En este mundo: Magdalena Goyheneix at TEDxRíodelaPlata-TEDxChange
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En este mundo: Magdalena Goyheneix at TEDxRíodelaPlata-TEDxChange

March 8, 2020


Translator: Gisela Giardino
Reviewer: Camille Martínez Thank you very much. I’m the first speaker, so it must
be going in order of height. Well, my story is a simple story. I haven’t done big things,
because I’m not big. But like Roberto Benigni says in the beginning of the film
Life is Beautiful: My story is a simple one, but it isn’t easy to tell. Like in any story, there’s pain, but like in every story, there’s wonder, and happiness. It’s the story of people
I worked with and of our experiences together. That’s what I’m here
to share with you today. I finished my residency in Pediatrics, and I went to work with
Doctors Without Borders. It’s is a medical
humanitarian organization that helps people
in precarious situations, victims of armed conflicts
or natural disasters, regardless of race, religion,
or political ideology. This image is the first photo that a human being took of the Earth, and it represents this experience I had of venturing out from my own universe
to see our bigger world, of changing my perspective, beginning to have a broader view, and with my eyes a bit more open. My two missions were in Africa; the first one in Chad
and the second one in Niger. So, I landed to 107°F heat, to another culture, other languages,
nomadic people, a lack of water, of roads…
of everything. In the beginning it was hard. It was a shock. Whenever someone asked, “What’s Africa like? How’s your trip?”
all I would think was: “You can’t even imagine.
It’s another world”. But Africa is in fact,
not another world. Because like I was just saying,
it is very much in “this” world. My second mission was in Niger. Niger has all the qualifications to win first prize for Poorest Country in the World. The life expectancy there is 44 years, so technically, an Argentinean
could live almost two lifetimes in Niger. It has the highest birth rate
in the world: Nigerian women have on average 8 children. Only 4 percent of Nigeria is arable, because the rest, or three-quarters
of it is the Sahara desert. So, it’s no surprise that Niger has a chronic nutrition crisis, exacerbated by spikes in severity, or periods of famine, which is when the food
from the last harvest has run out, but the food from the next one
isn’t ready yet. And during those periods,
malnutrition wreaks havoc, affecting especially
the most vulnerable, which are kids under five years old. And well, we all know that more or less five million children
die every year in this world for reasons related to malnutrition, which is, of course,
treatable and preventable. There are 55 million children — almost 1.5 Argentinas — who suffer from malnutrition. For me, these kids stopped being numbers, and started having faces, eyes, expressions, names, like Alio, surnames, like Iacuba Usuf, — that one was hard for me — Moms, Dads, little brothers, grandmothers, even great-grandmothers. I asked this woman
if I could take her picture, because it was unusual to see someone
that old there, and she said, “Yes it’s OK, but I’m not the grandmother
I’m the GREAT-grandmother.” So, everything that I had read
in medical school textbooks: that diarrhea kills, and that pneumonia
is the main cause of death in children less than five years old, all that started to become
my daily reality. I saw the face of malaria, I got to know it very well. And living in the midst of that reality, it turned into an everyday thing, something palpable. So it stopped being a statistic, and was now part of my life. There comes a point where
you start to burn out, which I did, and it felt like what
I was doing was useless, like we were treating a handful of kids, but outside there were millions more. But then I remembered a story about a man who, after a storm, goes out to walk along the beach, and he finds lots
— thousands and thousands — of sea-stars, that had been left stranded on the sand after the storm. At a distance, he sees another man
throwing them back into the sea. So he gets closer,
and with a bit of irony and a bit of pity, says to the guy, “Why bother doing that? In four hours, they’ll all be dead.” And the man picks one up, and says: “Not this one!” “Not this one!” “Not this one!” So I hit “rewind” and said, “Not this kid!” “Not this kid!” So, how did we deal with the malnutrition problem
staring us in the face? Basically, we had both an outpatient and an inpatient program. In the outpatient program, the Moms would bring their children, sometimes they’d walk
10 or 12 miles under full midday sun, and in Niger, the average temperature
is 113°F degrees to bring their children
for an appointment. There we got them registered. We’d take their height, weigh them, measure their brachial perimeter,
take all their vitals. We’d also play with the ones
who weren’t afraid I was from another planet for them,
because, having white skin, being short and a redhead, I may as well have been from Mars. Kids would rub my arm like this,
to see if I was black underneath. It was their first time seeing
someone like me. So, while we were with them, we’d do the medical exam, too, and once we had done
all the treatments, we would give them these
fast-acting therapeutic foods, that are revolutionary
in the treatment of malnutrition. It probably seems like no big deal, but it doesn’t need refrigeration,
or even water to prepare it. And that, in countries
like those in Africa for example, where there is no refrigeration
and no drinking water, allowed us to reach out
to millions of children, to treat malnutrition
on an outpatient basis, which was very difficult before,
because it implied inpatient care, but the mothers
couldn’t leave their other kids to bring 1 or 2 to the hospital. So these nutrition packs were,
and continue to be, amazing. There were children
who were so malnourished that they didn’t have the strength to eat, or who were suffering from some
associated medical pathology, and for those kids we had
an intensive nutritional recovery center, which is a hospital for kids
suffering from severe acute malnutrition, where we ended up having
the highest traffic during that famine period —
almost 400 inpatients. But we were able to do it,
thanks to teamwork. And that, I think, is one of the most
enriching experiences you have there, working side by side with the local people and with people
from other parts of the world toward a common goal. There, no borders exist. It doesn’t matter where you’re from,
what you think, what religion you are,
what your skin color is. We’re all there for the same cause. We took care of almost
400 kids every day. That was the average number of patients. This, for example, is one case: Senagu came in with severe malnutrition
and pneumonia. We treated him, and this is
how he looked before going home, to continue outpatient treatment. Sometimes we were successful,
sometimes we failed. You had to keep going. But mothers and their children, more than anyone,
fought till the end. This was what Furera
and her mother taught me. Furera arrived to the program,
and like with the other kids, we started her on nutritional
and medical treatments. Her weight began to improve,
but then it plateaued, and we realized that Furera
had advanced tuberculosis. And even though we had her
on a course of treatment, Furera began to get worse and worse, and there were many the times
when I left the hospital not knowing if I was going to see
Furera again the next day. But she had such courage and such tremendous fight, I saw Furera breathe and
fight for her life till the end. It was hard, for me and
for many of the others. We did everything that
was within our reach. This is the last picture
I have of Furera because my mission ended,
and I came back to Argentina. But it was the mothers and their children who taught me that
the fight is worth it, and that you have to fight till the end. That every sea-star that
returns to the sea is worth it. I don’t think that we have the solutions to the world’s problems
in our hands, but we do have our hands
to tackle world problems. Maybe we need to stop speaking in terms
of a First World, a Third World, because following that logic, we could
speak of a Fourth, a Fifth, a Sixth, and it is just one world. This world in which we all live. And I believe that
if we each do our little part, we can all make a difference. Each of us can contribute
a part of what we are, of what we have,
and of what we’re able to do. But I think that if we put
all of our contributions together, we can make a better,
kinder world for everybody. In my story, there are no superheroes. When I came back, I didn’t dare
get in contact with the people there to know what had become of Furera. I didn’t have the courage to find out that maybe another one
slipped through our hands. Two months after my return, my friend Michelle, another pediatrician
working there, contacted me. She sent me an e-mail,
along with this photo, which they took of Furera
when she was discharged. So, Furera was my sea-star. Thank you. (Applause)

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