helen weld public health

Amahoro, mwiriwe. . .

The torrential seasonal rains each day (Melino says hippos and elephants vs. cats and dogs) have been producing a lot of standing water everywhere, perfect habitat for mosquito larvae. Adults and children with cases of severe malaria continue to represent a huge portion of the patients admitted at VHW.

Last Monday Peter, Will, Brad and I walked to a neighboring village, Kirungu, for community outreach. We were accompanied by our armed guard Desiree (who had no idea he was going to be following the muzungus on a steady hike for four hours!). Many citizens had large pits from digging the clay for bricks right next to their houses half filled with rain water. No wonder malaria is rampant. We did our best to provide some education about the dangers of malaria. Luckily quinine is still a successful treatment and most people turn the corner fairly rapidly. Bed nets need to be distributed too. Over the weekend we had four malaria patients delivered by stretcher. It always amazes me to think of these people getting carried such far distances, lugged up and down these slippery tracks.

It was great to be out in the village talking to people (mostly women) about the access to health care in Kigutu. They are eager to attend the planned teaching sessions on home gardens and nutrition. They also seem eager to discuss family planning, though they were inhibited by the presence of children and men.

Preventative care, which is a bit of an alien concept, especially for children, was discussed. It was very gratifying that a father brought his healthy (utterly adorable too) twins in for “well child” checks on Friday after meeting them earlier in the week in Kirungu. We will return there soon. Peter is the perfect ambassador and guide.
Later in the week I accompanied our local Kigutu accompagnateur, Cecile, on her before sunset rounds. Seeing people in their regular daily routines vs. in the hospital is very appealing! I love being out and about in the community as people fetch their water from the pump, return home from the fields with full baskets on their heads; children play with balls made out of wadded up plastic bags and string and boys herding their cows home.

Many people know me now (and even if they don’t), there is a continuous litany of the standard greeting “Amahoro, mwiriwe“ (Peace, good afternoon) with firm handshakes as I walk the paths through the banana and cassava plots. It was sublime with spectacular evening Maxfield Parrish light with the background sounds of the drummers practicing and the children singing in the local church.

Cecile took me to a tiny mud hut with a woman in her 70’s (very old for Burundi) with extreme edema and ascites (fluid in her belly) lying on a fresh bed of grass outside her doorway. There were two lambs leaping over her head as she lay in a pool of sunlight. It was a serene image. Later she came to the clinic and Melino did a paracentesis, resulting in the drainage of 5 liters of peritoneal fluid which will make her much more comfortable. I look forward to following up with more home visits and time out in the community.

It was extremely gratifying to finally get a hand washing station with water and soap set up in both wards this past week. It’s certainly basic and simple, but nevertheless quite an achievement. Infection control at its best!

The malnutrition ward has been overflowing. It is so wonderful to see these children morph from frail, withdrawn waifs into plumpy, outgoing little characters over their time here, an average of 2 weeks. The mothers (or often grandmothers) become their own little tribe, forming a sisterhood of mothering as they care for their children. When one departs they all have a clapping sendoff as they walk out the driveway. When a new child is admitted I make a point of introducing the mother and child to the group. It’s a special place with Ada and Floride being the mother hens, keeping the milk supplied and the place clean.

A few of us had a weekend away in Buj. I had a swim in Lake Tanganyika which was a first for me. Brad, Will and Alex learned that eating ice cream, especially in public, is a sign of homosexuality in Burundi… though men holding hands and other public displays of affection aren’t seen as such.

I’m about two thirds of the way through my time…yikes….I feel as though I have barely made a dent in all there is for me to accomplish here on this stint.

Helen