ARTICLE - NUTRITION IN A TIME OF CHOLERA

NUTRITION IN A TIME OF CHOLERA: A CHALLENGE FOR HAITIAN MOTHERS AND BABIES
(ReliefWeb) - Source: United Nations Children's Fund (UNICEF)
By Tania McBride

PORT-AU-PRINCE – In the cramped and squalid conditions of the tented city in Mais Gate, a camp for Haitians displaced by the January earthquake, baby Sebastian brings a sparkle to his mother Lucienne's eyes.

At eight months, dribbling from cutting teeth and tipping the scales at a whopping 11 kg, Sebastian is alert, sitting up, clambering over his mother and almost standing on his own. He is the Brutus in the baby tent, an example to the young mothers of a well-nourished, breastfed baby.

Lucienne gives credit for Sebastian's good health and growth to the nurses at the tent – which is run by the non-governmental organization Concern and supported by UNICEF.

"Before the earthquake, I had no idea about how to handle a baby, how to even hold a baby, and certainly I knew nothing about breastfeeding," she recalls. "In some ways, it was due to the tremblement that I have this healthy boy."

Breastfed children thrive
On the day of the quake, Lucienne was in her house with three other family members. Spared injury but unable to live in the damaged house afterwards, she has been camped in Mais Gate, surviving as best she can and going to the baby tent every day with Sebastian.

"I came to the tents when I was heavily pregnant with Sebastian," she says. "With the information I received from Mauvette, I was able to prepare ahead of time what I would need to ensure Sebastian's survival."

Head nurse Mauvette, who lectured at a Port-au-Prince nursing school prior to the earthquake, has seen over 450 women through the baby-tent programme in Mais Gate since it was established in early February. She says education about the importance of exclusive breastfeeding and infant care in these difficult conditions is critical – not only for mothers but for fathers and other caregivers.

"Many of the mothers who came to the tent had fed their babies some form of liquids after they were born and solid foods before they reached six months," notes Mauvette. "With a lot of education, we were able to convert them exclusively to breastfeeding, and their children are thriving."

Education dispels myths
The baby tent staff also has worked to dispel myths associated with the earthquake. Many women feared that their breast milk had been affected by the quake and would harm their babies, for example. Mauvette and her team, including two nurses and a psychologist, reassured the mothers through education sessions. Now they report that approximately 80 per cent of the mothers in their caseload practice exclusive breastfeeding.

"This is extremely encouraging in a country like Haiti, as there is conclusive global evidence that exclusive breastfeeding is one the most effective child-survival interventions," says UNICEF Haiti Chief of Nutrition Dr. Mohamed A. Ayoya. "What we are seeing being practiced in this baby tent is being replicated in other UNICEF-supported baby tents, in community-based therapeutic programmes and also in stabilization centres for children with severe acute malnutrition."

Beyond the current emergency, adds Dr. Ayoya, a long-term, sustainable strategy will be needed to promote proper feeding for infants and young children throughout Haiti. "It's essential that a range of people are involved – women, men health professionals and traditional leaders," he says.

Preventing cholera
Meanwhile, at Mais Gate camp, stagnant pools of water line the makeshift roads and people live on top of each other, with little or no privacy, in makeshift tarpaulins or tents supplied by aid agencies. Men, women and children constantly traipse to the camp's water points to fill containers of water for drinking, washing and cooking.

The Concern baby tent is an oasis in a time of cholera, which broke out in Haiti in October.

Anyone who enters the tent has to wash his or her hands thoroughly with chlorine-treated water and soap. Mauvette vigilantly polices the visitors; those who don't wash thoroughly enough are given a demonstration of how to do so and a lecture on the importance of preventing cholera.

"Each of these mothers is receiving soap, oral rehydration salts and Aquatabs to help them through this time when cholera is rife in Haiti," the head nurse explains, referring to supplies intended to prevent and treat the diarrhoeal dehydration associated with the waterborne disease. "The baby tents are not just a place to learn about how to exclusively breastfeed," she says. "In many ways they are a vital lifeline to information that mothers and fathers need in order to keep their families healthy and safe from the spread of disease."

Lucienne agrees. She is thankful for the camaraderie and support of the doctor, nurses and other mothers in the baby tents. However, she shakes her head when she is asked if she would like to have more children. "These are the worst conditions to bring up a child," she says. "Until my family's situation changes, I am not going to subject another child to this sort of life."