The REAL first day

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At last, the outreach portion of the feeding program got underway for real.

With another truck back working at Bwafwano, we were able to head out to the Lukata site, which apparently hasn't been able to get visited in several weeks. At most of these visits, the clinical staff run through IMCI (Integrated Management of Childhood Illness) guidelines for children under 5-- a set of algorithms for treating common illnesses in the 3rd world. My best guess is that about 30 children were brought for treatment, with complaints ranging from coughs, chronic diarrhea, rashes, fevers, and many other issues. I ran that section, and only had a couple cases stump me. More frustrating were the ones that I knew needed either specialized evaluation (2 years of mucousy diarrhea) or that needed medicines we don't have (inhalers for classic asthma).

At another station, a nurse was running VCT (Voluntary Counseling and Testing) for people concerned about HIV infection. Of 24 people tested, there were 15 positives, including two children. Scary. A couple of statistics that I've learned since coming here: the HIV infection rate in Zambia is approximately 15%!o(MISSING)verall, with a great deal of variation among subgroups; for example, among the military the rate is over 30%! (MISSING) A major contributor to the problem is a lack of information, or sometimes worse, an abundance of misinformation. I'll post a picture another day of the most disturbing billboard I've ever seen.

Finally, the new malnourishment arm of things enrolled three new children, all three of which had been referred by the home-based care workers. The training worked! Two of the kids had a MUAC that was in the danger zone, and the other had edema of the feet and hands. It's exciting to think that under usual circumstances, these children would have either died or landed in the hospital for a month, and now they'll be treated at home and should be back to health without complications. The count is up to a dozen kids enrolled, with only two outpost sites visited so far.

Even though the day was long, the pace was fast enough that the time flew by. We got started around 10:30 (it had taken some time to drive there), and around 4 one of the nurses pointed out that I hadn't had lunch yet, and forced me to take a break. Oops! Sister Maseko isn't someone to argue with, and I realized at that point that I really was hungry. Luckily, I've gotten the hang of eating nshima, and so it took just 5 minutes to pound down a meal.

Apparently it's a holiday weekend here in Zambia just as it is in the states. Had I known, I would have planned to get away for the weekend. Instead, I'll just be taking it easy Monday, and so probably won't post new entries until at least Tuesday. Until then, enjoy all the pictures and videos I've posted! By the way, I realize that the videos look tiny, I didn't realize my camera shrunk them down so much on the low-memory-use option. If I find a really essential video, I'll try to get it full-size.

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