In our first couple of weeks with Gardens for Health International (GHI) in Rwanda, we were fortunate enough to visit a few of the families that had graduated GHI’s program so we would better understand the need for and the impact of our fight against childhood malnutrition. We were driven deep into the countryside and dropped off individually with different families that spoke very little or no English. I was introduced to my family in front of their mud and stick home, which they were waiting to expand when the rainy season returned and mud was easily available.
The mother of the family, Clementine, greeted us at the road with her child on her back. Her husband was off doing some work nearby in the village. We exchanged greetings and awkward smiles with a few laughs. We could not communicate anything more complicated than a game of charades would allow, but I could tell she was younger than me – probably not even into her 20’s yet.
Thiery, her young baby that she cared for everyday, could have been a poster child for malnutrition. He was less than a year old and was clearly emaciated and had the blonde hair that is a common sign of malnutrition among the universally dark-haired Africans of the region. The clearest signs were his eyes though. They seemed at once both sunken and swollen, and they never focused on anything. Thiery never made a sound the whole time I was there. He was dazed in the stupor of a brain literally starved for fuel.
Clementine- her child on her back – handed me two yellow jerry cans, and we started walking to fetch water along with two other young children from the area, also carrying jerry cans. We walked up the hill and through the village, attracting lots of stares and laughs on my part as the only white man within quite a few miles, no doubt. I took it in good humor and laughed as well at the absurdity of the experience, and we continued down into the valley more than a mile away to the village’s public well.
I arrived back at Clementine’s house with my arms aching after a few embarrassing failed attempts to balance the larger jerry can on my head as she was.
We began preparing sosoma, a nutritious porridge common in the area and our program. Clementine then explained the things she had learned with more charades and pointing at various parts of the printed training materials our program had provided in the native language of Kinyarwanda. She showed me how to properly wash my hands, indicated that she was chronically depressed through more gestures and pointing at the mental health training paper. She then showed me how she feeds Thiery plumpy’nut – a high calorie, high nutrient paste used as treatment for severe malnutrition. Her husband arrived and a few more neighborhood children showed up for some sosoma, and we all exchanged more awkward smiles and gestures for another hour until it was time to go.
Three months later, all of the fellows were encouraged to revisit our families – this time as a group so we could meet the other families and one of our Rwandan fellows could act as translator to communicate with our families and better understand their situation. Revisiting my family, some part of me wildly hoped that everything would be better – that the baby would be healthy and happy and walking, and that the mother would be all smiles and happiness. Instead I was greeted by another reminder that real and meaningful progress requires time and long term investment in the issue.
Thiery was still blonde and still looked rather skinny in Clementine’s arms as we arrived. His eyes still had that sunken look to them, but they did look at me. And then he cried, because that’s what many babies do when they see their first scary “mzungu” or white person. That crying was still infinitely more welcome than the vacant silence that I still remember from my last visit. He was also leaning and wobbling around with some excitement and trying to sit up by himself and struggling to crawl out of his mother’s lap – although he was clearly not capable of that particular physical feat, yet.
Through the gracious translation assistance of my Rwandan co-fellow Isaac, we were able to learn that before being enrolled in GHI’s educational program, Clementine thought that her baby had been bewitched by unknown enemies and that was the cause of his wasting. When she did seek help at the local community health center, they told her that the bewitching theory was ridiculous, of course. Then, they told her that the baby’s non-responsiveness was likely due to a mental illness and that she should seek treatment for her baby at the mental hospital. Technically, a lack of nutrition to the brain might qualify as a mental issue, but treatment with mental medication or baby therapy is not likely to be effective. The problem as it turned out was that Clementine had never began supplementary feedings in addition to breastfeeding even though Thiery was nearly a year old. After GHI’s training though, she said she understood that her baby was sick and needed plumpy’nut, whole milk, sosoma and other foods to receive the nutrients and calories for his body to bounce back and begin growing again.
It’s okay, you can say it. All of this seems absurd right? How could someone believe that babies can be bewitched or that mental problems cause babies not to eat and gain weight? Well, how does anyone learn these thing? Every child believes in magic, and no one figures out these things on their own. Someone, who cares, teaches them. It is incredibly easy to take education for granted especially at the earliest stages of development. In the rural areas, outside of the major cities where power, internet and even outsiders are a rarity, education is key to early childhood development. That is what makes GHI’s mission so powerful. Because, as always, knowledge is the gift that keeps on giving.