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Tuesday, September 25, 2007

A Day with Stephanie

. . . Is tiring but worthwhile! We started our day early because Jonah had called an emergency staff meeting, which incredibly dragged on for 2 1/2 hours. The main issues for discussion were: what time should staff be expected to arrive for work, and can we all commit to coming at that time? What should be done about staff who miss shifts consistently, or who are difficult to find when on call? Who decides how the hospital vehicle can be used? And can our underpaid “sweepers” keep this expanding facility clean? Africans are very skilled at discussing, everyone gets their say, and these meetings are an opportunity for nurses to politely and indirectly express their frustration with their superiors, or for those who are shirking their responsibilities to be warned. Meanwhile the staff meeting was occurring in the very spot we hold nutrition clinics on Tuesdays, so Stephanie politely tried to work around it. As soon as the meeting was over she rushed to finish distributing food and I rushed to see the rest of the inpatients so we could spend the afternoon together going to a small health unit for nutrition education.

We biked uphill all the way to Busunga where about twenty people awaited their afternoon of teaching, sitting on benches under a breezy veranda. Some are community health workers like TBAs, others work in the government health center as nursing assitants, while others are volunteers from a local church. First they reported on their homework assignment, counseling a breast feeding mother, dealing with lactation problems and encouraging exclusive breast feeding. Then they reviewed more of their previous teaching before launching into today’s topics: responsive feeding, the idea that the environment and manner of offering food is equally important to the quality of the food offered. Stephanie played a 1 year old in a hilarious skit contrasting two family meal scenes. There were brightly colored learning aids drawn on sugar sacks, on how to make a nutritious porridge. They grappled with some scientific concepts like calories and carbohydrates and frequency distributions for weight for height . . . All translated into very concrete and simple language since some of the older TBA ladies could not even hold a written paper right-side-up, or sign their names to the registry! The last order of business was to sample a nutritious snack of a boiled egg and a banana/cassava pancake.

This is the kind of energy and time intensive public health effort that must be done bit by bit, week after week, with small groups of people, to see real change in community beliefs and behaviours. So Stephanie will continue to slog through the river and pump up the hills, continue to patiently answer questions and creatively design lessons, continue to pray that her efforts translate into healthier children in Bundibugyo.

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