Saturday, May 13, 2006

How Many Dying Babies in the World Are There?

John plunged back into his work the day after we arrived in Port-au-Prince at the Grace Children’s Hospital clinic. It’s the Friday before the Sunday inauguration of president-elect Rene Preval, and we weren’t even sure if the clinic would be open. But it was. John was kept busy for four hours with patients, fortunately none of them too sick today.

After we finished our Cokes and had given the nurses an English book they had asked for, we were getting ready to leave, when we noticed a patient who hadn’t yet left. An older woman, her head wrapped in a scarf, sat on one of the wooden benches, holding a listless, pale brown baby. This baby had been a patient of one of the other doctors. His foot was wrapped in tape where an IV had been inserted. John could tell by looking at the baby that he was dehydrated.

“Combyen mwa?” I asked the lady holding him. She held up 10 fingers—10 months old. The baby has no neck strength and his head lags back; he can’t lift it at all, though his brown eyes are surprisingly bright. I don’t think she’s the mom I say to John, and he confirms that she wasn’t. Where is the mother? Mama mouri about eight months ago.

John talked with the lady about how important getting fluid into the baby is. She took a cup and a glass jar with a lid out of her bag. She unscrewed the top of the jar and poured some water into the cup. She gave the baby the water as he lay in her arms, but she gave it faster then the baby could swallow and some of the water ran down the sides of his face. John took the cup to demonstrate how to give the baby water. He poured a swallow into the baby’s mouth, removed the cup and let him swallow. After the baby swallowed, John repeated the process several times. “Jesus,” whispers the woman, under her breath. She doesn’t have time for this. She probably has more children at home and this clinic visit is taking the greater portion of a day, all for a baby who isn’t hers. It would make her life simpler if this motherless baby would die.

John stares down at the tableau. “The baby wants to drink,” he says, though the caretaker has put the water away again. One of the nurses walks by and hands the woman two packs of U.N. oral rehydration mix. This baby’s most serious problem, the cause of his dehydration, is diarrhea, the leading killer of children in poor countries. The rehydration mix contains sugar and salt, which the baby needs.

But really the baby should be in the hospital, receiving an IV and being monitored by a nurse says John. None of the clinic staff knows if a bed is open in the hospital. “There are babies like this all over Port-au-Prince,” says John, which partially accounts for the lack of urgency among the staff. John gives the old lady 500 gourdes about $12 U.S. “For the baby,” he tells her, and she nods.

John tortures himself over these cases. “If that baby came into an American hospital, I know the 15 things I would do for him. It would be so easy to save this baby’s life,” he says. Even in Haiti in a well-organized clinic stocked with some basic medicines and staff who have the training and time, this baby could be easily cured. Most times, though, in Haiti, the system doesn’t work and the doctors and nurses are overwhelmed and many of them calloused.

“I have to ask myself is this really a human baby?” John continues. Why are babies in Haiti who are totally curable just allowed to die?”

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