Si vous aimez vos enfants, prenez soin d'eux et donnez leur une alimentation équilibrée"If you love your children, take care of them and give them a balanced diet," reads the French message. But ideally, and as I've already found, the pictures mean more than the words--particularly in an illiterate population. Already we've begun weighing babies in the room rather than out in the hospital passageway and explain to mothers what sorts of foods are important for them (especially if they are pregnant) and for their kids. I'm amused when many have asked, "Mariam, why is the man leading a dog by a rope?" "It's a goat," I say. "Why does the dog have udders?" "It's a GOAT!" "Ohh...a goat. For milk." "YES!"
With patience, everything comes. The technique of rehabilitating a baby under 3kg requires the attachement of a modified IV tube next to the mother's breast to ensure as the baby suckles, it receives vitamin-enriched formula as well as breastmilk:
The danger of exclusively giving small children the Nutriset powdered milk is that the mother's breasts will stop producing. But attaching a tube and having a nurse sit by you while you breastfeed is disconcerting. The baby must be patient and continue to suckle until the suction is sufficient to pull up the milk from the cup. And I have to be patient with the mother trying to take her baby home with her. My new favorite Songhoy phrase: Gaham baani fonda, a ga waato zaa! The road to health takes time!
Action contre la faim (A French NGO) came to give a training on nutritional rehabilitation to all the head nurses at each CSCom in the Circle of Ansongo. I helped give some of the presentations, particularly pushing the use of education and counselling, since that is the large part of the work I do at the hospital. I had a great time with the ACF staff and was particularly amused by the French expat's interpretation of the local "seka seka" dance. Awesome. One evening of the week-long training I went with them to a town 30km up the road to where ACF WatSan workers were giving animations on good water treatment and water-borne illness prevention. They were actually traveling by pinasse from village to village giving the presentations. In the car-ride back, one of the ACF doctors asked me, using the French woman as an intermediary, to marry him. Though he is handsome and smart, I said a flat-out "Non." But he insisted, as did she, that I at least state my conditions. I said at first he had to fly to Seattle and ask my father's permission. He said he would bouff from ACF to buy the plane ticket. I demanded cows and camels, at least 40 head. He is Peulh, and said it wouldn't be a problem...and he'd arrange for the camels. "And I'd get all the milk I'd want?" "Naturally." He replied. I demanded he cook and clean and treat me like a queen. It was entertaining...
The last day of the training we received a petit poids (photographed above) and a severe case:
When Hamil was admitted to the program, he weighed 5kg. He is over a year old. His mother got pregnant when he was only 7 months old, and as soon as she knew of her condition, cut him off of breastmilk. No weening process at all. Women here believe if you continue to breastfeed you'll hurt the growing baby. Untrue. Early or improper weening is the cause of much of the infant deaths before the age of 5 here. I won't even get into why she got pregnant with a 7 month old to take care of...When the grandmother brought him to us, she said he was drinking some goat's milk but mostly just tradition medicines and lipton, or brewed tea. Suffice it to say the mural come in handy...Hamil was severe marasmus. He had candidosis of the mouth, sores on his lips (sign of dehydration), vomiting, and diarrhea. He was wasting away. Only after a few days of antibiotics and creams and our milk he was turning around. It was difficult at first to watch him throw up or reject everything, even just sugar water; but soon he was willingly taking the sippy cup of milk. One evening I had put the porridge on the fire for the mother of the petit poids to stimulate breastmilk production and Hamil comes crawling out of the rehab-room. He had his cup in his hand and banged it aside the cook-stove to get my attention. His appetite had retourned, and in a few days we started the weight gain program. Severe cases are fragile, and Nutriset through UNICEF has provided formula and enriched peanut paste for each stage of recovery. Despite a nagging cough, he is doing so much better and looks less like a tiny old man. Adiza, breastfeeding above and here, clothed in a much-too large but warm outfit I had her father buy for her, was our petit poids case. I fell in love with this tiny little girl:
She is 2kg. A case of a new mother who had malaria during her pregnancy. So even at one month, Adiza is too weak to really stimulate breastmilk production and hypothermic. Slowly but surely we'll help the mom, Safo, learn to breastfeed and eat well herself and rehabilitate Adiza in the process. I've "slept" at the hospital twice recently to feed these two little ones. I was at total peace eye-droppering milk for Adiza and decided I need to seek a career in nutrition and nursing. She isn't gaining any weight yet, but looking healthier and finishing all her rehab milk. Really, she was just hungry.I love sitting and talking with the women who gather each day to keep the patients company. We mostly chat about the "road to health" but also about witches and cooking, typical women's-circle topics. I keep thinking how difficult it really will be to leave here.
I know it is but one step; yet the first step in a lifetime committed to convincing people malnutrition is a serious affliction deserving as much if not more attention than HIV/AIDS or Polio. It's more difficult as a condition treated not simply with drugs and injections, but care and patience.
No comments:
Post a Comment