Friday, January 27, 2012

A Recap of My Nutrition Work in Haiti

Well, it's officially been 2.5 weeks since I have been home from Haiti. I figured it is about time that I release some information about the outcome of my nutrition experience in Haiti and the approach we have taken to enhance the overall health of the children and elderly we serve.


I'd first like to start out this blog post by thanking the Healing Haiti board and volunteers (especially the medical team, host family, and feeding center advocates), my uncle Jeff Gacek (the founder of Healing Haiti),  my family and friends, my school professors, my internship directors and fellow interns for all your continued support for my nutrition-related mission work in Haiti. Without any of this support and encouragement, I would not have been able to do so much in so few days! I would also like to thank the team at Meds & Food For Kids for their great costumer service and readiness to help me and support me with my mission in Haiti. I would like to thank Print 4 Change for purchasing the Medika Mamba supplements for the kids in Haiti; your organization is doing wonderful things to grow more good in Haiti... I love what you guys do!


I would also like to take this opportunity to give thanks to the most deserving of all praise and thanksgiving; my Father, God. Without His perfect plan, His never ending love and forgiveness, His power and His strength, I would not be able to do anything. For it is through Him, and through Him alone, I am strengthened to do His work.


Earlier this fall, I was sitting in the waiting room for a dentist appointment and looking through e-mails on my phone. The Academy of Nutrition and Dietetics (formerly known as the American Dietetic Association) sent out an e-mail with recent nutrition related articles from around the United States. One of the articles was about this peanut supplement used in Haiti that was saving lives of the malnourished babies. The article caught my attention and when I arrived at home I watched the video that talked about Meds & Food For Kids  and the outstanding work they are doing in Haiti.


 Meds & Food For Kids is based out of St. Louis, MO. However, they also have a factory in Haiti that is staffed with local Haitians, which means the organization is providing jobs and supporting the local people. So not only is Meds & Foods For Kids helping to reduce cases of malnutrition in Haiti's children with their peanut based nutrition supplement, it is also providing work for people in the local communities. Even more so, the organization is growing more good in Haiti by not only hiring locals to work for their factory, but by taking the efforts to work with local farmers to develop Haiti's peanut agriculture! Meds & Food For Kids is working with the farmers to increase their quality and yield of peanuts in order to meet the demands for the therapeutic food called Medika Mamba (which means peanut butter medicine in Creole).

A video about Meds & Food For Kids.

The mission of the organization captivated my interest, and I kept them in the back of my mind as a potential resource to use for Healing Haiti. About a month after stumbling across the Medika Mamba, I was asked to look into nutrition supplements for the underweight orphan kids sponsored by Healing Haiti . Immediately, I started doing my research and started looking for a Ready-To-Use- Therapeutic Food (RUTF) to help meet the nutritional needs of our kids. I started contacting people in my network (school professors, professional registered dietitians on LinkedIn, and others volunteers working with Healing Haiti's orphans) and the team at Meds & Foods For Kids. I started a list of potential supplements that we could use for our kids, as well as priced and analyzed the nutrition profile of our American supplements (pediasure, ensure, boost, and protein powders).  Even though I knew we could potentially get a supplement donation of American made supplements, something was tugging at my heart saying that the best option for our Haitian kids would be to use something that was produced in Haiti that was supporting the local people and agriculture. One question I keep active in the front of my mind is how can we do the most good for our Haitian family without making them completely dependent upon us as Americans. 

At the end of the day, the Medika Mamba produced by Meds & Foods for Kids was the product that stood out as the golden supplement.While it is traditionally used for infants and children 60 months to 5 years old, the nutrition profile of the supplement was ideal for the needs of our children and would add a significant amount of calories from fat and protein to aid in growth. The peanut based supplement provides 520 kcals, 26 grams of fat, 13 grams of protein, and a significant amount of calcium, phosphorus, potassium, magnesium, sodium, and iron per serving of Mamba. The supplement is composed of peanut butter (made from local peanuts), vegetable oil, skimmed milk, and a vitamin/ mineral powder that is formulated to prevent refeeding syndrome amongst malnourished/ undernourished children. 

While in Haiti, I traveled with two nurses that serve as Advocate Leaders for Healing Haiti's medical team and preformed over 95 nutrition assessments (79 orphans between the ages of 9 months and 17 years, and 16 elderly ranging in age from 27 to 103 years). I took the heights, weights, and arm circumferences of all the individuals, as well as examined their physical appearance to find any significant physical signs of nutrition related deficiencies. With the elderly population, I also did some speech pathology work to assess their lip and tongue muscle strength to identify potential issues with chewing and swallowing. 


 My make shift work space. 

 checking arm circumferences. 

 one of my youngest clients. 

 some very dry knees.. hopefully, more protein (with sources of B Vitamins) will help reduce the dry skin. 



 Dry, brittle, and discolored hair is one of the first things I look for when identifying malnutrition. 

 Very large abdomen either due to parasites or protein-calorie malnutrition. 



 This girl had very little muscle or fat pad. 

 Checking out the gums, teeth, and tongue for  signs of nutritional deficiencies. 




After each day of work, I plotted all of the children on The WHO Child Growth Charts so that we could see where our kids were falling in comparison to the world's standard. While each kid will follow their own pattern of growth, there are several red flags to look for in abnormal growth patterns; delayed growth, stunting, and significant low body weight for age and height. The reason low body weight for age and height is such a concern is that it can cause problems such as decreased immunity, delayed wound healing, poor brain development and cognitive functioning, mood alterations, and early death. 

After completing each child's growth chart and reviewing some of the nutrition-related physical signs, I compiled a list of kids that would need extra nutrition support to catch up on their growth and/or gain weight. Twenty kids at Grace Village and fifteen kids at our other orphanage were a significant low body weight for their height and age and/or had low arm circumferences that indicated poor body fat and muscle for their age. I also used physical symptoms such as discolored hair, extremely dry skin, and appearance of fat/muscle pads to confirm my decisions of which kids were in need of extra nutrition support. In addition to starting these kids on the Medika Mamba supplement, I worked with feeding center at Grace Village to help them provide meals for the kids that would be prepared with foods higher in protein, whole grains, Vitamin A (beta-cartoein), Vitamin C, Iron, and Calcium (all which are necessary for the normal growth and immunity of the kids). I made lists of foods that were produced locally in Haiti that would be high in each nutrient so that they could refer to the list when going to the market and preparing meals. 

I am happy to report that the 20 kids at Grace Village have started their Medika Mamba supplement this week. They will be on this supplement for a 4 week period, and then we will assess their growth status to see if the additional calories have aided in weight gain and overall growth.  I am also excited to watch how the overall health of the children at Grace Village will be enhanced as they began to receive the proper nutrients for normal growth and development, as well as receive clean drinking water. 

I am truly blessed to be able to use my nutrition-related knowledge to grow the good in Haiti. I continually thank God for the opportunities He has given me to use my talents to serve others, for none of this would have been possible without His strength and His blessings. I pray that God will continue to use me to serve those living in dire conditions to help them receive access to safe and nutritious foods. I pray that God will give me the courage and opportunity to take my skills and knowledge to the slums of Cite Soleil, where I have seen kids with significant nutritional deficiencies, wasting conditions, and weakened immunities. Only by the grace and protection of God will I be able to conquer this initiative. 


 Lunch at Grace Village. 

 I recommended they eat more peanut butter-- good source of protein and fat. 

 I was very excited to see that they listened to be recommendations and purchased Extra Fancy Wheat Flour... hopefully, we can work towards getting some oatmeal and whole grains. 

 Lunch on the stove in the Grace Village Kitchen. 

 Some of the girls dinning in the new feeding center. 

Little cuties visiting me after lunch! 




Wednesday, January 18, 2012

50 Friends in 50 weeks

I am so humbled and so blessed to be apart of this amazing project. A wonderful, young lady (and a former high school classmate of mine) living in Iowa has started a blog project that involves hearing other people's stories and sharing them with the world in hopes to step outside of herself and see the world from a new perspective. In 50 weeks she hopes to interview 50 women from each state in the United States. I am excited to see the stories unfold and to be able to hear how others are living their lives and making a difference in the world.

Thank you Alexandra Guzik for your beautiful words and amazing writing! I appreciate your humbleness in sharing other people's stories; this takes great strength in itself and is truly inspiring!! I wish you the best of luck on this project!!


Follow Along Here: 50 Friends in 50 Weeks

Tuesday, January 10, 2012

God spoke to me yesterday.

Call it coincidence or maybe just pure chance, but I am convinced that God spoke to me yesterday. I was upgraded to first class on my way home from Haiti; for whatever reason I was not assigned a seat, so the lady at the desk chose a spot for me and gave me one of the best seats in the house. A totally undeserving surprise that put me into shock. When I got to my seat, I was in complete disbelief.  I am pretty sure the flight attendant was getting a kick out of my excitement. When we arrived in the Miami airport yesterday, a few of the team members and myself had Chinese food for dinner. I grabbed a handful of fortune cookies and passed them out to the team saying, "Hopefully God will bless us all with good luck and success." My fortune cookie message said, " You will be a bundle of energy, always on the go." It was pretty cute...pretty generic. After time had passed for a bit, I grabbed two more fortune cookies for the plane ride.. just in case I needed a little snack later... and headed back to wait for the flight to Minnesota from Miami. While waiting to board, I wrote a blog about staying awake for God's signs and his voice speaking through our lives (see my blog below).  I posted the blog, and immediately boarded the plane. I sat next to a very nice couple and showed them pictures from my trip to Haiti; they were pretty blown away by the pictures and really interested in the work we were doing there. About half way through the plane ride, when all the people around me had pretty much fallen asleep, I opened up one of the fortune cookies in my bag, ate the cookie, and read the message. UNBELIEVABLE. In all of the years that I have eaten fortune cookies, I have never had a message say anything like this. And trust me, I have eaten plenty of fortune cookies in my day... I used to collect the messages for scrapbooking. The message put me into total and complete shock and made me realize that God is really speaking to me in my life. The message said,




 Totally ironic that I had just written about signs from God and opened a fortune cookie to read a message about Him. I just find it odd that a fortune cookie from a public restaurant would have such a message and that it would be revealed to me at such timing.

The good news that God revealed to me is that He is listening to me... He is revealing Himself to me in small, yet simple ways. And His messages are NOT failing to go unnoticed. We are called to have faith like a Child... and that is EXACTLY what I am doing. Believing, trusting, and not second guessing His calling..His plans.. and His signs.

"God will help you overcome any hardships." ... is true for all of us, not just myself. I have seen God help my friends in Haiti... I have seen Him help my friends in Minnesota.. and I have seen Him help my own self.

Thursday, January 5, 2012

Hope

Today was a special day, a little different than all of the rest. The first part of the day I hung out with the kids at Grace Village playing around on the playground and listening to them sing with Fanfan in their new Feeding Center. The sound of the children's voices singing some of Fanfan's favorite Christian songs just makes me feel absolutely full of joy; I can not imagine a better special leader for these children. God had been preparing this for Fanfan all along... and it is amazing to see His plans come into place.

After some time bonding with the orphans, It was time to continue my mission here in Haiti. The Haitian staff were picking up the elders sponsored by Healing Haiti and bringing them to Grace Village for check-ups with Dr. Sem. At first, I was a little unhesitant about working with the elders. I am much more of a kid person and tend to bond with them well, but today I learned just how special these elderly are and how well I was able to bond with them too. The elderly that came to visit today ranged in age from 40-100 (some of the oldest people in Haiti considering most people only live to about 60 years old). It amazed me what kind of conditions these people had; one man was missing toes due to leprosy, another had diabetes with glaucoma, another had hypertension, and several more were very handicapped/ frail. It was absolutely humbling to see the elderly smile at me as I checked their nutrition status; such joy they expressed despite the hard lives they have lived and the conditions in which they are living. Many of them smelt like urine, were dressed in ragged clothes, and had very dirty feet and nails. Despite their disheveled appearance, they were so sweet and delightful. It was a kind reminder that even the oldest people need our attention and affection and not just the kids. 







My assessments today consisted of obtaining heights and weights for the elderly, as well as checking if they have teeth and if they were able to move their tongues (this helps to determine if they would have trouble eating certain foods). I also looked at their eyes and nails for indications of any other vitamin deficiencies. It was a wonderful day spent observing a different age spectrum. 

Following the assessments, the medical team and I met up with the mission team at Yuvon's orphanage were I was greeted by one of the malnourished boys I had seen yesterday. He put his arms up to me and without hesitation I picked him up and hugged him; his smile shone from ear to ear. Carol, one of the care takers at the orphanage was there, and when I saw her I screamed her name and gave her a big hug! I have missed her so much... We caught up a bit before it was time to go. 


Wednesday, January 4, 2012

Heartbreak

Today was another busy day doing nutrition assessments on the kids at Yuvon's orphanage. We had two additional helping hands today, which helped to make the process go a little faster. There were at least 40 orphans that were weighed, measured, and checked for nutrition status. One little girl, who was new to the orphanage when I was there this summer, was so sad when she came up to me to get measured. The little girl was only a few years old and her mother had just died from cholera earlier this past summer; I suspected there may be some sort of emotional detachment that now caused her to be extremely closed off to new people. As I started to get her set for a height check, tears began to fill her little eyes and my heart just sunk to the concrete floor. My work at to wait; this little child needed some affection and love. I took her little face in my hands whipped the tears as they trickled out of her eyes, and then rubbed her back. After several minutes, the tears began to stop and I decided it would be a good idea to try this assessment again. As I was checking the little girl's height, she would not budge her head to look straight (this is part of getting an accurate height)-- she kept turning her head away trying not to make eye contact with me. My heart sunk again. After I finished doing a quick physical examine to check for any nutrition deficiencies, the little girl walked away and my next patient stepped up for her turn. When there was finally a chance to take a break and to think about the children I was seeing today, my heart sunk even deeper and tears began to fill up in my eyes. I felt so helpless for the little girl that had lost her mother.. I couldn't even imagine what she must be feeling or thinking... and how this traumatic event will affect her life.


Today, I saw several very malnourished kids. There were two in particular that were in very poor nutrition status and were wasting away. Two very cute kids, but with such a gangly appearance. There were several others that were showing signs of malnutrition in their hair; the pigmentation was slightly off.. an early sign of malnutrition. However, the nutrition status of these orphans is probably a million times better than the kids that live in Cite Soleil... I wish I could help these kids to get a good and nutritious diet, as well. In Cite Soleil see so many kids with red/ blonde hair (which is not normal for an African American baby), edema, and marasmus (a state of malnutrition).



Along with finding several kids that were very malnourished, I also recognized that the kids were showing signs of iron deficiencies and possibly Vitamin B deficiencies. Many kids had very dry and scaly skin (it looked incredibly painful), especially on the legs. This could be due to poor nutrition status... especially from protein, biotin, and vitamin A.

While there was a lot of emotional components to my nutrition assessment day, there was many joys as well. I felt in my element at the orphanage; it was fun working with the kids and playing detective as I analyzed their physical appearance for possible nutrition-related symptoms. I feel like I can actually serve a purpose here; helping kids to achieve their optimal growth, health, mental, and cognition status through their dietary intake. I feel so incredibly blessed to be exactly where I am right now...

Tomorrow will be another busy day; we will be assessing 30 elderly Haitians sponsored by Healing Haiti. I will also be sharing with the kids at Grace Village the letters from the kids in Omaha and will be showing them what snow looks like! ... and in addition to all this, there are a few more components to my nutrition work in Haiti that I will be doing before I leave on Monday. I will be finishing the growth charts and determining which kids will need a nutritional supplement to gain more weight.

Tuesday, January 3, 2012

My Mission

Today I was reminded of my mission down here in Haiti... I struggled a bit knowing that I was going to have to miss out on one of my favorite activities here in Haiti--the water truck day in Cite Soleil. I absolutely LOVE going to the slum to see the kids, especially my zamni (Patrick) who I met this summer. For people that are just starting to follow this blog, I met Patrick (he first introduced himself as Jameson to me) last January when I was on my first mission trip to Haiti. I saw him again several times this summer and had become friends with him.. he was one kid in Cite Soleil that stood out to me. He is a 13 year old boy that always is dancing and singing with me.. a little performer. I wish I could do more for him.. he is so thin. Well anyways, today the group went into Cite Soleil and I knew they would see my buddy, so I felt a little bummed that I had to miss out. When the group had arrived back home after their adventures, one of the team members told me that my buddy asked if I was with them!! It touched my heart knowing that he wanted to see me too... I hope to see him sometime before I leave Haiti this week.

None-the-less, this day was such a wonderful day.  When I stepped out of the truck this morning, I had little kids run up to me and hold my hand and hug me. Some shouted my name from across the playground. They were so welcoming... so loving. And I realized just how much affection these kids wanted.. I almost felt like their mother as I walked with three boys clinging on to me and I was rubbing each of their heads trying not to make one feel left out.


Missy, Jen and I set up our clinic in the front of the feeding center. I put together my make-shift clinic; a measuring tape on the wall and a scale on the ground. I used a book to assist in height measuring.. but the book eventually wondered off as the kids were enjoying looking at the pictures (it was the book I had made about my trip to Haiti this summer... the kids were amused), so I had to use a crayon box to help with getting accurate heights. One by one the kids would line up in alphabetical order and we got started with our assessments.. I took weights, heights and mid-arm circumferences of all 40 kids, and examined the skin, hair, eyes, nails, and mouth to look for signs of deficiencies. After about 20 kids, I was feeling hot and exhausted.. but some how managed to carry on! It was a lot of work.. a lot of kids!!





One of my favorite little clients was the 11 month old baby that I was trying to teach to walk the other day. While examining her face and mouth, the baby would grab my face and with the biggest smile--she would start "examining" mine too. It was absolutely adorable and made me realize just how much I love little kids.. and how fun it is to watch them become healthy and strong!

My work didn't end there...upon returning home, I had to collaborate all of the sheets from todays' assessment and start plotting heights and weights on the growth charts, as well as analyze some of the patterns of concern. About 10 charts in, and I decided to call it quiets for the night. Tomorrow will be another busy day... 40 more orphans to assess at the other orphanage sponsored by Healing Haiti.

Monday, January 2, 2012

new environments

What a beautiful day in Haiti... it was our first day seeing the orphans in their new home, Grace Village. It is unbelievable just HOW MUCH work has been COMPLETED in the past 6 months!! The new home for their kids in UNBELIEVABLE. Their lives have changed drastically. According to the team that moved the kids into Grace Village, many of them had never taken a shower before in their life. The team had to teach them how to shower... Their bathrooms actually had a real toilet and running water. Their bedrooms were colorful and had blankets.. sheets.. pillows.. mattress pads. Their kitchen had a stove, an oven, and was actually CLEAN. Their feeding center was spotless and read for serving and gathering. I just can not even fathom the exhilaration and the emotional impact this has on the kids... from rags to riches.. from absolute poverty to paradise. Forty orphans (and many more to come...) will now be able to grow up in an environment that is clean and nurturing, which will also help them to become healthy and strong.

Upon arriving at the orphanage, many of the kids started calling my name out, "kristina!" they would shout and smile as I waved at the children shouting my name. A sense of joy filled up inside me.. they didn't forget me from this summer. Instantly one of the little girls clung to me. I held her for hours as we walked around touring the orphanage. While touring the girls dormitory, several of the girls came over to me.. hugged me.. saying my name and holding my hand. It was such a beautiful moment...



We spent the day playing with the orphans and seeing them in their new home. Fanfan (our former translator) is now the spiritual director for the kids and lead them in a gospel melody. Several of the songs were ones Fanfan and I would sing in the taptap (our Haitian taxi) or at the Home for Sick and Dying Babies this summer... as the choir of the children filled the air around me, I couldn't help but close my eyes and lift my head up to the sky in praise. As much as I was going to miss Fanfan being with the mission groups everyday (Fanfan had become one of my really good friends while I was down here this past summer), I knew God has placed him exactly were he is meant to be and doing exactly what he is supposed to be doing. It was an unbelievable moment listening to the kids sing to some of Fanfan's favorite Michael W. Smith songs.. it even brought a huge smile to my face when one of the little orphans busted out the solo they have been working on. This little guy singing Michael W. Smith gospel songs at the top of his little lungs... it reminded me of the scene in Sister Act 2 when the boy busts out his solo.

After spending some time with the kids, I started a little of the nutrition work I had planned to accomplish while I am down here. I started in the most basic place possible... the kitchen and food storage room. I toured the storage room and wrote notes of what was on the shelves. Then I toured the way around the kitchen to see what the ladies were preparing for the kids for lunch.... rice, beans, chicken, some sort of vegetable looking herb, and a juice made from a fruit that is a cross between a grapefruit and an orange. I spoke with Junior (our taptap driver/ translator) and He helped me to get a "general" diet intake of the kids at the orphanage. He asked the ladies cooking the questions I had and helped me to communicate with them. I left the feeding center that day feeling a little bit uneasy and uncertain about where to start with the kids' diets... so many of them underweight and stunted, and knowing their is a limited budget for food costs.... feeding the masses and trying to meet individuals' needs is going to be difficult.

Upon returning home to the mission home, I realized I had my work cut-out for me on this trip. I started organizing my assessment sheets and growth charts. Tomorrow will be the day I get to collect heights, weights, and complete the physical examination of the kids.. It's really interesting already seeing where these kids are falling on the WHO (world Health Organization) charts, and I am excited to watch their growth, nutrition, and overall health progress as they continue to live in a clean and sanitary living environment and have access to higher quality food.