Today we did a field visit to one of the villages that is part of our Complementary Feeding study in Karachi. We were told that one of our study infants had passed away, so our main reason for this field visit was to offer our condolences. Additionally, my supervisors felt that visiting the village will provide me with experiential knowledge, especially now that I know the study in and out. =)

The village we visited is called Rehri, aka Rehri Goth (Goth=village). Rehri is located on the Arabian sea coast and has a large community of fishermen. I was utterly shocked when entering the village. First of all, since the village was located on the coast, the water level had raised. In order to prevent flooding, salt was added to pull the water back. However, when asked if they were afraid of tsunamis or its outcomes, the villagers said no. Individuals live in straw huts, which were scattered across the village. Up to 10 families can live in one compound, however, these families need not be related. A family usually has up to 7 children. A room in a compound is pretty much half the size of a bachelor's suite. In this little room, the family eats, sleeps, plays and toilets. There are no furnitures, only cooking utensils, sheets, and a few clothes. Each family co-resides with goats, chickens, cows, and a crazy number of flies! One of the families we were visiting was literally cooking with flies. They were cleaning fish with minute amount of water, hence, the fish was not being cleaned properly prior to cooking.

The child who passed away died from an infection and loss of large amounts of blood. It is common practice for mothers in villages to feed their 3 month old child paan (betel leaf with arcea nuts). However, the paan can include tobacco and other harmful chemicals. This child was given this, which resulted in uncontrollable bloody diarrhea. Surgery was needed but the surgical site became infection due to living conditions at home. This is all too common in these villages. Each day several children die due to misconceptions, myths and lack of knowledge. This "knowledge" is passed down to families from each generation-no one has corrected their behavior...until now. The families are now being taught appropriate feeding practices, maternal and child health, basic hygiene and sanitation practices as well as the importance of breast feeding.

This particular village is a very complex village. My supervisors and local health care workers shared with me many stories that blew me off my feet. Rehri Goth is a village that engages in drug consumption and trafficking (ex. heroine). There is also a high rate of domestic violence and marital affairs. There is no help coming in from the government, let alone international aid. Their problems are merely swiped under the rug. We are trying to raise awareness and share knowledge and resources but this does not happen over night. We need help from multiple shareholders-both private and public. Also, in order for change to happen, the people need to want to change. Change in attitude and behavior is extremely difficult when all you have been taught is otherwise.