Wednesday was our last day in Old Naledi, and we decided to spoil the kids a little by bringing bowls of M&Ms for them to share. We coupled it with a handwashing demonstration and the lesson to always wash before eating to, you know, justify giving them candy...
What we didn't expect was to play the part of human jungle gyms for most of the afternoon, children holding on to every appendage and two or three on my back at a time. In addition to just being kids who want to play, culturally, children aren't held very much in Botswana. Women tie babies on their back papoose-style for the first year or so. After that, you're on your own. These kids are worse off because parental involvement is minimal or nonexistent, and corporal punishment is the norm. Consequently, they are desperate for positive human contact and used every square inch of us as a playground. The three of us grew oddly attached to these kids during our month or so in Botswana, and seeing them every Wednesday was a bright spot in our week. Obviously, we each have our favorites, and it took every ounce of willpower not to put one in my carry-on. My favorite is a six year-old with crooked front teeth and an endless supply of energy. His (only) school uniform shirt is always open because all the buttons have ripped off and you can see his toes peeking our from inside of what used to be velcro high tops. We played airplane and spun around and chased after each other all afternoon. When I walked to the grocery store down the street to buy a water, I heard him chasing after me and we walked hand-in-hand the rest of the way, playing kick-the-can. I bought him a water, too, and he drank it as if we had been in the Sahara for a month (most of the kids we assessed are acutely dehydrated, which is only the tip of the iceberg when it comes to their health concerns). As we sat across from each other back at the center, him guzzling away, I realized just how small he is for his age. When we ran the data for all 27 kids we assessed, we found that 82% of them are below the 50th percentile for their height and weight. 36% are below the 30th percentile, and more than a quarter of them are below the third percentile, their numbers so low we could not even plot them on the growth charts.
Yet, these kids were running around like there was not a care in the world, begging to be the next one up on our shoulders. For all their severe malnutrition, a surprisingly low number of them needed referrals for things like cardiology or acute infections. The human body is amazing; it knows to prioritize the important things like pumping blood and keeping the kidneys working. Many of these kids may have patchy bald spots because they don't have enough protein in their diets to both keep vital organs functioning and make hair, but the body knows which of these is more important.
I choose to believe that the Center we worked at will be the positive influence these kids need to escape their current circumstances. That is more than a little idealisting, but fledgling as it is, it is too important to fail. We left behind all the medical supplies we could muster and a new physical assessment form that is much more comprehensive than the current one and asks important questions about sexual health and substance use. We aggregated the data we collected and are putting into a report for the site director to share with the Ministry of Health to argue for things like toothbrushes (82% had some sort of oral health issue) and soap (because, well, they don't bathe). The supplies will run out, the Ministry may not listen, and the local nurse (if they can ever get one to show up) may not use our form, but I choose to believe we left something behind that will have a lasting impact. It would only be fair, because that place certainly had one on me.