The unwavering love of NVM’s malnutrition nurses

by Brad Miller

“It’s when you pick them up. That’s the hardest part.”

I was sitting across from Brooke, a long-term nurse at NVM. She had been living and working in Haiti for some time, and was my expert and guide to their malnutrition program.

“When they bring the babies in their frilly dresses and loose shirts, you can’t tell how small they are. They look normal. But when you pick them up, you can feel their ribs move beneath your fingers.”

She grew quiet for a moment.

“You never forget that feeling.”


I had visited slums before. I had seen the sick, even the dying. But normally people in such desperate situations are spread out in a population. There is a certain unique horror in seeing them all at once, all starving, all babies.

I shadowed in the clinic while Brooke examined one of the children just starting the malnutrition program. Hollow-eyed and staring, she was limp in its mother’s arms. She barely responded as she was undressed, lifted, measured, and weighed.

Brooke fixed a measuring tape around the baby’s upper-arm, the best indicator of healthy weight. She drew it tight and recorded the measurement. 114 millimeters, barely the width of two fingers.

The measurement of the upper arm is the best indicator of weight.

The measurement of the upper arm is the best indicator of weight.

For the first time in my career, I was thankful for the distance my camera created between my subject and me. I retreated behind it, and tried to watch the rest of the patients with a detached, professional interest.

And yet this was one day of my one-month stay. How could the nurses do this day after day, month after month, year after year?

Lazarus Effect

I watched that day as children were brought in. I saw them at the beginning of the program, sickly and bloated. And I saw children coming in near the end of the malnutrition regimen, utterly transformed.

The children starting the program were barely recognizable as alive, but I could hardly tell the children who completed the program had ever been sick! I looked through their files and found photos from their first visit. The change was night-and-day. It was the epitome of the “Lazarus effect” – from death to life.

Afterwards, however, I sat down with Brooke and heard that not all children made it through the program. And it wasn’t because the program was faulty. It was because some mothers didn’t stick to it.

Sometimes there is superstition, family, or economic pressure. Despair fills these mothers, and many can’t believe that the treatment will actually work – so they give the food to their other children, desperate to protect them from the same fate.

And the nurses of NVM have had to watch helplessly as the babies they love, the babies they have been willing to uproot and move to another country for, have died.

And then the mothers, in grief and desperation, have returned to the clinic again with another sick child.

There, in that messy and terrible relationship between the nurses and the mothers of the dead and dying, a malnutrition program becomes more. It is a battleground, it is a church, it is struggle and love and the most intimate and intense of bonds – a common love and a common sorrow.

The relationship between mothers and nurses flows deep – a common love and a common sorrow

The relationship between mothers and nurses flows deep – a common love and a common sorrow

I asked Brooke, quite simply, how she would explain this to Americans. She didn’t hesitate to answer,

“It’s so much more.

It’s not just fixing this, or building that, or feeding them.

It’s time, and it’s relationship, and it’s anger.

So many of my best relationships have started with frustration. It’s messy, but it’s honest and it’s real and it takes time.

Americans come and build a house and want it to be clean and simple and done. And that’s great, but nothing has really changed. They have a house, but their life is still the same.”

The nurses of NVM have paid a high price to love these children.

The nurses of NVM have paid a high price to love these children.

But the nurses are here for the long haul. They have volunteered for an impossible task, to love a mother whose beliefs or fears or inaction will result in the death of a baby. To love that baby, knowing his mother may soon contribute to his death. And afterwards, when the baby is dead and the mother returns, to keep loving her.

Brooke’s voice cracked, “I have to choose to invest in him. I have to choose to get hurt in that. Because I will get hurt in that. After a few times… it’s hard.”

Choosing Hurt

I left the clinic stunned. Stunned by the sacrifice of those who choose to work there, who choose to be wounded there.

I’ve heard people talking about raising money to go and serve, giving up a house or a job or a car to go and serve. Their sacrifice was what they had to sell in order to travel.

But for these nurses, that price – the lost income and jobs and housing and friends, that was the fee they paid for the privilege of sacrificing. Because the real sacrifice, the real pain, came after they arrived.

Growing up, I used to hear my church talk about being a missionary. I heard people say that it’s about “being Jesus” to the poor and needy. And I’ve met people who talk about being “the teaching Jesus” or “the miracle Jesus” or “the healing Jesus”. This was the first time I’ve met “the bleeding Jesus”. But after all, isn’t he the one we’re truly thankful for?

I know I am thankful for these nurses, and for the love they bear that I still can’t understand. I want to go back. I want to learn more about the strength to choose love, even when you know you will be hurt. And maybe, just maybe, to learn to make that choice myself.

Tap to see the incredible before-and-after transformation of two children in the malnutrition program. These are only a few of the many children whose lives have been saved. Please be aware, some readers may find the “before” images disturbing (but all readers will find the “after” images inspiring!)