High-Risk in Haiti: A Novel Nutrition Program Nourishes HIV-Positive Mothers and Their Babies by Bridging the Gaps between Clinic and Community

Article excerpt

Mona Maitre was worried. One of her patients, a homeless woman, had not shown up for her appointment. Maitre fretted about the woman, who was HIV positive, and the woman's baby. They both needed medicine, food, and support. Each morning, Maitre drove around Port-au-Prince, Haiti--a vast, sprawling city--to scour the streets for the missing woman and her child.

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When Maitre, a nurse at Cornell's GHESKIO clinic, a center for the treatment of HIV/AIDS and related infections in Port-au-Prince, eventually found the woman, she discovered the baby had a serious respiratory infection.

The nurse's dedication and concern may seem unusual, but Rebecca Heidkamp, a Ph.D. candidate in the Division of Nutritional Sciences in the College of Human Ecology, said it is exemplary of how the clinic cares for the community. "For many of the staff, it is not about the data or the challenges faced in the clinic," Heidkamp said. "It is about caring for people."

Heidkamp spent three years at GHESKIO working on her doctoral thesis, where she designed and implemented an innovative program to meet the nutritional needs of HIV-infected mothers and their babies. Their multi-faceted approach educates these women about the importance of nutrition during a child's first two years of life, offers "mothers' clubs" where the women share advice and connect to the larger community, and provides nutritional supplements for their children. The program, overseen by nutritional experts in Human Ecology and clinical physicians at Weill Cornell Medical College (WCMC), is now in full swing and showing promising results as a behavioral intervention for high-risk mothers.

GHESKIO sees about 300 HIV-positive pregnant women a year. Under the new nutrition program, they meet monthly in a mothers' club and receive one-on-one medical care from clinic pediatricians and nurses. The mothers are grouped according to their babies' ages.

"For example, when the baby is 7 months old, we talk about diarrhea, which starts to be a problem at that age," Elizabeth Fox '09 explained. Fox, a nutritional sciences graduate, currently supervises the program in Port-au-Prince while Heidkamp finishes her thesis.

Working in a developing country with limited resources is not easy. Even before the catastrophic 2010 earthquake that flattened buildings in Port-au-Prince and throughout the region, work in Haiti presented some unique difficulties.

"Food insecurity is a big problem," explained Vanessa Rouzier, head of the pediatric department at GHESKIO. "When the parents ask for money and beg for food, you are tempted to give it to them for the children. We want to empower the community. Our mission goes beyond being a charitable organization."

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GHESKIO formed in 1982, the first institution in the world dedicated to combating the newly described HIV virus. Jean W. Pape, the founding and current director of GHESKIO and professor of medicine at Weill Cornell, along with a group of Haitian colleagues, noticed young men in Haiti dying of unusual opportunistic infections. With Warren Johnson, professor of medicine at WCMC, Pape and his colleagues created the Haitian Group for the Study of Kaposi's Sarcoma and Opportunistic Infections (GHESKIO--a French acronym, pronounced guess-key-o) to describe and combat what would be later recognized as HIV/AIDS.

Despite operating in a resource-poor country, GHESKIO has led the way in developing therapies for the major complications of HIV, including tuberculosis and diarrhea. The center's mission has expanded to include community development, with the nutrition program bridging gaps between clinical care and community-level connection.

New focus on maternal-child nutrition

When Johnson and his colleague Dan Fitzgerald heard about the work of Rebecca Stoltzfus, professor of nutrition in Human Ecology and co-founder of the Global Health Program, they knew that she should visit Haiti. …

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