Hitting the ground running

My first full day back was as busy as I would have expected, and then some. After sleeping only three hours the night before, I slept soundly until I was awakened around 7 by a thunderclap that rattled my bed, and I once again had no idea where I was for a few seconds. I set off down the road for the health center, greeting people on the road, and grateful for the cloud cover (I've already been told "You have changed your color, you are now very white").

Wednesdays are always busy at the health center, so I was trying to get back into the swing of things with Jennifer on the pediatric ward as well as working with Baguma on a nutrition program for ARV patients. It was good to be back there, but hard to see so many sick children again. The main event happened in the afternoon, as I went with Baguma for the opening day of a new site for our BBB nutrition program. He had trained community volunteers and taken care of the logistics in my absence, and I came back just in time for the big day. When we arrived around 1:30, there were about 20 mothers there with their children, and I expected that more would come throughout the afternoon. I spoke to the mothers about the program, lavishly thanked the volunteers, and then we began weighing kids and measuring their height in order to evaluate their nutrition status. We began to draw a crowd of onlookers, which didn't surprise me, given that this was a new event at this site, and that there was a white person there (this place is way out in the village). I wasn't prepared for what happened next. More and more children came, and I began to notice that most the kids we were measuring were big, chunky, healthy kids. Then I looked at the stack of papers for kids waiting to be weighed, it was growing rapidly. For every child we weighed, two more showed up. I realized that every mother passing on the road was stopping to have her child screened, and I was told that some women had run to their villages, shouting for everyone to come have their kids weighed - it was possibly the most effective community mobilization I have ever seen. Everyone, healthy, sick, and in-between, was coming to be weighed, probably in the hope of getting a free handout. But after measuring about 100 kids, with at least that many still waiting, we decided that Baguma would do triage, and send away all of those who were clearly not malnourished. Then we started to see the malnourished kids, and we finished weighing and measuring, but hadn't even started evaluating them, after three hours. After sorting through all of these papers, we decided on 17 kids who were in bad enough shape to qualify, and one who was barely clinging to life who I referred to the health center. As I started entering names and date into record books, the fun part began. Baguma demonstrated how to prepare the food we distribute, and watching him teach and engage with the mothers is a pleasure, even if I can't understand much of what he is saying. Then came the best part of my day - watching these malnourished kids stuff their faces with the nutritious food from the demonstration. It is simply beautiful. Whenever we do a demonstration at one of these programs, this brings joy to my heart and a beaming smile to my face - it gets me every time.

It was getting dark by the time we left, and we didn't get home until 7, officially the latest I have ever seen one of these program run. But it was great: eager mothers, competent and excited volunteers, health center staff present and helping, good food, smiles, crying, laughter. I felt sadness at working with pitiful malnourished children, and knowing that they may not improve, but also hope for recovery and excitement at the start of something new.