Friday, August 21, 2009

The Bulumwaki Baby

One month ago, an older woman in Bulumwaki Village showed up to a family planning sensitization, holding in her arms a baby malnourished almost to the point of death. It was impossible to tell how old the child was – his head seemed far too large for his body, which was about the size of a 3 month old, and his skin was light and tinged yellow, sucked in against his bones like thin, dry paper. His eyes were huge and glassy, appearing to see nothing, and his head lolled loosely on his neck.

The woman holding the child was its auntie – the mother had died in childbirth, about one year ago. ‘What are you feeding the baby,’ the team asked the auntie. Mostly water, she replied. She was poor, and a migrant to the village with no family around and too many mouths to feed already. She could not afford to buy milk for the baby, or anything else more nutritious than occasional, watery maize porridge.

The team was shocked, and the Ugandan women from SoftPower (the NGO conducting the family planning sensitization), said they had never seen such a malnourished child in all their lives. They promised to bring a high-calorie milk mixture for the child to their next Healthy Village outreach in Walukuba.

The next week Julius Ntalo – the Ugandan volunteer in the Bulumwaki summer volunteer team, though now UVP staff – came to Walukuba Village to fetch the milk mixture from the SoftPower staff. It was a thick mixture of powered milk, oil and sugar, to be mixed with boiled water and fed to the baby a few times a day. The Bulumwaki team gave the mixture to the baby’s auntie, along with directions, and also gave her money for transport to the Iganga Hospital, as it really appeared that the baby needed more care than simple feeding.

The auntie – grateful almost to the point of tears – began feeding the child on the milk mixture, and also took it to Iganga Hospital a couple weeks later. Upon arrival, however, there was no doctor to be seen. The auntie stayed at the hospital for four days (not uncommon at Ugandan hospitals), and at the end of this time the doctor came by just once, and looked at the baby for five minutes. ‘There is something wrong with its neck,’ the doctor said. ‘And it is malnourished.’ He gave the auntie a packet of milk mixture and told her to come back the next week for somebody else to look at the baby’s neck.

Of course, the woman had no money to return to the hospital. Two weeks later, after the Bulumwaki volunteer team had left, Julius and I went to check up on the baby. The auntie brought him out proudly, pinching skin off his frail little ribs to show how much healthier he had grown since he had begun on the milk mixture. This might have been true, but my instant reaction was one of horror – having not seen the baby before, it certainly still appeared to me to be on death’s doorstep. Julius agreed that the baby still looked very, very bad. He was still far, far too skinny, and his eyes stared in that wide, unseeing manner which accompanies sever malnourishment. His head still rolled listlessly on his neck, in a sickly fashion that made one’s skin quiver.

We asked the woman if she had been feeding the baby on the milk mixture every day, and she told us that she had, though it was almost out. She recounted the story of the hospital visit, and as the child obviously needed to be seen by a doctor again (preferably without the four-day wait), we decided to send her to the SoftPower Health Clinic in Jinja. We gave her and a friend the money for transport to come into Iganga Town a few days later, explaining that we would meet her in Iganga and take her to the Clinic.

Carrying through on this plan, we arrived last Thursday with the auntie, the auntie’s friend, and the child at the SoftPower clinic in Jinja. Sad news met the child’s examination: it had malaria, as well as being malnourished, and had been sick for so long that it might not ever fully recover. ‘Does he sleep under a mosquito net,’ the SoftPower staff asked the woman. No, she replied – they did not even have money for mats to sleep on, never mind mosquito nets. The SoftPower staff told the woman that she must acquire a mat and a mosquito net for the child, and must continue to feed it on the milk mixture until it could eat solid foods. If we are lucky, the child will be able to speak, and move about regularly in future. However, it may never speak, and its neck and spine – which had borne some infection in the past – may never function normally. It is probable that the child will be mentally impaired, due to the severe malnourishment it has suffered.

The milk mixture needed will cost 70,000 UShs per month, the US equivalent of $35 monthly, but an impossibly large sum in a Ugandan village. While we are not in the usual practice of spending large sums of money on a single villager (UVP is working with so many needy villagers, in so many poor villages), helping this child seems an issue of basic humanity. To refuse help would surely be the boy’s death sentence. So, we shall invest in this child’s life, and supply him with a net, a mat, and the milk mixture until he can eat solid food. I would challenge anyone to look into his eyes and decide differently.

If you wish to help the Bulumwaki baby, please go ahead and make a donation through our online paypal account, or write a check (made out to Uganda Village Project, with 'Bulumwaki' in the memo line) to our treasurer at:

Uganda Village Project
c/o Kristina Wang
1244 Dormouse Rd.
San Diego, California, 92129

Thursday, August 13, 2009

Obstetric Fistula in the Congo - Covered by Democracy Now!

As Secretary of State Hillary Clinton tours the Democratic Republic of the Congo, she is likely learning about obstetric fistula.  In Eastern Congo and other areas of violence in the DRC, obstetric fistula is common among women who have been violently raped and/or sexually abused.  

Congolese human rights activist Christine Schuler Deschryver describes, on radio station Democracy Now!,  the affect of obstetric fistula on women in the Congo.  Below is a link to her words (you'll have to listen for a couple minutes, or skip forward, to hear specifically about fistula), and the section of the transcript pertaining to obstetric fistula. 

    The Transcript

    AMY GOODMAN: They suffer from fistula. Can you explain what that is?

    CHRISTINE SCHULER DESCHRYVER: I’m not a doctor. It’s quite very difficult. But I know that when they have fistula, it’s like, you know, instead of—it’s everything, urine and things, everything comes out.

    AMY GOODMAN: They’re completely incontinent.

    CHRISTINE SCHULER DESCHRYVER: You cannot control. You’re out of control, so these people smell very bad, and they have infections. And they cannot live, you know, in communities. And they have to be repaired by heavy surgery.

    AMY GOODMAN: So they can’t control their urine or their bowel movement, and so—

    CHRISTINE SCHULER DESCHRYVER: Not at all. So everything just go out when they’re walking, when they’re sleeping. It’s just—

    AMY GOODMAN: They become pariahs in their community.

    CHRISTINE SCHULER DESCHRYVER: Yeah, yeah, of course. And also, you have to know that in your community, when they know you are raped, you are fired from the village. They stigmatize you, and also the husband, if you survive, he will just ask you to leave, most of the time with the children.

Friday, August 7, 2009

UVP Transports Women with Fistula for Repair

On Sunday, Uganda Village Project transported nine women from Namungalwe Health Center III to Kamuli Mission Hospital, a private hospital in Kamuli District about an hour’s drive from Iganga.  Five of these women suffer from obstetric fistula, a painful and isolating condition characterized by an abnormal passageway between the vagina or uterus and internal organs such as the bladder or rectum, which leads to persistent leakage of urine and/or feces through the vagina. 

Virtually unheard of in wealthier nations, obstetric fistula (Latin for hole) is an affliction of the very poor, and is predominantly caused by neglected, obstructed labour.  If the obstruction is unrelieved, the baby usually dies, the prolonged impaction of its head against the mother’s internal tissue resulting in a fistula.  The loss of the baby, the persistent incontinence and rank odor that follows, along with many other possible complications such as infertility and chronic infection, may all conspire to isolate the woman from family, society, and employment.  Though a simple surgical repair can mend most cases of obstetric fistula, most women go untreated, afraid to admit to the condition or too poor to afford the repair.

Obstetric fistula is particularly prevalent in Sub-Saharan Africa, and Uganda has been reported to have the third-highest rate of fistula in the world. 

We arrived on a hired mini-bus at Namungalwe Health Center at noon to pick up the women with fistula, and the women who have volunteered to be their care-takers while at Kamuli Mission Hospital.  It can take up to two weeks to be seen by the British doctors who are operating at this ‘fistula repair camp,’ and so these care-takers are friends indeed, to give so much of their time.  They will cook for the women undergoing the operation, clean and nurse them if necessary, and generally support them through the operation.  In Ugandan hospitals, where nurses are scarce, all patients must arrive with a care-taker if they intend to stay for any length of time.

Julius Ntalo, a tall, thin Ugandan graduate student who has volunteered with UVP for years now, working particularly around obstetric fistula, has organized the women who are attending this year’s camp.  He had arrived at 10am and stands waiting for us as we drive up, women and colorful bundles of food and supplies all around him.  One woman with fistula was not able to bring a care-taker, he informs us, but another care-taker volunteered to take charge of this woman as well as her own friend, so all is well.

We walk out to greet the women, and to greet the Namungalwe Health Center In-Charge (the man who oversees the Health Center), and the Namungalwe Senior Nurse, who is coming with us to drop off the women.  After a few minutes we parade back into the mini-bus – women, supplies and all – and begin to drive down the long, red, dirt road that leads to Kamuli.  The women are quiet in the bus, barely chatting amongst themselves.  A few are from the same village, Bulumwaki, one of UVP’s Healthy Villages.  Julius himself stayed in Bulumwaki with one of our five Healthy Village volunteer teams this summer, and conducted sensitizations about obstetric fistula while there.  In the days prior to this camp Julius also appeared on two local radio stations, talking about obstetric fistula and letting women listeners know that UVP would transport them from Namungalwe Health Center, as well as provide them with a small sum of money for the two weeks, if they wished to undergo the operation for repair.

When we arrive at Kamuli Mission Hospital we first meet with a head administrative official and then a nurse shows us the room for our women – the British doctors had reserved particular spots for women transported by UVP, as we have brought so many women in years past.  The room is mostly empty, but clean, with mattresses provided and an area to cook and fetch water nearby.  For a hospital in Uganda, it’s nicely outfitted.  We hang back as the women inspect the room, obviously satisfied, and then check to make sure they need nothing, are comfortable, have our phone numbers, and will contact us if anything goes awry.  Eventually the four of us – Mariam, Julius, Kevin the Head Nurse from Namungalwe, and myself – leave to begin our journey back to Iganga.  We plan to return next Sunday, to meet the British doctors who are not currently present at the camp.

An Update

On Thursday, we were contacted by Kamuli Mission Hospital, and told that each of the five women we brought had undergone surgery already, and are repaired!  It will be exciting to return on Sunday to visit the women at Kamuli – only one week later, and yet their lives so dramatically changed for the better!