Friday, June 17, 2016

Village Healing

Since Jess’s focus is malnutrition and that is really a problem in the villages, we asked around the hospital earlier in the week and found the people who go out to the villages to check on the children and administer vaccines. They’re called Health Surveillance Assistants (HSAs) and we met one named Pearson who invited us to come to an outreach clinic. So Wednesday morning Felix picked us up and brought us to meet Pearson at Songani Market, which is a market on either side of the road that leads to Domasi. When we got there, Pearson asked if Felix could drive all of us to the village to save time so Penny hopped in the back and we all bounced along to the village, Mkwera.


When we got there it looked like most of the villages I’ve seen- really dusty, out in the bushes and trees, with small cement or brick homes with tin or thatched roof scattered around, none very close to each other. There was one small cement building with a sort of porch which is where we stopped. While all the mothers were assembling, Pearson and another HSA that met us there named Ackim, filled us in.

The Mkwera outreach clinic services 6 villages: Mkwera, Misi, Masapi, Musula, Myam, and Kapile. Pearson is in charge of the first 4 and Ackim the last 2. The tribal language of these villages is Yao, so most of the children didn’t speak English or Chichewa, as they weren’t far enough along in school, or in some cases in school at all. Speaking of which, 8 and 9 year olds were quickly assembling to watch us. Here, being white seems to intrigue all children, so they gather around and slowly inch closer and closer to us in a big group any time we are around lots of them. One of the moms grabbed a stick and waved it at them so they’d disperse. Then it was their turn to entertain us. All the boys started giving each other piggy back rides and then waving at us, until I waved back at which point they’d all collapse laughing. Then they started doing what looked like action movie karate.

Also Ackim taught us how to say good morning in Yao, “Ajimachi uli” but whenever I said it to a kid they smiled bashfully and ran away. Points for trying though. Oh also Pearson had an Engish quirk common in Malawi, but it made Jess crack up which is why I remembered to include it in the blog. He said “okay fine” a lot, which in the U.S. would indicate mild displeasure, no one really says fine unless things are really medium or they’re a little mad. But Malawians say “okayfine” as all one word and as frequently as someone would say “okay” or “yeah” when they’re listening to someone talk. Jess is right it’s pretty funny.”

At the clinic, soon the walls of the porch were lined with mothers with babies and toddlers. The big kids stayed to watch outside the porch. While we and the HSAs were still waiting for another guy to show up to help, one of the moms (who I later found out was the Mkwera mom-health leader type of person) stood up and started clapping. She led all the moms in a song they all knew, and the HSAs obviously knew it too because they were clapping and singing along. It was in Chichewa but I heard “bwanji” in it and found out that it was a song to welcome us! It was so nice. Then they kept singing more songs and Ackim even led one and I found out those were lessons in song form about different principles of health. For example, one song that Ackim led, he started dancing where he lifted up one leg and patted his um gentleman’s area. Pearson told us the song said “if you have too many partners you’ll catch diseases that hurt your genitals.” Straight to the point. Then they asked if we wanted to say anything and Penny spoke a bit with Ackim’s translation and then Jess did too, while holding a chubby baby.


Then the clinic started. Penny helped weigh the babies with Ackim, using a hanging scale we tied up with some rope like you use to weigh veggies at a store. Moms would just hang their baby in a chitenji on the scale. Penny would plot it in a little chart in the child’s health passport. Oh here everyone’s health records are in a little booklet called their health passport.

Then the moms brought them to me and I took their MUAC. This was really awesome because I’ve research MUAC statistics and measurement all year for my device and then there I was actually in a village doing the work. I had to use the band to measure from their shoulder to elbow, and then take the circumference measurement of the halfway point. Then I wrote it in the health passport. Most of the village’s babies were really well fed which was great but also surprising, since the harvest was so terrible this year. I made some of them cry, and Pearson said they’ve probably just never seen a white person before. It hurts when your face makes a baby cry.

All the babies were classified as well nourished by their MUAC until the last baby. That mother came in late and before I took her daughter’s MUAC I could tell she was way too thin. It was 115 mm, the dividing line between moderate and severe malnourishment. I notified Pearson and he talked to the mom about brining in the baby for evaluation and supplementary feeding.

All the while Pearson had been administering vaccines to children and mothers. He looked at their passport and Jess reported what they were missing and he’d give them the injection. He was also giving mothers depo, an injected birth control. Family planning is one of the main things taught at the outreach clinics, because many village women don’t know contraception exists otherwise, and will just keep having babies without necessarily having the means to feed them. It also makes the women more vulnerable to health problems if they’re constantly getting pregnant. They like depo because most men don’t trust the idea of birth control, so they would be angry if they caught their wife taking the pill every day or something. Depo just requires an injection every 3 weeks.

After the clinic I tried to communicate some more with the older kids, but they couldn’t stop laughing at me so I gave up and tried pictures. They liked them, and see phones even less than the other kids I’ve met so they thought it was pretty cool.


Then we walked on a beautiful path back to Songani market, and Ackim and I talked about names. He asked if Penny was Penny’s birth name, and I explained nicknames. He said that my name is terrible for Malawians and said I should just introduce myself as Maureen because that was as close as anyone was going to get. Maybe I’ll try that in the future.

Felix met us there and drove us to Domasi where he dropped off me and Jess. We had a coke at MIE and reviewed our finances before she went to find a spot to write notes and I went to the Government school to help Dr. Pat and Sandra (Pat’s sister) with the pads again. The T&L girls had to paint at Melemia that day so they weren’t around to help Pat. She was really grateful I could come which made me really happy, she’s the best. She insists the standard 7 girls like when us young American girls are around to help, but they really just laugh at me all the time so I question how true that is.

That day at the petal pads assembly line things were the same, but all the girls finished so our job was to find out when they were finished and give them extras to make sure they each had 12 little pad inserts. They were really fast sewers so that was impressive to see. After they were all done we collected all the needles on magnets that were very fun for everyone to play with, and then we had the head teacher Gertrude translate some words of thanks for us, and all the girls told us they were grateful which is really nice. They have so much attitude and laughter and spunk, it’s hard to imagine how helpless it must feel to be inhibited from going to school because of something as natural as your monthly cycle. I hoped that these things we made with them would really help them; you never know if aid like that is going to stick or not.

Pat bought me and Sandra each a coke and we got to talk for about an hour. That was awesome because Pat is a very very smart and determined lady, and I haven’t gotten a chance to really talk with her yet since she’s mostly involved in education. She told me all kinds of things I didn’t know about Malawi, because only someone who knows it as well as her (she’s been 33 times) won’t walk on eggshells about how bad it can be. Here are some facts she said:
  •       There’s a severe patriarchy, even in schools, where the girls do all the school cleaning and the boys do nothing
  • -       When children address their parents at home, they kneel on the floor
  • -       Wealthy Malawians are always overweight because they stop walking anywhere, because walking is such a sign of the working (or lower) class here
  • -       One of the reasons access to water is such a problem is that it’s the women who walk to the water source to fetch it for the home, and if it’s too far their likelihood of being raped on the journey goes way up
  • -       I’ve observed some bullying at the primary schools, and at Melemia it’s because the kids who are descendants of this one powerful village chief are regarded as divinely in charge basically


So that was all really interesting and some of it quite sad. After we finished our cokes we went to the bus where we met Jess, and then picked up the T&L girls at Melemia and headed home. On the way we stopped at the market that Jess Penny and I visited over the weekend. Sammy gave us a fast-paced walking tour through the whole things so I’m sure we looked like a bunch of white ducklings all in a line. We also stopped at the fabric store one last time before getting back on the bus and going to the lodge.

We all had dinner at Annie’s again and discussed some wrap-up things like gifts for Sammy and the lodge staff. That was bittersweet, because it’s exciting to think of all the fun things coming up like Cape Maclear and seeing home again, but it feels a lot like we live at Annie’s now so it’s hard to imagine it just going on without us.

That night I worked on the med school application some more and talked to mom and dad on the phone and didn’t even cry that time. Also the dogs howled some more.


With love and the ridicule of 7th graders,
Lauren

I am grateful for…
Bananas
My little bed
One-Ear Scotty and the Cat Gang
What will I do to make today great?
Help sew some petal pads
Write in the blog
Spend 0 kwachas
Daily affirmations. I am…
Thrifty…now
3 Amazing things that happened today…
Singing and taking MUACs at the outreach clinic
Helping with petal pads and talking to Dr. Pat and Sandra
Writing a whole new personal statement
How could I have made today even better?

Interacting with the kids more

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