the children of the TFC

my gang of shadows


abdel-razid


ahmed


mariam


sunshine and raincloud

afternoons can be slow at the womens centre, especially on the days that aren't market days. after lunch the patients trickle in slowly, or not at all, and my staff have time to get other things done around the centre. once things have been cleaned, gauze has been cut and folded, schedules have been written up, drugs have been ordered, we have time to lie on the mat outside and relax. this is usually about the time that i wander over to the TFC tent and harrass the children.
there are now 21 children in our therapeutic feeding centre and when milena got here 5 months ago there were 3. to be admitted into the TFC program you must be less than 70% of what you should weigh for your height (severely malnourished). when the child first enters the program they may be admitted into the pediatric ward to treat all of the things that can go wrong with your body when you're that malnourished: dehydration, infections, hypothermia, hypoglycaemia, heart failure, severe anemia, etc. once they are medically stable they are put into phase I of the program. phase I is the stage that is meant to stabilize the child and restore their electrolyte and metabolic imbalances. you slowly introduce food back into their body to avoid shocking the system, which can kill them. this is done by giving them small, frequent meals of low energy food. this can be the hardest part as the children are often lethargic and have no appetite. watching their mothers pin them down and try to force life-giving food down their throats as the children scream is a definite low point of the day. daily, the children are weighed, have their vital signs checked and have a medical check-up. when they regain their appetite and lose their oedema, they are transferred to phase II. the purpose of phase II is to get the child to gain a lot of weight, very quickly. this is done by giving the kids a very high energy diet. children stay in the TFC until they reach 80% of what they should weigh, and then they can be transferred to the SFC (supplemental feeding centre). being in the TFC requires that the child spends all day at the hospital, and their mothers or other care-givers stay with them and are responsible for feeding them the food we provide. like i said before, this is to prevent the mother from taking the food that is provided for the most malnourished child and sharing it with her other children. some parents, upon being confronted with the fact that their child hasn't gained any weight, have confessed to being so hungry that they have eaten the food themselves. once the child enters the SFC, they become an outpatient. the family comes every two weeks to receive food and enough food is provided that the family can feed its other members as well, ensuring that the malnourished child receives enough. the children stay in the SFC program until they reach 85% of their desired weight, and then they are discharged (usually to fall back into a state of malnourishment and be readmitted).
while i love all of the babies in the TFC, there are some who, admittedly, are my favourites. one of them, abdel-razid, is one of the things here that makes me stay. he's 4 years old and has never spoken and never walked. we found him in his tukul when we were doing our milk distribution, alone, expressionless and naked on the floor. he was the first child i saw here who looked like the pictures you see on those informercials- the ones that make you turn the channel because who wants to see images like that and be faced with the inadequacy of your response? his arms and legs were long- the length that a 4 year old should be- but there was little on them other than skin. we convinced his mother to put him in our program, which involves her carrying him and her newborn the whole way to the hospital each day and leaving him with his two young brothers to care for him while she takes her newborn with her to collect firewood outside of habillah (her husband is absent- dead or not, i don't know- and i think that that newborn girl is a result of her collecting firewood). the two brothers, neither of which are yet 10, are complete opposites. i don't know their names so i refer to them in my mind as sunshine and raincloud. one is always smiling, and the other is the angriest child i have ever met. his face is set in an expression of permanent rage and he seemed physically unable to smile until the first time i tickled him and he collapsed on the ground in a pile of guffaws. he is now my shadow. abdel-razid sits on the mat outside, banished due to his inability to toilet himself. he sits on a mat and when he urinates it soaks through into the sand beneath him. there are times when i come to see him and he is so disgustingly filthy that i lift him under my arm (holding his urine-soaked shirt away from my clothes), traipse to the nearest water supply and rinse him down. when i am having those moments where all i want to do is go home, i go to the TFC tent and find him. i sit behind him and pull him to sit between my legs. he leans back against my chest and looks up at me with the purest eyes i have ever seen. when he looks at me he looks right into my eyes, he tilts his head to the side as though asking me a question and he smiles. i stroke his head, i tickle his feet and he laughs. sometimes when i play with him he gets so excited that he squeezes his eyes shut, tosses himself onto the mat and bangs on it with his fists as he howls with laughter. other times he lifts his hands to my hair to entwine his fingers through it. his favourite activity is to hold string and spend hours running it through his fingers, and my hair is apparently a welcome substitute. milena took the most beautiful pictures of us one day. my favorite is one where he is sitting between my legs, looking up at me. my head is bent down and he is touching my face with both of his hands. she and i were looking at the picture later and i remarked that i couldn't wait to hang out with him in heaven when he could actually talk to me. she looked at me with complete surprise and said "do you really believe that's going to happen?". of course i do.
along with abdel-razids two brothers there are 3 other children who make up my gang of shadows. one of them is ahmed, 5 years old and as tiny and frail as a baby bird (i can lift him over my head with one hand). he's ambulatory and has energy to run around now, and he just loooooooooooves to steal my sunglasses. his caretaker, and sister, is mariam. she's 7 or 8 years old and is the only girl in the club. the last one is a boy of maybe 13 who cares for his baby sister. he is bald and has a distinct tribal look that i see from time to time here. he tries to act like he's too cool for our antics, but he's definitely not too cool to run like hell when i decide to chase him.
it has become a daily ritual now, and pretty much the only exercise i get here. i sneak along one side of the tent and creep up on the 5 of them who are usually sitting out back with abdel-razid. the women inside have seen me coming and start to smile. i reach the back of the tent and once i round the corner i pounce on whoever is closest. they all scream at the top of their lungs and run for their lives. the one i caught is thrown over my shoulder and paraded out front for all to see. he/she is held upside down and tickled until i think they may pee. the first victim is released and i put on my sunglasses so i can scan the landscape without them seeing where i'm looking. the other 4 have inevitably crept closer, kind of hoping that i'll go after them next, yet kind of terrified that i'll go after them next. if i pretend not to see them, they slowly inch closer and closer. ahmed, the youngest of the group, often comes a bit too close (and if he doesn't, one of the other 4 will generally help him out by giving him a shove in my direction before fleeing) so he tends to be the one i catch the most. the rest of them i just chase around like the nutty hawaga (white person) everyone considers me to be. raincloud is too fast for me, so i have to ambush him if i want to catch him. getting him to laugh makes me feel like i've accomplished something that day. eventually the heat catches up to me and i go back to the mat and lie on it, dripping with sweat. my staff tell me i am crazy and i nod tiredly.