Doni doni kono nita niama

That is Jula for “slowly, slowly, the bird builds its nest”… little by little things come together. Very, very slowly.

On Wednesday we visited the CREN, or outpatient malnutrition ward. This is also where the kids above age 18 months who have HIV come to be checked in and have weight and temperature checked. Its all open air, with a tin roof and is made up of a cooking area, where they make breakfast & lunch for the kids every day over an open fire (with smoke filling the rest of the area), a weight / visit / education area and a paillote or palapa for eating in (funny that I know French & Spanish words but not an English word for that – it’s a conical roof structure, with low walls so its open to the breeze but the roof shape is cooler than a flat roof).

The kids are weighed every Wednesday, and their weights carefully written in their carnet de santé and their CREN chart. They come each morning for their breakfast & lunch, and the parents theoretically find dinner for them somewhere else. They have education sessions once every 2-4 weeks, things like how to prepare nutrition meals with local ingredients, etc. Some of the kids are losing weight even while being followed in the CREN… its not clear if anything different is done for those kids.

It was upsetting to see kids that are losing weight even there; two kids stand out. One had puffiness around his eyes and feet that suggested kwashiorkor; he was listless and a bit fussy. The nutritionist dutifully wrote down the weight, no plan to do anything else. The second was a 2 year old who weighed 4.9kg, and who’s weight has been decreasing steadily for 2 months of weekly weigh-ins in the CREN. When his mom put him on the scale to be weighed, he puckered his face as if to cry, but there was no energy to actually cry. He tried to raise his arm to his mother, but the tiny arm of skin & bones, only made it half way up before he couldn’t raise it any further. His skin hung off him in folds. His mother was cachectic (looked like she was starving herself). The morning brought home to me in a very painful way that we have been here 2 months and are not yet seeing patients… while we could ask about the kids, suggest they be referred, there was nothing we could actually do. When I got home, I cried.

On the optimistic side, we should be starting work in the hospital on Monday, so we will be spending 7-2 every day there, and then in the afternoons work on the meetings and relationship building that we need to do to get to know the players and the system and to integrate our project well. (And if you’re wondering why we’re not being pushier at this time, its because if we did that we could be creating bigger problems and roadblocks for ourselves, so we’re trying to do things the ‘right’ way).

On a totally unrelated, frivolous note…

I got a package from home! What a treat to get some mail. My dad sent me the DVD Capote, and my East Africa handbook. It took only 2 weeks, which was much faster than expected. And it cost 150CFA to liberate it from the post office… I think if it’s a high value package there may be taxes to pay as well, but there wasn’t on this package.

My garden is coming along, the zucchini & cucumber from seeds are coming up, there is are several tomato flowers and a small tomato on one of the plants, and I got some flowering bushes and a frangipani (my favorite flower, native to the Pacific) to put in the front yard yesterday.

It seems that every time I turn around I'm having a plumbing or electrical problem. Monday, blocked sink & 3 running toilets, Tuesday a broken light fixture cover, Wednesday a blown fuse, Thursday the kitchen tap started making bizarre sounds and then this morning after my shower I heard a "drip drip drip" and my hot water tank was leaking... so for the 2nd time this week, I had the plumber here and the hot water tank problem was easily fixed but the strange sounds from the kitchen tap signified a dying kitchen tap and so that I've had to replace for $50. Ugh! Good thing labor is cheap here - the electrician visit for the blown fuse (it’s the kind you need to replace the actual fuse) cost $1.50 for the fuse and $1 for the labor. Not the same as at home!

I hope everyone has a safe & relaxing weekend. Feel free to write comments on the blog!
With love,
Laura