We have been well briefed on the situation of children in Burundi (tl;dr: >50% under 18, >55% malnourished) on Day 3.

Today we are driving in convoy to Gitega, with a group of UNICEF staff from the various programme sections, as well as the new innovation lab.

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Below you will see how green the country is.  This blog post should be read with some thoughts of the cooks and eaters like Jamie Oliver, Michelle Obama and Jose Andres who are trying to help people be nourished in the modern world.

There are two big problems in Burundi.

Burundi Problem One: land is scarce and vertical.  Ownership of land has gone from 2 hectares per family to 0.2 in the last 10 years.  It’s also all on mountain sides.

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Burundi Problem Two: years of civil war have had people fleeing violence, running at night and hiding during the day, and destroyed any ability to relate to the land or two know what to eat for good nutrition.

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We arrive at a growth monitoring clinic in Gitega.  This is about a two-hour drive up the hills.

Here, women come once a month to weigh their children (on the scale) so that the whole community can be checked for malnutrition, children who are suffering can be triaged for care, and data can be collected.

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It’s a long queue, and weighting a kid is a tough thing to do.  They wiggle, and pee on you – pretty consistently.

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The MUAC (mid-upper arm circumference) band checks a kid’s nutritional status.  Green is OK.  Red and yellow need followup.  Data are collected in these log books, and referrals are made to feeding centres (see below).  A child’s upper arm stays roughly the same circumference for its first five years.

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This type of growth chart helps a mother track the growth of their child.  Each visit gets a new mark.  It makes sense to me, but Cartesian plotting is not, necessarily the most intuitive thing – and I always wonder how this is really interpreted by an illiterate mother.IMG_1117

We spend some time talking with the women about their phones.  This phone costs about 10USD (and is often given free as a promotion.)  Women in the group have phones (not all of them) and say that keeping them charged with battery is their biggest struggle.   (10-15% of daily income can go to charging)IMG_1121

After the Growth Monitoring, we go to the place where treatment happens.  For kids that are moderately malnourished, the feeding centre is a place for their mothers to learn how to combine local foods and provide a balanced meal.IMG_1130

The amazing staff of this centre explain how they ask every mother to bring what they have – a sort of stone soup  process – and, with them, cook balanced, healthy food and share the recipes.

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Our team asks questions, and is particularly struck by the low-tech aspects of this project.  It is about re-building knowledge, and not about building new technology.

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The kids and mothers also get a chance to learn to play – and to discover various child-rearing tips.  The entire experience lasts about 15 days.IMG_1144

When asked how many children they would like to have, the mothers replied that three was a good number.

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This is where some of the cooking happens.

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We spent about two hours talking with the staff and mothers

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I was pretty hungry by the end – partially because the food looked so tasty. IMG_1154

For the next two days (this post is written slightly after the event) we will continue to be struck by the verdant background and the seemingly incompatible foreground of poverty, malnutrition and stunting.

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I want to thank the women who run this feeding centre for spending their morning with us and teaching us about the work that they do.

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Christopher Fabian

Gitega, Burundi (posted from Kampala, 10 March))

7 March, 2013

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