Nicole's Story

Yesterday we went to a private clinic to meet a woman named Laisa and her nearly 2-year-old daughter, Nicole. Nicole’s story demonstrates a common problem in the area: malnutrition.

Nicole was breastfed until she was almost 1-½ years old, when she was weaned off breast milk and onto solid foods. However, as is common in many developing countries, Nicole’s diet consisted mainly of a single, low-nutrient food: porridge.

When Nicole began to lose weight, her mother was concerned. She took Nicole to a clinic: “At first I [took her to] the clinic for a weigh-in. And they weighed her…and they said ‘Ah, her weight is too [low]’”. When Nicole started getting larger again, Laisa thought her health was improving. However the reality was that Nicole had developed kwashiorkor, a form of malnutrition that leads to swelling.  

Because the swelling can cause weight gain, kwashiorkor often goes unrecognized and untreated until it is more advanced.  Laisa told us, “When she got sick she was swollen the legs, the hands, the head and even the stomach was swollen”. Here is Dr. David Goldfarb talking about kwashiorkor.

Nicole was admitted to hospital. While there, Nicole’s condition worsened as she developed diarrhea caused by gastroenteritis. Nicole had to stay in hospital for over a month. Here are some photos of Nicole taken by her mother when she was admitted which show the swelling:

It was amazing to see the improvement from the photos Laisa brought of Nicole’s swollen limbs. How could that be the same adorable child who sat shyly on her mother’s lap, holding a stuffed “tau” (lion) and afraid of the people talking to her mom?

Nicole waving at the camera!

This little girl’s bout of illness showed two common health problems in children under 5 in developing countries: malnutrition and diarrhea.  These, if left untreated, could have made Nicole much sicker. However, because of the care she received, she has made a good recovery! Laisa finished our interview with words that moved me. When asked if there was anything else she would like to talk about she said, "...and I am just thanking God to give more power to the doctors."

*Nicole's mother gave us permission to share her story

Princess Marina Hospital

This morning we were hosted by pediatrician Dr. David Goldfarb at the Princess Marina Hospital in Gaborone. He first showed us the neonatal unit where infants under 1 month are cared for. There were about 60 babies with various conditions including premature births. I had never seen a neonatal unit or a newborn baby before and my initial reaction was shock at the size of the newborns. Some were so premature that their arms were barely larger than the size of my thumb. There were babies everywhere in the 5 or 6 rooms of the unit (behind the doors in the picture below) wrapped in blankets lying in bassinets positioned end-to-end.

The neonatal unit at Princess Marina Hospital

Next we went to the pediatric ward, filled with mothers comforting and playing with their sick children. Here we met a young woman working as a medical officer. Having grown up in Francistown, another town in Botswana, she returned to the country after studying medicine in Norway. She is now doing research on gastroentiritis at the hospital. Gastro is the most common cause of admission to hospital for children under 5 (excluding newborns).

Drs. Goldfarb and Singer in the pediatric ward

She told us that in peak rotavirus season (which is happening right now), 5 to 7 children with gastroentiritis are admitted to the ward each day. I learned that, between the NNU and the pediatric ward, there is about a death a day. My experience showed me the importance of neonatal and child health. There were a lot of sick newborns and children, and they represented a big part of the hospital.

University of Botswana Medical School

Yesterday was the first day of my trip to Africa starting in Gaborone, Botswana! After arriving in the early afternoon, I went straight to the University of Botswana. UB has established the first and only medical school in the country, which started operating in 2009; they will be graduating their first class in a few years time. The medical school has about 50 students in each year and will continue to build capacity until it can accommodate more. The UB school of medicine currently has a faculty of about 40 and is hoping to increase its size as well. It's a big challenge to establish a medical school, and they are proud to have done it!

The purpose of the visit was for my dad, Dr. Peter Singer, to present to about 50 UB researchers about funding opportunities for innovation in the field of global health. These opportunities come from Grand Challenges Canada and the Bill & Melinda Gates Foundation Grand Challenges Exploration Program. The researchers who had, for the most part, never heard of these opportunities were intrigued. Several asked questions about what types of innovations could be funded, hoping to apply themselves. Some of the topics touched upon during the question period included: implementation research, health systems and delivery, accidents and injuries, and maternal and child health.

Discussion with researchers after the presentation

A great first day of the trip, helping to spread the word about the need for innovation in global health!

Welcome to my blog!

Hello and welcome to my blog, where I will be discussing issues that I'm passionate about! I am a high school student in Toronto, Canada where I'm fortunate to have the ability to study, read about, discuss and debate topics related to global health from afar. But now, I'm getting on the ground experiences while on a trip to Africa in August 2011. I'm experiencing firsthand a lot of what I've learned about, and would like to share that with you! So I hope you find this blog interesting and informative.