28433: Corbett: Work of Dr. Patricia Wolff in Haiti

[corbetre@webster.edu]

>From Bob Corbett

Physician Pat Wolff first went to Haiti with our group about 20 + years ago.  
She went back with us several times then started going on her own.  She 
continues to work regularly in Haiti.

-------------


Medika mamba
By _Daniel  O'Malley_ (mailto:editor@westendword.com) 
Posted Wednesday, June  7, 2006 - West End Word 
To Patricia Wolff itâ??s one of lifeâ??s unanswerable questions why people are 

born where they are. Like how she was born here in the United States while so  
many other people are born in places like Haiti, the poorest nation in the  
Western Hemisphere, a place where people live on a dollar a day and one-quarter

 of children under 3 are dangerously malnourished. 
â??Itâ??s a mystery of the universe why my soul came down the chute here, your 

soul came down the chute here; their souls came down the chute there and
theyâ??
re  trapped, they canâ??t make a living, they canâ??t support their children, 
they canâ??t  get education,â?? Wolff says. 
Wolff, a Central West End resident, is a pediatrician in private practice in  
St. Louis and an associate clinical professor of pediatrics at Washington  
University School of Medicine, but lately sheâ??s spending more and more of 
her 

time in Haiti.
In 1988 she, along with her husband and two children â?? then 11  and 14 â?? 
took their first trip to the island with a volunteer group called the  Haiti 
Project. 
â??It was so mind blowing I think for everybody,â?? she said. â??There were 
dead
 
bodies in the street, everybody was so poverty stricken you just couldnâ??t  
believe it. It was one of those things where you just couldnâ??t avert your 
gaze.â??
 
After that Wolff started making regular trips with a medical group, first  
once a year, then twice, then three and four times a year. On these visits she 

worked as a pediatrician in a clinic. She saw children with pneumonia, 
malaria,  typhoid and other serious illnesses. She treated them with
antibiotics, but 
she  knew they really needed to address the root of the problem. 
â??What they really needed was food and the reason they were sick is they were 

malnourished,â?? she said. 
In 2004 Wolff founded Meds and Food for Kids. The organization, which is an  
outgrowth of the Haiti Mission, a volunteer group sponsored by Methodist  
churches in North Carolina and Virginia, is dedicated to breaking the  
malnutrition cycle and keeping children healthy. 
â??Once you get malnourished and then you get sick, then you donâ??t eat 
because

 youâ??re sick, then you get more malnourished, then you get more sick, then 
you  get more malnourished and you dig yourself down into this hole and you 
really  need a lot of calories,â?? Wolff said. 
MFK uses a cutting-edge approach to supply those calories called Ready-to-Use 
 Therapeutic Food. Itâ??s a mixture of peanut butter, powdered milk, sugar, 
oil,  vitamins and minerals that packs in more than enough of the calories,  
antioxidants and nutrients necessary to nurse a child back to health.
The  technique was pioneered by fellow Washington University pediatrician 
Mark Manary  whose own work with malnourished children takes him to the African

nation of  Malawi. 
MFK buys as many of the ingredients as possible on the island, although the  
vitamins and minerals are brought in from the United States. Locally the  
foodstuff is known as Medika Mamba. 
The organization pays Haitians to grind all the ingredients into the peanut  
butter mixture. They do the grinding by hand for the most part, as electricity 
 is scarce and only recently has MFK had the luxury of a small motor-driven  
grinder. But even on a good day the power â?? which comes from an extension 
cord

 that stretches from MFKâ??s facility over the tops of a few buildings and 
plugs in  on the street corner â?? is only on for two hours. 
Once the mixture is made mothers can pick it up at the clinic in quantities  
large enough to last a couple of weeks. It requires no extra cooking,  
preparation or refrigeration and can just be spooned directly into 
childrenâ??s 

mouths. 
The treatment typically lasts four to six weeks. Itâ??s administered as an  
outpatient procedure, unlike the currently recommended malnutrition treatments 

that require mothers to bring their children to a hospital. In those cases more

 problems often develop at home. When she has to travel to the hospital a 
mother  canâ??t tend to all of her responsibilities. The other children get 
malnourished  as well because nobody can tend to the crops or provide food at
home, 
Wolff  said.
â??Letâ??s say she decides to go in the hospital, still the cure rates are  
really abysmal in these hospitals,â?? Wolff said. 
The traditional treatment â?? a gradual program that begins with diluted  
powdered milk and builds toward rice and beans â?? isnâ??t very effective, 
Wolff
 
said. It isnâ??t calorie-dense enough, itâ??s too slow and it doesnâ??t 
include 

antioxidants, she said. 
With the peanut butter mixture â?? which may soon become the treatment  
recommended by the World Health Organization â?? thereâ??s often a noticeable
change  
after only two weeks. Children who could barely hold up their heads before 
come 

to the clinic a few pounds heavier and with their eyes opened wide. 
Earlier in May MFK was selected as a winner in the first-ever Social  
Entrepreneurship and Innovation Competition held at Washington University. The 

competition was designed to foster the growth of organizations that develop  
innovative approaches to social problems. MFK won $25,000 of the $100,000 
total 

that was awarded to winners in various categories. 
Wolff wasnâ??t there when the announcement was made: she was actually on her  
way to Haiti. Starting later this year sheâ??ll be spending a lot more of her 
time  on the island. She plans to scale back her pediatric practice and divide 
her  time equally between St. Louis and Haiti. 
â??Iâ??m going to be there three weeks and here three weeks and there three 
weeks  and here three weeks,â?? she said. 
The transition will be difficult for Wolff and her family, but a local  
philanthropist committed to raising between $250,000 and $500,000 for MFK over 
the 
next three years if she does it. And Wolff is looking forward to the  change. 
As a doctor the impact is greater for each hour spent with patients in Haiti  
than in the United States, she said. 
So far MFK has treated about 600 kids and five years from now the group will  
have brought approximately 20,000 kids out of malnutrition. 
The hours Wolff has spent in Haiti since she began her work nearly two  
decades ago have had a tremendous effect on her perspective. 
In a country like the United States thereâ??s a hierarchy of needs and once you

 have the basics taken care of you can go on to worry about more trivial 
things.  â??In other places they donâ??t have survival taken care of, they
donâ??t have 
food  and water taken care of, theyâ??re not really worried about acne,â?? 
Wolff

said. 
As it is now in Haiti â?? where the infant mortality rate is roughly 10 times  
what it is in the U.S. â?? mothers often donâ??t even name their babies until 
they  get a bit older because they donâ??t know if theyâ??ll survive. Once a
child 
becomes  severely malnourished itâ??s difficult for a mother to stay hopeful. 
Itâ??s Wolffâ??s hope, though, that MFKâ??s work will have an effect on those  
mothers, too. 
â??When their children come back resurrected after two weeks the moms are  
elated, their own depression lifts,â?? she said, and then they can start
searching  
for solutions to other problems.