- TRADUZIONE IN ITALIANO courtesy of Tom Hiddleston Italia
It’s day four for actor Tom Hiddleston on his first trip with UNICEF UK, visiting Guinea in West Africa. Tom will be meeting with Guinean children, families and communities. He’ll also be seeing several UNICEF projects, and finding out about our work in child protection, education, and water and sanitation.
Tom with Alima and her one-year-old son, who’s receiving treatment at a UNICEF-supported hospital for malaria and malnutrition. © UNICEF/Harry Borden/2013
My fourth day begins with a run. We are in Kankan. Julien knocks on my door at 6:45am. I haven’t slept much, because it’s only at night that I have time to write. But I’m only here for a short while. It’s important to make the most of it. Julien and I run along the river. At this hour, the streets are already bustling with activity, but the riverbank is deserted. In a few hours’ time it will be almost as busy as Oxford Street. People will come from all over town to wash their clothes, their cars, and their bodies. Perhaps it’s because it’s very early in the morning, when the mind is clear, when our thoughts are unfettered by politeness and self-censorship, but Julien and I end up discussing our passions.
I share my admiration for Shakespeare, while Julien speaks with erudition about philosophy. He’s a big fan of Michel Foucault, the French philosopher who said (among many other things): “I don’t feel that it is necessary to know exactly what I am. The main interest in life and work is to become someone else that you were not in the beginning.” Every day is a creative act: a step closer to becoming who you want to be. I admire Julien enormously. He believes unwaveringly in the nature of public service. He believes in the power of legacy. He believes in leaving behind a better world than the one he found. He believes, quietly but fervently, in that attempt.
As the resident representative for UNICEF in Guinea, one of Julien’s greatest achievements is a project for the reintegration of children who used to be in the army, supported by the Peace Building Fund. It was our first visit of the day. In early 2011, working closely with the Minister of Youth, Julien personally persuaded the Prime Minister to approve a project to support 2000 young people who had been irregularly recruited by the armed forces. These children are essentially former child soldiers, although they have not seen actual conflict. They are young people in local communities in remote, rural areas who at the age of 15 to 17 who were recruited, some forcibly, and transported to military camps for training. They were not allowed to leave the camps and those who attempted to do so were beaten, physically punished, humiliated and deprived of food. In 2010, with the transition from military to civilian rule, these young men and women were released without any means of subsistence or transportation. In fear of stigmatisation, many of these children – frightened, scarred, adolescents – some of whom fell into crimes and banditry. Other vulnerable youths who had been affected by the conflicts in the region were recruited into the programme.
The Peace Building Fund paid for their reintegration through the government’s Professional Training Centres which although reasonably equipped did not have the money to run training programmes. The project aims to facilitate the reintegration of what are now young men and women through vocational training services. The centre is a hive of activity. As I get out of the car I am directed to a quadrangle of workshop buildings, specialising in different and specific skills: woodwork; welding; plumbing, carpentry; training for electricians; brick-laying and masonry. These young adults are consumed with purpose. I’ve never seen craftsmen and women so proud and passionate about their work.
Tom with the welding class at the training centre in Kankan © UNICEF/Harry Borden/2013
I speak to Claude, in the woodwork shop, who has been making chairs and tables and doors and beds here for the last two years. Later, in a quiet room in the Director’s office, Claude tells me his story. He was in his field. He was working on his crops. The military came and said to him: “You’re coming with us.” And that was it. When the troubles were over the army let them go he went back to his fields. When this project, the Peace Building Fund, came to him and offered him a second chance, his first response was: “No. I have been disappointed once. What are you really going to do? Je n’avais pas confiance.” But then he thought he might be able to make a success of it and decided to give it a try.
Claude has never looked back. When he was trying to get recruited into the military in his late teens, his mother had approved. He had hopes of getting a job, of earning money, of receiving training. He received nothing. But he got lucky. His final words are rousing: “I spend all my time in my workshop now. This is my life. This is what I do. Here, now, then, after. If there is wood, if I have my equipment, I will always be able to work. I love it. I own money. I am here.”
This doesn’t happen only to the boys. I also speak to Josephine, who is from exactly the same village as Claude. In between 2000 and 2007, she was studying. But her father passed away and she was alone with her mother. They were selling vegetables at the market. Nearby there were a lot of army camps. They came to her village and they were looking for new recruits. The army came into her house and told her that the location of their base was a secret and that if she revealed it they would kill her. “Ils vont tuer ma famille.” She was hired. She followed the soldiers into the bush to act as a cleaner: she had no options. It was hard, but she says she “got used to the sound of rifles.”
When the Peace Building Fund came to her, her mother warned her against it: “They are going to abuse you. They are recruiting you because of the boys. It’s too dangerous.” She pleaded with her mother. She said, “God is big.” Now Josephine is happy: she has skills, she is confident, she has money to share, and no worries for the future. She is so happy it makes her want to cry.
What UNICEF is doing for these young adults is enormous. The Centre de Formation is providing them with a vocational two-year training programme that will give them a purpose and a source of income for the rest of their lives. Kankan needs plumbers, electricians, carpenters, and builders. These are the technicians who build a society. And they will build their own.
At the Centre de Sante in Mandiana. The doctor is showing Tom how to first screen for malnutrition with a simple arm band. The red zone means severely malnourished. © UNICEF/Luke Windsor/2013
In the afternoon, we drive east from Kankan to Mandiana. It’s 35km as the crow flies to the border with Mali. It is the most remote place I have ever visited. The road is not a road at all. It is a dirt track through the bush, more uneven than any so far. The journey takes two and a half hours in our 4×4. When we arrive, my first question is: why? Why is there a settlement here? I can’t immediately understand the history of the place. There is no river and little vegetation.
The answer: gold. There are artisanal gold mines around Mandiana, which create a primary source of income for the men in the region, who scratch a living panning for the precious metal. We are here because it just about the furthest from Conakry that you can possibly travel, and UNICEF nutrition surveys have shown malnutrition in this area is at its worst. We park outside the Centre de Santé, which is full of women and children, and as soon as we’re inside, quite spontaneously a focus group seems to begin. These women are more direct and straightforward than any I have spoken to thus far. They seem less encumbered by shyness or mistrust. They are angry and their problems are urgent. What is the biggest problem for you here, I ask. Water, they reply. There is no water. The statement is so basic and baldly stated it hits me like a club to the head. Can you talk more about that, we ask. One woman speaks up. There is only one well, it is a long walk from the village, and we only have access to it for certain hours of the day because it is controlled by the military. I don’t need to expand on this. They are deprived of a basic need.
What follows is a demonstration of the methods of screening small children for signs of malnutrition. The first test is relatively simple. A small coloured band, like a bracelet or an ankle belt, is threaded around the left arm of the child, between the elbow and shoulder, to measure the width of their upper arm. If the measurement is in the green zone than all is well, in the yellow or red then there is cause for further treatment as the child is either moderately or severely malnourished. If a child is diagnosed to be malnourished, they are immediately treated by the centre de santé or referred to the local hospital which treats the most severe cases of malnutrition where there are also other complications. These complications may have caused the malnutrition, they may be a result of malnutrition, or they may have exacerbated existing malnutrition. Whatever the case, these are very sick children.
Moderately malnourished children are firstly prescribed with a peanut and protein-based packet of paste, with a consistency like cake icing, which is given to the mother to feed to the child, a certain quantity every day. It also contains essential vitamins and minerals, and the hope is that when the child returns to the health centre in a week or two weeks’ time, it will have increased the child’s level of health. If a child is severely malnourished he will be admitted immediately to the nearest in-patient centre or hospital and prescribed with a treatment of fortified therapeutic feeding milk: F75 and F100 which vary in strength and is given during the two main Phases of treatment. UNICEF is responsible for providing and supplying this milk and medical equipment.
The eight-month-old boy that is tested registers on the border of the yellow and the red zones. He’s diagnosed moderately malnourished. And there is no water here. He’s only eight months old. The road ahead of this young boy is unimaginably steep.
We are taken across the village to the hospital in Mandiana. There are twelve beds; four of them reserved specifically for children with malnutrition. We’re introduced to a young mother, eighteen-year-old Alima Diallo and her one-year-old son (her third child) who has been receiving treatment at the hospital for the last two days. He has malaria and he is also severely malnourished. Perhaps the former led to the latter. Alima’s first child died at fourteen months, probably from malaria as well. She lives 9 km from Mandiana, and regularly comes to this hospital: “Here they do good work.” The doctor explains that they provide therapeutic milk firstly, then medicines and antibiotics. They also provide folic acid to improve condition of blood, paracetamol to reduce fever, and tablets to reduce parasites. Multi-vitamins as well. A lot of meds.
The doctor needs to see 15% weight increase before the child can be released, which should take three weeks, after which Alima can go to the health centre which will reassess the child’s health status and could provide the specialized peanut paste.
In this scenario UNICEF provides therapeutic peanut paste as well as the training sessions for the doctors on severe acute malnutrition: instructions on new protocol; cooking demonstrations for young mothers; sessions on how to implement support groups for breast-feeding women, formula milk, arm measurement tapes, and weight scales. UNICEF provided the equipment and the supplies, but local medical staff save lives.
Alima is very happy about the treatment she’s received and she can see the improvement in her baby. The doctor says it’s likely that Alima only spent three years at school. She thinks she’s doing it right, but the doctor disagrees. Alima thinks she has enough food, when she doesn’t. Alima is a child herself. She’s 18, and has borne three children. She had her first child at the age of fourteen. The child died. Her second is three years’ old. She suspects he has malaria. Her third is malnourished.
As we walk away from the hospital Julien explains that this looks like a case of a young mother not knowing how best to ensure her child has a balanced diet, is protected from water borne diseases and malaria.. She lives far from the health centre, has missed out on a primary school education in general, and specifically in observing and diagnosing the symptoms of ill health. She has probably responded too slowly and too late in seeking medical assistance. Alima has done the best she can with what she has, but has been let down by a lack of education. She is learning, however. She says she won’t be having any more children until her youngest is healthy.
As we drive away from Mandiana, from this hot, barren place, I feel further away from home than ever. I can’t conceive of what life must be like there on a daily basis; and the simple challenges they face to survive. ‘There is no water’. I can’t get it out of my head.