Before the storm: Medika Mamba and mountain hikes

There’s a tropical storm, Emily, hours away from making landfall in Haiti. It could turn into a hurricane, so Canaan has been storing drinking water and positioning rain barrels and old oil drums to collect rainwater, and checking the cisterns for any leaks. 

I’ve taken clean water for granted. Water is a daily discussion at Canaan, and a few of the boys’ chore are solely to clean the water tanks and filter water for consumption. It’s a luxury to have drinkable water delivered straight to your faucets, or any water for that matter. In villages with a single well or water pump, women crowd with paint-crusted buckets and stained bleach jugs to catch precious drops, hauling them miles home on dry, fumy roads.

With all the work it takes, I am grateful for rain to fill our buckets for showers. And until then, I'm praying for the families living in the tents and shacks to weather the storm with ease.

Mamba is in full swing, and the past two days have been hectic with the missionary team and Mamba researchers from Georgia. I have sensed some of the Haitian mothers’ apprehension with the amount of Americans peeking in on exams, procedures and watching the rusty gears turn in our tiny rural clinic.

Each week, word of the Medika Mamba program spreads like pond ripples in the villages sprawling across Montrouis. I felt stressed as the new admissions to the malnourishment program crammed under the shade of sparse willows, packed in CESANOJE’s hallways and spilling into the consultation rooms.

We saw close to 50 patients and checked about 15 potential cases of malnourishment. I had my face between my knees with exhaustion in the heavy heat between patients, wondering how the mothers could bear waiting in the breezeless afternoon.

Some of the babies were shaking with hunger or thirst after waiting since 6 am for the consultation. One boy had a 104 fever and was crying feebly as I poured medicine down his throat, too weak to swallow.

It was difficult to feel enthusiastic when most of the babies seemed to be sick and loosing weight, or staying the same. Most of the babies graduate in six weeks or less, but out of all the enrolled babies, we had zero graduates Tuesday.

We did, however, readmit some of the children into the Mamba program— babies who graduated plump and vigorous 3 months ago, but now whittled back down to malnourishment.

Discouraging.

There’s a science to the Mamba. We can predict like clockwork—a well-researched bell curve—with how much weight babies should be gaining with proper feeding of the Medika Mamba. With my translator, Jennifer, I was able to demonstrate proper feeding (allowing small spoonfuls for the child to eat slowly, or mixing the thick Mamba with clean water) to help prevent vomiting with the babies. Many of the mothers had been force-feeding their child, and causing them to become ill and refuse the Mamba.

There were a couple patients who improved, and I did feel joy in giving mothers praise for their progress. Graduation from the program is a source of dignity and empowerment for the mothers as well—a contrast to the emotions of shame and avoidance we often see in those new to the program.

Malnourishment is as much disease as it is stigma.

Three women, public health researchers from Atlanta’s Moorhouse School of Medicine, interviewed mothers in the program to see if or how their breastfeeding habits changed when their malnourished babies were given Mamba to eat.

I’m really looking forward to their findings, although I was skeptical at first. Many of the babies are cared for by women other than the mothers, so we had to figure our which moms qualified for the study. In addition, many of the mothers had stopped lactating or stopped breastfeeding before the baby reached 6 months, when other foods can be introduced to supplement. This caused the malnourishment in the first place.

It’s awesome that Canaan will have a study that’s relevant and informative for others advocates of the Medika Mamba program to follow. I’m considering coming back for some research myself, focusing on the re-admissions to the Mamba program.

For the mobile Mamba clinic in Rousseau, I arrived with a nasty headache. I forgot my Excedrin at Canaan. One of the Haitian doctors, Dr. Guidson, saw me clutching my head and brought some migraine pills. I ended up sleeping, knees curled up to my nose, on a lopsided hospital bed while Caroline and Mis Joanne saw patients. With the tropical storm looming, many of the mothers stayed at home. My little power nap was magic, and I felt great around noon when the hospital closed, in time for the jarring drive back to Montrouis.

When Caroline and a couple visiting from Kansas City, Josh and Rachel, made our daily 2-hour hike up the mountains, we ran into groups of Haitians riding horses and carrying spades and shovels. A little girl followed us all the way back down, begging for candy and our (empty) water bottles.

A teenage boy attending English school in Montrouis asked me for my phone number, tagging behind me for the last 20-minute stretch of our hike. He was incredibly pushy, resolute and undeterred by my age. He’s the fifth Haitian male to ask me for my phone number, and wouldn’t accept no for an answer… even the fact that I don’t have a Haitian phone, and emptied my purse to prove it.

Perhaps it’s cultural for the men to approach a potential female interest with frustrating tenacity.

I can’t believe I have two weeks left in Haiti. Tonight I sat on the cistern at the top of Canaan’s hill—an enormous, panoramic view of Montrouis. It felt incredible to share prayers and stories with Americans conscious of Haiti’s needs and who share my love for this island. The team cooked cake and brownies for the Haitian staff, and we stayed late singing, playing guitar, and watching one of the babies, Marlucia, dance across the cafeteria table with every strum.