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Damien brown - australian doctor in mozambique Damien Brown is a medical doctor from Eltham in Victoria. He has just completed his second mission with Médecins Sans Frontières (MSF), this time in Mozambique. Here, he describes a nutritional screening which takes place in a camp for people who were displaced by flooding in late 2007 in Jonassi, Mozambique. It’s a little after 5am as we begin the arduously slow drive towards the Malawi border to another displaced people’s camp. I settle into that euphoric dream-like haze that is the morning drive; I fall asleep for a few seconds, before the next pothole prompts the window to spank my head and remind me to enjoy the view. The sun is rising over the mountains in the distance, kids are already walking to school with chairs and books balanced delicately on their heads, mums are out in the corn fields and rice-paddies and men are lugging unbelievably large loads of pretty much everything on the back of their bicycles. We arrive in Jonassi by mid-morning, and are greeted by the usual quorum of dozens of children. They watch as we unpack, they watch everything, and they are the easiest audience you could have – my uncoordinated attempts to swat a wasp draws laughter, as does a sneaky attempt to pick my nose. Life in a fish-bowl. Setting up for the day’s screening begins, as we set up crowd and queue control barriers, the tent, and quickly recruit local workers to help. Today, we are doing a nutritional screen, and the idea is to file as many kids between 6 months and 5 years as you can through a line where we measure their upper-arm circumference. If they are over a certain level, they leave with a de-worming tablet and a glob of purple ink on their finger (so curious kiddies don’t sneak back around again for another ‘lolly’!). If they are under a certain level, we measure their weight, height and screen them for medical problems. Malnourished kids are admitted into a program of supplemental feeds and followed up.
It sounds easy. At least I thought so when it was sold to me. It looked so on paper. It’s not. The population we are working with is a very rural population, with variable levels of numeracy and literacy. To get a local worker to read a scale accurately and write down the number is not as easy as you would expect. A significant number of mums don’t have any idea when their kid was born, give or take a year or two. Getting others to interpret graphs of which kids are malnourished based on their stats is equally tricky – either way too many healthy kids are admitted, or malnourished kids are sent home. So everything has to be supervised, repeated, questioned and re-explained (with patience I hope) over and over again… and then one more over again for good measure. And all this is going on at once. So there’s a line of hundreds of people waiting, its 40 degrees and the humidity is through the roof, and we are all already caked in dust. Adults are getting in line wanting pills for their headaches. Kids are sneaking through the barriers – curious kids want to be weighed, others want to dip their fingers in the dye, others want to just sit and watch near you. Other kids are screaming bloody murder when it comes to measure their arm, and in true crowd mentality, when one kids starts screaming, they all do - perhaps a kind of sympathetic show of solidarity on their behalf. So it goes through phases – for 15 minutes kids will wander up and grin at you as they thrust their arm into the tape, then one kid will start screaming and everyone behind him will be convinced that we must be ritualistically torturing him, so they all start and are petrified when they get to the white guy. Then it settles after a few minutes and you go through a happy phase again. So it goes for several hours – it’s a somewhat organised chaos, but we get through hundreds of kids and sort out the malnourished ones. And when we start to pack up, I am once again humbled and floored by the needs of these people. Dozens of people crowd around. We see a girl who broke her arm months ago but still has the bone poking out of her skin – unbelievable – it is surely infected, but she gets lost in the confusion (I curse myself later and vow to head back tomorrow to find her and bring her to hospital). But our day is done. We have to high-tail it back to our town before it gets dark. Our other logistician got given a chicken for our help here, which is too cute to eat I decide. I am dripping wet from sweat, the kids crowd around the car again laughing and smiling and we pull off back to town as I settle into my trance-like state for the ride home, waiting hopefully for the little chubby kid to do his foot-shuffle dance as we drive past. Another day in another universe goes by.
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