helen weld public health

Seven more sleeps in Kigutu. . .

It’s hard to believe that I only have a week before I depart Kigutu.

Today Tolstoy and I set off for another exhausting (yet paradoxically revitalizing) trek. We did a 5 hour circumnavigation of the valleys and hills to the south of Village Health Works. Up and down, up and down. (Feels like I walked the “Goat Track” on Castle Hill in Townsville about 6 times!). My respect and awe for the local residents continues to grow. The distances they travel regularly on foot with heavy loads are very impressive.

We were comparatively off the beaten path this time (the last walk was on a very well travelled route). It’s very humbling to see young children sprinting up steep tracks with heavy bundles on their heads, as well as firewood and buckets of water. Seeing two very young children heading off hand in hand to fetch hot coals from a neighbour in a metal pot was especially poignant. Tolstoy explains that they carry the pot back wrapped in banana leaves to prevent burns; the family is too poor to buy matches.

We passed by a local church in which about 15 teenagers (predominantly girls) were gathered for Bible study. The pastor invited us in to talk and I urged them to come to Kigutu for care and did a bit of health promotion too. Once again I am spurred on to try and get solar cooking happening here, as well as rain catchment.

These people would benefit very much from harnessing the sun and the water. (www.she-inc.org and www.savetherain.org are two organisations that I want to follow up with, post departure). As Tolstoy proclaims, there is enough work here for a lifetime! These ‘mountains beyond mountains' community outreach treks have been so informative and memorable. Once again, everyone we passed on the track was amazed to see a muzungu on foot.

It has been wonderful to have a chance to work/learn with/from Melino since his return from the ultrasonography training in Rwanda. He has been able to diagnose renal failure; a renal cyst; and, sadly, severe tricuspid valve regurgitation with heart enlargement and probable pulmonary stenosis in the 8 year old girl from Tanzania. Our fears about her grave cardiac condition were confirmed.

Late Tuesday afternoon, eight hours after Melino’s examination, the little girl suddenly went into cardiopulmonary failure. As Hilarie and Sincerite were getting the oxygen set up and tending to her, I checked her vital signs…respirations (40) and heart rate (140), then the blood pressure…nothing … I checked her heart again and heard nothing, then watched her take one last breath. This all happened in about 2 minutes. Her poor little heart just gave up. Somehow it was a bit easier for me to deal with this tragedy knowing that her heart was in such bad shape and that there was really nothing much to be done for her, except major cardiac surgery. Nevertheless, it was very sad and very intense to watch her take that last, long breath.

When informed, the poor parents were devastated, but unlike my experience with grief stricken Sierra Leonians who collapse in a heap and pound the ground and wail, the people here appear to contain their grief (relatively) and weep silently.

The scenario of the post-death was complicated as the family is Muslim and they were also a long way from home. Muslims require burial within 24 hours of death and also must be in the midst of other Muslims. There are no Muslims in Kigutu, but there are Muslim communities in nearby Mugara and Rumonge (within an hour). The parents were able to make a connection there and carry her body down the mountain for burial with their help.

We continue to see some remarkable pathology here (see the close up of the eye) and the goiter is one of the most impressive I have seen.

The Community Center is progressing well. The women from the community who come regularly on Fridays have done much digging and brick carrying near the site. It will be amazing to see it all completed and in use when I return in January.
The pink sunset was remarkable tonight, especially with the drumming practice as background audio. Now the crickets are thrumming and the crescent moon shines bright.

Tomorrow I will go to Vyanda (by vehicle) with Melino for some home visits and I expect I will have another extraordinary day.

Helen