Health Problems When Living In Extreme Poverty
I do my best thinking on the back of a boda. Each ride offers a magnified view into my surroundings, and induces thoughts that would never be provoked from a car or even on foot. It is a quickened examination of the vibrant reality that has become my life for the past 9 months.
Despite not being a market day, town is bustling this morning. Women have already returned from their pre-dawn visit to Tanzania, where they buy their vegetables, and are hustling to set up their roadside dukas before the first customer greets them. We pass men wheeling several full cow carcasses to the butcher as smoke seeps out of corrugated tin roofs where mamas’ fires are blazing to prepare chai. Light reflects off the palms of eager waiving school kids enthusiastically hollering “’ow are youuu?”
We are heading to Kehancha for my last meeting with our district Ministry Officials, and Laura’s first. Laura, a Master of Public Health graduate from Tuft’s University, is our new Healthcare Fellow. We are thrilled to welcome her to the team, and especially eager to tap into her monitoring and evaluation, and nutrition expertise as we develop our own monitoring and referral system.
These morning rides are my favorite because the day unfolds before your very eyes. The scene is picturesque, but not in the colonial romantic ‘Out of Africa’ way most people envision. It is organic and thriving in every sense—calm before chaos ensues.
During my work in Kuria it has become extremely evident how health problems are woven into the chaos of daily life. We visited a house on Wednesday where the family uses WaterGuard and fully immunized their children- huge successes! But, when the mother asked her son to show us the immunization card, he had to tread barefoot across feces, that can cause diarrhea and worms, to reach the room it was in because they keep their cows inside their compound at night because cattle thieving is rampant. The next family we visited made the cognitive decision to treat their water, an essential first commitment necessary for behavior change, but they could not produce the equivalent of 40 cents until he sells his recent harvest sometime that week or the next. How will he pay for the clinic visit when his 3-year-old gets typhoid from drinking unclean water in the meantime? Farmers are now using techniques to maximize their crop yield, but the rains are not cooperating, delaying planting, which may render families ineligible for seed input loans, and more imminently, it may leave their children hungry and eventually malnourished.
A series of mini success fraught with backward steps never seems to feel like progress. But this is exactly what we are tasked with: we take a mental and physical challenge to do what we can and persevere when the unexpected goes awry. We celebrate the small achievements made by our community and are always aware that no matter how hard we think we are working, they are working ten times harder to live, love and provide for their families.
Peter and I are now yelling to each other from one boda to another. I am riding with his friend, Emmanuel, and Peter is toting Laura, who rides along blind to the adventure she will experience, for which no one can predict the details.
Laura will inevitably become an integral part of the diverse Nuru family, which operates just like any other, sharing highs and lows, births and death, failures and breakthroughs. As I prepare for my return to the U.S. I can only hope to remain part of the same from a sleepy San Francisco neighborhood as I try my best to support Laura and the Healthcare Team’s work in a community that truly feels like home.