My week

So, not a lot of time to write. I'm on borrowed time in the office on a Sunday, while Milo naps.

Just a newsy post today. It was a full week. From Tuesday to Friday I was out in Mchinji, commuting as I mentioned I might do. It was a lot of time spent in a car, but I read two books in 4 days!

The district was starting a new malnutrition treatment program. Basically, they were setting up a special clinic day where they would screen children for malnutrition by weighing them, measuring their height, measuring their mid-upper arm circumference (a reliable measure of thinness) and checking for oedema, which is a common sign of malnutrition here. Then we identify the children who are very sick and need to be admitted as inpatients right away. The rest are given a therapeutic food that they take with them, to eat at home. The children come back once a week for a check-up and more therapeutic food.

Sounds simple. When you've got 100-200 children to weigh, a lot of tired mothers trying to jump the line, babies screaming...it's a bit intense.

It's been a long time since I spent a significant amount of time out at the health centers. When I worked in Darfur I was in the field about 3-4 days a week, and really got to know the mothers and babies. I miss that sometimes. Now I do a lot more policy-level work.

I enjoy working with the the health staff the most, and it's very gratifying to identify a serious case and get them treated right away. You feel like, just maybe, you helped a kid that was going to die otherwise.

But the hard part is that you always lose some. I always look for the serious cases first, and follow them up to make sure they are getting good care. On Tuesday, there was a 1-month-old baby at the hospital. His head looked like a tiny skeleton with skin stretched over it. He went straight to see the doctor on the ward, but didn't live to the end of the day.

Wednesday there was another - this one 5 months old and stick thin. I worked with the health staff to make sure that they gave the right treatment, and helped the mother to continue breastfeeding.

On Thursday we found a child who had just been sent home from the pediatric ward, but was still so wasted and sick, that we decided to take him back to the hospital. He and his mother rode in the car with me, and I couldn't stop checking to make sure he was still alive. He was so weak that his cries were just plaintive mews. He was so tiny in comparison to Milo, even though they were about the same age.

On Friday, around the time I was making sure that another serious case would get ambulance transport back to the hospital, I learned that Thursday's baby had died in the night, of pneumonia complicated by malnutrition.

It's hard knowing that I do all this work, helping the government to train health staff and raise community awareness, and still babies die of such preventable causes. I came home on Friday just feeling sad and defeated, unable to shake the image of that terrified, exhausted little boy, his tiny little lips and two miniature teeth poking out...I can only hope that the other two babies are still alive, and that through some miracle that make it to their 5th birthday. It was just such a reminder of how different the lives of Malawian children are from my own little boy's.

Ah, this post took a turn I didn't really see at the beginning, and I don't think I will write about all the other things that happened this week. That's enough for now, I think.