Sådan bekæmpes en uven / How to fight an enemy

Jeg har venner. Jeg har faktisk rigtigt mange venner. Det blev bevist idag da jeg ville sende en mail ud til alle mine venner fra min yahoo-konto, for at reklamere for denne blog, og min konto midlertidigt blev lukket med beskyldinger om Spam!  (Undskyld) Men nu er det ikke venner, eller spam dette indlæg skal handle om, men “uvenner”. 

Jeg er tilbage i Akobo, som fortiden fungerer som mit hjem. Desværre deler jeg hus med en uven; en flagermus og hele has udvidede familie. Dette er til nogen morskab for mine afrikanske kollegaer, som griner hvergang jeg bukker mig fordi jeg tror en flagermus vil flyve ind i mig, eller desperat svinger min lygte for at få flagermusene ud af mit værelse. desværre er det nogle legesyge væsner, som f.eks finder det underholdende at flyve i en spiral over min seng, under min seng, over min seng, under min seng osv.  Nu er vi altså nogen som har lært at flagermus har hundegalskab, og det har jeg altså bare ikke lyst til at dø af! -Nåh ja, jeg er jo vaccineret... men hvad nu hvis den ikke virker? Og de er da grimme, er de ikke? Og hvis de tisser på en får man udslæt... Og frygt er ikke rationel.

Mit nyeste våben mod disse “dæmoner” er en pose med vand og mønter i. (efter råd fra en sydafrikansk kollegas mor) -Virker det? Ja flagermusene syntes ikke at have særligt travlt med at komme ud af mit værelse da jeg bar posen herind, men jeg er villig til at prøve hvad som helst! -og hvis det virker kan i være sikre på at der også kommer en pose op i “badeværelset”

bush-livet har sine udfordringer for en storby-kvinde.

English:

I have friends. I would actually go as far as to say that I have many friends. I got the proof of this today, when trying to send out a message from my yahoo account to advertise for this blog, and for hours thereafter found my account closed, and me being under allegations of spamming! (sorry guys). But know my intentions was not to write about friends, neither about spam, but about my enemies. 

I am back in Akobo, which at the moment is the closet I have to a home. Unfortunately I share the house an enemy, a bat, and his whole extended family. This creates a lot of fun for my african colleagues, who is laughing whenever i bend, so the bats does not fly into me, or desperate swing my torch to make the bats leave my room. They are quite playful the bats. They enjoy a game of flying in a spiral around my bed; first over it, then under it, then over it and so on. (quite disturbing when you are trying to sleep). Know we are some who has been taught that bats carry rabies, and I am not ready to die from that. -yeah okay I was vaccinated, but what if that did not work? And they are ugly, aren’t they? and if they urinate on you, you will get a rash... Fear is not rational!

My latest weapon is a plastic-bag with water and coins in. (on advice from a south african colleagues mother) Does it help? -well it did not look like it intimidated the bats when I carried it into the room, but it is worth the try. And if it works, another bag goes in the “bathroom” 

Life in the bush does have some challenges for a city girl! 

På bjergets top / on the top of the mountain

Lørdag Morgen i Juba. Jeg er rullet ud af min seng exceptionelt tidligt. Vi vil bestige det lokale "Jebel" (bjerg), og vil igang før det bliver for varmt. Planen er at spise morgenmad på toppen. Vi mødes ved foden af bjerget med nogle af de andre NGO'er, iklædt vandresko, solbriller og en thermokande med kaffe. På vejen op kommer vi forbi det lokale kødmarked. Gederne er slagtet på stedet, og der stinker af rådentkød, eftersom resterne er efterladt som en godbid til ådselæderne. Vi når toppen efter ca. en times gåtur. Udsigten er fin, og der blæser en dejlig behagelig brise (kald det en naturlig aircondition) og morgenmaden nydes med behag, før nedstigningen. Jeg har set "min by" fra oven.

Saturday morning in Juba. I have rolled out of bed earliere than usual.  we want to climb the local jebel (mountain), and we want to get going before it becomes to hot. The plan is to have breakfast on the top. We meet with some other NGO's at the feet of the Jebel, dressed in hikingboots, sunglasses and a thermo with coffee. On the way up the mountain, we cross the local meat market. they slaughter the goats on the ground, and there is a terrible smell of rotten meat, as the left overs are left as a delicious snack for the scavengers. We reach the top after approximately one hours walk. the view is splendid, and a nice breeze is blowing (call it natures own airconditioner) and breakfast is taken with delight, before we climb back down. I have seen my city from above.

The medair climbers!

Historien on en Moder (The story of a Mother)

Jeg spotter hende allerede under appetit testen. Hun sidder med et hold tivillinger på skødet. Hun er ældre end de andre mødre. Hendes ansigt er vansiret af traditionelle tatoveringer. Jeg har ladet mig fortælle at tatoveringerne blev indført of englænderne under kolonitiden, for at de kunne adskille de forskellige stammer fra hinanden. Om det holder vand, ved jeg ikke. Hendes børn er små. Hun ammer dem. Hendes omsorg for børnene gør indtryk på mig
Da hun en time senere kommer til mig i konsultations teltet, får jeg min nysgerrighed stillet. Hun deler sin, og børnennes historie med mig. Begge børnenes forældre døde i forbindelse med massakren  i september. Hun er børnenes bedstemor, og har taget dem til sig som sine egne, ammet dem og kæmper dagligt for at forsørge sine børnebørn. Men som IDP har hun ingen indtægtskilde, og hendes egen produktion af mælk er ikke nok til at mætte to munde. Hun har påtaget sig en umulig opgave, men hun er fast besluttet på at give disse børn omsorg, og et liv, mod alle odds.

I notice her already during the appetite test. She is sitting with a pair of twins on her lap. She is older than the other mothers. Her face is scarred by the traditional tatoos.  I have been told, that it was the englishmen, during the colonization, who introduced these tatoos, to be able to tell the tripes apart. I do not know if it is true. Her children are small. She is breastfeeding them. Her care for the children makes an impression on me.
When she an hour later comes to me in the consultation-tent, I get answers to my curious questions, as she shares the story of the children with me. Both their parrents were killed during the massacre in September. She is the grandmother, and has taken care of them ever since, as if they were her own. She has been breatfeeding them, and is eveeryday fighting to be able to serve them a meal. But as an IDP she does not have an income, and her own milk is not enough to feed to mouths. She has taken upon her an impossible task, but she is determined to care for these children and give them life, against all odds. 

Når Sulten rammer / When Hunger hits

Idet jeg nærmer mig vores behandlingscenter for underernærede børn, hører jeg kvinde snak, og barnegråd. Det er morgen, men solen brænder allerede. Kvinderene møder tidligt, taknemmelige over at der nu er mad at få til deres børn. Mange af dem er gået i mere end en time, med deres børn i aflange kurve på deres hoved, og sidder nu og hviler i skyggen af et kæmpe træ. Det skal blive en lang dag, både for kvinderne, deres børn og mig.

Jeg er i Akobo, blot 5 km fra grænsen til Ethiopien. Området oplevede sidste sommer nogle voldsomme stamme-sammenstød, der nærmest lignede en massakre mod kvinderne. Nu lever en stor del af befolkningen som IDP’s (internt fodrevne/ flygtninge i eget land). De tør ikke tage tilbage til deres jord, som så ikke bliver dyrket. Regnen var sparsom sidste år, så høsten slog fejl. Nu er de afhængige af fødevarehjælp, men hjælpen har desværre ikke været tilstrækkelig. 

Når sult rammer en befolkning er det først børnene under fem år der lider. Taber et barn på 7 mdr et kilo, er det noget der kan ses, hvor der nok næppe er nogen der ville opdage det hvis jeg smed et kilo. Derfor er vores behandling rettet mod disse børn.

Fremødet er overvældende, jeg griber mit “MUAC”-tape, og går i gang med at screene børnene. Vi måler omfanget af overarmen, og kategorisere børnene i rød, gul og grøn. Grøn er et sundt barn, de kan gå hjem. Gul er moderat underernæret, børnene kan fedes op med normalt mad, henvises til suplementerende føde-program. Hvis børnene er røde, er de svært underernærede, og har brug for hjælp her og nu. De fleste børn er røde. Efter screeningen vejes de og måles.  

Når jeg er færdig med screeningen, er der allerede ved at være travlt i området for appetit testning. Jeg starter med at instruere mødrene med tegnsprog  i “appetit-testen” hvor børnene skal bevise at de kan spise. En følge af underernærring er ikke kan spise, gavner det ikke at give dem mad. 

For at bestå testen skal barnet spise 3 teskefulde plumpy nut, en beriget jordnøde-creme, på en halv time.

Efter at have været involveret her et stykke tid overlader jeg opgaven til en anden medarbejder for at  gribe en oversætter og et stetoskop og sætte mig ind i konsultations-teltet. Alle børnene skal undersøges, der skal optages sygehistorie,  og vi skal vurdere om de er i stand til at indgå i et ambulant forløb, eller om de skal henvises til børneafdelingen på hospitalet.

Børnene er virkeligt små, en et årig kan veje 4 kg,  mange har haft diarre i flere uger, nogle er helt matte, andre vågne og vakse. Nogle smiler til mig, andre stikker i et vræl når de ser mit hvide ansigt. Sidst på dagen er det svært at skelne børnene fra hinanden... 87 børn kom igennem programmet denne dag, og går hjem med antibiotika og plumpy nut til en uge. Forhåbentlig når jeg ser dem igen i næste uge er de kvikkere, og har taget lidt på.

Det er et privilege at arbejde et sted, hvor behovet er så stort. At vide at jeg dagligt er med til at redde liv. Men det bryder også mit hjerte, at der stadig er børn som sulter i verden. En af mine første oplevelser af at der var folk som var mindre heldige end mig, var de store tv-spots der kørte i 80‘erne for at samle penge ind til de sultne børn på Afrikas horn, og nu 30 år senere spørg jeg mig selv om der overhovedet er blevet gjort noget for at udrydde sult? Kan der overhovedet gøres noget? Vi hjælper børnene igennem denne krise, men hvad sker der næste gang sulten rammer?

english:

As I come close to our treatment-center for malnourished children, I hear womans talk and children cry. It is morning, but the sun is already burning hot. The woman come early, grateful that there now is food available for their children. many of them have traveled on foot for more than an hour, carrying children in long baskets on their heads, and is now sitting and resting in the shadow of a gigantic tree. It is going to be a long day, for the woman, the children, and me.

I am in Akobo, only 5 km from the border to Ethiopia. Last summer the area experienced some violent tribal attacks, which most all looked like a massacre against the woman, with many deaths and casualties. Now a big proportion of the population is living as IDP’s in Akobo. They are afraid to return to their land, that as a result is not farmed. The Rain has been spares last year, so the harvest was poor. They are now dependent on international help, to be able to feed themselves and their children, but the help given has not been enough.

When Hunger hits a population, the ones suffering first will be the children less than 5 years old. If a child 7 months old looses a kilo, you will see it, whereas no one would notice it if I lost a kilo.We therefore aim our program on assisting these children.

The attendance is overwhelming. I grab my “MUAC-tape”, and start screening the children, by measuring the Mid Upper arm circumference, and categorizing the children into a red, yellow and green group. If the child is green, it is healthy and can go home. If it is yellow it has moderate degree of malnutrition, and can be helped by eating a normal diet, and i referred to a supplementary feeding program. But if the tape is red, the child suffers from server malnutrition, and they need help now. A lot of the children are red.

After being screened, the children are measured and weighed. 

When the screening is done, the area of appetite testing is already busy. I start instructing the mothers with sign language to wash their hands, and feeding the child with Plumpy nut. One of the symptoms of malnutrition is loss of appetite, and giving the children food to bring home if they can not eat, will not help at all. To pass the appetite test you need to eat 3 the-spoons of plumpy nut, and enriched peanut-butter, in half an hour.

After being involved here a while, I have to pass on the assignment to another worker in the centre, as my help is needed in the consultation tent. So I grab my stethoscope and a translator, and take a seat in the tent. All the children need to be examined, their medical history needs to be recorded, and we have to assess wether the child is fit for an outpatient program, or wether they need to be admitted in the stabilization centre at the hospital.

the children are really small, a one year old can weigh 4 kg (normal birth weight in Denmark), many has had diarrhea for weeks, some are drowsy, others wide awake. Some is smiling at me, others cries out loud when seeing my white face. At the end of the day, it is difficult to tell the children apart. 87 children came to the clinic and received treatment this day, leaving with antibiotics and a weeks supply of plumpy nut. Hopefully I will see then again next week, more alert and gaining weight.

It is a privilege to work in a place, where the need is so big. To know that everyday I am part of saving lives. But it breaks my heart, that there is still hungry children in the world today. Oe of my first experiences of people being less fortunate in life than me, was as a child in the 80’s, watching the tv-spots collecting money to help the victims of the big famine on the Horn of Africa, and now 30 years later i can ask myself, if we have done anything to eradicate hunger in the world? Can anything be done? We are helping the children through this crisis, but what will happen next time hunger hits Africa?