This summer, the GROW team aimed to conduct a research project in order to assess the nutritional status of the children of the women who have already completed MHEP. We came to Rwanda having full faith that the clinic would have comprehensive records for all of the children who visit it and that we would be able to spend a day or two in the clinic looking through the records in order to find the information we needed. We were wrong.
The first week, we asked the nurse for the records so we could start the process of looking through the handwritten records for the height, weight and upper arm circumference of the children whose mothers had completed MHEP. Unfortunately, we found out that she only had records for the children who were found to be severely malnourished and this year would be the first year that the clinic would keep records for each and every child. Despite this setback, we started by looking through these two record books of severely malnourished children and were able to find some information for some of the children we needed but we still were missing a lot of information.
The next step we would need to take was to obtain the remaining records from the health professionals who work in the villages. Contacting the health professionals meant we would need to go and visit them in their homes so last week, Molly and I set out with Hyacinthe to make a few home visits and hopefully get the records we needed. Before we left, Molly asked if we thought the houses would have outlets in case we needed to charge her computer. We clearly had no idea what kind of adventure we about to embark upon.
We took Moto taxis to the clinic and then began a short hike to the house of the president of the co-op who would be in charge of showing us around a few villages to the homes of the health professionals. She led us up small hills, through fields growing potatoes and cassava, and down footpaths with only enough space to walk in a single file line in order to reach the various houses. Molly and I had both worn flip-flops, another clear sign that we were not quite prepared for this journey. After multiple stops on the way to say “muraho” to cooperative members, we finally arrived at our destination. We sat down in a small sitting room lit only with natural light and waited patiently as Hyacinthe and the health professional began an in depth conversation. About 10 min later we were informed that the health professional only had some of her records as an organization had already come before us to take her records in order to enter them into a computer. Fortunately she had one of her record books from 2011, so from that combined with her amazing memory of the people in her community, we were able to find the weight and upper arm circumference for all of the children we needed from her village.
The next three visits were less successful. After taking winding pathways up and down a couple of hills, we moved on to the next village where unfortunately the two health professionals who worked there were also missing several of their record books and did not have information for any of the children we were looking for. Though it was starting to get dark outside and we were far from any place with streetlights, we continued on to the last village we were visiting that day. The health professional we were meeting was not home yet so while we waited for her near her house. Several residents of the village came up to us to greet us and two young boys brought us a small bench out from one of the nearby houses. We sat down with the children and played with them while we waited. Just as the sun was about to set, the last health professional we were meeting for the day arrived. We sat down in a very small, dark room and tried to see if she had the records we needed but unfortunately it was now far too dark to read her record-books and her house had no electricity. We walked back through the fields and up and down the hills until we reached the clinic. By this time, it was very dark outside and we had to walk back to the main road without any streetlights. Luckily, we made it to the main road and easily found Moto taxis to get us back into the city.
Though we did not obtain the information we expected that day, our adventure was a learning experience and a reminder that Rwanda functions very differently from the U.S. If Rwandan’s system was similar to America’s we would have been able to obtain our desired data in the clinics electronic records under 15 minutes. However, we never would have had the opportunity to trek through the Rwandan hills with a parade of children behind us, or see first hand how the health professionals actually measure the children’s nutritional indicators. Because of this opportunity our data is no longer numbers on a spreadsheet but holds the memory of individual faces and the visual of the actual size of a severely malnourished upper arm. We had the opportunity to experience a small taste of Rwandan village life and demonstrated our ability to improvise and think on our feet. We learned not to be surprised when our plans fail and to formulate not only plan B’s but plan C’s and D’s as well. I am proud of our GROW team for facing all of the challenges head on without letting frustration affect our work.