) this money can be spent on additional snack food. The nurse in charge of this school – being proactive and diligent noticed this and pulled the oldest brother aside to instruct him what to buy. 5 Gourd is to be spent on bread so that they can put the peanut butter on it (making it more filling) and the remaining 5 Gourd is spent on frozen milk or something similar which is mostly eaten by the youngest brother (the malnourished one). This happened within my first two weeks of being in Haiti.
Having been here for over a month now, I have gotten pretty busy and the little boy, though never completely out of mind has been pushed aside for other things. But today, as I was visiting the school early in the morning before it started I could see three boys running late. I yelled for them to hurry up and as they got to the school I noticed that it was the little boy and two of his brothers. Quelle surprise! The boy was running! A normal thing for a kid to do, but for a little boy who two weeks ago didn’t even get up for recess but preferred to sit this was a sight to see. His whole demeanor was different – he was smiling, talking and engaged.
It was so good to see and got me and my two colleagues pumped up for the rest of the day. Granted, we didn’t do much for him besides get him to the hospital, the fact that he has changed since going to the hospital is encouraging. The school staff, especially the director has been supportive of our project and has begun improvement to the school such as purchasing a water pump and filter for drinking and handwashing (with clean water!), the parents are sending extra money for a mid-day snack for their kids, the nurse is ensuring that he eats the whole peanut butter packet – all of these things are giving him a chance to get better. I can’t wait to see him again.
Subscribe to:
Posts (Atom)