Pendu has two small children...a two year old and 2 WEEK old. This is the baby that the day earlier we had been told was 2 months old! Perhaps this is the most frustrating part of not being able to speak the local language...the inadequacies of communication, particularly when it comes to the health of someone. When Pendu arrived, I was still under the understanding that the baby was 2 months old, which was very disturbing considering the baby was only about 5 1/2 pounds and had clear evidence of malnutrition. We also discovered that the whole family was positive for Malaria. I worked with Pendu and a translator for close to an hour, going over the importance of breastfeeding her baby every 3 hours to keep her milk supply going, but also teaching her how to mix some formula for after she breastfeeds, to help the baby grow stronger. The reality is this Mom did not have enough breast milk because she wasn't feeding frequently enough, so until the milk supply increased, the formula would supplement. It's nerve wracking teaching someone how to mix formula when you know they don't have clean water and when your communication is going through a translator (formula, if mixed wrong can cause serious damage to a baby). I talked about the need to boil water first and marked measurements on the cup and syringe very clearly with black marker. We also involved her Mother in on the teaching. As Matari pointed out, it seemed that Pendu herself had a hard time grasping the teaching...I don't know whether she was just overwhelmed or whether there was a learning deficit there. So, it was at the end of all this time of teaching that it became clear (through the grandmother) that in fact the baby was only 2 weeks old! I confess I felt tremendous relief in the sense that he was healthier than I thought at that weight for 2 weeks old contrary to 2 months old, but he was still under weight and malnourished so at least we had some intervention!
I also spent a very brief part of the day, instructing Valena, the head Midwife at the Urafiki Health Centre, on how to use the neonatal resuscitation bag that we had brought for the Clinic. Dr. Mukulla was also there and there was a certain reassurance for me that he has used an ambu-bag previously and will be able to continue teaching the health team at Urafiki. I'll be honest, it was difficult not to have more time to do this training with the group at large, but the reality is, you have to do what you can do and beyond that...there is no more control. The clinic was so busy that they just couldn't spare the time or people for the training.
While we had consistently run out of certain medications, there were other medications that we had much left over of. This is good in that the medications will be used by Urafiki. The tricky part though is that some North American medications are different than what they are used to, so part of the team spent time organizing the meds and preparing teaching sheets for the staff, as well as, reviewing with Dr. Mukulla all of the meds that were there. He was a busy man.
I would be lying if I didn't say that at this point in the trip, we were exhausted. It was hard to leave Urafiki but at the same time, there is a reality that one becomes weary and spent and the thought of returning home feels wonderful...especially for those with children and husbands at home! I take my hat off to my teammates who left their families behind for these two weeks. The intensity of our days dealing with 100's of patients and swimming our way through the language and cultural differences was a great challenge...one I look forward to doing again, but at this point, I felt it's wearing on me.
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