Dr. Deborah A. Frank met Duvon Haughton when he was 10 months old, rushed to Boston Medical Center with an infection. The baby weighed a scant 14 pounds, roughly the weight expected for a 3-month-old.
“He was lying on the bed, floppy-looking,” recalled Frank, founder and director of the hospital's Grow Clinic.
The youngest of six children in a struggling immigrant family, Duvon did not have enough to eat at home.
The Grow Clinic provided food, supplies, medical help, social workers, and Duvon’s first toy, a truck — typical treatment at the largest clinic in a network established in 1984 by the state Legislature to address childhood malnutrition.
Boston Medical Center contends with the unseen toll of hunger every day. More than 14 percent of children younger than 4 are underweight when they come to the hospital’s pediatric emergency room. Nearly 25 percent live in families who worry they will not have enough to eat.
Today, Duvon Haughton stands nearly 6 feet tall. The once-sick, floppy child is now an 18-year-old college freshman with dreams of owning a business. “He is a really good example of investing in children,” said Frank, who has kept in touch with him and his family over the years. “What you do for the youngest children sets their trajectory forever.”
At age 68, Frank is a diminutive woman who describes herself as a “grandma doctor.” When she started the Grow Clinic, she never dreamed she would still be doing this work three decades later.
“I thought I would explain it to people . . . and they would say, ‘Oh, I get it,’ and they would fix it,” she said.
Instead, she has seen the size of the clinic’s clientele fluctuate with government spending. Each cutback in food stamp eligibility brought a new cluster of sick children to her door.
“You can see public policy written on the bodies of babies,” she said. The number of Grow Clinic patients has doubled in recent years.
Many more Boston children are malnourished than people realize, Frank said. The cute, chubby-cheeked 2-year-old a passerby sees bundled up in a stroller may actually be 4 years old, she said, adding that facial fat is the last to go.
Unlike a seizure or an asthma attack, malnutrition sneaks up on a child, often unnoticed and influenced by many factors. The year when Duvon first came to the Grow Clinic, his father had just had two heart attacks and had to quit work as a landscaper, leaving the family with few resources. Duvon had an allergy to eggs, making it harder to feed him.
The Grow Clinic deployed its staff of pediatricians, dietitians, and social workers. The family took advantage of the hospital’s food pantry. A social worker visited their home to help with paperwork to enroll Duvon in Head Start.
Restoring the health of a malnourished child is a slow and tricky process. Food must be added gradually. The child must get enough nutrition to support current needs and also make up for the earlier deficit. Then, it takes three months for the immune system to regain full strength.
Time and time again, an infection would grab Duvon during that three-month window. “He’d be looking much better, then he’d catch something,” Frank said. The typical Grow Clinic patient starts at around age 2 and stays with the program for about a year. Duvon came early and continued to be a patient — visiting once or twice a month — until he was 5.
But he had the advantage of a loving, attentive family. His older sisters often accompanied him to medical appointments. His father helped him with his reading in the waiting room.
Duvon needed special education to help with reading and math. But he graduated from Dorchester Academy with high marks, and he now attends Fisher College and works as a valet.
Frank said childhood malnutrition often leads to difficulty learning reading and math. It also causes problems with “executive function” — the ability to pay attention, make decisions, and control emotions. But Duvon Haughton, she said, has excellent executive function, a key to his success.
“I map out strategies to make me a better person,” Haughton said.
Boston Medical Center’s Grow Clinic relies on charity for two-thirds of its income, the rest coming from a state budget allocation and Medicaid reimbursements for physician visits. On Monday, Haughton spoke at the clinic’s annual fund-raiser, expressing his thanks for how the clinic changed his life’s path.
Today, the Grow Clinic enrolls about 200 patients at any given time. About 11 percent of the clinic’s patients are homeless, a new and worsening problem. In addition to food and health care, the clinic provides basic necessities such as crib mattresses and high chairs.
The clinic spends about $5,000 a year on each child it sees, much less than the cost of repeated hospitalizations. Commonly, children develop severe infections when their immune systems are weakened by lack of food. Decades ago, half of them needed hospitalization. Today, the hospitalization rate for malnourished children at Boston Medical Center is down to 5 percent.
Although Haughton “graduated” from the Grow Clinic at age 5, he and Frank continued to run into each other at the hospital, the medical home for his entire family. Asked recently to think about what the physician means to him, Haughton smiled, closed his eyes, and threw his arms around her.
“I got that second chance,” Haughton said. “They turned me into a person that is so driven to be successful that I won’t take failure.”
But Frank is worried about other children who continue to face hunger.
“I’m very sad, and angry,” Frank said. “We have the knowledge to fix it but we won’t, and that makes me mad.”