Yesterday afternoon I accompanied the Sister to Koubou, a village 15km from Ndele, where she was checking the level of childhood malnutrition. Never have you heard babies scream until you try to put them in the truss-like UNICEF scale! In theory it's highly accurate, but the babies bounce around so much it's hard to get a good reading. Plus by the time you finish you'll be deaf.
Koubou's choir of screaming babies included two sets of twins, one six months and the other nine months. In both cases, one twin was substantially larger than the other. In the case of the six-month-olds, the little one weighed about half of what the big one weighed (3.2kg – the size of a robust newborn! – and 5.6kg, respectively). According to their mother, the little one sleeps too much. And while she sleeps, her twin enjoys all the milk. In all the time I've spent around African villages, this was the first time I'd knowingly seen twins. It made me think of the societies where people believe twins to be bad luck, or evil, and abandon the weaker one in the woods. (Apparently this happens in some parts of CAR, too, even quite near here.) It almost seemed like something similar was going on with the twins in Koubou, only in this case a drawn out version fueled by a combination of evolution and poverty, rather than belief.
During a conversation with a recent hire at UNICEF recently, my interlocutor expressed skepticism that mothers here need to be taught about nutrition, as UNICEF plans to do. Don't they already know better than we do how to get by in these difficult conditions, he wondered? They've been living this way for many years, after all. Yes and no: the Portuguese introduction of manioc (in the late eighteenth century, I think) has been a blessing and a curse. With colonization and the push toward cash crops, manioc became the staple. It grows easily and cheaply, but its nutritional value is next to nil. One of Nobel laureate Wangari Maathai's valuable contributions has been to reclaim and put back into use knowledge of Africans' once-varied and nutritious diets.
In my completely unscientific assessment, though, the main cause of malnutrition here is simply that women have too many babies. Even the (Catholic) Sister decries this (“Les gens d'ici font des enfants en désordre!”) We saw several mothers with 3-month-olds in their arms and 1-year-olds on their backs. Not enough milk then, and one or both kids will lose out. (Abortion, too, takes on a much less polemical cast here. The Sister told of visiting a woman in the hospital this week who had just had one. “She has eleven kids. She is tired. The mothers here are TIRED.”)