Formula V. Breast Feeding

Today has been filled with the constant theme of policy/theory vs. practice. I continue to be amazed at how these two ideas can never work hand in hand and I am constantly reminded of the struggle to attain the practices to meet such policy: as micro as Christa’s dream to build Mt. Sinai, and as macro as governmental policies on infant feeding. Although these two in many ways go hand in hand, it is important to separate them to understand why such policies are not being implemented on the ground. I have not done the proper research in the case of Namibia’s ministry of health’s policy on infant breast vs. formula feeding, but I have been getting a sense, on the ground, that these two issues are in constant competition. On the one hand, formula feeding reduces the risk of HIV transmission to the baby by it’s positive mother, while on the other hand it can also increase infant mortality rates as well as infectious diseases in that baby because, again I am not properly researched in this area, but breast milk provides anti-bodies and nutritious value that will reduce these risks. So then the question arises, if formula feeding can no doubt reduce the risk of transmission, why is it left out of the education to mothers and breastfeeding so adamantly pushed in hospitals?
Charlotte, a nurse in the natal clinic here in Katutura has attended many workshops on infant feeding and has time and time again been told to address formula feeding outside the compounds of those meetings. “If the mother has a question about formula feeding, tell her you can talk to her outside after”. She reminded us, during our discussion that HIV/AIDS is a reality of this nation and many people are choosing to push it aside…i.e. not addressing and education mother on formula feeding. While the cost of formula feeding is higher because many mothers, a. can’t afford the formula itself b. don’t have access to clean water c. because it is attach with the stigma of HIV, it is important to remember that it is a viable solution for mothers who are HIV+ and want their children to be remain HIV negative (that is if they are born negative in the first place) The ministry of health issued a policy on infant and young child feeding, concluding that 22 out of 100 pregnant mothers at HIV+, out of those 22, 30% (6.6) will transmit the disease to their child, 2 out of the 6.6 through breastfeeding and the remaining (4.6) through the uterus. Like I said I have not done extensive research on the matter, but I believe there is a drug called navoprin(sp?), that reduces the risk of transmission while the child is being born. There is so much involved here, but after talking with Charlotte, I do not see why the ministry would so adamantly push for breastfeeding when formula feeding can reduce the risk of transmission from mother to child, in fact can save the child from even contracting the disease through breast milk, if born HIV negative. Again it’s this whole policy vs practice thing. The policy here states that they are protecting mothers and their right to breastfeed. Many mothers know that their milk can transmit the disease, but because of the conditions they live in (the cost of formula, having to travel far distances for water, the stigma associated etc..) they are forced to breastfeed. So then, how many children COULD HAVE BEEN saved if they were to be provided with formula??
This is where christa comes in. She provides the formula to the mothers, but where is she getting the formula from. One place where she is NOT getting it from is the government. As you can see, (I will try to put the link this National Policy soon), the government wants nothing to do with the type of treatment and they are so adamantly pursuing the path of breastfeeding. I, being quick to judge, have many questions to why they are so against such a method, when, if you are to look at things economically, this will provide more labor power and less people that are infected hence having to be on ARV’s. If you continue with breastfeeding how many of those children could have been saved from HIV and lived a healthy life, as opposed to being exposed to it, in turn filling up hospitals and being left to die? Is it because they see it as one less child to feed? Are they so against a healthy child? Because, I would assume, a healthy child costs more to maintain than a sick child who is more than likely going to die before they reach 12.

[“This policy [breasfeeding] is founded on the Namibian constitution that guarantees the rights of women and children, including the right to adequate food and nutrition and the right to social services such as health, education and housing”.

Where are these things?
I do not see them on the ground??
If they are to guarantee the right to adequate food and nutrition, wouldn’t that include providing formula and water for mothers that want their children to remain HIV negative?
I see the struggle in Christa’s eyes and her heart works so hard for these children.
She cares so much for these children. She runs this center out of her house! She does as much as she can to make sure that they are provided for. I have seen a child, Milka, who is healthy and HIV negative because of Christa’s program. So why is the government not jumping at the chance to sponsor such programs and to provide formula for these babies??
A healthy child costs too much I presume!
The policy of Christa’s program is, in the long run without regard to limitations, to help ALL children who can remain HIV negative.
But in practice, it is a struggle.
She is struggling to build a center, she is struggling to provide formula, water and food parcels. She relies strictly on private donations, never receiving anything from her government. If the constitution guarantees these rights, where are they?
Charlotte came to us with a problem and this of course is the overflow of pregnant mothers, who once again 22 out 100 are HIV positive.
What I see here is a bunch of NGO’s trying to solve the problem. Where is the government?

I suppose I need to spend days researching all of this, but as of now I don’t see one speck of government on the ground. Where is the UNAIDS funds going? Where is US AID funds going? Have they even trickled down to the lowest grassroots level? Because that is where change happens, it is with the people on the ground. Why can’t Christa receive any help, even a little from the gov? She has petitioned and petitioned! This program of hers is amazing and yet, it is such a struggle; one that she carries on her back.
There are so many questions! I need to search for the answers some how, but this damn internet costs money.
Where can I steal wireless around here????

This is just a speck of what I have been thinking today.
More to come.
Peace,
Mary


Ps:

We met with Christa and her pastor today, who has promised to help her with getting the plans drawn up through this contractor her knows. SO, what we are trying to do is organize a groundbreaking ceremony before we go so that we can get publicity out there about Mt. Sinai. Of course Christa is well known across Windhoek, always knowing people wherever she is, so we are going to send out letter inviting people to this thing including the newspaper so that she can gain more support for her cause. I see the struggle and headaches she has, but she is a very positive person and has faith that one day her dream will come true! Hopefully one of these days there will be no limits on how many mothers she can sponsor and she will have a beautiful clinic/center to go along with her program. It is going to take some time, but it can and will be done! It’s time to rally the troops and get this woman her long awaited center.