Tuesday, November 27, 2012

A lot to catch up on - Hodeidah Edition

Wow, it's taken me a long time to get around to writing about my recent field trip to Al Hodeidah and Hajja Governorates. I'm really not sure where to begin, as I've written so much about them for my work, I'm not sure how much more I can write!

So I guess I'll just start writing and see where we end up...The purpose of my trip was to interview and document the beliefs and practices around key issues so over time they can be looked at to see what the links to malnutrition are. My technical colleauges in Water, Sanitation and Hygiene (WASH) and Emergency Food Security and Livelihoods (EFSL) developed a list of questions that they were interested in finding out the answers to. These included questions around water usage and treatment, defecation, hand washing, and solid waste disposal on the WASH side, and breastfeeding, dietary diversity and income generation on the EFSL side.

A public health colleague M, who's from Sudan was tasked to work with me on it, and it was great to not only have a native speaker to do the interviewing, but also a technical person who could explain certain things to me (like what bilharziasis is). As we had cash distributions underway in both Hodeidah and Hajja that's where we set off to find people to interview. We spoke to 15 women over five days in the field, and the vast majority of them are really struggling: with the health of their families, with finding income, with poor sanitation and hygiene - all the things I, and I assume most of the people reading this take for granted.

We started at a cash distribution in Al Shokna district. The distributions are run from schools, and were relatively orderly in Hodeidah. Even the donkeys were well behaved.

After interviewing a couple of women at the distribution, we ventured out to a nearby village where we were introduced to Hind and her family. Hind is only 18, her son is 2 years 4 months, and her malnourished daughter is 14 months. She says her baby doesn't like to eat, and they tried to feed her the Plumpynut (a high protein paste designed to treat malnutrition) that they were given at a clinic, but she doesn't like it so they give it to her older brother. "Our daughter is sick from God. We boil water so there is no contamination, we give her the food we get from the health clinic and spend most of our money on her, but God chooses that she continues to be sick." With the money they received from Oxfam they were planning to repay some of the debts incurred by the medical expenses, and buy some chicken. They haven't been able to afford any meat in a long time.   

We spoke with Noura, whose 10 month old baby is malnourished. They've had to cancel appointments for his treatment recently because they can't afford either the cost of the treatment, or the transport to get to the clinic. Her husband, Mahfouz (below) spends most of the year working in Saudi Arabia to earn more money to support his family. Unfortunately for this family, they weren't being supported by Oxfam, or the government's Social Welfare Fund.
 In total we spoke to six families in Hodeidah, and there was quite a range of good and bad practices, and interesting beliefs. I was very interested in the beliefs around colostrum, some women thought that it causes diarrhoea and vomiting, one woman said it was stale, spoiled milk that needs to be thrown away. Another woman told us that if you breastfeed for too long it will firstly cause illiteracy in the child, and if it continues, eventually death. There's obviously a huge need for education.

After long days in the field it's nice to unwind with colleagues and get to know them better. The international women share a house and are all from East Africa. They invited me over one night and produced a delectable feast and entertaining conversation and it was lovely getting to know them all a bit better. Another night, I went out with some of the gents, who are all from South Asia. We went back to the fish restaurant I'd been taken to last time, and this is what it looked like when we were done.
Sometimes it's hard to reconcile eating so much when you've spent the day with people who have close to nothing. I've written before about the afternoon I spent in a malnutrition clinic in Pakistan and how difficult that was, and this was no different. What we can hope for is the cash that Oxfam is providing to over 100,000 people in Hodeidah will go some way to alleviate their current situations.

I'll write about the Hajja part of my trip at a later point.

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