Wednesday, February 27, 2008

weighing children to save their lives....

If you are a mom or dad (or if you remember going to the doctor when you were a toddler!) you know that a routine part of a doctor's visit for a child is for him to be weighted and for his size to be charted. Weighing a child is a way of monitoring her growth, and discovering whether or not she's healthy.

Here in Rwanda (Kibogora), as recently as five years ago, children were generally not weighed. This was not because of ignorance but because of poverty. There were scales at the health centers in scattered villages, but the concept of a "regular check-up" for a child is laughable in a community where the average person makes $2 a day. In the meantime, children would die of malnutrition (and other illnesses made worse by malnutrition).

This changed about four years ago, when WR's child survival program instituted community growth monitoring, a monthly program to weigh children at neighbors' homes, right in the villages, in order to prevent malnutrition and monitor low-weight children before they became severely (and life-threatening-ly) ill. The scales are the kind you can hang from a tree or a beam in the roof....here's a photo from the Mbande Clinic:



Malnutrition rates in Kibogora were reduced since instituting growth monitoring and introducing malnutrition programs in local homes. Awesome!

interesting facts about sub-saharan africa

Hi everyone! A friend here in Africa forwarded these to me today with the comment, "No wonder this continent is in need of some child survival...." I thought I'd share it with you here. Just reading the list through is a geography lesson...I had to go find Mauritius and the Seychelles on a map.

FYI, further down the list, there are little indicators that say (MDG #). MDG stands for Millennium Development Goal, goals set by the United Nations in 2000, to be achieved by 2015. For more info, please see: http://www.un.org/millenniumgoals/

Here's the list:

INTERESTING FACTS ABOUT SUB-SAHARAN AFRICA
Source: Africa Development Indicators (ADI) 2007

South Africa uses the most electric power per person (4,884.8kW/h); Ethiopia uses the least (32.7 kW/h).

Burundi has the highest proportion of women in its labor force (90.5% 2005); Sudan has the lowest (22.5%).

Niger has the highest proportion of men in its labor force (95.1%); Namibia has the lowest (62.7%).

In South Africa, the poorest 20 per cent have 3.5% of national consumption; in Ethiopia they have 9.1%. (MDG 1).

Thirty three percent of children who start first grade reaches grade five in Chad; in Mauritius 97% reach fifth grade. (MDG 2).

The lowest net primary enrolment ratio is found in Djibouti (33.3%); the highest is in Sao Tome and Principe (96.7 per cent). (MDG 2).

In Swaziland more than one in every three 15-49 year olds has contracted HIV (33.4%); the rate is six in every thousand in Mauritania.

Mauritius has the highest life expectancy (73 years); Botswana has the lowest (35 years).

In the last decade Rwanda and Uganda have made the greatest gains in live expectancy: 12 and 7 years respectively.

Conversely, life expectancy has decreased 21 years in Botswana, 17 years in Lesotho, and 16 years in Swaziland.

The Seychelles have the highest adult literacy rate (92%); Mali and Burkina Faso have the lowest (24%).

In Seychelles 92% of women are literate; the figure is 13% for Chad and 15% for Niger.

In Mauritius there are 22 children per primary school teacher; there are 72 in Ethiopia.

Mauritania has the highest gross enrolment rate in secondary education (88%); Namibia has the lowest (7%).

In Sierra Leone two women die for every 100 live births; in Mauritius 24 die per 100,000 live births. (MDG 5)

In Burundi, 56.8% of children under the age of 5 are short for their age; in Gambia it is 19.2%.

In South Africa, 2.5% of population are below the minimum dietary energy consumption; in Eritrea, 75% are below.

Nearly one child in two under the age of five is underweight in Burundi (45.1%); in Swaziland it is one in 10. (MDG 4)

In Ethiopia, 22% of the population has access to a safe source of water. In Mauritius, it is 100%. (MDG 7)

South Africa has 724.3 mobile phones per 1000 people; Ethiopia has the least with 5.8 per 1000 people.

In Chad, 9% of the population has access to improved sanitation facilities; in Mauritius 94% have such access.

In Democratic Republic of Congo, Ethiopia and Niger 2 persons out of a thousand are Internet users; there are 249 in every thousand people in Seychelles, which also has 189 computers per 1000 people. (MDG 8).

In 2004 the poverty headcount ratio at $1 a day was 41% of population from 47% in 1990.

In South Africa 10.7% of the people live under $1 per day (PPP); 70.8% do so in Nigeria. (MDG 1, IDA 1)

In Sierra Leone 165 out of 1,000 children die before the age of one; in Seychelles the rate is 12 per 1,000. (MDG 4)

In Sierra Leone 282 children per 1,000 die before the age of five; in Seychelles, the rate is 13 per 1,000. (MDG 4, IDA 2)

Skilled personnel attend 5.7% of births in Ethiopia; they attend 99.2% of births in Mauritius. (MDG 5, IDA 4)

Liberia has three phone lines per 1,000 people (0.28); the Seychelles has 93 per 100 people. (MDG 8, IDA 8)

For more interesting facts (and for data sources) see http://web.worldbank.org/WBSITE/EXTERNAL/COUNTRIES/AFRICAEXT/0,,contentMDK:20563739~menuPK:1613741~pagePK:146736~piPK:146830~theSitePK:258644,00.html

Saturday, February 23, 2008

an effort at transparency, thanks to Kristin

My good friend Kristin has a blog at http://girlmeetsohio.blogspot.com. A few weeks back she wrote an entry about transparency. One thing I like about Kristin is she always did have the courage to be transparent.

So, strengthend by her example, and prompted by a British preacher, here is my effort at a little sliver of e-transparency:

On Saturday, the entry from Oswald Chamber's famous devotional "My Utmost for His Highest" included the following paragraph:

"If our devotion is to the cause of humanity, we will be quickly defeated and broken-hearted, since we will often be confronted with a great deal of ingratitude from other people. But if we are motivated by our love for God, no amount of ingratitude will be able to hinder us from serving one another."

(If you'd like to read the whole entry...and it's a good one....please go to http://www.rbc.org/utmost/index.php)

I share this because, when I'm honest, I can't always feel certain about my motives for being here. What's really in my heart? If I felt unappreciated or unsupported, would I be so eager to be here? Maybe time will tell. Or maybe it will always be a mystery. They say at four months all the excitement of being in a new place wears off, and then the proverbial rubber hits the road. I'm at week...let's see...week 7 right now, I think, and everything is still fresh and exciting. But reading this devotional entry was a good reminder to examine my heart and get a little prepared for what likely lies ahead. I'll have to keep you posted.....

visiting Prez and mandatory meetings

Hi all! Just a quick update on how things are going this week, and random related thoughts! I am hopelessly behind in email so if I owe you one, I apologize....I will try to get to it as soon as I can.

Melene and I arrived back in Kigali on Tuesday and hit major traffic snarls on our way into town. Come to find out, the President (as in, George W) and his wife were visiting Rwanda for the day. We knew they were coming, we just weren't sure which day, and since we were in Kibogora all last week, we were extra in-the-dark. Anyhow. The Bushes just completed a five-nation tour of Africa, and they were very well-received here (and safely received, as well...I have never seen such a high ratio of policeman to street corners, ever). I heard from Becca, who's friends with the wife of a US Embassy official, that in addition to AirForce One, another plane accompanied the President and his wife around Africa, carrying all the vehicles of their entourage as well as a fleet of secret service agents and guard dogs. The guard dogs arrived here on Monday, apparently, and did quite well overnight in the Novotel. In case you were wondering.

That evening we eagerly watched CNN for presidential coverage in Rwanda...surely there would be at least a little clip of Bush outside the new Embassy, or shaking hands with Kigalians, or something like that. Sure enough, a few minutes into the broadcast, President Bush appeared on the screen, in Kagame's administrative chambers, sandwiched between two Rwandan flags, talking about.....Castro. Of all the days for the dictator to step down, he had to pick the same day that Bush visited Kigali. :) Ah, well. There's always next time. Oh, wait....

At any rate! That was Tuesday. The rest of the week has been a whirlwind; my focus here has shifted for the moment, from newborn health to overall child survival, and I'll explain why and how, etc., the next time I write. I am very busy with some new work, though (which hopefully will clear the way for me to return to newborn health....we'll see). I'm loving what I'm doing, though, and although I often feel in over my head I'm learning so much every day. It's crazy and fun! I have some good friends at home to thank for keeping me grounded...you're the best. :)

Friday a fun thing happened: at about 1:00 pm I got an email that said, "Did you hear about this afternoon?" from one of the WR staff people. I thought for a minute, in case I had actually heard whatever it was, but had forgotten I'd heard (does anyone else do this??). But I finally concluded that no, I hadn't heard anything about the afternoon. I responded as such.

Well, it turns out that everyone was being told to close down shop for the afternoon---like, the whole city---and all Rwandan citizens were to report to the city stadium at 2 pm for a logistics meeting about new identity cards, driver's licenses, and the upcoming elections (not for President, but for his government). Wow! An afternoon off! And with no advance notice whatsoever!! Apparently the news had been circulated late in the morning.

(In case you're wondering, I didn't go home....too much work to do! But it was a nice thought.)

I'll post this while I still have a strong internet connection. Talk to you again soon!

Thursday, February 14, 2008

the earth is still shaking

(Hi everyone! I've been in Nyamsheke for the past eleven days, in southwest Rwanda, and I wrote the following entry while I was down there, thinking I could get online and post it. That's what I get for thinking! While we actually did have internet connection, it was very slow, and we lost electricity for three days, even. Anyhow, I'm back in Kigali now...will write more soon...in the meantime, here's news from Nyamasheke:)

For the last two nights in a row, I've been shaken awake in my bed as aftershocks from the earthquake continue to pulse through this region. It was especially disconcerting two nights ago, when the bed was actually jumping. Just when I gained enough foggy awareness of what was happening and decided to rush for a secure doorway, the quake stopped. I went back to sleep, my heart racing. Phew. Never a dull moment!

A small team of us (Melene, Melanie, and I) have been down here in Nyamasheke since last weekend, facilitating a training in the Care Group model of community health outreach. Care Groups are groups of organized members of the local communities committed to teaching a specified number of households about health-related issues. The Care Group model was very successful in helping reduce child deaths and illness here in Nyamasheke during World Relief's previous child survival program. A small group of Congolese health workers joined us here in Nyamasheke to work on a plan to implement Care Groups in Bukavu, Congo. Here are some of our Congolese friends:



You might remember that I was in Nyamasheke a year and a half ago to complete my thesis research. It is great to be back! At that time, the hospital was under construction, but it is now finished. (And what a great job they did!) Below are two photos: the top is a "before" picture from 18 months ago, and the photo below depicts the new state of affairs.





Yesterday I was startled by the load this woman carried, out on the road. It's a common mode of transport for various goods, but this is a bigger load than most!



More later....

Saturday, February 9, 2008

off to nyamasheke

Hello again! I'll be in southwest Rwanda with Melene for the next ten days....not sure if I'll have internet connection or not, but I'll try to be in touch the best I can. I still owe many of you emails!

We'll be conducting two different trainings in the community related to child survival; one of the trainings is with a partner organization in the Congo.

Thanks for your prayers for safety in travel (a five hour drive, one way) and that our work would be effective and honoring to God. And thank you all for your continued emails....it is always so great to hear from you!

Talk to you soon! -Christine

Friday, February 8, 2008

a month in review: newborn health in Rwanda

It's hard to believe it's been one month since I got here....it flew by! Thank you for your prayers and support along the way; I have really appreciated your emails and notes of encouragement (and owe some of you a reply!!). I will try to catch up on my correspondence ASAP.

Until then, I wanted to give you an update on the work project here.

Did you know that the World Health Organization estimates that 10 million children under the age of 5 die every year from preventable causes? Things like pneumonia and malaria, even diarrhea, are killers of children in developing nations. It's hard to imagine something much worse than watching your own child die of something that should be simple to cure....

Of those 10 million children who die, nearly 40%, or 4 million, are less than one month old. Newborns the world over require specialized attention and care, and in developing nations, several factors combined inhibit the provision of such care. Sometimes it's ignorance, sometimes it's harmful but traditional cultural beliefs about newborn care, sometimes it's the lack of trained personnel to handle complications, and sometimes it's environmental factors, like little or no access to water. Oftentimes, it's a combination of all these factors.

My role here for the year is to explore the factors surrounding newborn health that are specific to Rwanda. While I am working with a pre-existing child survival program (run by three non-government organizations who are partnering together), I've spent the last month getting the lay of the land, not only learning where the child survival program has been working here and what they've been doing so far, but also meeting with other organizations in-country (like UNICEF) who are also working in newborn health, and attending meetings about child health at the Rwandan Ministry of Health.

After all these meetings and orientations, my role has been distilled and refined, and in collaboration with the Ministry of Health I will be conducting research over the next several months to explore the social and cultural norms surrounding newborn health here in Rwanda. I'll be trying to uncover why and how mothers and families and community health workers and health facility workers perceive and care for newborns in the ways that they do. Then, armed with that information, we'll be able to develop health messages specific to the Rwandan culture and environment regarding how to best care for newborn babies.

If you like pictures better (like me), here's a picture that the US Agency of International Development put together to describe the process of development in an international setting. My work can be placed in the second column over, the "product development" column, doing research as a basis for a future "product" (forming relevant health messages).

(Sorry, the picture is supposed to go here, but it can't load!! I'll work on it.)

I am really excited about doing the research because it means I get to go out into the villages and work with child survival program staff and interact with villagers. I will essentially be conducting trainings (in French, yikes!) for the staff and then overseeing collection and compilation of data. I am madly trying to fill in all the gaps in my French vocabulary (newborn health has a whole dictionary of its own terms, it seems...), and I appreciate your prayers for that! And I am continually thankful for your prayers for health (physical, spiritual, emotional, all)....what a blessing. :)

My prayer is that my focus in all of this work would be on the One Who purely loves and delights in all newborn babies, and Who (amazingly) knows Himself what it is to be born in very unfavorable conditions to parents with minimal resources.

Catch you again soon!

Monday, February 4, 2008

the earth is shaking

http://news.bbc.co.uk/2/hi/africa/7225896.stm

Please follow the above link for BBC news about the earthquake that hit southwest Rwanda on Sunday. I am very sad to report there were casualties and many injuries (not to mention damages to churches and homes) down in Nyamasheke, the area where I lived in 2006. WR currently is working in child survival in Nyamasheke as well.

World Relief is mobilizing volunteers and helping to organize the relief effort right now; thank you for your prayers. World Relief staff and families are all safe.

Thank you for your emails of concern; we did feel the earthquake here in Kigali but it was nothing serious. I'll keep you posted with any further developments.