Bernoucheka. She is an 18 month old girl who was admitted with severe edema involving her whole body, which is likely secondary to kwashiorkor. She lives with both of her parents in a rural mountain village. Her mother is pregnant with her second child and due to give birth any day. Bernoucheka’s father brought her to the clinic. He could see that his daughter was very sick, but was very hesitant to let us admit her to the inpatient malnutrition center. However, we felt that Bernoucheka would die if she went home, so we convinced her father to let her stay. Her father left and went home to his pregnant wife, but sent his mother to stay with Bernoucheka.

Bernoucheka’s grandmother is very attentive to her granddaughter. But she does not understand the treatment protocol that we are using to treat Bernoucheka, despite multiple conversations to try and help her understand. Children with severe malnutrition/ kwashiorkor often have blunted intestinal villi and so have difficulty absorbing food normally and they often get diarrhea if fed a normal diet. We use special formulas during the first 1-2 weeks of admission that are recommended by the WHO. Bernoucheka’s grandmother does not understand why we are only giving her milk and why she cannot feed her food. But by the grace of God, Bernoucheka is slowly improving and we will start letting her eat food tomorrow.

I share this story because I cannot imagine what it would be like to admit my child to a hospital and leave, not knowing if she would survive, if she would receive good care. Would anyone comfort her when she is scared or in pain? So many parents of the children we admit are not able to stay with them because they have other children at home they need to care for or they need to work to provide for the family. So pray for Bernoucheka’s recovery and pray for peace for her parents and understanding for her grandmother.