Not All Peaches and Cream

Reality sets in quickly when the poverty that you know is out there hits you right in the face. I have been writing a lot about the fun trips and occurrences that I have been able to experience while I’ve been here, but it is probably time to write a post about what I also see throughout the area that I live and do work in.

Last Thursday morning, the 17^th, we went to one of the main health centers in the Nyalenda slum where we are implementing our formal survey. It is called Pandi Pieri Health Center and has a comprehensive network of services for the area. That morning we just wanted to make an initial contact in order to set up the time that we would conduct the survey. We have found that it is much better to form a relationship with these centers before taking up a good deal of their time with our survey. One of our favorite community health workers, Beatrice, also works there so we met her and participated in her nutrition clinic that morning. These are the types of clinics that we would want to see in this area. Beatrice’s work for these mothers is amazing. The deal is that every Thursday morning the women in the area who have children under five years old can bring them in to get their weight, height, and MUAC (middle upper arm circumference – this helps determine whether the child is malnourished). When the majority of the women had finished getting the numbers, Beatrice took them over to a cooking pot where she showed them how to properly cook the nutritional porridge in order to keep their children healthy. This was taken from an essential nutrition pack that the USAID provided. Next all the women came together and listened to Beatrice discuss one of the health topics for the day. Today was on weaning children after 6 months. It is promoted here to have 6 months of exclusive breastfeeding. This is because the child will be properly nourished, harmful substances won’t be introduced into their diet, and it is the most affordable option. She explained the weaning techniques to the mothers and went around the room asking what foods their children like to eat most. This is to make sure they are feeding them the best food that they could be.

Beatrice and the other community health worker helping out, Daniel, took their weight and MUAC results to determine the food supplements that they could provide at the end of the session. Those children who had very poor measurements would receive enough plumpy nut to last them the week. Plumpy nut is a peanut-based food for use in famine relief which was formulated in 1997 by André Briend (thank you Wikipedia). Overall it is a great supplement to children who are malnourished to help increase their weight while providing them with the correct nutrition that they should be receiving daily. I tasted it and it was like a reese’s peanut butter cup minus the chocolate, so yeah pretty yummy. For those children who weren’t severe, but still needed more nourishment, the CHWs gave out a fortified flour supplied by USAID that they could make into porridge, just like the demonstration earlier. So all mothers - around 25 ended up showing this morning - were able to receive some sort of food to provide their family for the week. If they wanted more supplements for the next week they would have to return to the next nutrition clinic the following Thursday. This promotes great nutritional behaviors and truly shows how work on the ground can make a difference in the lives of the community.

This experience was so great we came back this past Thursday to help out again. We first implemented our survey this time then came to the clinic to do what we could with the remaining time left. There were almost 30 mothers there, so there were a lot of children running all around. We gave out tons of nutritional packets and plumpy nut to supplement them for the following week. It quickly felt like a blow to the face when we learned that one of the babies that we weighed last Thursday had died this past week. He had come down with something and by the time they brought him to the hospital he could not recover. He was only ten months old. Reality quickly sets in.

A few days ago Beatrice took Lauren and I around the community because she wanted to show us some of the families that she works with. Beatrice sees malnourished children in the pediatric ward in the district hospital to teach them about the proper way of feeding their young children. She will then do follow up visits in their homes to make sure they are continuing the correct feeding practices and help provide them with any additional counseling that they may need regarding these issues. It is an amazing on-the-ground program that she has been doing for over ten years now, and is truly making a difference in the lives of these women and children. Lauren and I accompanied her on her home visits for the morning. She was planning on seeing three places, but it was the second one that truly displayed the hardships that these families face regarding malnourishment and disease. The three of us walked into one hut and greeted the mother and child. The child, who was probably about 5 foot 4 inches, would be lucky to weigh 90 pounds. She was so frail and quiet, only looking up when she was spoken to. After we left Beatrice started telling us how this girl used to be so beautiful and healthy, but she fell ill and no one could figure out what was wrong. They tested her for HIV, malaria, etc, and nothing came back positive so they just sent her home. I have a feeling that they couldn’t pay for the hospital visits and tests so she had to leave. She looked so young because of how tiny she was, but when I asked her age Beatrice said she was 19 years old.19! I couldn’t believe it. Beatrice said that the family isn’t doing anything at this point and that the girl is eating very little even when the food is available. We had to continue on to the next house, but I was left wondering if the next time we made the community visit rounds if we would get to see her again.

Last story for this post. These are the difficult but telling truths of the area, and this is the story that will last with me for a lifetime. Yesterday, after a morning implementing our survey and helping out in the nutrition center, we grabbed some lunch right before going on to the next place to do some more surveys. Lauren and I (Jess was at home not feeling well) started to walk along the sidewalk to meet Steve who was going to show us to a pharmacy in the area. We saw a girl walking in front of us who seemed completely out of it and was only wearing what looked like an apron of some sort. That is all. Her backside was completely bare to the world. Lauren described the scene perfectly when she said she felt like she was in a horror movie and a mentally ill patient just escaped from the ward, walking around in a daze, and at any moment something big was about to occur. The school children who were passing by were pointing and laughing, and it was all we could do to try to tell them to stop and have them go away. Not one adult looked twice and it seemed like we were in a parallel universe where no one else saw this poor girl walking down the sidewalk oblivious to the rest of the world. We decided immediately that we needed to put some clothes on this girl. Lauren went after her to try to stop her and I looked around for a place I could buy some pants. Steve saw me and asked what was going on and I just said I needed pants. Somehow there was a shop ten feet away with pants hanging in the doorway. I pulled the first pair there was and bought them for 350 shillings. This is probably the best $4.50 I’ve ever spent. They looked small, but there was obviously no time to try something on. Lauren had come back by this point saying that she could not communicate with the girl at all and that it seemed like the girl was completely out of it. The three of us got back on the sidewalk and saw that she had traveled quite a distance down. We did not want to run after her and make a bigger spectacle than it already was, so we walked as fast as we could, watching where she was going. I saw her turn left and I was just hoping that she did not get too far. We walked far enough where I saw the dirt road she had gone down. Steve and I caught up to her and he was trying to communicate any way he could. She still would not respond and he even commented that he thought she was mentally ill. Steve and I opened the pants for her to step in and once she realized what we were doing she stepped into them. I zipped and buttoned it up and then folded down the top. I thought the pants were small, but she was even smaller. I was just glad that she had some clothing on her.

We did not know what to do next; still no one batted an eye at her or made any attempt to reach out and help. She looked at us, still without making a sound and continued to walk in the opposite direction. We made the decision that we had to leave. It makes you feel helpless when you know there is nothing more you can do to help. I, at the very least, left knowing that we had given her some part of her dignity back, although she was unaware that it was fleeting, and that she may be somewhat less vulnerable to the dangers that surround her. This is what I have to tell myself, so that I am okay with leaving her there. I hope now that someone kind discovered her and helped her find her way. This is just another reminder that I am working in a slum area and stories like this surround me every day. Sometimes you just wish you had enough pants for them all.

So this is my humble post to put in perspective all of the fun I have also had in Kenya. Just one more week in Kisumu before traveling to Eldoret where I am sure to experience so much more in many different ways. Just hope this post can help make each one of you thankful for everything that you have and the loved ones that surround you every day. :)