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.
Last week we did our first trial with the household surveys. Overall, I think it is a good survey. It was a success and we got good information. We need to do a few adjustments, but overall I think it is going to be a useful tool for IRD. I am a little concerned about it though. As we were going through the survey one of the mothers got upset and started to cry a little. I think she was embarrassed of her home and possibly thought that we were judging her. I tried to soothe her worries and explain why we were taking the survey (to improve the data on the subject and hopefully improve services down the road), but it left me feeling bad. The survey is tricky: on the one hand, it is an incredibly useful tool that will provide data where there is currently a gap and hopefully lead to projects to fill those gaps, but on the other hand, the surveys are very personal and could be seen as an invasion of privacy. The people that we are surveying say they want to participate and we hope it is a sincere desire to participate, but we have to wonder if they are participating because if they don’t they think they may lose the assistance we provide. I don’t know what to do about it yet – the nutritionist and I are discussing some strategies to address this and hopefully we have some kind of answer by the time I go. I think we have to make the survey voluntary and clearly explain that they won’t lose any help if they don’t participate.
I am spending this weekend painting the educational materials with the nutritionist because he will be out of town next week. It’s my last week in Tumaco. I want to thank everyone for reading. I also want to thank Dr. Jenkins and IRD for sending my here – this has been an incredibly useful internship and learning experience. Every day I learned something new and I’m taking home a ton of lessons that I hope to apply in my future public health career. I think I’m ready to go back; I’m definitely looking forward to sleeping in my bed, seeing my friends, picking fruit, and eating pie. And, though I’ve learned that I can happily live off of seafood and fruit, I am looking forward to some vegetables in my diet. At the same time, leaving Tumaco is bittersweet because I’ve met some wonderful people here, most of whom I’ll never see again. I’m learning that comes with the territory in this field. The IRD team here was wonderful and saying a small goodbye to a few people on Friday was more emotional than I expected it to be. I’m going to miss working with them and I’m going to miss Tumaco. I hope to return one day, but in the end, who knows? I feel lucky that my experience here was positive and I won’t forget my time here anytime soon.