Last Monday Cont'd

I've finally recovered from the week and ready to blog again...
So continuing with the rural clinic work...
I attended a meeting for two hours with Mardge, Nina, Dr. JMV, the clinic director, and a woman named Aren who does something...she doesn't speak much english and Mardge was a little too busy for some explanations. Anyway, our meeting was to address the HIV+ pregnant population of Nycungu (spelling?) and their breast feeding practice. (Vertical) Transmission can occur at birth when mom and baby's blood can mix, but there are prophylactic pills that can be given to the mother and baby to reduce the risk a great deal. The other method of transmission is through breast feeding, which harbors a 10% risk for the first 6 months. All risk for all modes depends on viral count of the infected person--the more copies of the virus, the more chance of transmitting HIV. Here's the problem: the women don't have clean water for formula and dysentery is, I believe, the top cause of mortality in children under the age of 5 in most African countries. Mothers know that dirty water = death. The other problem is that the babies won't be getting mom's antibodies for certain diseases, which translates to generally weaker immune systems and poorer health. Bottom line is kids will be sick one way or another here. There have also been new studies out of South Africa that show mixing breast feeding and formula for the first 6 months increases not only the incidence of poverty related disease: malaria, TB, dysentery, but also the risk of HIV transmission.

The debate now becomes, how do we keep them safe from diseases and get these women milk/clean water for formula--for 6 months? This was the topic of the day. Two hours, six of us in a crowded office, Kinyarwanda and French with very little English translation. I am amazed by the ability to understand and communicate without speaking the language. This is what I took away from the meeting:

The rural clinic of Nycungu serves 28,000 people, most of whom travel a great distance through the mountains to make it for a visit. (One grandmother walks two hours through the mountains to pick up ARVs for her grandkids once a month.) We are dealing with an estimated 96 HIV+ pregnant women each year. Not only is there a need to increase efforts for bringing these women into clinics and hospitals to deliver (to receive prophylaxis as mentioned above), but fresh milk and water needs to find its way into their homes. The proposed idea is to raise two dairy cows at the clinic and each day boil fresh milk and water to mix for each woman to come and get 1-2 liters to replace their breast feeding. Problems: too far to travel each day...
So, give each village or neighborhood a cow. Problems: not enough milk to share with people who aren't pregnant and you know everyone will want some. Still have to boil milk and water--water's not commonly boiled now. Run the risk of dividing milk up and the women are so poor they might still breast feed to save the cow milk for other children who are typically getting one meal a day.
This debate was obviously not settled.

We left the meeting to tour the rest of the simple, yet elegant facilities. (True beauty in extreme simplicity.) Nina and I were waiting for Mardge when I saw a toddler in the waiting room. The room was extremely crowded and everyone was looking at the Mzungo's standing around. The toddler takes one look at me and starts balling. I generally don't have this reaction from children, so I was slightly surprised. Everyone in the waiting room was pointing and laughing at me...I imagine "Oh silly mzungo! Hahaha" Every time she saw me, crying. Not just quiet sobbing or clinging to mom, but down right horrendous screaming. I looked at the women, threw up my hands, shrugged, and we all laughed.

I am impressed by this aspect of human nature: the uncanny ability to share thoughts and feelings that overcome the language barrier. Every day I have these encounters, especially with the children, where I feel connected to others, who seemingly live in a totally different world, yet there is a strong, stunning something that links us all. I know this sounds like a Lion King song, but it is entirely true. It is humbling and awe-some, in the truest sense of the word, to be welcomed in this way and to feel a universal, innate bond, true love, I suppose. It always makes me wonder, How would these people be received in the US? Why have I never felt this connection with strangers I meet in my daily life back home? After all, we speak the same language. I think it's because language often colors our world and attitude in such a way as to distract us from this feeling. I often find myself losing my patience with those around me and thinking negative things after my interactions with many other people. This all comes back to the Anthony de Mello quote I posted earlier. I suppose, I am not truly seeing those around me at home. It is sad in many ways that it takes something as extreme as a trip to another continent to come to this realization. Better late than never. I am anxiously awaiting the search for this connection when I return.