Perhaps 300 professionals from the St. Louis area have helped in Haiti in the past year, and most want to help the Haitians help themselves.

The poorest nation in the Western hemisphere must not continue as a charity case, St. Louis volunteers said. Most Haitians don't want to stand in line for help but to learn, work and help themselves, the volunteers sai.

After two decades of helping in Haiti, St. Louis pediatrician and Washington University medical professor Dr. Patricia Wolff sees new hope, even though the earthquake stalled her food production expansion plans.

"I am seeing a silver lining," she said, among the nation's government and business leaders. "Lots of them are not the same cast of characters we used to see. There is a lot of extreme pressure to do the right thing, from many places -- other nations, and the people of Haiti. Such high visibility doesn't allow for 'business as usual'," she said.

Wolff was last in Haiti about a month ago. She wearies of North Americans whining about Haiti's corrupt government, she said.

"We have plenty of corruption here," she said. "In Haiti, it does not involve huge amounts of money, suitcases of money like here. Nor do we hear huge lies, like we heard about Iraq."

Wolff first went to Haiti with Bob and Jane Corbett, when the once married couple from Webster Groves annually escorted students from Nerinx Hall and other area schools to work at Mother Teresa's Missionaries of Charity home.

"How can I get discouraged when I've seen thankful Haitians who never seem to weary?" she said. Wolff spends nearly half her year in Haiti, three weeks at a time.

She now consults and supervises qualified Haitian doctors and nurses rather than treats patients. She spends hours with accountants and doing other administrative work.

She began the nonprofit Meds and Food for Kids, better known as MFK, which employs Haitians to make a food successful in Africa in treating malnutrition. The food combines peanuts ground into a paste with powdered milk, sugar, vegetable oil, minerals and vitamins. The peanut butter medicine, medika mamba in Haitian Creole, requires no addition of water and no refrigeration.

More than 90 percent of malnourished children regain health and reboot their vulnerable immune systems. The treatment takes 44 pounds of this mixture eaten over six weeks and costs just $100. Wolff's production unit, run out of a house in Cape Haitian, has stabilized 20,000 Haitian children over the past year.

Even with problems of getting supplies, the MFK production team has made more than they had in any previous year, but did not double production as it had expected.

"We got a new low-tech grinder, which is more efficient," she said. "So we made more even with the earthquake, electricity (problems), demonstrations before and after the elections, and accusing the U.N. for causing the cholera, even with all of that and the mandatory three weeks vacation."

Wolff's pre-earthquake plans for a real factory are taking longer to realize. In July, she told the Beacon that she expected to open the factory by the end of 2010, but now she hopes to be in production by early summer.

"We will get the first of our high-tech machinery in February, begin installing it in March in the current building, until we get the factory built," she said.

"We will be able to make eight times as much medika mamba," she said. "We will be able to help 80,000 children and employ 50 Haitians."

Part of the delay comes because revised plans for the factory call for a bigger building with special high-tech equipment, according to the stricter protocols of the formula's recipe owner, Nutriset of Malauney, Normandy, France.

"UNICEF and other NGOs who won't take our current product will buy it when it's made to Nutriset's standards," Wolff said. Ten percent of Haiti's children are acutely malnourished, and 20 percent are underweight, she said agencies have told her.

Her first two applications to partner with Nutriset were rejected. She calls its partnership the humanitarians' "Good Housekeeping seal of approval." Nutriset took another look after the earthquake, and its French leaders agreed to help Wolff and the MFK board meet Nutriset's goals and criteria. They must buy state-of-the-art equipment to put into a sterile production facility.

Wolff and her board want the planned factory to be self-sustaining. It is being designed and fabricated in the U.S., said MFK board chairman Thad Simons, whose day job is president and CEO of St. Charles-based Novus International. Simons works in a platinum-rated LEED building and strongly believes in sustainability, he said.

After being slowed by the earthquake, many things are being prepared.

"Four Haiti workers are going to France to get training in February," Wolff said.

All four speak French, Haiti's language of higher education. Two have attended college. The third is MFK's quality assurance manager, who has had pharmacology training. The fourth has a background in electrical and mechanical technology and will maintain its planned high-tech machinery.

Instead of importing most of the peanuts, MFK hopes to go completely local -- eventually. For several years with the aid of peanut experts from the University of Georgia, MFK has helped 500 Haitian peanut farmers get rid of a virus, a blight on the peanut plant. Advisers have worked to help fertilize to increase farmers' peanut yield. At first, almost no Haitian peanuts met MFK standards. Today about 500 Haitian farmers sell 60 tons of peanuts a year to MFK. When the factory is opened, MFK hopes to buy from 1,000 farmers, Simons said.

The world's most famous peanut farmer, former President Jimmy Carter, has agreed to be the honorary chair of MFK's spring fundraiser. Over the past year, $1.3 million of the $3 million needed for the new factory has been raised, Simons said.

Sunday is a day off for rehabilitation therapy school that Charles Gulas helped start at the Hopital Albert Schweitzer.

Where chaos reined last year, on a recent peaceful Sunday, Gulas, dean of Maryville University's health professions school, was taking "a lesson" from the 8-year-old daughter of the cook at the volunteers' residence. She taught him how to play a really hot game of dominoes -– a favorite game in Haiti. Gulas taught her how to speak English.

"It's good for her to know she is helping someone," Gulas said.