Happy International Women’s Day! Today is considered a public holiday in Uganda meaning many people except for those in essential services are off of work today. For the hospital this means it operates as if it is a weekend day. To honor the women of the community, the hospital hosted a nutrition seminar for women to learn and practice cooking hygiene skills. I was planning to go to this, but the rainy season got in the way and there was actually a hail storm here. Yes, you read that right: there was ice falling from the sky in equatorial Africa. Suffice it to say, I was not going to be pelted by ice in order to get to the nutrition seminar.
What I did end up doing today was returning to pediatrics to continue to learn about tropical diseases and malnutrition. Nutrition of infants up to the age of 12 months is especially tricky in Uganda as they are completely reliant on breastmilk. Some women, just as in the US, struggle with breastfeeding and while there is some education surrounding breastfeeding before discharge when a woman delivers there are no dedicated lactation specialists or a lot of resources for breastfeeding difficulties. Furthermore, formula is extremely expensive, and there is no government support in this regard. For these reasons, cows milk is introduced far too early and is notoriously calorically and electrolyte imbalanced. The youngest patient I have seen taking cows milk was five weeks old. This causes babies to be deficient in protein, calories, iron, key vitamins, and have low sodium which causes a number of issues for the brain. As most milk in this region is unpasteurized as well, it introduces the risk of acquiring infection from the milk. Interestingly, while the culture here is one of sharing and everyone lives in a communal manner, it is unacceptable to be a wet nurse for another woman’s child or to donate breastmilk. This would be a logical solution to the issues above, but because of the societal norms this option is almost nonexistent. I am interested to learn about the education that is provided to new mothers and to hear the perspective of new mothers about matters such as these. I will try to find opportunities to explore this more.
Lugandan word of the day: okwebaka (verb, to fall asleep)
Medical learning point of the day: Malaria can cause the rapid typhoid test to be false positive. So, if they are positive for malaria, treat the malaria and then reassess to see if they have symptoms of typhoid fever.
