Tuesdays

I realize that I provide very little indication of what I actually do on any given day, so here's a glimpse of Tuesday, usually a very long, intense day primarily consisting of malnutrition work.

In the morning I go the health center to do rounds with Jennifer, starting with the severe malnutrition cases. A few of the kids on the ward now:

I first saw Asaba at one of the outpatient programs, and immediately referred him to the health center for the inpatient care that he needs. He's been a troubling case, not responding to receiving the therapeutic milk in the way that we usually see these kids recover. His weight is starting to trend upward, so I'm hopeful that he's finally on the right track.


Tumwine is absolutely pitiful, one of the worst cases I've seen since being here. His body is wasting away, every rib, vertebra, and most other bones are clearly visible, and he is so sick that he has little appetite for the F100 milk that UNICEF supplies to us, so he is another sad case of someone who made it to the health center, but can't seem to turn the corner. Jennifer has said numerous times that she doesn't expect to see him alive the next day, but he has somehow clung to life. Part of his problem is child spacing. His mother just gave birth days ago, so she had stopped breast feeding him during her pregnancy, which was too soon for him. It's painful to see him in such a horrible condition every day, but somehow he's held on, so I try to keep my hope for him alive too.

Finally, a happy story. Kabasa is an object of wonder for me. He's been admitted for a long time, and wasn't responding for several weeks. His protein deficiency had caused major edema, and his skin was deteriorating. About three weeks ago, I said to one of the nurses, "He's going to die by tomorrow. What can we do differently?" Since then, this seemingly hopeless case has been a miraculous recovery. Within days he started smiling, and by now his weight it shooting upward and he's a smiling, playful five year old boy who gives me an energetic high-five whenever I see him, and loves to throw a ball back and forth. Every time I look at him I'm amazed, he brings joy to my day and hope to my heart.

On the first Tuesday of the month we have our motherless program, which supports caregivers to be surrogate breast feeders for children whose mothers died in childbirth, so in the late morning I see these cases. We give beans every month to nourish these heroic aunts and grandmothers, so that they can be strong enough to provide breast milk for these unfortunate infants. Some of the kids to great, and some don't; some families are incredibly dedicated to caring for these kids, while some don't seem to be very invested and are probably looking for any handout they can get a hold of. But I'm always amazed to see aunts, already breast feeding their own child and often struggling to provide for them, taking on the responsibility of caring for another child, or grandmothers who haven't had a child in years but have managed to re-lactate, these wrinkled old women who throw 25-pound sacks of beans on their backs, strap them across their foreheads, and walk slowly, steadily away, perhaps having to cover many kilometers to get back home.

In the afternoon, I jump on a motorcycle with Baguma and head out near the border with Congo for the BBB program, an outpatient nutrition program. The road is always an adventure, especially with the recent unusually heavy and long lasting rains. Their used to be a bridge over the river we have to cross, but it has been gone for years and now the motorcycles drive across when the water is low enough, and men ferry people back and forth on their backs.

Here are some of the kids from the BBB program.


Some do wonderfully on the locally produced peanut paste and soy flour that we distribute, while others don't respond well, but outpatient programs will always have those issues. It's been a great learning experience for me, and I've encountered many interesting cultural issues. For instance, one of the big difficulties with these types of programs is that it is culturally almost impossible for a parent to give a certain food to one child - the supplemental food that we provide, in this instance - without sharing it between all of their children, meaning that often the malnourished child enrolled in the program might not even get the majority of the calories that we give them. But I've had great experiences, worked with some wonderful kids, seen spectacular recoveries, and have built a great relationship with Baguma.

We get back sometime around 4 or 5 usually, and I run down to Christ School for soccer practice. The season starts next week and their are high expectations, so we're training hard every day. After two hours of playing, drilling, talking, running, yelling, and encouraging, I make my way back up the road around 7, with the sun setting behind me, tired, thirsty, hungry, and aching, but usually it's a good ache.