A few months ago I was sitting in a hot tent, sweat literally dripping from my face. It was 50 degrees Celsius and I had given up catching the drops on my sleeve and was constantly looking for my next glass of water. If someone told me that soon I would be wishing I’d brought more warm clothes, I would not have believed them. Now I sit in the same tent wearing all my extra layers. I am still cold, so what hope does a malnourished child, living in a tent at home, have to keep warm?
It is getting colder by the day. With the change in weather comes a new set of challenges and a new type of patient. Whereas before we would struggle to keep the wards and the patients cool, now we battle to keep them warm. Cold water and fans have given way to heaters and blankets. The conditions have brought people into closer proximity with each other and the illnesses that follow are upon us.
Every day we admit a new pneumonia patient and every day a child is on oxygen. Diarrhoea cases are increasing, which leads to children dehydrating. Sometimes the issues from months past seem to be both polar opposite and also closely linked.
When these children arrive they feel cold — you can see every rib and they have no energy. They are taken in by a nurse and given nutrition and medical care. Their families don’t have much hope. A few days later, I see a child again wrapped in blankets or being nursed by its mother. All that can be seen in the face is deep, sunken eyes and prominent cheekbones, but now they are taking food, and a smile as they swallow tells me that they are starting to enjoy it again. A little hope has crept back in. It’s still touch-and-go and until the child’s strength has returned and they are at a healthy weight again.
The environment is so harsh: both hot and cold. The crops and the people are fighting both extremes. Yet new life is always present. The children call to me, “Hello, how are you?” as I walk to the clinic. I answer and they run away giggling.
With the arrival of powdered milk formulas and a heavy workload on the mothers, breastfeeding often gets overlooked and this often leads to many other problems in their children. Most of the malnourished children I see aren’t breastfed and haven’t been for some time. One of the proudest moments for me over here is after days, or even weeks, of training, teaching and prompting, seeing a mother realise that she is able to supply her infant with all the nutrition they need from exclusive breastfeeding.
This has follow-on effects, not only for the child she is currently nursing but for her future children, and hopefully she can pass this knowledge on to her children too. Through our education programs it’s nice to think that once we have left, we will leave something behind that these mothers can use wherever they are.