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.