Monday, May 17, 2010
Our little guy, Aidan has now passed the 6 month mark of life! He has now spent more days in Africa than in America. At a shop that sells cold sodas (a real treat!) in Bundibugyo Town, a gregarious Ugandan remarked that Aidan should have dual citizenship. Not sure that it is possible, but it does make me wonder how his early days, months, years spent here will mark his life.
Which brings me to think about babies, children, and survival here.
From what I understand, when a woman gives birth, a customary greeting is “Webele Kwejuna” or “Thank you for surviving.” In this rural area of Uganda, it is documented that the death rate for infants is 33% and the under 5 child mortality rate is 1/5 children. The Myrhes suggest that this is an underestimation, that perhaps it is more like 2/5 children die here before they reach the age of 5.
Many of the children that come to the health center come due to critical malnourishment. Travis has remarked that there may be an infant that is thriving in the same bed with a sibling a year older that is malnourished. It is not uncommon for a woman to become pregnant while she still has a young infant, so when she delivers (or as they say “produces”) the baby, the older infant no longer gets the good nutrition from the breastmilk and thus, becomes malnourished. Our 6 month Aidan rivals in size many of these malnourished two year olds.
And that is what motivates the BundiNutrition team here.
This team of WHM missionaries and Ugandan workers address malnutrition in three ways. First, they treat severe malnutrition. This is when a child weighs less than 25% of the minimal weight he or she should. For example, a typical six month old child should weigh between 14-16 pounds. This means a severely malnourished six month old weighs less than 9 pounds. Too often, eight to twelve month olds here weigh less than 8 pounds. In the health center now, there are several two year olds that weigh less than 12 pounds. There is an eight year old that weighs 24 pounds. These little ones that are severely malnourished are admitted into the health center, given a high protein formula, weighed daily, and when they are able to eat solid foods, they are given eggs and beans. They are kept on this diet and under supervision until they reach their target minimal weight to survive. This usually takes about a month.
The second stage in addressing malnutrition is to enroll them in an outpatient program where they come twice a month to be weighed, assessed, and receive a locally-made ground-nut/meringa paste and soy flour. This is a ten-week program.
The third effort is the Demonstration Garden Education and Matiti Goat Project. The Demonstration Garden introduces ways to grow nutritious, high-yielding foods. Most people in Bundibugyo have a garden, so it is a great way to encourage them to use their rich land to produce something more than the poorly-nutritious, high-carbohydrate roots that are typically grown and eaten. Included in this effort is the chicken project, a favorite of mine, which I will go into more depth on a different day. Nonetheless, the goal is to have an egg per child per day.
The Matiti Goat Project is the blood, sweat and tears of so many people over years. And lives have been rescued as a result. The Matiti Goat Program's goal is to give families that have children who struggle with malnutrition a constant source of protein through goat milk. These children include those who have been in the severe malnutrition program as well as orphans and those whose mother is HIV positive. During the last goat distribution, I was moved by the story of one particular mother. This young woman had birthed and buried her first two babies. She was then enrolled in the Kwejuna Project and started on antiretroviral drugs. She was able to deliver her third baby, this time, a HIV negative one. The child is surviving. By giving this little one goat's milk, it now has a future and the mother has hope. To see this mother with a living, breathing baby on her back and a rope in her hand tied to a high yielding milk goat is one thing that gives us "staying power" in this hard place where survival is not the norm.
So, today, I say "Happy (6 month) Birthday" to my little Aidan and to all of the other little ones who are praying just to survive. And I applaud all of those in BundiNutrition who are daily fighting malnutrition to make another birthday possible for the children of Bundibugyo, Uganda.
Monday, May 10, 2010
While talking with a new friend this past week, he thanked me for spending time with the people. He said that we, our little family, have done well on three fronts; we have come, we take time to talk with people when we greet and we have even reached a couple of funerals. He said the people have really appreciated this.
Funerals, I guess I expected them to be a part of our life here, as any doctor would, but I did not expect them to be such a constant and integral part of the culture here. Life surrounds funerals. At least once a week we will hear wailing and music through the night as family and friends mourn the lost of a loved one and seek to please the ancestors and recently deceased from haunting them or taking someone else. Once or twice a week, we have friends and random people knock on our door asking for a contribution for a family that has lost someone. In a real way, the death becomes a provision of money and a forgiveness of dept for those who remain. It is also a time of bonding and friendship. When someone dies, friends go and “sit” with the family for three to four days to show friendship and support. As Scott Myhre told me, if we want to love the living, we must spend time amongst the dead.
Sadly, we lost two long-time friends to the mission this past month. It is sad when any one dies. It is sad and painful when two responsible, grace-filled hopes of the community are taken away. Frustratingly, both deaths died because of a delay to surgery. The delay was caused by the lack of an x-ray machine, which delayed diagnosis of abdominal perforations, and the lack of hospital staff, which delayed time to the corrective surgery.
The first friend we lost this month was an elder of the church, one of the first friends of the mission and a helper to many. He was well loved and his testimony reached many families here. He often led worship and faithfully sat on the front left of the Church. Many former missionaries emailed us sad letters to be passed to the family.
The other friend was one of the youth, practically a family member of the missionaries. He was 33, had a wife and 2 children. When people spoke of him, they would say, “Oh, he was the responsible one.” He really is a Joseph story. Being sponsored by several of the missionaries to go to school, he studied hard and qualified to go to teaching school. When he got a job teaching, the family became jealous of his income (even though it was minuscule) and denied him his portion of the family land and crops. He faithfully trusted the Lord, saved money (a very counter-cultural practice here), and bought a small plot to farm and provide for his family. The uncles, seeing his resourcefulness and realizing all the other men in the family were addicted to alcohol, came to him, and requested that he come back and manage the family farm as well. He was a leader of the young generation of men here and a great role model for the children he taught at Bundamalinga Primary School.
Per the current missionaries here, the funeral for both of these men were unusually well attended. The time was filled with paradoxical praise for the promise of the gospel and wailing grief for the loss of greatly loved men. As dirt was shoveled on to the grave, the people sang, “Even in the grave, Jesus is the King.” This thought struck me as something I had not thought about. I often think of Him as Lord of the Living, a provider for our needs on earth, a giver of grace and an extender of mercy. I also think of Him as Lord of Heaven, as we live in the life eternal. But the grave- the grave is a necessary evil. It is something as a doctor I try to prevent everyday. But it is not seen this way here. It is a part of life. Even in death, life is provided for here on earth. As the last dirt is pushed into the ground, a tree is planted as a marker of the grave. New life will spring. For the family, this also gives a fresh start. Money is given, land is redistributed, and debts are forgiven.
This is not so unbiblical. Jesus stated that unless a grain falls to the earth and dies, no new life can come. In His death, Christ brought us life and forgiveness. Jesus came to redeem our lives. He has also redeems our death. It does not have to be the end of a meaningless existence or even a forever good-bye. The death itself can bring meaning and life with the hope of another reunion. Jesus blessed those who mourn and promised to comfort us. We can cry now because we will rejoice later. Otherwise, the grief would be too great and death to calloused. Even in the grave, He is the king.