Liven’s was 3 years old when he was admitted to our inpatient treatment center with whole body edema thought to be secondary kwashiorkor. He was treated with broad spectrum antibiotics, F75 and then medika mamba and his edema resolved. He seemed to be on the mend, but then had diarrhea for several days and the edema came back. He had a heart murmur which was concerning that was present on admission. He had an echocardiogram with Haiti Cardiac Alliance, which was normal. Kidney function was normal and he did not have protein in his urine. Liver function tests were slightly elevated, which is not unexpected in a child with kwashiorkor. He then developed a GI bleed. This was not expected. Plans were made to transfer Liven’s by helicopter to a hospital, however, the hospital subsequently declined to accept the transfer because they were out of oxygen. A second hospital also declined to accept transfer because they were also out of oxygen. After a few more phone calls, he was transferred via Casey to Cabaret and then via ambulance to a hospital in Port au Prince. Keverly, an RN visiting from the states for the summer went with the patient until we could locate Liven’s mother. His parents live back in the mountains- there is no road access and they do not have a phone. So Moliere left immediately to find his mom. He arrived at her house late in the afternoon, but she was not there. She was working in her field. Neighbors said they would relay the message. Liven’s mom came to Cazale early the next morning and Casey drove her to the hospital. By this time, Livens was on a ventilator and had received several blood transfusions. He spent 3 days in the hospital, but unfortunately, his care team was unable to determine the cause of the bleeding and Liven’s passed away.  His mother was heart broken as were all of us back in Cazale who had cared for him.

5 days later, both of Liven’s parents came to clinic. They came to thank us for taking care of Liven’s. They brought a large amount of citron, bananas and mangos, which his mother transported on her head in a bucket on her head and traveled on foot for 4 hours from her home in the mountains. This was a humbling experience for us. Oh, how I wish that Liven’s was alive and with is mom! But for reasons that I do not currently comprehend, God took Liven’s from this earth.