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July 12, 2011

This past week I went to the nutritional recovery center for the last time to check in on a little girl that we referred there a couple of weeks ago.  While the nurse was taking the information we needed, I saw that one of the babies was not in a crib, but in a basin on the floor lined with blankets. Her skin was splotchy and she had an intense look on her face and I went ahead and picked her up.  After holding her for a few moments I noticed that her hands and feet were severely disfigured.  Instead of palms her hands and feet were sort of like a V coming off of her ankles and wrists with two fingers at the ends.  She can sort of stand, but will never walk normally (or possibly at all). I had never seen that and I asked the nurse what it was and whether it was genetic or a disease.  The nurse told me that the disfigurement is caused by the chemicals that the government uses to fumigate to coca crops in the fight against drugs.  The chemical gets into other crops and the water and there are apparently a lot of children with the same condition.  I was thinking more about it and I am curious about what chemicals are used to fumigate the fields, who manufactures them and who pays for it.  Mostly, I wonder if American anti-drug money is being used to buy these chemicals that are having such a negative effect on the population.  When I thought about the situation and the chemicals being used, the image of the “Made in USA” label on the canisters of teargas that were used to quell the Egyptian riots flashed in my mind.  It also highlights (in fact my whole experience in Tumaco highlights) how easily whole populations are affected and discarded byproducts in the war between the armed drug cartels and the military. READ MORE

Nutrition

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July 12, 2011

Yesterday the day started with the nutritionist at IRD asking if I wanted to go to the nutrition center. I said yes, thinking it would be great to see how Lady was progressing and see what was going on there. I knew that there was some tension between the center and IRD lately –a case had gone poorly (a baby girl had died) and there is an ongoing investigation and the center was getting a lot of heat and they thought it was because of IRD. I didn’t know we were going to the center to hash it out. We got there and received a frosty reception (though I did get to see Lady and she is back to a healthy weight and eating like a fiend) and were ignored for 20 minutes. Then we went into an office, sat in a mini circle while the doctor and three other employees at the center chewed us out for 20 minutes. I thought it would only be a couple of minutes, but he kept going and going and he told us about how the center’s name was being dragged through the mud and how a mother had heard they had killed a child and wasn’t letting them take her child and how the doctor was being personally investigated. It was awkward and all we could do was sit there. I had some idea of the background, but did not know that it had gotten so bad for them and they had every right to be upset. Then the nutritionist talked and told the IRD side and showed documentation showing that IRD had not done anything improper and how IRD had also documented from the start that the center had not done anything wrong (they never even saw the girl because they couldn’t – she had developmental issues that they are not prepared to handle so we could not even refer the child to them). He also promised to support them in the investigation and made everyone feel like things were going to be okay because IRD and the Center had done nothing wrong – there were just a lot of rumors floating around that needed to be cleared up. It was pretty amazing to see the situation go from toxic to good in the 20 minutes the nutritionist talked. I was impressed. It is also interesting to see how the two organizations worked together to fix the issue. There was a lot of talk about lessons learned from this experience and a discussion about how to improve the relationship to keep something like this from happening again. In the end, the whole situation will make the both organizations a little smarter and ready if something like this happens again. READ MORE

American Good Will

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July 12, 2011

I think that when it comes to the relationship between people from other countries and the United States, Americans walk on a very thin line and we have to work hard to impress and not mess up because people are wary and looking to have their suspicions about the US confirmed.

Yesterday, the nutritionist and I went to the IRD warehouse to take inventory of all the supplies that were donated from the Comfort.  There were 10 full pallets that we had to sort – 6 from the Church of Jesus Christ of Latter Day Saints, 2 from Project Cure and 2 others.  We spent all morning and part of the afternoon going through the LDS materials and documenting everything. I was impressed by how much stuff they donate, the quality of the packaging, how well it was labeled and how easy it will be to distribute even though it is a ton of stuff. Then we moved to the Project Cure pallets and it was a lot of different kinds of boxes (a lot of Barnes and Noble boxes) that were poorly marked.  There are probably 80 big boxes we have to sort through (we did 30 yesterday).  We opened the first one of catheters and I noticed that they were all expired.  As we started sorting through the boxes, 80 percent of them had expired equipment (and not expired in 2010 either, expired from 2008, 2009) or things in open packages or used stethoscopes wrapped in gauze.  I was very upset and disappointed and then the nutritionist said, “Americans, they like to pass off their useless things to developing countries because they don’t care.” I know where that sentiment comes from, but it stopped me cold, because it crystallized for me how difficult it is for Americans to improve their image. Here we are in a warehouse full (and I mean stuffed) with free, new, donated American goods representing the goodwill of many organizations in the US and these two pallets (that represent 2% of the goods) from Project Cure wipes all that good away and the image people are left with is of thoughtless Americans giving developing countries their leftovers, their scraps.

On a brighter note: READ MORE

Comfort

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July 12, 2011

On the way to the office on our first day in Bogota, the operations manager was telling me how excited she was because the Comfort was coming.  She spoke softly and I didn’t catch it all, but I knew that it was a big deal.  It wasn’t mentioned again so I forgot about it until I got to Tumaco. Here, the office was getting ready for the Comfort and they knew something was going to happen, but they didn’t know how IRD was going to be involved. People thought that we were going to go to the ship, maybe help unload medical supplies (the IRD supplies were actually airlifted by helicopter and delivered by truck to their storage facility).  Then, last week, there were a lot of emails back and forth between a nurse on the Comfort and the office in Bogota, with me being copied because I speak English and would serve as a translator. As I wrote last week, the emails asked us to organize a group of midwives for training. We asked about covering transportation costs for the midwives, but we never heard back.  I got a final email last Friday asking me to forward the list of midwives to another person on the boat, which I did.  Then I waited.  Monday was a holiday, Tuesday we did distributions.  I had heard a rumor that we were going to the boat on Thursday, but Wednesday passed and we heard nothing. READ MORE

Closing humanitarian gaps in Tumaco

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July 12, 2011

Last week the nutritionist and I sat down to try to create a short nutrition survey so he can get a better idea of the nutritional situation of the displaced population here in Tumaco and teach to the gaps.  I was doing some background research to see what kind of questions we wanted to ask when I came across a World Food Program report about Colombia.  They had looked at nutrition in several other provinces but not Tumaco and their first question was how long the family had been displaced. They didn’t really go into it a lot in the report, but the question got me thinking.  They divided people who were displaced in displaced 1-3 months, 4-9 months and over 9 months, but then did not explain differences in diet among the groups.  I wondered if after a year the diet of displaced people is generally better or worse.  My gut reaction is that if you were to do a food survey after a year the diet would be better than when they arrived because they have lived in their new community for a year and know the markets and are “settled.” But then I started thinking that, at least in Tumaco, for the first three months, people who are served by IRD get a ton of free food. Then the government provides free food for the next 6 months (which coincidently lines up with the WFP timeline) – how settled are people really? How well do they know the markets? How much did they learn about nutrition in those 9 months both from programs and by seeing what was distributed? Did that change their buying habits? I could imagine a scenario where, after a year, people are actually eating worse than they did during the first nine months. READ MORE

Week 4 in Colombia

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June 7, 2011

This weekend was supposed to be a long weekend because Monday was a holiday, but we had to come in on Saturday because we were a behind on the distributions.  We came in on Saturday and there were a ton of people there – 85 families, which included over 50 children whose height and weight we had to take.  We should have been finished around noon, but there were problems with the internet (all the surveys and nutritional surveys are done online) and we ended up staying until after 2.  I hurried to get lunch, worried that I was going to get there and there would be no food. The women at my restaurant know I come every day so they had saved me food and I went home happy.

During the week Richard had organized a soccer game between the guys at IRD and a bank for Saturday night. I got a ride and we went to a “synthetic” field, the size of a basketball court with netting all around. The game was an hour long and it was back and forth, but we finally won 11-10 with Richard scoring the winning goal with less than a minute to go.  It was early evening and it was hot and it felt like the heat and humidity had grabbed and squeezed all t the juices out of me.  It’s been a long time since I sweat that much.  I scored 4 goals and afterwards one of the guys told me that he could tell I was Argentine.  I’m not sure what that meant, either that I was too offensive minded and played no defense or that I was scrappy, which is to make up for a lack of skill – either way I took it as a compliment.  We stayed afterwards and had a few beers, which was a little awkward for me because I was soaked in sweat.  It was nice though and on the way home I sat in the bed of the truck and saw what Tumaco is like at night as the wind cooled me off.  Halfway home, as an homage to Rick and Peace Corps, I stood up in the bed and road standing up the rest of the way – absolutely the best way to ride in the back of a truck.  After we got home from the game, my neighbor, who works for IRD, his girlfriend and another IRD guy and his girlfriend sat around the pool at my place drinking whiskey and not really talking.   READ MORE

Food Distribution, Colombia

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June 1, 2011

Beneficiaries wait their turn at Distribution Day, where IRD distributes aid to displaced families.

On Tuesdays and Fridays IRD does distributions of aid for displaced families. The (mostly) women sit on chairs under an IRD tent and wait to be called – from there they go into the office where they are interviewed and a survey is taken. After that they go back outside where the children under five are weighed and have their height taken. Families with children under five get extra food and IRD monitors how the children are growing, looking out for malnutrition, stunting and wasting. If a case is found, the child is referred to the Center for Nutritional Recuperation, which I wrote a little about in the last post (that is where I met Lady). The child is supposed to stay there for 30 days until he or she is fully recovered. And they do a great job, too. Earlier I told you how I went to that nutrition training; during that training, the presenter showed a series of very malnourished children they had treated. They were the worst cases they had seen. On Friday, Ibeth, the IRD staff member who had taken me to the training, pointed out a child who was running around, telling me that this was the same child from the one of the pictures from the training session.

On Friday I helped with measuring the children (later I will help with interviews). If the child is over 2, they can go on a regular scale and we take their height standing up. If the child is under 2, they are weighed on an infant scale and their height is taken lying down. We then compute the child’s Z-score (look at me applying what I’m learning in school!) to assess their nutritional status. Most of the children are “at risk for malnutrition,” and a lot of them are adequate. READ MORE

A picture of severe malnutrition

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May 28, 2011

Lady is one of the severely malnourished children who are in Tumaco’s nutrition clinic for recovery.

I’ll quickly sum up today. I was picked up at 7:20 and taken to a training that another organization was holding on nutrition. They were teaching nurses how to diagnose severe malnutrition, which is a big problem in Tumaco. I was then introduced to the presenter and we went to their nutrition clinic, where malnourished children are kept for a month to recover. When we got there, we met the doctor, who showed us around while he talked about the situation in Tumaco. While we were talking, we were standing next to a crib with a baby with severe malnutrition named Lady. She had big eyes and was just sitting, staring and scared. The doctor showed us the lesions all over her skin, which is an indicator of severe malnutrition. Finally, I couldn’t help myself and picked her up and held her for about 30 minutes, rocking her until she finally relaxed, putting her head on my chest and closing her eyes. READ MORE

First thoughts from Tumaco

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Lisandro Torre

I’m finally in Tumaco and it’s all starting to come together. I got picked up at 4:30 in the morning on Wednesday and taken to the airport to catch my 6 am flight to Cali, landed at 7:15 and hopped on the 7:35 flight to Tumaco to arrive at 8am. A two-hour flight that takes over 25 hours to do overland. As soon as I landed I felt at home and much more comfortable than in Bogota. I’ve been thinking a lot about how to describe Tumaco, or how to contextualize it for myself and I end up comparing a lot of things to Uganda. It’s not the same, but it is the only other experience I’ve had working abroad and I can’t help but to compare the two. I apologize ahead of time if that’s annoying.

Tumaco Street Scene

Tumaco Street Scene

Tumaco is completely different than Bogota. In Uganda (it starts) Kampala was different from Bududa, but they were still a lot alike – you could see how both places fit together in the same country. Tumaco is a different world from Bogota and it’s noticeable immediately. It’s hot—and sticky hot—and sunny. My ride was immediately there and rather than sketchy people asking to take me somewhere or to some hotel, a bunch of kids followed us to the car, opened our door and begged for a tip. Fewer cars, a ton more motorcycles (and there were a fair amount in Bogota), no helmets, no seatbelts, kids riding on the front of motorcycles (women don’t side saddle here), fewer traffic lights, bumpier roads, no tall buildings, a lot more litter, shacks. It feels like another country and I would believe that it was except the Colombian military is everywhere. READ MORE