Tag: Malnutrition

Wrapping Up the Week 3.2.13

Published on by Marilyn8 Comments

I’m couch-bound so it affords a perfect opportunity to sit back and wrap up the week. Remember the Ugly, Beautiful Scars? Well – we’re waiting to see just how ugly, beautiful this one is. Surgery was yesterday and yes, there will be a blog post. There is something terrifying and lonely as you gaze up at bright operating room lights and you realize you are completely out of control. And then you remember that, lonely as you are, there is One present who knew you before you were born and your nervous heart and anxious mind begin to rest in His care….(to be continued!)

On to the weekend wrap up.

On human trafficking: In the west it is easy to armchair simplify some of the problems in the world. From poverty to health care to world hunger we want big, sweeping, answers and progress. We want people to make healthy choices without considering some of the obstacles that could prevent them from making those choices – for instance, having to take three buses to get to a grocery store, yet McDonald’s is across the street and offers a full stomach and 1400 calories for $1.49 plus tax. And that’s only one small example. I believe human trafficking is one of those issues that our limited vision sees as one-dimensional. We’d love to swoop in and rescue, but usually these problems are far more complex. In the article You Can’t End Human Trafficking Without Ending Hunger the author points to the desperation created by poverty and hunger. Desperation that can lead to the unthinkable. Take a look and see what you think.

On rice: Even as hunger looms as a world-wide problem, there are glimmers of hope. India’s Rice Revolution tells the story of a “Miracle Village” in Bihar that has set a record for growing rice – all with no artificial herbicides. It has scientists and food experts around the globe cautiously excited. Could this be an answer to world hunger? I don’t know enough about it, but the article is hopeful and a great read.

On birthing children in faraway places: This article is an older article found through a new blog. Rachel lives in Djibouti and blogs from Djibouti Jones – Life at the Crossroads of Faith & Culture. I have loved perusing through her blog and I think you will as well. The article I read resonated fully with me as I gave birth to one child in Pakistan and two in Cairo, Egypt. She chronicles well the process and realization that this child has begun a life between two worlds. Take a look at A Child of Two Worlds published in the New York Times.

2013-02-26-mlady1On Family Pride: My daughter-in-law Lauren turned 25 this week. We are so honored to be a part of her family. Lauren is an amazing, talented actor and this week her improv group, M’Lady, was featured in the Huffington Post. Take a look here at The Oscars Improvaganza. Their group is the first one featured. We are so proud of her and this group so if you live or visit Los Angeles, think about going to the show!

On my bedside stand: I’m immersed in Behind the Beautiful Forevers. It is so well written; poignant and heart piercing. To end this weekend wrap-up I leave you with some words to draw you in:

“Asha grasped many of her own contradictions, among them that you could be proud of having spared your offspring hardship while also resenting them for having been spared.”

Thank you for reading and engaging in Communicating Across Boundaries!

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Wrapping Up the Week

Published on by Marilyn2 Comments

It’s felt like a long week! With a weekend – that ‘oh so favorite time for the middle class’ – comes our weekend wrap-up.

On Malnutrition and World Hunger: This is a big topic for me. I feel it in my gut and several times a week read a blurb or article on malnutrition in the developing world.  The question asked in the linked article is whether fortified rice can be a game-changer in the fight against malnutrition. The irony of course is that I now live in a country where our biggest health problem is obesity….that’s a hard one. Read Cambodia: The Game Changer Against Malnutrition and let us know what you think of the issue and the article!

On hate: – There’s disagreement….and then there’s hate. Is it possible to disagree with someone and yet not hate them? Absolutely. But what I often hear about President Obama is pure venomous hate. Is this racially motivated? It’s a hard question – it’s an important question. Take a look at this article and see what you think – Hating President Obama (in Jesus’s Name). “But it is possible to disagree and challenge with respect. And if you can’t conjure up respect, you can at least disagree and challenge without being hateful.” from the article.

On College Costs: As a mom of 5 this is a soapbox topic for me – college costs and school loans. Here’s one man’s take on how to get what he affectionately calls his 10 K-B.A. The comments are all over the map in this one so don’t read too far! But what do you think of college costs and the dilemma of higher education? Weigh in through the comments after you read My Valuable, Cheap College Degree.

On Saying Goodbye to Adult Children: The GypsyNesters are a couple that are living an unconventional and wonderful empty nest life — instead of pining for the days with kids, they are embracing a life of adventure as ’empty nesters’. This article is a great look at saying goodbye to adult children. Take a look at Post-Parting Depression: Saying Goodbye to My Adult Kids and see what you think.

On Downton Abbey: What if the episode were Facebook updates? Take a look at this hilarious Facebook recap of Season 3, Episode 1.

Most interesting comments on the blog: These came from Cab Driver Conversations. Turns out that there are many of you who have had interesting conversations with cab drivers. Two links below are from a reader who blogs at Outasiteoutamind. I love these two stories!

1. http://outtasiteouttamind.com/2012/02/15/global-litter/
2. http://outtasiteouttamind.com/2012/11/05/on-american-progress/

On the same article Pari commented “We all have a little drama, many short stories and at least a novel in each of our lives.” If you haven’t had an opportunity, take a look at the comments on the article. They are proof that the readers of CAB are amazing!

Crime and Punishment

On my bedside table:  Oops! No changes from last week! First They Killed My Father and Crime and Punishment call out to me by day and by night!

I’d also love to know what have you been reading. Feel free to share and link in the comments and with that, Have a great day!

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The Face of Hunger

Published on by Marilyn6 Comments

This piece was originally posted just under 2 years ago when I began blogging. At a time of year when my refrigerator is full, and making or buying special sweets and savouries is daily on my ‘to do’ list, I find it’s easy to lose perspective; to fret about what I can’t afford instead of recognize all that I have, and all that I need to realize about those who go without. So with that in mind I wanted to post it again. Thank you for reading.

I was not  familiar with the face of hunger. 

While I am aware of this as a problem, my personal experience with it is limited.  Somehow the problem of hunger had worked its way to a corner of my brain that registers “Real but not understandable” in a robotic voice.  I grew up in the developing world and children with bloated stomachs and tiny legs were common.  As can often happen when one is a child and sees their world through a child’s eyes, adult experience is needed to bring better understanding and perspective.  It was in this context that I saw the face of hunger with new eyes, with transformed vision.

It was in Pakistan 2 years ago – the beginning of week two of my trip to take part in flood relief with internally displaced persons.  This particular village had just been re-inhabited   You could see the line from the flood waters on the mud and brick homes about three feet from the ground.  The crumbling bricks promised the need for a complete rebuilding of the homes to make them safe.  Animatedly, the women told us their story:  “The water came!  We knew we had to leave – we took whatever we could and walked 5 days to Khanpur.  We couldn’t walk at night because of the robbers.  Look!  Look over there!  You can see that the water is still here! We lost so much.  We just returned a couple of days ago.”

It was another story of loss and displacement.

This day it would be a tail-gate clinic.  This put ‘tail-gating’ in a new context and forever changed the idea for me.  We opened the back of the van and arranged the portable pharmacy as best we could and began the clinic.

There seemed more than the usual number of malnourished children on this day.  We were giving out Plumpy’Nut, the miracle pint of goodness guaranteed to make a dent in malnutrition, like it was candy.  “Two tablespoons, morning and evening”  “Buh chumcha isubh, isham.”  We had it memorized so when the doctor needed the community health worker/interpreter we could function alone with no need for interpretation.

The face of hunger came half way through the morning in the person of a young mom, emaciated with her dark eyes sunken into a lovely face, a baby clinging to her breast sucking furiously, desperate for a drop of milk.  The breast was completely dry, there was no milk.  The baby’s face and body so thin, wide-eyed, not even energy to cry.  I stepped back, hardly believing what I saw.  My heart caught in my throat and I felt a wave of nausea.  The baby couldn’t have been more than 4 or 5 kilos but by his length I knew this was not a new-born.  Maybe seven or eight months old.  The mom was desperate.  This was not a malnourished child – this was a child that was starving accompanied by a hungry mother. Plumpy’Nut was not going to work its miracle this time.  This baby needed an act of God and admission to the mission hospital. The mom was holding her baby with a depth of love that words would fail to describe.  Cradled in her arms, her eyes pleaded for help and a miracle.

I don’t know if the miracle ever came.  The nature of our work was moving to different areas with medical needs every day.  There was a need to move forward no matter how difficult the situation; we couldn’t afford to be paralyzed by emotions that would prevent us from helping other people with other needs at other villages. During those minutes we did exactly what we should have, what we could have.  Vitamins, Plumpy’nut, instructions to the mom, a letter to authorize admission to the mission hospital, all with the un-spoken thought “It’s not enough, I know it isn’t enough”

This was the face of hunger. I had seen it, touched it, wept for it. Now stamped in my brain, marked on my heart, I would never forget, could never forget.

The robotic part of my brain had been re-programmed with human emotion to cry out to God to feed and comfort the face of hunger.  My response to “care for the widow and the orphans” would be forever adjusted.

“Pure and genuine religion in the sight of God the Father means caring for orphans and widows in their distress” James 1:27
During this time of year, when hearts and pocketbooks are more open, might I suggest a couple of organizations to donate to that work specifically to provide either food directly or to develop projects that affect the local economy, ultimately offering long-term solutions to the problem of hunger. 
  • Food for the Hungry – With a mission to “To walk with churches, leaders and families in overcoming all forms of human poverty by living in healthy relationship with God and His creation.” this organization is well-run and innovative in its approach to world hunger.
  • Central Asia Harvest Project, Kazakhstan – this project “seeks to improve the quality of life for small-scale fruit farmers of eastern Kazakhstan through a farmer to farmer training program and development assistance designed to improve farming methods and livelihoods.” I’ll be doing a longer post on this organization in the next week.
*The picture shown is not a picture of the child mentioned in the post. While this child is malnourished, she was treatable with Plumpy’nut and vitamins.  
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Moms and Babes – the First 1000 Days

Published on by Marilyn5 Comments

Every day I wake up and I know my children have enough to eat. It’s always been that way. When I lived in Chicago with a new-born baby, breastfeeding for the first time, I would wake up and have a nutritious breakfast, full of protein and the calories necessary for my baby to thrive. When we lived in Pakistan, a land where the average daily wage is three dollars and fifty cents and poverty inescapable, my children were well nourished babies and toddlers. Egypt was the same.

No matter how poor I thought we were, there was always food, there was always healthcare. But I, well (perhaps over?) nourished, am not the norm.

Each year over 2.6 million children die of malnutrition.

Save the Children has published their “State of the World’s Mothers” report for 2012. This annual report focuses on the first 1000 days of life, that critical period of development for a child — a time when the effects of poor nutrition will yield long-term results that cannot be reversed.

The period begins at the start of a woman’s pregnancy and goes through a child’s second birthday. It is during this time that good nutrition is necessary for a child to grow both intellectually and physically, in brain and in body. Malnutrition not only affects the baby, it affects the entire country and ultimately the world through extending poverty, lower earning power and loss of human potential.

The report looks at which countries are successful at providing adequate nutrition during these first 1000 days and which are not. But it also goes further and looks at solutions that are not costly and can make all the difference in a child’s life.

Some of Save the Children’s key findings include:

  • Children in an alarming number of countries are not getting adequate nutrition in their first 1000 days. “Out of 73 developing countries- which together account for 95 percent of child deaths – only four score”very good” on measures of young child nutrition”
  • Child malnutrition is limiting the future success of millions of children and by default their countries
  • Economic growth is not enough to fight malnutrition. It seems like it should be so easy, right? Just offer more aid, more money, increase assistance to farmers. But like many things it takes not only money but also policy change in a world where women and children don’t stand on the highest rung of the global ladder.
  • Health workers are the key to success. By this they don’t mean doctors and nurses in traditional primary care settings, but rather community health workers and midwives stationed in communities and available to bring community care of teaching on hygiene and nutrition, vitamins, promoting breast-feeding,and treating diarrhea.

The report is not all bleak. Solutions are introduced in the form of 6 low-cost nutrition interventions that were identified. These are iron folate, breastfeeding, complementary feeding, vitamin A, zinc and hygiene. None of them are expensive and Save the Children estimates that these could be provided for a cost of $20/per child for the first 1000 days. The report suggests that over 2 million lives could be saved through world-wide implementation of these interventions.

But for the interventions to work people and policy have to come together and care. So what to do? It’s a Tuesday morning and if you are like me you are probably sitting a bit removed from all of this — I just had a coffee worth half a day’s wages for a Pakistani.

I’m told in the book of James that “Religion that God our Father accepts as pure and faultless is this: to look after orphans and widows in their distress and to keep oneself from being polluted by the world.” and I can believe that malnourished children, and moms who can’t afford the nourishment fit well into that category.

A start for me is to take a closer look at this 70 page report.  Awareness is always a first and necessary step.

And after awareness I’m not sure – I do know this —  it is not about guilt, not about feeling forced, rather any steps are out of a greater understanding and commitment to my faith and God’s world.

Series on Pakistan: The Face of Hunger

Published on by Marilyn6 Comments

This entry is Part 4 of a 5 part series.  If you have just begun to read please feel free to reference Part 1: Orientation.  Thank you for your interest!

I am not  familiar with the face of hunger.  While I am aware of this as a problem, my personal view of it is limited.  Somehow it works its way to a corner of my brain that registers “Real but not understandable” in a robotic voice.  I grew up in the developing world and children with bloated stomachs and tiny legs were not uncommon.  As often happens when one is a child and something is understood through a child’s eyes, adult experience is needed to bring better understanding and perspective. It was into this context that I saw the face of hunger with new vision.

It was the beginning of week two of our medical camps.  This particular village had just been reinhabited.  You could see the water line on the mud and brick homes about three feet from the ground.  The crumbling bricks promised the need for a complete rebuilding of the homes in order to make them safe.  With animation the women told us their story:  “The water came!  We knew we had to leave – we took whatever we could and walked 5 days to Khanpur.  We couldn’t walk at night because of the robbers.  Look!  Look over there!  You can see that the water is still here! We lost so much.  We just returned a couple of days ago.”  It was another story of loss and displacement.

This day it would be a tail-gate clinic.  It forever changed the idea of tail-gating for me.  The back of the van was opened and we arranged the portable pharmacy as best we could and began the clinic.  (*It should be noted that one of the not so complimentary pictures of our trip was taken that day – that of 50 year old backsides bending and reaching over and into the back of a van.  Not so pretty!)

There seemed more than the usual malnourishment today.  We were giving out Plumpy’Nut like it was candy.  “Two tablespoons, morning and evening”  “Buh chumcha isubh, isham.”  We had it down so when the community health worker was needed by the doctor we were covered!

The face of hunger came half way through the morning in the person of a young mom, emaciated with her dark eyes sunken into a lovely face, a baby clinging to her breast sucking furiously, desperate for a drop of milk.  The breast was completely dry, there was no milk.  The baby’s face and body so thin, wide-eyed, not even energy to cry.  I stepped back, hardly believing what I saw.  My heart caught in my throat and I felt a wave of nausea.  The baby couldn’t have been more than 4 or 5 kilos but by his length I knew this was not a new-born.  Maybe 7,8 months old.  The mom was desperate.  This was not malnourishment – this was starvation and Plumpy’Nut was not going to do it this time.  An act of God and admission to the mission hospital is what was needed.   The mom was holding her baby with a depth of love that words would fail to describe.  Cradled in her arms, her eyes pleaded for help and a miracle.

I don’t know if the miracle ever came.  The nature of our work was moving to different areas with medical needs daily.  There was a need to move forward no matter how difficult the situation so that we weren’t paralyzed by emotions that would prevent us from helping others. During that minute we did exactly what we should have, what we could have.  Vitamins, Plumpy’nut, instructions to the mom, a letter to authorize admission to the mission hospital, all with the un-spoken thought “It’s not enough, I know it isn’t enough”

The robotic part of my brain had been re-programmed with human emotion to cry out to God to feed and comfort the face of hunger.  My response to “care for the widow and the orphans” would be forever adjusted.

“Pure and genuine religion in the sight of God the Father means caring for orphans and widows in their distress”

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Series on Pakistan: A Shout-Out to Plumpy’Nut!

Published on by Marilyn7 Comments

Note from Author:  This is Number Two in a 5-part series on Medical Flood Relief in Pakistan. For those who are just beginning the series please feel free to reference the first post .

We woke at the first Call to Prayer from the neighborhood mosque.  Echoes of the call from other mosques all over Shikarpur were like hitting the snooze button on an alarm.  As I would fall back into a doze I would hear another.  For me a sure sign that I had come home. I drowsily recalled the controversy that had made headlines in the US when President Obama described the Call to Prayer as “one of the prettiest sounds on earth….” thinking “But it IS!”

Our sleep had been fitful.  The Hindu temple next door was in full event mode with singing until 4am.  Electricity went on and off throughout the night and using the generator meant a trip to the porch, stepping on a 3-foot high stool, and taking a wrench to move the handle to generator mode.  Despite these interruptions, we were ready to begin Day Two and prove our newly acquired ability to work with a portable clinic, communicate with rusty language skills and  face the challenges that were sure to be a part of our day.

The streets were already crowded as our van inched its way to our destination through a traffic jam of donkey carts, rickshaws, bicycles, women in burqas, children holding tightly to the  flowing fabric, and a sea of men.  We arrived at a Baluch village 20 minutes outside of the city limits and were immediately surrounded and greeted by women and children.  “Kush ha?”.  “Ha Kush ha” we would reply.

It became acutely apparent to us that if there was any shade in the area it would be given to the doctor;  the nurses?  Umm, not so much!  This day we were lucky and a charpai (rope bed) was set up under a small thatched roof area where we quickly organized our pharmacy and created a space for our community health worker to advise patients and make sure babies and children were immediately taking their malaria medication.  The thatched roof proved to be a challenge for us but  high on entertainment value as one of the beams was in a perfect place for an adult to hit their head – and it HURT!  The giggles it provided for children and women surrounding us forced us to laugh rather than cry when the collision was particularly hard.

The medical problems were much the same as we had seen on day one and a pattern emerged.  Each person  came to us with a paper in their hands containing:

  • their name
  • who their father was
  • chief complaint
  • the doctors quick notes
  • the treatment plan

Usually it was a group of around 5 – A mom, a baby and her 4 or more children.  Today we began to grasp the toll the flooding and resultant lack of food and close quarters had taken on people.  There was Mohammad, 3 years old, looked like he was 10 months old; Samara, 1-year-old, appeared to be 4 months. Not only did everyone have malaria, but along with the high fevers they were itching from scabies, runny nosed from colds, and most had worms. Tears seemed to come quickly this day – was it because I was so tired?

Let your heart break for things that break the heart of God went through my head.  Mother Theresa said that didn’t she?  If she could do this kind of work for years then surely I can do it for two weeks!

Every malnourished child received vitamins and Plumpy’Nut.    I had only heard of Plumpy’Nut the day we arrived but it was already my favorite treatment.   A READY TO USE THERAPEUTIC FOOD! (RUTF) developed by a French pediatrician as a wonder drug for malnourished children, the French government had distributed a gazillion packets to Pakistan and we were the grateful recipients of hundreds of these.  Better still, one of the doctors at the hospital had figured out how to make it with local ingredients. Once the precious supply was gone we would still have this available for these kids.

This pint-sized packet of goodness was full of peanut butter, oil, nutrients, powdered milk and more and had already proved its value in other areas where malnourishment claimed childrens lives and if not their lives then certainly their IQ’s and any chance for normal development.

(To see more on Plumpy’Nut – Take a look at this CBS News Clip “A Life Saver Called ‘Plumpynut'”)

As the day moved on, we were better able to enjoy those around us – the smiles,  stares, the laughing at our fumbling attempts at communicating in Sindhi and along with that we began to hear their stories.  We were sustained with humor and Grace far more than our human capability. Around 1 in the afternoon we said our goodbyes, packed up our mobile clinic and moved on to another clinic, not initially planned but brought about by the tenacity of a widow who had walked over a mile in 98 degree heat to urge us with passion that:

Our village has needs too! You need to come to our village!” The request was too emphatic and the need too great – and so of course, we went.