A narrow red dirt road, often lined with pedestrians, leads to the hospital complex. It is a maze of rectangular buildings attached by sloping cement walkways all adorned with corrugated tin awnings. To reach the maternity and pediatric wards, you must first pass through a metal gate adjacent to a snack stand emblazoned with Coca Cola logos. Immediately to your left are a few clothes lines where people have hung their colorful laundry to dry and further in the distance a fire pit presumably to burn trash. Walking on there will most likely be a number of women to your left, some pregnant, sitting outside on cement block benches. You have now reached the maternity ward.
The baby formula which MKMF donates is used for children under the age of 6 months. (Preemies are fed the formula so they don't strain themselves breastfeeding.) It was for this reason that we were brought to the maternity ward.
I took off my clunky hiking boots as I entered and slipped into a mandatory pair of white plastic shoes. The small room we were in led to a larger room where the baby formula was prepared in the back. Off of this room were two smaller ones. In the first were 4 or 5 incubators with a total of five tiny and adorable naked babies. Two women sitting on a wooden bench in the center of the cramped room looked at us warily as they breastfed their newborn babies. The next room held two babies, each in their own cribs, who had been abandoned. One was a beautiful baby boy who seemed quite comfortable sleeping face down at the narrow end of his crib with his feet poking out between the bars. He poked his head up and stared at us for a brief second then put it back down. He had recently been born and his mother had left the hospital without taking him with her. The other child we were told had been there for quite some time.
From there we walked over to the pediatric ward where I will be spending the majority of my time. It is a long rectangular building with a straight hallway running down the center of its length. The sides of the hallway and much of the floors are made of reddish, smooth cement. A strip runs down the middle where "CHILDRENS WARD" is written in big block letters made of two toned gravel. Along either side of the hallway are a number of rooms, or "cubes", whose turquoise and white walls end abruptly at equal height before reaching the partially exposed tin roof above them. Red metal support beams can be seen underneath.
Cube C is for PEM (Protein-Energy Malnutrition) and Abandoned Babies. It's a large room with 4 white metal beds lining the back wall below a grid of plate glass windows. Directly to the right are 2 cribs with abandoned children. The girl is adorable and curious taking any chance she can get to wander off and explore the ward. Directly to the left and suspended from the wall is a TV in a turquoise metal cage. The 8 mothers of the 8 malnourished children who all share these four beds can often be seen with their faces turned upwards towards the dubbed soap operas which I've found are quite popular (and entertaining!) here. Almost half of the children have been discharged, but their mothers have stayed waiting for government waivers of their hospital bills. The standard daily cost at the hospital is KSH 200, or $2.11, but even this subsidized price is hard for many of the mothers to afford.
To the back left is a small room taken up almost entirely with two beds, a desk, and a wooden bench shared by three malnourished children in critical condition and their mothers. This is the room where the children with the most severe cases stay. It is also possible to tell how severe a child's condition is by what type of formula they are on. F-75 is used initially to boost their weight and stabilize them and then they are switched to F-100. One of the baby girls suffered from edema caused by a buildup of fluids in her tissues. When she first arrived her whole body was completely swollen, but now the swelling has gone down considerably and she is doing much better. In addition, her skin is peeling and her face is a few shades lighter than the rest of her body with a distinct line around the perimeter of her face where the skin stopped peeling. In the corner was a heater which at the time appeared to be broken but we found out later had gone off with the electricity.
I think I can honestly say that some of the things I saw and experienced in South Africa prepared me for what I saw yesterday and what I will be seeing in the future. As a result, I felt much more emotionally prepared than I think I would have otherwise.
Later in the afternoon we went to the Kaaga School for the Deaf to talk to the librarian of the library MKMF built and furnished there. Some of the kids playing outside got really excited when we arrived. They all ran up and started signing to us. I felt bad I didn't know any sign language, but it wouldn't have mattered anyways because they know Kenyan sign language which I found out is completely different from ASL. The kids were really animated and we gestured back and forth for a bit. I handed over my notebook and they had fun writing down their names for me.
I had heard that an American volunteer was working at the school, but I didn't think he'd still be there. All of a sudden the kids got extra excited and started pointing off into the distance. I instantly knew it was him. They kept making gestures that we looked alike, that much I could understand! It's nice to know there is someone around to talk to with a similar perspective as mine. He also gave me some good advice on how to get unlimited texts, too bad I don't know many people to send them to!
I ran some ideas by the librarian for some fun promotional events we hope to host in the upcoming months. Currently about 20 people from the community visit the library each day (30 on holidays) and our goal is to increase those numbers.
I caught a ride to the hospital from the superintendent today, no big deal. He's been really nice and supportive with my work there, so it was nice to get a chance to talk to him a little more.
I met up with a student from a nearby university who took me to the pediatric ward to talk to some of the mothers with malnourished children. We started in the critical room where a woman sat hunched over on the wooden bench wringing her green handkerchief in her hands. On either side of her were two mothers with their young daughters. The student asked one what was wrong with her in Swahili. Her 5 year old son had passed away during the night. He had been brought in two days before and placed in the critical care room to treat him for malnutrition. I wanted to say something to her but I was at a loss of words and remained silent.
He pulled back the blanket of the young girl in the bed to the right. I'd seen her the day before and knew she was in critical condition, even after a month of being at the hospital, but didn't know the extent. She is 5 years old and weighs less than 10 kgs...that's 22 lbs! I thought I'd misheard but he confirmed that her weight was in fact correct.
He spoke to her mother for a time and asked her a few questions. I also observed while he spoke to a 20 year old mother with a 6 month old malnourished baby.
So far, commonalities between the mothers seems to be little or no education and lack of stable employment. Many women appear to be single mothers who brought their children to the hospital for other symptoms, not knowing until they arrived that they were malnourished.
I am interested to find out more and to see if these trends continue. I'll be spending every Tuesday in the pediatric and/or maternity wards and every Friday in the HIV clinic.