Tuesday, July 19, 2011

Children. (A borrowed post.)

I am shamelessly borrowing this post from Julia's blog. I want to share her poignant thoughts on the children of Anam with all of you. You should definitely check out her blog as well.

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I am continuously struck by the children in Anam: the number of them, their distended abdomens, their curiosity to learn and the lack of opportunity to support their potential.

Everywhere we go, children gather. Partly the children gather because we are a spectacle of foreigners and they are curious. Partly they gather because they seem to roam in packs. One of the first days we arrived in Ebenebe we were on a site tour. There were only two children at the school because the teacher had not come that day, so they joined our walk. Then at one house there were 21 children under the age of 5 and maybe 3 women. I thought that was a lot, until we went on a trip to Iyiora where 70 kids plodded along behind us as we walked from house to house.

The kids are thrilled with the novelty of our presence and they want to be involved in what we are doing. They want to be in photos and ask for a 'snap.' They jump when the camera flashes and celebrate the completion of the photo with squeals of excitement or shy glances from behind older siblings. The older ones carry the younger ones on their backs wrapped in vibrant West African fabrics and knit caps. Their toys consist of old bicycle tires that they push with stick or the newest toy is a version of pushing a stick with two bucket lids attached like a wheel at the end. The latter reminds me of the Fisher Price push popcorn vacuum toys popular when I was a child. They smile and laugh and remind me that the joy children exude is universal and appears to exist independent of life conditions.

When surveying a 24 year old woman, she sat with 6 children, 3 of whom were hers. After the older kids got bored of watching us asking healthcare questions, they ran to a neighboring hut to play. Only her 7 month old was left playing on an empty rice bag next to her. The infant was content chewing on a leaf for a while; then she moved onto handfuls of dirt. After a few fistfuls, her mother picked her up and bounced her on her knee until she breastfed the little girl. After getting her fill and smiling the milk-drunk smiles of contentment, the girl peed her pants while sitting on the edge of her mother's lap. Unable to crawl, she simply sat there unphased by the bodily function. At another house, I met a two year old who was able to eat well with a spoon when he was fed. His abdomen was distended and his hair was beginning to thin and had a reddish hue, indicating kwashiorkor. He was able to stand with support, but he could not walk and he crawled to follow his other siblings until they picked him up to play. It is this kind of scene that devastates and motivates me. What will become of these children's futures? Will they grow up to be strong contributing members of their families? Will they grow up at all? What can we do to make this better?

In Otuocha at the chemist's office, a woman from Ebenebe came to see Juliette after her three week old had been sick for the last week. The woman reported that the baby had suffered with diarrhea and vomiting for the whole week. When the chemist listened with her stethoscope, which was lacking a membrane on the bell, she said, 'There is no heart beat', which explained the stillness and silence of the swaddled child. The worst part was that they simply wrapped the child up again and left.

Who knows why they waited a week? Perhaps they were trying herbal remedies that were not effective. Perhaps they did not understand the risk of dehydration in an infant. Perhaps they could not sacrifice the day in the field to paddle the boat for over an hour to get there. Or perhaps they came on a market day because they had to sell something before they could afford to consider getting medication for this child that was alive for such a brief time.

Unfortunately this is not an isolated situation. The chemist told me that she sees approximately five children per month who have died. Generally they come from Ebenebe or Iyiora where they have no access to health services. Usually they are the poorest in the community. Farmers living in remote areas. And they just don't have the resources they need. She told me that in April, 14 children died because there was a measles outbreak. Since then the health centre made a big push to vaccinate for measles and the numbers hover in the single digits. But the fact is that she is only one of twenty chemists, separate from the health centre, and this does not account any of the traditional doctors from the area. I am working to get an idea of the actual number through the surveys, but what is the impact that this is having on the people?

The hardest part of this experience for me was the matter-of-factness of children dying for completely preventable reasons. How many of these deaths could have been avoided with simple treatments? How many families must suffer the grief of losing a child due to malnutrition or dehydration? This should never have to be a regular part of life.

After this visit to Otuocha, I immediately began to wrestle with questions: Are we doing enough? and Are we doing it fast enough? At the same time, I know for sure that what we are doing will dramatically improve the life and the health of this community. Providing access, providing care for children, providing health education. This will insure a better, healthier future.

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