Skin and Bones
Many times during my life I've been described as "nothing but skin and bones." And, I know at times it was meant as a compliment but also most saying I was too skinny. In fact, our whole family is on the lean side; anyone familiar with Mason knows he is barely able to maintain weight. Yet even at my thinnest, I have never been close to the literal vision of "skin and bones." Since working with malnourished children, I am now quite familiar with the true description of those words.
Three weeks ago, I received a quick turn-over of the Nutrition Program, which was started and has been managed for many years by a Mission Momma & nurse, who has now relocated to Indonesia. I have taken over management of the program during the summer before a new and scheduled director (and I am sure somewhat more prepared than I) takes over in September. Currently, I see the mothers and their malnourished children, once per week on an outpatient basis. Essentially, running a clinic for the day. I assess their weight and general appearance and take a brief history of intake/output and general health from the mother, any illness or fever.
Yesterday, with the help of several members of the Public Health team and my girls, we saw 17 children from the age of 2 months to 2 years. And yes, most of them aptly fit the description "skin and bones." A new child for the program weighed in at 4.5kg at 10 months old. As I placed him on the scale, I could feel every curve and angle of the bottom of his pelvic bones; the weight upon my hands was light but the burden upon my heart quite heavy. Any child accepted into the Nutrition program to receive supplemental formula must fall within 3 standard deviations below the median for height/weight according to a WHO table. It was obvious upon first glance that he would indeed fall well below the 3rd. Thankfully, the mother breastfeeds and combined with education classes, nutritional supplements and a round of meds to treat malaria and worms, he has a good chance of recovery. Additionally, he received vitamin A and a B12 shot. I sent him to the pediatric ward to receive his injection because after 12 years of motherhood and away from nursing, I wasn't about to jump back in with an IM injection for a child without muscle tissue.
The morning wasn't entirely discouraging, there are 3 children who are very close to goal weight and will very soon graduate from the program. Even more encouraging, 4 mother's walked over 20km to attend classes and receive formula. In a culture where the life of infants and young children is not highly valued but seen as more transient, finding mothers committed to their child's health is uplifting. The care for these kiddos is definitely a roller coaster of emotions. The gravity of malnutrition is a tough sight yet I still spent much of the morning laughing and the mom's too. Mostly at my attempts in learning the language, they love me trying to roll these foreign sounds over my tongue. A good laugh is also had when I mix up moms and kids, they are all still new to me. And of course, it is always comical trying to express wit across cultural and language barriers.
Our time here has been short but our experiences thus far have been extraordinary. We have quickly learned willing hands can do much more work than you may expect, even smaller ones like my girl's who have been side by side with me as we learn to serve the women and children here. Overall, despite the difficult circumstances we see, it is very rewarding.
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