Week two!

The past week I spent my time in Masiaka (I take back the given pronunciation in the past post , say “ma-shek-ka”.. but then again, people here even say it differently). Masiaka is our “home base” so to speak.. its where the Global Action Foundation hopes to build a therapeutic feeding center (TFC) in the future. From Masiaka we drove deep into the villiages seeking out all of the Peripheral Health Units (PHUs) in three chiefdoms of the Portloko district. The drive out to the villiages is difficult and scary a lot of the time.. I’m amazed day after day how our beat up SUV can handle the rocky roads (which are sometimes non-existent) and makeshift log bridges. The experience is like your favorite roller coaster ride, except for five hours a day.

The work we’re doing is really, really grassroots.. it doesn’t get more local and personal than this. Each PHU (which is like the local clinic.. it’s the first level of healthcare a villager might seek when necessary.. its where they go for vitamin A, immunizations, deworming medicine.. etc) has two community workers who go door to door in their villiage to conduct a simple survey with eight questions on all children under five. At this time, they take a measurement of the child’s mid-upper arm circumference (MUAC). If this value falls in the red area as indicated on the MUAC strip (a tape measurer-like device designed to take the MUAC), they are referred to the PHU. At the PHU the National Organization for Welbody (NOW) nurses will take their weight, height, and MUAC to determine if the child qualifies for treatment at the TFC in Makeni. This TFC is in another district (districts can be thought of like states and chiefdoms can be thought of as counties) and it’s the only one in all of Sierra Leone. I visited this past Saturday to arrange a stay with them at the end of this month.

Children who are severely acutely malnourished are treated at the TFC for an average of 28 days to a month before they are discharged. Children who were referred to the PHU but do not qualify for treatment at the TFC are told to undergo community-based therapy with Plumpynut. And Plumpynut is my domain (actually, no.. but I like to think so ^^). Plumpynut is a fortified peanut butter, a ready-to-use therapeutic food (RUTF) that is an effective component of treating malnutrition. Plumpynut is good stuff. Plumpynut is a gift from God and Plumpynut is why I’m here. This past week was a monumental week: I held, for the first time in my life, a sachet of 92 grams of that peanut buttery goodness and I got it on the end of my index finger as I fed a child. AND… I even snuck a tiny drop of it onto the tip of my tongue (I mean, I have to know how good it is if I’m going to continue to tell the entire world that this stuff is really, really good). The verdict: that stuff is delicious and the children thought so too.

Right now, all but a handful of PHUs in the Portloko district have just one box of 150 sachets of Plumpynut. They received the box from the district hospital without any instructions on usage or distribution. Because of the uncertainty of continued supply, we’ve been recommending 1 sachet per day. This is 92 grams compared to the 260 g of Plumpynut that was given in other studies.. but at least its an improvement from the 1 sachet/week that some PHUs were giving out.

This next week, I’ll be on the same schedule as last week and go out for those daily priceless roller coaster rides you can’t find elsewhere on the planet. This week, pray that I become the most unattractive thing to all the insects on the planet… just today, I woke up with 12 new itchy red welts on my right hand. C’mon.. ask the bugs to have the etiquette not to bite through a knuckle or between my fingers.. its really painful!

On a lighter note.. this country is overflowing with mangoes, pineapples, mangoes, coconuts, and mangoes! It seems that I am being blessed with pineapples. Many chiefs of the villages I’ve visited like to gift me with pineapples.  

Thank you for all your good vibes, thoughts and prayers… keep ‘em coming. ^^