Work Update

For the past two weeks Sembrando Infancia has been performing a series of surveys throughout Cambio Puente. The project has just finished its first year and while they are happy with the results of all their hard work, they are also dealing with some disappointments. The data shows a mixed outcome. Some of the children’s health has greatly improved, but many have also showed no change or a continued decline. This is especially frustrating for those families who’ve whole-heartedly believed in the project and have done everything possible to achieve maximum results. How then do you explain to them that the supplements are important? How do you maintain your credibility within the community? 

One of the families we interviewed.

This sent the team back to the drawing board.

Okay, the kids have been receiving supplements and health advice for the past year. But our data shows that there is a certain percentage of children in each sector suffering from a decline in health even though we know they are participating to the fullest extent.

What's causing this?

After an examination of all the data, the team realized that there is a direct correlation between children who haven’t seen positive results and those who suffer from chronic illness, diarrhea being the major culprit.

Did you know that diarrhea killed nearly 1.3 million children in 2008?[1] 

I didn’t.

I also didn’t know that diarrhea kills more children than meningitis, measles, HIV/AIDS, pertussis and injury combined.

Or that it’s the third largest cause of childhood mortality after neo-natal illnesses, right behind pneumonia.

Cholera, shigellosis, rotavirus, typhoid, dysentery and other diarrheal diseases account for 14 percent of deaths in children aged 1-59 months. [1]

Black R, Cousens S, Johnson HL, Lawn JE, Rudan I, Bassani DG, et al. Global, regional, and national causes of child mortality in 2008: a systematic analysis. The Lancet. 2010;375:1969-87.

 Diarrhea is mainly transmitted through water and food born parasites.

It’s no surprise then that diarrhea especially effects third world countries and rural areas like Cambio Puente.  

Although there aren’t any kids necessarily dying from diarrhea in Cambio Puente, Sembrando Infancia believes it is one of the major reasons there has been some backsliding in their results. It’s difficult for a child maintain an adequate level of nutrients if they are in a constant state of dehydration and nutrient loss.  

The evolution of a house, sticks to estera or bamboo then finally to adobe.

 The team decided that, since diarrhea is cause by poor sanitation, they needed to get a better understanding of what they were dealing with in that regard.

We needed to get into these houses.

We’ve surveyed more than a hundred families to feel out the cooking, drinking and bathroom situations that the kids in the project are living with and I think the team hit the bull’s-eye.

First of all, none of the houses have desague, or drainage, for their bathrooms. This means that they are using an outhouse system. 

An example of the most common style of bathroom in Cambio Puente.

 

Inside. The concrete helps to reduce hazardous conditions.

 They dig a deep hole, use it until it’s filled up and then dig another hole close by.

I’ve seen a huge range of bathrooms, ranging from something similar to a bathroom I’d see in the U.S. to the downright disturbing. One thing is clear though: the hole in the ground method is unsafe and unsanitary.

Some families have done a lot of resourceful things to mitigate the negatives. Some have covered the ground with cement so it’s easier to clean, some have placed commodes over the hole and flush it by pouring water into the top. Some of them have installed ventilation tubes. The best thing I seen is a family who dug a giant septic hole a bit of a distance from their home and connected it to a commode in their house, creating something similar to a septic system we’d see in the U.S.

The most widespread problem is that many of the families don’t cover the hole with anything so there is a lot of cross contamination between the bathroom and the kitchen, especially by the omnipresent flies.

Maribel, one of the community agents helping with the survey.

 Another big problem is that many cook with wood on the ground, camp-fire style. While it is cheap and effective, there are some detrimental side-effects. Firstly, the smoke is obviously bad for everyone’s health. Secondly, it’s hard to get water to come to a full boil while cooking with wood. When cooking a pot of beans or boiling water for drinking, few have time to wait thirty minutes to sanitize the water properly. Thirdly, when cooking on a wood fire, regulating the cooking temperature is pretty much impossible. This throws safe cooking practices out the window easily leading to improperly cooked food. 

These findings have framed the focus of Sembrando for the upcoming year. Not only do they need to focus on nutrition, they are also going to have to ensure that the children are living in an environment that fosters these nutritional changes. We plan on incorporating better sanitation practices to the capacity building workshops over the next months.

This has been cool for me to see. Not only do I feel like I’m finally pulling my own weight since my Spanish has gotten good enough that I could perform the surveys on my own, I also got to see the project overcome a big hurdle and respond with an action plan. This is definitely a lesson that will help me in my work with WGC.

Overall, the past week has shown me another side of the people in Cambio Puente. For them to let me into their homes to look at something as intimate as their bathroom was humbling.

“Puedo observer tu bano?”

Their head would jerk up to look at me to make sure I was being serious.

They’d close the door a little and look back over their shoulder as if trying to see the bathroom through the wall to see the state it was in.

Then they’d smile shyly and sometimes ask, “Do you have to?”

 Although there were a few that outright told me I couldn’t come in because they didn’t trust me—which is understandable—the majority were hospitable and patient with my Spanish.

It really motivates me to work harder now that I know the families I’m working on behalf of. Now,t here are faces that correspond to all the tables and pie-charts we’ve been evaluating. 

                                       

Two brothers and their sister playing marbles outside their home.

Black R, Cousens S, Johnson HL, Lawn JE, Rudan I, Bassani DG, et al. Global, regional, and national causes of child mortality in 2008: a systematic analysis. The Lancet. 2010;375:1969-87.4