We purchased an esky and filled it with the Combantrin de-worming chocolate squares and frozen water bottles, then walked around from one part of the slum to another and waited for kids to come. We never have to wait long... the amazing thing about the slum is how quickly words spread! Once a few kids and parents have come, within minutes they come back with their neighbours and friends, etc. Older kids often return bringing back younger siblings or just random neighbourhood kids they have spotted.
Most of the kids know it as "chocolate" and seem to like it. Some are wary though - especially if they haven't had it before. We use a marker to put a little dot on each child's ear so that we know they have been de-wormed. This is because some kids are a bit cheeky and they try to come back multiple times to get more "chocolates".
Combantrin is meant to be given out according to weight. However, hardly any kids would know what they weigh since they are not weighed regularly. In the past, they have relied on asking the children their ages. However, I have found that this is totally unreliable because so many kids are severely malnourished. So many times kids would come up and shock us when they tell us their age. Kids who say they are 9 years old sometimes look like they are only 5 years old because they are so skinny and small.
Short of weighing them all one-by-one, which would be a logistical difficulty, we just had to do our best and gauge their weight. I just compare their sizes to my three boys (since I know what my children weigh) and work off that. Not exactly a Scientific way but really the most practical.
One lesson we've learnt is that it is easier to break apart the chocolate squares first and put it in a container. This way the frozen water bottles don't melt and get the packaging all wet and making them difficult to tear open and holding up the distribution line when there's a queue of kids.
Because of the chocolate nature of the medication, they are prone to melting in the hot Manila climate. Some mums would come up and request some squares for their children who are at school or at home sleeping. We do give it to them and tell them how many squares each child should have. However, it is hard when you don't see the child in front of you as you don't know how much they are likely to weigh. We also remind them to keep the chocolate squares in a cool place or in a fridge (but not everyone would have a fridge at home) until they can be consumed by the child.
A few things struck me during these pop-up de-worming sessions.
Many of the mothers are extremely young and have multiple children. Some still look like kids themselves. This is in part due to the nature of early marriage in poverty-stricken areas but also in part due to the anti-contraception stance in this predominantly Catholic country.
How malnourished the children are. Even when they eat, it is often cheap sugary things and nothing of significant nutritional value.
Many of the kids have visible medical conditions. The most obvious probably being head-lice and skin condition such as scabies - we can see this because the kids are often scratching their heads or their arms/legs as they line up for their Combantrin. Given the lack of hygiene and dense living condition, these conditions unfortunately spread so quickly and very difficult to treat successfully unless everyone can be treated altogether and bedding etc. all treated simultaneously. Some kids have visible eye or teeth issues as well.
As a mother, these are probably the most distressing things to see. Many of the illnesses/conditions are highly treatable and preventable - so it is incredibly sad to see that the children are suffering un-necessarily.
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