I was anxious to get back to the PEM ward and see Udadisi again. The nutritionists were down the hallway in a meeting when I arrived and told me it shouldn’t be a problem if I sat in on it. I was hoping to sneak in and find a seat in the back, but when the door swung open I was standing in the center of the room with a ring of 20+ people sitting along the walls staring at me. I snagged the only seat, in the center of the front row, and sat down awkwardly.
The latch on the door was broken and it swung open periodically as we learned how to fill out various forms. One woman talked about HIV prevalence in Meru, of 415 patients tested, 2.4% were HIV+. When tests were repeated again later, the rate was 2.7%.
The head nutritionist discussed the two options available to HIV+ mothers when feeding their infants. The first option is exclusive breastfeeding for up to six months with the possibility of continuing for up to a year if the mother is on prophylaxis. The alternative is exclusive replacement feeding with commercial formula which for 6 months would cost KES 50,000 (about $530). She stressed that the mother, and not the doctor or nurse, should choose the regimen that’s best for her. Animal milk, including that from cows and goats, is not recommended because it can lead to malnourishment and cause infections which may lead to death.
After the meeting one of the men attending shyly walked up to me. “He wants to greet you” one of the nutritionists said. I stuck out my hand to shake his “Fine” he said before I could ask how he was. That tends to be a common occurrence, people saying “fine” to me before I say anything to them. I can’t quite figure it out. What’s also interesting is that everyone I’ve met so far has given me the “dead fish” handshake we’re told in America is unprofessional. I guess it’s unusual here to shake people’s hands firmly. I've been trying to remember that.
Udadisi immediately recognized me when I walked in the PEM ward. She pointed me out and started babbling. There was a small blanket wrapped around her waist, under her overalls, acting as a makeshift diaper. She waddled as she walked back and forth in her crib. She held a smelly hot pink rag in her hand which she hit me with over and over again. She got upset when she dropped the rag on the dirty floor and I wouldn’t return it to her. Then she took off her little fleece jacket, and holding me with one hand, she hit me with it with the other.
Tea was served in silver metal buckets to the women in the ward and Udadisi was given some milk to drink. It dribbled down her chin as she drank. She peered at me from over the top of the cup and wagged her finger as I laughed.
I was nervous when I first arrived in the ward and realized that a number of the children were missing. One in particular had been in critical condition and my first thought was that she had died. I found out to my relief that a number of the discharged children had been moved across the hallway. Mwanafunzi took me to see some of the children.
I immediately recognized the first toddler I saw as the girl with the peeling face who had been in the critical ward during my first tour. She was sitting up in bed happily chewing on bread dipped in porridge. Much of the swelling from the edema had gone down and she was looking much healthier. It was nice to see a success story through from bleak beginning to full recovery. Mwanafunzi told the mother that she should try and leave the hospital as soon as possible. Her baby was healthy but risked getting illnesses from the other children in the ward if she didn’t leave soon. She can’t afford to pay the hospital bills and will most likely be there for a while waiting for a waiver.
As I was leaving the pediatric ward, a woman walked by me carrying a stack of papers with two bags of blood precariously balanced on top.
We returned to Karima Primary to drop off roughly a month’s supply of porridge. The head teacher recruited a few of the older boys to help carry the heavy bags into the front office. When they turned their backs to me to unload the car, I noticed many of their pink uniform shirts were torn and one boy had blue pen marks all over the back of his shoulder. The pockets were missing on some of their shorts while others hung by a few threads.
Their excitement was tangible as they carried the porridge inside. It was incredible how happy the sight of food made them. The head teacher translated what one of the boys said, “He said he will come with a big mug and they are very happy”.
An elderly woman smiled with what teeth she had left and led us to meet a few of the other women in the group. She was wearing a bright blue sweater with cows embroidered on it and a gray leopard print scarf on her head. The floor inside the house was made of compacted dirt and the women made room for us on the couch. They served us masala tea and slices of white bread. My hands were full when one woman arrived late and went to shake my hand, so she hugged me instead. The women were cheerful and when I asked, via Dorcas’s translation in Kiswahili, what types of food they would benefit the most from, they said anything would do. They were grateful to receive whatever we could give them.
That night I met up with a bunch of American volunteers for pizza at a place called Sherlock’s Den. Afterward we headed to Simba Wells, a club which has a swinging wood bridge for an entrance.