Upcoming Projects...Yayyy..I Am Finally Useful

Malnutrition is a huge issue in Burkina as it is very prevalent. There are many causes of malnutrition. They include the following: 1)low birth weight(malnourished mothers) 2)Inadequate breastfeeding during the first six months of life (e.g. introduction of complementary food or drink before six months), 3)Children are weaned from the breast milk too early (e.g. ahead of the recommended 2 years--another pregnancy), 4)Unbalanced diet (the child does not get a variety of foods (construction, energy, and protection, 5)Insufficient food intake, 6)Micronutrient deficiency, 7)Diarrhea and childhood diseases (Often times a child will lose his/her appetite due to illness. That, coupled with diarrhea, exacerbates malnutrition).

In a few days, upon returning back to village I will be starting a hearth model with a group of women from one of my village quartiers (neighborhoods). The Hearth Model is a way to combat malnutrition at the community level. The Heath Model was introduced in the 1980’s in Haiti and has since been replicated in countries such as Vietnam, Guinea, Mali, Tanzania, etc. The model posits that despite poverty, there are local practices, knowledge, and resources that can be exploited to promote positive health practices. If adopted, even mothers in the poorest of communities are still able to raise healthy, well-nourished children. In practice, the Model brings together six to ten mothers of malnourished children over a two week period to practice and learn healthy nutrition behaviors. The Hearth Model has three main objectives: 1) to rehabilitate malnourished children, 2) to educate women on basic health issues, 3) to demonstrate that raising well nourished and healthy children is possible even with limited means. The Hearth Model is a project that does not require a lot of funding. An effective project simply requires community participation and cotising money or sharing the locally available materials. There is no medicine to cure malnutrition; only a nourishing diet and protection against diarrhea can alleviate malnutrition. However, prior to the beginning of the project, vitamin A and guinea worm will be administered. The Hearth requires 12 days of participation for approximately two hours each morning. The mother will come with her child and assist in the making of four enriched porridges that the group of mothers has chosen to make. There are several different recipes that they women can chose from(12 in all); recipe selection depends on the time of the year and locally available projects. In addition to preparing the porridge, each mother will learn about different health topics. Instead of choosing twelve health topics, I have chosen six to focus on in the first week; the second week will be review of the first week. The six topics I have chosen are the following: 1) Overview of the Hearth and basics of growth monitoring and baby weighing, 2) Early childhood nutrition and signs and causes of malnutrition, 3) Proper weaning, 4) Treating water, food preparation, and personal hygiene, 5) Diarrhea and Oral Re-hydration Salts (ORS), and 6) Malaria and its prevention. Each morning the child will eat the porridge and then bring enough home to last the rest of the day. The porridge is not meant as a replacement to the breast milk and other complementary foods, but as an addition to them. The child will be weighed on the first and last day of the Hearth. Weight gain is not always immediate or guaranteed as it takes time for a child’s appetite to increase or if it takes some time for the child to like the recipe. Prior to the commencement of the Hearth, it is recommended to find a Mama Lumiere (a woman who is highly respected in her quartier, who has healthy children and practices good healthy behaviors) to help lead the Hearth. Ideally, she is of the same ethnic and socio-economic group as all the other women in the group. After finding a Mama Lumiere and getting her agreed participation, she will then find interested mothers and then give me their child’s heath cards. I will then review the cards and pick out those children who fit the criteria for the Hearth. For this Hearth, I initially rejected about 2/3 of the children, and chose eight children. They were either too young or did not fit the weight requirement. I felt really bad doing this. Children must fall under the category of moderately to severely (lower level of severity) malnourished; these children must also have stagnant growth or trouble gaining weight. It is not recommended for children on the higher end of the severe malnutrition to participate, as they should be directed to the clinic for a referral to a CREN (explained in one of my previous blogs). However, with a lack of money, most families cannot afford to send their children to a CREN, so many volunteers (including myself) allow children who fit in this category to participate. After choosing the eligible children, it is then necessary to visit each father to explain the project and get his permission. After I have each of the father’s permission, I will then meet with all of the mothers a group to decide on recipe selection, best time of day and date to have the hearth, where to hold the hearth, and whether or not the women want to cotiser the money or share the materials. However, at this meeting that was originally intended for eight women + the Mama Lumiere, many more women got word of the meeting and came with their children and thier health cards to see if they made the cut. Eventually, the number swelled to include twenty kids. While having this many children/mothers participate is not recommended as it is less personal, I am not one to tell a mother who wants to help her malnourished child, that she could not participate. Although, I did have to turn away a couple of mothers because their childrens weights were in the healthy range. I did tell them that even though their child did not need to participate in the formation, the mother and child could still participate to learn about the enriched porridges and health topics. All that remains is to meet with the families one week and one day before the beginning of the Hearth to administer the vitamin A and guinea worm medication. I will visit each child after one month, two months, and one year later to check to growth monitoring as well as to see if the families are putting into practice what they learned at the formation.

There are potential obstacles to carrying out an effective project. In previous volunteers’ experiences, women will often arrive late or not at all, some women may send their daughters to attend that morning formation and/or just to pick up the porridge, mothers may give a portion of the porridge to other children in the family, some children get sick during the Hearth which the mother might attribute it to the Hearth, and some children do not end up gaining weight (some even lose). Despite all of these obstacles, if done correctly, the Hearth model is effective.

In addition to the hearth, I will be starting a couple of English clubs where I tutor children and adults. I will also be starting to teach health classes to the primary school students once a week. Rainy season begins in a few weeks so it is quite hard to start any big projects. Once the rains come, everyone will be in the fields from dawn til dusk(most of money that the family lives off of for the rest of the year comes from the money earned during the rainy season). However, along with the rains, comes the mosquitoes and consequently, malaria. Therefore, I would like to give a couple malaria sensibilizations before the rainy season begins. In July I would like to lead a week long girls club, start a moringa garden in september, and put together a AIDS bike-a-thon for late September.