So this chap came to us this week. His name is Duoth and he has been poorly for some weeks now and has gradually developed the clear malnutrition that you see in the photo. I am hoping that I will be able to post an ‘after’ photo in a few weeks and you will see a significant change.

It has been a mixed week really. Many successes to celebrate and some tragedy to mourn. If I had to say what the biggest achievement has been it would be the stabilisation of about 5 children like Duoth as we get ready to move them into the transition phase of the nutrition programme before we start working to really fatten them up rapidly. They have to be eased into having a decent level of nutrition after being deprived for a long period. If we went straight into the phase 2 where we feed them more aggressively it could be fatal. As a nurse who has worked just about exclusively with adults at home I often feel worried about these delicate children.

Yesterday I was on call and we had an extremely sick man brought into the ER . He was as dehydrated as anyone I have ever seen and that would include Cholera patients I looked after in 2008. We infused 2 litres of IV fluid within the first hour to try to correct his shock. Remarkably he was still alive this morning when I handed over. We will see.

Today has been a relaxing day after a very tiring 24 hours. I will be going to bed very early tonight I suspect.

I had a nice walk to the market with some of the team today . It was good to get away from the compound and hospital for a while.

I have been here just over a month now. I am very happy with the project. There is a lot to do of course, there always will be . I feel I have the staff in the feeding centres on my side and I guess that is half of the battle.