Inside Duke Medicine

Rittgers’ Haitian journal

The Caribbean nation of Haiti is the poorest in the Western Hemisphere. On her own time, Shelia Rittgers, a clinical social worker at Duke Children’s Health Center, has traveled there to work at a rural clinic. Here are selections from her most recent journal:

July 5
I remembered the mom from last year. She says she cannot breastfeed because she has not eaten. She looks worn. She has the baby and two others in tow. All small, with classic red tint to their hair. The baby is hot with fever. After a quick check, it’s time to re-hydrate her a little, then check her again.

The mother seems so sorrowful. She says she has good water but hasn’t eaten much.

She was able to give the child some breastmilk after her second syringe of ORT [oral re-hydration solution]. The baby is hungry, hanging onto the breast tightly with one hand. She perks up after an hour.

We talk to the clinic nurse about ways to help the mother. We ask her to come and talk with the pastor.

After we teach her how to give the rest of the ORT, she takes the children, goes to the mission kitchen and is given two bowls of rice. She says she will talk to the pastor and go to another place the nurse recommends. So they eat today. What about tomorrow?

July 7
About midday, my name is being called.

Someone is here to see me. As I turn the corner I recognize them immediately. The grandmother stood there with him in her arms.

She explained that she came last year with the boy. I remembered them well. He was so tiny, sitting in her lap, very alert.

He was about nine months old and weighed less than 10 pounds. His mother died shortly after his birth ... Today, he’s about 21 months. He’s small but healthy, as alert as ever. Grandma just wanted to say thanks and let us see how he was doing. It was good to see him, so good.

July 10
There are many people today. Two of us come out onto the porch as we are preparing to re-hydrate a toddler when she is spotted.

She is laying on a sheet on the concrete. She is thin and old and there are flies buzzing around her face. There are two women with her. After a brief study, we move grann to the church. She is in heart failure and we can do nothing.

Her breathing is very sporadic. We sit her up to make her more comfortable. April and our Haitian friends talk to her and her daughters about the situation ... Tears, anguish that she had been surrounded by flies. How long had she been there? We do not have much time to process. There are about a hundred people waiting ...