Kwashiorkor

The word comes from Africa and, literally translated, refers to the child who is ill because he has a new brother or sister and no longer is able to feed at the mother's breast.

Kwashiorkor, or "kwash" (as we refer to it), is one of two types of severe malnutrition. This particular type is a protein-calorie malnutrition. It is due to severely deficient protein and calorie intake that results in hypoalbuminemia. Albumin is need to maintain intact cell walls. And when it is reduced, the cells break down and the person becomes severely edematous.

Here at the Center of Hope, we have the only facility in this part of Haiti dedicated exclusively to the treatment of children with kwash. When they are brought to us, the child is often critically ill. Their tiny arms, legs, and face are often so edematous that the skin has been stretched to breaking. Many have infections, and almost no energy. Often they have low hemoglobin and are very anemic.

There is a protocol we follow in treating these children. Besides antibiotics for infections and vitamins and iron, their little bodies have to be "retrained" to accept protein. So they are given special feedings, in small amounts, around the clock. All this is combined with HUGE amounts of TLC, especially holding and cuddling. And, once recovery is on the way, they are in need of stimulation, including lots of bright colors.

Now, let's make this information come alive as I introduce you to our newest kwash baby. Her name is Gelista. She is 19 months old and came with her mother from a distant mountain village called Castion. The child - and mother - will live here during her entire treatment. As treatment commences, much education is done with the mothers on diet, signs and symptoms of problems, need for lots of bodily contact with the child, etc.

Gelista has lab work done and we discover her hemoglobin is 2.7!! That is so dangerously low that her heart could stop at any time. Also, her body loses its ability to regulate her body temperature and she can become very, very cold. Before all else, she must receive blood - and that can be done only at the hospital. We call the hospital, but by now it is late afternoon, and nothing can be done until morning. So we insert a feeding tube and slowly begin her first feeding. For the night, all we can do is keep her comfortable and warm, and encourage the mother to hold her and talk to her to keep her quiet.

This morning, Gelista was taken to the hospital to receive blood. I will keep you posted on her progress.

The pictures? The first is a "teaching of mothers" session held on the "porch" of the Center. While the kwash nurse teaches, Devon, a volunteer nurse from the US who is presently responsible for the program listens and joins in on the teaching.

The other is a picture of Gelista and her mom right after arriving.

Till next time, may these coming days of Holy Week have special meaning for all of you.

God bless. Mary Ann