Giving and Receiving

"Doc, I promise to use everything you have imparted to me in the last five weeks in Jesus name!" Sheila told me.   To which I replied, "Amen!"

Sheila and I at the Nutrition Counselors Graduation Ceremony

Sheila is one of 19 nutrition counselors that we recently trained.  The nutrition counselors complete a 6 week training program that cover topics such as maternal and child nutrition, nutrition counseling, nutrition and diabetes, nutrition and HIV/AIDS, and nutrition assessment.  After the training, they are posted to 3 hospitals within the Cameroon Baptist Convention's health system for 6 months practical experience.  Upon satisfactory completion they are sent to hospitals and health centers in four regions of Cameroon to work as nutrition counselors.

For the last year we have been working on redeveloping the training curriculum to make it more "hands-on" and evidence-based. A colleague and friend of mine, Alena Clark, came and assisted with the first 2 weeks of the training and was a huge help as she could provide the nutrition counselors with information regarding the clinical aspects of nutrition.

Alena teaching about the basics of nutrition

Nutrition Counselors working on a role play about hygiene and sanitation

  After a year of thinking, planning, and arranging, it was fulfilling to see what the nutrition counselors learned and practiced.

Sister Doreen doing nutrition assessment on a malnourished child

And at the very end of the 6 weeks to participate in their graduation ceremonies, during which I was thanked for making the Nutrition Improvement Program, "the essence of my existence."

Nutrition Counselors with their graduation certificates. 

The day before the graduation the hospital administration gave me a traditional dress and hat to thank me for my contributions and during the graduation ceremony the trainees gave me a traditional bag.

Traditional Dress with the Nutrition Improvement Program Lab Coat

Christiana presenting me with a traditional bag

Receiving such gifts was unexpected and humbling.  It brought to mind another gift of a meal I had received a few weeks prior to the graduation ceremony.

Eating fufu and njamajama

I received the meal of fufu and njamajama from Maxilline when I was in Kumbo for a quick visit.  I worked in Kumbo a few years ago when I was doing my doctoral research.

Maxilline and I

I was on my way to visit a friend when Maxilline recognized me.  She asked me if I was Sister Kate and after I said yes, she told me she was a participant in my research project and proceeded to tell me everything she remembered about the importance of breastfeeding.  She immediately invited me to her house to meet her family and her son, Daniel, with whom she was pregnant with during our research project.  Unfortunately Daniel was born with sickle cell anemia and was undergoing an attack when I visited her home.

Daniel 

After I met Daniel, Maxilline told me that when she earlier met me on the road she was on her way back for praying for Daniel.  She said, "I know that God loves Daniel more than me and knows his pain and will take care of him."

As I reflect on my recent trip I am struck by all that I received from the Cameroonians.  After I received the gift of the traditional dress, I told the administrator of Mbingo Baptist Hospital, that I come to Cameroon to be renewed through their spiritual strength.  I come to give my nutrition knowledge and I return inspired by their faith, prayers for safety, greetings for my family and friends, and their songs.  And I am learning that it is in the giving and receiving that our relationships are equalized, maintained, and strengthened.

It is hard for me to accept that the best I can is probably not to give but to receive.  By receiving in a true and open way, those who give to me can become aware of their gifts.  After all, we come to recognize our own gifts in the eyes of those who receive them gratefully.  

Henri Nouwen, Gracias!: A Latin American Journal

He Walked With Us

Without the cold weather, the lights, and the commercials Advent feels different in Cameroon than in the States.  Cameroonians who work with the Cameroon Baptist Convention mark the season by having a song and dance competition each morning the week before Christmas.  I thought the songs and dances on the last day were the best, which also happened to be the last morning I was in Cameroon.  I was able to capture one of the songs on video.  It is from South Africa and the words translate to "He Walked With Us".

I reflected on those words and my experiences in Cameroon during the seven hour car trip from Bamenda to Douala.  I thought about what those words, "He Walked With Us" mean to Cameroonians who walk so many places.  

 I pondered why in my list of Cameroonian contacts the names "Emmanuel" and "Emmanuella" meaning "God with us" are the most prevalent.  I recalled the conversations I had with many Cameroonians during the past two weeks; many filled with challenges such as unexpected deaths, necessary surgeries, lack of job prospects, and few educational opportunities, but also hope.   As one of friend said after our conversation about her current financial hardship, "I know God will provide.  He hasn't failed us yet." And I remembered the words I shared earlier in the morning when I said goodbye to my colleagues after hearing the song.   Now I don't recall exactly what I said but I remember thanking them for sharing their joy with me and thanking them for the work they are doing for their country.  That I know the obstacles and challenges are many many, but what they are doing is making a difference and improving the health of many people.   

Advent is different in Cameroon than in the States, but the message is the same, Jesus walked and walks with us.  In the midst of our challenges and providing hope.

May the God of hope go with us everyday, filling our lives with love and joy and peace.  May the God of justice speed us on our way, bringing light and hope to every land and race.  Praying let us work for peace; singing share our joy with all; working for a world that's new; faithful when we hear God's call.

Argentine folk melody 

Heart Training

Sometimes Cameroon can feel like a black hole.  So many problems that could be fixed but are not.  So many needs that repeatedly are not met.  A few weeks before my departure from the States to Cameroon the emails and messages started coming:

“Sister, please we are building a house and need money for the roof.”

“Kate, my child is very sick and the doctor says she needs a surgery.”

“I have started a training program and still need to pay 150,000 CFA otherwise I will be thrown out.”

And then I arrive in Cameroon and quickly reminded of the struggles of daily living.  The water stops flowing exactly at the moment I return from a morning run, hot and sweating, in need of a shower.  The Internet stops functioning on the day that I am trying to post my student’s grades.  The electricity goes out the night before I am to give a presentation on Ebola and Infant Feeding and forced to work by candlelight. 

Working by Candlelight

In the midst of these struggles and needs it occurs to me that I do not have to do this anymore.  I no longer work in Cameroon to fulfill academic requirements.   My university does not require me to do international research.  I am here this time as part of a grant to evaluate the Nutrition Improvement Program.  After the grant is finished, my obligations to work in Cameroon are finished.  I can move on and focus on my life and career that I am building in the US.  

I spent the last couple of days in Kumbo for a Nutrition Improvement Program (NIP) Coordination Meeting.  I have been working with the NIP program for a year and half and it was gratifying to hear positive reports from the Nutrition Counselors and Administrative staff.  The program has quickly moved beyond providing basic nutrition education to medical nutrition therapy.  It was a reminder that although much has been done, much more training and program expansion is needed.  Most of the nutrition counselors have little more than the equivalent of an Associates Degree in Nutrition and have little access to further education.  At the end of the first day one of the Nutrition Counselors came to me, excited to show me that she recently found a "new" Nutrition textbook  in Douala that was dated 2003.  

Nutrition Counselors

 While I was there a colleague from the Cameroon Baptist Convention Primary Health Care Program died from sickle cell anemia. He was less than 25 years old and the fourth out of five children to die.  I also reunited with some of my mothers that took care of me while I lived there from 2011-2012.  Both of them are widows who are responsible for taking care of their children, grandchildren, and work long hours as either as a farmer or cleaner.  

For my friend Doris, I brought her a scarf for a Christmas present and she was so incredibly proud and happy that she knocked on my door early the next morning to have me "snap her".

 I left Kumbo reminded of all of the reasons why I do need to keep coming back to Cameroon. To re-calibrate and remember the daily struggles of the majority of people in this world.  As an educated, single female I am an anomaly in the world.  I wasn't traded for sheep and cows when I was 18 and expected to start bearing children before the age of 20.  I haven't watched four of my children die of something completely preventable.  I haven't been told that there is no money for my school fees or the government no longer recognizes my degrees.   I have access to the latest nutrition and health knowledge.  I believe that I have been blessed so I can bless others.  And taking part in my friend's lives and hearing their hardships trains my heart to expand and care that I don't have to do when I am in the States.  It's like a muscle that has to be used otherwise it withers away.   

Suffering and solidarity with the suffering of others has an immense capacity to "make room" inside of us. It is probably our primary spiritual teacher. 

Richard Rohr

Flash Forward

The sun was just rising in Mambu as I climbed into Father Cosmas’ small Suzukui jeep.  After three house of dodging pot holes and leaving behind a large cloud of red dust, we arrived at our destination, Saint Peter and Paul’s Parish in Ndop.  I met Father Cosmas a few months prior to our excursion when I was working in Mambu  as a Peace Corps Volunteer.  As one of the few people who lived in Mambu, but not from Mambu, he helped me understand the mindset of the people.  We bonded as I complained to him the difficulties in mobilizing the community to repair their water system.  In the process we became friends and one day he invited me to speak at a youth retreat in Ndop about servant leadership.  After we spoke, we walked around the grounds and I was immediately struck by the cleanliness and peacefulness of the retreat center.  I thought to myself that someday it would be nice to return and stay longer than just a day.  Flash forward seven years and there I was, staying at the same retreat center, co-facilitating a training session with Peer Educators on promotion of exclusive breastfeeding.

Peer Educators teaching women in the market about breastfeeding

It was a cold, rainy afternoon in Melim when we finished a discussion with women about their beliefs and practices about breastfeeding.  Many interesting themes came from that discussion, including women emphasizing that they rely heavily of the nurse or midwife for information about how to feed their child.  When asked what information the nurse will provide, one participant said the nurse may tell them to drink palm wine to stimulate breastmilk flow.  Two important conclusions came from that discussion: first, a great song about breastfeeding that was used as the theme song in our audio program; second, that nurses in the area need further training in how to encourage and support women in breastfeeding.  Flash forward three years and there I was, co-facilitating a training with health workers on infant and young child feeding and learning a new song about the importance of breastfeeding.

Health workers singing a song about breastfeeding in Pidgin at the end of their training.  English Translation:  What is breastmilk?  Breastmilk is the best food for the child!  You wash your hands, you sit down, you give your child breastmilk.  You wash your hands, you sit down, you give your child breastmilk. 

“The possible answers are like a ladder.  If you very much agree with the answer, you will circle 5.  If you somewhat agree with the answer, you will circle 4, if you agree you will circle 3, if you somewhat disagree you will circle 2, if you really disagree, you will circle 1.”  That is how my assistant Gilbert tried to explain to a room full of mothers with small babies about how to answer a post-test with Likert scale questions.  No matter how he and I tried to explain the concept of a gradient of possible answers, I don’t think they ever quite understood. Instead, they just circled 3 or looked at whatever their neighbor was circling.  Flash forward three years and there I was working on a new survey about breastfeeding practices in preparation for training with data collectors.  This time all of the possible answers are either yes or no and the surveys will be completed in private. 

Data Collectors practicing interviewing caregivers for the Infant Feeding Survey

Data Collectors practicing taking a child's height

At the end of my trip to Cameroon I was reminded of all the mistakes I’ve made, the lessons learned, and the relationships built during the past eight years.  There is still so much about Cameroon that I don’t know or understand, but it is gratifying to be able to use what I have learned in the design and implementation of new projects.  I see now how some of those struggles and misunderstandings help me do my current job better.  I still am amazed at how I became involved in this country in the first place and how God continues to keep me involved through new grants and projects.  A few months ago I was trying to explain to a friend my involvement in Cameroon and said, “I didn’t choose Cameroon.  I didn’t grow up longing to go to Africa.  In fact, when I was a child and traveled to Canada with my family I was so relieved when we crossed the border back to the States.  It hasn’t always been easy and there are many days that I wish I wasn’t involved.  But as I look back and see how things have come together I know that it is my calling and task.” 

A calling is a deep sense that your very being is implicated in what you do.  You feel that you fit into the scheme of things when you do this particular work.  You have a sense of purpose and completion in the work. It defines you and gives you an essential tranquility.

Life at Work, Thomas Moore