The Dignitaries

 

Sunday, May 14, 2006

The Dignitaries

The Haitian grandma sat on the wooden bench in the clinic looking at her 10-month-old grandson who lay quietly on her lap. Her eyes were tired and full of despair. And he glanced at her with his own tired and sunken eyes. He weighed a little less than nine pounds and I noticed that he didn’t look around at others as he should have. 

Overhead obnoxiously loud helicopters flew over the clinic escorting dignitaries from all over the world to hotels for the Haitian presidential election. Neither the gandma nor the baby cared about the noise from the helicopters or the bevy of activity in Port au Prince regarding the inauguration. The baby was too sick to care and the grandma was out of hope.

The baby had vomiting and diarrhea for two days and his mother had died months ago. Grandma is the “primary care provider”. She would gently move the baby on her lap but his head would flop backwards without support and his tiny arms hung down from his side. His breathing was fast because his brainstem told him to breathe as fast as he could to neutralize the acid that has accumulated in his body from his depleted circulation. He had been given IV fluids but the IV was now pulled and he was being sent home because the clinic was closing, we had no room, and grandma had no money for any other hospital.

Before they left, we taught grandma how to slowly give him sips of water from a plastic cup mixed with powder containing sodium, potassium, and bicarbonate to help his body come back to life. He avidly swallowed the solution when she offered it. However, a fair amount fell onto his chest. 

During this teaching session, I started thinking that grandma has no time for this. She doesn’t even have potable water in her shack. She has other responsibilities, too. But the baby needs the fluids to save his life. The baby was trying and grandma did her best. But I feared that grandma will give up after a while and the baby will die without a whimper. When grandma softly said, “O Jesu,” she was not using Jesus’ name in vain. She simply meant that she will be burying another little family member soon.

Haiti has one inauguration every 5 years but we see Haitian babies dying like this every day. Gastrointestinal diseases and respiratory tract illnesses cause the majority of deaths in the first year of life around the world. Globally, 4 million babies die in their first month of life. The real problem is poverty which causes these babies to get sick in the first place. The vast majority of these 4 million deaths are preventable.

We live in the Information Age. The information on how to save this baby is well known all over the world. But the system and material have to be in place to "deliver the goods." By system and material, I mean a rehydration center, with a nurse that will provide education and oral rehydration solution for as long as it takes to rehydrate this baby. The lack of a good system and good material make delivery academic. 

So grandma and grandson headed back into the scorching mid-afternoon sun. The roads have been cleaned some and the Haitian National Police are everywhere. Much money is being spent at hotels for the local Haitian drink this weekend as journalists, camera crews, and dignitaries meet in upscale locations perched in high cool locations away from the hell that lies below them in the city. The inauguration is Sunday at the National Palace which will be the same day grandma buries her grandbaby for lack of the basics. 

“Distance negates responsibility.” 

Guy Davenport

John A. Carroll, MD

www.haitianhearts.org