"Wow! That's a lot of beans"

As this year comes to close, for BundiNutrition, it ends with a wonderful gift to keep our quarterly distribution of food to our Kwejuna mothers - those who are living with HIV - going for another calendar year. Yes, through the very generous support of friends from my home church in New York City, Redeemer Presbyterian, we can continue to provide our mothers and their families with 20 kilos (about 50 pounds) of beans - grown locally in Bundibugyo and of course an excellent source of protein - along with a 5 litre jug of cooking oil and a 1/2 pound bag of salt, every three months. In 2007, with similar support, we were able to hold 5 such distributions and give out 725 servings of food. Good nutrition is important for all of us, but even more so for those living with HIV. It keeps their immune systems stronger and for those on HIV drugs (antiretrovirals), a stronger body helps these drugs to be more effective in slowing down the process of the virus replicating in their body. So we say a big 'THANK YOU (Webale, in Lubwisi) for this generous gift, to these women and their families, who are among the very poorest of the poor. And as our team leader, Dr. Scott Myhre put it, when he heard about this gift, he exclaimed. "Wow! That's a lot of beans."

PS. This is my last post on BundiNutrition... Sadly, my 2 year term in Uganda is over this month and I am returning to the U.S., but thankfully these food distributions will continue. Now that we have been given these funds, this aspect of BundiNutrition will be in the capable hands of my dear friend and teammate, Pat Abbott.

Full Truck!!

Yeah! From what I can tell, it looks like we have enough donations to fill a truck with over 50 goats! Thanks for all of your Christmas gifts of goats. Bundibugyo will be blessed through your giving this season. After I (Karen) get back to Uganda in January, the preparations can get underway for the goat distribution. It will involve chosing people to receive the goats. They will need to be trained in goat care and build a goat shed. Lamech will go to Masaka, Uganda, and meet with small scale goat breeders in their villages. He will then choose and buy females of a good age. Next he'll get the paperwork and vaccinations they need to travel. We'll keep you posted here on the progress.

Jesus came for the least of these. Thanks for your generosity toward these little ones as we celebrate His coming

Christmas Goats

This Christmas you may want to give a gift to a needy child. When young children lose their mother or their mother's milk is tainted with HIV they are at risk of death and disease themselves. Formula and other sources of milk are not readily available or affordable in Bundibugyo. A donation of $110 provides a dairy goat that will give milk for such a child. In time, the goat will likely produce offspring and the firstborn female is passed on to another child in need of milk.
A Ugandan artist has made goat ornaments that we'd like to send to those who have purchased a goat. For those who donate a goat this Christmas, email me (Karen) at masso@iname.com sending your name and mailing address. That way I can mail off your ornament in time for Christmas.

Donations can be made online or by mail (designate fund #12375)

Vumiliya

On two Tuesdays in a row, as I worked at Nyahuka Health Center, he kept finding me. A man, holding a baby in an oversized blanket, repeated his story for the second time: His wife was very sick and she was an inpatient on the ward. She had breast problems and could not breastfeed their baby girl, Vumiliya. Could I help them with some food? Because nearly all my training regarding nutrition in developing countries emphasizes the benefits of exclusive breastfeeding and the precariousness of feeding young children infant formula or other replacement feeds, I was not eager to supplement Vumiliya’s diet with formula or milk. The first time he asked for help, I said that I needed the mother to be seen by Dr. Jennifer or Dr. Jonah before we could offer nutritional assistance – I needed someone more experienced to speak into the situation. I did give some milk, but felt very hesitant and uneasy about it, saying the mother should really try to breastfeed. He came the next Tuesday without a note from a doctor. We gave him a bit more help, still very uneasy. Finally, I told Jennifer about the situation, and she graciously went to find the mother and get an accurate read on the child’s story.

Vumiliya’s mother is HIV-positive. She is indeed very sick and should not be breastfeeding her child while supplementing the baby’s diet with other foods as this increases the risk of HIV transmission from herself to Vumiliya. As Jennifer talked with the father, she asked “Do we have a goat ready? This child would be a perfect candidate for a goat.” At the time, there were no goats giving milk, ready to be given to beneficiaries. So we told the father we’d help with milk for one month, giving him time to find a surrogate breastfeeder. A few days later, Lamech told me there was a goat giving milk ready to be given to a beneficiary, because the child for which it was originally intended shifted to Congo (we do not give goats to children living in Congo because providing veterinary care is dangerous for our agriculture extension workers). I was praising the Lord for this goat giving milk to give to baby Vumiliya!

The saga continues, however. On Tuesday, when her father came with me to WHM Matiti Farm to get the goat, we discovered it had diarrhea. Pauline decided to keep the goat on the Farm until it completed its full course of medicine. We are continuing to provide Vumiliya’s father with milk for her to drink. I was struck once again at how difficult it is to get sustainable sources of protein for children here in Bundibugyo: Farmers decide it is more lucrative to plant cocoa shambas than to plant groundnuts. Chickens get coccidiosis and die en masse. And exotic dairy goats get diarrhea. It is messy! But not hopless ~ Please pray that Vumiliya would get to enjoy goats’ milk sometime soon, and that God would preserve her life and provide abundantly for her family.

Living on the edge...

Several days ago, this Kwejuna mother, Bena, turned up at my door. She had travelled many miles to see me, probablyat least 20 kilometers. She is a mother of 6, including the twin girls you see here which she has named Patricia and Pamela, after Pat & I. She is very sick, has advanced HIV disease, and lost her husband who was a soldier in early May just before the twins were born. She is from eastern Uganda, but since her husband is from Bundibugyo and she has been away from her own area for many years due to her husband's work transfers, she has nothing to go back to there. Besides, culturally speaking, all her children belong to her husband's family, so it makes sense for her to remain here. But she is desperate: extremely weak, unable to afford to send her older children to secondary school, living with her in-laws in one room (she and the 6 children) which doesn't have walls that go up to the ceiling, no income, no land on which to dig and grow food for her family (land passes from husbands to male children only here), and trying to nurse twins.

When I first met her at Bundibugyo Hospital shortly after the twins were born, she had turned up in the HIV care clinic, for a refill of her antiretroviral drugs. She and the twins were suffering from a skin condition, and she was already struggling to produce enough breast milk for both babies. The next week, she made the trip to the mission and Dr. Scott examined her and prescribed some antibiotics for them all. Because she lives too far away to benefit from our existing nutrition program, I have taken to providing boxed long life milk for the twins, which her teenage son comes to pick up from Bundibugyo Town every 2 weeks. To my surprise and delight, they have continue to grow and thrive. At our last food distribution, when she heard I was leaving next month, she began to worry about how she would manage when I am gone and who would help her. She had come to tell me this and to see if I could help her with money to start a business. I reminded her that God is the one who has always helped her, (though sometimes he has used me to do so), and that he will continue to be faithful to her.... I believe those words, but does she?

As I look at her twins, just shy of 6 months, I wonder what their future holds. Should their mother die in a few years - if she lasts that long - what will become of them? What will become of her teenage son and daughter, or her other children? It looks like such a bleak situation, and yet I pray that for her, as for us that Paul's words ring true, that her "light and momentary troubles are achieving ... an eternal glory that far outweighs them all". I don't know if this is true for her because I don't know if she has a belief in the Christ who died to make this a reality, but I pray that if not, she will come to know in a real and personal way, the God of the universe who gives us a hope in a life beyond this one.

October 2007 Monthly Report of BundiNutrition Activities

Below is a listing of various BundiNutrition projects and current activities. These projects are financially supported by private donations to World Harvest Mission. The projects are practically and logistically supported by NHC staff, lay health workers, WHM agriculture extension officers and missionaries, community members, and patients’ caregivers.

• NHC/WHM Inpatient and Outpatient Feeding Programs
o Inpatient Feeding Program: Serve malnourished inpatients, often with chronic illness or severe infection (HIV, TB). Often these children have kwashiorkor and/or marasmus or are below the Road to Health line.
 Inpatients are given either starter milk (if they present as severely malnourished) or high energy milk (if recovering from severe malnutrition)
 In some cases, eggs and groundnut paste/powder are also provided to boost nutrition
o Outpatient Feeding Program: Serve motherless infants under 1 year, multiple birth babies, low birth weight babies (<2.5 kg), and those recovering from severe malnutrition (kwashiorkor, marasmus)
 When initially enrolled, children are given 24 boxes of milk, oil, sugar and told to find a surrogate breastfeeding and return the following month.
 Surrogates receive 10 cups of beans each month through the child’s 12th month.
 In October 2007, we served 70 children through the outpatient feeding program, 35 males, and 35 females.
o HIV-affected children
 Weerve children between 6-18 months when mothers are weaning children off breastmilk, as well as HIV-positive children who are also underweight.
 Children receive growth monitoring and bi-weekly protein supplements such as eggs or groundnut paste or powder. Caregiver nutrition education is also provided.
o In October 2007, 33 new motherless infants or malnourished inpatients were enrolled in either the inpatient or outpatient feeding program
o In October 2007, an average of 15 HIV-affected children was served each week.
• Nutrition Trainings
o Nutrition Trainings in October 2007 included sessions on hygiene, nutrition education key messages, behavior change theory and approach, and each group conducted recipe trials to cook a healthy biscuit.
o During the final week of the training (30 October – 2 November), participants reviewed all previous sessions and were awarded certificates of attendance.
o Average attendance was 15 people, including health center staff, TBAs, BBB production team members, and other interested community members
• Byokuliya Bisemeye mu Bantu (BBB) Project
o To promote cultivation of high-protein food crops such as sesame, groundnut, and soybean
o Trained farmers and gave seed for quick-growing food crops (e.g., papaya)
o Distributed BBB T-shirts to farmers and production teams
o Monthly meetings with production teams (women’s groups who are producing the high-protein food supplement)
 Repaired two broken grinders with new auger helices
 Recipe trials with production teams
 Purchase of seeds for production teams
 Collection of high-protein food supplement and distribution to NHC
 Construction of 1 solar dryer, to dry moringa leaves
o Conducted 4 agriculture sensitization seminars with local farmers
o On-going monitoring of seed recipients’ fields
• Chicken Project
o To promote children’s consumption of sustainable animal protein
o On-going monitoring of health and wellness of chickens
o Follow-up and vaccination for local farmer raising exotic layer hens
o In October 2007, 748 eggs distributed to Nyahuka Health Center
o On-farm trainings regarding chicken management and fodder establishment
• Matiti Dairy Goat Project
o To promote children’s consumption of sustainable animal protein by distributing dairy goats; Over 50 goats distributed in April 2007
o Matings between local goats and exotic dairy goats
o On-going monitoring and treatment for dairy goats; De-worming of goats
o Agroforestry sensitization seminars
o Goat management training in Kirindi Parrish
o Management of a Matiti dairy goats demonstration farm
 Planting of bananas, phase II
 Planting of beans in banana field, phase I
 Desucking and pruning of banana plantation
o On-farm trainings with Naksiona Women’s Group regarding goat management, chicken management, and fodder establishment

Grand Finale, and a tearful goodbye

On Monday, 29 October, we had our last (and largest ever) food distribution of the year. The day dawned bright and sunny and by 8.30am, about 90 women were already assembled and seated on benches in our community center, eagerly awaiting the start of regsitration. Over the next 7 hours, another 95 women and their babies trickled in and joined in the festivities. As in past distributions, all women were registered and weighed, those who brought their babies had them weighed as well, and 16 babies were tested for HIV. Only one of these tested positive, though she was only 6 months old and that test may reflect her mother's antibodies and not a true infection, so she will need to test again in 3 months. The rest of the babies tested were found to be free of HIV. Praise God for that!

After finishing rounds on the pediatric ward with Dr. Jennifer, our short term Physician Assistants - Rachel and Scott W - came to help, praying over those who requested prayer. Later, just before we gave out food, Rachel shared from the Bible, reminding the women of how much they are loved by God, and as we distributed beans, cooking oil and salt, Scott jumped into the fray and helped these women - some of whom are quite frail due to their health - to carry out their 40 pound bags.

During the day, I tried not to think about the fact that this was my last distribution, and the last time I would see almost 200 of our mothers and their babies assembled in one place, to receive food that will help them to supplement their diet. But as we gathered them all to begin giving out the food, I knew it wouldn't be fair to them or to me to fail to tell them that next year when they return, I will not be among them. Several women near the front audibly gasped when I said this, and that brought me to tears. Fortunately, despite my heavy heart, I was able to remind them that though people come and go in their lives, God always remains present with them and he is the one always sustaining them. I was preaching this to myself as well, for these are words I also needed to hear. As my time in Bundibugyo draws to a close in December, I will go from this place to face a future that is largely uncertain, and so I too need to be freshly reminded that God will indeed be my sustainer through the upcoming transition and that he has good plans for me. And so I leave knowing that God has already provided funds to keep this distribution program going for another year, a tangible sign of his never-ending love and care. A generous gift from a couple in my church in New York City makes this possible. Mukama Asiimwe! (Praise be to God).

I burst into tears when Geofrey recently told me what happened at the end of a long work day. (For those of you who don’t know, Geofrey is a Ugandan Agriculture Extension Officer working on the project to establish a locally produced, nutrient-dense paste to provide to malnourished children in Bundibugyo.) Geofrey was traveling home after a productive day of monitoring farmers’ fields, conducting agriculture trainings, and monitoring teams of women producing the nutrient-dense paste. Over the past month, a teammate (Michael Masso, water engineer) graciously allowed Geofrey to move around the District using his recently repaired but very weathered motorcycle. Unfortunately, on the day in question, suddenly the motorcycle died! Geofrey reported that he and another Extension Officer (Lamech) had to push it nearly 1 mile back to World Harvest Mission property. I cried about this because I was feeling very discouraged about several seemingly broken machines in my life.

So please pray that God would provide us with a new motorcycle for Geofrey. The machine I have my eye on would cost 4500 – 5000 USD. We have been spending a lot of money on hiring boda bodas (for-hire motorcycles) for Geofrey to travel throughout the District. These hired motorcycles are not high quality machines, and they offer very little flexibility in terms of when and where a person can move. I am very pleased with Geofrey’s work thus far, and I would be so happy if we were able to provide him with a new motorcycle to use for his work. The safety, flexibility, and cost-savings afforded by purchasing a new motorcycle would be well worth it! In the picture above, you can see Geofrey and Lamech posing by the motorcycles, just one week before the breakdown.

BundiNutrition September 2007 Monthly Report

Below is a listing of various BundiNutrition projects and current activities. These projects are financially supported by private donations. The projects are practically and logistically supported by Nyahuka Health Center staff, lay health workers, WHM agriculture extension officers and missionaries, community members, and patients’ caregivers.

· NHC/WHM Inpatient and Outpatient Feeding Programs
o Inpatient Feeding Program: Serve malnourished inpatients, often with chronic illness or severe infection (HIV, TB). Often these children have kwashiorkor and/or marasmus or are below the Road to Health line.
§ Inpatients are given either starter milk (if they present as severely malnourished) or high energy milk (if recovering from severe malnutrition)
§ In some cases, eggs and groundnut paste/powder are also provided to boost nutrition
§ In August 2007, we served 32 total, 14 males, 18 females
§ In September 2007, we served 22 total, 13 females, and 7 males (2 unidentified gender).

o Outpatient Feeding Program: Serve motherless infants under 1 year, multiple birth babies, low birth weight babies (<2.5 kg), and those recovering from severe malnutrition (kwashiorkor, marasmus)
§ When initially enrolled, children are given 24 boxes of milk, oil, sugar and told to find a surrogate breastfeeding and return the following month
§ Surrogates receive 10 cups of beans each month through the child’s 12th month
§ In August 2007, we served 55 children, 31 males and 24 females.
§ In September 2007, we served 53 children, 22 males, and 29 females.

o HIV-affected children
§ Serve children between 6-18 months when mothers are weaning children off breastmilk, as well as HIV-positive children who are also underweight
§ Children receive growth monitoring and bi-weekly protein supplements such as eggs or groundnut paste or powder. Caregiver education is also provided.
§ In August 2007, we served an average of 11 children per week.
§ In September 2007, we served an average of 15 children per week.

· Nutrition Trainings
o Beginning 11 Sept 2007, 3 trainings were conducted on the following topics: (1) Growth monitoring and identification of malnourished children; (2) General nutrition (concepts of energy, vitamins, minerals and the purpose of each in the body), exclusive breastfeeding; and (3) Healthy young child nutrition, including responsive feeding and recovery feeding.
o Conducted at Busunga (Tuesday afternoons), Busaru (Wednesday afternoons), and Nyahuka (Friday afternoons) Health Centers.
o Average attendance was 15 people, which includes health center staff, TBAs, BBB production team members, and other interested community members

· Byokuliya Bisemeye mu Bantu (BBB) Project
o To promote cultivation of high-protein food crops such as sesame, groundnut, and soybean
o Seed distributed to 116 beneficiaries in July 2007 (asked to return a portion of the crop to the project); Monitoring and field education is on-going
o Agriculture sensitization seminars conducted
o Distributed 3 hand-powered seed grinders for community use and production of a high-protein powder to be distributed at NHC and possibly in other health centers.

· Chicken Project
o To promote sustainable animal protein food sources, with emphasis on children
o As of 24 September 2007, 1005 eggs distributed to NHC
o Total of 1112 eggs collected since they began laying on 7 August until 23 September
o On-farm trainings regarding chicken management and fodder establishment

· Matiti Dairy Goat Project
o To promote sustainable animal protein, emphasizing children
o Over 50 goats distributed in April 2007; Follow-up and veterinary care are on-going
o Offer matings between local goats and exotic dairy goats
o Management of a Matiti dairy goats demonstration farm
o On-farm trainings regarding goat management and fodder establishment

The Valparaiso University grant has enabled us to conduct a series of 8 nutrition trainings in 3 different health centers. Average attendance is 15 people, including health center staff and lay health workers. The training topics include antenatal nutrition, growth monitoring, healthy complementary foods, recovery feeding, responsive feeding, and hygiene. We are also training folks to actually deliver nutrition education messages. It has been a really rich time for me ~ I’ve learned at least as much as I’ve taught! To celebrate completion of the fourth training session, I presented participants with brand new green “Byokuliya Bisemeye mu Bantu” t-shirts (Byokuliya Bisemeye mu Bantu means “good food for people”). On the front of the shirts, a groundnut plant is pictured, with a young girl going to school, a father digging in the garden, and a pregnant mother. The graphic represents a father supporting his daughter and pregnant wife by cultivating high protein foods in the garden, resulting in healthy children who are successful in school. On the back of the shirt is a paraphrase of 2 Corinthians 9:10 “God, who supplies seed to sow…will enlarge the harvest of your righteousness.” It was such a joy to see people’s faces light up when they received this gift ~ thanks Valparaiso!!

Please continue to pray for enthusiasm, creativity, and wisdom for training preparation.

Makuni goes home...

Today was a big day for Makuni. Two months after being admitted, he went home! He's still not able to walk unassisted, but looks much more like the 4 year old that he is than when he first arrived. Home is over the border in Congo, probably at least 10km from Nyahuka health center and a few hours walk, at the very least. He left in the arms of his father, accompanied by sister Annet, and a brother who showed up today for the first time, with a bicycle. The bicylce was used to wheel a big bundle full of all the possessions they'd used for their hospital stay: sheets, blankets, towels, a few items of clothing, cooking dishes and utensiles, and rags which Makuni sat on in bed, instead of using diapers.

Makuni knew he was headed home and appeared fine with that: no tears of protest or sadness. Though there is no mother there to welcome him (she died some time ago), it seemed he was happy to be going back to somewhere known and familiar. Pat bought him sweets at the gate, and I sent him home with a new outfit (recently arrived from friends in the US) and his sister in a similarly "new" dress. He also went home with 24 boxes of milk to last him for the next 2 weeks when he should return for a weight check. Thank God for the way he has turned the health of this child around. Its quite remarkable really, and continue to pray for Makuni's family to care for him well at home - his foot still needs a daily dressing -and for him to gain even more weight in the next 2 weeks.

And as Makuni heads home, there are others now admitted - also severly malnourished - and in desperate need of care and prayer: James, Ngonzi, (both of whom are HIV infected), Masereka, the list goes on..... Pray for God to meet their needs as he did Makuni's.

Makuni laughs!

Makuni has made noticeable improvements though he is still very malnourished and continues to need much prayer and love. Last Friday when I visited, the edema (swelling) in his eyelids had all but disappeared and his eyes were open and he was looking around, alert and interested in what was going on in the bed next to him. He was also holding a cup of milk and drinking it himself. This may sound minor for a 4 year old child, but the previous week, he'd been too weak to hold his own cup and we'd been feeding him milk spoon by spoon. Then on Tuesday, I found him sitting outside on the veranda with his father. Its been very hot here in the afternoons so I was glad he was getting some fresh air. He looked up at me with his large, sad eyes. I had brought a small green rubber ball for him, though I'd been reluctant to give it to him because he can't chase it. He is too weak to walk and spends most of his day sitting up in bed - with no back rest. Anyway, I gave the ball to his father, who gave it to him, and he looked at it and then smiled. No actually he laughed! It was the first time I've ever seen him laugh or smile. He continued to look at it and chuckle to himself with glee. Then he rolled it back and forth between his skinny outstretched legs and began playing happily with it.

I know that Makuni's improvements are evidence of God's love for him and a reflection of the many prayers that are being offered up on behalf of him and his family. THANK YOU. Please don't stop praying. Makuni has a long way to go before he becomes a healthy 4 year old. Continue to pray for his appetite to increase and for him to receive healthy, calorie-rich foods, and pray particularly for healing for a terrible wound he has on the top of his left foot where the skin has been eaten away - a symptom of extreme malnutrition - exposing red, raw flesh.

Motherless Makuni

Meet Makuni, a 4 year old boy who weighs just 8.5 kilos or about 19 pounds. He has an enlarged head, bloated stomach, and blotchy skin. His shoulder blades protrdue glaringly out of his back, his tiny body not more than skin and bones. He is from across the border in Congo and his father brought him to Nyahuka Health Center about a month ago in a severely malnourished state. Makuni's mother died sometime ago - its unclear exactly when and how but its likely Makuni's malnourished state has something to do with her death. He is cared for largely by his 10 year old sister, Annet, (pictured with him) and although his father stays with him at the health center at night, frequently during the afternoons when Stephanie and I tend to visit, he is noticeably absent.

Please pray for this little fighter! I first learned of him when Jennifer asked for prayer for him at one of our team meetings and then I discovered him one day early last month in the new pediatric ward when I was visiting the daughter of one of our Kwejuna mothers. He was sitting up in bed - alone - and crying quietly. His eyes were large and sunken and sad. In recent days, he has taken to keeping his eyes closed most of the time. When I first saw him with his eyes closed, I feared he'd gone blind, but when I gave him a small teddy bear to cuddle on Thursday, he felt it, then opened his eyes and screamed in fear. An unexpected response, but a good sign. He can still see! However, its likely he doesn't have the muscle strength to keep his eyes open all the time, but he continues to hang on. He doesn't talk but but responds to yes/no questions and seems quite aware of what is going on. We're giving him high energy milk - a mixture of boxed whole milk, diluted with a small amount of water, and a small bit of oil and sugar, and though he is largely spoon fed at this point, he takes the milk drink with relish. Another great sign. He is not rejecting food and has an appetite. Yeah! (Sometimes kids at this advanced stage of malnutrition lose all interest in food.) We've also provided his father with eggs but its unclear whether Makuni himself is getting them to eat.

Please, please pray for this child, and pray for this family. They are grieving the loss of their wife and mother, and struggling to care for a very sick child who needs to be fed small amounts 6 times a day. It is laborious and consumes much energy, and we see signs of them tiring of this. But we know God loves this child and he loves this family. Pray for God to bring him back from the brink of death. Pray for this family to be encouraged and strengthened to continue to care for Makuni. Pray for the health center staff to have hope too. Our God is able to do all this and more.

Yummy, yummy to my tummy!

This past Thursday, we had our first ‘recipe trial’ to create the nutrient-dense paste. The product ended up more like a powder than a paste, likely due to how close the grinder’s steel burrs were to each other. The mixture of roasted groundnuts, soybeans, and moringa leaf powder was quite tasty! Keep praying for creativity and wisdom as we conduct more recipe trials.

Webale, Webale!!

Many thanks to our faithful prayer and financial supporters!! Your support is helping us purchase ingredients for therapeutic milk (milk, sugar, oil) to strengthen and heal malnourished children like Mukuuni (see picture on the right). Many of you have supported the chicken project ~ the hens have begun laying eggs, given to malnourished inpatients at the local health center (see Basaija with some of the first eggs, picture on the left). We are so grateful for your partnership in spreading God’s love to malnourished and at-risk children in Bundibugyo.

“If you do away with the yoke of oppression, with the pointing finger and malicious talk, and if you spend yourselves in behalf of the hungry and satisfy the needs of the oppressed, then your light will rise in the darkness, and your night will become like the noonday. The Lord will guide you always; He will satisfy your needs in a sun-scorched land and will strengthen your frame.” Is 58:9b – 11a

Pray for a Plentiful Harvest!

On July 23 and 24, we distributed 1000 kg of soybean, groundnut, and sesame seed to farmers in Bubandi and Busaru Sub-counties. We are praying for a plentiful harvest, and that God would use this project to glorify Himself as we all rely on Him for rain and sun to grow up healthy plants. We hope to use the resulting harvest for another seed distribution, and we also hope to use the soybeans, groundnuts, and sesame seeds to produce a nutrient-dense paste for malnourished children in Bundibugyo. Pray for the literal and Spiritual harvests both to be rich and plentiful!

"But the one who received the seed that fell on good soil is the man who hears the word and understands it. He produces a crop, yielding a hundred, sixty, or thirty times what was sown." Mt 13:23

Bad Beans

On Monday, we were just completing what we thought was another successful food distribution when things turned unexpectedly ugly. None of the babies who had been tested that day turned out to be HIV positive (hallelujah!) and the story of the feeding of the 5, 000 had been told - most hearing it for the first time - reminding us all of the God who loves us and whose resources are limitless. Following this, 130 women each received 20 kilos of beans, a 1/2 kilo bag of salt and a 5 liter jug of oil, but just as we gave out the last ration of food, Scott and I were almost mobbed by 40 disgruntled and unhappy recipients. It turns out they had received beans that had been left over from one of our previous distributions in March and the beans had become "old". In comparing their beans with those who got fresh, newer beans, they were angry with us. The old beans would take longer to cook - one woman even demanded that we give them charcoal - and would be less palatable. It was a very discouraging moment . We found ourselves suggesting that since the beans were a gift, they were free to refuse them.... and at first many of them walked away leaving their bags of beans on the floor. But in the end, the women relented and took them home, reluctantly. It was a lesson in the importance of equity in this culture whenever gifts are concerned and it was a lesson in humility for me. For though I may not know the difference between fresh beans and 3 month old beans, women who are farmers and who grow them in their own gardens certainly do and they are not to be underestimated.

Binyobwa Bisemeye Mu Bana!

Groundnuts are good food for children! We have started a new "Peanut Butter" Project, hoping to eventually create a high-protein nut paste for children in the decentralized nutrition programs. We also hope to promote this paste for children in general, to decrease the incidence of stunting (low height-for-age) in Bundibugyo.

We brought back 3 hand-powered nut grinders from America, and 2 Universal Nut Shellers, donated by the Full Belly Project (http://www.fullybellyproject.org/). Geofrey and I were trained on how to use the Nut Shellers in Iganga District (see pictures). This project is part of our vision to transition to using local foods to care for malnourished children.

Alice - one month later

On Sunday, I returned from a month away and had been back just over 24 hours when I was coming home from visiting friends and found that Alice was on her way to see me. She looked sadder than usual with her eyes large and heavy, and I soon learned why: her 3 month old, Kansime Edina, had died 2 weeks before. Though Edina was her 5th child, she was the 3rd child Alice has buried. What grief she must feel. She fought back tears as we talked through our translator, Pauline, who is an extension worker on the Matiti project. To make matters more complicated, as her baby's health had deteriorated, she had borrowed 70,000 Ugandan shillings (about $38) to pay for Edina's medicines and then ultimately used what was remaining for her funeral. Funerals are a big community event here. Since Alice personally didn't have this money, she used her goat as collateral and now she needed to re-pay the goatkeeper in order to get her goat back. I offered to cover the cost of getting her goat back, but until she is in a less "urban" situation, the goat, which was a gift from World Harvest's Mattiti project, will be returned and kept at the goat farm on the mission. Alice was less than pleased about this, but right now its really the only (and best) solution. She has nowhere to keep the goat and trying to care for it in the middle of overcrowded Nyahuka Trading Center, she risks losing it to sickness, death, or even theft. Then, though the baby has been buried, at the end of this month are the final funeral rites. This is another community-wide event where family and friends gather to pay their final respects, and involves feeding those who come. Understandly Alice wants to give her baby girl an honorable send-off from this world, but how brutal this seems. Not only is she grieving the loss of her third child, but she is struggling to find the money to bury her with dignity. I will assist her in doing so ( by providing a gift in the way of cash), but was reminded by Donato, my Ugandan colleague, that there are others in our Kwejuna Project just as needy as she is. Oh, for the wisdom to know how to best help these needy and vulnerable ones....

Alice

On Friday evening, as a rainstorm was beginning to blow in, Lamech, the Ugandan extension worker for our Matiti (goat) project, visited my home to tell me about the plight of one of our HIV positve mothers and goat recipients, Alice. He had been following up on her goat in the village where she lived, only to learn that she had moved into nearby Nyahuka trading center without her goat - whom she left with another goat keeper - but with her 5 children and her mother. Recently widowed, her home in the village was accidently burned to the ground by one of her children, and she was only able to afford to rent a small shelter. Lamech took me to her home, just behind a main road and I found her huddled in a tiny grass covered hut, smaller than the size of our 8ft x 4ft cho (pit latrine) and much less glamourous: unpainted mud walls and an unfinished floor. The door was ajar and she was cooking food just inside the doorway over a charcoal stove, with a newborn baby in her lap, and her 3 and 5 year olds playing on an old, tattered 4 inch mattress. I wondered to myself who got to sleep on it at night. Both of the children were coughing heavily and frequently. The room was so small that neither Lamech nor I could fit inside and so we sat just outside the door, our eyes tingling with smoke from the hot coals. All of Alice's wordly possessions were contained in this tiny room that she shares with 6 other people. As if that weren't bad enough, on the other side of one of the walls, inches from where they live, sleep, and eat was a pit latrine the same size as her shelter.

It was truly one of the worst housing situations I have ever seen, and I just couldn't help thinking of how vivid this picture was of what a terribly broken world we live in. We talked about her options- building a new home on property owned by her husband's family but Lamech said that would cost upward of 1 million Ugandan shillings (about $600) which is currently beyond what I can help her to do - or at least in the short term, moving to another place to live. She was confident that other rented rooms were available nearby, at least with cement walls and zinc roofs, even if they didn't offer any separate space for cookng. So I gave her money to rent such a place for the next few months. I then came slowly home with a heavy heart and a deeper appreciation for my 3 bedroom house, my electric lights, my running water which I heated for a bucket bath, my spacious kitchen, and the nutritious dinner I prepared and sat down to eat. My assistance to her felt like little more than a band aid because that's really all it was.

It was extremely humbling.

There but for the grace of God go I.

The Survivors

From 204 to 39…after the coccidiosis plague subsided, we are left with 39 chickens. (Basaija is counting the remaining birds.) I am reminded that God works through weakness, and He “chose the weak things of the world to shame the strong.” He has already used this situation to humble me, and to build greater faith in me. As a team, we look forward to seeing how such a small flock of chickens will be used by Him.

Baby Goat on the Move

The night before the goat distribution a goat named Opera gave birth to a little boy kid. It was white with some brown spots. He awkwardly moved his long legs to hobble around. They stayed with us for a 2 weeks to make sure they were all well. My children enjoyed helping with the milkings which happened twice a day. This week, Opera and Ricky (as my kids dubbed him) headed off on two motorcycles to their new home. Opera is giving nearly a liter of milk a day and Ricky is suckling as well. The breeder, who is HIV+ will rapidly wean her 6 month old child and start giving goat's milk. In a few months, when the child is tested for HIV, we hope to find her negative.

Beans, Oil and a Bag of Salt

This past Thursday, we had our second food distribution of the year and our largest ever: 130 women came, many with babies and young children and several with their husbands, to haul home 20 kilos of beans and a 3 litre jug of cooking oil. The beans came by lorry from Kasese, a town in the west of Uganda about 4 hours away from here. The oil was bought from Kampala-based Mukwano Industries, one of the largest companies in this country that supplies all sorts of household goods. After we had registered all the women, weighed them and their babies, and tested those babies and children who had not yet been tested, one of the women approached Donato, our Ugandan colleague, and asked him "Where is the salt?" Truthfully we had not planned to give out salt, but it is locally available in large quantities - though it actually comes from Kenya - and is very inexpensive. Plus it was a very reasonable request: salt will definitely make those beans more tasty! So, Scott and Donato drove down to Nyahuka Trading Center, less than 1 kilometer away, and within minutes returned with 150 bags of salt.

As I watched the women taking home their bags of salt, along with their beans and oil, I was reminded that salt was important to Jesus too. He told his followers, "You are the salt of the earth" and so he calls us to live distinctive (flavorful) lives that bring him honor and glory.

Join Us!

As God has called us to Bundibugyo many of us have our children with us. We have 16 children on the team currently, most of them are school aged. We are hoping for one more teacher for them in their 4 room school house we call Rwenzori Mission School. If you are interested in joining the team as a teacher, thus facilitating the health, nutrition, Christ School, church strengthening efforts of this place, check it out on the WHM website. It will allow you to serve the team as well as immerse yourself in the beauty of Bundibugyo and it's people.

Donato

Meet Donato, the Senior Administrative Assistant for the Kwejuna Project, which serves HIV positive women and their families. Actually its a very misleading job title since Donato's role is quite varied. Donato has been with working with World Harvest for almost 4 years now, before the Kwejuna Project even had a name. He was one of the folks chosen as a community mobilizer in the fall of 2003 when Drs. Scott & Jennifer were informing communties about the upcoming HIV prevention project that was about to be launched for pregnant women. Donato did such an outstanding job of organizing these community events and liaising with the local village heads, that he was brought on to provide day to day support and supervision to what came to be known as the Kwejuna Project. His role involves making sure the sites - now 9 - have adequate supplies to conduct HIV testing to all mothers who come for prenatal care; helping to collect data for the monthly, bi-monthly and quarterly reports we are required to submit; and helping to work with the many staff scattered across the district. His latest responsibility has been to take on the procuring of over 3,000 kilos of beans from Kasese - a town 4 hours away - as part of our food supplement program. The latest shipment of beans arrived last Thursday, and have been stacked in our store, ready to be given out to the 125 women expected to arrive this Thursday. What a blessing Donato is to the Kwejuna project!

Goats, God's provision

It was a goat party, one big goat party, the kind God would throw, where mostly widows, orphans, the infected and desperate were invited. About a hundred adults (which in Africa means at least a hundred kids tagging along) gathered on Thursday for the distribution of 68 specially breeded dairy goats, the fruits of Karen’s Matiti project, purchased by generous donations from friends in the US, and arranged by Karen’s visionary work here. The goats arrived from a dairy-goat-farm British mission project in Masaka (near Kampala) on Tuesday. After a day of feeding and sorting and matching ear tags with lists of eligible patients, the community gathered for the celebration. A representative of the recipients, mostly HIV-positive women and a smattering of grandmothers caring for orphans, got up to say that they would be praying for God to bless our mission. That was powerful for me, the prayers of the poor extravagantly poured upon us. For me these were not just names on a list, or faces in a crowd. I could remember grieving with this woman the death of her child, or celebrating with that one the news that the baby had avoided infection, or struggling to pull another’s infant through severe illness. Pamela encouraged the people to care for their animals, and Karen drew the analogy to seeds, as each goat could breed with local varieties so that the blessing could propagate on to many, many families. We live in a district of chronic undernutrition, so that a sustainable source of calories and protein for young children can have wide-ranging benefits for development.

Scott spoke on behalf of the mission, telling the story of Abraham and Isaac in dramatic detail. If you have never lived among people for whom Bible-story standards are as shocking and fresh as a first-run Hollywood movie plot, you can’t appreciate the gasps and laughter. And if you’ve not lived among people for whom goats are the traditional currency and source of life, you can’t imagine the relevance of stories like this one. The child at risk, the grieving and wondering parent, the moment of near-death, the ram in the thicket, God’s provision. The goat saves Isaac’s life. What a context for goats being handed out to people with hungry, marginalized children, to save their lives. Then Scott pointed out that Jesus was the ultimate sacrifice, God’s true provision for our lives. It was a great blending of real-life flesh-and-blood salvation from starvation pointing to deeper truths in the spiritual realm.

Pamela and Karen and Stephanie tirelessly shepherded the waiting recipients through registration and speeches and a generous lunch, then the group migrated from the community center to the Masso yard where the 68 goats were penned. Our veterinary assistants were joined by some of the kids (Acacia, Julia, and Jack) bringing goats out of the pen one by one. It became a nearly whole-team effort to match the goats to the records, the records to the right patient, documenting, handing over. Rascally goats jumped energetically while women stunned at their good fortune grasped ropes and hauled them away towards home.

A community leader from each of 16 subcounties received males to make available for breeding, while the females went to families whose children needed the protein boost of milk (something to think about when you pull a carton of milk out of the fridge so easily).

God’s provision, but detoured through the efforts of many, many people. The kind of party that Jesus would definitely attend. It was so much fun we’d like to do it again this year, if the money comes in.
Jennifer (from our paradoxuganda blog)

The goats have arrived!

Yesterday, the goats began to enter the truck at 5:15 am. They arrived in Bundibugyo at 6:30pm! It was so nice to receive them in daylight hours. 18 males and 50 females came off the truck and were so happy to be free of the constraints of the snug vehicle. They rushed to eat the food that was laid out for them. Two females were milked immediately. A sick goat was given an injection. The male goats were in a daze and fought wildly. There was serious rearing and head butting going on as they tried to find comfort in their temporary abodes. During the night they were generally quiet, though some head clunking was still heard. Today is their resting day before they meet their new owners tomorrow and walk to their new home. We praise God for these blessings. We are so grateful to so many of you for your part in this journey.

Pauline

I’d like to introduce you to Pauline. She is an animal husbandry extension worker. She came to Bundibugyo in Sept 2006. She began assessing the health and condition of the dairy goats that had been placed in villages earlier in the year. She went on maternity leave and is back with Keith, a healthy young boy.
Currently she is supervising the 2 projects on mission property: the chicken coop and the Dairy Goat Breeding Station. She will arrange for supplies from Fort Portal like grain feeds, medicines and vaccines. She’ll manage coop changes for the chickens as they grow. She’ll direct the breeding, record keeping and tagging of goats. She will be responsible for identifying and treating sick animals.
She is also designing and overseeing the fodder (animal food) fields as well. There is a small garden for the chickens greens. There will also be a demonstration garden. It will show local people how to grow food for their family on their plots of land, while interspersing it with goat food to get the most out of their land.

Last Minute Goat Preparations

We are down to the wire now. Lamech has gone back to Masaka to join his family for Easter and meet his newborn little girl- 2wks old. He will return on Tuesday, April 11th with a load of goats. The journey could take up to 12 hours, so they'll leave at sunrise.
Meanwhile, Pauline is making sure we are ready on this end. Invitations for recipients and government officials like the District Veterinary Officer (DVO) are being delivered for the distribution ceremony on Thurs. the 13th. Plans are being made for the catering that day. The goat sheds are ready. A fence is being strengthened. A water tap is being added to the Buck Station on WHM grounds making easy access to drinking water and water for pen cleaning. Materials are being brought for a small storage garage for all the gardening, and feeding supplies, wheelbarrow, etc.
We are looking forward to an exciting week.

Tip of the Iceberg

Malnutrition in the developing world has been described as an iceberg: acute malnutrition cases (low weight-for-height or weight-for-age) representing only a small portion of those whose nutritional status is negatively influencing their ability to develop into productive members of society. Experts acknowledge there are masses of children who are stunted (low height-for-age), desperately crying out from beneath the surface. This is indeed the case in 3 sub-counties in Bundibugyo, where results of the anthropometric survey WHM conducted in January reveal that 45% of the children we measured had a height-for-age < -2 z-scores from the median of an adequately nourished American reference population.



As we provide families with food aide such as dairy goats, chicken eggs, or groundnut paste, it is our hope that social norms will change so that feeding young children high-protein foods is acceptable. Training on how to care for dairy goats and chickens will increase feasibility and access such foods. Decentralized feeding centers will also help to increase general awareness of the importance of growth monitoring. Finally, we plan to provide additional community education through recipe trials and community dramas. Though these efforts seem small relative to the enormity of the problem, we have hope!

“May the God of hope fill you with all joy and peace as you trust in Him, so that you may overflow with hope by the power of the Holy Spirit” Romans 15:13

“You gave abundant showers, O God; you refreshed your weary inheritance. Your people settled in it, and from your bounty, O God, you provided for the poor.” Psalm 68:9&10

Easter Goats

The goats have now all been vaccinated and have their moving permits. The Tuesday after Easter we hope to have them travel here and be distributed. In the meantime, more training of reciepients has been going on, shelters are being built, and the field for fodder is being cultivated. The rains have started, which allows parisites to thrive, but they also help the growth of the fodder. The fodder is made up of grasses and legume plants (for protein).

Passing on of the gift

This past week, two goat have been returned to the project. Each family that receives a goat returns the first born female to the program. That goat is then given to another needy family. This helps make the program sustainable and blesses the community.

Vaccinations!

The Chicks!

Corn-Soymeal, Beans & Oil

Yesterday was a glorious day where 115 Kwejuna (HIV positive) mothers came to the World Harvest Mission Community Center to receive food supplements for themselves and their families. This distribution continued right where we left off last year, and if you hadn't known that our previous food supplier, the UN's World Food Program (WFP), has left Bundibugyo, it would not have been evident. With some 100+ corn-soymeal blend bags and 70 containers of cooking oil left over from WFP; the generous support of a couple in my home church in New York City (Redeemer Presbyterian Church) which is enabling us to buy food locally; and the competence of Donato, our Ugandan colleague, who travelled to nearby Kasese (4 hours away) and purchased over 3,000 kilos of beans; we were able to serve our mothers as if it was business as usual. What a joy it was to see these women coming from near and far, babies in tow, defying the stigma attached to those living with HIV here, hauling home food for their families for the next 5 weeks!

"So do not worry, saying 'what shall we eat?'...for... your heavenly Father knows that you need them." Matt 6:31-32.