Latrines and edema

Latrines and edema

Half of Project Peanut Butter spent Wednesday night at Namandaje village, north of Blantyre.We go their once a fortnight (yes, people say fortnight in Malawi) as a home away from home when we go to very distant villages. It allows us to treat three health centers in two days that are much too far from Blantyre to otherwise serve. We stay with a Catholic priest who has done amazing work in his village! I was so impressed by the medical and educational facilities he was able to support and expand on. Here is Ben (pictured right), a Peace Corp volunteer posted in Namandaje, explaining the latrine project he worked on to me and Ricky (pictured left), a medical student working for Project Peanut Butter.

This project of Ben’s is so powerful because it’s sustainable! A group of parents whose children attend the primary school approached him about getting four more latrines built. There had only been a handful for the 2,000 students! Ben worked with them to write a grant, and a short while later the latrines were built. Ben found out later that the parents he worked with went on to raise even more funds, without his help this time, and built about eight more! The people at the school demonstrated that they now have the skills to plan out a building project, to raise funds, and to implement the plans after this small push from Ben! It’s every exciting and bodes well for the village that they are making huge strides towards improving quality of life with being dependent on outsiders. Ben recently taught a health class at the secondary school. The culmination of the class was to design some sort of project to improve the health of the community. One group of students had an idea for a hand washing station for their latrines. Ben helped them to make an action plan to implement it and voila! The students built them! Ben is doing such a great job helping the Namandaje villagers get done what they want to get done! Below are pictures of a boy we treated the day after we were in Namandaje. The boy suffers from kwashiorkor malnutrition. It appears that medically kwashiorkor is not well understood. At its root, though, in this type of malnutrition the body starts collecting water where it shouldn’t be collecting. Typical cases that I see children with kwashiorkor have water pooling in their feet. In children with more severe cases of this malnutrition the water collection, edema, spreads farther up the legs, perhaps to the knee, and shows in the hands and face. The diagnostic tool we use at clinic to determine if swelling is this kwashiorkor caused edema is a simple thumb press into the skin. We push our thumb into the skin for five seconds, withdraw and if there is a discernible pit in the skin after two seconds there is edema.

This boy has severe edema. His face is so swollen that his left eye can’t even open.

This is the boy’s foot after I pressed my thumb for five seconds.

Given the effectiveness of the peanut based food, RUTF, that we give out at Chiponde Clinic, this boy will very likely recover fully from this acute bout of malnutrition within two months. Having seen this boy last fortnight, I can gladly say that his edema is actually resolving! I’ve been at clinic long enough to be able to see children I enrolled with edema look healthy again and to see very skinny children look a bit chubby. It’s all very exciting! Kate