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Wednesday, September 24, 2014

Weighin' and feedin' babies in Teyel

Every month, Abdoulaye, my ASC (community health worker) and a few relais (volunteers from the community) weigh babies at the health hut in my village.  During my first four months in Teyel, I missed these weighings.  Either Abdoulaye didn’t tell me, or he tried to, but the language barrier was still too high, or I was out of town.  As I was eating a bean sandwich the morning of the 20th, Abdoulaye sat next to me and asked if I was coming to the health hut because today they were going to weigh babies.  “Tuma fuddi?!” I asked excitedly.  When does it start?  “Boyanni,” he answered.  Not long.  This was not specific enough for my still-not-integrated internal clock.  “Neuf heure? Onze heure?  Apres bottari?” (9:00?  11:00?  After lunch?).  Abdoulaye laughed.  “Boyanni,” he answered.  Not long.  It rarely gets more specific than that here.

I excitedly went home and changed into my best Senegalese dress (the one with the oscillating fan and lion print) while reviewing useful vocabulary and verb conjugations in my head.  I proudly explained to my family where I was going – they seemed as happy about my newfound productivity as I felt - and went to the health hut. 

No one was there.

I sat and waited for about twenty minutes, thankful that I never go anywhere without a book.

No one came.

I heard someone call my name.  “Kadiatou!  Ar!” (Kadiatou!  Come!)  It was Aliou, one of the relais.  I walked up to him. 
A weetori hande!” You are late waking up today!
Alaa.  Mi fini bimbi law. Mino fadi peesugol boobooji.” No.  I woke up early.  I am waiting for the baby weighing.
 “Arga.” Come here.

We walked together to Abdoulaye’s house, where the scale had been set up.  Abdoulaye explained that at the health hut, there was no shade, so they would weigh at his house instead.  I asked if the women in the community knew the weighing would be there instead of the health hut.  He looked confused, then said yes, they knew.  I asked if all the women knew the event would be happening today – after all, I had just found out about 10 minutes before.  He looked confused again, and repeated that yes, the women knew.  Sure enough, the babies started to come, most carried by their older siblings, since the mothers were still busy cooking breakfast, doing laundry, pounding millet, sweeping the compound, and the dozens of other chores they do every day.  I suppose village word of mouth is as good a way to organize an event as any.

We put the babies in the hanging scale
They loved it, clearly
We consulted a dog-eared growth chart to see if the babies were “green” “yellow” or “red,” depending on degree of malnutrition.  When I first got to Teyel four months ago, I had looked through data at the health post and noticed that Teyel had very low rates of malnutrition, and decided that it wasn’t something worth focusing my time on here.  However, I had failed to take seasonal fluctuations into account.  There was indeed very little hunger in Teyel during the period I was looking at, dry season, but right now is hungry season.  Last years’ crops are finished and this years’ aren’t ready yet.  No one has enough to eat.  This is unfortunate for everybody, but no one’s hurt worse than the babies.  Of the dozens of babies we weighed that day and throughout the weekend, eleven were found to be “yellow” – moderately malnourished – though thankfully none were “red.”

I asked Abdoulaye what he would do next with the malnourished kids.  He said that if the kids were “red,” they were referred to the district health post immediately, but if they’re yellow, they’re just monitored over the coming months.  He said that sometimes, WorldVision or USAID sponsors a mass feeding program, but that none were going on currently.  I considered this carefully.  I am extremely opposed to handouts, since I think they foster dependence and feelings of inadequacy in those they are supposed to be “helping.”  On the other hand…these were babies we were talking about.  And they were hungry.  Their little brains were not getting the nutrition they needed to develop properly.  They cannot wait and develop cognitive skills later, when food supplies are better – they are victims of their own biology.  How could I stand by and do nothing? 

I thought about it overnight, and the next day I approached Abdoulaye and Aliou with my plan.  Over the course of the next week or so, I would go to the houses of each “yellow” baby. I would do a small lesson on child nutrition with anyone in the compound at the time – parents, older siblings, grandparents, aunts and uncles.  I would give a small sample of ceremine (a nutritious porridge) to the mother, then show her how to prepare it and watch her as she fed it to her child (to ensure it didn’t end up in the mouth of a bullying older sibling instead.)  I would give the mother the option of purchasing more ceremine from me at a slightly subsidized rate (150 CFA/bag instead of 200 CFA), but she would only get the one free sample.  Best case scenario:  The mother uses her newfound nutrition knowledge to feed her child more balanced meals and the child reaches a healthy weight.  Worst case scenario: the mother’s delighted that she scammed a free meal out of that weird toubab girl, but does not change feeding habits in any way and the child stays malnourished.  Even in the worst case scenario, the baby got one nutritious meal that they otherwise would not have had access to.

Aliou and Abdoulaye were on board with the idea, and Aliou offered to come with me for language help as I conducted the nutrition lessons.  Luckily, Peace Corps promotes an absurdly easy nutrition lesson called “the complet model,” so I was pretty sure I’d be able to get my point across with my still-terrible Pulaar.  
Complet model: Draw a woman in a 3-piece outfit in the sand.  The headscarf is foods that help her skin and hair stay beautiful - fruits and vegetables.  The shirt is foods that give her muscles to pound grain- meat, beans, fish.  The skirt is foods that give her energy to walk - corn, rice, millet.  Just as you need a skirt, shirt, AND headscarf before leaving the house, you also need all three components in a healthy meal.
We’ve gone to four houses so far, and the response has been positive.  All the babies ate their porridge, and one woman bought a bag.  
Baby Adama Hawa (the only kid I've met here with two first names) lovin' some ceremine.
Even if the women don’t buy the ceremine, they are still (hopefully) learning something from the nutrition talk.  After the discussion, I had one woman tell me, alarmed, that her baby had eaten only rice and okra sauce for dinner – “Wutee alaa!” No shirt!  I told her if the baby ate other “shirt” foods from the complet model during the day, it could still have good balanced nutrition.

That's all for this week!  Talk to you all later.