Today I went to children's support group. I almost killed Burtan...the group supervisor. I get there and it's the hottest day of the season so far. It's so hot that the kids can't play. Over 100 kids between 5 and 18. Rounding up small children is difficult enough when I speak the same language as them, but forget it here. It took about 45 minutes to get them all seated, but that's only half the battle because now we need to get their attention.
Burtan gets up and starts yelling. They ignore him for a bit longer. Then he begins to quiz them about the lectures he has given them in the past. They talk about HIV, associated infections, nutrition, and healthy attitudes. I'm listening to Nyla, a trauma counselor, as she offers her hand at translation and randomly hear my name, look up, and see Burtan smiling with a million little hands waiving in the air. Uh-oh...
Burtan called me up to the front and informed me that the kids wanted me to give a lecture on Vitamins, nutrition, and healthy eating. Fabulous...let's all enjoy a good laugh about that...the future physician that openly detests fruits and vegetables has to explain good eating habits to a group of kids that are generally malnourished. I slowly walk to the front of the group and wait for Alice to translate for me. Alice is a great person with a huge personality, but nearly inaudible voice. Here's the scene: Me, standing in front of 100 kids, screaming "how many of you eat one piece of fruit each day" followed by Alice's hushed murmur of a translation and a sea of confused faces. Uh...ok. Once the kids got the general idea of my talk and my question, only about half of them raised their hand. I kept asking about their diets, following the same line of questioning and each time less than half the kids raised their hand.
After my quick polling, I started to lecture on the two fruits, most important for their immune system: oranges and bananas. About thirty seconds after I opened my mouth I leaned over and quietly asked Alice if they even have oranges here...it was going to be a long day...Once I had a list of culturally appropriate food, I started telling them about how to eat a little from each food group and what things were best for staying healthy while HIV+ and came to realize that even though Burtan claimed to have taught them about the immune system, they had no idea what I was talking about. So I back tracked a little and explained about the part of our bodies that fights off disease and protects us. At which point I had kids making gun motions and smacking each other. Not going well...I look around for Burtan to maybe help me out a little and he's no where to be found.
Ok, so let's move on. I get a suggestion being shouted at me from the back of the mob. It's another intern trying to convince me to tell them about the benefits of antioxidants in tea. Um, if these kids don't understand the immune system, I'm pretty sure terms like 'antioxidants' are going to be a bit more elusive. Eventually, I got across a couple of main points: bananas and oranges are good. Milk is good. Eat some fruits and vegetables each day and try to eat some meat. This is really quite a big joke because I've seen these kids eat and I know that if meat is available, there's not a chance in hell, they're going to pass it up. If they could maintain healthy eating habits, they would because anything is better than not eating and fruits and vegetables are cheaper than meat. There is virtually no chance of obesity, diabetes, or heart disease for this community.
My brief vitamin/nutrition lecture concluded with a question/answer session. This is the most important part of the discussion and I got in a fight with Burtan because he tried to cut it extremely short. He informed me that in Rwanda students are lectured to and not allowed to ask questions, so he felt that as long as I covered what he asked me to (which was pretty vague to begin with...vitamins, go!), things had been adequately accomplished. Well, the kids had quite a few good questions about sugar. I had to laugh because, despite their limited diet, kids love sugar. So I asked how many kids like Fanta. This time everyone raised their hand. So I tried to explain the little nutritional value held by soda and stressed the importance of milk and water. The day eventually concluded with Burtan volunteering me as the guest lecturer each week on a different health topic. This is only funny to me because it's so typical of my experience here. You're supposed to teach 200 kids english...last minute change to health topics two weeks earlier than your lectures were supposed to begin. I always felt like a pretty flexible person, but I now feel 100 percent justified in considering myself to have quite a bit of adaptability. Most days I'm flying by the seat of my pants...and yet it always works out.
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