What was it about this little girl? Her eyes? Deep, and filled with some hidden sadness. What had happened to her?
Lately, I find myself questioning God. What is it that He wants me to do here? One person can’t possibly make a difference in a culture so true to their ancestral traditions and beliefs. Who am I to tell them about life?
It’s become clear that I’m not here on my own terms anymore. That vision faded. It was naïve. God’s been shifting the gears, back and forth, and at times, suddenly slamming on the brakes.
I find myself surrendering once again as I did when he first called me here to Malawi, Africa. Searching for guidance in every movement. Literally. I’m asking if it’s His Will that I go on a run today or just stay home and read.
Despite my weaknesses and my Earthly worries, I sense His hand guiding me in directions that at times feel off track.
Some days I find myself tied up in town, waiting in long lines; dealing with the Malawian game of life. Other days I find myself in the Hospital, following around the Chaplains, trying to meet patients that are in critical health conditions or dysfunctional family situations.
On this particular day I found myself at Nathenje Health Center. Mainly there to just deliver RUTF peanut butter to the clinicians. What caught my eye immediately, was a six-year old girl that sat on her mother’s lap. She was three and a half feet tall, and weighed around 37 pounds. She was swollen; like a child who just had a severe allergic reaction. Edema is one of the easiest signs and symptoms of malnutrition in children. But for a 6 year old to have it this bad.. Something was happening both within her and most likely at her home.
Nicole (founder of an orphanage called Africare), quickly scanned Apatsa, checking for severity of edema in her feet, legs, hands, and forehead. All of which kept the indentation of the thumb when applied pressure too. We were convinced she had TB.
We took Apatsa and her mother to a room in the back to discuss what should be done. It was written all over her mother’s face, her fear and worry for her daughter. We spoke of her condition; we being Myself, Stanley, Nicole, and the clinicians. Debating if she should be taken to the hospital that day or wait to see if the swelling goes down with the RUTF peanut butter. It was a Friday, and if she got worse over the weekend surely her condition would be fatal within the next week. It was apparent her mother needed some form of counseling, as tears streamed down her face; we discussed her traveling back to Nkhoma with us.
Apatsa stood in front of her mother, scared and confused passing looks at us all. Gently taking her mother’s hand in hers, trying to understand why she was crying.
Malawian women never cry. Unless there is a death they are allowed to grieve loudly for a time, but after that they are silent and withdrawn. Depression runs high with the women of Malawi; life is not easy in the slightest for them. When Apatsa saw that her mother was weak and nonresponsive to her need of comfort, she rebelled. She made her way to the door as she painfully walked with swollen legs. Trying to leave the room, wanting to go away; as if exiting the room would make this situation disappear.
I watched her every move and facial expression. Memories from my own childhood flooded my mind. The feeling of helplessness.
The diagnosis was to wait a few days. But this woman needed help, and this child, like so many children here, was spiraling towards a painful death if the treatment was put off. I had seen enough of this in the hospital, children slipping through the cracks.
Apatsa needed treatment immediately; we decided to get involved.
The plan was to take Apatsa and her mother back to their village, check out the living conditions, and allow them time to collect their belongings. On our way back from town we’d pick them up and take them to Nkhoma Hospital.
I slowly approached Apatsa, reaching out my hand as she gripped the handle door. I whispered “Tiene”, ‘let’s go’ in Chichewa and she slowly went to hold my hand. As we walked out the room, she looked up at me. I put out my hands motioning if she wanted to be held. She immediately lifted up her arms and I pulled her into my embrace, close to my chest, I felt for the first time actually needed.
I carried Apatsa in my arms to the car with her mother following close behind. We dropped them off and headed into town to finish some tasks. Later that evening we found them both ready to go, Apatsa in her school uniform, the best clothes she had, and Nyezera holding a trash bag with their belongings.
By the time we reached the hospital it was after hours, meaning everyone was on slow motion mode and all the main doctors and nurses had gone home. I tried to hurry along with getting Apatsa admitted and checked so she could start treatment immediately. F75 would be the best milk formula for her right then. It would help reduce her swelling within days and then the peanut butter would come in next when her body was ready. Nicole and I were convinced she had TB, a reasonable explanation for her severe edema at such a late age. We wouldn’t know until Monday next week. After getting weighted and measured multiple times and finger pricked for blood checks, it was finally time for bed. I said goodnight to them both and would come by tomorrow.
That weekend was a slow one. I pushed for Apatsa to get fed F75 milk as they were given it every 3 hours. Most of the time the nurses aren’t aware of the severity of the children’s conditions and assume they are or will be fine.
Days passed and still her Edema stayed. I tried to visit as often as I could so Nyezera and Apatsa both knew they were cared for and not forgotten. From the few words of Chichewa I knew, Nyezera and Apatsa asked me for soap to wash her school dress. I slipped into the office in the ward and grabbed a bar, wrapping it in a piece of paper. I snuck it in their bag at the end of their bed so the other women wouldn’t know. Later that week I went back to counsel them with Frank, one of the Hospital Chaplains. Nyezera knew what I did and thanked me with smiles and giggles.
I asked Frank to translate for me to see what was going on back at home. Apatsa’s mother had remarried, which explained half the story.
In Malawian culture when a women remarries the new husband does not care for the children from the previous man, only his own. This leaves those children neglected within the family or worse out on the streets, begging for food, hungry and sick. This information was vital but it wasn’t the whole story. Apatsa’s results came back and she was negative for TB. Confused, Nicole and I continued to investigate what the main cause was. Finally after 2 weeks Apatsa’s swelling had finally gone down. She was put on PB+Jesus RUTF peanut butter and was discharged to go home.
A few days later on my way back from town I decided to stop by their village and see how they were doing. I was accompanied with Emily, the PB+J factory manager’s wife. As we walked through her village, the children sent the message that we were coming. Rounding the corner to Apatsa’s hut, I see her mother walking out from behind the old brick hut. Instantly, she bolts into a sprint, arms waving in the air, eyes beaming with excitement, and a smile that reached from one cheek to the other. I was surprised by her enthusiasm and joy. I suppose you never really know how much you mean to someone until you catch them off guard and see what their instant reaction is.
Nyezera welcomed us inside her hut and laid out her straw mat for visitors to sit on. She shook our hands eagerly and nudged Apatsa to do the same. She then pointed out something on Apatsa’s face. It seemed to be some kind of sore from an infection. Thankfully with Emily translating, we were able to tell her to travel to Nkhoma Hospital the following day to pick up some antibiotics. There I would meet her and pay for the treatment since Malawi Government had announced their withdrawal of coverage for children under 5 and breast feeding mothers. We said goodbye and provided a bit of money for transportation. Nyezera was always pleased with whatever we could do for her, but Apatsa still seemed shy to her condition.
The following day I ran into Nyezera and Apatsa in perfect timing. They had collected their antibiotics and treatment of PB&J peanut butter. We greeted briefly and said we’d catch up soon.
A week later I found myself frustrated in town. Working on some business for the organization, I had spent the whole day irritated at the slow impossible pace of Malawi. Finally making my way home with music blaring out the windows I came upon the turn off to Apatsa’s village.
Without hesitation I found myself turning off the main road to go visit someone who felt familiar. Earlier that day I had bought a bundle of bananas, not even needing them, but wanting to help the woman who was selling make a profit for the day. I parked the truck and reached in the backseat for my overpriced bananas. Effortlessly I walked through the village alone, heading to a home where at least I knew some Malawians would be happy to see me.
As I approached the cozy hut I noticed Nyezera splashing water on the front step. With her double take at me I began to smile and wave. She once again bolted at me with arms to be embraced in. In that moment I felt like home. Something about that dirt in the village, the chickens clucking around you, goats happily skipping along, children running around with sticks and old bottles. What was it about these people that brought me so much comfort? They had nothing of material to offer but everything in their hearts.
I rubbed Apatsa on her head as my hello and began to exam her. The sores were gone and scaring over. Her swelling had gone down and she was finally looking better. She had good pink blood flow under the eyes, clear for anemia. Relieved I walked into the hut and sat down on the straw mat laid out for me. We chatted for a bit with broken words but sign language of champs. I gave her the bananas and she grinned politely. After a few minutes I told her I had to go before the sun went down. She grabbed my hand and brought me around the village quickly to meet her family members. Honored I greeted everyone in a traditional manner.
Nyezera insisted that she’d carry my backpack for me and then stopped me in my tracks and pointed at a chicken. She said, “Coo coo?”. I laughed and said, “No that’s your coo coo, you keep it.” She giggled and continued our walk back to the truck. But before we reached it I was again introduced to some more local villagers. Three women sat on the floor with some babies, one woman in particular caught my attention. She pointed to her arms and spoke in Chichewa; as if she was asking what I could do for her. Her arms were dry and the skin was brittle on top of her forearms. I reached out to touch her and examined the skin. I said she needed to moisturize them; she needed what they were putting on the babies’ right then. I reached into my bag, remembering I always carried some coco butter lotion on me. I squeezed some on her arms and took her hand. As I began to rub the lotion into her arm, children swarmed all around in awe to watch. Time seemed to slow down. Abstraction. I felt as though my spirit was outside of my body and was watching it from afar.
I had never met this woman; she didn’t know me, and I didn’t know her. But there was something powerful in that interaction. She let me hold her hand, and massage the coco cream into her brown dried skin. She watched me in curiosity as I observed the skins natural absorption.
How good it felt to openly love. To be able to care for someone, without any boundaries, without expectations of something in return. She looked at me and laughed. Her eyes expressed gratitude.
I took a few photos together with Apatsa and Nyezera right before getting in the truck. I said my goodbyes and was off. The rest of the drive home was peaceful as I watched the sun set over a Malawian horizon.
Not long after that, I found myself back in their welcoming little village. We went through the usual routine, exchanging smiles, hugs, shaking hands, and piling into a little hut. This time I got to meet her sisters on a more personal level as well as their children. I was accompanied by Stanley, PB+J accountant/outreach leader, and was able to get more information on their family. Apatsa has 3 other siblings. An older sister Cecila, 11 years old, who kept grinning largely at me and giggling, Namoni, 9, and baby Fatima, 2, who cries uncontrollably every time she sees me. White people are still scary to her innocent eyes.
Out of the 4 children, there are 3 dads. Two still come around every once in a while to provide food and clothes, but I’m not convinced at how much truth that statement holds. The 3rd dad is a drunk. Nyezera is pretty much on her own but is able to provide for her family by making and selling “Madaze”; a donut kind of bread. Water access is about a 200 meter walk, and they also have a quarter acre for Maize as well as farming beans. However food is becoming sparse. Malawians don’t really plan well in advance. They live day to day, season to season, just moving as life takes them. This can be a blessing and a curse. Most families have already run out of food completely; this is only the beginning of the hunger season. On top of that the grass roof of their hut is destroyed. The rains are coming soon and there are no blankets or a sturdy roof to protect them from the wind and rain. I calculate in my mind if I am able to budget this repair within the donations that have been provided to me, I snap a few pictures. It’s not a fortune maybe about $30-40 USD. Of course as simple as it is to send money to provide for families here, you must be careful on how you go about it and how much you provide; as you could end up hurting them instead of helping. Sometimes if there is too much support they start to rely on you completely, or they expect you to commit to more than you are able, leaving them with empty promises.
The most important goal is to build relationships with the people, pour into their souls with love and care. Build them up with encouragement, determination, and optimism. And always pray for them, as God is already doing more than you ever could.
Today Apatsa is doing well. The swelling in her feet, legs and hands have all reduced, however there is still a bit in her face. There seems to be a mystery as to why her cheeks are still swollen. She is TB negative and HIV negative. We’re hoping to find out another additional medical problem that she may be dealing with. The good news is she is eating Chiponde with an appetite, playing with the other village children, and becoming more comfortable speaking out loud to me. A few days ago I ran into them at Nathenje Health Center where I first met them. They were coming for another regular assessment and PB+J RUTF Chiponde supply. I know Nyezera loves her daughter and it’s obvious she is doing what she can in order for Apatsa to reach a full recovery. I’m confident in saying that with continual follow ups, encouraging messages, love, and God’s provision; they will prevail through the difficult months to come.
The magic begins to show when realizing God’s Will is expressed in the details; the little things, like smiles, and laughs, holding a child, talking to a family, letting them know they’re loved, and cared for. It’s the tiny things that fill our day that seem to hold the key to his infinite, unconditional love, and the experience of his everlasting peace.
If you’d like to help with malnutrition in Malawi, children like Apatsa would gladly receive your love. www.pbjfoods.org just $30 helps provide a full treatment of RUTF supply.
My work here is funded also through love via donations. There is quite a lot we’d like to do; if you wish to donate to help my work send through www.pbjfood.org and send me an email so we can pull the funds accordingly.
Written by Rachel Falomir