Saturday, December 14, 2013

Rougie


One of the foremost strengths of Peace Corps work is that volunteers live in the community they are working with. Unlike other development agencies or almost anyone else devoted to public service of disadvantaged peoples, Peace Corps volunteers can see the problems of their village with greater detail and nuance because they experience it firsthand. 

Peace Corps volunteers also have the opportunity to live with host families, an experience I have treasured and one that brings you even closer to the community. I have come to think of my mothers as my own for the constant care, attention and love they give me. I respect and admire my father. I joke with my sister and delight in her happiness and achievements. I love the babies as if they were my own siblings. 

When I arrived at my site the youngest child was 4 months old, a baby girl named Rougie. I have four younger siblings in America and I have been around many babies in the states, but I have never met one like Rougie. She was the happiest and most joyful baby, smiling and just laughing for the thrill of it every couple minutes with that adorable hiccuping belly laugh that babies have. She was healthy and beautiful and loving. You can see why I fell in love. In the first three months of service volunteers are supposed to hold off on projects to become more integrated into their communities and improve their language, so I spent a lot of my free time with Rougie, enjoying her smile and letting her brighten my day. 






As you may have read in a previous blog post, being sick in Senegal and the ensuing fasting of Ramadan hit me hard. It ended up taking me weeks to feel normal again, and my normal here is significantly weaker and lower energy than my normal in America. I have been totally blown away by the drastic effect nutrition has had on my body. The nutrition at my house actually got worse after that. Before the harvest came in we had a period typically known as starving season. We had our usual plain bread in the morning, and then for lunch we would have a medium to small bowl of rice and half a potato for six people and a baby. Sometimes we got dinner, but for a while it was every other day or every two days. I wish I were exaggerating this. Simply put, I was starving.

But this story isn’t about me. As much as it hurt me and made me unhappy to have so little food, I am a grown woman with years of consuming bountiful healthy food supporting me so my body can handle periods of little food. But for children who are still in development and at vulnerable stages of their lives, it is infinitely more difficult and dangerous. At first I didn’t notice a difference in them. No one ever complained and no one ever said that they were hungry. They played and went to school just as they usually did. But you could tell in little things. They ate frantically when food did come. They cried more often. They slept more. The worst hit by this was of course the littlest, baby Rougie. The first two years of a child’s life are when they are most vulnerable to just about everything, including malnutrition and sickness. Rougie started crying more, a lot more. She didn’t smile or laugh anymore. Her mother, very hungry herself, couldn’t console Rougie and everyone became irritable. Looking back, I didn’t realize why Rougie was crying so much, why she had changed so much from the happy baby I used to know. I thought her mother just wasn’t paying enough attention to her or that she was going through and colicky stage. Towards the end of October her increasingly frail system got sick and she had diarrhea for ten days. Ten days of completely emptying your body when your body is less than 20lbs can be a death sentence. Diarrhea is the number one killer of children under two in this area, and it can happen incredibly fast. I am actually surprised Rougie didn’t get worse faster than she did. It took its toll though. After several days of worriedly watching her and trying desperately to get her to drink ORS, her sickness reached a peak. She started throwing up and couldn’t keep much of anything down. She became listless and couldn’t even hold herself up into a sitting position. I was terrified. I thought we were going to lose Rougie, this tiny beautiful soul that everyone loved so dearly. Her mom and I went to the doctor 4km (2.5 miles) away and he gave Rougie medicine. The next day, she could sit up. She recovered, but she still wasn’t back to her old self. She still cried almost constantly and she didn’t try to crawl or stand up like she had before. She had lost weight over the past month. When I picked her up I could feel her ribs. She had lost a lot of her protective baby fat and you could see it on her tiny frame.

The village health staff and I do baby weighings for children under two years of age in our village once every month. For the month of October we had record numbers of babies whose weight for age put them “in the yellow.” Other children were suffering just like Rougie. 

On the first of November, my work counterparts and I decided to do what is known as a hearth project. My counterpart had heard about it from the Senegalese government organization PRN and I had heard about it from my Peace Corps training, but it was essentially the same thing and is used in many areas where malnutrition is prevalent. Typically you gather a group of 10 to 15 women and their babies and every day one woman cooks while you all talk about proper nutrition and feeding techniques. The children get good food for the duration of the project and the mothers learn how to continue the recipes and practices. For our project we included all the yellow babies who could eat normal food (my counterparts and I strongly advocate for exclusive breastfeeding for the baby’s first six months) in our hearth group and had them come to my counterpart Penda’s house in the evening for 15 days. On the first day we weighed them all to establish baseline weights. We made porridges and rice dishes that were hearty without being too expensive and stressed supervised feeding to the mothers. 

There are two main times a child under two is especially likely to dangerously lose weight. The first is after 6 months when breast milk is no longer enough to sustain the baby and they need to be introduced to other foods. Mothers here feed the babies rice, which has far less nutritional value than breastmilk, or foods that are too adult for their stomachs to handle- things with a lot of hot spices or too much oil. They are also now in danger of getting sick from unclean drinking water or being fed from unclean hands. The second time starts at about a year and a half, when the baby can walk. Mothers and women in general here are extremely busy- just getting water for the day from the well can take 3 hours depending on your family size, not to mention cooking over a fire for as many as 20 people and doing the dishes afterwards, bathing all the children, sweeping the house and yard, doing laundry for everyone, the list goes on. Once a child can walk they are a child of the village and wander and play wherever they please with their friends. How much a toddler is eating or if they are eating at all can get overlooked when they can feed themselves and walk away after Mom gives them bread. They are still at a vulnerable stage of development and can’t quite take care of themselves, but they don’t require the constant attention from their mothers that they used to. The hearth project works on two things to help each of these periods. The first is nutritional, which helps babies of any age, but we specifically teach about foods that are appropriate for young babies to transition to normal solid food. The second focus is the supervised feeding, talking to mothers about overseeing their child’s feeding time and having them practice it for the 15 days. 

I was excited about the project and loved having all the mothers and babies come over in the evenings to eat and hang out. I knew that this kind of project was something I was supposed to be doing as a Peace Corps volunteer and I was happy my village was following through with it. I liked that my counterpart was doing most everything. She was being a leader in the community and I was supporting her, just the role I was supposed to take. I was doing my job, following the book. What I didn’t expect was the drastic change it would have on baby Rougie and how thankful I would be for that. Rougie ate the food ravenously and her mother, initially unenthusiastic about the project, started to watch her more closely and feed her more at lunchtime as well. Before the 15 days were even over I saw a change in Rougie. She stopped crying as much. She started smiling more. She crawled more and started laughing again. She would crawl over to something she had never seen before and just laugh at the joy of discovery. She gained weight and her baby rolls started to come back. In the weeks after, she continued to improve. She was just happier. She would respond to my smile and her mother’s singing. She crawls like a pro now and is starting to climb and stand. She got her first two teeth recently and not even teething has put her out of her naturally sunny disposition. I’m so worried that I am going to miss her first steps. I didn’t fully realize before how much she had changed for the worse when she was sick and hungry. I thought her happiness as a baby just hadn’t lasted through to her toddlerhood. It turned out to be much more than that, but all it took to help her was some knowledge and a little community organization.

The change that I have witnessed in Rougie because of the hearth project is astounding and it gives meaning to all of the work my village does. I know I haven’t written anything in a while and I’m sorry for that, but I hope this post gives some insight to what I have been up to. Sometimes, things are really tough here. Sometimes they end up with an inspiring happy ending. Most times I don’t know what I’m doing. No matter what happens, I am learning a lot and I am surrounded by love.