Wednesday's Child

I see you looking at me. I know you're out there, but I get no comments. Not a ton of page views, but I'm not famous... yet. Eric, the cofounder of Cheerful Hearts Foundation, is trying to change that, though. He wants to start a new campaign for health and sanitation to go on TV - and says he expects me to be interviewed. Yes, Jennifer Du Mond will get her 15 minutes... on Africa TV.

Back to our regularly scheduled programming.

First, a poem:


Monday's child is fair of face
Tuesday's child is full of grace,
Wednesday's child is full of woe,
Thursday's child has far to go,
Friday's child is loving and giving,
Saturday's child works hard for a living,
But the child who is born on the Sabbath Day
Is bonny and blithe and good and gay.



At the hospital they alternately call me Jen, Akua (sp? sounds more like Akwiyah, but that’s not what the internet tells me), or Obruni. Sometimes a combination – I’ve also gotten Akua Obruni. Jen is obvious and Obruni simply means “white person” – I’ve been encouraged by at least one person to respond by saying “obibini”, which means “black person”. Akua is the reason for the poem – it’s a Twi name that means I was born on Wednesday, in other words, “Wednesday’s child”.

At the hospital the nurses are very friendly, sometimes too much. I’m never left alone for a moment, even when I say I want to go explore for food on my own. That just leads to “what do you want?” and someone accompanying me to get whatever I say sounds okay… even though I really did just want to wander around. They’re especially concerned about me getting enough to eat. They all want to feed me. It’s the first time I’ve consistently had people telling me I don’t eat enough. I’ve had some problems with a probable esophageal ulcer the last 6 months or so, and the nurses have seen me taking meds for it, and they told me the reason I have the ulcer is because I don’t eat. And if I don’t eat enough, they think they don’t like Ghanaian food. There are a few things I’m not terribly fond of (fufu is kind of weird, it’s just sticky dough), but for the most part I really enjoy the flavors. My Clif bars they call sweets and don’t think they’re enough to eat, and they aren’t convinced yet that I can handle the sachets of water like everyone else, and instead buy bottles for me. It’s just the first week, though, I’m sure we’ll figure things out.

This first week so far I’ve spent two days in the infant/young child area. I spent the first day just helping with baby weighings, which involves a bag with leg holes and a hanging scale, some very complacent babies and some that are very unhappy to be suspended in this way. On day 2 I did a bit more, starting with tallying for neo-natal immunizations (BCG and, if they come in the first two weeks, polio) and then going to registration. I spent more time asking questions on my second day, frustrated by how little I had learned on my first day. At the immunization station, I noted that although they are only supposed to give polio to infants that show up in the first two weeks since birth (the reasons for this are unclear to me), occasionally the infant was given polio vaccine anyway – but the nurse administering it did not want me to tally that for the epi records or note it in the child’s health records, which seems like a huge flaw in the system that will introduce gross inaccuracies about vaccine stores and records. I didn’t stay there long.

When I moved to the registration area I learned more about the general vaccine schedule. BCG is given as soon as possible after birth. I want to look into this more – with any vaccine there is concern that maternal antibodies present for the first 6 months after birth can reduce the ability of the child to develop their own antibodies, and a live attenuated vaccine (like BCG) carries disease development risk in those with compromised or underdeveloped immune systems. Polio is given within the first two weeks IF the child attends a clinic within that time, otherwise they start on a 3-dose regimen at 6 weeks (or as soon as possible thereafter), and then at 10 and 14 (or on successive visits). No other doses are potentially skipped. A pentavalent diphtheria-tetanus-pertussis-Hep B-Haemophilus influenzae B vaccine is given on the same dosing schedule as polio. I also want to check this, I think I remember hearing that this 5-in-one vaccine combo, instead of the 3-in-1 used in the US, plus separate Hib and Hep B, is less effective… but I’m sure it makes up for it in cost, and thus is preferred. Vitamin A supplementation is given starting at 6 months, and is given every 6 months after that until age 5. Measles and Yellow Fever vaccines are given at 9 months (when the immune system is fully developed). Pneumoccocal and rotavirus vaccines are given at any time if available – today the clinic ran out of stores of both, and I didn’t encounter a single record that already had a note that the child had received a dose of vaccine. These are also given in three doses. Children are supposed to come in once a month for weighing until 5 years, but few do. Weight for age is marked on a chart, and most children fall below the line indicating a “z-score” of 0 – meaning they are not necessarily malnourished, but certainly underweight for whatever the standard is. There is no indicator for height.

The books that all of this is recorded in is kept by the parents and is full of other important health messages, although I wonder how many parents actually read it, and if there is a huge lost opportunity to share health messages at these monthly visits. Part of the issue is that many do not speak English especially well, and many of the health messages are in English. And if they do speak it, they may not be able to read it (although those who do learn theoretically do so in school, where they are taught to read and write it as well as speak, and all instruction is in English).

Next week I start outreach education. There was some initial confusion about what my skills/plans were, but it should be sorted out now.

Wanted to post pics with this but haven't quite managed to get them! Hopefully tomorrow...