i have refrained from writing too much about the children here so far… it’s hard. anything i have to say will be a hopelessly incomplete picture either coloured with my emotional perspective or presented in a distant scientific way. there really isn’t anything in-between, but my heart aches even as i review medical terms for desperately sad conditions.

at Dambwa clinic i have had the unfortunate opportunity to see many severely malnourished children affected by protein deficiencies like kwashiorkor and marasmas. i had previously only read these foreign terms on a textbook page in my child development courses. it was strange to hear the clinical officer pronounce them and bring them to life.

this morning we were presented with a 2-year old that weighed less than 4kg. her arms were lost in her tiny sweater jacket: chopsticks ending in limp fingers. her hair was sparse and thin and huge sunken eyes stared blankly at us from a skull perched precariously atop her weak neck. she bellowed quite loudly when her mom first put her down, but seemed to lack the energy to keep up her vocal distress. her small stomach protruded angrily from her slight frame and the hard distention looked completely out of place. if there had been a few flies stuck to the wet around her eyes and nose, she would have been a poster child for Save the Children or some such infomercial hosted by a has-been celebrity or two.

shortly before this tiny child was admitted, we saw a 1-year old that was easily half the size she should have been. her mother was wearing a low-cut animal print halter over a filthy pale yellow velour tracksuit. she had several hard white scars on her neck and forehead. her left eye was blackish-blue and the rest of her face covered in old scratches. she was attempting to feed the poor thing from a small limp breast. again, the baby’s stomach was distended and hard to the touch. the clinical officer commented that often socio-economic factors play a large role in child malnutrition. this mother and babe obviously came from a rough home.

throughout the rest of the day, we saw a 4-year old girl with genital warts(?!), a young boy with bright yellow eyes of jaundice, a small girl with the swollen morning face of nephritis, a weakened shell of a boy suspected of having type I diabetes, and a perfectly healthy 2-year old with a mother that was intensely concerned with a soft stool and small cough. apparently mothers can be overly-vigilant with the minute health details of their firstborn.

outside the clinic, children are everywhere. in school, out of school, in stores, on the streets, shouting from their yards, chasing dogs with rocks, waving shyly in uniforms, clinging like monkeys to their mother’s back, running down roads after our van, selling cellular top-up cards on the street, and sidling up next to you in the grocery store to ask for money. absolutely everywhere.

the kids that go to “basic” schools (as opposed to the free “community” schools) wear grey uniforms, most often with burgundy or blue ties and trim. white socks stretch smartly from dusty black dress shoes. the boys have their hair cropped short, while the girls most often wear braids. they walk in groups and will wave quietly or smile shyly in your direction.

all bets are off with just about any other kids on the streets. while all of the children brought into the clinic have shoes, most seem to prefer to run around in bare feet outside. clothes of all sizes, shapes, and colours are mismatched to make the perfect outfit. i have seen t-shirts and sweaters with faded Cinderella, Star Wars, Transformers, and Pokemon, as well as fancy skirts and dresses worn through with daily use. you can actually get to recognize most of the children at the community schools by their clothes. because they wear the same thing every day.

because i work in the clinics and not the schools, my direct interaction with children is quite limited. i see the sick ones. healthy brothers or sisters accompanying mom on the clinic visit will just sit and stare blankly at me and my novel skin. funny faces and peek-a-boo have yet to arouse any reaction at all. however, outside the clinic, young children will run to the edge of their yard to yell “muzungu!” at me as i walk by. small hands wave up at us on the truck on our way to/from the clinics.

filthy feet, filthy faces, runny noses, one English phrase (“howare yuuu!”), and big wide smiles are the main characteristics of a lot of the children here in Livingstone. on one home-based care visit, we passed a small girl using a bowl of water to make piles of mud out of the dusty sand. the Zambian volunteer with me asked “do English girls do that?” and laughed.

i said, “oh yes. in many ways, children around the world are exactly the same.”

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