09 December 2008

African Field Report #2: Alleviating Infant Mortality in Guinea-Bissau

AFRICAN FIELD REPORT #2: Alleviating Infant Mortality in Guinea-Bissau
The Milkman Cometh!
You ever wonder what ever happened to the baby in the bed next to you at the
nursery? Did he go on to become a doctor? Is she a race-car driver?
It wasn’t until I landed here in Guinea-Bissau, a tiny impoverished
nation in West Africa that I pondered this question. You see, Guinea-Bissau and
I share a common bond, but I didn’t discover this until I scoured the streets
of the capitol city Bissau for an affordable hotel room. Since there are no
tourists whatsoever in this undeveloped country of one and a half million
people, the only hotels exist to cater to foreign development workers whose
organizations pay their expensive hotel bills. After trudging through the dusty
streets for an hour with my backpack getting heavier by the minute, I was told
about a somewhat-affordable place on Avenida 12 de Setembro. Ecstatic to
finally speak Portuguese in Africa, I asked the importance of this date, for I
assumed it had not been named in honor of my birthday. I was told that September 12, 1974 is Guinea-Bissau’s
independence was recognized by Portugal.

But despite our common birthday, our destinies could not be more different. I
was conceived out of the pure love of two wonderful parents. Sure, I had a bit
of a tumultuous delivery; my mother still complains about my two-week late
arrival, but in the midst of placental bliss, I must not have gotten the memo
telling me my nine months were up. But upon my arrival, I received excellent
medical care, nourishing breast milk and a happy home.

Guinea-Bissau, on the other hand, was born out of centuries of conflict. For
two hundred years, this region was home to the torturous slave trade between the
Portuguese empire and the African tribes that thrived from this shameful
practice. This human commerce was so profitable that the region was coined
“The Slave Coast” and colonized by the Portuguese in the eighteenth century.
After hundreds of years under the yoke of colonialism, an independence movement
was born in 1956, but nearly twenty years of armed conflict would take place
before independence was granted. Shortly before its birth, its founding father
Amilcar Cabral was assassinated. When Guinea-Bissau was officially born, the
Portuguese left the country en masse, and what remained was a struggling economy
beset with political instability and under-funded and inefficient health and
educational systems.

Since our shared birthday, while I have received nourishing food, wonderful
schooling and a healthy upbringing, Guinea-Bissau has been wracked by uprisings,
coups and a crippling civil war in 1998. (As a sidenote: I visited a British
organization that is still clearing undetonated ammunition from the countryside
here that has remains from the civil war; farmers and children still lose
limbs and lives to these unexploded weapons). While many countries have enjoyed
economic expansion, Guinea-Bissau has been plagued by debt and a lack of social
services; today, roughly a quarter of kids here complete the sixth grade and
it’s per capita income hovers around $600 a year. To make matters worse, this
country has become a transit point for South American cocaine shipments to
Europe, with many government officials involved in the trafficking, which
generates ten times the country’s national income.

Arriving in complete darkness in the absence of streetlights while crammed into
a station-wagon with nine other passengers, it was immediately obvious this
country is beset with problems. Besides the fact there was a failed coup
attempt six days before my arrival when a military faction invaded the
presidential palace, there is virtually no running water in the entire country
and only electricity in the capitol city of Bissau. Even here though, power is
spotty at best, as I learned while trying in vain to sleep in a sweaty bed.
While in the country’s second largest city, Bafata, I learned there is no
internet available in town - anywhere. Imagine Los Angeles without a single
internet connection.

But what is especially troubling about this country are the horrific health
conditions. The male life expectancy in the US is 75 years, but only 45 here in
Guinea-Bissau, so while I consider myself enjoying the prime of my life, that
baby in the crib next to me, if he were from Guinea-Bissau, would be only ten
years from his grave.

That got me thinking about the babies here in Bissau that are born into such a
fragile existence. In fact, Guinea-Bissau’s infant mortality rate ranks as
one of the highest in the world. Over eleven percent of babies born here do not
survive their first year of life and twenty percent of babies do not live to
celebrate their 5th birthday. Just think about that a second; imagine if every
child you gave birth to or knew had a 11% chance of dying before it’s first
birthday. It’s a startling statistic. As a result, many babies here are not
even named until six months after their birth, so as to avoid an emotional
attachment with a child with such a tenuous lease on life. While funerals for
old members of the community are very somber events, the deaths of young babies
do not warrant big ceremonies. The main causes of infant mortality are malaria,
acute respiratory infections, malnutrition and water-borne diseases.

Another related health problem for babies and the entire population is AIDS.
While the nation’s HIV rate is much lower than many other African countries,
what is especially troubling is the “vertical transmission” rate from HIV+
mothers to their babies, a figure that stands at about 25%. After researching
this problem, I learned that by treating the mother with a drug called Retrovir
during pregnancy and delivery and then administering the newborn with the same
drug for the first six months of its life can reduce to rate of transmission to

In the process of searching out a local project that addresses this need, I
visited with officials from international health organizations, the European
Commission and the Maternity Ward at the government hospital (which was a very
troubling experience). Several people I spoke with in Bissau
raved about the same project: Clinica Ceu e Terra, which was founded in 2001 by
a Cuban doctor who has been working here for twenty years. This clinic (which
translates to Sky and Earth Clinic) offers free services to more than 2,000 HIV+
women in order to prevent the vertical transmission of the virus to their
babies. Without this clinic, there is no chance these women would be able to
afford the Retrovir or the powdered milk to feed their babies. 25% of these
children (500 babies) would be sentenced to a life with HIV, but thanks to the
wonderful work of Ceu e Terra, only 2.5% (50 of them) will inherit the virus.
That’s 450 prosperous lives spared. Those are the kind of results I look for
before supporting a project!

Speaking with the director of the clinic, I offered to help on behalf of 100
Friends, at which point she let out a huge sigh of relief as she explained that
one of the clinic’s foreign donors had recently re-allocated its resources,
leaving her with a shortage of the fortified powdered milk the mothers feed
their babies. I went directly to the supplier and purchased $600 worth of
product, tossed it in the trunk of a taxi and returned an hour later as the
Milkman Extraordinaire. I also sought out two mothers that are in especially
dire straits and provided each with $60(over a months wages here) to spend on food for their babies, as
they are currently facing malnutrition.

As I held baby Mamadou in my arms, it saddened me to reflect the uphill battle she faces.
I thought back to my own days as a newborn and more than ever, I realize just how blessed I have been. I only hope that
with the help of clinics like this and through the generous donations of people
like you, Mamadou will live a happy, productive life in this challenging land of
limited opportunity.

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