Rose Darline is an 18 month old baby girl who was admitted to the malnutrition center at RHFH on May 31st. She was enrolled in the outpatient malnutrition program in November of 2016- but she was not brought to her follow up appointment. She was enrolled in the outpatient program again in December, came for one follow up appointment but then then did not come again until May 31. Her home is back in the mountains and I suspect her parents are impoverished, living on limited means, even as compared to the rest of Haiti. This baby was 14 months at admission and weighed 5.5 kg (12.1 pounds)- she qualified for severe malnutrition. She had some edema, but only in her legs. She also has a very significant heart murmur. She was treated with F75 (a special formula for malnourished kids with edema), antibiotics, and a host of vitamins. After her edema resolved, she was started on medika mamba (a ready to use therapeutic food made especially for malnourished kids that is fortified with vitamins and minerals that are typically low in kids with severe malnutrition). However, this child’s weight continued to decrease. Some weight loss is expected with loss of edema- but Rose Darline’s weight went down every week even after resolution of edema. She got down to 4.4 kg (9.7 kg)- my kids weighed that much or more when they were born!
Rose Darline was evaluated by a Haitian physician who collaborates with Haiti Cardiac Alliance (HCA). HCA is an organization that evaluates children with possible heart defects and then arranges surgery for children who need it. Cardiac surgery is not done in Haiti at all. Rose Darline had an echocardiogram (ultrasound of her heart) which showed multiple defects- she has a moderate to large ventral septal defect- a hole between her right and left ventricle- with a left to right shunt- oxygenated blood from the left ventricle gets pushed through the hole to the right ventricle and mixes with the unoxygenated blood. This is not good. She also has coarctation of the right pulmonary artery- essentially it’s not as wide as it should be in one spot. She also has pulmonary hypertension and a very dilated left ventricle. This child needs surgery. She was started on some medications for heart failure.
HCA needs to do some further evaluations and hopefully will be able to arrange much needed, but very expensive, heart surgery for this baby girl. We are working on getting paperwork in order for a medical visa so she will be ready to go if and when the call comes.
This baby is sweet. She has a look that says, “I’m not complaining, but you can hold me with if you want to”. She almost never cries, but it is the most pathetic, soft cry you ever heard. She loves to be held, though I feel like I am going to break her bones every time I pick her up- she is so skinny! Pray for this little lady- she doesn’t have a lot of time left. Pray that surgery will happen, that she will be healthy enough for surgery, or better yet, that God will miraculously heal her!