["Malnutrition is a disease just like TB or alcoholism."]
Sunday October 10th
9:15pm: Well I'm still writing my diary by candlelight. We finally got the generator running on Saturday morning. We had to bypass the fuel line around the fuel filter and take out the air filter to finally get it started. But then after an hour it broke down again. I was hoping to print out Claude's report and my Job description. I think the Job description will especially help me in defining my activities, but like Christian said, the main thing is to keep the place running. So I suppose that's really all I have to do. We took the generator to the workshop and they said that we need a new fuel pump and these are pretty hard to get for this type of generator and that we would probably have to get it from Paris. I wish I would have taken the generator to the workshop like Peter Konah said before we by-passed the fuel filter.
On Saturday I went to the feeding centre. It cares for the patients 24 hours a day, 7 days a week so you need a lot of staff. We have 40 staff in the centre and you can't really run a Therapeutic feeding centre with any less according to James the supervisor. There is also 9 home visitors who try and find malnourished people in the community for the centre. At the moment there is 12 patients. Usually there is an increase around April-June when the number can shoot up to 25 patients. James said that then we will have to put on more staff to cope with the increase, but I said we will cross that bridge when we come to it. It is always a good idea to be a bit tough at the beginning.
The expatriate nurse for the centre left a month or two ago and they have been having a hard to finding a replacement, but hopefully in the next few weeks one will come. Until then its my job just to keep things ticking over here and the logistics in order. The feeding centre is pretty big, but we only use one of the building due to low patient numbers at the moment. It is a pretty relaxed environment and a really tranquil place for these sick little kiddies to get better.
Malnutrition is a disease just like TB or alcoholism. No body really knows the exact cause but there are lots of factors like not eating enough and not washing your hands before going to the toilet. That's why we have a latrine programme to address the underlying causes of Malnutrition. There are lots of different types of Malnutrition like severe, bloated, acute, marasmus, wasting, moderate and kwashiorkor. The best way to treat them is to get them into a centre like ours. The kids have to lose weight first to get better. So they are put on a diet, then when they loose enough weight we start to feed them again with special milks. Sometimes it takes months to get the kiddy back on its feet. Its pretty gut wrenching to see the kiddies this way and it really makes me feel lucky that I didn't catch it when I was a kid.
James has been working for Hope for 4 years and although he doesn't have any medical or nutritional training he does a really good job of supervising the centre. It is pretty tough to keep a team of 49 people running in the centre. James said that our patient staff ratio is good for a feeding centre. It is 4:1 and this is really good you get the ratio by diving the patients by the staff or vice versa. There are heaps of statistics to keep track of in the centre like the mortality rate and the morbidity rate and the number of discharges and the admissions. It's really complicated and I'm glad I don't have to do the reports.
Apart from James there are several nurses and Clinical Health Officers, these are better than nurses. We have two, Alfred and Abdulai. They are a bit quieter than James and seemed not as enthusiastic about the centre as James and the life saving work we carry out. James talks a lot about Claude, and Thierry the guy who worked before Claude and said they were really great guys and very generous and good to the staff. I hope the staff will respect and like me just as much.
Today was Sunday so I had a nice quiet day to myself, I wrote a long letter to Jen and I will have to figure out a way to get it to her. I will try and send it by car this week with my diary entries for this week. So my diary entries might be a week or two behind until I get the generator fixed. I went for a walk into the market and everyone was really friendly and the kids were talking and carrying on at me I didn't really understand them. So I think I will have an early night, since I have got a big week ahead of me.
Dave (me) Claudia