by Katie Chisholm, Kathryn Chinn, Sydney Ryan, Sai Cheruvu, MD
The first stop at the Outreach Clinic in Syokisinga was child malnutrtion screening with Sai and Katie, CHW Mutinda and others. The children were weighed and measured to determine nutrition status.
The severity of malnutrition is based on the weight for height measurement . . Although the majority of children were considered malnourished, the number that met the criteria for supplements was small.
One of the most memorable children was this 12 month old boy who had been on unimix but still had lost weight. When the volunteers brought out a package of PlumpiNut, the child lit up and devoured the contents.
PlumpiNut is a a fortified peanut butter product that is given to the most malnourished infants (3 standard deviations below normal weight, older children and slightly less malnourished children may be given Unimix, a fortified whole grain porridge.
Today started out slow but got busier and more complicated. I saw some very interesting cases.
The first one was an elderly gentleman who stopped speaking about 5 months ago. His son said he was doing other strange behaviors like eating paper. He would wander off during the day but came home for meals. He seems to understand some things but did not have any expression or response. He did not seem in pain and could feed himself but he was incontinent of stool and urine. He had been very healthy before this happened and had no known medical problems but did drink a lot of alcohol. On exam he also had a large lump by the right hip. It had been there for years and felt partly soft and partly hard. Neither Angelo or myself had any idea about what was wrong with him. He clearly needed further testing but it was not something that could be done in the clinic.
After that a man came into the clinic with an extremely high blood sugar. His diabetes had been out of control for so long that his muscles had wasted away. He had been refusing insulin. When we saw him today he could barely hold his head up and his sugars were over 600 (normal is up to 125). Someone with a sugar that high is very dehydrated and we started an IV and finally he agreed to take insulin and it took about 3 hours to get his level down. Then we gave instructions to his family about giving insulin shots.
The other providers had a women with HIV who was not on treatment and had a one month old baby. The mom finally agreed to give the baby medication to prevent transmission of HIV and then the mom is waiting for more testing to see if she needs meds. The clinic staff had been trying for a month to get the mom to accept treatment, so we were all very happy.
Luckly, HIV is not a big problem here. There is only about 5% rate of HIV infection in the country and lower in this area.
The last was a severly malnourished 5 month old baby with a mom who was only 19 y/o. The mom has some psychiatric problems and is not very capable of taking care of her children. The baby was so anemic that it was decided to take her to the hospital. We are still waiting to hear how she is.
Aug 3 2011. Late in the day we were called to the clinic to see a severely malnourished child who was 10 months old but weighed only 10 lbs, about half of normal according to WHO standard growth curves.
The mother, Patricia, 35, had stopped producing milk when little Katwili was only one month old. She substituted goat milk and a little porridge. She has not thrived. Patricia has 7 other children aged 3 to 15 years old. Her husband hauls water and sell it at the market. No one else in the family can work, and with the drought the garden produced nothing last year.
No Supplemental Food
The have a few chickens, but no other animals. Today, the baby had a cough, Patricia took her to the Katangi Health Center, but seeing the malnourished state of the baby and because they had no PlumpiNut for supplemental feeding, they sent her to our clinic–several hours on a motorcycle taxi away.
On investigation, we learned that there are six other children and a husband in the family. Mbitha was a twin and her brother died last month after a brief illness.
Your support can help
Would you like to help this family? Global Health Partnerships is establishing a fund to be administered by the head nurse to help the most vulnerable families. Consider setting up monthly credit card donation of $50, $1.60 per day, for Patricia and her family. Every cent will help this family and we’ll send you occasional updates and photos.