Kimiko Utsonomiya | CMMB/NDMVA Volunteer | Lima, Peru

I’m living in Chorrillos, a shanty town in Lima, Peru, where on one side of the street the houses don’t have electricity or running water and the other side does. I will be living here for a year as a Notre Dame Mission Volunteer in convent-type housing, working primarily at the Fe y Alegria School, which has grades from Kindergarten through 11th. Most of the students come from low-income and at-risk families. Right now, I am a teacher’s assistant in Professor Diana’s third grade class, helping with homework, with preparing assignments and keeping students focused.

Living right beside the church with Sister Magda and Sheila, you are never bored. There are countless rings on the door and questions to answer, not to mention the multitude of visitors, coupled with the basic tasks of maintaining the house; sharing in cooking meals, buying groceries and cleaning keeps us busy. At first, it was a bit overwhelming; but I concluded that if Sister Magda has been doing it for twenty plus years, I should be able to for my short time here.

“God led me to this house,” replied Sheila, our new live in guest, when Sister Magda asked why she had decided to knock on this particular door late one night. Sister Magda told me how Sheila had come with “Una cara tan triste [a face so very sad].” She also came with hunger, lice, dirt and grime from living on the streets and tuberculosis- and an even greater need for kindness and love. Magda, with her generous heart and kind spirit, opened Tupac’s arms to Sheila. She has been Sheila’s “Mamita” figure to her, and I have been “La chinita” (now “Kimiko”) to her, who cooks food, bakes the beloved banana bread, and talks to her. Each day she becomes more confident and talkative; and her considerate nature and eagerness for learning about different things really shows.

For more than a month, Sheila had highly contagious tuberculosis. But with regular treatment, pills in the morning and at night that Magda administers, proper rest and a healthy diet, Sheila has gotten better, gained more weight and is overall much happier and communicative. Last week, we found out that she is no longer contagious but still needs to continue her treatment for the entire six months. What a blessing that she is better!

Sheila, like many people in this community has had a tough life. At 25, she is already the mother of two, has suffered from an abusive husband; turned to selling candy, drugs, cigarettes, herself in order to survive, mental difficulties, lived and ran away from family members houses. Her many aunts say that every time she stayed with one of them, she’d run away, leaving their doors wide open. But here, she’s stayed. And hopefully will continue to stay until her treatment is complete. “Dios es grande,” as Magda always says.

Here, Sheila seems content. Magda began teaching her how to read, write and other basic skills, such as counting money. These past few days, I have also been helping her to read. She recently learned how to read “Mama,” and “Ama [loves].” Illiteracy runs rampant here; especially among the very poor. Tuberculosis is also a huge problem; so much that free treatment for it is offered. Instead of hearing Sheila’s hacking cough and spitting phlegm, we hear her clapping and singing songs at the top of her voice; in Quechua, songs praising God and popular rock and pop songs. I always hear her shouting “Gracias Dios.” Knowing and meeting Sheila has made me realize how there is so much to be grateful for; so many things that can be done to help people here.

Each day we can see Sheila blossoming and coming into herself. Many times, she falls back into her past, the stinging memories, the pain and the trails of shadows that still follow her; she continues to repeat the most painful experience, still says she’s a “Cualquiera [a nothing].” Recently, she has begun confiding and talking to me, asking me for advice. Sheila recounts all of this while we are eating lunch, during dinner, while I am sitting at the downstairs dining table keeping her company. All of a sudden, she begins talking about everything. But soon, we hope to help guide her away from all of these shadows and help her live in the present, look to the future; like the Founder of the Sisters of Notre Dame, Julie Billiart said, “To be simple is to be like a sunflower which follows all the movements of the sun and ever turns toward it.” How wonderful it would be if Sheila could always turn towards the sun and forget all of her shadows!

Kayla Bronder, has been volunteering with CMMB at St. Camillus Hospital in Karungu, Kenya as a Public Health Officer.

Karungu, Kenya is situated along the southern shores of Lake Victoria in Southwest Kenya with a dense population of over 28,700 people (World Vision Survey 2001). This area has the highest HIV/AIDS infection rate in all of Kenya due to various socio-economic and cultural practices. The increased infection rate translates to a large increase in the number of widows, widowers, orphans and horrible living situations in Karungu Division. Families struggle to find food and live in dilapidated homes, which in turn lead to a high spread of jiggers infection. Common challenges are malnutrition, poor health care, reduced access to education, child labor, homelessness, and lack of adult supervision or guidance. The cycle of HIV/AIDS, poverty, and poor health creates a huge obstacle for individuals and families attempting to life a full and healthy life.

Poverty and "Jiggers"

A devastating result of this cycle of sickness and poverty is the increase of Tunga penetrans, locally known as jiggers, infestations. Tunga penetrans are the smallest known flea that lives in sand and loose dirt. Tunga penetrans most commonly burrow into the hands and feet, causing a disease known as Tungiasis. Tungiasis presents with severe itching, inflammation, auto-amputation of fingers and toes, deformation of nails, fissures, ulcers, gangrene, and walking difficulties. The open sores leave those inflicted by jiggers open to secondary infections, most significantly the potentially fatal tetanus. Finally, the severe itching often causes insomnia and other psychological discomforts.

Tungiasis is a disease of the poor, uneducated, and most needy. The severity of the Tunga penetrans is compounded by social stigma, community apathy, and ignorance of proper control measures. Because of fear and ignorance, the community shuns those infected rather than helping individuals remove their Tunga penetrans, clean their homes, and report cases to public health authorities. Tunga penetrans are easily spread through homes with earthen or dirt floors. The fleas live and breed in the sand and cracks in the floors of the un-cemented and un-smeared homes. Other factors influencing the spread of jiggers include stray animals in close vicinity to living quarters, unpaved streets, insufficient or non-existent sanitation, walking barefoot, illiteracy, ignorance, and neglect.

In 2009 Tunga penetrans were present in 88 countries world wide with some of the poorest communities having infection rates of over 50%. Children and the elderly are more severely impacted and rates of infection are highest during the dry seasons. Treatment for Tungiasis is limited to physical removal of the flea from the skin. Care must be taken to remove the entire flea, including the burrowed head. Following removal, the cavity left by the Tunga penetrans must be thoroughly cleaned and a tetanus vaccination can help prevent dangerous secondary infection. In addition to removing the fleas, it is recommended that the infected homes be sprayed with insecticide to kill the eggs and larvae buried in the sand.

Treating Tungiasis is necessary for those already plagued by jiggers; however, the most essential eradication measure is preventing jigger infestations. The flea lives 2-5 cm below the surface of sand. Therefore, the most effective means of preventing jiggers include good personal hygiene, wearing closed shoes, sweeping the floor, sprinkling water on the floor, and keeping domestic animals contained. In severe cases, cementing or smearing the homes can assure prevention.

Jiggers Eradication Efforts in Karungu

As a CMMB volunteer working as the Public Health Officer at St. Camillus Mission Hospital, I was in an ideal position to address this public health burden. The project began after Community Health Workers found one extremely poor family covered by the parasites. We removed their jiggers and raised funds to build them a new, concrete home. Subsequently, numerous individuals, families, and communities were found to be plagued by the fleas. Working in coordination with the Government of Kenya Ministry of Public Health and Sanitation and other local leaders, over 230 individuals have had their jiggers removed, over 70 homes and 6 schools have been sprayed with insecticide, and seven homes have been cemented or smeared. Additionally, 108 individuals have been given a new pair of shoes to protect their feet from secondary infections and to prevent re-infection from jiggers. Health talks have been given to two communities and individual families to teach them how to prevent the jiggers from returning. Most importantly, 72 Community Health Volunteers (CHV) have been trained on Jiggers Treatment, Prevention, and Data Collection. The CHVs will give the community ownership of the project and ensure sustainability.

The project will continue systematically reporting Tungiasis cases, training community health volunteers to identify and assist families with jiggers, hosting Removal and Spray Days, and educate the community on the prevention and treatment of jiggers. Ideally by the end of my volunteer position in June, the project will have reached a level of sustainability.

Susan Tang, PA, has been volunteering with CMMB at the Policlinico San Pablo in Arequipa, Peru.

Dennis (front left) and Susan (front right) with colleagues at staff dinner in Peru.

When Dennis and I first arrived in Peru, Father Alex told us that we would fall in love with the people. It was true and almost immediate. We were quickly touched by their warmth and humility. We live in Primero de Junio, a town on the outskirts of the city of Arequipa with a population of about 31,000 people, the majority of whom have migrated from the mountains in search of a better life closer to the city.
My work involves seeing patients in their outpatient clinic, home visits to the elderly and disabled, and physical therapy class for the disabled. Not so easy at first when I realized my limitations with Spanish. I knew enough to have conversations and ask for directions, but to explain a disease or an illness was beyond my capability. Luckily, I was in a place where the clinic staff was extremely patient with me and within a month I was able to see patients on my own.
After becoming comfortable in the clinic, I started the home visits and physical therapy class as a way of addressing the needs of the community. In between the normal work schedule we would have groups which allowed us to contribute either by actively seeing patients or by teaching. Dennis spends his time teaching English or translating Spanish and he also assists me with my classes. We are thoroughly enjoying our stay here not only because we find the work fulfilling but because in the end, we know we are receiving far more than we’re giving.

Susan

Emerald Russell is a counselor and CMMB volunteer at Youth Encouragement Services in Uganda. She works with HIV positive children, helping to get them medical services.

“On Sunday morning Adolf woke up with a bad fever an in the afternoon the pain really started to set in. Mostly he was just complaining about his abdomen, crying "enda nasasa". I rubbed his belly. We lay for a couple hours, but he was really freaking out, and crying for his dead mother. Around 6:30, my friends Johnny & Mary came through Kampala from Gulu, which is 6 hours north. Having them there we were able to take the attention away from his pain, which really calmed him down, and we got to take some pictures. Taking the oxygen off helped him calm down a bit too, which was a catch 22, not knowing if he breathed better upset with the oxygen on, or calm without it. It was by far the longest and worst night of our lives. He was just so weak, so tired, and in so much pain. He mostly complained about his stomach. Later in the evening he said his heart really hurt. Also his head. Also his chest. Around 7:00 or 7:30 Adolf became very very cold, but refused to even have a sheet over him. The day shift of doctors and nurses came at 8:00. About 9:20 the doctor came out and spoke with us. He said that the damage had been done long before he came to live with us in January. Even if they had found it all out through their tests days ago, there wasn't much anyone could have done. But pretty much it was a three-way fight between his heart, lungs, and liver. So I guess he stopped breathing on his own soon after he got to the ICU, and went into cardiac arrest just after 9:00. I'll never stop wondering about the things I could have done differently that night, or demanded from the nurses. But I need to just remind myself, that even if different things were done, and he lived through the night, he would not have made it much longer.

We got a nice, little casket, and drove him home to Fort Portal yesterday. I somewhat held it together until I saw a bus with the other kids from the home. They were looking through the car windows at Adolf's casket. I lost it. I took him off to the hospital, expecting to come back within days, and he never got to say goodbye to his friends. They were all at school when he and I left. We drove up to his grandfather's little mud hut. The villagers were all sitting on benches, waiting for us. I didn't even know how I got out of the car. I just kept thinking, "How dare I deliver this village their dead child?" Especially to his grandfather, the only living family member now. He has lost all of his children, and now the only living grandchild.

His grandfather was nothing but grateful to us. I was so scared about how I could look his grandfather in the eye. He said he didn't think Adolf would have lived these final two and a half months if he was not with us. And he was just grateful for all the love and care that he got in his final time. Before we went to Kampala, we brought his grandfather out to the Rescue Home to see Adolf off, and sign consent for me to take him and make medical decisions. When he was visiting he said to me "I now leave this child in your hands." That sounded like a shockingly final comment, and I just laughed it off saying, "we're only going for a few days!" But this old man has buried every single one of his family members. He is wiser than I could ever imagine.

I had to give a speech. I pulled it together for the most part and said a few things in Rutooro, then had Florence translate the rest for me. I explained to the village what happened, and also all of the fun things that we did in his last days. But I made it quite clear that it was his distended stomach that was the prime culprit, as well as his heart and lungs. That way, the other sick kids would realize that those are problems they do not have. They all have HIV or AIDS, like Adolf, but they don't have his abdomen, and they aren't as sick as he was.

I ask that you all pray for Adolf's soul, and for his grandfather. He was the most gracious man, and is now alone. I hope you are all well. I miss you all now more than ever.

Emerald

Enriqueta Donovan, Teacher, has been a CMMB volunteer at the Little Flower Orphanage in Beijing, China since June 2007.

Peace of Christ! Last week we lost two little ones, really it is something that I feel like I can't speak of as I would like, it is both a pain and a joy so deep in the heart.

I can't even begin to express how much these two have touched my life and how much I have learned from them. Watching them suffer the last few days was so painful, really I was looking at Christ on the Cross, but baby Christ.

This picture was taken they day after our second little one died, the whole house was a little down since his death took us by surprise. I was holding the little boy, Jia Wei, the one in the when Yan Xin started crying. Yan Xin has hydrocephalus. She likes it when you rub a certain spot on her head and sing to her and so I took Jia Wei over to sing to her and rub her head and then I was rubbing her face too and she took her little arm and wrapped it around mine-she hugged me…wow, what a moment. I absolutely love this picture. She does not usually interact too much. I stayed with her for quite some time enjoying her loving me!!

For more visit the Field Reports Archive>

Volunteer with CMMB

CMMB MVP...Medical Volunteer Program
Become a CMMB MVP
Volunteer Program Resources
Field Reports for CMMB Volunteers
Medical Supplies for Mission Trips