Wednesday, November 21, 2007

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 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)

Friday, November 9, 2007


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.

Thursday, November 8, 2007

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.

Monday, November 5, 2007

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

Sunday, November 4, 2007

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).