Community Health Worker in Iboni

Lohutok, Sudan

I drove Martha and Marcia to Iboni this morning to give medicines to the community health worker.  It seems that he has only given out medicine on four days during the past month.  We went to his compound. There was a bit of tobacco being grown there.  Most of the compounds had some sorghum or maize growing in them.  The sorghum looks very good in the flat area near the Iboni turnoff.

Photo: Tobacco Growing in a Lotuko Village

I wrote letters to several friends.  I have nine personal letters and one letter to Dr. Poleman to go out on this plane.  I got letters from Mom and Dad and from Uncle John and Aunt Opal.  I was disappointed that there was no letter from Dr. Poleman.  Mom and Dad said the wheat harvest at home is going rapidly.  It is only making about 25 bushels per acre on average.  Dad cut about thirty acres on each of two days.

We are having a goat barbeque today.  We received no potato chips or other such goodies on the plane.  No big loss.

Food Distribution at Lalanga Clinic

Lohutok, Sudan

This morning, I took Martha, Marcia and David to the clinic at Lalanga.  The children seemed healthier and fewer in number than last time, but I am not sure of this.  I did not collect data this time.  The man who runs the Lalanga health center seemed to have a bit better record of his medicine than before.  We sold some of the canned goulash from Food for the Hungry and gave out milk powder.  Much goulash, beans and milk had also been sold at Lohutok.

This afternoon I helped put away supplies and started helping pull up the pipe from the well.  I talked to Tobia for a while and he showed me his notebooks from history and science in secondary school.  His drawings of flower parts, cells, etc. were very good.

We are still planning to go to Torit tomorrow morning.  I hope it does not rain too much.  I have not yet thought much about what I will say to the Norwegian Church Aid (NCA) agricultural staff or what I will ask them.

Death in Imehejek

Lohutok, Sudan

Today was an interesting day full of surprises which, if not all pleasant, were at least very thought provoking.

I drove Martha to Imehejek this morning.  Michael, David and Esyiak  went along to help.  We brought enough measles vaccine for 120 children.  There was a big turnout, so they used all the vaccine by about 1:00 pm.  I imagine their half day of work prevented a measles epidemic in Imehejek.  Our plan to go on to Mura and vaccinate more children was cancelled because we had no more vaccine.

While the others were giving vaccinations, I spent a little time looking at gardens near the village.  A woman motioned me to follow her.  She led me to her hut.  Her husband motioned me to follow him into the hut.  I got down on my belly and went through the eighteen inch high door into the hut.  Inside was a man who seemed in great pain.  I tried to tell them that I could not help but that I would bring one of the medical people.  I went back and talked to Martha.  She told me to take David with me.  When we got there, the women had already started the death wail.  We looked in and the man was still breathing weakly, but he soon stopped breathing.  A man in the hut raised the dead man to show that his head flopped back, thus proving he was dead.  I felt so helpless watching him die.  Things like that and the sick children I see make me think the unspoken requirement that a thesis have much data is a superfluous requirement in a place like this.  Isn't it enough that children are losing weight, getting measles and dying to get a health program started?  If people are starving, must their weights be documented before help is sent?  I've seen people die.  I've seen children hanging onto life by a thread.  I've talked with farmers and seen their resources and problems.  Why must I document things when I can so easily see what must be done?
 
We started home, but the Land Rover's engine was missing very badly.  It did not have enough power to get through the first dry river, so we had to half-push, half-drive it out of the river and back to Imehejek.  We sent Esyiak ahead and started walking after we had parked the Land Rover.  We walked for about 3 hours, perhaps 10 miles.  We got well past Iboni when Thelma met us in her Suzuki with water.  She then took us the rest of the way back to Lohutok.

Photo:  Road crosses dry river bed  

 
It was good that we had to walk.  It gave me a better appreciation of how the Lotuko feel when they do all their walking.  It also gave me a better view of the country than I get from the Land Rover.
 
When we got to Lohutok, we found that the plane had come.  Lanny Arensen had come on it, as expected.  But Marcia Orner had also come.  She was not expected for another month or two.  She is a young nurse.  I think it will be good to have help for Martha.
 
The plane brought mail, including letters from Mom and Dad and from several friends at Cornell.  I wrote letters to Dad and Mom and some of my friends.  The plane is our only way of getting mail in and out.  It arrives one afternoon and leaves the next morning.  Everyone hurries to read their mail and get answers written in time for the plane's departure.

Recalcitrant Land Rover

Lohutok, Sudan

This morning, I marked out where my hut is to be.  The men already have several poles ready for it.  Samuel McConnell (builder of clinics and missionary houses) took a crew of men to Imehejek this morning.  The Land Rover did not want to start.  I checked the spark and it was alright.  Then I disconnected the air cleaner and looked at the carburetor.  When I held my hand over the carburetor and left only a small opening for air while Samuel ran the starter, it started.  I guess it needed to be choked harder than the choke would choke it.  It gave no more problems for the rest of the day.  I adjusted the idle when they got back.

I spent the morning at the Lohutok children's clinic gathering data.  I do not know how good the weight data is.  It shows a big problem of underweight children this time of year.  That is almost certainly partly due to bias caused by a higher turnout of sick than of healthy children.  I need to gather more data later in the year to see if there are changes.

Photo: Nurse Martha Hughell talks with some women outside Lohutok clinic

  

This afternoon, a missionary from Katiri or Katire.  (I am unsure of the spelling.)  She wants to pick up some stuff from tomorrow's plane.  She used to work here at Lohutok.

Construction of My Hut Begins

Lohutok, Sudan
 
This morning I drove Martha to the clinic in Lalanga.  Once again I collected weight information for the children.  I noticed that the few who came both weeks are those in the poorest health.  The clinics are intended to help the children stay healthy, so I was expecting that those who came regularly would be the ones in the best health.  But apparently what is happening is that only those most acutely in need of medical care are repeat attenders.  The others do not come regularly.  One wonders how effective the malaria prophylaxis (Maloprim) is under such conditions.  Martha gives Maloprim to all the children who come, but it is supposed to be taken weekly.

Samuel and I finished another rafter (#4 of 6) today.  Six or seven men began work on my hut today.  I saw that they have some poles made for it.  It will be rectangular rather than round as I originally thought.  That is mainly so that things such as a bed will fit in it more easily.

Photos: My hut under construction
(Actually taken on a later date)

I thought I saw groundnuts and sorghum interplanted just east of where the side road to Lohutok intersects the main road.  They were on the south side of the road.  I could not tell for sure from the Land Rover.  I will have to walk down there and have a look sometime.

Impassable Road, a Hike and the Doum Palm

Lohutok, Sudan

This morning I drove Martha to the medical clinic in Iboni. We had to stop one place to fill in a ditch so we could get through.

Photo: I am repairing the road so we can continue our trip.

Martha gave pills of various sorts to the community health worker at Iboni. Then we tried to go to Imehejek. We got through one bad river. We figured out that four-wheel drive was only working in the high range on the Land Rover. When we got to the big river, we had to turn around because it was quite badly washed. Perhaps we can fix it another day with a crew of men. We need to get through to give inoculations before the measles vaccine expires.

This afternoon Janis, Katie, Kristie, Martha and I hiked up to the rock called Lohofan. It was a very nice place which reminded me of Buttermilk Falls in Ithaca, New York. A stream ran down the mountainside and across the rocks. Unfortunately it began pouring rain on us when we were up there. We all got soaking wet and muddy. Janis had to carry Katie most of the way back which must have been difficult on some of the slippery rocks we traversed. Katie and Kristie cried because of the cold. Except for the rain, it was an enjoyable trek.

Below: Children Playing at Lohofon

Photo by Irina Balytsky, October 2010, http://sitwiththepoor.blogspot.com/

I figured out the name of a tree today, the doum palm (or dom palm). I found a nut from one of them on the trip to Iboni. That sparked my curiosity enough to key it out in Tropical Crops by Purseglove. It has fan-like palmately compound leaves. The kernel or seed is very hard and is used as a "vegetable ivory" in some places. It took quite a bit of work with a hammer and chisel to break the husk open and more work with a hack saw to cut the seed in two. It is hollow inside. The plant is used as a source of sisal-like material for use in mats, hats, etc. The people here tell me the tree must be quite young if it is to be used for sisal, about waist high.

Below: Doum Palm Seed

Our Hitchhiker Arrested After Clinic at Lalanga

Lohutok, Sudan

I drove Martha to the clinic at Lalanga today. I collected data on each child, making note of identification number, name, sex, birthday, months he or she was underweight and months dangerously underweight. I am told that high carbohydrate foods are in short supply so lower calorie vegetables are making up a greater portion of the diet. I suppose that is alright for older children and adults, but children cannot get enough carbohydrates and protein on that sort of diet. Martha said the swollen abdomens could be caused by malnutrition, worms or a spleen swollen from malaria. The children seem to me to be less well fed than the adults. But maybe I am just seeing a biased sample. Most of the children I have seen are those who come to the clinics. They are likely the least healthy children. I asked Michael if it is Lotuko custom for the women and children to eat after the men. He said it is the other way around; the women and children eat first. So much for one theory. Martha thinks the youngest children get along better than the older ones because the younger ones are still breast fed.

Below: Weighing a child at the clinic in Lalanga.

When we left Lalanga, we brought along a woman and her child who needed to get treatment at Lohutok. A man came along in our Land Rover as well. He said he needed to see Daniel, the chief. We met Daniel and about three policemen walking along the road. They were escorting some men to prison. We stopped to talk. The guy riding with us tried to hide his face. The next thing I knew, he was bolting out the back door. The police grabbed him, threw him down to the ground and tied him up after a bit of a scuffle. It turned out that Daniel was looking for him. He had stabbed someone, but I did not learn anything more about the incident.

This afternoon I read more in The Mountain People, studied some Lotuko and puttered around a bit. I really should set aside more time for prayer and Bible study. The battle here is definitely a spiritual one against him who blinds men to the saving words of the good news of Christ. A full day of prayer would be an excellent idea followed by more time alone in prayer on a daily basis.

First Visit to a Medical Clinic

Lohutok, Sudan

I went to the clinic at Lalanga with Martha (a nurse) and Daniel (Lohutok's chief).  The road was very bad in places.  We had to climb a few rock covered banks and dodge ditches with the Land Rover.  There were many sick and malnourished children at the clinic.  Each child has a card that he / she is to bring to the clinic.  It contains a graph which is supposed to indicate whether the child is at or below normal weight.  Most were below normal weight, especially those who had measles.  They are weighed each month.  The weights could be a good source of data about existence of a "hungry season".  However, weekly frequency of disease may also be an indicator.  Much of the weight loss seems to be the result of disease which in turn may result from malnutrition.  By going through the daily records, I could get data for a longer time period and more complete data.  The weight data might be a good supplement to this if I could collect it.

Above: Weighing a baby at the clinic in Lalanga.

Below: Martha giving an injection to a child.

As we were returning to Lohutok, we saw a man carrying an automatic, military type rifle.  Daniel motioned me to stop.  Daniel chewed the man out for having the gun.  Daniel said that two Lotuko people had been killed in their gardens by people from another tribe (Taposa, I think).  The Lotuko found those who did the killing and killed them.  Sickness and death seem to be just a part of daily life here.  I guess they do not even sound drums for a child below a certain age who dies.  I guess there are too many of them who die.

Daniel apparently has a big responsibility as chief.  He has to try many cases.  There is a jail up in the village.  Once, each of the villages was supposed to build one of the shelters at the school.  The people in the village just northeast of us did not do theirs.  Daniel put all the men in jail every night for a month.  On the morning of the last night, they all gave a big shout when they got out.  It could be heard all the way to church where the Sunday service was in progress.  That must be over one-quarter mile away.

Today I wrote to Bob Kempf, a friend from Inter-Varsity Christian Fellowship at Cornell University.