In Haiti’s Port-au-Prince/Carrefour region I am supervising MSF’s only Inpatient Therapeutic Feeding Centre (ITFC). My program is small, fluctuating between 15 to 30 children admitted on any given day. Unstable malnourished patients come to my program from all over Haiti for stabilization before they can be transferred into an ambulatory program. The sooner a child can be transferred into an ambulatory program, the more likely he will thrive, as the disruption to a family’s daily routine is far less thus allowing a parent to balance the many priorities they have in a day.
MSF has an enormous capacity here in Haiti and I work closely with all of the sections. With so many other NGO’s running medical activities however, a very important part of my time here has been spent building connections among local hospitals and clinics, making sure other organizations are equipped to both identify malnutrition and know how to properly refer them for the treatment they need. There are many ambulatory feeding programs located throughout the Port-au-Prince area, some run by other organizations, which I have had to evaluate to ensure that they use the same protocols as MSF, that their programs are indeed free and well run before we could encourage any organizations to refer any stable malnourished children they encounter there. In doing these evaluations with other organizations who encounter malnutrition, I have built up quite a network of contacts in the region.
Every organization has its specialty, it is inevitable however to encounter patients who are beyond your capacity and, at that moment, you try your hardest to find someone else who can help the patient. Every person has that special case and every time they meet someone from another organization they inquire…. do you? Could you? Do you know where? In building these connections around malnutrition I have become somewhat of a fixer for people, whether it be helping one organization find out who to call to successfully refer a burn patient for plastic surgery, or where someone else can get free echocardiograms, who runs pediatric TB/HIV, or the best way to get a patient into a neonatology unit, all of which are often full in the area.
Being able to help in these situations has become a small highlight for me. We have all had those patients we have wanted to help and couldn’t. With MSF in Africa, I have been in that helpless situation more times that I care to remember, where you are forced to tell a family that there is nothing more that can be done, and it still haunts me. Here in Haiti, I am able to help people better access/utilize this huge NGO health care network so that no patient should ever have to be turned away because a volunteer in a small health centre doesn’t know where to turn for help.