Re: Challenges

Today was my first day of volunteering at the clinic in B. with Grace. Vicki, Grace, and I are each going in 2 mornings a week to work alongside the clinic staff and
help see patients. This was an idea from Dr. Rob, our medical director, to help us cope with the growing number of sick people arriving at our gate each day during
this time before our health center opens and we have the staff and resources to run it. During these months over the rainy season, our focus is Mabaan language
learning and building relationships with people in nearby communities and we were finding it increasingly difficult to do this with the number of patients coming at
all hours each day. So now we have been spreading the word that people should go to the B. clinic and that 2 of us will be there on Tuesdays, Wednesdays, and
Thursdays.

There are no doctors at this clinic but 2 medics, a couple medical assistants and a traditional birth attendant. It is a very busy place and it is presently the only
health facility for most of M. county so people walk for hours to reach it (as they have been doing to reach us in D. also).

I've agreed to focus on seeing the children while I'm at the clinic. Reality hit fast and hard this morning as my first patient was a severely malnourished 4 year old
with a complex health history. Most of the morning there were 2 translators available but at the beginning there was only one who was helping Grace. The little girl's
father spoke some English so we did the best we could. Talk about being thrown into the deep end and feeling like you're about to sink! Malnutrition in children is a
real area of interest for me, but other than one little boy I helped Vicki with in Doro one day, I have only studied it in the classroom and the textbooks, and
certainly not enough! I had my Handbook of Paediatrics for Developing Countries with me so did the best I could with what I knew and what I had available for treatment
(which wasn't much). I tried to give some advice to her father about increasing the frequency of her meals and giving goat's milk etc. and asked them to come back next
week. I also asked if I could pray for her before they left. I had once again quickly come to the end of my knowledge and resources and knew this little girl needs the
touch of God if she is to survive.

She has been heavy on my heart this afternoon. After my language study, I spent a couple of hours pouring over my nutrition books, trying to learn as much as I could
about severe marasmus (protein-energy malnutrition with severe wasting). Fortunately, Vicki will be in B. with me tomorrow and she has had a lot of experience with a
feeding center for malnourished children in Zambia. We are going to try to send word to the family to bring her back tomorrow so Vicki can see her also and we can try to do a bit more to treat her underlying infections and hopefully arrange a home visit where we can sit down with the family and discuss feeding in depth. Severely malnourished children always have underlying, often hidden, infections and need a range of medications to treat these. They are also at risk of hypothermia, hypoglycaemia and many other complications. Please pray for this little girl. I don't remember her name after a hectic morning but God knows it! Please pray that we can find her tomorrow.