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FEBRUARY 1-ISH, 2004 Ambohitsilaozana, Madagascar

Well, it has been a quiet week in Ambohitsilaozana, where the women are strong, the men have no teeth and the children are malnourished. I’ve been at site here in Madagascar for about three weeks. I spend my mornings observing at the clinic. This morning was a zoo because it was vaccine day. I actually administered vaccines to the pregnant women. I refused to vaccinate babies. I’m afraid I’ll pop them or something. Each morning has a task: vaccines, family planning, prenatal consultations. The nurse collects all the medical records from the patients, does the paperwork, then herds the people in groups. There is no such thing as privacy; the one pelvic exam I’ve seen was done with the door wide open and chickens wandering in and out. Vaccine day is definitely the craziest: it takes the nurse over two hours to do the paperwork, while babies and mothers wait outside in sun and rain. The doctor kind of scares me. She is a tiny woman who chain smokes and wears heavy suits. She always makes me look like an idiot because she talks really fast to me and I have no clue what she is saying. Yesterday, I saw the skinniest child I’ve ever seen. His bones jutted out, his eyes were so sunken that he could barely blink because the skin was pulled tight. He made little gulping noises, as if he were incapable of crying. He was eleven months and I weighed more when I was born. In the United States, this child would be declared a ward of the state and immediately hooked up to feeding tubes and IV lines. Here, the doctor just reprimanded the mother for not giving the child more fluids. FEBRUARY 14, 2004 The malnourished and dehydrated child was back at the clinic this week. This time he got fluids via IV. He’d been having diarrhea and vomiting for more than a week. I found myself angry with the parents and all the family members who came to the hospital to gawk. I don’t understand how you can let a child get so near death from malnutrition and dehydration. Perhaps my frustrations are misplaced. With one out of ten kids in Madagascar dying before their first birthday, it now makes sense to me that the burial rituals are different and a child isn’t really thought of equally until their first birthday. FEBRUARY 28, 2004 It hasn’t been the best two weeks in Madagascar. The malnourished, dehydrated boy with the IV died. It wasn’t surprising, just sad. I’ve thought about him a lot. It’s frustrating that someone can die of dehydration when there is plenty of clean water to be found, and it really doesn’t take that much to feed a child: a little rice, some produce and a little oil should give a kid a good start. The average Malagasy person lives on less than a dollar a day, so it is difficult to afford food. Most manage by growing their own rice and COA | 25

Profile for College of the Atlantic

COA Magazine: Vol 1. No 1. Winter 2005  

COA Magazine: Vol 1. No 1. Winter 2005