Tag: Plumpy’nut

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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Series on Pakistan: The Benediction

Published on by Marilyn8 Comments

Note from Author:  This is the closing post to a 5-part series on Pakistan.  If you are beginning the series feel free to link back to the first entry “Orientation”. Thank you for reading and caring!

Our time was coming to an end. We had only 32 hours left before leaving by van, back to the Sukkur airport and the journey from Karachi to New York via Abu Dhabi.   We had laughed until our stomachs ached, and cried from the depths of our souls.  We had communicated across the boundaries of place, poverty, language, and crisis and were humbled through the process. While dreading the thought of leaving, we knew it was time.  Husbands, jobs, children and life in general were waiting for us back in the United States.

The last IDP camp was just a kilometer away from the hospital compound.  The tents stretched from main road to railroad tracks, some surrounded by children, men, women and buffaloes and others empty with only the remains of a cooking fire left to show they had been occupied.  In between the tents were lean-to’s that sometimes sheltered buffaloes and other times people’s belongings – today it was our shelter!  A newly produced cow pie was evidence that the last inhabitant was not human.  I cursed my strong  sense of smell and buckled down to organize our clinic for a final time.

Quickly we saw the difference between this camp, where medical help had been offered 2 weeks earlier, and the others we had held.  It was encouraging to see less malaria, almost no scabies, wounds that were healing, and give out minimal Plumpy‘Nut.    Some of the people around us were gathering belongings, preparing to pack and go back to their villages.  The camp went smoothly and we began to pack up as the last patient was seen.

The old woman came up to us as we were putting away supplies.  Her right foot had two wounds, one deeply ulcerating, the other healing.  They were wounds that both Carol and I knew would heal quickly had she been in the west with good wound care. 

As Carol dressed the wound she exclaimed her amazement to the woman in how clean the wounds were: “You have kept them so clean!  This is a good thing!”  We marveled at her ability to accomplish this in the circumstances that were her reality.  (See ‘Wound Care for the Wounded’) No running water, no dressings, no ointments, no shoes…We both looked at each other at the same time – “No shoes, we can change that!  We can get her shoes!!”  Carol first took off her sturdy, close-toed shoes to try them.  Too big, too difficult to put on when she needed.  My not-so-sturdy close-toed shoes were next. No. Not a fit.  We remembered the soft soled, comfortable sandals in our closet back at the hospital and knew that was the answer.  I located our team leader and asked that I be taken back to the hospital “I’ll be quick, I promise! We need shoes!”  I knew the food and survey team was anxious to pack up and head out to another village.  Within 10 minutes I was back, shoes in hand.

The woman was sitting on a charpai.  She had no idea what was happening, just that we had asked her to wait.  I approached her with the shoes and her eyes welled up.  “Allah jo shukr aahey” ‘Thanks be to God’  Over and over she pointed to Heaven – thanking God, touching my head with blessing as I  put the shoes over the dressing carefully applied by Carol.

My last view was of the woman holding out her hands in thanks to God, her verbal expressions of amazement and gratefulness serving as a benediction to our time in Pakistan. The service was over, it was time to go home.

Marilyn Gardner & Carol Brown returned to the United States, arriving in JFK International Airport the evening of October 30th.  They are currently developing plans to return as soon as possible.  For more information about ongoing relief efforts and news on the flood here are a couple of organizations that they believe would funnel funds directly to flood victims with very little overhead.   All the organizations have the capability for online giving.  Here is the disclaimer: They are not relief work experts and are learning as they go and work to create awareness.

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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”

Enjoy reading this blog?  Sign up for regular posts by clicking the Stay Tuned to This Blog Link at the upper left side of the Home page!

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.