One’s first impression upon arrival at the Nakivale Refugee Camp is that it is swarming with children, many wearing clothes as brown as the earth itself but the earth here is red. I took a walk at lunch break and was promptly followed by a whole bunch of kids, making me feel like the Piped Piper.
At the camp we were told of a woman who died at childbirth trying to give birth to her twenty-third child beating the woman in the reality show of “19 kids and Counting”. Unfortunately this is the reality of life here not a show. A TV producer would not have chosen her to air her tragic story. Why would he? The rating would likely be low and who would like to see a string of malnourished children in ragged clothing, the older ones with children on their backs emulating their mothers and the younger ones playing barefoot on the dirt, snot running from their noses? The audience would prefer to watch the Duggars in their big comfortable home doing happy family stuff and watching the children going to educational outings.
Why have so many children? Some of the reasons that were given to us are: these women lost many of their children in the war and they are replacing them and another is they get more food per family as the food distributed by the World Food Program is based on the number of family members. If one sees the homes that the refugees built, one has to wonder how all these children would fit in them comfortably.
Many girls have their first child at a tender age of 17. Their young faces still bear traces of childhood innocence. Their own mothers are still actively having babies and they have to care for their little siblings while caring for their own baby. But soon they have two or more children tying one to their back, carrying one in front and two in tow or a year or two apart. The business of childbearing and child rearing begin to wear them down and they age rather quickly.
This woman lost her husband and a twin child in the war and is left to rear four children on her own. Her baby is clearly malnourished and she looks a picture of despair as she waits to receive food for her child.
Then there is this woman whose husband left her to stay in the Congo and she is left to raise two children. One of them is most likely blind in the right eye but we are not sure whether there is a growth behind that eye but she cannot afford to take her to Mbarara to see an eye specialist.
Children come in all sizes and with various afflictions. One 10 year-old boy walked for an hour to the clinic by himself because he was not feeling well. When he arrived he had a warping of a fever and he turned out to have the ubiquitous infection: malaria. I gave him a shot of diclofenac before sending him to the lab. He looked quite good after his fever broke and was sent home walking with his medicines.
An eight-year-old was brought in by his father with a thorn in his foot for two weeks. The foot was swollen and draining. There was quite a gash at the bottom of the foot from an incision that was made a week ago at another clinic when a medical officer attempted to remove the thorn unsuccessfully. He was then given a tetanus shot and some antibiotics. This boy came to our clinic barefoot. An inch-long thorn (probably from an Arcadia bush) was removed from his swollen foot. He suffered stoically for two weeks and probably continued to play barefoot with the long thorn buried in the foot.
A mother brought her three-year-old concerned that she has not been able to stand or walk. It sounded as though she had sustained some traumatic birth injuries that might have caused her disabilities.
This woman is forty-two and she could not believe it when I told her that she is pregnant for the eleventh time. She has seven living children.
Everywhere you look you see mothers and children and sometimes grandmothers and babies. It is not uncommon for the mothers of the babies to pass on leaving the babies in the care of the grandmothers who have finished with their child rearing many years ago. My African medical officer who shares exam room with me commented that it is always the grandmothers that are left with the babies but never the fathers or grandfathers.
Every morning I watch this young lady with her baby strapped to her back while she sweeps the ground of the Kibengo Health Center. She does that with the greatest of ease. I have even seen her moving a wheelbarrow full of things in the vegetable garden.
There are happy and sad children around the clinic and the pictures speak for themselves.