Hamada-Gaza is at the same time hopeless and resilient. It never ceases to amaze me that people in difficult circumstances don’t, at some point, just decide to roll over and die. After seven hours on difficult roads, across bridges that required everyone to get out of the truck, inspect the bridge and then re-load on the other side, we started work on Thursday. The purpose of our trip was to do a survey of the health of children from 0-5 years. Rather than go door to door, the hospital health team sets-up under a mango tree and people start lining up to have their children weighed, measured, poked and prodded. Our team consisted of me, the food security specialist, two nurses, a midwife and a doctor. For each child that we saw, we asked a series of questions that were recorded and will, eventually, be entered in a report.
On the first day, my job was to ask the questions, while Clarisse weighed each child and measured their height and arm circumference. I used all the language skills I have, pulling out my Sango, French and the few words I know in Gbaya and Fulfulde. Even then, hearing people’s names and recording them is a talent I am still working on. Clarisse gave several lessons on health and nutrition, specifically focusing on the foods that are appropriate for infants and children. It is common here to find mothers starting children on solid food and water as early as two months, while the recommendation is not to start until 6 months. Breast milk is best! Giving water too early also results in the early introduction of worms and parasites which quickly leads to malnutrition.
I was shocked not so much at the state of health of the children we were seeing the first morning, but at the answers to the survey questions. In particular, I was asking each woman how many children she had. It was common to hear 8, 9, 10, 11, up to 14. But when I asked them how many of the children were still living, the answers were shocking. A woman who gave birth to 14 children had 9 living. Five of her children had died, all at various ages from one sickness or another. No one could give you details, it was just a fact of life. As I asked the name of the child we were weighing, many women didn’t know their child’s proper name, as though they had too many names to remember or the name itself had no significance. Even worse was knowing how old their children were. Very few women could give an accurate age of their child. One woman had no idea how old her children were, except to know that her first child was around five. She had four children under the age of five and the oldest two were both very malnourished. I asked her if the four kids were really four kids that she had given birth to (as it is common to raise other people’s children) and she replied, “Yes. A woman’s work is to give birth”. I wanted to cry for her. Her husband had left her and she believed that the only thing she was good for was having babies.
On Friday a grandmother came with a 10 day old baby, born premature and weighing 1.9kg. We had to resuscitate the baby 5 times before the Doctor finally gave up and she died in the early hours of the morning. I think the baby girl was the first child I have seen die right in front of me and it was a tragic and emotional experience. What was worse is that they had this baby at home for several days before bringing her to the health clinic, where the government ‘nurse’ on duty proceeded to give this tiny baby girl everything from quinine (for malaria), several antibiotics and diazepam, all within a 24 hour period. Before coming to the government health clinic the family had tried various forms of traditional medicine, and, as a last resort, brought the child to the Baptist health clinic. By then it was too late and it made me so angry to know that this baby suffered so much at the hands of ignorant people. With only ten percent of children attending a school that barely works, there is little hope for the future.
There are many different food taboos that have been passed down generations in the region that make it a very difficult place nutritionally as well. Children are not supposed to eat papayas or bananas, as it is said to give them worms. They shouldn’t eat eggs, fresh meat (only meat that has been dried over a fire) or fish (the smell of fish is what makes kids limbs swell, supposedly). The end result of these taboos is children ending up with kwashiorkor, a form of malnutrition resulting from a lack of protein where the belly and limbs are severely swollen. Pregnant women are also subject to many of the same taboos resulting in low birth weights and generally unhealthy children. I am convinced that a bunch of men got together, decided on what was the best tasting food in the village and then made up a bunch of rules that made sure they were always the ones to get to eat them. With this sort of ignorance, what will it take to save the next generation? Certainly it will take more than a few visits from a village health team.
