I didn’t think it really existed until now. People talked about the rainy season, dry season, harvesting season, sowing season, even the rat season (which I’ve become all too familiar with), and then there’s the death season. And it’s strange to think how it’s just a natural part of the life cycle and how well people react to it.
I attended my first funeral in Malawi just last week. It was the child of my youth club’s treasurer. He was only 2 years old. And it was so surreal to think that I had touched the child one day and even prayed for him. 24 hours later, he was dead. The funeral was somber as any other funeral would be. The most heart-breaking part was seeing and hearing my friend cry, “My child! My child!” (I had to really refrain from crying with him for fear of bringing attention upon myself.) I saw him 48 hours later laughing as he always was, though I could see the sadness in his eyes. He couldn’t even bear to look while I picked up a 2-year-old child. How do you comfort someone after he lost his only child? How do you make him laugh knowing that there’s an emptiness within him?
My youth club’s secretary lost his father to a car accident and his uncle to some illness all within two weeks.
This death season is unfortunately caused by the breeding of mosquitoes that come with the rainy season. Sadly, it’s the number one (and easily preventable) killer for under-five children. At our health center, there were only 52 cases of under-five children with malaria in October (pre-rainy season), and within just 3 weeks in January, there were 209 cases of under-five children with malaria – the aforementioned child being one of them. My friend told me that the child was given 4 types of medication, none of which worked. I guess it was too late, and he passed. When you’ve entered the advanced stage of malaria, you start to convulse uncontrollably, which can result in brain damage if not treated ahead of time.
If you’re worried about me, you shouldn’t – I’m taking my anti-malarial pills weekly (though they come with nightmares, nausea, hallucinations, among other things). I probably had, have, or will have malaria, but the medicine is already in my house if I ever need it, and my anti-malaria pills are doing their duties to repressing the poison from being inserted into my blood.
But what about the other people who can’t afford to go to a private health clinic? Or to buy medication? What if the hospitals run out of medication? (Thank God for the U.S. Presidential Malaria Initiative, because they have distributed free medication to all health centers – public or private – for at least three months.) I can see the fear in people’s eyes, as people are frantically asking me and the health workers for mosquito nets. We had just done an assessment of the 92 villages in my catchment area (total population of about 39,000) and discovered that only 25% of children under five are using mosquito nets. So that puts the 75% of children at an increased risk of contracting malaria, which without being treated, can result in death. Currently, they’re only given out to antenatal mothers and new-born infants receiving their BCG immunizations, or with money, they can be bought in town. Previously, they were given out to all under-five children and were even sold in the villages for really cheap, but they were stopped for various reasons – one of which being that fishermen were using them as fishing nets. But now I’m frustrated and can understand the mothers’ fears. If malaria can easily be prevented by simply sleeping in a mosquito net (mosquitoes attack viciously at night), then why not just distribute them? There are times when I feel so helpless when I know that simple solutions are readily available to address an issue – and this is one of those times.
But on a lighter note (are my entries always this depressing? Sorry!), an aspect that I’ve been working hard on is addressing malnutrition. Since this is the sowing season, that means there isn’t any food in the fields, so a lot of children are malnourished. I was becoming so concerned when I saw them coming and leaving without anything being done. The World Food Program (in partnership with UNICEF or Action Against Hunger or some other NGO) used to provide supplementary food but they have withdrawn that program to only be used for those who are admitted to the nutrition rehabilitation unit or out patient department (usually the severely malnourished ones). So, now children come, are weighed, and leave without any record or monitoring of the underweight children. The most frustrating part for me was watching the health workers record their weights and not say a thing to them. I had to inquire about it a few times, but when I realized that they either didn’t care enough or didn’t know what to say or do, I had to take it upon myself to do something.
I’ve currently started a book to diagnose and monitor the underweight children’s weight and nutrition statuses. I’m also recruiting about half of the health workers with good counseling skills, so I can train them about nutrition, counseling, and food preparation. But because the mothers can only come for a short period of time and contact with the mothers is infrequent, I wanted to make the program as effective as possible in the short amount of time given. I’ve discovered that most people like to lecture and listen to themselves talk, so I realized that counseling is an important skill in order to make an education effective. At the same time, interactive activities benefit the mothers by allowing them to learn for themselves.
However, 20 minutes would not suffice for mothers to learn behavior change. So, another program I’m interested in implementing is the Positive Deviance Hearth. The main idea behind it is using mothers with healthy children as role models for mothers with malnourished children. After assessing the “positive deviance” behaviors that mothers use and the local resources they use, the 12-day program is implemented through the mothers sharing their knowledge and skills while learning that they can use what they already have to nourish their children. People often think that you have to feed them soda and other junk food in order to nourish their children (what do you think causes obesity in America?), and so they often resort into the “Woe is me, because I don’t have money” mentality. It’s amazing how a little education about nutrition can change one’s perspective. (I also realized how little I knew about nutrition before coming here; that was how much I took it for granted or how little I cared for it. Fortunately, my mother always prepared healthy food and subsequently taught me.)
I’m hoping that the monitoring book I’ve developed will help me to pinpoint the villages with higher malnutrition rates, as well as the types of illnesses or other causes that are major contributing factors to malnutrition. From there on, I hope to develop a malnutrition clinic once a month (already in place at other health centers) or another nutrition program.
But on an even lighter (and more amusing I promise!) note… about the Rat Season. I guess a certain little rat decided it would make his little home underneath my bed before I had moved into the house. I was hemming and hawing about getting a cat or using a trap (because I would have to inevitably touch the rat!), but I figured it was more cumbersome to lock up all my food away, stare angrily at my chewed-up plastic bottles, clean up after its droppings, and listen to the scrapings. Last month, I (as well as a few others) even saw the rat (or was it a mouse?) run around my house! I thought enough is enough! So, I asked my trustworthy agogo (“grandmother”) to set a trap and kill it while I was gone for New Year’s. I came home; the rat was dead! Hallelujah!! She said it was fat. Why wouldn’t it be? It was chewing up my plastics! Then, she served it to the crows. Serves it right for invading my home! (Sorry, I’m not usually that cruel. haha)
Yes, I know that “Ratatouille” came out recently. My mom kept telling me that I should watch it; my brother told me she watched it twice and demanded him to send me a copy of the movie. I thought, why?! I hate rats! So you may find it amusing to read about my rat problems and hear about how awesome and amazing Remy – a rat – is. I watched it and I had to laugh; I don’t think my rat was planning on becoming a world famous chef. But I think some other chefs may have been planning on using him, though. (My neighbor wanted to eat him, but the wife refused.) There was a bonus feature about rats’ rights and I had to think, wow. I almost wanted to start justifying that they didn’t have rights! According to Remy (the main character) or was it Emile?, all the rats wanted were “garbage to eat”. And I thought, well, Malawi is so poor; there’s no food to eat, much less garbage to spare; and I don’t want to risk being bitten by a rat (several people have told me about rats being so hungry that they’ve bitten people’s feet in the villages). O.K., maybe I’m taking the movie too seriously! haha But seriously, though, I couldn’t stand having it in my house any longer. So, I’m rejoicing that my house is now rat-free (for awhile at least)! I’m still waiting to get a cat, but I didn’t realize how difficult it would be to get a kitten. If it’s that difficult, I might end up getting a ferret, because better yet, they eat rats. But I heard they’re naughty and sly. We’ll see. :)
