The Special Needs of the Smallest Victims in Haiti

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A statistical study conducted by a specialist group made of researchers from the Children’s Hospital in Los Angeles and the University of Southern California indicates that nearly half of the victims of the January 12 earthquake in Haiti are children – more than 110,000. This situation has significant consequences for relief efforts, including specialized medical equipment and nutrition sources.

In Haiti, 35% of the population is under the age of 15, meaning that the estimated total number of injuries contains more children than it might in other areas.

The developers of a software tool to aid medical service providers, called the Pediatric Emergency Decision Support System or PEDSS, have set up a website to help guide the choice and distribution of relief supplies. The PEDSS report details injuries that are expected for each of eleven diagnoses, ranging from abdominal trauma to spine injury, in each age group. The software then calculates the amount and types of medications and supplies that this group will need.

Crush injuries, for example, are estimated to have affected approximately 1000 children between the ages of 6 to 8. The medical needs for this group include calcium gluconate 1g/10ml at 265,263 doses. Other needs include 99,479 40-milligram vials of Solu-Medrol to treat spine injuries, 11,108 standard doses of Tetanus toxoid to treat lacerations, and 165,780 half-milligram tablets of Lorazepam.

While most Americans can’t help with donations of specific medications, one prominent need stood out from the PEDSS report. Children in Haiti will need about 580,209 units of O-negative blood because of abdominal or chest trauma. The American Red Cross continues to actively work to meet the health needs of Haitian survivors by providing not only relief supplies, but also shipment of blood products. To donate, contact your local Red Cross Agency, call 1-800-GIVE-LIFE, or visit www.redcrossblood.org.

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Other groups have focused on the nutritional needs of the children in Haiti. The global humanitarian organization Save the Children is supporting the efforts to promote breastfeeding among the new mothers in Haiti, particularly because of the concerns with the tainted water supply. The agency is broadcasting messages on local radio stations in Creole. They are also training midwives, health workers, and nutritional educators to reach out to pregnant and new mothers at camps in Port-au-Prince, Leogane, and Jacmel.

“Newborns and infants are very vulnerable during emergencies, especially from diarrhea, pneumonia and malnutrition. But mothers can take simple steps to protect their baby's health through exclusive and proper breastfeeding," said Kathryn Bolles, Save the Children's emergency health and nutrition director. "Breast milk provides essential nutrients and strengthens a baby's immunity, protecting the baby from other illnesses."

For women unable to breastfeed, or for orphans who have lost their mothers, several breast milk donation banks are offering to help, under some concern. The international Emergency Nutrition Network has asked the Human Milk Banking Association of North America (HMBANA) to retract an earlier press release that issued an urgent call for breast milk for orphaned and premature babies in Haiti, saying that donations contradict best practices for children in emergencies. The Office of US Foreign Disaster Assistance (OFDA) has called such donations an “unfeasible and unsafe intervention” and that the current infrastructure is not available to meet storage and distribution needs. The HMBANA has said that the group was simply trying to help fill a need.

The International Breast Milk Project has arranged for the donation and transport of 500 ounces of breast milk to the US Navy ship Comfort for their neonatal intensive care unit. They have enough freezer space to feed a newborn for a couple of weeks with that amount of milk. However, according to David Shark, a Navy spokesman, the milk remains unused out of concern of its safety.

Dr. Nune Mangasaryan, senior adviser on infant nutrition for UNICEF has issued a statement on behalf of the World Health Organization and the United Nations World Food Programme that said, in part, "Human milk donations while safe when processed and pasteurized in a human milk bank also require fully functioning cold chains. Such conditions are not currently met in Haiti and human milk donations cannot be used at present. At this point, it is not the recommended way of assisting Haiti.” UNICEF says what is currently needed is ready-to-use infant formula.

The HMBANA has issued a statement on their website to say that “if UNICEF, the Red Cross, WHO, or other international organization involved on the front lines were to contact us (to provide donor milk)” they are actively seeking donors. Information on the strict requirements and where to donate are included at http://www.hmbana.org/index/haiti

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