Alison Talbert - Kenya |
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Prayer Letter April 2008
“Wash yourselves and be clean! Let me no longer see your evil deeds. Give up your wicked ways. Learn to do good. Seek justice. Help the oppressed. Defend the orphan. Fight for the rights of widows.” - Isaiah chapter 1 v 16.17 New living translation.
A quarter of 2008 has gone by already! Not everyone gets my monthly Prayer Emails (get on the emailing list: contact geoff[at]crosslinks.org) so I thought it was time to update you with a proper Prayer Letter.
Interview with student KESHO Day
The year started in a state of tension- no New Year celebrations in Kilifi. Because of the post-election troubles, people stayed at home. Even though there was little disturbance in Kilifi, just a few traders’ stalls burnt down, the Kikuyu businessmen were scared of tribal violence and there were shortages of fuel and food. In February there were mounting fears of widespread violence until Kofi Annan brokered a peace deal between the 2 main party leaders Mwai Kibaki and Raila Odinga. Things seemed to calm down but since then power-sharing has not proved straightforward and there are more fears of breakdown in law and order.
In February the endotoxin in malnutrition study got underway. I trained the training team of the lab in the technique for measuring blood endotoxin levels having done the assay myself 3 times at the Royal Brompton Hospital in London back in August last year! The trainers then trained all the outpatient lab staff and we started recruiting children to the study. The aim of the study is to see if a new assay for measuring endotoxin ( which is part of the cell wall of bacteria) can detect bloodstream infections in malnourished children quicker than conventional tests like blood cultures which take over 24 hours to get results.
In March I helped to write a proposal for an intervention study to prevent children who get infections such as diarrhoea and pneumonia who are already moderately malnourished from worsening into severe malnutrition. The aim of the study is to compare nutritional status in children who are given supplementary food for either 2 or 4 weeks with those on usual diets. The supplementary food is a paste made of soya flour, maize, sorghum and millet mixed with palm oil, sugar and vitamins and minerals. A similar supplement but with peanuts has been successful in treating severely malnourished children in Niger, Malawi Sudan and Ethiopia.
The idea of peanut paste as a ready to use therapeutic food apparently came to a nutrition expert as he was eating Nuttella for breakfast. He thought if chocolate hazelnut spread is so tasty and rich in calories surely something like it fortified with vitamins and minerals could be given to malnourished children to help them gain weight fast. The result was Plumpynut, a peanut, milk powder, oil and sugar paste fortified with vitamins and minerals made by a French company and used widely in emergency situations as a more practical way of feeding many severely malnourished children than making up milk-based feeds which have to be made up fresh each feed. It doesn’t need refrigeration, doesn’t get contaminated by bacteria and can be handed out as weekly rations to those children without complications who can be treated at home. A cheaper version made locally in Nairobi with soya instead of peanuts will form the basis of our study. If it works in outpatients it could be used in health centres and dispensaries to prevent malnutrition in those at risk when they come for treatment of acute illnesses.
So much for the theory, now its time for the practical preparations for the trial which will be held in Kilifi District Hospital outpatients and recruit 500 children under the age of 5 years. The proposal got through its first committee hearing, the Kilifi KEMRI scientific steering committee, at the beginning of April and has to pass through 2 more stages before the study can start. They are a national scientific committee and a national ethics committee. If all goes smoothly it should start in August. Nurses in outpatients have to be trained in screening for malnutrition and giving nutrition advice to mothers. Consent forms and patient questionnaires have to be translated in Kiswahili and the local language Kigiriama. The company donating the food supplements want us to do a 5 week acceptability trial; if the children don’t like the taste of the soya paste then its back to the drawing board…
So that’s just a taste of what clinical research is about- pardon the pun. What else have I been doing? I have been helping with an orphan support group called Upendo ( Kiswahili for love) which was started by a group of women at the Methodist church. They realized that several of the street children in Kilifi were orphans and started a feeding progamme alongside social work. It has grown and now comprises a nursery school and day care centre where the children can get a Christian education and nutritious meals, and their extended families are helped with food and clothing so that children do not have to go into orphanages. I have been helping with medical advice and have been asked to be a Board member.
Another local organization I’m involved in is KESHO (Kiswahili for tomorrow) . It has sponsored over 100 children from poor families in Kilifi District through primary and secondary schools and at the start of every term has a KESHO day where the students bring their reports and requests for fees, uniforms and textbooks. (Picture at top) I previously helped with the letter writing to sponsors- very interesting and occasionally poignant when describing their daily life and ambitions. This term over 80 children turned up and as well as the normal interviews with students , 2 school leavers who’d achieved top grades received prizes and gave motivational talks to the other students. Some of the KEMRI interns, young graduates who are on 6 month placements to learn about scientific research, helped with careers advice and how to apply to university.
Aziza and Ibrahim with aunty Paha
Aziza's father with some of his dependents
I helped to interview the Omari family which was very special for me as I looked after the 2 youngest children, Aziza now 1 year 10 months and her brother Ibrahim aged 5 when they were admitted to the high dependency ward last May with severe burns from a house fire. Their mother died from injuries incurred when rescuing them from the blaze. The father’s sister who was caring for them while they were in hospital died last August and then his mother who also helped in their care died in September. The mother’s sister Paha then stayed with them until they were ready for discharge in October and they were referred to specialist hospitals for skin grafting and contracture release. Ibrahim was very shy this time and his father said he was scared of doctors, not surprising after all he has been through. Aziza seemed less withdrawn and will soon be measured for special shoes (she lost her toes but has otherwise made a good physical recovery) Both children are developmentally delayed and still traumatized. Sponsors have paid for rebuilding the house and living expenses through Upendo. The father has 6 children of his own and also has to look after his late sisters’ 3 children; he has had to give up his job as watchman. All the children came to KESHO day to get school fees and collect vouchers for uniforms and text books from shops which have an arrangement with KESHO.
Otherwise I have recently been on a retreat for Crosslinks mission partners serving in East Africa. Most came from Kenya and Tanzania but we also had a family now working in Nigeria, the Gerrys, who used to be in Dar-es-Salaam, and Karen Salmon working in Ethiopia whom I hadn’t seen for 18 years. We had good praise and prayer sessions and bible teaching on Ruth and I shared a little on the practice of widow inheritance which still goes on amongst the Giriama people here on the coast. When the mourning period is over a group of elders decide who will marry the widow. We recently had a child admitted with kwashiorkor whose mother had been passed on to her late husband’s brother who ran off with her money and left her pregnant. Ruth fared better with Boaz and their descendants included King David and Jesus.
All these problems seem a world away from the political discussions about how many cabinet ministers to appoint (44 at the last count each with a monthly basic salary of £6,679 before allowances) yet ultimately the politicians are here to work for the ordinary people of Kenya aren’t they?
Please pray:
- For malnutrition and other research studies at KEMRI (Kenyan Medical Research Institute) aimed at improving the lives of ordinary Kenyans
- For those who in the post-election violence had to flee for safety and lost homes and jobs that they could rebuild their lives
- For the committed Christians working at community level to help those in need
- For strong church leadership at national level to speak out against injustice
- For peace in Kenya and a solution to political problems resulting from the flawed election in December
- For the poor, oppressed, displaced, widows and orphans of Kenya that their welfare would be considered by those in power
With love in Christ,
Alison